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Epidemic Clostridium difficile- Associated Diarrhea: Role of Second- and Third-Generation Cephalosporins

Infection control & Hospital Epidemiology 2015年第2期15卷 88-94页

作者： David E. Nelson Steven B. Auerbach Aldona L. Baltch Ethel Desjardin Consuelo Beck-Sague Carol Rheal Raymond P. Smith William R. Jarvis Office on Smoking and Health National Center for Chronic Disease Prevention and Health Promotion Centers for Disease Control and Prevention Atlanta Georgia Hospital Infections Program National Center for Infectious Diseases Centers for Disease Control and Prevention Atlanta Georgia Department of Medicine Section of Infectious Disease Stratton Veterans Affairs Medical Center Albany New York

Objective:To better define the role of multiple risk factors for cytotoxic Clostridium difficile-associated ***:Case-control ***:A Veterans Affairs Medical ***:Thirty-three case patients with C difficile -associated diarrhea. Two control groups were used: one group consisted of 32 patients from the same ward as the case patients, and one group consisted of 34 patients with nosocomial diarrhea and negative C difficile toxin ***:***:Multivariate analyses revealed that exposure to second- or third-generation cepha-losporins was the most important independent risk factor, even after controlling for other antimicrobial use (odds ratio [OR]=8.3, 95% confidence interval [CI95] = 1.4 to 48.9 compared to ward controls; OR= 9.6, CI95 = 2.1 to 44.1 compared with diarrhea controls). Persons exposed to two or more antimicrobials simultaneously were at substantially elevated risk (OR= 18.7, CI95 = 4.1 to 85.8 compared with ward controls; OR=21.5, CI95=3.2 to 141.9 compared with diarrhea controls).Conclusion:Physicians should consider carefully the appropriateness of second- and third-generation cephalosporin use and combination antimicrobial therapy, especially during nosocomial C difficile -associated diarrhea outbreaks.

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Human neutralizing antibodies isolated from a Zika patient and their molecular determinants

Human neutralizing antibodies isolated from a Zika patient a...

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第十一届全国免疫学学术大会

作者： Wang Qihui Yang Huabing Liu Xiaoqing Dai Lianpan Ma Tong Qi Jianxun Wong Gary Peng Ruchao Liu Sheng Li Junfu Li Shihua Song Jian Liu Jianying He Jianhua Yuan Hui Xiong Ying Liao Yong Li Jianhua Yang Jianping Tong Zhou Griffin Bryan Bi Yuhai Liang Mifang Xu Xiaoning Qin Chuan Cheng Gong Wang Peiyi Qiu Xiangguo Kobinger Gary Shi Yi Yan Jinghua Gao Fu CAS Key Laboratory of Microbial Physiological and Metabolic Engineering Institute of Microbiology Chinese Academy of Sciences Shenzhen Key Laboratory of Pathogen and Immunity Shenzhen Third People’s Hospital School of Life Sciences Anhui University Jiangxi province center for disease control and prevention Research Network of Immunity and Health (RNIH) Beijing Institutes of Life Science Chinese Academy of Sciences CAS Key Laboratory of Pathogenic Microbiology and Immunology Institute of Microbiology Chinese Academy of Sciences CAS Center for Influenza Research and Early-warning (CASCIRE) Chinese Academy of Sciences School of Life Sciences University of Science and Technology of China Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases School of Medicine Tsinghua University Shanghai Institute of Applied Physics Chinese Academy of Sciences Ganzhou Prefecture Center for Disease Control and Prevention Special Pathogens Program National Microbiology Laboratory Public Health Agency of Canada National Institute for Viral Disease Control and Prevention Chinese Center for Disease Control and Prevention (China CDC) MRC Human Immunology Unit University of Oxford Key Laboratory of Human Diseases Comparative Medicine Ministry of Health Institute of Medical Laboratory Animal Science Chinese Academy of Medical Sciences Faculty of Biological Science University of Leeds College of Life Sciences University of Chinese Academy of Sciences Savaid Medical School University of Chinese Academy of Sciences

