Author Interviews, Flu - Influenza, Pediatrics / 14.02.2014

Philip M. Polgreen, MD, MPH. Associate Professor of Internal Medicine - Infectious Diseases University of Iowa Carver College of MedicineMedicalResearch.com Interview with: Philip M. Polgreen, MD, MPH. Associate Professor of Internal Medicine - Infectious Diseases University of Iowa Carver College of Medicine MedicalResearch.com: What are the main findings of the study? Dr. Polgreen: In this paper, to determine if well-child visits are associated with increased risk for subsequent influenza-like-illness visits, we used a large database that tracks healthcare expenditures of families over time. Controlling for other factors such as the presence of other children, insurance and demographics, we found that well-child visits were a risk factor for subsequent influenza-like-illness within the next two weeks for a patient or for a family member. The estimated probability of a subsequent influenza-like illness visit was increased by 3.2 percentage points for those with well-child visit. We estimated that this additional risk translates to over 700,000 cases of influenza-like-illness per year in the United States. Total costs (lost wages, medical costs, etc.) for these infections could amount to $500 million annually. (more…)
Author Interviews, HPV, Outcomes & Safety / 13.02.2014

Craig Meyers, Ph.D. Distinguished Professor Department of Microbiology and Immunology H107 The Penn State College of Medicine Hershey, PA 17033MedicalResearch.com Interview with: Craig Meyers, Ph.D. Distinguished Professor Department of Microbiology and Immunology H107 The Penn State College of Medicine Hershey, PA 17033 MedicalResearch.com: What are the main findings of the study? Dr. Meyers: The human papillomavirus type 16 (HPV16) is the most common HPV type associated with human cancer. It has always been assumed that HPV16 was susceptible to commonly used disinfectants. However, this has never been tested. We developed the only reproducible method to grow authentic HPV in the laboratory. Our studies show that highly resistant virus; more so than other non-enveloped viruses previously tested. Simply stated that any materials in a healthcare facility that rely on disinfectants (those presently used by healthcare facilities) do absolutely nothing to HPV. This suggests the possibility of risk of infection from inanimate objects, particularly those use in healthcare and dental clinics that depend on disinfectant treatment. Additionally it has been reported that at any one time 20% of individuals with anogenital HPV infections have the virus on their fingertips and the common hand sanitizers do nothing to inactivate the virus. (more…)
Author Interviews, Hospital Acquired / 12.02.2014

Patricia W. Stone, PhD, FAAN Columbia University School of Nursing New York, NY 10032.MedicalResearch.com Interview with: Patricia W. Stone, PhD, FAAN Columbia University School of Nursing New York, NY 10032. MedicalResearch.com: What are the main findings of the study? Dr. Stone: Our study found variation in the presence of infection control policies directed at central-line bloodstream infections, ventilator-associated pneumonia and catheter-associated urinary tract infections. Even when present, the policies were adhered to only about half of the time. (more…)
Author Interviews, HPV, JAMA, Karolinski Institute, Vaccine Studies / 12.02.2014

Lisen Arnheim Dahlström Associate Professor (Docent) Institutionen för medicinsk epidemiologi och biostatistik Department of Medical Epidemiology and Biostatistics Karolinska Institutet SwedenMedicalResearch.com Interview with: Lisen Arnheim Dahlström Associate Professor (Docent) Institutionen för medicinsk epidemiologi och biostatistik Department of Medical Epidemiology and Biostatistics Karolinska Institutet Sweden MedicalResearch.com: What are the main findings of the study? Answer: The main finding, when studying HPV vaccine effectiveness against condyloma by dose level is that 3 doses offered the maximum protection, although 2 doses also offered a substantial protection. (more…)
Author Interviews, Critical Care - Intensive Care - ICUs, Duke, Flu - Influenza, Vaccine Studies / 11.02.2014

