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The International Atomic Energy Agency organized a technical meeting at its headquarters in Vienna, Austria, in 2022 that included 17 experts representing 12 countries, whose research spanned the development and use of radiolabeled agents for imaging infection. The meeting focused largely on bacterial pathogens. The group discussed and evaluated the advantages and disadvantages of several radiopharmaceuticals, as well as the science driving various imaging approaches. The main objective was to understand why few infection-targeted radiotracers are used in clinical practice despite the urgent need to better characterize bacterial infections. This article summarizes the resulting consensus, at least among the included scientists and countries, on the current status of radiopharmaceutical development for infection imaging. Also included are opinions and recommendations regarding current research standards in this area. This and future International Atomic Energy Agency-sponsored collaborations will advance the goal of providing the medical community with innovative, practical tools for the specific image-based diagnosis of infection.
- Klíčová slova
- antibiotics, development, infection, molecular imaging, radiotracer,
- MeSH
- bakteriální infekce * diagnostické zobrazování MeSH
- lidé MeSH
- radiofarmaka * MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
- Názvy látek
- radiofarmaka * MeSH
OBJECTIVES: Surgical site infections (SSIs) are a frequent complication of surgical procedures and one of the most common forms of hospital acquired infection (HAI). National/international guidelines and recommendations have been issued for prevention. The objective of this study was to observe the behaviour of healthcare workers engaged in surgical procedures and hence assess compliance with SSI guidelines. METHODS: An observational descriptive study was conducted at a University hospital in southern Italy. A specifically designed form was used to record the actions of the surgical team during randomly selected surgical operations. Observations comprised the use of surgical attire, the frequency of doors opening and the number of staff in the operating room. RESULTS: A total of 308 operating room personnel was observed during 402 surgical procedures: 127 surgeons (41%), 39 anaesthesiologists (13%), 62 nurses (20%) and 80 students in training (26%). 96% of the surgical team wore scrubs, 93% of health workers wore a mask and of these 78% wore it correctly in order to completely cover the nose, mouth and beard (when present), 99% wore a cap (only in 48% was the hair completely covered), 50% of the operators wore gloves, 95% wore shoes dedicated to the operating theater and 23% also wore shoe covers, 56% wore gowns, and 22% had eye protection. Furthermore, the average number of health personnel in the operating theater was 8, the doors remained closed in 261 (65%) surgical operations. CONCLUSION: As the results indicated a low adherence to international guidelines among the personnel, it is suggested that training courses should be provided to increase staff awareness on prevention and management of HAI.
- Klíčová slova
- attitude, infection control, international guidelines, operating room, practice, surgical site infection,
- MeSH
- dodržování směrnic statistika a číselné údaje MeSH
- infekce chirurgické rány prevence a kontrola MeSH
- infekce spojené se zdravotní péčí prevence a kontrola MeSH
- lidé MeSH
- ochranné oděvy statistika a číselné údaje MeSH
- operační sály * MeSH
- personál nemocniční psychologie statistika a číselné údaje MeSH
- směrnice pro lékařskou praxi jako téma MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
- Geografické názvy
- Itálie MeSH
AIM: This study aimed to quantify types and frequencies of missed infection control care and to develop a theoretical model for estimating nurses' consensus scores about this form of missed care. DESIGN: A non-experimental research design using self-audit data was selected to collect information about the types and frequencies of missed infection control care from nurses employed in hospitals located in three different countries. Data collection commenced mid-year 2018. METHODS: A multivariate approach was used to apply the consensus scores of 1.911 internationally based nurses in the missed opportunities for maintaining infection control. RESULTS/FINDINGS: Thirteen variables exert direct effects on the nurses' total scores underpinning missed infection control care. These include the methods used to prevent hospital-acquired infections, surveillance and hand hygiene practices. Significant nurses' demographic factors also included their countries of origin, employment status, employer type, job retention intentions, work intensity, length of clinical experience and staff development attendance. CONCLUSION: In magnitude of importance and having the largest effect on missed infection control care is missed care related to reducing hospital-acquired infections followed closely by surveillance. Missed infection control care can be quantified, and variances in its practices can be accounted by exploring the nurses' differing demographic factors, including the nurses' country of origin. IMPACT: Variations in missed infection control care can be accounted for across three countries. While ward hygiene is underestimated by staff as a mechanism to minimize nosocomial infections, infection control surveillance remains the key to reducing hospital-acquired infections. The study's outcomes invite the use of an ongoing, whole-of-organization approach to infection control with scrutiny being needed for improved staff adherence particularly with hand hygiene.
- Klíčová slova
- hand hygiene, infection control, missed care, modelling, nurses,
- MeSH
- hygiena rukou * MeSH
- infekce spojené se zdravotní péčí * prevence a kontrola MeSH
- kontrola infekce MeSH
- lidé MeSH
- nemocnice MeSH
- personál sesterský nemocniční * MeSH
- úmysl MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
An unusual case of a primary cutaneous Absidia corymbifera infection in a premature twin successfully treated with low doses of intravenous amphotericin B and topical natamycin is described. Epidemiological and therapeutical aspects of the case are discussed and in vitro antifungal susceptibility data are presented.