Zika virus infections are associated with fetal microcephaly,neurological complications and constitute a public health ***,we report the isolation of 13 specific,human-origin monoclonal antibodies from an imported Zika case to *** of the isolated antibodies(Z23 and Z3L1)demonstrate potent Zika-specific neutralization in vitro without binding or neutralizing activity against Zika’s closest relative Dengue virus(DENV)1-4,

关键词： Zika virus envelope protein human neutralizing MAbs B cell sequencing crystal structure Cryo-EM

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Correction: Distinct germline genetic susceptibility profiles identified for common non-Hodgkin lymphoma subtypes

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Leukemia 2023年第10期37卷 2142页

作者： Sonja I Berndt Joseph Vijai Yolanda Benavente Nicola J Camp Alexandra Nieters Zhaoming Wang Karin E Smedby Geffen Kleinstern Henrik Hjalgrim Caroline Besson Christine F Skibola Lindsay M Morton Angela R Brooks-Wilson Lauren R Teras Charles Breeze Joshua Arias Hans-Olov Adami Demetrius Albanes Kenneth C Anderson Stephen M Ansell Bryan Bassig Nikolaus Becker Parveen Bhatti Brenda M Birmann Paolo Boffetta Paige M Bracci Paul Brennan Elizabeth E Brown Laurie Burdett Lisa A Cannon-Albright Ellen T Chang Brian C H Chiu Charles C Chung Jacqueline Clavel Pierluigi Cocco Graham Colditz Lucia Conde David V Conti David G Cox Karen Curtin Delphine Casabonne Immaculata De Vivo Arjan Diepstra W Ryan Diver Ahmet Dogan Christopher K Edlund Lenka Foretova Joseph F Fraumeni Attilio Gabbas Hervé Ghesquières Graham G Giles Sally Glaser Martha Glenn Bengt Glimelius Jian Gu Thomas M Habermann Christopher A Haiman Corinne Haioun Jonathan N Hofmann Theodore R Holford Elizabeth A Holly Amy Hutchinson Aalin Izhar Rebecca D Jackson Ruth F Jarrett Rudolph Kaaks Eleanor Kane Laurence N Kolonel Yinfei Kong Peter Kraft Anne Kricker Annette Lake Qing Lan Charles Lawrence Dalin Li Mark Liebow Brian K Link Corrado Magnani Marc Maynadie James McKay Mads Melbye Lucia Miligi Roger L Milne Thierry J Molina Alain Monnereau Rebecca Montalvan Kari E North Anne J Novak Kenan Onel Mark P Purdue Kristin A Rand Elio Riboli Jacques Riby Eve Roman Gilles Salles Douglas W Sborov Richard K Severson Tait D Shanafelt Martyn T Smith Alexandra Smith Kevin W Song Lei Song Melissa C Southey John J Spinelli Anthony Staines Deborah Stephens Heather J Sutherland Kaitlyn Tkachuk Carrie A Thompson Hervé Tilly Lesley F Tinker Ruth C Travis Jenny Turner Celine M Vachon Claire M Vajdic Anke Van Den Berg David J Van Den Berg Roel C H Vermeulen Paolo Vineis Sophia S Wang Elisabete Weiderpass George J Weiner Stephanie Weinstein Nicole Wong Doo Yuanqing Ye Meredith Yeager Kai Yu Anne Zeleniuch-Jacquotte Yawei Zhang Tongzhang Zheng Elad Ziv Joshua Sampson Nilanjan Chatterjee Kenn Division of Cancer Epidemiology and Genetics National Cancer Institute Bethesda Md USA. berndts@mail.nih.gov. Department of Medicine Memorial Sloan Kettering Cancer Center New York NY USA. Cancer Epidemiology Research Programme Catalan Institute of Oncology-IDIBELL L'Hospitalet de Llobregat Barcelona Spain. CIBER de Epidemiología y Salud Pública (CIBERESP) Barcelona Spain. Department of Internal Medicine and Huntsman Cancer Institute University of Utah School of Medicine Salt Lake City UT USA. Institute for Immunodeficiency University Medical Center Freiburg Freiburg Germany. Department of Epidemiology and Cancer Control St. Jude Children's Research Hospital Memphis TN USA. Laboratory of Translational Genomics Division of Cancer Epidemiology and Genetics National Cancer Institute Bethesda MD USA. Department of Medicine Solna Karolinska Institutet Stockholm Sweden. Hematology Center Karolinska University Hospital Stockholm Sweden. School of Public Health University of Haifa Haifa Israel. Department of Epidemiology Research Division of Health Surveillance and Research Statens Serum Institut Copenhagen Denmark. Department of Clinical Medicine University of Copenhagen Copenhagen Denmark. Department of Haematology Rigshospitalet Copenhagen Denmark. Danish Cancer Society Research Center Danish Cancer Society Copenhagen Denmark. Centre Hospitalier de Versailles Le Chesnay France. Université Paris-Saclay UVSQ Inserm Équipe "Exposome et Hérédité" CESP Villejuif France. Department of Hematology and Medical Oncology Emory University School of Medicine Atlanta GA USA. Division of Cancer Epidemiology and Genetics National Cancer Institute Bethesda Md USA. Genome Sciences Centre BC Cancer Agency Vancouver BC Canada. Department of Biomedical Physiology and Kinesiology Simon Fraser University Burnaby BC Canada. Department of Population Science American Cancer Society Atlanta GA USA. Department of Medical Epidemiology and Biostatistics Karolinska In

