55 research outputs found
Negligence in the Paint: The Case for Applying the Risk Contribution Doctrine to Lead Litigation -- A Response to Gray & Faulk
What Proportion of Patients Meet the Criteria for Uncomplicated Sepsis in an Irish Emergency Department?
Emergency medicine plays a central role in the early recognition of patients presenting to hospital with sepsis. However, the epidemiology of sepsis in the Irish Emergency Department (ED) setting has not been described. The primary aim of this study was to determine the proportion of adult ED patients who meet the current criteria for uncomplicated sepsis. This cross-sectional study was performed in the ED of Beaumont Hospital, Dublin. The clinical records of all patients presenting to the ED over a four-week period were retrospectively screened to determine if they met the current Health Service Executive (HSE) criteria for uncomplicated sepsis. Overall, 3,585 adult patients attended the ED during the study period, with 152 patients meeting the criteria for uncomplicated sepsis. The proportion of ED patients who met the criteria for uncomplicated sepsis was 4.24% (95% CI 3.57-4.91%)
The prevalence of severe sepsis or septic shock in an Irish emergency department
Severe sepsis and septic shock are among the leading causes of death globally. Despite the central role the emergency department (ED) plays in the early identification of patients presenting to hospital with sepsis, the prevalence of severe sepsis and septic shock in the Irish ED setting has not been described. The primary aim of this study was to measure the prevalence of severe sepsis or septic shock in an Irish adult ED setting. The clinical records of patients presenting to the ED over a four-week period were retrospectively reviewed to determine if they met the current Health Service Executive (HSE) criteria for severe sepsis or septic shock. Overall, 3,585 adult patients attended the ED during the study period, with 42 patients meeting the criteria for severe sepsis or septic shock. The ED prevalence of severe sepsis or septic shock was 11.7 patients (95% CI 8.1 – 15.4%) per 1000 ED attendances
Treatment of Clostridium difficile infection: a national survey of clinician recommendations and the use of faecal microbiota transplantation
Adherence to Clostridium difficile infection treatment guidelines is associated with lower recurrence rates and mortality as well as cost savings. Our survey of Irish clinicians indicates that patients are managed using a variety of approaches. FMT is potentially underutilised despite its recommendation in national and European guidelines
PCR-ribotype distribution of Clostridium difficile in Irish pigs
Clostridium difficile is an important enteric pathogen in humans causing infections in the healthcare environment and the community. Carriage of C. difficile and C. difficile-related enterocolitis has been reported in piglets worldwide. The aim of this study was to investigate the rates of C. difficile isolation from pigs in Ireland. Faecal samples from piglet litters and sows were collected from six farms in 2015. The sows were non-diarrhoeal at the time of sampling. The diarrhoeal status of the piglets was unknown. C. difficile was isolated from 34/44 (77%) of piglet litter samples and from 33/156 (21%) of sow samples. The isolation rate in sows varied from 3 to 39% and in piglet litters from 72 to 86% depending on farm location. Toxin A and toxin B were present in 99% (66/67) of isolates; and binary toxin in 85% (57/67). Only PCR-ribotypes 078 (88%) and 193 (12%) were identified in piglets. Seven PCR-ribotypes were detected in sow C. difficile isolates: PCR-ribotypes 078 (67%), 050 (12%), 014/020 (6%), 015 (6%), 029 (3%), 035 (3%) and 193 (3%). This study shows that toxigenic C. difficile strains such as PCR-ribotype 078 can be commonly isolated from pigs at different geographical locations in Ireland. Since PCR-ribotype 078 is frequently found in humans in Ireland, this highlights the potential for interspecies transmission
Painting Over Long-Standing Precedent: How the Rhode Island Supreme Court Misapplied Public Nuisance Law in State v. Lead Industries Association
Using Artificial Intelligence in Infection Prevention
Purpose of Review Artificial intelligence (AI) offers huge potential in infection prevention and control (IPC). We explore its potential IPC benefits in epidemiology, laboratory infection diagnosis, and hand hygiene.
Recent Findings AI has the potential to detect transmission events during outbreaks or predict high-risk patients, enabling development of tailored IPC interventions. AI offers opportunities to enhance diagnostics with objective pattern recognition, standardize the diagnosis of infections with IPC implications, and facilitate the dissemination of IPC expertise. AI hand hygiene applications can deliver behaviour change, though it requires further evaluation in different clinical settings. However, staff can become dependent on automatic reminders, and performance returns to baseline if feedback is removed. Summary Advantages for IPC include speed, consistency, and capability of handling
infinitely large datasets. However, many challenges remain, improving the availability of high-quality representative datasets and consideration of biases within pre-existing
databases are important challenges for future developments. AI in itself will not improve IPC; this requires culture and behaviour change. Most studies to date assess performance
retrospectively so there is a need for prospective evaluation in the real-life, often chaotic, clinical setting. Close collaboration with IPC experts to interpret outputs and ensure clinical relevance is essentia
Airborne transmission of Covid-19: implications for Irish hospitals
The pandemic spread of COVID-19 raises many questions about
its transmissibility. The initial consensus was that spread was primarily by
contact with a contaminated surface and by inhalation of droplets. However,
airborne transmission is increasingly considered probable. Clarifying COVID-19
transmission is crucial for effective infection prevention and control (IPC)
and healthcare worker (HCW) protection. SARS-C0V-2 is more transmissible than
influenza, with a mean reproductive number of 2.65, even if not as high as other
viruses such as measles. Personal protective equipment (PPE) shortages, IPC
lapses, workload intensity and other factors not yet known, may explain
significant hospital transmission during the early stages of the pandemic in
Ireland and elsewhere.</p
Evidence for icaADBC-Independent Biofilm Development Mechanism in Methicillin-Resistant Staphylococcus aureus Clinical Isolates
Synthesis of a polysaccharide adhesin by icaADBC-encoded enzymes is currently the best-understood mechanism of staphylococcal biofilm development. In four methicillin-resistant Staphylococcus aureus isolates, environmental activation of icaADBC did not always correlate with increased biofilm production. Moreover, glucose-mediated biofilm development in these isolates was icaADBC independent. Apparently, an environmentally regulated, ica-independent mechanism(s) of biofilm development exists in S. aureus clinical isolates
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