Dr Cameron Wolfe MBBS(Hons), MPH Assistant Professor of Medicine Clinical / Transplant Infectious Diseases Duke University Medical CenterMedicalResearch.com Interview with: Dr Cameron Wolfe MBBS(Hons), MPH Assistant Professor of Medicine Clinical / Transplant Infectious Diseases Duke University Medical Center MedicalResearch.com: What are the main findings of the study? Dr. Wolfe: The major findings of the study were that at least in our center, there was a significant burden of critical illness due to H1N1 influenza infection.  The average age of the patients admitted to the hospital was just 28yrs, consistent with the younger patient age in 2009 when H1N1 emerged.  Most critically, we also observed a significantly lower rate of influenza vaccine uptake in patients admitted to the Intensive Care Units at our center. (more…)
Author Interviews, C. difficile, Gastrointestinal Disease / 10.02.2014

Stephanie Angione PhD Candidate Brown University School of Engineering Center for Biomedical EngineeringMedicalResearch.com Interview with: Stephanie Angione PhD Candidate Brown University School of Engineering Center for Biomedical Engineering MedicalResearch.com: What are the main findings of the study? Answer: This study demonstrates the application of a novel nucleic acid detection platform to detect Clostridium difficile (C. difficile) in subjects presenting with acute diarrheal symptoms. This method amplifies three genes associated with C. difficile infection as well as genes associated with virulence attributed to the NAP1/027/BI strain. The novel PCR assay allows for simple and rapid detection of three C. difficile genes: tcdB, cdtB, and tcdC, which code for C. difficile toxin B, C. difficile binary toxin, and a protein suspected to regulate toxin production, which includes the NAP1/027/BI tcdC variant. Amplification of DNA from the tcdB, tcdC and cdtB genes can be carried out using a droplet sandwich platform that performs real-time polymerase chain reaction (PCR) in microliter droplets for the detection and identification of amplified fragments of DNA. Our technique of multiplex gene amplification provides a unique method that is both sensitive and specific to rapidly detect C. difficile in patient stool samples that can be adapted to point-of-care testing. (more…)
Author Interviews, Critical Care - Intensive Care - ICUs, Infections, Outcomes & Safety / 20.01.2014

Allan J. Walkey, M.D., M.Sc Boston University School of Medicine Pulmonary Center Boston, MassachusettsMedicalResearch.com Interview with: Allan J. Walkey, M.D., M.Sc Boston University School of Medicine Pulmonary Center Boston, Massachusetts MedicalResearch.com: What are the main findings of the study? Dr. Walkey: Thank you for the interest in our study.  Current evidence-based treatments for severe sepsis (ie, infection+systemic inflammatory response+ end organ dysfunction) include specific processes of care rather specific therapeutics.  These processes include early administration of antibiotics, early fluid resuscitation, and lung protective ventilation strategies.  We hypothesized that hospitals with more ‘practice’ at treating patients with severe sepsis may have more effective care processes leading to improved patient outcomes.  We examined more than 15,000 severe sepsis admissions from 124 US academic medical centers. Our findings supported our hypothesis. After adjustment for patient severity of illness and hospital characteristics, mortality in the highest quartile severe sepsis case volume hospitals was 22% and  mortality in lowest severe sepsis case volume hospitals was 29%.  The 7% absolute mortality difference would result in an estimated number needed to treat in high severe sepsis volume hospitals to prevent one death in low case volume hospitals of 14 (though we advise caution in interpretation of a number needed to treat in an observational study). Costs and length of stay were not different across levels of severe sepsis case volume.  Results were robust to multiple subgroup and sensitivity analyses. (more…)
Author Interviews, Gastrointestinal Disease, Infections, NEJM, Vaccine Studies / 15.01.2014

MedicalResearch.com Interview with Eric S. Weintraub, M.P.H. Epidemiologist at Centers for Disease Control and Prevention MedicalResearch.com: What are the main findings of the study? Mr. Weintraub: While current rotavirus vaccines were not associated with intussusception in large pre-licensure trials, recent post-licensure data (from international settings) suggest the possibility of a low risk of intussusception occurrence after receipt of monovalent rotavirus vaccination (RV1).  We examined the risk of intussusception following RV1 vaccination in a U.S. population.  In this study of more than 200,000 doses of RV1, a slight increased risk of intussusception was observed after vaccination, which should be considered in light of the benefits of preventing rotavirus associated illness. (more…)
Author Interviews, Geriatrics, MRSA / 11.01.2014

