1/9. Recognizing and managing clostridium difficile-associated diarrhea.clostridium difficile-associated diarrhea poses a significant physical risk and cost to the recovery of hospitalized older adults. C. difficile is responsible for 75% or more of the diarrhea-associated enteric infections acquired during a hospital stay (Gerding, Johnson, Peterson, Mulligan, & Silva, 1995). C. difficile is easily spread by direct or indirect contact, therefore placing other patients at great risk for contamination by this organism. nursing plays a significant role in early identification, management, and control of the spread of this potentially lethal infection.- - - - - - - - - - ranking = 1keywords = physical (Clic here for more details about this article) |
2/9. Transmissions of hepatitis c virus during the ancillary procedures for assisted conception.Since mother to child transmissions of hepatitis c virus (HCV) have been reported to be low, teams involved in assisted reproductive technologies have accepted HCV positive patients into their programmes. We report in the present paper two cases of undoubted patient to patient HCV transmission while patients were attending for assisted conception. In both cases, HCV genotyping and sequencing of the first hypervariable region of the HCV genome provided molecular evidence for nosocomial transmission. Investigations made to elucidate the route of contamination have shown that the most likely route of contamination is through healthcare workers. Such nosocomial HCV infection has been reported in other healthcare situations, mainly in dialysis units, and physical proximity was also suspected to be at the origin of the infection. We conclude that assisted reproduction teams must be very prudent when including such patients in their programmes.- - - - - - - - - - ranking = 1keywords = physical (Clic here for more details about this article) |
3/9. enterobacter sakazakii infections among neonates, infants, children, and adults. case reports and a review of the literature.enterobacter sakazakii can cause serious infections especially among the very young and the elderly. It continues to be more common among neonates and infants than adults. Its tropism for the central nervous system in neonates and infants remains a mystery. Among neonates and infants, E. sakazakii has a propensity to cause meningitis resulting in ventriculitis, brain abscess or cyst formation, and development of hydrocephalus requiring ventricular-peritoneal shunt. Computed tomography of the head is therefore useful in following patients with E. sakazakii meningitis. mortality and morbidity of E. sakazakii meningitis is high, and virtually all patients recovering from the central nervous system infection suffered mental and physical developmental delays. The case-fatality rate decreased among patients with meningitis treated with the third-generation cephalosporins. Most adults with E. sakazakii infection had serious underlying diseases and 50% of the adults with the infection had malignancies. However there has never been a known case of meningitis. Increasing antibiotic resistance among enterobacter species should lead one to consider using the carbapenems or the newer cephalosporins in combination with a second agent such as an aminoglycoside. Limited data suggest that trimethoprim-sulfamethoxazole may be a useful agent in the treatment of infections caused by the enterobacter species, especially in view of the production of extended-spectrum beta-lactamases capable of inactivating the cephalosporins and extended-spectrum penicillin.- - - - - - - - - - ranking = 1keywords = physical (Clic here for more details about this article) |
4/9. Horizontal transmission of candida parapsilosis candidemia in a neonatal intensive care unit.This report describes the nosocomial acquisition of candida parapsilosis candidemia by one of the six premature newborns housed in the same room of a neonatal intensive care unit at the Ospedale Santa Chiara, Pisa, italy. The infant had progeria, a disorder characterized by retarded physical development and progressive senile degeneration. The infant, who was not found to harbor C. parapsilosis at the time of his admission to the intensive care unit, had exhibited symptomatic conjunctivitis before the onset of a severe bloodstream infection. In order to evaluate the source of infection and the route of transmission, two independent molecular typing methods were used to determine the genetic relatedness among the isolates recovered from the newborn, the inanimate hospital environment, hospital personnel, topically and intravenously administered medicaments, and indwelling catheters. Among the isolates collected, only those recovered from the hands of two nurses attending the newborns and from both the conjunctiva and the blood of the infected infant were genetically indistinguishable. Since C. parapsilosis was never recovered from indwelling catheters or from any of the drugs administered to the newborn, we concluded that (i) horizontal transmission of C. parapsilosis occurred through direct interaction between nurses and the newborn and (ii) the conjunctiva was the site through which C. parapsilosis entered the bloodstream. This finding highlights the possibility that a previous C. parapsilosis colonization and/or infection of other body sites may be a predisposing condition for subsequent C. parapsilosis hematogenous dissemination in severely ill newborns.- - - - - - - - - - ranking = 1keywords = physical (Clic here for more details about this article) |