- MeSH
- Absidia izolace a purifikace MeSH
- infekční nemoci kůže * diagnóza farmakoterapie epidemiologie MeSH
- lidé MeSH
- mukormykóza * diagnóza farmakoterapie epidemiologie MeSH
- novorozenec MeSH
- předčasná porodní činnost MeSH
- těhotenství MeSH
- Check Tag
- lidé MeSH
- novorozenec MeSH
- těhotenství MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- kazuistiky MeSH
- práce podpořená grantem MeSH
Associations between different infectious agents and obesity have been reported in humans for over thirty years. In many cases, as in nosocomial infections, this relationship reflects the greater susceptibility of obese individuals to infection due to impaired immunity. In such cases, the infection is not related to obesity as a causal factor but represents a complication of obesity. In contrast, several infections have been suggested as potential causal factors in human obesity. However, evidence of a causal linkage to human obesity has only been provided for adenovirus 36 (Adv36). This virus activates lipogenic and proinflammatory pathways in adipose tissue, improves insulin sensitivity, lipid profile and hepatic steatosis. The E4orf1 gene of Adv36 exerts insulin senzitizing effects, but is devoid of its pro-inflammatory modalities. The development of a vaccine to prevent Adv36-induced obesity or the use of E4orf1 as a ligand for novel antidiabetic drugs could open new horizons in the prophylaxis and treatment of obesity and diabetes. More experimental and clinical studies are needed to elucidate the mutual relations between infection and obesity, identify additional infectious agents causing human obesity, as well as define the conditions that predispose obese individuals to specific infections.
- MeSH
- adenovirové infekce lidí diagnóza epidemiologie MeSH
- infekce spojené se zdravotní péčí diagnóza epidemiologie MeSH
- infekční nemoci diagnóza epidemiologie MeSH
- lidé MeSH
- obezita diagnóza epidemiologie MeSH
- zvířata MeSH
- Check Tag
- lidé MeSH
- zvířata MeSH
- Publikační typ
- časopisecké články MeSH
- práce podpořená grantem MeSH
- přehledy MeSH
BACKGROUND: Clostridioides difficile infections (CDI) are traditionally attributed to an older adult patient group but children can also be affected. Although the causative pathogen is the same in both populations, the management of CDI may differ. OBJECTIVES: To discuss the current literature on CDI in the paediatric population and to provide CDI diagnostics and treatment guidance. SOURCES: The literature was drawn from a search of PubMed from January 2017 to July 2021. CONTENT: In the paediatric population, laboratory diagnostics for CDI should preferably be combined with laboratory diagnostics for other gastrointestinal pathogens. Coinfections of CDI are also possible. Though the detection of toxigenic C. difficile using a molecular assay may simply reflect colonisation rather than infection, detection of C. difficile free toxins A/B in faeces is much more indicative of true infection. CDI in children below 2 years of age and in the absence of risk factors is very difficult to diagnose and requires careful clinical judgement pending additional studies. Fidaxomicin has been shown to be superior to vancomycin with a sustained clinical response up to 30 days after the end of CDI treatment in children. Metronidazole is less effective than vancomycin in adults and there are no supporting data for its use in children. In recurrent CDI, treatment should be adjusted according to the drug or drug regimen used for the treatment of a previous episode(s). In multiple recurrent CDI, faecal microbiota transplantation can be effective. IMPLICATIONS: If CDI laboratory testing is indicated in children with diarrhoea, the likelihood of C. difficile colonisation and coinfection with other intestinal pathogens should be considered. The currently available data support a change in the treatment strategy of CDI in children.
