Last data update: May 13, 2024. (Total: 46773 publications since 2009)
Records 1-17 (of 17 Records) |
Query Trace: Marino L[original query] |
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Two rotavirus outbreaks caused by genotype G2P[4] at large retirement communities: cohort studies.
Cardemil CV , Cortese MM , Medina-Marino A , Jasuja S , Desai R , Leung J , Rodriguez-Hart C , Villarruel G , Howland J , Quaye O , Tam KI , Bowen MD , Parashar UD , Gerber SI . Ann Intern Med 2012 157 (9) 621-31 BACKGROUND: Outbreaks of rotavirus gastroenteritis in elderly adults are reported infrequently but are often caused by G2P[4] strains. In 2011, outbreaks were reported in 2 Illinois retirement facilities. OBJECTIVE: To implement control measures, determine the extent and severity of illness, and assess risk factors for disease among residents and employees. DESIGN: Cohort studies using surveys and medical chart abstraction. SETTING: Two large retirement facilities in Cook County, Illinois. PATIENTS: Residents and employees at both facilities and community residents with rotavirus disease. MEASUREMENTS: Attack rates, hospitalization rates, and rotavirus genotype. RESULTS: At facility A, 84 of 324 residents (26%) were identified with clinical or laboratory-confirmed rotavirus gastroenteritis (median age, 84 years) and 11 (13%) were hospitalized. The outbreak lasted 7 weeks. At facility B, 90 case patients among 855 residents (11%) were identified (median age, 88 years) and 19 (21%) were hospitalized. The facility B outbreak lasted 9.3 weeks. Ill employees were identified at both locations. In each facility, attack rates seemed to differ by residential setting, with the lowest rates among those in more separated settings or with high baseline level of infection control measures. The causative genotype for both outbreaks was G2P[4]. Some individuals shed virus detected by enzyme immunoassay or genotyping reverse transcription polymerase chain reaction for at least 35 days. G2P[4] was also identified in 17 of 19 (89%) samples from the older adult community but only 15 of 40 (38%) pediatric samples. LIMITATION: Medical or cognitive impairment among residents limited the success of some interviews. CONCLUSION: Rotavirus outbreaks can occur among elderly adults in residential facilities and can result in considerable morbidity. Among older adults, G2P[4] may be of unique importance. Health professionals should consider rotavirus as a cause of acute gastroenteritis in adults. PRIMARY FUNDING SOURCE: None. |
Changes in tobacco product use among students aged 13 to 15 years in 34 countries, Global Youth Tobacco Survey, 2012-2020
Njie GJ , Kirksey Jones C , Jacques N , Adetokun A , Ross J , Owens A , Anton L , Johns M , Pan L . Prev Chronic Dis 2023 20 E68 INTRODUCTION: Most adults who currently use tobacco start before age 21. Comprehensive, cost-effective strategies and interventions to prevent initiation and encourage tobacco use cessation among youth are critical aspects of protecting youth from the harms of commercial tobacco. We describe changes in current tobacco product use among youth in 34 sites using data from the Global Youth Tobacco Survey (GYTS). METHODS: GYTS is a nationally representative school-based survey of students aged 13 to 15 years. The analysis included 34 sites that completed 2 survey waves during 2012-2020. Prevalence of current tobacco use was assessed for each country. Marginal effects in multivariable logistic regression models were used to estimate adjusted prevalence difference (aPD) between waves. RESULTS: The adjusted prevalence of current tobacco product use remained unchanged in more than 60% of the included sites. For any tobacco use, significant decreases were reported for Bhutan (aPD = -8.1; 95% CI, -12.9 to -3.4), Micronesia (aPD = -7.2; 95% CI, -9.7 to -4.7), San Marino (aPD = -7.0; 95% CI, -11.2 to -2.7), Togo (aPD = -2.7; 95% CI, -4.6 to -0.7), and Panama (aPD = -2.2; 95% CI, -4.1 to -0.4); significant increases were reported for Moldova, Albania, and Paraguay. Current e-cigarette use increased significantly in 7 of 10 sites. CONCLUSION: Data show that progress toward reducing tobacco use among youth stalled during 2012-2020, while e-cigarette use increased in a few sites with available data. |
