Randomized controlled trial to determine the impact of probiotic administration on colonization with multidrug-resistant organisms in critically ill patients

This was a randomized controlled pilot study of Lactobacillus rhamnosus GG versus standard of care to prevent gastrointestinal multidrug-resistant organism (MDRO) colonization in ICU patients. Seventy subjects were included in analyses. There were no significant differences in acquisition or loss of any MDROs (p>0.05). There were no probiotic-associated adverse events

Frequency of instrument, environment, and laboratory technologist contamination during routine diagnostic testing of infectious specimens

ABSTRACT Laboratory testing to support the care of patients with highly infectious diseases may pose a risk for laboratory workers. However, data on the risk of virus transmission during routine laboratory testing conducted using standard personal protective equipment (PPE) are sparse. Our objective was to measure laboratory contamination during routine analysis of patient specimens. Remnant specimens were spiked with the nonpathogenic bacteriophage MS2 at 1.0 × 10 7 PFU/ml, and contamination was assessed using reverse transcriptase PCR (RT-PCR) for MS2. Specimen containers were exteriorly coated with a fluorescent powder to enable the visualization of gross contamination using UV light. Testing was performed by two experienced laboratory technologists using standard laboratory PPE and sample-to-answer instrumentation. Fluorescence was noted on the gloves, bare hands, and laboratory coat cuffs of the laboratory technologist in 36/36 (100%), 13/36 (36%), and 4/36 (11%) tests performed, respectively. Fluorescence was observed in the biosafety cabinet (BSC) in 8/36 (22%) tests, on test cartridges/devices in 14/32 (44%) tests, and on testing accessory items in 29/32 (91%) tests. Fluorescence was not observed on or in laboratory instrumentation or adjacent surfaces. In contrast to fluorescence detection, MS2 detection was infrequent (3/286 instances [1%]) and occurred during test setup for the FilmArray instrument and on FilmArray accessory equipment. The information from this study may provide opportunities for the improvement of clinical laboratory safety practices so as to reduce the risk of pathogen transmission to laboratory workers. </jats:p

Co/Ni element ratio in the galactic cosmic rays between 0.8 and 4.3 GeV/nucleon

In a one-day balloon flight of the Trans-Iron Galactic Element Recorder (TIGER) in 1997, the instrument achieved excellent charge resolution for elements near the Fe peak, permitting a new measurement of the element ratio Co/Ni. The best fit to the data, extrapolated to the top of the atmosphere, gives an upper limit for this ratio of 0.093±0.037 over the energy interval 0.8 to 4.3 GeV/nucleon; because a Co peak is not seen in the data, this result is given as an upper limit. Comparing this upper limit with calculations by Webber & Gupta suggests that at the source of these cosmic rays a substantial amount of the electron-capture isotope 59Ni survived. This conclusion is in conflict with the clear evidence from ACE/CRIS below 0.5 GeV/nucleon that there is negligible 59Ni surviving at the source. Possible explanations for this apparent discrepancy are discussed

Assessment of healthcare worker protocol deviations and self-contamination during personal protective equipment donning and doffing

OBJECTIVETo evaluate healthcare worker (HCW) risk of self-contamination when donning and doffing personal protective equipment (PPE) using fluorescence and MS2 bacteriophage.DESIGNProspective pilot study.SETTINGTertiary-care hospital.PARTICIPANTSA total of 36 HCWs were included in this study: 18 donned/doffed contact precaution (CP) PPE and 18 donned/doffed Ebola virus disease (EVD) PPE.INTERVENTIONSHCWs donned PPE according to standard protocols. Fluorescent liquid and MS2 bacteriophage were applied to HCWs. HCWs then doffed their PPE. After doffing, HCWs were scanned for fluorescence and swabbed for MS2. MS2 detection was performed using reverse transcriptase PCR. The donning and doffing processes were videotaped, and protocol deviations were recorded.RESULTSOverall, 27% of EVD PPE HCWs and 50% of CP PPE HCWs made ≥1 protocol deviation while donning, and 100% of EVD PPE HCWs and 67% of CP PPE HCWs made ≥1 protocol deviation while doffing (P=.02). The median number of doffing protocol deviations among EVD PPE HCWs was 4, versus 1 among CP PPE HCWs. Also, 15 EVD PPE protocol deviations were committed by doffing assistants and/or trained observers. Fluorescence was detected on 8 EVD PPE HCWs (44%) and 5 CP PPE HCWs (28%), most commonly on hands. MS2 was recovered from 2 EVD PPE HCWs (11%) and 3 CP PPE HCWs (17%).CONCLUSIONSProtocol deviations were common during both EVD and CP PPE doffing, and some deviations during EVD PPE doffing were committed by the HCW doffing assistant and/or the trained observer. Self-contamination was common. PPE donning/doffing are complex and deserve additional study.Infect Control Hosp Epidemiol 2017;38:1077–1083</jats:sec

Constraints on the nucleosynthesis of refractory nuclides in galactic cosmic rays

Abundances of the isotopes of the refractory elements Ca, Fe, Co, and Ni in the galactic cosmic-ray source are compared with corresponding abundances in solar-system matter. For the 12 nuclides considered, relative abundances agree to within a factor of 2, and typically within 20–30%. In addition, comparisons of cosmic-ray abundances with model calculations of supernova yields are used to argue that cosmic rays contain contributions from stars with a broad range of masses. Based on these and other results we suggest that cosmic rays probably represent a sample of contemporary interstellar matter, at least for refractory species

