To develop an investigation form for postoperative infection outbreak (PIO), and to identify sources of the outbreak in the early stage.
After an exhaustive literature review, we used the Delphi ...method to determine the indicators and relative risk scores of the assessment tools through 2 rounds of specialist consultation and overall consideration of the opinions and suggestions of 20 specialists.
A total of 203 studies of PIO were eligible for inclusion. The mean authority coefficient (Cr) was 0.87. Kendall’s W coefficient of the specialist consultation was 0.704 after 2 rounds of consultation (P < .005), suggesting that the specialists had similar opinions. Based on 4 primary items and 19 secondary items of the source of PIO, and tripartite distribution characteristics of infected patients, we constructed the PIO investigation form.
The PIO investigation form can be used in the investigation of the early-stage cluster of cases, it’s a prerequisite for taking effective control measures, avoiding PIO occurrence. However, the effect of the investigation form needs to be further evaluated.
•Postoperative infection outbreak investigation differs from individual infection.•Identifying the source of the outbreak is the most crucial aspect of investigation.•The investigation form provides a reference for infection preventionists.•The Delphi method combined with literature research is better than traditional.
This study was conducted to investigate the effects of the dietary supplementation of shrimp protein hydrolysate (SPH) on somatic growth performance, innate immune response in juvenile European sea ...bass (Dicentrarchus labrax) and their differential cumulative mortality when affected by a Vibrio pelagius natural infection outbreak. A diet containing 20% fish meal (FM) was used as a control, whereas three other diets differing in the level of FM inclusion (75 and 25% FM replacement by plant protein sources) and the inclusion of the additive (5% FM, 5% FM + 5% SPH and 15% FM + 5% SPH) were tested. After 110 days, there were no statistically significant differences in somatic growth parameters nor proximate composition in fish fed different experimental diets (P > 0.05), while the humoral non-specific immune responses (lysozyme, bacteriolytic and complement activities) were significantly enhanced by the inclusion of SPH in diets (P < 0.05). Additionally, an outbreak of the pathogenic bacteria V. pelagius, a bacterial species previously described as producer of the virulence factor hemolysin, occurred in all experimental tanks (4 replicates per diet) due to crowding and repeated handling stress for fish sorting. Survival rates among different experimental groups ten days after the bacterial epizootic differed depending on the diets, with groups containing SPH showing the best results (P < 0.05). In particular, fish fed the 15% FM + 5% SPH diet showed the highest survival rate (96.4 ± 5.0%), followed by those fed the 5% FM5 + 5% SPH5 (61.8 ± 16.3%). In contrast, survival rates in fish fed diets deprived of the additive (20% FM and 5% FM5 diets) were the lowest ones (32.0 ± 6.7% and 38.2 ± 13.5%, respectively). The present study showed that SPH can be incorporated in aquafeeds with high levels of FM substitution by PP sources without detrimental impact on the somatic growth performance of fish. In addition, the non-specific humoral immunity in seabass and their survival when affected by an epizootic outbreak of V. pelagius were positively affected, which showed the immunomodulatory benefits of shrimp protein hydrolysate to promote health and prevent diseases in fish.
•Diets with low levels of fishmeal (5%) affected the sea bass immune condition.•Shrimp protein hydrolysate had immunomodulatory properties.•Sea bass fed shrimp protein hydrolysate had higher levels of serological non-specific immune parameters.•Shrimp protein hydrolysate provided protection in front of opportunistic pathogenic bacteria Vibrio pelagius.
We report a human coronavirus OC43 infection outbreak in hospitalized patients and healthcare workers in São Paulo, Brazil, occurring after SARS-CoV-2 cases disappeared. Infection was associated with ...healthcare workers in 5 (29.4%) patients. Routine surveillance including a respiratory virus panel can improve coronavirus detection in both healthcare professionals and patients.
Zika virus (ZIKV) is now considered an emerging flavivirosis, with a first large outbreak registered in the Yap Islands in 2007. In 2013, a new outbreak was reported in the French Polynesia, with ...associated cases of neurological complications including Guillain-Barré syndrome (GBS). The incidence of GBS has increased in Brazil since 2015, what is speculated to be secondary to the ZIKV infection outbreak. The gold-standard test for detection of acute ZIKV infection is the polymerase-chain reaction technique, an essay largely unavailable in Brazil. The diagnosis of GBS is feasible even in resource-limited areas using the criteria proposed by the GBS Classification Group, which is based solely on clinical grounds. Further understanding on the relationship of ZIKV with neurological complications is a research urgency.