Percentage of current tobacco smoking students receiving help or advice to quit: Evidence from the Global Youth Tobacco Survey, 56 countries, 2012-2015
Arrazola RA , Seidenberg AB , Ahluwalia IB . Tob Prev Cessat 2019 5 5 INTRODUCTION: We assessed self-reported receipt of help or advice to stop smoking among current tobacco smoking students enrolled in school. METHODS: Using cross-sectional data collected between 2012-2015 from the Global Youth Tobacco Survey (GYTS), and representing the latest year for which data were collected, we calculated prevalence of receipt of help or advice to stop smoking among current tobacco smoking students aged 13-15 years from 56 countries. The sources of help or advice assessed in the GYTS were: 1) from a program or professional, 2) from a friend, and 3) from a family member. Overall response rates ranged from 60.3% in Nicaragua to 99.2% in Sudan. The analytic sample size ranged from 55 in Gabon to 950 in Bulgaria. RESULTS: In 53 of the 56 assessed countries, more than half of current tobacco smoking students received help or advice to quit from either a program or professional, friend, or family member (range=39.9% San Marino to 96.9% Timor-Leste). From a friend or family member only, the range was 37.2% Bahamas to 69.9% Montenegro, and from a program or professional only, the range was 3.7% Latvia to 34.2% Togo. CONCLUSIONS: Family and friends are the most common sources of help or advice to quit smoking among current tobacco smoking students in the GYTS countries assessed, while programs and professionals were the least common. The use of evidence-based measures is critical to prevent and reduce tobacco use among youth and to ensure they are receiving appropriate help or advice to quit. |
Case-case comparison of Candida auris versus other Candida species bloodstream infections: Results of an outbreak investigation in Colombia
Caceres DH , Rivera SM , Armstrong PA , Escandon P , Chow NA , Ovalle MV , Díaz J , Derado G , Salcedo S , Berrio I , Espinosa-Bode A , Varón C , Stuckey MJ , Mariño A , Villalobos N , Lockhart SR , Chiller TM , Prieto FE , Jackson BR . Mycopathologia 2020 185 (5) 917-923 BACKGROUND: Candida auris is an emerging multidrug-resistant yeast that causes outbreaks in healthcare settings around the world. In 2016, clinicians and public health officials identified patients with C. auris bloodstream infections (BSI) in Colombian healthcare facilities. To evaluate potential risk factors and outcomes for these infections, we investigated epidemiologic and clinical features of patients with C. auris and other Candida species BSI. METHODS: We performed a retrospective case-case investigation in four Colombian acute care hospitals, defining a case as Candida spp. isolated from blood culture during January 2015-September 2016. C. auris BSI cases were compared to other Candida species BSI cases. Odds ratio (OR), estimated using logistic regression, was used to assess the association between risk factors and outcomes. RESULTS: We analyzed 90 patients with BSI, including 40 with C. auris and 50 with other Candida species. All had been admitted to the intensive care unit (ICU). No significant demographic differences existed between the two groups. The following variables were independently associated with C. auris BSI: ≥ 15 days of pre-infection ICU stay (OR: 5.62, CI: 2.04-15.5), evidence of severe sepsis (OR: 3.70, CI 1.19-11.48), and diabetes mellitus (OR 5.69, CI 1.01-31.9). CONCLUSION: Patients with C. auris BSI had longer lengths of ICU stay than those with other candidemias, suggesting that infections are acquired during hospitalization. This is different from other Candida infections, which are usually thought to result from autoinfection with host flora. |
Zika Virus Surveillance at the Human-Animal Interface in West-Central Brazil, 2017-2018.
