Authorship and citation gender trends in immunology and microbiology.

Immunology and microbiology research are essential for human and animal health. Unlike many other health fields, they do not usually centre around the curing or helping individual patients but focus on the microscopic scale instead. These fields are interesting from a gender perspective because two theories seeking to explain gender differences in career choices in the USA (people/things and communal/agentic goals) might produce conflicting expectations about their gender balances. This article assesses the gender shares of journal articles and gendered citation rates of five subfields of the Scopus Immunology and Microbiology broad category 1996-2014/18, for research with solely US author affiliations. Only Applied Microbiology and Biotechnology (38% female) had not reached gender parity in publishing by 2018. There was a female first author citation advantage in Parasitology but a disadvantage in Immunology. Immunology, Parasitology and Virology, had female last author citation disadvantages, but all gender effects were much smaller (<5%) than that of an extra author (10%-56%). Citation differences cannot therefore account for the current underrepresentation of women in senior roles.

A nationwide survey on involvement of clinical microbiologists in antibiotic stewardship programmes in large French hospitals.

Antibiotic stewardship programmes (ASP) are essential to tackle antibiotic resistance. Clinical microbiologists (CMs) play a key role in these programmes; however, few studies describe their actual involvement. Our objective was to explore CMs' involvement in French hospital ASP. In 2018, we conducted a survey among CMs working in large public French hospitals (600 acute care beds or more). The questionnaire focused on the following topics: microbiology department's characteristics, hospital ASP, and CMs' involvement in this programme, including their use of rapid diagnostic tests (RDT). Fifty/74 CMs answered (response rate 68%), with 68% working in a teaching hospital. CMs were leading the ASP in 6% of cases, and 57% of hospitals had a multidisciplinary antibiotic stewardship team. Most microbiology departments (92%) were using specific PCR, processed 24/7 in 74% of hospitals. More than half (58%) were using syndromic panel-based testing, 94% mass spectrometry, and 96% immunochromatographic/colorimetric RDT. Blood cultures were processed 24/7 in 44% of hospitals. CMs were involved in this. Finally, 42% of CMs wished to be more involved in their hospital's ASP, the most frequently reported barrier being lack of time (36%). CMs should be more involved in ASP. RDT are widely used, but not implemented in an optimal way.

Microbiological colonization of healthcare workers' mobile phones in a tertiary-level Italian intensive care unit.

BACKGROUND: Careful hand hygiene of healthcare workers is recommended to reduce transmission of pathogenic microorganisms to patients. Mobile phones are commonly used during work shifts and may act as vehicles of pathogens. OBJECTIVE: To assess the colonizsation rate of intensive care unit healthcare workers' mobile phones before and after work shifts. METHODS: Prospective observational study conducted in an academic, tertiary-level intensive care unit. Healthcare workers (including doctors, nurses and healthcare assistants) had their mobile phones sampled for microbiology before and after work shifts. Samples were taken with a swab in a standardizsed modality. RESULTS: Fifty healthcare workers participated in the study (91% of the department staff). One hundred swabs were taken from 50 mobile phones. Forty-three healthcare workers (86%) reported a habitual use of their phones during the work shift. All phones (100%) were positive for bacteria. The most frequently isolated bacteria were Coagulase Negative Staphylococci, Bacillus sp. and Methicillin-resistant Staphylococcus aureus (97%, 56%, 17%, respectively). No patient admitted to the intensive care unit during the study period was positive for bacteria found on healthcare workers' mobile phones. No difference in bacteria types and burden was found between the beginning and the end of work shifts. CONCLUSION: Healthcare workers' mobile phones are colonized even before the work shift and irrespective of the patients' microbiological flora.

Perspectives on multidrug-resistant organisms at the end of life : A focus group study of staff members and institutional stakeholders.