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Infectious Diseases and Death Among Nursing Home Residents: Results of Surveillance in 13 Nursing Homes

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Infection control & Hospital Epidemiology 2015年第7期15卷 494-496页

作者： Consuelo Beck-Sague Elsa Villarino Diane Giuliano Sharon Welbel Lisa Latts Lilia M. Manangan Ronda L. Sinkowitz William R Jarvis Hospital Infections Program National Center for Infectious Diseases Centers for Disease Control and Prevention Atlanta Georgia Hospital Services Laboratory Garden Grove California

An increasing proportion of the U.S. population resides in nursing homes (NHs). No surveillance system exists for infections in these facilities. To determine the incidence and types of infections in NH residents, and to identify predictors of death among residents with infections, we initiated a surveillance system at 13 NHs in California during a 6-month period from October 1989 through March 1990. The study included 1,754 residents, among whom 835 infections were identified during the study period. The most common infections were urinary tract infections (UTIs; 286, 34.2%), respiratory tract infections (RTIs; 259, 31%), and skin infections (150,17.9%). Of the 259 residents with respiratory tract infections, 69 (27%) had pneumonia. Antimicrobials were prescribed for 646 (77%) of the infectious episodes. Residents with pneumonia were more likely to die than residents with other infections (4 of 69 versus 12 of 766; P=0.04). Symptoms of altered body temperature (fever, hypothermia, chills) and change in mental status also were associated with an increased risk of a fatal outcome (10 of 260 versus 6 of 575; P= 0.01) and (7 of 127 versus 9 of 708; P= 0.004). This study suggests that the most common infections among NH residents are UTIs, RTIs, and skin infections. Pneumonia, symptoms of fever, and mental status changes all were associated with increased mortality. The frequency of infections among NH residents and their impact on resident outcome highlights the need for infectious disease surveillance in this population.

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SHEA-CDC TB Survey, Part II: Efficacy of TB Infection control programs at Member Hospitals, 1992

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Infection control & Hospital Epidemiology 2015年第3期16卷 135-140页

作者： Scott K. Fridkin Lilia Manangan Elizabeth Bolyard William R. Jarvis The Society for Healthcare Epidemiology of America Hospital Infections Program National Center for Infectious Diseases Centers for Disease Control and Prevention Atlanta Georgia Society for Healthcare Epidemiology of America West Deptford New Jersey