Pauvolid-Correa A , Goncalves Dias H , Marina Siqueira Maia L , Porfirio G , Oliveira Morgado T , Sabino-Santos G , Helena Santa Rita P , Teixeira Gomes Barreto W , Carvalho de Macedo G , Marinho Torres J , Arruda Gimenes Nantes W , Martins Santos F , Oliveira de Assis W , Castro Rucco A , Mamoru Dos Santos Yui R , Bosco Vilela Campos J , Rodrigues Leandro ESilva R , da Silva Ferreira R , Aparecido da Silva Neves N , Charlles de Souza Costa M , Ramos Martins L , Marques de Souza E , Dos Santos Carvalho M , Goncalves Lima M , de Cassia Goncalves Alves F , Humberto Guimaraes Riquelme-Junior L , Luiz Batista Figueiro L , Fernandes Gomes de Santana M , Gustavo Rodrigues Oliveira Santos L , Serra Medeiros S , Lopes Seino L , Hime Miranda E , Henrique Rezende Linhares J , de Oliveira Santos V , Almeida da Silva S , Araujo Lucio K , Silva Gomes V , de Araujo Oliveira A , Dos Santos Silva J , de Almeida Marques W , Schafer Marques M , Junior Franca de Barros J , Campos L , Couto-Lima D , Coutinho Netto C , Strussmann C , Panella N , Hannon E , Cristina de Macedo B , Ramos de Almeida J , Ramos Ribeiro K , Carolina Barros de Castro M , Pratta Campos L , Paula Rosa Dos Santos A , Marino de Souza I , de Assis Bianchini M , Helena Ramiro Correa S , Ordones Baptista Luz R , Dos Santos Vieira A , Maria de Oliveira Pinto L , Azeredo E , Tadeu Moraes Figueiredo L , Augusto Fonseca Alencar J , Maria Barbosa de Lima S , Miraglia Herrera H , Dezengrini Shlessarenko R , Barreto Dos Santos F , Maria Bispo de Filippis A , Salyer S , Montgomery J , Komar N . Viruses 2019 11 (12) Zika virus (ZIKV) was first discovered in 1947 in Uganda but was not considered a public health threat until 2007 when it found to be the source of epidemic activity in Asia. Epidemic activity spread to Brazil in 2014 and continued to spread throughout the tropical and subtropical regions of the Americas. Despite ZIKV being zoonotic in origin, information about transmission, or even exposure of non-human vertebrates and mosquitoes to ZIKV in the Americas, is lacking. Accordingly, from February 2017 to March 2018, we sought evidence of sylvatic ZIKV transmission by sampling whole blood from approximately 2000 domestic and wild vertebrates of over 100 species in West-Central Brazil within the active human ZIKV transmission area. In addition, we collected over 24,300 mosquitoes of at least 17 genera and 62 species. We screened whole blood samples and mosquito pools for ZIKV RNA using pan-flavivirus primers in a real-time reverse-transcription polymerase chain reaction (RT-PCR) in a SYBR Green platform. Positives were confirmed using ZIKV-specific envelope gene real-time RT-PCR and nucleotide sequencing. Of the 2068 vertebrates tested, none were ZIKV positive. Of the 23,315 non-engorged mosquitoes consolidated into 1503 pools tested, 22 (1.5%) with full data available showed some degree of homology to insect-specific flaviviruses. To identify previous exposure to ZIKV, 1498 plasma samples representing 62 species of domestic and sylvatic vertebrates were tested for ZIKV-neutralizing antibodies by plaque reduction neutralization test (PRNT90). From these, 23 (1.5%) of seven species were seropositive for ZIKV and negative for dengue virus serotype 2, yellow fever virus, and West Nile virus, suggesting potential monotypic reaction for ZIKV. Results presented here suggest no active transmission of ZIKV in non-human vertebrate populations or in alternative vector candidates, but suggest that vertebrates around human populations have indeed been exposed to ZIKV in West-Central Brazil. |
Public health approach to improve outcomes for congenital heart disease across the life span
Jenkins KJ , Botto LD , Correa A , Foster E , Kupiec JK , Marino BS , Oster ME , Stout KK , Honein MA . J Am Heart Assoc 2019 8 (8) e009450 Congenital heart disease (CHD), which is present in around 1.0% (1 in 110) of all live births in the United States, is the most common birth defect.1, 2, 3, 4, 5 Defined generally as malformations present at birth that involve the heart or major associated blood vessels, CHD includes a remarkably heterogeneous group of chronic conditions, with very different phenotypes, prevalence, risk factors, and outcomes. CHD is a significant contributor to birth‐defect–related morbidity, mortality, and healthcare costs6 in early life and increasingly among adolescents and adults.7 Because of their broad impact at the population level, a public health approach is needed to address the challenges of these common, critical, and costly conditions.8 We sought to create a framework to address CHD from a population‐based perspective, to serve as a model for a public health agenda for the United States, with a goal of improving the lives of those with or at risk for CHD. This framework is complementary to previous work outlining the Centers for Disease Control and Prevention's scientific priorities related to CHD,9 because implementation strategies are also needed in addition to addressing gaps in scientific knowledge.9, 10, 11 |