BACKGROUND: There is a lack of research into how hospital staff and institutional stakeholders (i. e. institutional representatives from public health authorities, hospital hygiene, and the departments of microbiology, palliative care, and geriatrics) engage with patients who are carriers of multidrug-resistant organisms and receiving end-of-life care. Knowledge of their experiences, workload, and needs should be considered in dealing with hospitalized carriers of multidrug-resistant organisms as well as staff education. OBJECTIVE: This study explored and compared staff members' and stakeholders' perspectives on multidrug-resistant organisms and on provision of end-of-life care to carrier patients. METHODS: In this study four focus groups consisting of hospital staff members and institutional stakeholders were formed within a mixed-methods parent study in a palliative care unit at a university clinic and a geriatric ward of a Catholic and academic teaching hospital. Participants discussed results from staff and stakeholder interviews from a former study phase. Data were analyzed according to Grounded Theory and perspectives of staff members and institutional stakeholders were compared and contrasted. RESULTS: Key issues debated by staff members (N = 19) and institutional stakeholders (N = 10) were 1) the additional workload, 2) reasons for uncertainty about handling carrier patients, 3) the format of continuing education, and 4) the preferred management approach for dealing with multidrug-resistant organism carrier patients. Although similar barriers (e. g. colleagues' ambiguous opinions) were identified, both groups drew different conclusions concerning the management of these barriers. While institutional stakeholders recommended making decisions on hygiene measures under consideration of the specific patient situation, staff members preferred the use of standardized hygiene measures which should be applied uniformly to all patients. DISCUSSION: Staff members and institutional stakeholders perceived similar barriers to practice caused by multidrug-resistant organisms and similar needs for continuing education. The staff members' preferred management approach might originate from an uncertainty about the multidrug-resistant organism infection risk. Experiences and visions of both groups should be included in a specific recommendation for end-of-life care to ensure behavioral confidence.

Methodological approach towards a Gap Assessment of the Serbian microbiology system in the function of surveillance in line with EU standards and acquis.

INTRODUCTION: Italian and Serbian Health authorities performed an in-depth Gap Assessment of the Serbian microbiology system in the function of communicable disease surveillance using a methodology adapted to context and information needs. METHODS: There were two study phases: a capacity based survey and an equipment mapping survey. Invited participants included national health authorities, heads of national reference laboratories and of public/private diagnostic laboratories in Serbia. Findings were analysed preliminarily and identified gaps were discussed, prioritized and validated through two ad hoc workshops involving all concerned institutions. RESULTS: The Gap Assessment was performed between September and December 2017. The overall response rate was 69% for phase one and 74% for phase two. Identified gaps were assessed as highly relevant during the project workshops. DISCUSSION: Gaps and priorities were highlighted, validated, and studied with a suitable level of detail to develop a concrete action-plan. The same methodological approach could be used to monitor progress in Serbia as well as in other EU candidate countries.

Blogging in Infectious Diseases and Clinical Microbiology: Assessment of 'Blogosphere' Content.

OBJECTIVE To analyze influential infectious diseases, antimicrobial stewardship, infection control, or medical microbiology blogs and bloggers SETTING World wide web DESIGN We conducted a systematic search for blogs in accordance with the PRISMA guidelines in September 2015. METHODS A snowball sampling approach was applied to identify blogs using various search engines. Blogs were eligible if they (1) focused on infectious diseases, antimicrobial stewardship, infection control, or medical microbiology; (2) were intended for health professionals; and (3) were written in English and (4) were updated regularly. We mapped blog and blogger characteristics and used an innovative tool to assess the architecture and content of the included blogs. The motivations and perceptions of bloggers and readers were also assessed. RESULTS A total of 88 blogs were identified. Moreover, 28 blogs (32%) focused on infectious diseases, 46 (52%) focused on medical microbiology, and 14 (16%) focused on infection control or antimicrobial stewardship. Bloggers were mainly male with medical doctorates and/or PhDs; 32 bloggers (36%) posted at least weekly; and 51 (58%) had a research purpose. The aims were considered clear for 23 blogs (26%), and the field covered was considered broad for 25 blogs (28%). Presentation was considered good for 22 blogs (25%), 51 blogs (58%) were easy to read, and 46 blogs (52%) included expert interpretation. Among the top 10 blogs, 3 focused on infectious diseases, 6 focused on medical microbiology, and 2 focused on infection control (2 were equally ranked). The bloggers we questioned were motivated to share their independent expertise and opinions. Readers appreciated the concise messages on scientific topics and practical updates. CONCLUSIONS This study describes high-level blogs in the fields of infectious diseases, infection control, and medical microbiology. Our findings suggest ways in which bloggers should build/orientate blogs for readers, and we have highlighted current gaps in blog topics such as antimicrobial stewardship. Infect. Control Hosp. Epidemiol 2017;38:832-839.