The cosmic-ray contribution to galactic abundances of the light elements: Interpretation of GCR LiBeB abundance measurements from ACE/CRIS

Inelastic collisions between the galactic cosmic rays (GCRs) and the interstellar medium (ISM) are responsible for producing essentially all of the light elements Li, Be, and B (LiBeB) observed in the cosmic rays. Previous calculations (e.g., [1]) have shown that GCR fragmentation can explain the bulk of the existing LiBeB abundance in the present day Galaxy. However, elemental abundances of LiBeB in old halo stars indicate inconsistencies with this explanation. We have used a simple leaky-box model to predict the cosmic-ray elemental and isotopic abundances of LiBeB in the present epoch. We conducted a survey of recent scientific literature on fragmentation cross sections and have calculated the amount of uncertainty they introduce into our model. The predicted particle intensities of this model were compared with high energy (E_(ISM) = 200–500 MeV/nucleon) cosmic-ray data from the Cosmic Ray Isotope Spectrometer (CRIS), which indicates fairly good agreement with absolute fluxes for Z ≥ 5 and relative isotopic abundances for all LiBeB species

Measurements of the isotopes of lithium, beryllium, and boron from ACE/CRIS

The isotopes of lithium, beryllium, and boron (LiBeB) are known in nature to be produced primarily by CNO spallation and α-α fusion from interactions between cosmic rays and interstellar nuclei. While the dominant source of LiBeB isotopes in the present epoch is cosmic-ray interactions, other sources are known to exist, including the production of ^(7)Li from big bang nucleosynthesis. Precise observations of galactic cosmic-ray LiBeB in addition to accurate modeling of cosmic-ray transport can help to constrain the relative importance among the different production mechanisms. The Cosmic Ray Isotope Spectrometer (CRIS) on the Advanced Composition Explorer (ACE) has measured nuclei with 2 ≲ Z ≲ 30 in the energy range ~30–500 MeV/nucleon since 1997 with good statistical accuracy. We present measurements of the isotopic abundances of LiBeB and discuss these observations in the context of previous cosmic-ray measurements and spectroscopic observations

The Trans-Iron Galactic Element Recorder (TIGER): A Balloon-borne Cosmic-Ray Experiment

TIGER is a balloon-borne cosmic-ray experiment designed to measure the elemental abundances of Galactic Cosmic Rays (GCRs) in the charge range 26<Z<40 with better than 0.25 charge unit( cu) resolution. The experiment consists of a combination of plastic scintillators, plastic and aerogel Cherenkov detectors, and scintillating fiber hodoscopes. TIGER was flown from Fort Sumner, NM aboard a high-altitude balloon on September 24, 1997 at geomagnetic cutoffs between 4.2GV and 3.2GV, and atmospheric depths between 3g/cm^2 and 6g/cm^2. The 23.5-hour balloon flight provided a statistically significant sample of GCR nuclei up through Ni and achieved charge resolution capable of resolving Co from the much more abundant Fe

Estimation of GRB detection by FiberGLAST

FiberGLAST is one of several instrument concepts being developed for possible inclusion as the primary Gamma-ray Large Area Space Telescope (GLAST) instrument. The predicted FiberGLAST effective area is more than 12,000 cm2 for energies between 30 MeV and 300 GeV, with a field of view that is essentially flat from 0°–80°. The detector will achieve a sensitivity more than 10 times that of EGRET. We present results of simulations that illustrate the sensitivity of FiberGLAST for the detection of gamma-ray bursts

Assessment of antibiotic-resistant organism transmission among rooms of hospitalized patients, healthcare personnel, and the hospital environment utilizing surrogate markers and selective bacterial cultures

OBJECTIVE: To assess potential transmission of antibiotic-resistant organisms (AROs) using surrogate markers and bacterial cultures. DESIGN: Pilot study. SETTING: A 1,260-bed tertiary-care academic medical center. PARTICIPANTS: The study included 25 patients (17 of whom were on contact precautions for AROs) and 77 healthcare personnel (HCP). METHODS: Fluorescent powder (FP) and MS2 bacteriophage were applied in patient rooms. HCP visits to each room were observed for 2-4 hours; hand hygiene (HH) compliance was recorded. Surfaces inside and outside the room and HCP skin and clothing were assessed for fluorescence, and swabs were collected for MS2 detection by polymerase chain reaction (PCR) and selective bacterial cultures. RESULTS: Transfer of FP was observed for 20 rooms (80%) and 26 HCP (34%). Transfer of MS2 was detected for 10 rooms (40%) and 15 HCP (19%). Bacterial cultures were positive for 1 room and 8 HCP (10%). Interactions with patients on contact precautions resulted in fewer FP detections than interactions with patients not on precautions (P \u3c .001); MS2 detections did not differ by patient isolation status. Fluorescent powder detections did not differ by HCP type, but MS2 was recovered more frequently from physicians than from nurses (P = .03). Overall, HH compliance was better among HCP caring for patients on contact precautions than among HCP caring for patients not on precautions (P = .003), among nurses than among other nonphysician HCP at room entry (P = .002), and among nurses than among physicians at room exit (P = .03). Moreover, HCP who performed HH prior to assessment had fewer fluorescence detections (P = .008). CONCLUSIONS: Contact precautions were associated with greater HCP HH compliance and reduced detection of FP and MS2