Evaluating the electronic tuberculosis register surveillance system in Eden District, Western Cape, South Africa, 2015
Mlotshwa M , Smit S , Williams S , Reddy C , Medina-Marino A . Glob Health Action 2017 10 (1) 1360560 BACKGROUND: Tuberculosis (TB) surveillance data are crucial to the effectiveness of National TB Control Programs. In South Africa, few surveillance system evaluations have been undertaken to provide a rigorous assessment of the platform from which the national and district health systems draws data to inform programs and policies. OBJECTIVE: Evaluate the attributes of Eden District's TB surveillance system, Western Cape Province, South Africa. METHODS: Data quality, sensitivity and positive predictive value were assessed using secondary data from 40,033 TB cases entered in Eden District's ETR.Net from 2007 to 2013, and 79 purposively selected TB Blue Cards (TBCs), a medical patient file and source document for data entered into ETR.Net. Simplicity, flexibility, acceptability, stability and usefulness of the ETR.Net were assessed qualitatively through interviews with TB nurses, information health officers, sub-district and district coordinators involved in the TB surveillance. RESULTS: TB surveillance system stakeholders report that Eden District's ETR.Net system was simple, acceptable, flexible and stable, and achieves its objective of informing TB control program, policies and activities. Data were less complete in the ETR.Net (66-100%) than in the TBCs (76-100%), and concordant for most variables except pre-treatment smear results, antiretroviral therapy (ART) and treatment outcome. The sensitivity of recorded variables in ETR.Net was 98% for gender, 97% for patient category, 93% for ART, 92% for treatment outcome and 90% for pre-treatment smear grading. CONCLUSIONS: Our results reveal that the system provides useful information to guide TB control program activities in Eden District. However, urgent attention is needed to address gaps in clinical recording on the TBC and data capturing into the ETR.Net system. We recommend continuous training and support of TB personnel involved with TB care, management and surveillance on TB data recording into the TBCs and ETR.Net as well as the implementation of a well-structured quality control and assurance system. |
Effect of stressful life events on changes in smoking among the French: longitudinal findings from GAZEL
Tamers SL , Okechukwu C , Marino M , Gueguen A , Goldberg M , Zins M . Eur J Public Health 2015 25 (4) 711-5 BACKGROUND: Changes in life events may play a contributing role in changes in smoking behaviors. The objective was to examine the impact of stressful life events (SLEs) on smoking among French adults. METHODS: We examined smoking prevalence in 20 625 employees of the French GAZEL cohort for up to 5 years before and after a SLE during three time periods (years -1 vs. -5; years +1 vs. -1; years +5 vs. +1). Repeated measures analysis of time series data indexed to events were used, employing generalized estimating equations. RESULTS: For women, comparing 1 year after vs. 1 year before SLEs, decreased odds of smoking were found for employment promotion (OR: 0.80; 95% CI = 0.67-0.95), marriage (OR: 0.57; 95% CI = 0.48-0.68) and divorce (OR: 0.78; 95% CI = 0.68-0.90). Comparing 5 years after to 1 year after SLEs, women had decreased odds of smoking for important purchase (OR: 0.87; 95% CI = 0.79-0.96), children leaving home (OR: 0.83; 95% CI = 0.74-0.93), retirement (OR: 0.73; 95% CI = 0.64-0.83) and death of loved one (OR: 0.86; 95% CI = 0.79-0.93). For men, decreased odds of smoking were observed in all three time periods for all SLEs except when comparing 1 year before to 5 years before marriage (OR: 1.66; 95% CI = 1.09-2.52) and divorce (OR: 1.49; 95% CI = 1.25-1.77). CONCLUSION: Time surrounding SLEs during which individuals are susceptible to changing smoking behaviors may be an important consideration. |
Genome Sequences of Vibrio navarrensis, a Potential Human Pathogen.