Courtney Reynolds, PhD Medical Scientist Training Program University of California Irvine, School of MedicineMedicalResearch.com Interview with: Courtney Reynolds, PhD Medical Scientist Training Program University of California Irvine, School of Medicine MedicalResearch.com: What are the main findings of the study? Dr. Reynolds: Our survey of factors influencing admission to 13 nursing homes in Orange County, California showed that MRSA carriers are denied admission more often than non-carriers, even after accounting for other important factors such as insurance status, required level of care and previous experience at the facility. In 80% of cases where MRSA carriage was responsible for denial of admission, nursing home administrators cited a lack of available single or cohort (MRSA only) rooms to accommodate these potential residents. (more…)
Author Interviews, Education, Exercise - Fitness, Infections / 11.01.2014

MedicalResearch.com Interview with: Anna-Christina Lauer, MD Department of Audiology and Phoniatrics Charité-University Medicine Berlin Berlin, Germany MedicalResearch.com: What are the main findings of the study? Dr. Gross: We could show that the injury rates depend on the undergraduate medical training the students attended. This demonstrates that medical undergraduatue education, especially a hands-on training, is critical in the prevention of needlestick- and sharps injuries. Also the use of safety devices has proven to reduce injury rates significantly. Given the large size of our study we could not only comfirm that needlestick and sharps injuries are still a common problem, looking at an injury rate of about 20% per year, we also learned a lot about the accident circumstances: Most accidents occur at bedside during venepuncture and intravenous cannulation. The second most common setting is the operating room, where suturing and instrument transfers can lead to injuries. Since we analyzed official reports and the anonymous surveys at the same time we could affirm an underreporting rate of more than 50%. (more…)
Author Interviews, MRSA, OBGYNE / 10.01.2014

MedicalResearch.com Interview with: Dr. Andrea Parriott MPH, PhD Department of Epidemiology Fielding School of Public Health University of California Los Angeles

MedicalResearch.com: What are the main findings of the study? Dr. Parriott:  We wanted to know whether hospital and provider volume (i.e. the number of deliveries performed by each hospital and provider per quarter) and cesarean section rates were predictors of the risk of methicillin-resistant Staphylococcus aureus (MRSA) infection before discharge from the hospital (after delivering a baby). We did not find an association between any of these variables and risk of MRSA infection. (more…)
Author Interviews, CHEST, Obstructive Sleep Apnea, Respiratory / 02.01.2014

Dr. Peter Lindenauer MD MS Director, Center for Quality of Care Research Baystate Medical Center, Springfield, MA, USMedicalResearch.com Interview Invitation with: Dr. Peter Lindenauer MD MS Director, Center for Quality of Care Research Baystate Medical Center, Springfield, MA, US MedicalResearch.com: What are the main findings of the study? Answer: Among a cohort of 250,000 patients hospitalized for pneumonia at 347 US hospitals, those with a diagnosis of obstructive sleep apnea were twice as likely to be intubated at the time of hospital admission than patients without sleep apnea.  In addition, patients with sleep apnea had approximately 50% higher risk of needing to be transferred to the ICU after initial admission to a regular bed, and a 70% increased risk of requiring intubation later in the hospital stay.  Patients with sleep apnea stayed longer in the hospital and incurred higher costs than those without sleep apnea. (more…)
Author Interviews, CHEST, Critical Care - Intensive Care - ICUs, Respiratory / 02.01.2014

