Syndromic surveillance for evaluating the occurrence of healthcare-associated infections in equine hospitals.

REASONS FOR PERFORMING STUDY: Methods that can be used to estimate rates of healthcare-associated infections and other nosocomial events have not been well established for use in equine hospitals. Traditional laboratory-based surveillance is expensive and cannot be applied in all of these settings. OBJECTIVES: To evaluate the use of a syndromic surveillance system for estimating rates of occurrence of healthcare-associated infections among hospitalised equine cases. STUDY DESIGN: Multicentre, prospective longitudinal study. METHODS: This study included weaned equids (n = 297) that were admitted for gastrointestinal disorders at one of 5 participating veterinary referral hospitals during a 12-week period in 2006. A survey form was completed by the primary clinician to summarise basic case information, procedures and treatments the horse received, and whether one or more of 7 predefined nosocomial syndromes were recognised at any point during hospitalisation. Adjusted rates of nosocomial events were estimated using Poisson regression. Risk factors associated with the risk of developing a nosocomial event were analysed using multivariable logistic regression. RESULTS: Among the study population, 95 nosocomial events were reported to have occurred in 65 horses. Controlling for differences among hospitals, 19.7% (95% confidence interval, 14.5-26.7) of the study population was reported to have had at least one nosocomial event recognised during hospitalisation. The most commonly reported nosocomial syndromes that were unrelated to the reason for hospitalisation were surgical site inflammation and i.v. catheter site inflammation. CONCLUSIONS: Syndromic surveillance systems can be standardised successfully for use across multiple hospitals without interfering with established organisational structures, in order to provide useful estimates of rates related to healthcare-associated infections.

Using syndromic surveillance to estimate baseline rates for healthcare-associated infections in critical care units of small animal referral hospitals.

BACKGROUND: Expected rates of healthcare-associated infections (HCAI) have not been established in veterinary hospitals. Baseline rates are critically needed as benchmarks for quality animal care. OBJECTIVE: To estimate the occurrence of events related to HCAI identified using a standardized syndromic surveillance system in small animals in critical care cases at referral hospitals. ANIMALS: Weaned dogs and cats (n = 1,951) that were hospitalized in the critical care unit of referral teaching hospitals during a 12-week period. METHODS: Multicenter, prospective longitudinal study. A survey was completed for all enrolled animals to record basic demographics, information about procedures and treatments that animals received, and to document the occurrence of defined nosocomial syndromes. Data were analyzed to identify risk factors associated with the occurrence of these nosocomial syndromes. RESULTS: Controlling for hospital of admission, 16.3% of dogs (95% confidence intervals [CI], 14.3-18.5) and 12% of cats (95% CI, 9.3-15.5) were reported to have had ≥ 1 nosocomial syndrome occur during hospitalization. Risk factors found to have a positive association with the development of a nosocomial syndrome were longer hospital stays, placement of a urinary catheter, surgical procedures being performed, and the administration of antiulcer medications and antimicrobial drugs excluding those given perioperatively. CONCLUSIONS AND CLINICAL IMPORTANCE: Syndromic surveillance systems can be successfully standardized for use across multiple hospitals to effectively collect data pertinent to HCAI rates and risk factors for occurrence.

Lack of evidence of pregnancy-induced alloantibodies in dogs.

BACKGROUND: It is controversial whether or not pregnant bitches become sensitized to red blood cell (RBC) antigens. HYPOTHESIS: Bitches do not develop alloantibodies to RBC antigens during gestation and can be used safely as blood donors. ANIMALS: The study group included 35 healthy female dogs with a prior history of 1 (n = 12), 2 (n = 14), or >or= 3 (n = 9) pregnancies. The control group consisted of 15 healthy female dogs without any history of pregnancy. METHODS: All dogs were blood typed for dog erythrocyte antigens (DEA) 1.1, 1.2, 3, 4, 5, and 7 using ethylenediaminetetraacetic acid blood samples and polyclonal antisera. Antibody screening was performed with serum and canine RBC panels of known blood type. An autocontrol and direct antiglobulin test were performed to rule out the presence of autoantibodies. RESULTS: The only alloantibodies identified were those against DEA 7 and the prevalence of anti-DEA 7 alloantibodies was similar in dogs with known history of pregnancy (11.4%) and in the control group (13.3%). CONCLUSIONS AND CLINICAL IMPORTANCE: These results confirm previous studies and clinical transfusion medicine experience. Naturally occurring anti-DEA 7 alloantibodies have been reported but their clinical relevance has not been shown. Pregnancy does not appear to sensitize dogs to RBC antigens. Consequently, dogs with prior history of pregnancy can be used safely as blood donors. Conversely, no additional pretransfusion compatibility studies would be required should these dogs themselves need to be transfused.

Mutational studies of yeast transcription factor IIB in vivo reveal a functional surface important for gene activation.

Recent experiments in yeast (Saccharomyces cerevisiae) cells have identified a species-specific region of yeast transcription factor IIB (TFIIB) located at residues 144-157. According to the human TFIIB structure, this region is part of a solvent-exposed helix in the first repeat of the carboxyl-terminal core domain. In this report, we systematically analyze four positions in this region (Lys-147, Cys-149, Lys-151, and Glu-152) that together have been shown previously to be important for yeast TFIIB's function in vivo. Our experiments suggest that all of these four positions, and in particular positions 151, 149, and 152, are critical for yeast TFIIB's ability to support cell growth. In addition, we describe an intragenic suppressor screening experiment to identify mutations that reverse, or partially reverse, the temperature-sensitive phenotype of a yeast TFIIB derivative bearing amino acid changes at these four positions to human residues. The suppressor mutations reveal changes at positions 115, 117, and 182 that are located outside the species-specific region of yeast TFIIB, suggesting an extended surface available to interact with other proteins. Finally, we demonstrate that the suppressor mutations restore gene activation in vivo, further supporting the idea that one important function of yeast TFIIB in living cells is to mediate gene activation.

Identifying a species-specific region of yeast TF11B in vivo.

The general transcription factor IIB (TFIIB) is required for RNA polymerase II transcription in eukaryotes. It provides a physical link between the TATA-binding protein (TBP) and the RNA polymerase and is a component previously suggested to respond to transcriptional activators in vitro. In this report, we compare the yeast (Saccharomyces cerevisiae) and human forms of the protein in yeast cells to study their functional differences. We demonstrate that human TFIIB fails to functionally replace yeast TFIIB in yeast cells. By analyzing various human-yeast hybrid TFIIB molecules, we show that a 14-amino-acid region at the amino terminus of the first repeat of yeast TFIIB plays an important role in determining species specificity in vivo. In addition, we identify four amino acids in this region that are critical for an amphipathic helix unique to yeast TFIIB. By site-directed mutagenesis analyses we demonstrate that these four amino acids are important for yeast TFIIB's activity in vivo. Finally, we show that mutations in the species-specific region of yeast TFIIB can differentially affect the expression of genes activated by different activators in vivo. These results provide strong evidence suggesting that yeast TFIIB is involved in the process of transcriptional activation in living cells.

A comparison of depression rating scales.

In a comparison of assessment methods of severity of depressive illness, the Montgomery-Asberg Scale had, broadly, a performance equal to the Hamilton Scale. The Beck Depression Inventory, it subscale, and the Wakefield Inventory all had overall poor performances and should now be abandoned in research. The two-patient-rated scales were, overall, similar and fairly satisfactory measures. The comparisons were at points in severity of illness and not on change of severity.