[Nationwide survey among institutes of microbiology in academic medicine : Is the interdisciplinary approach the right way to treat patients with urogenital infections?] / Infektiologisch interessierte Urologen werden gebraucht : Nationale Umfrage universitärer Mikrobiologien zur interdisziplinären Zusammenarbeit von Urologie und Mikrobiologie.

BACKGROUND: Increasing antibiotic resistance is a current and severe problem in medicine, especially in urology. Multidisciplinary antibiotic stewardship programmes are an important approach to counteract increasing resistance rates. This approach includes collaboration between urologists and microbiologists. OBJECTIVES: The primary endpoint was to describe the current setting of interdisciplinary work of urologists and microbiologists in university hospitals in Germany. The secondary endpoints were the identification of problems of this interdisciplinary approach in daily routine and implications for the future in patient treatment. MATERIALS AND METHODS: A newly developed, 24-item questionnaire was sent to 34 German microbiology departments at medical universities between June and October 2016; the departments were contacted up to four times. Only complete questionnaires were included in our analysis. RESULTS: The response rate was 50.0%. In the majority of the urological cases a microbiologist was only contacted sporadically and asked for advice, but on the other hand most of the microbiologists think that this contact and discussion about the patient is reasonable and preferable. Of the respondents, 82.4% think that with a consequent interdisciplinary approach there might be lower antibiotic resistance rates in the future. One essential problem of ideal microbial diagnostics and therapeutic advice is that the microbiologist does not receive all relevant information upon request. This might be the case in up to 76.5%. Other problems are of economic nature or shortage of manpower. CONCLUSION: Interdisciplinary patient care between urologists and microbiologists is reasonable and preferable. This approach has the potential of decreasing antibiotic resistance rates in the future.

Uma nova estratégia para PDT antimicrobiana em Endodontia / A new approach for antimicrobial Endodontic PDT

O presente estudo avaliou diferentes parâmetros como concentração do fotossensibilizador,tempo/energia de irradiação e uso de fibras ópticas, na a PDT para redução bacteriana intracanal.Avaliou-se, in vitro, em cubetas de quartzo contendo concentrações de 50, 100, 150 e 300μM de solução aquosa de Azul de Metileno (AM) a produção de espécies reativas de oxigênio (EROs) em irradiações adicionais de 30s com um laser de diodo emitindo em 660nm. Utilizando-se a mesma metodologia, foi avaliado os efeitos na produção de EROs com e sem o uso de fibra óptica. Concentrações de 50, 150 e 300μM de AM e análise por imagens, avaliaram a formação do fenômeno escudo óptico. Dez incisivos contaminados com P. Aeruginosas bioluminescentes, foram utilizados para analisar as energias/tempo para redução bacteriana intracanal. Imagens obtidas nos dentes avaliaram a contaminação inicial. Os canais foram preenchidos com o fotossensibilizador (PS) eirradiações de 2,4J foram realizadas. A cada irradiação, imagens foram obtidas e a redução bacteriana avaliada. A formação de EROs é maior em concentrações menores do PS, assim como a formação de escudo óptico. O uso de fibra aumenta a formação de ERO quando comparado a irradiação sem fibra. Irradiação com 7J impossibilitou a detecção de biofilme intracanal. A concentração do PS em que há maior eficiência na formação de EROs e menor formação de escudo óptico se encontra entre 50 a 100μM. O uso de fibras ópticas contribui para maior formação de EROs. Energia de irradiação mínima de 7J promove significativa redução bacteriana intracanal.

This study evaluates different approach such as photos sensitizer (PS) concentration, irradiation time/energy, and the use of optical fiber for intracanal microbial reduction. In a quartzcurvet, aqueous solution of Methylene blue at 50, 100, 150 and 300μM was tested for reactive oxygen species production (ROS) after successive irradiations of 30s with a diode laser (660nm,100mW). Using the same methodology, the ROS production was tested using an optical fiber. Image analyses evaluated the presence of optical shield in 3 different concentration of PS. Tencentral incisors were contaminated with bioluminescent P. aeruginosas to test the ideal energy/time for endodontic microbial reduction. Initial contamination was recorded by image after biofilm grown. The root canals were ful filled with Ps and irradiated with successive energiesof 2.4J. After every irradiation new images were recorded to compare the microbial reduction. ROS formation was improved using low concentration of PS, such as optical shield formation. The use of optical fiber did enhance the ROS formation when compared to irradiation with thelaser tip. Energy of 7J was the minimal energy to achieve lost of bioluminescent signal. For more efficient ROS production and minor optical shield presence, a concentration between 50 and 100μM seams to be ideal. The use of an optical fiber improves ROS production. Energy of 7J promotes significative intracanal de contamination.

