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Didier Guillemot - One of the best experts on this subject based on the ideXlab platform.
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Limits of patient isolation measures to control extended-spectrum beta-lactamase–producing Enterobacteriaceae: model-based analysis of clinical data in a Pediatric Ward
BMC Infectious Diseases, 2013Co-Authors: Matthieu Domenech De Cellès, Veronique Abadie, Jean-ralph Zahar, Didier GuillemotAbstract:Extended-spectrum beta-lactamase–producing Enterobacteriaceae (ESBL-E) are a growing concern in hospitals and the community. How to control the nosocomial ESBL-E transmission is a matter of debate. Contact isolation of patients has been recommended but evidence supporting it in non-outbreak settings has been inconclusive. We used stochastic transmission models to analyze retrospective observational data from a two-phase intervention in a Pediatric Ward, successively implementing single-room isolation and patient cohorting in an isolation Ward, combined with active ESBL-E screening. For both periods, model estimates suggested reduced transmission from isolated/cohorted patients. However, most of the incidence originated from sporadic sources (i.e. independent of cross-transmission), unaffected by the isolation measures. When sporadic sources are high, our model predicted that even substantial efforts to prevent transmission from carriers would have limited impact on ESBL-E rates. Our results provide evidence that, considering the importance of sporadic acquisition, e.g. endogenous selection of resistant strains following antibiotic treatment, contact-isolation measures alone might not suffice to control ESBL-E. They also support the view that estimating cross-transmission extent is key to predicting the relative success of contact-isolation measures. Mathematical models could prove useful for those estimations and guide decisions concerning the most effective control strategy.
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limits of patient isolation measures to control extended spectrum beta lactamase producing enterobacteriaceae model based analysis of clinical data in a Pediatric Ward
BMC Infectious Diseases, 2013Co-Authors: Matthieu Domenech De Cellès, Veronique Abadie, Jean-ralph Zahar, Didier GuillemotAbstract:Extended-spectrum beta-lactamase–producing Enterobacteriaceae (ESBL-E) are a growing concern in hospitals and the community. How to control the nosocomial ESBL-E transmission is a matter of debate. Contact isolation of patients has been recommended but evidence supporting it in non-outbreak settings has been inconclusive. We used stochastic transmission models to analyze retrospective observational data from a two-phase intervention in a Pediatric Ward, successively implementing single-room isolation and patient cohorting in an isolation Ward, combined with active ESBL-E screening. For both periods, model estimates suggested reduced transmission from isolated/cohorted patients. However, most of the incidence originated from sporadic sources (i.e. independent of cross-transmission), unaffected by the isolation measures. When sporadic sources are high, our model predicted that even substantial efforts to prevent transmission from carriers would have limited impact on ESBL-E rates. Our results provide evidence that, considering the importance of sporadic acquisition, e.g. endogenous selection of resistant strains following antibiotic treatment, contact-isolation measures alone might not suffice to control ESBL-E. They also support the view that estimating cross-transmission extent is key to predicting the relative success of contact-isolation measures. Mathematical models could prove useful for those estimations and guide decisions concerning the most effective control strategy.
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Limits of patient isolation measures to control extended-spectrum beta-lactamase-producing Enterobacteriaceae: model-based analysis of clinical data in a Pediatric Ward
BMC Infectious Diseases, 2013Co-Authors: Matthieu Domenech De Cellès, Veronique Abadie, Jean-ralph Zahar, Didier GuillemotAbstract:Background Extended-spectrum beta-lactamase-producing Enterobacteriaceae (ESBL-E) are a growing concern in hospitals and the community. How to control the nosocomial ESBL-E transmission is a matter of debate. Contact isolation of patients has been recommended but evidence supporting it in non-outbreak settings has been inconclusive. Methods We used stochastic transmission models to analyze retrospective observational data from a two-phase intervention in a Pediatric Ward, successively implementing single-room isolation and patient cohorting in an isolation Ward, combined with active ESBL-E screening. Results For both periods, model estimates suggested reduced transmission from isolated/cohorted patients. However, most of the incidence originated from sporadic sources (i.e. independent of cross-transmission), unaffected by the isolation measures. When sporadic sources are high, our model predicted that even substantial efforts to prevent transmission from carriers would have limited impact on ESBL-E rates. Conclusions Our results provide evidence that, considering the importance of sporadic acquisition, e.g. endogenous selection of resistant strains following antibiotic treatment, contact-isolation measures alone might not suffice to control ESBL-E. They also support the view that estimating cross-transmission extent is key to predicting the relative success of contact-isolation measures. Mathematical models could prove useful for those estimations and guide decisions concerning the most effective control strategy.
