Evolutionary approaches to sexually transmitted infections

Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/87105/1/j.1749-6632.2011.06078.x.pd

Response

Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/28947/1/0000784.pd

Epidemiology of neonatal sepsis in South Korea

Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/72115/1/j.1442-200X.2008.02685.x.pd

Mastitis among lactating women: Occurrence and risk factors

Puerperal mastitis is a potentially serious illness among lactating women which traditionally has been thought to be associated with primiparity, stress, improper nursing technique, and incomplete emptying of the breast. However, none of these putative associations has been examined analytically in recent years. Further, the incidence of mastitis in the United States has not been estimated since 1975, although the prevalence of breastfeeding has increased dramatically since then. In this retrospective cohort study of 966 lactating women, the cumulative incidence of mastitis in the first seven weeks postpartum was 2.9%. This incidence was associated with professional, technical, or managerial occupation in both parents (rate RATIO = 12.29; 95% CI: 1.62, 93.43) and with giving birth in the hospital delivery room, rather than the labor room (rate RATIO = 4.05; 95% CI: 0.92, 17.83). Parity was not associated with risk of mastitis in this sample.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/29639/1/0000728.pd

Recall of age of weaning and other breastfeeding variables

BACKGROUND: Many studies of the impact of breastfeeding on child or maternal health have relied on data reported retrospectively. The goal of this study was to assess recall accuracy among breastfeeding mothers of retrospectively collected data on age of weaning, reasons for cessation, breast pain, lactation mastitis, and pumping. METHODS: Women in Michigan and Nebraska, U.S.A. were interviewed by telephone every 3 weeks during the first 3 months after the birth of their child, and mailed a questionnaire at 6 months. A subset was interviewed again by telephone approximately 1–3.5 years after the birth. The results for the three recall periods, collected 1994–1998, were compared using correlation, linear and Cox regression analysis, and sensitivity and specificity estimates. RESULTS: The 184 participants were aged 18–42, mostly white (95%) and 63% had an older child. The age of weaning tended to be overestimated in interviews 1–3.5 years after birth compared to those within 3 weeks of the event, by approximately one month for 1–3.5 year recall and two weeks for 6-month recall (p < 0.001 in both cases). Recall accuracy of reasons for weaning varied greatly by reason, with mastitis and return to work having the most recall validity. The sensitivity of 1–3.5 year recall of mastitis was 80%, but was only 54% for nipple cracks or sores. CONCLUSION: Breastfeeding duration among short-term breastfeeders tended to be somewhat overestimated when measured at 1–3.5 years post-partum. Reporting of other breastfeeding characteristics had variable reliability. Studies employing retrospective breastfeeding data should consider the possibility of such errors

Conceptualizing Human Microbiota: From Multicelled Organ to Ecological Community

The microbiota of a typical, healthy human contains 10 times as many cells as the human body and incorporates bacteria, viruses, archea, protozoans, and fungi. This diverse microbiome (the collective genomes of the microbial symbionts that inhabit a human host) is essential for human functioning. We discuss the unstated assumptions and implications of current conceptualizations of human microbiota: (1) a single unit that interacts with the host and the external environment; a multicelled organ; (2) an assemblage of multiple taxa, but considered as a single unit in its interactions with the host; (3) an assemblage of multiple taxa, which each interacts with the host and the environment independently; and (4) a dynamic ecological community consisting of multiple taxa each potentially interacting with each other, the host, and the environment. Each conceptualization leads to different predictions, methodologies, and research strategies

Healthcare Workers’ Hand Microbiome May Mediate Carriage of Hospital Pathogens

One function of skin microbiota is to resist colonization and infection by external microorganisms. We sought to detect whether the structure of the hand microbiota of 34 healthcare workers (HCW) in a surgical intensive care unit mediates or modifies the relationship between demographic and behavioral factors and potential pathogen carriage on hands after accounting for pathogen exposure. We used a taxonomic screen (16S rRNA) to characterize the bacterial community, and qPCR to detect presence of Staphylococcus aureus, Enterococcus spp., methicillin-resistant Staphylococcus aureus (MRSA), and Candida albicans on their dominant hands. Hands were sampled weekly over a 3-week period. Age, hand hygiene, and work shift were significantly associated with potential pathogen carriage and the associations were pathogen dependent. Additionally, the overall hand microbiota structure was associated with the carriage of potential pathogens. Hand microbiota community structure may act as a biomarker of pathogen carriage, and modifying that structure may potentially limit pathogen carriage among HCW

The association between handwashing practices and illness symptoms among college students living in a university dormitory

http://deepblue.lib.umich.edu/bitstream/2027.42/61178/1/Thumma J, Aiello AE, Foxman B, The association between handwashing practices and illness symptoms among college students living in a university dormitory_2008.pd

Prevalence and risk factors for vaginal Candida colonization in women with type 1 and type 2 diabetes

BACKGROUND: Diabetes mellitus increases the rate of vaginal colonization and infection with Candida species METHODS: We surveyed women with diabetes receiving care at either an urban or suburban diabetes clinic to examine the relationship between vaginal Candida colonization, diabetes type and duration, and HbA(1c) level. 101 participants completed the self-administered questionnaire and self-collected a vaginal swab for Candida culture. Candida colonization was similar by age and race. RESULTS: Type 1 diabetics were three times as likely as type 2 diabetics to be colonized with any Candida species (OR = 3.4; 95% CI: 1.03, 11.41; p = 0.04); even after adjusting for abnormal HbA(1c), which had an independent effect (OR = 1.4; 95% CI: 1.04, 1.76; p = 0.02). Recent antibiotic use (OR = 4.5; 95% CI: 1.18, 16.79; p = 0.03), lifetime history of chlamydia (OR = 5.8; 95% CI: 1.09, 30.54; p = 0.04), and performing oral sex during the past 2 weeks (OR = 4.9; 95% CI:0.84, 28.27; p = 0.08) were also associated with Candida carriage after adjusting for diabetic type and abnormal HbA(1c). C. albicans was isolated from the majority of colonized type 1 participants (56%), while C. glabrata was the most common isolate among colonized type 2 participants (54%). CONCLUSIONS: Improving glucose control and possibly modifying sexual behavior may reduce risk of Candida colonization, and potentially symptomatic infection, among women with diabetes

Choosing an appropriate bacterial typing technique for epidemiologic studies

A wide variety of bacterial typing systems are currently in use that vary greatly with respect to the effort required, cost, reliability and ability to discriminate between bacterial strains. No one technique is optimal for all forms of investigation. We discuss the desired level of discrimination and need for a biologic basis for grouping strains of apparently different types when using bacterial typing techniques for different epidemiologic applications: 1) confirming epidemiologic linkage in outbreak investigations, 2) generating hypotheses about epidemiologic relationships between bacterial strains in the absence of epidemiologic information, and 3) describing the distributions of bacterial types and identifying determinants of those distributions. Inferences made from molecular epidemiologic studies of bacteria depend upon both the typing technique selected and the study design used; thus, choice of typing technique is pivotal for increasing our understanding of the pathogenesis and transmission, and eventual disease prevention