International nosocomial infection control consortium (INICC) report, data summary of 36 countries, for 2004-2009

The results of a surveillance study conducted by the International Nosocomial Infection Control Consortium (INICC) from January 2004 through December 2009 in 422 intensive care units (ICUs) of 36 countries in Latin America, Asia, Africa, and Europe are reported. During the 6-year study period, using Centers for Disease Control and Prevention (CDC) National Healthcare Safety Network (NHSN; formerly the National Nosocomial Infection Surveillance system [NNIS]) definitions for device-associated health care-associated infections, we gathered prospective data from 313,008 patients hospitalized in the consortium's ICUs for an aggregate of 2,194,897 ICU bed-days. Despite the fact that the use of devices in the developing countries' ICUs was remarkably similar to that reported in US ICUs in the CDC's NHSN, rates of device-associated nosocomial infection were significantly higher in the ICUs of the INICC hospitals; the pooled rate of central line-associated bloodstream infection in the INICC ICUs of 6.8 per 1,000 central line-days was more than 3-fold higher than the 2.0 per 1,000 central line-days reported in comparable US ICUs. The overall rate of ventilator-associated pneumonia also was far higher (15.8 vs 3.3 per 1,000 ventilator-days), as was the rate of catheter-associated urinary tract infection (6.3 vs. 3.3 per 1,000 catheter-days). Notably, the frequencies of resistance of Pseudomonas aeruginosa isolates to imipenem (47.2% vs 23.0%), Klebsiella pneumoniae isolates to ceftazidime (76.3% vs 27.1%), Escherichia coli isolates to ceftazidime (66.7% vs 8.1%), Staphylococcus aureus isolates to methicillin (84.4% vs 56.8%), were also higher in the consortium's ICUs, and the crude unadjusted excess mortalities of device-related infections ranged from 7.3% (for catheter-associated urinary tract infection) to 15.2% (for ventilator-associated pneumonia). Copyright © 2012 by the Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc. All rights reserved

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Not AvailableThe important reason for investigating an outbreak is to identify the source of ongoing outbreaks and prevent subsequent cases thereby controlling the disease. The present study highlighting the investigation of foot-and-mouth disease (FMD) outbreak in organized cattle and pig farm at Mannuthy, Kerala was done between January and March 2013. A total of 14 serum samples from cattle, 30 serum samples from pigs along with 7 snout epithelial samples from pigs were collected. In 3AB non-structural protein (NSP) ELISA, 92.85% cattle and 43.33% pig sera were found positive indicating high to moderate virus activity in the animals. All serum samples were also subjected to liquid phase blocking (LPB) ELISA to assess the level of protective antibody titre against FMD virus (FMDV) serotypes O, A and Asia 1, where 64.28% cattle and 23.33% pigs were found to have protective log10 antibody titre of >1.8 against all three serotypes. This indicates poor herd immunity against FMDV in pigs and moderate in case of cattle. Further, 4 snout epithelial samples from pigs were found to be positive for serotype O in serotype differentiating antigen detection ELISA and 3 were subsequently found positive in multiplex PCR. In VP1 region based phylogenetic analysis, the serotype O isolates clustered within ‘Ind2001’ lineage. Poor level of herd immunity might have been one of the contributing factors behind the outbreak in the farm.Not Availabl

Esophageal lung – A rare bronchopulmonary foregut malformation

Esophageal lung is a rare variety of communicating bronchopulmonary foregut malformation characterized by a fistula between an isolated portion of respiratory tissue and esophagus or stomach. It may involve the entire lung or one of the pulmonary lobes. Only 20 cases have been reviewed in 2011. Fifty percent of cases are associated with a tracheoesophageal fistula. We report a case of a 6 month old girl who was previously operated for TEF repair, with esophageal lobe which was successfully excised. The relevant literature is reviewed