Bao-ping Zhu - One of the best experts on this subject based on the ideXlab platform.
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Measles outbreak amplified in a Pediatric Ward: Lyantonde District, Uganda, August 2017
BMC Infectious Diseases, 2020Co-Authors: Claire Biribawa, Joselyn Annet Atuhairwe, Lilian Bulage, Denis Othuba Okethwangu, Benon Kwesiga, Alex Riolexus Ario, Bao-ping ZhuAbstract:Background Measles is a highly infectious viral disease. In August 2017, Lyantonde District, Uganda reported a measles outbreak to Uganda Ministry of Health. We investigated the outbreak to assess the scope, factors facilitating transmission, and recommend control measures. Methods We defined a probable case as sudden onset of fever and generalized rash in a resident of Lyantonde, Lwengo, or Rakai Districts from 1 June-30 September 2017, plus ≥1 of the following: coryza, conjunctivitis, or cough. A confirmed case was a probable case with serum positivity of measles-specific IgM. We conducted a neighborhood- and age-matched case-control study to identified exposure factors, and used conditional logistic regression to analyze the data. We estimated vaccine effectiveness and vaccination coverage. Results We identified 81 cases (75 probable, 6 confirmed); 4 patients (4.9%) died. In the case-control study, 47% of case-patients and 2.3% of controls were hospitalized at Lyantonde Hospital Pediatric department for non-measles conditions 7–21 days before case-patient’s onset (OR_adj = 34, 95%CI: 5.1–225). Estimated vaccine effectiveness was 95% (95%CI: 75–99%) and vaccination coverage was 76% (95%CI: 68–82%). During the outbreak, an “isolation” Ward was established inside the general Pediatric Ward where there was mixing of both measles and non-measles patients. Conclusions This outbreak was amplified by nosocomial transmission and facilitated by low vaccination coverage. We recommended moving the isolation Ward outside of the building, supplemental vaccination, and vaccinating Pediatric patients during measles outbreaks.
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Measles Outbreak Amplified in a Pediatric Ward: Lyantonde District, Uganda, August 2017
2019Co-Authors: Claire Biribawa, Joselyn Annet Atuhairwe, Lilian Bulage, Denis Othuba Okethwangu, Benon Kwesiga, Alex Riolexus Ario, Bao-ping ZhuAbstract:Abstract Background: Measles is a highly infectious viral disease. In August 2017, Lyantonde District, Uganda reported a measles outbreak to Uganda Ministry of Health. We investigated to assess the outbreak scope, factors facilitating transmission, and recommend control measures. Methods: We defined a probable case as sudden onset of fever and generalized rash in a resident of Lyantonde, Lwengo, or Rakai Districts from 1 June-30 September 2017, plus ≥1 of the following: coryza, conjunctivitis, or cough. A confirmed case was a probable case with serum positivity of measles-specific IgM. We conducted a neighborhood- and age-matched case-control study to identified exposure factors, and used conditional logistic regression to analyze the data. We estimated vaccine effectiveness and vaccination coverage. Findings: We identified 81 cases (75 probable, 6 confirmed); 4 patients (4.9%) died. In the case-control study, 47% of case-patients and 2.3% of controls were hospitalized at Lyantonde Hospital Pediatric department for non-measles conditions 7-21 days before case-patient’s onset (ORadj=34, 95%CI: 5.1-225). Estimated vaccine effectiveness was 95% (95%CI: 75-99%) and vaccination coverage was 76% (95%CI: 68-82%). During the outbreak, an “isolation” Ward was established inside the Pediatric Ward. Measles and non-measles patients were mixed in regular Pediatric Wards. Conclusion:This outbreak was amplified by nosocomial transmission and facilitated by low vaccination coverage. We recommended moving the isolation Ward outside of the building, supplemental vaccination, and vaccinating Pediatric patients during measles outbreaks.
Claire Biribawa - One of the best experts on this subject based on the ideXlab platform.
