Results from the Scottish national HAI prevalence survey

A national point prevalence survey was undertaken over the period of one calendar year in Scotland from October 2005 to October 2006. The prevalence of healthcare-associated infection (HAI) was 9.5% in acute hospitals and 7.3% in non-acute hospitals. The highest prevalence of HAI in acute hospital inpatients was found in the following specialties: care of the elderly (11.9%), surgery (11.2%), medicine (9.6%) and orthopaedics (9.2%). The lowest prevalence was found in obstetrics (0.9%). The most common types of HAI in acute hospital inpatients were: urinary tract infections (17.9% of all HAI), surgical site infections (15.9%) and gastrointestinal infections (15.4%). In non-acute hospitals one in ten inpatients in two specialties (combined) medicine (11.4%) and care of the elderly (7.8%) was found to have HAI, and one in 20 inpatients in psychiatry (5.0%) had HAI. In non-acute hospital patients, urinary tract infections were frequent (28.1% of all HAI) and similarly skin and soft tissue infection (26.8% of all HAI). When combined, these two HAI types affected 4% of all the inpatients in non-acute hospitals. This is the first survey of its kind in Scotland and describes the burden of HAI at a national level

Healthcare-Associated Infections Among Neonates in Brazil

Abstract Objective: To describe the epidemiology of healthcare-associated infections (HAIs) among neonates. Design: Prospective surveillance of HAIs was conducted during 2 years. Infections beginning within 48 hours of birth were defined as HAIs of maternal origin. Death occurring during an active episode of HAI was considered related to HAI. Setting: Seven neonatal units located in three Brazilian cities. Patients: All admitted neonates were included and observed until discharge. Results: Twenty-two percent of 4,878 neonates had at least one HAI. The overall incidence density was 24.9 per 1,000 patient-days, and 28.1% of all HAIs were maternally acquired. HAI rates ranged from 12.3% in the group with a birth weight (BW) of more than 2,500 g to 51.9% in the group with a BW of 1,000 g or less. The main HAIs were bloodstream infection (BSI) and pneumonia. Coagulase-negative staphylococci, Enterobacter species, Staphylococcus aureus, and Klebsiella pneumoniae were the main pathogens. Forty percent of all deaths were related to HAI. Central venous catheter (CVC)-associated BSIs per 1,000 CVC-days ranged from 17.3 (BW, 1,501 to 2,500 g; device utilization [DU], 0.11) to 34.9 (BW, ≤ 1,000 g; DU, 34.92). Ventilator-associated pneumonia per 1,000 ventilator-days ranged from 7.0 (BW, ≤ 1,000 g; DU, 0.34) to 9.2 (BW, 1,001 to 1,500 g; DU, 0.14). Conclusions: The high proportion of HAIs of maternal origin highlights perinatal care issues in Brazil and the need to improve the diagnosis of neonatal HAIs. The very low BW group and device-associated infections should be priorities for prevention strategies in this populatio

Excess length of hospital stay due to healthcare acquired infections. Methodologies evaluation

BACKGROUND: Healthcare acquired infections (HAI) cause an increase of burden and in particular excess length of hospital stay (LOS) accounts for approximately up to 90% of total costs. Therefore accurate estimation of extra hospital stay due to healthcare acquired infections is very important. METHODS: The authors carried out a review comparing the principal methods internationally used for estimating the excess LOS attributable to healthcare acquired infections. RESULTS: The methods described and analysed are: 1) Implicit physician assessment; 2) appropriateness evaluation protocol; 3) unmatched case-control; 4) matched case-control; 5) regression analysis; 6) multistate model. The various methodologies are described underlining advantages and limits which researchers need to know before starting any economic analysis. CONCLUSIONS: Overall, studies taking into account the time-dependent nature of HAI show to give more precise and reliable results

Torsion-free crystallographic groups with indecomposable holonomy group II.

Let K be a principal ideal domain, G a finite group, and M a KG-module which is a free K-module of finite rank on which G acts faithfully. A generalized crystallographic group is a non-split extension C of M by G such that conjugation in C induces the G-module structure on M. ( When K = Z, these are just the classical crystallographic groups.) The dimension of C is the K-rank of M, the holonomy group of C is G, and C is indecomposable if M is an indecomposable KG-module. We study indecomposable torsion-free generalized crystallographic groups with holonomy group G when K is Z, or its localization Z((p)) at the prime p, or the ring Z(p) of p-adic integers. We prove that the dimensions of such groups with G non-cyclic of order p(2) are unbounded. For K = Z, we show that there are infinitely many non-isomorphic such groups with G the alternating group of degree 4 and we study the dimensions of such groups with G cyclic of certain orders

How do we evaluate the cost of nosocomial infection? The ECONI protocol: an incidence study with nested case-control evaluating cost and quality of life