MedicalResearch.com Interview with: Dr Simone Gattarello Vall d’Hebron Hospital, Critical Care Department Universitat Autonoma de Barcelona and Medicine Department, Spain MedicalResearch.com: What are the main findings of the study? Dr. Gattarello: The main findings from the present study are a 15% decrease in ICU mortality due to severe community-acquired pneumonia caused by Streptococcus pneumoniae in the last decade; moreover, several changes in antibiotic prescription practices were detected and an association between improved survival and both earlier antibiotic administration and increased combined antibiotic therapy were identified. In summary, in severe pneumococcal pneumonia combined antibiotic therapy and early antibiotic administration are associated with lower mortality. (more…)
Author Interviews, Infections / 28.12.2013

Anders P. Hakansson, Ph.D. Assistant Professor of Microbiology Department of Microbiology and Immunology Buffalo, NY 14214MedicalResearch.com Interview with: Anders P. Hakansson, Ph.D. Assistant Professor of Microbiology Department of Microbiology and Immunology Buffalo, NY 14214 MedicalResearch.com: What are the main findings of the study: Dr. Hakansson: During the last couple of years we have shown that Streptococcus pneumoniae, a common colonizer of the nasopharynx in small children and elderly that sometimes cause respiratory infections such as middle ear infections and pneumonia, and Streptococcus pyogenes, a common colonizer of the oropharynx and also the cause of strep throat and skin infections, colonize us humans by forming biofilms; intricate bacterial communities. Biofilms have been studied for a long time but these specific organisms have not been shown to form biofilms during colonization until recently. As biofilms are much more resistant to environmental stresses and antibiotics, we were interested to see whether biofilms formed by these organisms could survive in the environment. The main reason for doing the experiments was that CDC guidelines indicate that spread of these organisms between individuals occur solely by inhalation of bacteria-containing droplets after coughing or sneezing. The risk of spread through surfaces has been estimated to be very low as laboratory experiments over the last 40 years have shown that these bacteria die very rapidly on surfaces. These studies were not, however, done with biofilm bacteria. Laura Marks in the laboratory with help from Ryan Reddinger therefore first tested how long biofilm bacteria could survive on plastic surfaces and found that rather than hours these bacteria were alive even after a month and could be used to successfully colonize animals. This made us interested in understanding if these bacteria survive better on hands, a common way to spread bacteria. And just as on inanimate surfaces, the biofilms survived much better on hands than bacteria grown in laboratory media. Based on these results, we were allowed to sample bacteria from stuffed toys, books, crib linens and others surfaces in a day care center early in the morning before the children arrived, and found both S. pneumoniae and S. pyogenes on these items. The results of the study indicate that these bacteria can survive in the environment longer than we have previously thought and may therefore play a role in spread between individuals. (more…)
Author Interviews, Flu - Influenza, NEJM, Pediatrics, Vaccine Studies / 15.12.2013

Ghassan Dbaibo, M.D., FAAP Professor and Vice-Chair for Research and Faculty Development Department of Pediatrics and Adolescent Medicine Head, Division of Pediatric Infectious Diseases Director, Center for Infectious Diseases Research Professor, Department of Biochemistry and Molecular Genetics American University of Beirut Beirut, LebanonMedicalResearch.com Interview with: Ghassan Dbaibo, M.D., FAAP Professor and Vice-Chair for Research and Faculty Development Department of Pediatrics and Adolescent Medicine Head, Division of Pediatric Infectious Diseases Director, Center for Infectious Diseases Research Professor, Department of Biochemistry and Molecular Genetics American University of Beirut Beirut, Lebanon MedicalResearch.com: What are the main findings of the study? Dr. Dbaibo:
  • 55% efficacy (95% CI 39–67%) for prevention of all influenza
  • These results are comparable with other estimates of efficacy and effectiveness for trivalent inactivated flu vaccines in this age group
  •  73% efficacy (97.5% CI 47–86%) for prevention of moderate-to-severe influenza
  • By preventing moderate-to-severe influenza, vaccination prevented the most clinically consequential outcomes of infection, reducing hospitalisations by 75% and medical visits by 69%.
  • Seroprotection rates of more than 95% for each of the four influenza strains in the vaccine
  • An acceptable safety and reactogenicity profile (more…)
Author Interviews, Cost of Health Care, Infections / 05.12.2013

