Occult Nosocomial Infections

Even with a good surveillance program, nosocomial infections may be not recognized because of several reasons: absence of symptoms or prolonged incubation period (eg, viral bloodborne infections, tuberculosis); problems with the microbiological diagnosis, because adequate specimens may be difficult to obtain or special methods should be used (eg, fungal infections, virus, new agents); shorter hospital stays (eg, surgical-site infections); difficulty in distinguishing between nosocomial and community-acquired infections (eg, influenza); and failure to detect clinically relevant colonization (eg, multiresistant microorganisms). Because of the important potential consequences of occult nosocomial infections, specific surveillance programs should be designed to address these problem

Passive Temperature-Compensating Technique for Microstructured Fiber Bragg Gratings

The thermal drift of the characteristic wavelength of fiber Bragg gratings (FBGs) photowritten in the core of microstructured fibers (MOFs) is significantly reduced by inserting a liquid of suitable refractive index into their holes. For instance, the spectral range of variations is divided by a factor of 4 over a temperature range larger than 20\degree C in a six-hole MOF, and the maximum sensitivity is reduced. Such passive FBG temperature compensation technique is of great interest for applications involving accurate sensing free of thermal effects

Molecular Epidemiology of Methicillin-Resistant Staphyloccocus aureus at a Low-Incidence Hospital over a 4-Year Period

Abstract Objective: To study the epidemiology of methicillin-resistant Staphylococcus aureus (MRSA) over a prolonged period of time with the aid of a molecular typing method (ribotyping). Setting: A 1,000-bed tertiary university medical center. Patients and Methods: Defined epidemiological data were recorded for all patients culture-positive for MRSA between 1989 and 1992. Ribotyping of MRSA strains was performed using three restriction enzymes: EcoRv, HindHI, and KpnI. Results: From 1989 to 1992, MRSA was isolated from clinical specimens in 98 patients and from surveillance cultures in 27 patients. Among the 122 isolates available for typing, 26 different ribotypes were identified. In 20% of the cases, MRSA was community-acquired, and a third of these patients never had been hospitalized previously. Nine ribotypes were responsible for more than one case (2 to 64 patients); 17 appeared only once. Epidemiological data correlated with ribotyping results revealed 14 epidemiologic clusters involving six different ribotypes, whereas only three outbreaks were suspected initially. The median follow-up after the last isolation of a given ribotype was 14 months (range, 1 to 42) for clusters and 25 months (range, 1 to 46) for ribotypes that appeared only once. During clusters, only 16% of the cases occurred after the implementation of control measures in the ward (breakthrough cases). Conclusions: The high diversity of MRSA strains observed over 4 years suggested that new strains were introduced continuously in our hospital. Furthermore, that 17 ribotypes were isolated only once, that breakthrough cases represented only 16% of the cases in clusters, and that the follow-up duration after the last isolation of a given ribotype was more than 14 months suggest that infection control measures were effective in limiting the nosocomial spread of MRSA over a prolonged period of tim

La etnografía de las prácticas ordinarias de escritura como contribución a una antropología de la educación