Gladney LM , Katz LS , Knipe KM , Rowe LA , Conley AB , Rishishwar L , Marino-Ramirez L , Jordan IK , Tarr CL . Genome Announc 2014 2 (6) Vibrio navarrensis is an aquatic bacterium recently shown to be associated with human illness. We report the first genome sequences of three V. navarrensis strains obtained from clinical and environmental sources. Preliminary analyses of the sequences reveal that V. navarrensis contains genes commonly associated with virulence in other human pathogens. |
Disparities among 2009 pandemic influenza A (H1N1) hospital admissions: a mixed methods analysis - Illinois, April-December 2009
Soyemi K , Medina-Marino A , Sinkowitz-Cochran R , Schneider A , Njai R , McDonald M , Glover M , Garcia J , Aiello AE . PLoS One 2014 9 (4) e84380 During late April 2009, the first cases of 2009 pandemic influenza A (H1N1) (pH1N1) in Illinois were reported. On-going, sustained local transmission resulted in an estimated 500,000 infected persons. We conducted a mixed method analysis using both quantitative (surveillance) and qualitative (interview) data; surveillance data was used to analyze demographic distribution of hospitalized cases and follow-up interview data was used to assess health seeking behavior. Invitations to participate in a telephone interview were sent to 120 randomly selected Illinois residents that were hospitalized during April-December 2009. During April-December 2009, 2,824 pH1N1 hospitalizations occurred in Illinois hospitals; median age (interquartile range) at admission was 24 (range: 6-49) years. Hospitalization rates/100,000 persons for blacks and Hispanics, regardless of age or sex were 2-3 times greater than for whites (blacks, 36/100,000 (95% Confidence Interval ([95% CI], 33-39)); Hispanics, 35/100,000 [95%CI,32-37] (; whites, 13/100,000[95%CI, 12-14); p<0.001). Mortality rates were higher for blacks (0.9/100,000; p<0.09) and Hispanics (1/100,000; p<0.04) when compared with the mortality rates for whites (0.6/100,000). Of 33 interview respondents, 31 (94%) stated that they had heard of pH1N1 before being hospitalized, and 24 (73%) did not believed they were at risk for pH1N1. On average, respondents reported experiencing symptoms for 2 days (range: 1-7) before seeking medical care. When asked how to prevent pH1N1 infection in the future, the most common responses were getting vaccinated and practicing hand hygiene. Blacks and Hispanics in Illinois experienced disproportionate pH1N1 hospitalization and mortality rates. Public health education and outreach efforts in preparation for future influenza pandemics should include prevention messaging focused on perception of risk, and ensure community wide access to prevention messages and practices. |
Influenza viruses in Nigeria, 2009-2010: results from the first 17 months of a national influenza sentinel surveillance system
Dalhatu IT , Medina-Marino A , Olsen SJ , Hwang I , Gubio AB , Ekanem EE , Coker EB , Akpan H , Adedeji AA . J Infect Dis 2012 206 Suppl 1 S121-8 BACKGROUND: Influenza surveillance data from tropical, sub-Saharan African countries are limited. To better understand the epidemiology of influenza, Nigeria initiated influenza surveillance in 2008. METHODS: Outpatients with influenza-like illness (ILI) and inpatients with severe acute respiratory illness (SARI) were enrolled at 4 sentinel facilities. Epidemiologic data were obtained, and respiratory specimens were tested for influenza viruses, using real-time reverse-transcription polymerase chain reaction assays. RESULTS: During April 2009-August 2010, 2841 patients were enrolled. Of 2803 specimens tested, 217 (7.7%) were positive for influenza viruses (167 [8%] were from subjects with ILI, 17 [5%] were from subjects with SARI, and 33 were from subjects with an unclassified condition). During the prepandemic period, subtype H3N2 (A[H3N2]) was the dominant circulating influenza A virus subtype; 2009 pandemic influenza A virus subtype H1N1 (A[H1N1]pdm09) replaced A(H3N2) as the dominant circulating virus during November 2009. Among persons with ILI, A(H1N1)pdm09 was most frequently found in children aged 5-17 years, whereas among subjects with SARI, it was most frequently found in persons aged ≥ 65 years. The percentage of specimens that tested positive for influenza viruses peaked at 18.9% in February 2010, and the majority were A(H1N1)pdm09. CONCLUSIONS: Influenza viruses cause ILI and SARI in Nigeria. Data from additional years are needed to better understand the epidemiology and seasonality of influenza viruses in Nigeria. |
Genome sequences for six Rhodanobacter strains, isolated from soils and the terrestrial subsurface, with variable denitrification capabilities.
