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

Complete upper urinary tract obstruction caused by penetrating pellet injury of the ureter

Ureteral injuries due to gunshots are tend to be misdiagnosed because of concomitant vascular and intraabdominal organ wounds. Our case is a 23-year old man who was admitted to the hospital with multiple abdominal gunshot wounds. Laboratory findings showed worsening anemia, and the computed tomography (CT) scan showed multiple lead bullets inside the abdomen and retroperitoneum. Patient was then taken to the operation room for laparatomy. There were many intestinal injuries and also a stable retroperitoneal hematoma. There was no ureteral injury mentioned in the operation note or the initial CT report. Two weeks after this operation, the patient developed significant urine leakage from the abdominal wounds. Ureteral J stent placement was our first choice of treatment. This was complicated with a late ureteral obstruction. The final treatment was an ureteroureterostomy. Diagnosing ureteral injuries due to traumatic causes can be hard in most of the cases. Physicians should consider early evaluation of the patient for ureteral leakage if there is suspicion about ureteral injury.Keywords: Gunshot, ureteral obstruction, woun

An enzyme-linked immunosorbent assay for brucella specific antibody and real-time PCR for detecting Brucella spp. in milk and cheese in Sanliurfa, Turkey

The objective of this study was to investigate the presence of anti-Brucella antibody and Brucella spp. DNA in cow, sheep and goat milk and in Urfa cheese collected from markets and bazaars in Sanliurfa, located in southeast of Turkey. A total of 258 samples consisting of 178 raw milk (48 cow milk, 65 sheep milk and 65 goat milk) samples and 80 Urfa cheese samples were investigated. Anti-Brucella antibody was detected by indirect ELISA (i-ELISA), and the presence of Brucella spp. DNA was screened by real time Polymerase Chain Reaction (RT-PCR). 16.6% of the cow, 6.1% of the goat and 6.1% of the sheep milk and 16.25% of the cheese samples were found as positive for brucella antibodies by i-ELISA. The RT-PCR assay amplified Brucella DNA from 18.75, 7.6 and 6.1% cow, goat and sheep milk samples respectively. Brucella DNA was amplified from 22.5% cheese samples. The 11.2% and 13.9% of the samples were found as positive by i-ELISA and RT-PCR respectively. This study indicates that milk and milk products consumed in Sanliurfa poses a risk to public health in terms of brucellosis. The combining usage of both i-ELISA and RT-PCR methods could lead to more reliable results to detect anti-Brucella antibody and Brucella spp. DNA from milk and cheese samples. © 2016 PVJ

A Comparison Study between Traditional and Finite Element Methods for Slope Stability Evaluations

Landslides are amongst the major disasters that have occurred in Karabük, Turkey. Due to the rapid increase in population movement to new habitats in urban areas, the need for engineering structures will increase. This condition has led to the construction of arts, cultural facilities and housing in insecure regions these days. The excavations to prepare the construction site, the external loads due to heavy structures and the changes in coverage of the earth surface are among the reasons for landslides in such areas. In this study, the landslides that occurred due to unsupported excavation for the construction of Karabük university stadium were analyzed using the three softwares like Plaxis, Geoslope and Slide. The study area is critical in terms of slope problems. Mass movement in the stadium occurred in high plasticity clay units containing sand and silt. For this reason, it is necessary to carry out detailed studies before the construction of engineering structures. The landslide considered in the study were analyzed using finite element (FE) analysis and slice method. These approaches are used for evaluating the stability of natural slope by considering a failure mechanism, which is known as the plastic limit condition. Regarding safety factors calculated using the different numerical solutions confirm that the results obtained are similar. In addition, the landslide area is close to the predicted simulation results. © 2018, Geological Society of India

Terahertz Spectroscopy of Bacteriorhodopsin and Rhodopsin: Similarities and Differences

We studied the low-frequency terahertz spectroscopy of two photoactive protein systems, rhodopsin and bacteriorhodopsin, as a means to characterize collective low-frequency motions in helical transmembrane proteins. From this work, we found that the nature of the vibrational motions activated by terahertz radiation is surprisingly similar between these two structurally similar proteins. Specifically, at the lowest frequencies probed, the cytoplasmic loop regions of the proteins are highly active; and at the higher terahertz frequencies studied, the extracellular loop regions of the protein systems become vibrationally activated. In the case of bacteriorhodopsin, the calculated terahertz spectra are compared with the experimental terahertz signature. This work illustrates the importance of terahertz spectroscopy to identify vibrational degrees of freedom which correlate to known conformational changes in these proteins

Impact of International Nosocomial Infection Control Consortium (INICC) strategy on central line-associated bloodstream infection rates in the intensive care units of 15 developing countries

BACKGROUND. The International Nosocomial Infection Control Consortium (INICC) was established in 15 developing countries to reduce infection rates in resource-limited hospitals by focusing on education and feedback of outcome surveillance (infection rates) and process surveillance (adherence to infection control measures). We report a time-sequence analysis of the effectiveness of this approach in reducing rates of central line-associated bloodstream infection (CLABSI) and associated deaths in 86 intensive care units with a minimum of 6-month INICC membership. METHODS. Pooled CLABSI rates during the first 3 months (baseline) were compared with rates at 6-month intervals during the first 24 months in 53,719 patients (190,905 central line-days). Process surveillance results at baseline were compared with intervention period data. RESULTS. During the first 6 months, CLABSI incidence decreased by 33% (from 14.5 to 9.7 CLABSIs per 1,000 central line-days). Over the first 24 months there was a cumulative reduction from baseline of 54% (from 16.0 to 7.4 CLABSIs per 1,000 central line-days; relative risk, 0.46 [95% confidence interval, 0.33-0.63]; P < .001). The number of deaths in patients with CLABSI decreased by 58%. During the intervention period, hand hygiene adherence improved from 50% to 60% (P < .001); the percentage of intensive care units that used maximal sterile barriers at insertion increased from 45% to 85% (P < .001 ), that adopted chlorhexidine for antisepsis increased from 7% to 27% (P=.018 ), and that sought to remove unneeded catheters increased from 37% to 83% (P=.004); and the duration of central line placement decreased from 4.1 to 3.5 days (P < .001). CONCLUSIONS. Education, performance feedback, and outcome and process surveillance of CLABSI rates significantly improved infection control adherence, reducing the CLABSI incidence by 54% and the number of CLABSI-associated deaths by 58% in INICC hospitals during the first 2 years. © 2010 by The Society for Healthcare Epidemiology of America. All rights reserved