Este texto se presentó como comunicación al II Congreso Internacional de Etnografía y Educación: Migraciones y Ciudadanías. Universidad Autónoma de Barcelona, Barcelona, 5-8 Septiembre 2008.El aprendizaje de la escritura, como el de la lectura, constituye un aprendizaje fundamental que está en el centro de las enseñanzas de la escuela elemental. Una vez adquiridas las bases indispensables de la literacy, los alumnos, dentro y fuera del sistema escolar, ponen en ejecución estos aprendizajes de maneras muy diversas. Los utilizan, desde luego, en el marco de los ejercicios escolares exigidos por la institución pero también en una multitud de situaciones fuera de este marco. La etnografía no puede limitarse a describir únicamente las situaciones escolares, debe interesarse por el conjunto de prácticas de los alumnos. Una de éstas presenta un interés particular para el etnólogo: la escritura personal, íntima, dentro y fuera de la escuela. En efecto, tan pronto el saber elemental es adquirido, lo vuelven a investir en usos personales, íntimos o para afirmar una identidad. Es lo que observamos estudiando las prácticas de escritura de los alumnos en el colegio y particularmente las de las muchachas. Los temas tratados en estas producciones escritas son casi siempre los mismos: las amigas, las fiestas, las vacaciones, los amores, las penas, las inquietudes y las discusiones. Ese vaivén de la intimidad a la escena pública, de lo individual a lo colectivo constituye la trama de una experimentación de la vida que no es sólo un juego (aunque también lo es) pero otro aprendizaje, diferente, parecido al que los antropólogos suelen estudiar en las sociedades sin escuela y sin escritura. Esta comunicación pretende describir y analizar este mundo mal conocido. Refiriéndonos a una serie de estudios realizados en el Centro de Antropología de Toulouse sobre el tema de "las escrituras ordinarias", intentaremos mostrar cómo, hoy en día, el acceso a una identidad, social, personal y de género es un proceso complejo que se desarrolla forzosamente dentro y fuera de la escuela y en el cual las prácticas a la vez íntimas y compartidas de una escritura invisible o ilegítima desde el punto de vista de la institución pueden jugar un papel decisivo desde el punto de vista de los jóvenes adolescentes

A study of users documents memory for the design of personal information systems

This study aims at finding out which attributes (e.g., names, location etc.) people actually recall about their own documents (electronic and paper), and how they recall them, in order to provide recommendations on how to design tools that allow users to retrieve their electronic files more effectively and more easily. A quasi-experiment was conducted with fourteen participants at their workplace. They were asked first to recall features about one (or several) of their own work document(s), and secondly to find these documents. First of all, when participants were asked to find their document(s), they only used a small subset of the attributes they were able to recall, and often they had difficulties in finding their document(s), with current available tools. This correlates with the need for better tools for retrieval. In addition, the results indicate which document attributes are more often recalled (e.g., keywords) but also which ones are best recalled, that is with less errors (e.g. type). Thus, results indicate which attributes are candidate for facilitating file retrieval. Results also provide potential recommendations on: how the retrieval system should allow users to express these attributes; how the retrieval system should include a tolerance in the results to overcome the unreliable nature of memory; and what particular information in relation to the use of files should be tracked by the system. Finally, results suggest that the design of search tools could exploit the fact that the recall of document attributes depend on the type of user and the frequency of use of the files

Quantitative Antibiogram as a Typing Method for the Prospective Epidemiological Surveillance and Control of MRSA Comparison with Molecular Typing

Abstract Objective: Evaluation of the quantitative antibiogram as an epidemiological tool for the prospective typing of methicillin-resistant Staphylococcus aureus (MRSA), and comparison with ribotyping. Methods: The method is based on the multivariate analysis of inhibition zone diameters of antibiotics in disk diffusion tests. Five antibiotics were used (erythromycin, clindamycin, cotrimoxazole, gentamicin, and ciprofloxacin). Ribotyping was performed using seven restriction enzymes (EcoRV, HindIII, KpnI, PstI, EcoRI, SfuI, and BamHI). Setting: 1,000-bed tertiary university medical center. Results: During a 1-year period, 31 patients were found to be infected or colonized with MRSA. Cluster analysis of antibiogram data showed nine distinct antibiotypes. Four antibiotypes were isolated from multiple patients (2, 4, 7, and 13, respectively). Five additional antibiotypes were isolated from the remaining five patients. When analyzed with respect to the epidemiological data, the method was found to be equivalent to ribotyping. Among 206 staff members who were screened, six were carriers of MRSA. Both typing methods identified concordant of MRSA types in staff members and in the patients under their care. Conclusions: The quantitative antibiogram was found to be equivalent to ribotyping as an epidemiological tool for typing of MRSA in our setting. Thus, this simple, rapid, and readily available method appears to be suitable for the prospective surveillance and control of MRSA for hospitals that do not have molecular typing facilities and in which MRSA isolates are not uniformly resistant or susceptible to the antibiotics teste