MedicalResearch.com Interview with: Michael D. April, MD, DPhil San Antonio Uniformed Services Health Education Consortium.Department Harvard Medical School The Medical Practice Evaluation Center MedicalResearch.com: What are the main findings of this study? Dr. April: Using a mathematical model, this study quantified the survival benefits associated with antiretroviral therapy to HIV-infected people in South Africa since 2004.  Our results highlight the astounding benefits of treatment.  In short, antiretroviral therapy has saved 2.8 million years of life in South Africa to date and is projected to save an additional 15.1 million years of life by 2030. (more…)
Author Interviews, Herpes Viruses, Infections, Nature, Pulmonary Disease / 21.11.2013

Gerard Nuovo MD Professor College of Medicine, The Ohio State University Satellite Laboratory, Ohio State Univ Comprehensive Cancer Center Phylogeny Inc, Powell, OhioMedicalResearch.com Interview with: Gerard Nuovo MD Professor College of Medicine, The Ohio State University Satellite Laboratory, Ohio State Univ Comprehensive Cancer Center Phylogeny Inc, Powell, Ohio MedicalResearch.com: What are the main findings of the study? Dr. Nuovo: The main finding of the study was that idiopathic pulmonary fibrosis was strongly associated with an infection by a herpesvirus.  The data that supported this main finding included:
  • 1) detection of the viral DNA by in situ hybridization in each case of idiopathic pulmonary fibrosis (IPF) and in none of the controls;
  • 2) the localization of the viral DNA to the nucleus of the cell that orchestrates IPF, the regenerating epithelial cell (herpes viruses localize to the nucleus of the target cell);
  • 3) the demonstration that the viral DNA co-localized with "pirated proteins" that the virus makes during productive infection (these were IL-17. cyclin D, dihydrofolate reductase, and thymidylate synthase); this combination of proteins are rarely if ever co-expressed in lung disease and  their co-expression per se was highly suggestive of a viral infection;
  • 4) the demonstration by RTPCR that the cyclin D RNA in IPF comes from the virus and not the human cells;
  • 5) the recognition that this family of herpesviruses (called gammaherpesvirus) causes IPF in other animals including horses, mice, and donkeys;
  • 6) the cloning of part of the gene of the virus from a clinical IPF sample that showed 100% homology to the published sequence of the likely viral pathogen - herpesvirus saimiri. (more…)
Author Interviews, NEJM, Urinary Tract Infections / 14.11.2013

Thomas M. Hooton M.D. Associate Chief of Staff, Medical Service, Miami VA Healthcare System Professor of Clinical Medicine and Vice Chair for VA Affairs, Department of Medicine, UMSOM Clinical Director, Division of Infectious Diseases, UMSOMMedicalResearch.com Interview with: Thomas M. Hooton M.D. Professor of Medicine and Vice Chair for VA Affairs, University of Miami Miller School of Medicine Associate Chief of Staff, Medical Service, Miami VA Healthcare System Clinical Director, Division of Infectious Diseases MedicalResearch.com: What are the main findings of the study? Dr. Hooten: The main findings from this study are: ·        Voided urine colony counts of E. coli as low as 101 to 102 cfu/mL are highly sensitive and specific for their presence in bladder urine in symptomatic women (growth of bacteria in bladder urine is the gold standard for the etiology of UTI). Moreover, even when E. coli is found along with other mixed flora in voided urine, it should not be considered a contaminant since it likely represents true bladder infection. ·        On the other hand, enterococci and Group B streptococci, which are frequently isolated from voided urine, are rarely isolated from paired catheter specimens, suggesting that these organisms only rarely cause acute uncomplicated cystitis. In our study, E. coli frequently grew from the urines of these women and is the likely cause for UTI symptoms in such episodes. ·        Organisms usually considered contaminants, such as lactobacilli, occasionally grow from catheter urines, but they are rarely found alone with pyuria, suggesting that these bacteria rarely cause acute uncomplicated cystitis. ·        The etiology of a quarter of acute uncomplicated cystitis episodes is unknown.  It is possible that some of these women have E. coli urethritis, which has been documented in some women with UTI symptoms, but we did not do further studies to evaluate this. It is possible also that enterococci and Group B streptococci may also cause urethritis, but there is no published evidence of this in young women with UTI symptoms. ·        Although voided urine cultures growing mixed flora are common in women with acute cystitis, true polymicrobic cystitis, as determined by sampling bladder urine, appears to be rare in this population. (more…)
Author Interviews, Flu - Influenza / 12.11.2013