- Klíčová slova
- Diagnostics, Faecal microbiota transplant, Fidaxomicin, Paediatrics, Vancomycin,
- MeSH
- antibakteriální látky terapeutické užití MeSH
- Clostridioides difficile * MeSH
- dítě MeSH
- fidaxomicin terapeutické užití MeSH
- klostridiové infekce * diagnóza epidemiologie terapie MeSH
- lidé MeSH
- senioři MeSH
- vankomycin terapeutické užití MeSH
- Check Tag
- dítě MeSH
- lidé MeSH
- senioři MeSH
- Publikační typ
- časopisecké články MeSH
- přehledy MeSH
- Názvy látek
- antibakteriální látky MeSH
- fidaxomicin MeSH
- vankomycin MeSH
BACKGROUND: The focal infection theory has been used to explain several chronic systemic diseases in the past. Systemic diseases were thought to be caused by focal infections, such as caries and periodontal diseases, and dentists were held responsible for these diseases due to the spread of oral infections. As knowledge of the interrelationship between oral microorganisms and the host immune response has evolved over the last few decades, the focal infection theory has been modified in various ways. The relationship between oral and systemic health appears to be more complex than that suggested by the classical theory of focal infections. Indeed, the contribution of the oral microbiota to some systemic diseases is gaining acceptance, as there are strong associations between periodontal disease and atherosclerotic vascular disease, diabetes, and hospital-associated pneumonia, amongst others. As many jurisdictions have various protocols for managing this oral-systemic axis of disease, we sought to provide a consensus on this notion with the help of a multidisciplinary team from the Czech Republic. METHODS: A multidisciplinary team comprising physicians/surgeons in the specialities of dentistry, ear-nose and throat (ENT), cardiology, orthopaedics, oncology, and diabetology were quetioned with regard to their conceptual understanding of the focal infection theory particularly in relation to the oral-systemic axis. The team also established a protocol to determine the strength of these associations and to plan the therapeutic steps needed to treat focal odontogenic infections whenever possible. RESULTS: Scoring algorithms were devised for odontogenic inflammatory diseases and systemic risks, and standardised procedures were developed for general use. CONCLUSIONS: The designed algorithm of the oral-systemic axis will be helpful for all health care workers in guiding their patient management protocol.
- Klíčová slova
- Focal infection, Microbiota, Oral health, Systemic diseases,
- MeSH
- fokální infekce zubní * komplikace terapie MeSH
- konsensus MeSH
- lidé MeSH
- nemoci parodontu terapie MeSH
- týmová péče o pacienty MeSH
- zubní kaz terapie MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
- konsensus - konference MeSH
- Geografické názvy
- Česká republika MeSH
In spite of its incidence decreasing to 1% nowadays, prosthesis-related infection remains a research, diagnostic, therapeutic and cost-related problem. It can be defined as a presence of bacteria in the artificial joint space, which is significantly associated with evident laboratory and/or tissue markers, and clinical signs of running infection. We believe that the more precise understanding of pathogenesis, the more effective preventative and therapeutic measures, and the lower infection rate. The implants are colonized by airborne, skin-, and/ or surgeon-related bacteria during surgery despite being operated in closely respected operating regime. Some prosthetic characteristics are advantageous and may play important roles in the process of bacterial adherence. After successful attachment on the biomaterial surface bacteria multiply and physiologically transform into a "biofilm" community, making them much more resistant to antibiotic therapy and host immunity. Bacterial resistance is a complex phenomenon influenced by intrinsic and extrinsic factors, including the cell configuration in the biofilm community. So the cure of periprosthetic sepsis without removing of all foreign bodies and necrotic bone fragments is often ineffective. Acute hematogenous sepsis is suggestive of a distortion of a previously aseptic joint space by invasion of bacteria through the vessels.
A case of disseminated infection with Nocardia asteroides in a 55-year-old immunocompetent woman after mild trauma to the arm is reported. Secondary dissemination was identified in the skin, right kidney, liver, peritoneal cavity, lungs and thigh. The patient was successfully treated with surgical drainage and a 9-week course of antibiotics including cefotaxime, amikacin, chloramphenicol, trimethoprim/sulfamethoxazole (TMP/SMX) and doxycycline. The administration of TMP/SMX in combination with doxycycline was clinically beneficial despite in vitro resistance.
- MeSH
- absces jater farmakoterapie mikrobiologie MeSH
- imunokompetence MeSH
- lidé středního věku MeSH
- lidé MeSH
- následné studie MeSH
- Nocardia asteroides * izolace a purifikace MeSH
- nokardióza diagnóza diagnostické zobrazování etiologie MeSH
- počítačová rentgenová tomografie MeSH
- poranění paže komplikace MeSH
- Check Tag
- lidé středního věku MeSH
- lidé MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- kazuistiky MeSH
CLINICAL PRESENTATION: Case history of a paediatric patient with a cochlear implant and a surgical site infection that developed as a result of acute otitis media is presented. INTERVENTION: After conservative management including wound debridement it was decided to explant a functioning device. OBJECTIVE AND IMPORTANCE: In a number of cases, it is necessary to remove the infected albeit functioning device, especially in the event of formation of the biofilm has occurred. It is necessary to review and evaluate the methods with which these major complications are routinely managed with the aim to increase the survival ratio for the implanted device.
- Klíčová slova
- Biofilm, Cochlear, Implants, Infection, Wound,
- MeSH
- biofilmy * MeSH
- infekce chirurgické rány mikrobiologie chirurgie MeSH
- infekce spojené s protézou mikrobiologie chirurgie MeSH
- kochleární implantace škodlivé účinky MeSH
- kochleární implantáty škodlivé účinky MeSH
- lidé MeSH
- odstranění implantátu metody MeSH
- otitis media mikrobiologie chirurgie MeSH
- předškolní dítě MeSH
- Check Tag
- lidé MeSH
- mužské pohlaví MeSH
- předškolní dítě MeSH
- Publikační typ
- časopisecké články MeSH
- kazuistiky MeSH
