Impact of projected sea surface temperature biases on tropical cyclones projections in the South Pacific.

Climate model projections generally indicate fewer but more intense tropical cyclones (TCs) in response to increasing anthropogenic emissions. However these simulations suffer from long-standing biases in their Sea Surface Temperature (SST). While most studies investigating future changes in TC activity using high-resolution atmospheric models correct for the present-day SST bias, they do not consider the reliability of the projected SST changes from global climate models. The present study illustrates that future South Pacific TC activity changes are strongly sensitive to correcting the projected SST changes using an emergent constraint method. This additional correction indeed leads to a strong reduction of the cyclogenesis (-55%) over the South Pacific basin, while no statistically significant change arises in the uncorrected simulations. Cyclogenesis indices suggest that this strong reduction in the corrected experiment is caused by stronger vertical wind shear in response to a South Pacific Convergence Zone equatorward shift. We thus find that uncertainty in the projected SST patterns could strongly hamper the reliability of South Pacific TC projections. The strong sensitivity found in the current study will need to be investigated with other models, observational constraint methods and in other TC basins in order to assess the reliability of regional TC projections.

Evaluation of the efficacy of antibacterial medical gloves in the ICU setting.

BACKGROUND: Inappropriate use of medical gloves may support microbial transmission. New strategies could increase the safety of medical gloves without the risk of patient and surface contamination. AIM: To compare the efficacy of synthetic antibacterial nitrile medical gloves coated with polyhexamethylen-biguanid hydrochloride (PHMB) on the external surface with identical non-antibacterial medical gloves in reducing glove contamination after common patient care measures in an intensive care unit (ICU) setting. METHODS: ICU staff wore either standard or antibacterial gloves during patient care activities. The number of bacteria on gloves was measured semi-quantitatively immediately after the performance of four clinical activities. FINDINGS: There was a significant difference in mean bacterial growth [colony-forming units (cfu)] between control gloves and antibacterial gloves {60 [standard deviation (SD) 23] vs 16 (SD 23) cfu/glove imprint, P < 0.001}. In three of the four clinical activities (intravenous fluid handling, oral toilet and physiotherapy), the antibacterial gloves had significantly less bacterial contamination compared with the control gloves (P = 0.011 and <0.001, respectively). Although antibacterial gloves showed lower bacterial contamination after changing linen compared with control gloves, the difference was not significant (P = 0.311). CONCLUSION: This study showed that use of antibacterial medical gloves significantly reduced bacterial contamination after typical patient care activities in 57% of the investigated clinical activities (P < 0.01). The use of antibacterial medical gloves may support reduction of cross-contamination in the ICU setting.

HIV-Mycobacterium tuberculosis co-infection: a 'danger-couple model' of disease pathogenesis.

Tuberculosis (TB) and human immunodeficiency virus (HIV) infection interfere and impact the pathogenesis phenomena of each other. Owing to atypical clinical presentations and diagnostic complications, HIV/TB co-infection continues to be a menace for healthcare providers. Although the increased access to highly active antiretroviral therapy (HAART) has led to a reduction in HIV-associated opportunistic infections and mortality, the concurrent management of HIV/TB co-infection remains a challenge owing to adverse effects, complex drug interactions, overlapping toxicities and tuberculosis -associated immune reconstitution inflammatory syndrome. Several hypotheses have been put forward for the exacerbation of tuberculosis by HIV and vice versa supported by immunological studies. Discussion on the mechanisms produced by infectious cofactors with impact on disease pathology could shed light on how to design potential interventions that could decelerate disease progression. With no vaccine for HIV and lack of an effective vaccine for tuberculosis, it is essential to design strategies against HIV-TB co-infection.

Fatal influenza A (H3N2) and Campylobacter jejuni coinfection.

The rapid diagnosis and subtyping of influenza is particularly important in areas where avian influenza (H5N1) is present. The ability to recognise both typical and atypical presentations of influenza is also critical in such settings. A six-month-old male child who visited a H5N1-affected area subsequently died from a severe febrile diarrhoeal illness with minimal respiratory symptoms, and was initially diagnosed with influenza A of an unknown subtype. The final microbiological results showed a highly unusual combination of influenza A (H3N2) and Campylobacter jejuni infection.

Anaerobiospirillum succiniciproducens bacteraemia in a patient with acute lymphoblastic leukaemia.

A 17-year-old man with acute lymphoblastic leukaemia had fever and diarrhoea during a febrile neutropenic episode. A spiral-shaped, Gram-negative anaerobic bacterium was isolated from blood, and confirmed as Anaerobiospirillum succiniciproducens by 16S rRNA sequencing. The patient responded to imipenem.

Varicella-zoster virus seroprevalence in healthcare workers in Kuala Lumpur, Malaysia.

Varicella-zoster virus (VZV) infections are a particular problem in healthcare settings. A survey of chickenpox was carried out amongst healthcare workers (HCWs) following potential ward exposures. A prior history of chickenpox was given by 61/98 (62.2%). Of 64 HCWs tested for VZV IgG, 10 (15.6%) were seronegative, indicating susceptibility. The sensitivity, specificity, positive predictive value, and negative predictive value of a history of prior chickenpox were 57.4%, 90%, 96.4%, and 31.0%, respectively. VZV screening of HCWs without a history of chickenpox, and vaccination of susceptible HCWs should be undertaken in this hospital.