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Measles outbreak amplified in a Pediatric Ward: Lyantonde District, Uganda, August 2017
BMC Infectious Diseases, 2020Co-Authors: Claire Biribawa, Joselyn Annet Atuhairwe, Lilian Bulage, Denis Othuba Okethwangu, Benon Kwesiga, Alex Riolexus Ario, Bao-ping ZhuAbstract:Background Measles is a highly infectious viral disease. In August 2017, Lyantonde District, Uganda reported a measles outbreak to Uganda Ministry of Health. We investigated the outbreak to assess the scope, factors facilitating transmission, and recommend control measures. Methods We defined a probable case as sudden onset of fever and generalized rash in a resident of Lyantonde, Lwengo, or Rakai Districts from 1 June-30 September 2017, plus ≥1 of the following: coryza, conjunctivitis, or cough. A confirmed case was a probable case with serum positivity of measles-specific IgM. We conducted a neighborhood- and age-matched case-control study to identified exposure factors, and used conditional logistic regression to analyze the data. We estimated vaccine effectiveness and vaccination coverage. Results We identified 81 cases (75 probable, 6 confirmed); 4 patients (4.9%) died. In the case-control study, 47% of case-patients and 2.3% of controls were hospitalized at Lyantonde Hospital Pediatric department for non-measles conditions 7–21 days before case-patient’s onset (OR_adj = 34, 95%CI: 5.1–225). Estimated vaccine effectiveness was 95% (95%CI: 75–99%) and vaccination coverage was 76% (95%CI: 68–82%). During the outbreak, an “isolation” Ward was established inside the general Pediatric Ward where there was mixing of both measles and non-measles patients. Conclusions This outbreak was amplified by nosocomial transmission and facilitated by low vaccination coverage. We recommended moving the isolation Ward outside of the building, supplemental vaccination, and vaccinating Pediatric patients during measles outbreaks.
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Measles Outbreak Amplified in a Pediatric Ward: Lyantonde District, Uganda, August 2017
2019Co-Authors: Claire Biribawa, Joselyn Annet Atuhairwe, Lilian Bulage, Denis Othuba Okethwangu, Benon Kwesiga, Alex Riolexus Ario, Bao-ping ZhuAbstract:Abstract Background: Measles is a highly infectious viral disease. In August 2017, Lyantonde District, Uganda reported a measles outbreak to Uganda Ministry of Health. We investigated to assess the outbreak scope, factors facilitating transmission, and recommend control measures. Methods: We defined a probable case as sudden onset of fever and generalized rash in a resident of Lyantonde, Lwengo, or Rakai Districts from 1 June-30 September 2017, plus ≥1 of the following: coryza, conjunctivitis, or cough. A confirmed case was a probable case with serum positivity of measles-specific IgM. We conducted a neighborhood- and age-matched case-control study to identified exposure factors, and used conditional logistic regression to analyze the data. We estimated vaccine effectiveness and vaccination coverage. Findings: We identified 81 cases (75 probable, 6 confirmed); 4 patients (4.9%) died. In the case-control study, 47% of case-patients and 2.3% of controls were hospitalized at Lyantonde Hospital Pediatric department for non-measles conditions 7-21 days before case-patient’s onset (ORadj=34, 95%CI: 5.1-225). Estimated vaccine effectiveness was 95% (95%CI: 75-99%) and vaccination coverage was 76% (95%CI: 68-82%). During the outbreak, an “isolation” Ward was established inside the Pediatric Ward. Measles and non-measles patients were mixed in regular Pediatric Wards. Conclusion:This outbreak was amplified by nosocomial transmission and facilitated by low vaccination coverage. We recommended moving the isolation Ward outside of the building, supplemental vaccination, and vaccinating Pediatric patients during measles outbreaks.
Chenwei Huang - One of the best experts on this subject based on the ideXlab platform.
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Microbial Distribution and Antibiotic Susceptibility of Lower Respiratory Tract Infections Patients From Pediatric Ward, Adult Respiratory Ward, and Respiratory Intensive Care Unit.
