Evaluation of the national surveillance system for point-prevalence of healthcare-associated infections in hospitals and in long-term care facilities for elderly in Norway, 2002-2008

<p>Abstract</p> <p>Background</p> <p>Since 2002, the Norwegian Institute of Public Health has invited all hospitals and long-term care facilities for elderly (LTCFs) to participate in two annual point-prevalence surveys covering the most frequent types of healthcare-associated infections (HAIs). In a comprehensive evaluation we assessed how well the system operates to meet its objectives.</p> <p>Methods</p> <p>Surveillance protocols and the national database were reviewed. Data managers at national level, infection control practitioners and ward personnel in hospitals as well as contact persons in LTCFs involved in prevalence data collection were surveyed.</p> <p>Results</p> <p>The evaluation showed that the system was structurally simple, flexible and accepted by the key partners. On average 87% of hospitals and 32% of LTCFs participated in 2004-2008; high level of data completeness was achieved. The data collected described trends in the prevalence of reportable HAIs in Norway and informed policy makers. Local results were used in hospitals to implement targeted infection control measures and to argue for more resources to a greater extent than in LTCFs. Both the use of simplified Centers for Disease Control and Prevention (CDC) definitions and validity of data seemed problematic as compliance with the standard methodology were reportedly low.</p> <p>Conclusions</p> <p>The surveillance system provides important information on selected HAIs in Norway. The system is overall functional and well-established in hospitals, however, requires active promotion in LTCFs. Validity of data needs to be controlled in the participating institutions before reporting to the national level.</p

Gastro-enteritis outbreak among Nordic patients with psoriasis in a health centre in Gran Canaria, Spain: a cohort study

BACKGROUND: Between November 2 and 10, 2002 several patients with psoriasis and personnel staying in the health centre in Gran Canaria, Spain fell ill with diarrhoea, vomiting or both. Patient original came from Norway, Sweden and Finland. The patient group was scheduled to stay until 8 November. A new group of patients were due to arrive from 7 November. METHODS: A retrospective cohort study was conducted to assess the extent of the outbreak, to identify the source and mode of transmission and to prevent similar problems in the following group. RESULTS: Altogether 41% (48/116) of persons staying at the centre fell ill. Norovirus infection was suspected based on clinical presentations and the fact that no bacteria were identified. Kaplan criteria were met. Five persons in this outbreak were hospitalised and the mean duration of diarrhoea was 3 days. The consequences of the illness were more severe compared to many other norovirus outbreaks, possibly because many of the cases suffered from chronic diseases and were treated with drugs reported to affect the immunity (methotrexate or steroids). During the two first days of the outbreak, the attack rate was higher in residents who had consumed dried fruit (adjusted RR = 3.1; 95% CI: 1.4–7.1) and strawberry jam (adjusted RR = 1.9; 95% CI: 0.9–4.1) than those who did not. In the following days, no association was found. The investigation suggests two modes of transmission: a common source for those who fell ill during the two first days of the outbreak and thereafter mainly person to person transmission. This is supported by a lower risk associated with the two food items at the end of the outbreak. CONCLUSIONS: We believe that the food items were contaminated by foodhandlers who reported sick before the outbreak started. Control measures were successfully implemented; food buffets were banned, strict hygiene measures were implemented and sick personnel stayed at home >48 hours after last symptoms

First results from the L3+C experiment at CERN

The L3+C experiment combines the high-precision spectrometer of the L3 detector at LEP, CERN, with a small air shower array. The momenta of cosmic ray induced muons can be measured from 20 to 2000 GeV/c. During the 1999 data taking period 5 billion muon events were recorded in the spectrometer. From April until mid Summer 2000 an additional 3 billion muon events have been recorded as well as 25 million air shower events. Here the first results on the muon momentum spectrum and charge ratio will be presented

Healthcare-associated infections in Northern Russia: Results of ten point-prevalence surveys in 2006–2010

Background and objective: Statistics on healthcare-associated infections (HAIs) in Russia is scarce and has been considered to suffer from underreporting. We assessed the prevalence and changes in the prevalence of HAIs over 5 years and identified factors associated with acquiring HAIs in the pediatric hospital in Arkhangelsk, Northern Russia. Materials and methods: Ten cross-sectional studies were conducted in the Arkhangelsk regional pediatric hospital biannually during 2006–2010. We used a standardized protocol, including the criteria of HAI proposed by the Centers for Disease Control and Prevention. Binary logistic regression was applied to study factors associated with HAI. Results: Altogether, 3264 inpatients were enrolled in the study and 347 of them had HAI (11.2%). The prevalence of HAI per survey ranged from 7.1% (95% CI: 4.8%–10.4%) to 16.7% (95% CI: 13.1%–21.2%). The most prevalent HAIs were upper respiratory tract infections 5.1% (95% CI: 4.4%–5.9%), followed by urinary tract infections, 1.5% (95% CI: 1.2%–2.0%), and acute gastroenteritis, 1.4% (95% CI: 1.1%–1.9%). Compared to infants, children aged 5–9 years (OR = 0.7, 95% CI: 0.4–1.0), 10–14 years (OR = 0.4, 95% CI: 0.3–0.7), and ≥15 years (OR = 0.3, 95% CI: 0.2–0.5) were less likely to have HAI. Neutropenia (OR = 1.5, 95% CI: 1.0–2.3) and use of intravascular catheter(s) (OR = 1.8, 95% CI: 1.1–3.0) were positively associated with HAI. Conclusions: The observed prevalence of HAIs is within the range reported in several other European countries. We do not recommend generalizing our findings to other Russian settings given considerable variations between regions in both socio-economic situation and conditions of medical facilities

Effect of Liothyronine Treatment on Dermal Temperature and Activation of Brown Adipose Tissue in Female Hypothyroid Patients: A Randomized Crossover Study

Background Thyroid hormones are essential for the full thermogenic response of brown adipose tissue (BAT) and have been implicated in dermal temperature regulation. Nevertheless, persistent cold-intolerance exists among a substantial proportion of hypothyroid patients on adequate levothyroxine (LT4) substitution. Materials and Methods To assess if skin temperature and activation of BAT during treatment with liothyronine (LT3) differs from that of LT4 treatment, fifty-nine female hypothyroid patients with residual symptoms on LT4 or LT4/LT3 combination therapy were randomly assigned in a non-blinded crossover study to receive monotherapy with LT4 or LT3 for 12 weeks each. Change in supraclavicular (SCV) skin temperature overlying BAT, and sternal skin temperature not overlying BAT, during rest and cold stimulation were assessed by infrared thermography (IRT). In addition, abundance of exosomal miR-92a, a biomarker of BAT activation, was estimated as a secondary outcome. Results Cold stimulated skin temperatures decreased less with LT3 vs . LT4 in both SCV (mean 0.009°C/min [95% CI: 0.004, 0.014]; P &amp;lt;0.001) and sternal areas (mean 0.014°C/min [95% CI: 0.008, 0.020]; P &amp;lt;0.001). No difference in serum exosomal miR-92a abundance was observed between the two treatment groups Conclusion LT3 may reduce dermal heat loss. Thermography data suggested increased BAT activation in hypothyroid patients with cold-intolerance. However, this finding was not corroborated by assessment of the microRNA biomarker of BAT activation. Clinical Trial Registration ClinicalTrials.gov , identifier NCT0362761