Introduction Healthcare-associated or nosocomial infection (HAI) is distressing to patients and costly for the National Health Service (NHS). With increasing pressure to demonstrate cost-effectiveness of interventions to control HAI and notwithstanding the risk from antimicrobial-resistant infections, there is a need to understand the incidence rates of HAI and costs incurred by the health system and for patients themselves. Methods and analysis The Evaluation of Cost of Nosocomial Infection study (ECONI) is an observational incidence survey with record linkage and a nested case-control study that will include postdischarge longitudinal follow-up and qualitative interviews. ECONI will be conducted in one large teaching hospital and one district general hospital in NHS Scotland. The case mix of these hospitals reflects the majority of overnight admissions within Scotland. An incidence survey will record all HAI cases using standard case definitions. Subsequent linkage to routine data sets will provide information on an admission cohort which will be grouped into HAI and non-HAI cases. The case-control study will recruit eligible patients who develop HAI and twice that number without HAI as controls. Patients will be asked to complete five questionnaires: the first during their stay, and four others during the year following discharge from their recruitment admission (1, 3, 6 and 12 months). Multiple data collection methods will include clinical case note review; patient-reported outcome; linkage to electronic health records and qualitative interviews. Outcomes collected encompass infection types; morbidity and mortality; length of stay; quality of life; healthcare utilisation; repeat admissions and postdischarge prescribing. Ethics and dissemination The study has received a favourable ethical opinion from the Scotland A Research Ethics Committee (reference 16/SS/0199). All publications arising from this study will be published in open-access peer-reviewed journal. Lay-person summaries will be published on the ECONI website. Trial registration number NCT03253640; Pre-results

On the proof of some theorem on locally nilpotent subgroups in division rings

In Hai-Thin (2009), there is a theorem, stating that every locally nilpotent subnormal subgroup in a division ring $D$ is central (see Hai-Thin (2009, Th. 2.2)). Unfortunately, there is some mistake in the proof of this theorem. In this note we give the another proof of this theorem.Comment: 3 page

Results from the third Scottish National Prevalence Survey: is a population health approach now needed to prevent healthcare-associated infections?

Summary Background Healthcare associated infections (HAI) are a major public health concern and a significant cause of morbidity and mortality. A robust and current evidence base that is specific to local, national and Europe-wide settings is necessary to inform the development of strategies to reduce HAI and contain antimicrobial resistance (AMR). Aim To measure the prevalence of HAI and antimicrobial prescribing and identify key priority areas for interventions to reduce the burden of infection. Methods A national rolling PPS in National Health Service (NHS) acute, NHS non-acute, NHS paediatric and independent hospitals was carried out between September and November 2016 using the European Centre for Disease Prevention and Control protocol designed for the European PPS. Findings The prevalence of HAI was 4.6%, 2.7% and 3.2% in acute adults, paediatric and non-acute patient groups, respectively. The most common HAI types reported in adult patients were urinary tract infection and pneumonia. The prevalence of antimicrobial prescribing was 35.7%, 29.3% and 13.8% in acute adults, paediatric and non-acute patient groups, respectively. Respiratory, skin and soft tissue, gastrointestinal and urinary tract infections were the most common infections being treated at the time of survey. Conclusion HAI continues to be a public health concern in Scotland. UTI and pneumonia continue to place a significant burden on patients and on healthcare delivery, including those that develop in the community and require hospital admission. A broader population health approach which focuses on reducing the risk of infection upstream would reduce these infections in both community and hospital settings

Health monitoring of plants by their emitted volatiles: A temporary increase in the concentration of nethyl salicylate after pathogen inoculation of tomato plants at greenhouse scale

This paper describes a method to alert growers of the presence of a pathogen infection in their greenhouse based on the detection of pathogen-induced emissions of volatile organic compounds (VOCs) from plants. Greenhouse-grown plants were inoculated with spores of a fungus to learn more about this concept. The specific objective of the present study was to determine whether VOCs are detectable after inoculation, and if so, to determine the time course of the concentrations of these compounds. To achieve this objective, we inoculated 60 greenhouse-grown tomato plants (Lycopersicon esculentum) with an aqueous suspension of Botrytis cinerea spores. Upon inoculation, the greenhouse air was sampled semi-continuously with a one hour time interval until 72 hours after inoculation (HAI). The samples were transferred to the laboratory and analysed using gas chromatography - mass spectrometry. Ten leaves were randomly selected to monitor the visible symptoms of infection. The severity of these visual symptoms was assessed at 0, 24, 48, and 72 HAI. Results demonstrated no detection of C6-compounds, and an almost constant concentration of all monoterpenes, most sesquiterpenes, and (E,E)-4,8,12-trimethyl-1,3,7,11-tridecatetraene. However, the concentration of methyl salicylate increased 10-fold and 3-fold at 32 and 34 HAI respectively. At 24 HAI, 10% of the selected leaves showed mild symptoms while 20% of the selected leaves showed mild symptoms at 48 HAI. These results indicate that methyl salicylate might alert a grower of the presence of a B. cinerea infection of tomato plants at greenhouse scale. Further research is required to confirm these findings