MedicalResearch.com with: Dr Kate Mandeville MD MPH Clinical Research Fellow, London School of Hygiene and Tropical MedicineDr Kate Mandeville MD MPH Clinical Research Fellow, London School of Hygiene and Tropical Medicine   MedicalResearch.com: What is the background for your study? Dr. Mandeville: The UK spent nearly one billion pounds on pharmaceutical drugs during the swine flu pandemic, including vaccine and antiviral drugs. After the swine flu pandemic, it was revealed that some scientists on the World Health Organization’s advisory committee had links with the pharmaceutical industry. Scientists often provide commentary for journalists on emerging health risks and we set out to see whether scientists commentating on swine flu were also more likely to have links to pharmaceutical companies. We analysed UK newspaper coverage of the swine flu pandemic between April and July 2009. This was the period in which the UK government was making decisions on how best to respond to the emerging pandemic, including providing the public with vaccine and antiviral drugs. We looked for how often scientists were quoted in articles on the pandemic from a wide range of newspapers. We then examined these comments in more detail to see if scientists made an assessment of the risk to the public from swine flu, and compared these against assessments made by official agencies like the Department of Health. We also judged whether the scientists promoted or rejected the use of vaccines or antiviral drugs. For each scientist, we then looked for links with the pharmaceutical industry – or what we formally call competing interests - from a variety of sources, including scientific papers and the internet. (more…)
Author Interviews, Flu - Influenza, Pediatrics, Vaccine Studies / 29.10.2013

MedicalResearch.com Interview with: Karen K. Wong, MD MPH Community Interventions for Infection Control Unit Division of Global Migration & Quarantine Centers for Disease Control and Prevention MedicalResearch.com: What are the main findings of the study? Dr. Wong: There were 830 pediatric influenza-associated deaths reported to CDC during the 2004–2005 through 2011–2012 seasons; deaths occurred in children of all ages, and 43% had no high-risk medical conditions. Of children 6 months of age or older whose vaccination status was known, only 16% had been fully vaccinated with seasonal influenza vaccine. (more…)
Author Interviews, HPV, Vaccine Studies / 12.10.2013

Lisen Arnheim Dahlström, Associate Professor (Docent) Institutionen för medicinsk epidemiologi och biostatistik Department of Medical Epidemiology and Biostatistics Karolinska Institutet 171 77 Stockholm, SwedenMedicalResearch.com Interview with: Lisen Arnheim Dahlström, Associate Professor (Docent) Institutionen för medicinsk epidemiologi och biostatistik Department of Medical Epidemiology and Biostatistics Karolinska Institutet 171 77 Stockholm, Sweden   MedicalResearch.com: What are the main findings of the study? Answer: This is a Swedish/Danish population-based study comparing serious disease outcomes in girls immunized with the quadrivalent HPV vaccine against the unvaccinated population. The main finding of this study was that none of the 53 outcomes included in the study were more common in the vaccinated population compared to the non-vaccinated population. (more…)
Author Interviews, Infections / 07.10.2013