Surveillance cultures in intensive care units: a nationwide survey on current practice providing future perspectives.

PURPOSE: To explore the extent of surveillance culture (SC) implementation underlying motives for obtaining SC and decision making based on the results. MATERIALS AND METHODS: A questionnaire was distributed to Heads of Department (HODs) and microbiologists within all intensive care departments in the Netherlands. RESULTS: Response was provided by 75 (79%) of 95 HODs and 38 (64%) of 59 laboratories allied to an intensive care unit (ICU). Surveillance cultures were routinely obtained according to 55 (73%) of 75 HODs and 33 (87%) of 38 microbiologists. Surveillance cultures were obtained in more than 80% of higher-level ICUs and in 58% of lower-level ICUs (P < .05). Surveillance cultures were obtained twice weekly (88%) and sampled from trachea (87%), pharynx (74%), and rectum (68%). Thirty (58%) of 52 HODs obtained SC to optimize individual patient treatment. On suspicion of infection from an unknown source, microorganisms identified by SC were targeted according to 87%. One third of HODs targeted microorganisms identified by SC in the case of an infection not at the location where the SC was obtained. This was significantly more often than microbiologists in case of no infection (P = .02) or infection of unknown origin (P < .05). CONCLUSIONS: Surveillance culture implementation is common in Dutch ICUs to optimize individual patients' treatment. Consensus is lacking on how to deal with SC results when the focus of infection is not at the sampled site.

Optimal experimental design for discriminating between microbial growth models as function of suboptimal temperature.

In the field of predictive microbiology, mathematical models play an important role for describing microbial growth, survival and inactivation. Often different models are available for describing the microbial dynamics in a similar way. However, the model that describes the system in the best way is desired. Optimal experimental design for model discrimination (OED-MD) is an efficient tool for discriminating among rival models. In this work the T12-criterion proposed by Atkinson and Fedorov (1975) [1] and applied efficiently by Ucinski and Bogacka (2005) [2] and the Schwaab-approach proposed by Schwaab et al. (2008) [3] and Donckels et al. (2009) [4] will be applied for discriminating among rival models for the microbial growth rate as a function of temperature. The two methods will be tested in silico and their performances will be compared. Results from a simulation study indicate that it is possible to validate the case that one of the proposed models is more accurate for describing the temperature effect on the microbial growth rate. Both methods are able to design inputs with a sufficient discrimination potential. However, it has been observed that the Schwaab-approach provides inputs with a higher discrimination potential in combination with more accurate parameter estimates.

Real-time surveillance of laboratory confirmed influenza based on the Danish microbiology database (MiBa).

The Danish microbiology database (MiBa) is a national database that automatically accumulates patient test results from all Danish Departments of Clinical Microbiology. As an example for use of MiBa, we describe the real-time surveillance of laboratory confirmed influenza established in October 2012. It functions without any extra burdens of reporting by laboratories or clinicians. This is an important improvement of the existing surveillance for influenza like illness (ILI) which includes only limited virological testing. The MiBa based surveillance adds complete national virological data which are specific for influenza, in contrast to ILI, and serves as a tool for regional and national preparedness and planning.