Frontiers in microbiology, 2020Co-Authors: Nan Duan, Chenwei HuangAbstract:Introduction Lower respiratory tract infections (LRTIs) account for significant morbidity and mortality in patients admitted to hospitals worldwide, especially in children and elderly. The prevalent microorganisms and antibiotic susceptibility were investigated among LRTI patients from the Pediatric Ward, adult respiratory Ward, and respiratory intensive care unit (RICU) in order to achieve more efficient treatment protocols and better recovery. Methods In this retrospective cross-sectional study (January 2016 to December 2019), 4,161 positive culture samples out of 18,798 different specimens (9,645 respiratory tract samples and 9,153 blood samples) from LRTI patients were analyzed for pathogen incidence and antibiotic sensitivity. Results Among the respiratory tract cultures, the frequency of Gram-negative bacterial strains was higher than Gram-positive bacterial strains. Pseudomonas aeruginosa was the dominant pathogen in both the adult respiratory Ward (n = 156, 21.49%) and RICU (n = 975, 35.67%), whereas Staphylococcus aureus (n = 66, 19.19%) was the most common bacterium in the Pediatric Ward. Among the blood cultures, Gram-positive bacteria remained the major microorganisms involved in LRTIs, and the most frequent pathogen was Staphylococcus epidermidis (n = 59, 47.20%) in the Pediatric Ward and Staphylococcus aureus (n = 10, 21.8%) in adult respiratory Ward. However, Gram-negative bacteria were the main pathogens in the RICU, of which Klebsiella pneumoniae (n = 51, 27.57%) is the most prevalent. Pseudomonas aeruginosa of LRTI patients remained highly susceptible (>70%) to routine antibiotics in Pediatric Ward. However, it only had high susceptibility to amikacin, tobramycin, gentamicin in both the adult respiratory Ward and RICU and its antibiotic sensitivity to meropenem and imipenem was moderate in the adult respiratory Ward and mild (
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microbial distribution and antibiotic susceptibility of lower respiratory tract infections patients from Pediatric Ward adult respiratory Ward and respiratory intensive care unit
Frontiers in Microbiology, 2020Co-Authors: Nan Duan, Chenwei HuangAbstract:Introduction Lower respiratory tract infections (LRTIs) account for significant morbidity and mortality in patients admitted to hospitals worldwide, especially in children and elderly. The prevalent microorganisms and antibiotic susceptibility were investigated among LRTI patients from the Pediatric Ward, adult respiratory Ward, and respiratory intensive care unit (RICU) in order to achieve more efficient treatment protocols and better recovery. Methods In this retrospective cross-sectional study (January 2016 to December 2019), 4,161 positive culture samples out of 18,798 different specimens (9,645 respiratory tract samples and 9,153 blood samples) from LRTI patients were analyzed for pathogen incidence and antibiotic sensitivity. Results Among the respiratory tract cultures, the frequency of Gram-negative bacterial strains was higher than Gram-positive bacterial strains. Pseudomonas aeruginosa was the dominant pathogen in both the adult respiratory Ward (n = 156, 21.49%) and RICU (n = 975, 35.67%), whereas Staphylococcus aureus (n = 66, 19.19%) was the most common bacterium in the Pediatric Ward. Among the blood cultures, Gram-positive bacteria remained the major microorganisms involved in LRTIs, and the most frequent pathogen was Staphylococcus epidermidis (n = 59, 47.20%) in the Pediatric Ward and Staphylococcus aureus (n = 10, 21.8%) in adult respiratory Ward. However, Gram-negative bacteria were the main pathogens in the RICU, of which Klebsiella pneumoniae (n = 51, 27.57%) is the most prevalent. Pseudomonas aeruginosa of LRTI patients remained highly susceptible (>70%) to routine antibiotics in Pediatric Ward. However, it only had high susceptibility to amikacin, tobramycin, gentamicin in both the adult respiratory Ward and RICU and its antibiotic sensitivity to meropenem and imipenem was moderate in the adult respiratory Ward and mild (<30%) in the RICU. Staphylococcus aureus isolated from LRTI patients was highly susceptible to linezolid, daptomycin, teicoplanin, vancomycin, tigecycline, rifampicin, and trimethoprim/sulfamethoxazole in all three Wards, moderately susceptible to gentamicin in both the adult respiratory Ward and RICU and to clindamycin, oxacillin, moxifloxacin only in the adult respiratory Ward. Conclusions Microbial distribution and their patterns of antibiotic susceptibility revealed a high divergence among LRTI patients admitted to different Wards in this hospital. Thus, different antibiotic therapies should be considered for distinct age groups.
Jean-ralph Zahar - One of the best experts on this subject based on the ideXlab platform.