Aim. Delineation of epidemiologic features of clustered morbidity caused by enteroviral infections (EVI) in the Ural Federal District (UFD) and West Siberia in 2017. Materials and methods. ...Retrospective epidemiologic analysis of clustered EVI morbidity was performed with the data obtained from the standardized Federal statistical observation reports and the data provided by the regional Departments of the Federal Service for Supervision of Consumer Rights Protection and Human Well-Being (Rospotrebnadzor). Detection and identification of enteroviruses was carried out by molecular genetic methods. Results. Totally 51 focus of clustered EVI was registered. The incidence density and time course of outbreaks closely correlated with the general EVI incidence level (r = 0.65; p < 0.05) and seasonal variations (r = 0.80; p < 0.05) at the given territory. Droplet nuclei transmission was considered the main route of infection in 68.2% of cases, in 22.0% - as an accessory route, and in 14.6% - as an obligate route. Contact transmission via fomites was reported as an obligate route in 9.8% of outbreaks. In the etiological structure, the proportion of Enterovirus A species was 51.4% (Coxsackievirus A6 (CV-A6) - 43.2%), Enterovirus B species - 70.3% (Echovirus 30 (E30) - 48.6%). Conclusion. In 2017 the clustered morbidity caused by EVI in the UFD and Western Siberia involved mainly children under 6 years of age from preschool institutions, where outbreaks of low incidence density with short duration were observed. Two genotypes of enteroviruses (E30 and CV-A6) were prevalent in the etiological structure of the outbreaks, therefore determining predominant clinical forms of EVI: aseptic meningitis or hand, foot, and mouth disease.
Using multipathogen PCR testing, we identified 195 students with adenovirus type 4 infections on a university campus in South Carolina, USA, during January-May 2022. We co-detected other respiratory ...viruses in 43 (22%) students. Continued surveillance of circulating viruses is needed to prevent virus infection outbreaks in congregate communities.
Human infections with Serratia spp. are generally limited to Serratia marcescens and the Serratia liquefaciens complex. There is little data regarding the infections caused by the remaining Serratia ...spp., as they are seldom isolated from clinical specimens.
In this health care setting in Kathmandu, Nepal routine blood culture is performed on all febrile patients with a temperature >38°C or when there is clinical suspicion of bacteremia. During 2015 we atypically isolated and identified several Serratia spp. We extracted clinical data from these cases and performed whole genome sequencing on all isolates using a MiSeq system (Ilumina, San Diego, CA, USA).
Between June and November 2015, we identified eight patients with suspected bacteremia that produced a positive blood culture for Serratia spp., six Serratia rubidaea and five Serratia marcescens. The S. rubidaea were isolated from three neonates and were concentrated in the neonatal intensive care unit between June and July 2015. All patients were severely ill and one patient died. Whole genome sequencing confirmed that six Nepalese S. rubidaea sequences were identical and indicative of a single-source outbreak.
Despite extensive screening we were unable to identify the source of the outbreak, but the inferred timeline suggested that these atypical infections were associated with the aftermath of two massive earthquakes. We speculate that deficits in hygienic behavior, combined with a lack of standard infection control, in the post-earthquake emergency situation contributed to these unusual Serratia spp. outbreaks.
Context: Older people and people with an intellectual disability who receive long-term care are considered particularly vulnerable to infection outbreaks, such as the current Coronavirus Disease ...2019. The combination of healthcare concerns and infection-related restrictions may result in specific challenges for long-term care staff serving these populations during infection outbreaks.Objectives: This review aimed to: (1) provide insight about the potential impact of infection outbreaks on the psychological state of healthcare staff and (2) explore suggestions to support and protect their psychological well-being.Method: Four databases were searched, resulting in 2,176 hits, which were systematically screened until six articles remained. Thematic analysis was used to structure and categorise the data.Findings: Studies about healthcare staff working in long-term care for people with intellectual disabilities were not identified. Psychological outcomes of healthcare staff serving older people covered three themes: emotional responses (i.e., fears and concerns, tension, stress, confusion, and no additional challenges), ethical dilemmas, and reflections on work attendance. Identified suggestions to support and protect care staff were related to education, provision of information, housing, materials, policy and guidelines.Limitations: Only six articles were included in the syntheses.Implications: Research into support for long-term care staff during an infection outbreak is scarce. Without conscious management, policy and research focus, the needs of this professional group may remain underexposed in current and future infection outbreaks. The content synthesis and reflection on it in this article provide starting points for new research and contribute to the preparation for future infection outbreaks.
Context: Older people and people with an intellectual disability who receive long-term care are considered particularly vulnerable to infection outbreaks, such as the current Coronavirus Disease ...2019. The combination of healthcare concerns and infection-related restrictions may result in specific challenges for long-term care staff serving these populations during infection outbreaks. Objectives: This review aimed to: (1) provide insight about the potential impact of infection outbreaks on the psychological state of healthcare staff and (2) explore suggestions to support and protect their psychological well-being. Method: Four databases were searched, resulting in 2,176 hits, which were systematically screened until six articles remained. Thematic analysis was used to structure and categorise the data. Findings: Studies about healthcare staff working in long-term care for people with intellectual disabilities were not identified. Psychological outcomes of healthcare staff serving older people covered three themes: emotional responses (i.e., fears and concerns, tension, stress, confusion, and no additional challenges), ethical dilemmas, and reflections on work attendance. Identified suggestions to support and protect care staff were related to education, provision of information, housing, materials, policy and guidelines. Limitations: Only six articles were included in the syntheses. Implications: Research into support for long-term care staff during an infection outbreak is scarce. Without conscious management, policy and research focus, the needs of this professional group may remain underexposed in current and future infection outbreaks. The content synthesis and reflection on it in this article provide starting points for new research and contribute to the preparation for future infection outbreaks.
A total of 272 soldiers out of the 301 soldiers (90.4%) were infected with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) Delta variant of concern (VOC) on a single navy ship. This ...outbreak provides three lessons for the pandemic. This incident clearly demonstrates the transmission characteristics of the SARS-CoV-2 Delta VOC.
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