George Alangaden MD Senior Staff Physician, Transplant Infectious Diseases Medical Director of Infection Prevention Henry Ford Hospital Professor of Medicine, Wayne State University Infectious Diseases, CFP-316 Detroit, MI  48202MedicalResearch.com Interview with: George Alangaden MD Senior Staff Physician, Transplant Infectious Diseases Medical Director of Infection Prevention Henry Ford Hospital Professor of Medicine, Wayne State University Infectious Diseases, CFP-316 Detroit, MI  48202 MedicalResearch.com: What are the main findings of the study? Dr. Alangaden:
  • Infections caused by Mycobacterium marinum infections are rare. A total of 5 patients were identified in our hospital over a 10 year period.
  • In all instances the infection affected the skin and soft tissues of the hand and arm and presented as sores or bumps on the skin that did not improve after usual antibiotic therapy.
  • All patients had an history of some trauma to the hand and subsequent exposure to water  from home aquariums
  • The time to onset of infection after exposure ranged from 11 days to 56 days.
  • The median time from infection to diagnosis and appropriate therapy was 161 days (range 33-379 days).
  • In all cases the diagnosis was made by doing a skin biopsy.
  • All patients were cured after several weeks of treatment with appropriate antibiotics. (more…)
Author Interviews, Hand Washing, JAMA, MRSA / 07.10.2013

Anthony Harris, MD, MPH Department of Epidemiology and Public Health Professor University of Maryland School of Medicine Acting Medical Director of Infection Control University of Maryland Medical CenterMedicalResearch.com Interview with: Anthony Harris, MD, MPH Department of Epidemiology and Public Health Professor University of Maryland School of Medicine Acting Medical Director of Infection Control University of Maryland Medical Center     MedicalResearch.com: What are the main findings of the study? Dr. Harris: The aim of the study was to understand if wearing disposable gowns and gloves for all patient contact in the ICU could help prevent the spread of MRSA and similar antibiotic-resistant bacteria. Secondarily we wanted to make sure this type of patient isolation did not result in any harm to patients. The results of the study were that gowns and gloves worn by healthcare workers for contact with all patients in the ICU did not decrease the number of patients who acquired VRE but did decrease MRSA about 40 percent.  Also, wearing gloves and gowns did not adversely impact patient care.  For our goal of studying all types of infection, we did not find a benefit to universal gown and glove use. However, for transmission of MRSA alone, the intervention decreased transmission by about 40 percent. Although previous studies have showed isolation is associated with falls, bed sores and other adverse events, we found gowns and gloves did not produce more of these negative events. (more…)
Hospital Acquired, Infections, Outcomes & Safety, Pediatrics / 07.10.2013

MedicalResearch.com Interview with: Elias Iosifidis, MD, PhD Pediatric Infectious Disease Fellow Aristotle University of Thessaloniki Hippokration Hospital Thessaloniki, Greece MedicalResearch.com: What are the main findings of the study? Dr. Iosifidis: A large outbreak of VRE colonization was found in neonates hospitalized in an intensive care unit (Neonatal Intensive Care Unit, NICU) after the implementation of an active surveillance program. Both high incidence of VRE colonization (or “colonization pressure”) and antibiotic use promoted VRE spread according to the results of the case control study. No proven sources of VRE were found (in local hospital or even in local livestock). A multifaceted management was implemented and included enhanced infection control measures, active surveillance cultures, cohorting of colonized patients, daily audits and optimization of antibiotic therapy. Although the outbreak had a biphasic pattern (monoclonal first wave followed by a polyclonal second wave) strict adherence to the aforementioned bundle of actions was proved essential for reducing VRE colonized cases. During the study period no new VRE infection occurred in neonates. (more…)
Author Interviews, Global Health, Infections, Lancet / 01.10.2013

Prof Didier Pittet, MD, MS Director of the Infection Control Programme and WHO Collaborating Centre on Patient Safety, University of Geneva Hospitals, Geneva, SwitzerlandMedicalResearch.com Interview with : Prof Didier Pittet, MD, MS Director of the Infection Control Programme and WHO Collaborating Centre on Patient Safety, University of Geneva Hospitals, Geneva, Switzerland   MedicalResearch.com : What are the main findings of the study? Prof. Pittet: The main finding is that the WHO hand hygiene promotion strategy is feasible and sustainable across healthcare settings worldwide. For the first time, we have evidence of its feasibility and successful effects to improve hand hygiene in a variety of different geographical and income settings, with an even greater impact in low-/middle-income countries than in high-income countries. (more…)
Author Interviews, C. difficile, Infections, NEJM / 26.09.2013