5/9. infection and inflammation in dialysis patients: impact on laboratory parameters and anemia. Case study of the anemic patient.infection and inflammation trigger an acute-phase response that can precipitate the development of mild to moderate anemia. In many cases, changes in hematological parameters may be the initial sign of an occult infectious or inflammatory disorder. In dialysis patients, the decrease in erythropoiesis attributed to these conditions is often additive--aggravating the preexisting anemia associated with end-stage renal disease (ESRD). nephrology nurses are in a unique position to conduct regular physical assessments and laboratory evaluations to proactively detect infection or inflammation and limit the short- and long-term impact of these conditions.- - - - - - - - - - ranking = 1keywords = physical (Clic here for more details about this article) |
6/9. serratia marcescens bacteremia associated with schistosomiasis mansoni.The case of a 21-year-old man coming from rural Paraiba, northwestern brazil, with schistosomiasis mansoni associated with serratia marcescens bacteremia, is reported. His main complaints on admission were fever, diaphoresis and chills for ten days, and diarrhoea that lasted for four days. On physical examination he had jaundice and hepatosplenomegaly. Diagnosis of S. marcescens bacteremia was made by isolation of the bacterium in blood culture, and schistosomiasis was diagnosed by rectal and liver biopsies. This is the first time that the association of S. marcescens bacteremia and schistosomiasis mansoni is recognized. Although our case does not fit into the classic definition of prolonged bacteremia associated with schistosomiasis, it can be considered as a mild form of this association. With the improvement of medical assistance and laboratory facilities, early diagnosis of this association will be made more frequently, cases with short duration will be diagnosed few days after the start of the symptoms, and classic prolonged cases will become rarer.- - - - - - - - - - ranking = 1keywords = physical (Clic here for more details about this article) |
7/9. Epidemic Norwegian scabies.Norwegian scabies is an ectoparasitic infestation by sarcoptes scabiei, characterized by hyperkeratotic lesions of the hands, feet, ears, and scalp, which contain many mites. An epidemic of Norwegian scabies involved 22 patients in a 25-patient ward of mentally and physically handicapped persons (mostly mongoloids). The pathogenesis of the prolific mite population is unclear, but either a specific immunologic deficit or the inability to effectively eliminate the mites by scratching is a plausible possibility.- - - - - - - - - - ranking = 1keywords = physical (Clic here for more details about this article) |
8/9. Nosocomial candidemia: risk factors and attributable mortality.Over the past decade, the incidence of hospital-acquired bloodstream infections caused by candida species has risen and the species associated with such infections have changed. The incidence of candidemia is dramatically higher in high-risk, critical-care units than in other parts of the hospital. Certain underlying physical conditions including acute leukemia, leukopenia, burns, gastrointestinal disease, and premature birth predispose patients to nosocomial candidemia. Independent risk factors include prior treatment with multiple antibiotics, prior Hickman catheterization, isolation of candida species from sites other than the blood, and prior hemodialysis. In this article some of the challenges posed by the management of nosocomial candidemia are presented in three case studies. In addition, the results of several investigations of nosocomial candidemia at the University of iowa hospitals and Clinics are reviewed.- - - - - - - - - - ranking = 1keywords = physical (Clic here for more details about this article) |
9/9. Lucilia sericata (diptera: Calliphoridae) causing hospital-acquired myiasis of a traumatic wound.A case of traumatic nosocomial myiasis caused by the green bottle fly Lucilia sericata (Meigen, 1826) occurred in a patient hospitalized following a serious road traffic accident. The patient had suffered extensive polytrauma particularly in the facial area of the skull. A total of 50 larvae was discovered in the oral cavity, nose, paranasal sinuses and enucleated eye-socket. Projected timing indicated that the eggs were laid while the patient was hospitalized. The development of myiasis was facilitated by the mental and physical debility and dependency of the patient, numerous and deep facial necrotic wounds and a lengthy period of hot weather which led to prolonged open window ventilation of his room.- - - - - - - - - - ranking = 1keywords = physical (Clic here for more details about this article) |