Risk Factors for SARS Transmission from Patients Requiring Intubation: A Multicentre Investigation in Toronto, Canada

In the 2003 Toronto SARS outbreak, SARS-CoV was transmitted in hospitals despite adherence to infection control procedures. Considerable controversy resulted regarding which procedures and behaviours were associated with the greatest risk of SARS-CoV transmission.A retrospective cohort study was conducted to identify risk factors for transmission of SARS-CoV during intubation from laboratory confirmed SARS patients to HCWs involved in their care. All SARS patients requiring intubation during the Toronto outbreak were identified. All HCWs who provided care to intubated SARS patients during treatment or transportation and who entered a patient room or had direct patient contact from 24 hours before to 4 hours after intubation were eligible for this study. Data was collected on patients by chart review and on HCWs by interviewer-administered questionnaire. Generalized estimating equation (GEE) logistic regression models and classification and regression trees (CART) were used to identify risk factors for SARS transmission. ratio ≤59 (OR = 8.65, p = .001) were associated with increased risk of transmission of SARS-CoV. In CART analyses, the four covariates which explained the greatest amount of variation in SARS-CoV transmission were covariates representing individual patients.Close contact with the airway of severely ill patients and failure of infection control practices to prevent exposure to respiratory secretions were associated with transmission of SARS-CoV. Rates of transmission of SARS-CoV varied widely among patients

Evaluation of a New Chromogenic Medium, MRSA Select, for Detection of Methicillin-Resistant Staphylococcus aureus

We compared MRSA Select to mannitol-salt agar with 8 μg/ml cefoxitin for the detection of methicillin-resistant Staphylococcus aureus (MRSA) from 6,199 clinical samples submitted for MRSA screening. The sensitivities and specificities of MRSA Select and mannitol-salt agar with cefoxitin were 98% and 92% versus 90% and 78%, respectively (P < 0.0001). Most (96%) MRSA were detected after overnight incubation using MRSA Select

A Caenorhabditis elegans Host Model Correlates with Invasive Disease Caused by Staphylococcus aureus Recovered during an Outbreak in Neonatal Intensive Care

BACKGROUND: Caenorhabditis elegans has previously been used as a host model to determine the virulence of clinical methicillin-resistant Staphylococcus aureus isolates. In the present study, methicillin-susceptible S aureus (MSSA) strains associated with an outbreak in a neonatal intensive care unit (NICU) were investigated using the C elegans model.METHODS: Two distinct outbreak clones, MSSA type-C and MSSA type-G, were identified by pulsed-field gel electrophoresis in a MSSA outbreak during a seven-month period in the NICU of the Sunnybrook Health Sciences Centre (Toronto, Ontario). MSSA type-C was associated with severe infection, while type-G was associated with less invasive disease. Four representative type-C isolates, three type-G and three infant-colonized isolates unrelated to the outbreak, were sent to Calgary (Alberta), for the double-blinded virulence tests in the C elegans host model and for further molecular characterization.RESULTS: The invasive outbreak strains (type-C) demonstrated highly nematocidal activity, the noninvasive outbreak strains (type-G) an intermediate virulence, and the outbreak-unrelated colonization isolates demonstrated avirulence or low virulence in the C elegans model, with mean killing rates of 93.0%, 61.0% and 14.4% by day 9, respectively, for these three group strains. Different group MSSA strains had their own unique genetic profiles and virulence gene profiles, but all isolates within the same group (type-C or type-G) shared identical genetic characteristics and virulence gene patterns.CONCLUSIONS: The present blinded evaluation demonstrated that the nematocidal activities of MSSA strains correlated well with the clinical manifestation in an MSSA outbreak in the NICU, supporting C elegans as a robust host model to study the pathogenesis of S aureus.Peer Reviewe

Implementación de las 5S para mejorar las buenas prácticas en el punto de acopio principal de la Empresa Sima Astillero - Chimbote 2017

El presente proyecto de investigación, tuvo como objetivo principal implementar las 5s para mejorar las buenas prácticas en el Punto de Acopio Principal de la empresa SIMA Astillero Chimbote, con la finalidad de demostrar que mediante la aplicación de esta herramienta se puede mejorar las buenas prácticas creando un cambio cultural en el desempeño laboral de los trabajadores. Por ende, el diseño del estudio fue experimental de tipo pre – experimental aplicando un pre test y post test a una muestra representada por el cumplimiento de las actividades realizadas por los veinticinco trabajadores que operan en el Punto de Acopio Principal (PAP) de la empresa en estudio, mediante la observación directa como técnica de recolección de datos y el uso de un checklist constituida por once ítems y el uso de formatos para la aplicación de la metodología 5s. Posterior al procesamiento de los datos obtenidos en el desarrollo de la investigación, se concluye que la aplicación de la metodología 5s en el PAP contribuyó a mejorar la organización, el orden y la limpieza con un índice de 45% en el nivel de cumplimiento de las buenas prácticas

Guidelines for the Prevention and Management of Community-Associated Methicillin-Resistant Staphylococcus aureus: A Perspective for Canadian Health Care Practitioners

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