Objective:To assess the efficacy of current Myco-bacterium tuberculosis control ***:Voluntary questionnaire to members of the Society for Healthcare Epidemiology of ***:Healthcare worker (HCW) tuberculin skin-test (TST) conversion rates were significantly higher in larger hospitals ( ≥ 437 beds) (0.9% versus 0.6%; P < 0.05), or in hospitals reporting ≥ 6 TB patients in 1992 (1.2% versus 0.6%; P < 0.05). Among larger hospitals or those hospitals surveyed reporting ≥ 6 TB patients, those without at least three of the four criteria suggested in the 1990 Centers for Disease control and prevention (CDC) TB guidelines for acid-fast bacilli (AFB) isolation (specifically, a single-patient room; negative pressure; and air exhausted directly outside) had significantly higher annual TST conversion rates than those with these criteria (1.8% versus 0.6%; P < 0.05). Respiratory therapist or bronchoscopist TST conversion rates were significantly lower in hospitals compliant with the exhaust criteria (1.2% versus 2.8%; P < 0.05). Regardless of hospital characteristic, HCW TST conversion rates did not differ between hospitals in which HCWs used surgical masks or used disposable particulate ***:Among larger hospitals or hospitals reporting ≥ 6 TB patients per year, failure to comply with the 1990 CDC TB recommendations for AFB isolation room guidelines was associated with higher HCW TST conversion rates. These data suggest that complete implementation of the 1990 CDC TB guidelines would decrease HCWs’ risk of nosocomial transmission of TB in larger hospitals or those reporting more TB patients. However, in nonoutbreak situations, disposable particulate respirators or submicron surgical masks may not offer significantly greater protection to HCWs than surgical masks.

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Molecular Characterization of Carbapenem-Resistant Enterobacteriaceae in the USA, 2011–2015

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Open Forum Infect Dis 2017年第SUPPL 1期4卷 S179-S179页

作者： Uzma Ansari Adrian Lawsin Davina Campbell Valerie Albrecht Gillian McAllister Sandra Bulens Maroya Spalding Walters Jesse T Jacob Sarah W Satola Lucy E Wilson Ruth Lynfield Paula M Snippes Vagnone Sarah J Janelle Karen Xavier Ghinwa Dumyati Dwight Hardy Erin C Phipps Karissa Culbreath Zintars Beldavs Karim Morey Marion A Kainer Sheri Roberts Alexander Kallen J Kamile Rasheed Maria S Karlsson Division of Healthcare Quality Promotion Centers for Disease Control and Prevention Atlanta Georgia Georgia Emerging Infections Program Decatur Georgia Division of Infectious Diseases Emory University School of Medicine Atlanta Georgia Georgia Emerging Infections Program Atlanta Georgia Maryland Department of Health and Mental Hygiene Baltimore MD Minnesota Department of Health St. Paul Minnesota Colorado Department of Public Health and Environment Denver Colorado New York Emerging Infections Program at the University of Rochester Medical Center Rochester New York New Mexico Emerging Infections Program University of New Mexico Albuquerque New Mexico TriCore Reference Laboratories Albuquerque New Mexico University of New Mexico School of Medicine Albuquerque New Mexico Oregon Health Authority Portland OR Tennessee Department of Public Health Nashville TN

Background Carbapenem-resistant Enterobacteriaceae (CRE) have emerged as an important cause of healthcare-associated infections. We characterized the molecular epidemiology of CRE in isolates collected through the Emerging Infections program (EIP) at the Centers for Disease control and prevention (CDC). Methods From 2011–2015, 8 U.S. EIP sites (CO, GA, MD, MN, NY, NM, TN and OR) collected CRE ( Escherichia coli, Enterobacter aerogenes, Enterobacter cloacae complex , Klebsiella pneumoniae, and Klebsiella oxytoca) isolated from a normally sterile site or urine. Isolates were sent to CDC for reference antimicrobial susceptibility testing and real-time PCR detection of carbapenemase genes ( bla KPC , bla NDM , bla OXA-48 ). Phenotypically confirmed CRE were analyzed by whole genome sequencing (WGS) using an Illumina MiSeq benchtop sequencer. Results Among 639 Enterobacteriaceae evaluated, 414 (65%) were phenotypically confirmed as CRE using CDC’s current surveillance definition (resistant to ertapenem, imipenem, doripenem, or meropenem). Among isolates confirmed as CRE, 303 (73%) were carbapenemase-producers (CP-CRE). The majority of CP-CRE originated from GA (39%), MD (35%) and MN (11%); most non-CP-CREs originated from MN (27%), CO (25%) and OR (17%). K. pneumoniae was the predominant carbapenemase-producing species (78%) followed by E. cloacae complex spp (12%), E. coli (7.9%), E . A erogenes (0.9%) and K. oxytoca (0.6%). The most common carbapenemase genes detected were bla KPC-3 (76%) and bla KPC-2 (19%); bla NDM and bla OXA-48 -like genes were detected in 1.6% and 0.3% of isolates, respectively. For carbapenemase-producing K. pneumoniae , Enterobacter spp, and E. coli, the predominant sequence types (ST) were ST258 (65%), ST171 (35%) and ST131 (29%), respectively. Conclusion The distribution of CP and non-CP-CRE varied across the catchment sites. Among CP-CRE, KPC-producing K. pneumoniae predominated; other carbapenemases were rarely identified in the locations un