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Limits of patient isolation measures to control extended-spectrum beta-lactamase–producing Enterobacteriaceae: model-based analysis of clinical data in a Pediatric Ward
BMC Infectious Diseases, 2013Co-Authors: Matthieu Domenech De Cellès, Veronique Abadie, Jean-ralph Zahar, Didier GuillemotAbstract:Extended-spectrum beta-lactamase–producing Enterobacteriaceae (ESBL-E) are a growing concern in hospitals and the community. How to control the nosocomial ESBL-E transmission is a matter of debate. Contact isolation of patients has been recommended but evidence supporting it in non-outbreak settings has been inconclusive. We used stochastic transmission models to analyze retrospective observational data from a two-phase intervention in a Pediatric Ward, successively implementing single-room isolation and patient cohorting in an isolation Ward, combined with active ESBL-E screening. For both periods, model estimates suggested reduced transmission from isolated/cohorted patients. However, most of the incidence originated from sporadic sources (i.e. independent of cross-transmission), unaffected by the isolation measures. When sporadic sources are high, our model predicted that even substantial efforts to prevent transmission from carriers would have limited impact on ESBL-E rates. Our results provide evidence that, considering the importance of sporadic acquisition, e.g. endogenous selection of resistant strains following antibiotic treatment, contact-isolation measures alone might not suffice to control ESBL-E. They also support the view that estimating cross-transmission extent is key to predicting the relative success of contact-isolation measures. Mathematical models could prove useful for those estimations and guide decisions concerning the most effective control strategy.
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limits of patient isolation measures to control extended spectrum beta lactamase producing enterobacteriaceae model based analysis of clinical data in a Pediatric Ward
BMC Infectious Diseases, 2013Co-Authors: Matthieu Domenech De Cellès, Veronique Abadie, Jean-ralph Zahar, Didier GuillemotAbstract:Extended-spectrum beta-lactamase–producing Enterobacteriaceae (ESBL-E) are a growing concern in hospitals and the community. How to control the nosocomial ESBL-E transmission is a matter of debate. Contact isolation of patients has been recommended but evidence supporting it in non-outbreak settings has been inconclusive. We used stochastic transmission models to analyze retrospective observational data from a two-phase intervention in a Pediatric Ward, successively implementing single-room isolation and patient cohorting in an isolation Ward, combined with active ESBL-E screening. For both periods, model estimates suggested reduced transmission from isolated/cohorted patients. However, most of the incidence originated from sporadic sources (i.e. independent of cross-transmission), unaffected by the isolation measures. When sporadic sources are high, our model predicted that even substantial efforts to prevent transmission from carriers would have limited impact on ESBL-E rates. Our results provide evidence that, considering the importance of sporadic acquisition, e.g. endogenous selection of resistant strains following antibiotic treatment, contact-isolation measures alone might not suffice to control ESBL-E. They also support the view that estimating cross-transmission extent is key to predicting the relative success of contact-isolation measures. Mathematical models could prove useful for those estimations and guide decisions concerning the most effective control strategy.
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Limits of patient isolation measures to control extended-spectrum beta-lactamase-producing Enterobacteriaceae: model-based analysis of clinical data in a Pediatric Ward
BMC Infectious Diseases, 2013Co-Authors: Matthieu Domenech De Cellès, Veronique Abadie, Jean-ralph Zahar, Didier GuillemotAbstract:Background Extended-spectrum beta-lactamase-producing Enterobacteriaceae (ESBL-E) are a growing concern in hospitals and the community. How to control the nosocomial ESBL-E transmission is a matter of debate. Contact isolation of patients has been recommended but evidence supporting it in non-outbreak settings has been inconclusive. Methods We used stochastic transmission models to analyze retrospective observational data from a two-phase intervention in a Pediatric Ward, successively implementing single-room isolation and patient cohorting in an isolation Ward, combined with active ESBL-E screening. Results For both periods, model estimates suggested reduced transmission from isolated/cohorted patients. However, most of the incidence originated from sporadic sources (i.e. independent of cross-transmission), unaffected by the isolation measures. When sporadic sources are high, our model predicted that even substantial efforts to prevent transmission from carriers would have limited impact on ESBL-E rates. Conclusions Our results provide evidence that, considering the importance of sporadic acquisition, e.g. endogenous selection of resistant strains following antibiotic treatment, contact-isolation measures alone might not suffice to control ESBL-E. They also support the view that estimating cross-transmission extent is key to predicting the relative success of contact-isolation measures. Mathematical models could prove useful for those estimations and guide decisions concerning the most effective control strategy.