MedicalResearch.com Interview with: David W. Eyre, B.M., B.Ch. Nuffield Department of Clinical Medicine University of Oxford National Institute for Health Research (NIHR) Oxford Biomedical Research Centre John Radcliffe Hospital MedicalResearch.com: What are the main findings of this study? Dr. Eyre: All cases of Clostridium difficile in Oxfordshire were studied over 3 years. Isolates were characterized by whole genome sequencing and the data was linked to hospital databases allowing epidemiological relationships between patients at the level of the hospital ward, hospital specialty, and post code to be identified. For comparison, similar information was also available for all other patients with and without diarrhea.  Preliminary work on the genetic diversity of Clostridium difficile within individuals and between individuals within discrete outbreaks allowed reliable interpretation of transmission events using genomic data. This allowed a complete reconstruction of the pattern of transmission between affected cases in Oxfordshire to be made. The findings were: 1. Unexpectedly few cases (13%) appear to be acquired from direct ward based contact with other symptomatic cases (these have previously been thought to be the main source of infections, and the focus of prevention efforts). Another 6% were associated with other hospital contact and 3% had plausible community contacts. 2. In 13% of cases potential donors were identified gnomically but no contact, within hospitals or the community, were identified. This suggests that the existence of other modes of transmission of Clostridium difficile. 3. The sources of Clostridium difficile infections were highly genetically diverse, with 45% of cases having a genetically distinct origin - suggesting a diverse reservoir of disease, not previously appreciated 4. During the 3 years of the study the rate of Clostridium difficile in Oxfordshire fell.  Any improvement in infection control techniques would be expected to reduce the incidence of cases caused by within hospital transmission. Surprisingly, similar rates of fall occurred in both in secondary cases (considered to be acquired from hospital associated symptomatic cases) and for primary cases (cases not associated with transmission from symptomatic cases). (more…)
Author Interviews, MRSA, Pediatrics / 23.09.2013

MedicalResearch.com Interview with: Dr. Martha Iwamoto, MD, MPH Centers for Disease Control and Prevention, Atlanta, Georgia; MedicalResearch.com: What are the main findings of the study? Dr. Iwamoto: We have been successful in decreasing invasive MRSA infections among infants younger than 3 months, mostly due to declines in hospital –onset infections in NICUs. However, more needs to be done among pediatric patients older than 3 months, especially those in the community settings and without recent healthcare exposures. (more…)
Author Interviews, CMAJ, Infections, Outcomes & Safety, Urinary Tract Infections / 18.09.2013

MedicalResearch.com Interview with: Mohamad Fakih, MD, MPH Medical Director, Infection Prevention and Control St John Hospital and Medical Center MedicalResearch.com: What are the main findings of the study? Dr. Fakih: Urinary catheters are commonly used in the hospital.  Although they help in the management of the sickest patients, they also present a risk for infection and other harms to the patient. The Centers for Medicaid and Medicare Services (CMS) have made catheter associated urinary tract infections (CAUTI) publicly reportable, and no longer reimburse hospitals for these infections if they occur in hospital setting. The definition of CAUTI is based on the surveillance definition of the National Healthcare Safety Network (NHSN) by the Centers for Disease Control and Prevention (CDC). We looked at clinician practice, including the Infectious Diseases specialist’s impression and compared them to the NHSN definition. We found a significant difference between what clinicians think is a urinary catheter infection and give antibiotics for it compared to the NHSN definition. The NHSN definition predicted clinical infection by the Infectious Diseases specialist in only about a third of the cases. We also found that Infectious Disease specialists considered patients to have true CAUTI in only half of what clinicians treated as CAUTI. (more…)