Kostka JE , Green SJ , Rishishwar L , Prakash O , Katz LS , Marino-Ramirez L , Jordan IK , Munk C , Ivanova N , Mikhailova N , Watson DB , Brown SD , Palumbo AV , Brooks SC . J Bacteriol 2012 194 (16) 4461-2 We report the first genome sequences for six strains of Rhodanobacter species isolated from a variety of soil and subsurface environments. Three of these strains are capable of complete denitrification and three others are not. However, all six strains contain most of the genes required for the respiration of nitrate to gaseous nitrogen. The nondenitrifying members of the genus lack only the gene for nitrate reduction, the first step in the full denitrification pathway. The data suggest that the environmental role of bacteria from the genus Rhodanobacter should be reevaluated. |
Childhood lead poisoning associated with gold ore processing: a village-level investigation - Zamfara State, Nigeria, October-November 2010
Lo YC , Dooyema CA , Neri A , Durant J , Jefferies T , Medina-Marino A , de Ravello L , Thoroughman D , Davis L , Dankoli RS , Samson MY , Ibrahim LM , Okechukwu O , Umar-Tsafe NT , Dama AH , Brown MJ . Environ Health Perspect 2012 120 (10) 1450-5 BACKGROUND: During May-June 2010, a childhood lead poisoning outbreak related to gold-ore-processing was confirmed in 2 villages in Zamfara State, Nigeria. During June-September, villages with suspected or confirmed childhood lead poisoning continued to be identified in Zamfara State. OBJECTIVES: We investigated the extent of childhood lead poisoning (≥1 child with a blood lead level [BLL] ≥10 microg/dL) and lead contamination (≥1 soil/dust sample with a lead level >400 parts per million) among villages in Zamfara State and identified villages that should be prioritized for urgent interventions. METHODS: We used chain-referral sampling to identify villages of interest, defined as villages suspected of participation in gold-ore-processing during the previous 12 months. We interviewed villagers, determined BLLs among children aged <5 years, and analyzed soil/dust from public areas and homes for lead. RESULTS: We identified 131 villages of interest and visited 74 (56%) villages in 3 local government areas. Fifty-four (77%) of 70 villages that completed the survey reported gold-ore-processing. Ore-processing villages were more likely to have ≥1 child aged <5 years with lead poisoning (68% vs. 50%, p=0.17) or death following convulsions (74% vs. 44%, p=0.02). Soil/dust contamination and BLL ≥45 microg/dL were identified in ore-processing villages only [50% (p<0.001) and 15% (p=0.22), respectively]. The odds of childhood lead poisoning or lead contamination was 3.5 times as high in ore-processing villages than the other villages (95% CI: 1.1, 11.3). CONCLUSION: Childhood lead poisoning and lead contamination were widespread in surveyed areas, particularly among villages that had processed ore recently. Urgent interventions are required to reduce lead exposure, morbidity, and mortality in affected communities. |
Status of rubella and congenital rubella syndrome surveillance, 2005-2009, the World Health Organization European Region
Zimmerman LA , Muscat M , Jankovic D , Goel A , Bang H , Khetsuriani N , Martin R . J Infect Dis 2011 204 Suppl 1 S381-8 BACKGROUND: The World Health Organization European Region has a goal for rubella elimination and congenital rubella syndrome (CRS) prevention. Although all Member States recommend a rubella-containing vaccine in their national immunization programs, rubella and CRS continue to occur, and surveillance quality varies throughout the region. METHODS: To describe the status of regional rubella and CRS surveillance and assess progress toward elimination, we reviewed surveillance practices by surveying all 53 Member States and analyzed rubella and CRS surveillance data during 2005-2009. RESULTS: Overall, 41 (91%) of 45 responding Member States have nationwide rubella surveillance, and 39 (87%) have nationwide CRS surveillance. During 2005-2009, rubella cases reported in the region decreased by 94% from 206,359 cases to 11,623 cases. The greatest decrease (99%) was observed in newly independent states of the former Soviet Union. In the rest of the region, high rubella incidence was observed in Poland, Romania, Italy, and San Marino during 2005-2008 and in Poland, Bosnia and Herzegovina, and Austria in 2009. A total of 68 CRS cases were reported during 2005-2009. CONCLUSIONS: As the foundation to achieving and verifying rubella elimination, high-quality rubella and CRS surveillance needs to be implemented and sustained in all Member States. |
Investigation of increased rates of isolation of bacillus species
