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Due to the fact that complications from infections are more frequent and serious related to intravenous therapy it is necessary to implement multidisciplinary measures which reduce their incidence. The recommendations made by the CDC help to guarantee the quality of the services which nursing professionals provides to patients when applying this procedure.
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The efficacy and safety of mezlocillin, a new broad-spectrum semisynthetic penicillin, were compared with those of carbenicillin in a nonblind, controlled clinical study in 89 adult patients. The infections treated were primarily those of the urinary tract, skin, and gastrointestinal or hepatobiliary tract. Escherichia coli, Proteus mirabilis, Proteus morganii, and Pseudomonas aeruginosa were the causative organisms isolated most frequently. A complete resolution of signs and symptoms was achieved in 78% of the mezlocillin patients and in 71% of the carbenicillin patients. In the mezlocillin group, causative organisms were eliminated in 80% of the courses, and in the carbenicillin group the elimination rate was 86%. Two adverse reactions, rash and diarrhea, were reported in mezlocillin-treated patients; none were reported for the carbenicillin group.
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Hepatitis C virus (HCV) has become the most significant cause of chronic liver disease of infectious etiology in the United States. The recognition that HCV can be transmitted perinatally or through blood transfusions warrants particular attention by the pediatrician. The American Academy of Pediatrics recommends screening infants born to HCV-infected mothers and persons with risk factors for HCV infection such as injection drug use, transfusion of >/= 1 U of blood or blood products before 1992, or hemodialysis should be screened for anti-HCV. Also, persons who received clotting factor concentrates before 1987, when effective inactivation procedures were introduced, also should be screened. Guidelines for counseling families of HCV-infected children are provided.
Many advisory reports of the Health Council of the Netherlands in the past century have dealt, directly or indirectly, with infectious diseases. One example is vaccination against smallpox. At the start of the last century, advice on this subject was important: initially, vaccination was compulsory by law, but people became increasingly aware of the associated side effects. A second example is immunisation against acute anterior poliomyelitis, which became a reality during the fifties. The advice also contained a discussion of which vaccine should be chosen: the inactivated 'dead' (Salk) form or the attenuated 'live' form (Sabin). Due to sound national organisation and associated logistics, a high level of vaccination was (and still is) achieved and the clinical disease known as polio disappeared from the Netherlands. Food-borne infections form the third example. The effect of the advice published by the Council on this subject (from 1960 onwards) has been limited, for a large part due to the significant economic consequences of the proposals for beef farming. The developments in the field of infectious diseases, immunology and vaccinology, together with social developments make it likely that in the coming years the Council will also frequently be asked for advice in the field of infectious diseases and the fight against them.
Pathogen genomic data are increasingly being used to investigate transmission dynamics in infectious disease outbreaks. Combining genomic data with epidemiological data should substantially increase our understanding of outbreaks, but this is highly challenging when the outbreak under study is only partially sampled, so that both genomic and epidemiological data are missing for intermediate links in the transmission chains. Here, we present a new dynamic programming algorithm to perform this task efficiently. We implement this methodology into the well-established TransPhylo framework to reconstruct partially sampled outbreaks using a combination of genomic and epidemiological data. We use simulated datasets to show that including epidemiological data can improve the accuracy of the inferred transmission links compared with inference based on genomic data only. This also allows us to estimate parameters specific to the epidemiological data (such as transmission rates between particular groups), which would otherwise not be possible. We then apply these methods to two real-world examples. First, we use genomic data from an outbreak of tuberculosis in Argentina, for which data was also available on the HIV status of sampled individuals, in order to investigate the role of HIV coinfection in the spread of this tuberculosis outbreak. Second, we use genomic and geographical data from the 2003 epidemic of avian influenza H7N7 in the Netherlands to reconstruct its spatial epidemiology. In both cases, we show that incorporating epidemiological data into the genomic analysis allows us to investigate the role of epidemiological properties in the spread of infectious diseases.