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SHEA-CDC TB Survey, Part I: Status of TB Infection control programs at Member Hospitals, 1989-1992

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Infection control & Hospital Epidemiology 2015年第3期16卷 129-134页

Objective:To determine trends in Mycobacterium tuberculosis infection in healthcare workers, tuberculosis (TB) control measures, and compliance with the 1990 Centers for Disease control and prevention (CDC) guideline for preventing transmission of TB in healthcare ***:Voluntary questionnaire sent to all members of the Society for Healthcare Epidemiology of America, representing 359 ***:Respondents’ hospitals (210 [58%]) had a median of 2,400 healthcare workers (range, 396 to 13,745), 437 beds (range, 48 to 1,250), 5.6 patients with TB per year (range, 0 to 492), and 0 multidrug-resistant (MDR) TB patients per year (range, 0 to 33). Of 166 respondents’ hospitals for which data were provided for 1989 through 1992, the number caring for MDR-TB patients increased from 10 (6%) in 1989 to 49 (30%) in 1992. Reported policies for routine healthcare worker tuberculin skin testing varied. The median skin-test positivity rate for healthcare workers at the time of hire increased from 0.54% in 1989 to 0.81% in 1992, but the median conversion rate during routine testing remained similar: 0.35% in 1989 and 0.33% in 1992. Among 196 hospitals with reported data on respiratory protection use for 1989 through 1992, the use of either surgical submicron, dust-mist, or dust-fume-mist respirators for healthcare workers increased from 9 (5%) in 1989 to 85 (43%) in 1992. Of 181 hospitals with reported data, 113 (62%) had acid-fast bacilli isolation facilities consistent with the 1990 CDC guideline (ie, a single patient room, negative air pressure relative to the hallway, air exhausted directly outside, and ≥ 6 air exchanges per hour).Conclusions:While the number of surveyed hospitals caring for TB and MDR-TB patients increased during 1989 through 1992, TB infection control measures at many hospitals still did not meet the 1990 CDC guideline recommendations.

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Reduction in the Prevalence of Healthcare-Associated Infections in U.S. Acute Care Hospitals, 2015 vs 2011

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Open Forum Infectious Diseases 2017年第SUPPL_1期4卷 S49-S49页

作者： Magill, Shelley S Wilson, Lucy E Thompson, Deborah L Ray, Susan M Nadle, Joelle Lynfield, Ruth Janelle, Sarah J Kainer, Marion A Greissman, Samantha Dumyati, Ghinwa Beldavs, Zintars G Edwards, Jonathan R Emerging Infections program Hospital Prevalence Survey Team Division of Healthcare Quality Promotion Centers for Disease Control and Prevention Atlanta Georgia Maryland Department of Health and Mental Hygiene Baltimore MD Presbyterian Healthcare Services Albuquerque New Mexico New Mexico Department of Health Santa Fe New Mexico Division of Infectious Diseases Emory University School of Medicine Atlanta Georgia Georgia Emerging Infections Program Decatur Georgia California Emerging Infections Program Oakland California Minnesota Department of Health St. Paul Minnesota Colorado Department of Public Health and Environment Denver Colorado Tennessee Department of Public Health Nashville Tennessee Connecticut Emerging Infections Program Hartford and New Haven Connecticut New York Emerging Infections Program at the University of Rochester Medical Center Rochester New York Oregon Health Authority Portland Oregon