Meites E , Taur Y , Marino L , Schaefer M , Eagan J , Jensen B , Williams M , Kamboj M , Srinivasan A . Infect Control Hosp Epidemiol 2010 31 (12) 1257-63 BACKGROUND: In 2007-2008, several US hospitals reported summertime increases in the number of clinical blood cultures positive for Bacillus species, which are common environmental bacteria. OBJECTIVE: To investigate increased rates of isolation of Bacillus species from blood cultures, identify risk factors, and recommend control strategies. DESIGN: Survey and case-control study. SETTING: Multiple hospitals, including a cancer center. METHODS: We surveyed 24 facilities that reported increases. We also conducted a field investigation at a hospital with a high rate, reviewing charts, collecting clinical and environmental isolates, and observing infection control procedures. A case-control study compared inpatient case patients who had any blood culture positive for Bacillus with unmatched control patients who had a blood culture with no growth during June-August 2008. RESULTS: Among surveyed facilities, mean monthly rates rose from 25 to a peak of 75 Bacillus-positive blood cultures per 10,000 blood cultures performed during the period June-August. At the hospital where the case-control investigation was conducted, for most case patients (75%), the Bacillus-positive blood cultures represented contamination or device colonization rather than infection. We enrolled 48 case patients and 48 control patients; in multivariate analysis, only central venous access device use was significantly associated with case status (odds ratio, 14.0; [Formula: see text]). Laboratory testing identified at least 12 different Bacillus species (non-anthracis) among the isolates. Observation of infection control procedures revealed variability in central line care and blood sample collection techniques. CONCLUSIONS: Periodic increases in the environmental load of Bacillus species may occur in hospitals. Our investigation indicated that at one facility, these increases likely represented a pseudo-outbreak of Bacillus species colonizing central venous lines or their accessories, such as needleless connector devices. Vigilant attention should be paid to infection control practices when collecting blood samples for culture, to minimize the risk of contamination by environmental microorganisms. |
Characteristics of complementary and alternative medicine use among adults with current asthma, 2006
Marino LA , Shen J . J Asthma 2010 47 (5) 521-5 BACKGROUND: Prevalence estimates of complementary and alternative medicine (CAM) use among persons with asthma vary widely; prior studies reported that patients do not discuss CAM use with their physicians. The authors examined the prevalence and characteristics of CAM use among adults with asthma to prepare physicians to discuss CAM use with their patients. METHODS: CAM use among adults with current asthma was analyzed using the 2006 Behavioral Risk Factor Surveillance System (BRFSS) data from a subset of 25 states that completed the follow-up Asthma Callback Survey. CAM use was defined as a "Yes" response to the use of one or more CAM therapies to control asthma during the previous 12 months. Statistics were calculated using SAS v9.2 Proc Surveyfreq to provide weighted estimates and account for complex sample design. RESULTS: The prevalence of CAM use among adults with asthma was 39.6% (95% confidence interval [CI] = 36.9-42.3). There was no significant association with CAM use by sex, race/ethnicity, age, education, or geographic region. After adjusting for demographics and region, CAM use was significantly higher among persons with (1) financial barriers to asthma care (odds ratio [OR] = 2.8, 95% CI = 1.9-4.1); (2) an emergency room (ER) visit due to asthma (OR = 1.7 95% CI = 1.1-2.6); and (3) ≥14 asthma-associated disability days during the previous year (OR = 2.1, 95% CI = 1.4-3.1). CONCLUSIONS: CAM use is common among adults with asthma. It is associated with financial barriers to asthma care and poor asthma control. Physicians should discuss CAM use with their asthma patients. |
The influence of the multi-basic cleavage site of the H5 hemagglutinin on the attenuation, immunogenicity and efficacy of a live attenuated influenza A H5N1 cold-adapted vaccine virus
Suguitan AL Jr , Marino MP , Desai PD , Chen LM , Matsuoka Y , Donis RO , Jin H , Swayne DE , Kemble G , Subbarao K . Virology 2009 395 (2) 280-8 A recombinant live attenuated influenza virus DeltaH5N1 vaccine with a modified hemagglutinin (HA) and intact neuraminidase genes from A/Vietnam/1203/04 (H5N1) and six remaining genome segments from A/Ann Arbor/6/60 (H2N2) cold-adapted (AA ca) virus was previously shown to be attenuated in chickens, mice and ferrets. Evaluation of the recombinant H5N1 viruses in mice indicated that three independent factors contributed to the attenuation of the DeltaH5N1 vaccine: the attenuating mutations specified by the AA ca loci had the greatest influence, followed by the deletion of the H5 HA multi-basic cleavage site (MBS), and the constellation effects of the AA genes acting in concert with the H5N1 glycoproteins. Restoring the MBS in the H5 HA of the vaccine virus improved its immunogenicity and efficacy, likely as a consequence of increased virus replication, indicating that removal of the MBS had a deleterious effect on the immunogenicity and efficacy of the DeltaH5N1 vaccine in mice. |
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