Background A 2011 prevalence survey conducted by CDC and the Emerging Infections program (EIP) showed that 1 in 25 hospital patients had ≥1 healthcare-associated infection (HAI). We repeated the survey in 2015 to assess changes in HAI prevalence. Methods In EIP sites (CA, CO, CT, GA, MD, MN, NM, NY, OR, TN) hospitals that participated in the 2011 survey were recruited for the 2015 survey. Hospitals selected 1 day from May–September 2015 on which a random patient sample was identified from the morning census. Trained EIP staff reviewed patient medical records using comparable methods and the same National Healthcare Safety Network HAI definitions used in 2011. Proportions of patients with HAIs were compared using chi-square tests; patient characteristics were compared using chi-square or median tests (OpenEpi 3.01, SAS 9.3). Results Data were available from 143 hospitals that participated in both surveys; data from 8954 patients in the 2011 survey were compared with preliminary data from 8833 patients in the 2015 survey. Patient characteristics such as median age, days from admission to survey, and critical care location were similar. Urinary catheter prevalence was lower in 2015 (1,589/8,833, 18.0%) compared with 2011 (2,052/8,954, 22.9%, P < 0.0001), as was central line prevalence (2015: 1,539/8,833, 17.4%, vs. 2011: 1,687/8,954, 18.8%, P = 0.02). The proportion of patients with HAIs was lower in 2015 (284/8,833, 3.2%, 95% confidence interval [CI] 2.9–3.6%) than in 2011 (362/8,954, 4.0%, 95% CI 3.7–4.5%, P = 0.003). Of 309 HAIs in 2015, pneumonia (PNEU) and Clostridium difficile infections (CDI) were most common (Figure); proportions of patients with PNEU and/or CDI were similar in 2015 (130/8833, 1.5%) and 2011 (133/8954, 1.5%, P = 0.94). A lower proportion of patients had surgical site (SSI) and/or urinary tract infections (UTI) in 2015 (77/8833, 0.9%) vs. 2011 (136/8954, 1.5%, P < 0.001). Conclusion HAI prevalence was significantly lower in 2015 compared with 2

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Multi-Facility Assessment of Variation in Transmission-Based Precautions (TBP) Policies and Healthcare Personnel (HCP) Personal Protective Equipment (PPE) Use Behavior

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Open Forum Infectious Diseases 2017年第SUPPL_1期4卷 S170–S171页

作者： Croft, Lindsay D Drews, Frank Berryrieser, Dennis Haroldsen, Candace Nevers, McKenna Huber, Tavis Donskey, Curtis Krein, Sarah L Safdar, Nasia Fiore, Anthony E Jernigan, John A Slayton, Rachel B Samore, Matthew Mayer, Jeanmarie Division of Epidemiology University of Utah School of Medicine Salt Lake City Utah IDEAS Center Salt Lake City VA Health Care System Salt Lake City Utah Department of Psychology University of Utah Salt Lake City Utah Case Western Reserve University Cleveland Ohio Louis Stokes Cleveland VA Medical Center Cleveland Ohio Hospital Outcomes Program of Excellence (HOPE) VA Ann Arbor Healthcare System Ann Arbor Michigan Section of Infectious Diseases Department of Medicine University of Wisconsin School of Medicine and Public Health Madison Wisconsin Centers for Disease Control and Prevention Atlanta Georgia Division of Healthcare Quality Promotion Centers for Disease Control and Prevention Atlanta Georgia University of Utah School of Medicine Division of Epidemiology Salt Lake City Utah

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Infection prevention and control Heroes: The Challenge of Being a Student in the Clinical Environment

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American Journal of Infection control 2016年第6期44卷 S4-S4页

作者： Peta-Anne P. Zimmerman Julia Gilbert Lynne Brown Lecturer/Visiting Research Fellow Graduate Infection Prevention and Control Program Griffith University Gold Hospital and Health Service Lecturer School of Nursing and Midwifery Griffith University

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