Detecção e quantificação de patógenos periodontais em fumantes e não fumantes com periodontite crônica pela PCR em tempo real / Detection and quantification of periodontal pathogens in smokers and never-smokers with chronic periodontitis by Real-Time Polymerase Chain Reaction

O objetivo do presente trabalho foi comparar fumantes e não fumantes com periodontite crônica com relação a presença e quantidade de patógenos periodontais, através da reação em cadeia da polimerase em tempo real. Quarenta fumantes e quarenta não fumantes, pareados por idade, sexo e profundidade clínica de sondagem dos sítios de coleta microbiológica, foram incluídos no estudo. Foi realizado exame periodontal completo, e coletado um pool de biofilme subgengival dos sítios mais profundos de cada quadrante, em cada sujeito de pesquisa. Para confirmar os dados sobre tabagismo, os sujeitos foram submetidos à avaliação das concentrações de monóxido de carbono expirado, através de um monoxímetro. A presença e quantificação de Aggregatibacter actinomycetemcomitans, Porphyromonas gingivalis, Tannerella forsythia e Treponema denticola foi determinada pela reação em cadeia da polimerase em tempo real. Fumantes apresentaram maior média de profundidade clínica de sondagem (p = 0,001) e nível clinico de inserção (p = 0,006), e menos sítios com sangramento à sondagem (p = 0,001) do que os não fumantes. Foi observada associação entre fumo e presença de A. actinomycetemcomitans (p < 0,001). Contagens médias de A. actinomycetemcomitans (p < 0,001), P. gingivalis (p = 0,042) e T. forsythia (p < 0,001) foram significantemente maiores nos fumantes. Os resultados permitiram concluir que o fumo altera a composição da microbiota subgengival em indivíduos com periodontite crônica, com diferenças na presença e quantidade dos patógenos periodontais investigados

The aim of the present investigation is to compare smokers and nonsmokers with chronic periodontitis, regarding the presence and quantity of periodontal pathogens, using real-time polymerase chain reaction. Forty current smokers and forty never-smokers, matched for age, sex and sampling sites mean probing depth, were included in this investigation. A full-mouth periodontal examination was performed, and a pooled subgingival plaque sample was collected from the deepest site, in each quadrant, of each subject. To confirm smoking status, subjects had their expired air carbon monoxide concentrations measured with the help of a carbon monoxide monitor. The presence and quantification of Aggregatibacter actinomycetemcomitans, Porphyromonas gingivalis, Tannerella forsythia and Treponema denticola were determined by real-time polymerase chain reaction. Smokers presented greater overall mean probing depth (p = 0,001) and mean clinical attachment level (p = 0,006), and fewer bleeding on probing sites (p = 0,001). An association was observed between smoking status and presence of A. actinomycetemcomitans (p < 0.001). Counts of A. actinomycetemcomitans (p < 0,001), P. gingivalis (p = 0,042) and T. forsythia (p< 0,001) were significantly higher in smokers. We concluded that smoking changes the composition of the subgingival microbiota in chronic periodontitis patients, with differences in the presence and quantification of investigated periodontopathogens

Consensus of microbiology reporting of ear swab results to primary care clinicians in patients with otitis externa.

Otitis externa is a ubiquitous inflammatory disease; although it arises most commonly from an infection, there is no consensus in the UK for the reporting of ear swab culture results. This study aims to review current microbiology laboratory reporting of ear swab specimens to primary care and reach an evidence-based consensus for a reporting policy. Fifty consecutive ear swab reports were reviewed from each of 12 laboratories in the South West region to determine and discuss reporting practice. The Health Protection Agency (HPA) GP Microbiology Laboratory Use Group reviewed the underlying evidence and worked towards a consensus of expert microbiology opinion for laboratory reporting of ear swab results using a modified version of the Delphi technique. A total of 487 reports from primary care were reviewed (54% female; 46% male). Cultures most commonly yielded Pseudomonas species (36%), Staphylococcus species (21%), Streptococcus species (15%) and fungi (11%). Five reporting policies were agreed: Policy 1: Common pathogens such as group A beta-haemolytic streptococci, Streptococcus pneumoniae, Staphylococcus aureus - Always reported by name with antibiotic susceptibilities. Policy 2: Pseudomonas species - Always reported, but antibiotic susceptibilities only reported in severe disease. Policy 3: Aspergillus, Candida, coliforms and Proteus species, as well as non-group A streptococci and anaerobes - Only reported if moderate numbers of colonies and it is the predominant organism present; if appropriate report antibiotic susceptibilities. Policy 4: Coagulase-negative staphylococci, diphtheroids and enterococci - Not reported by name; generic terms used and antibiotic susceptibilities not reported. Policy 5: When antibiotic susceptibilities reported these must include susceptibility to a topical antibiotic. It is suggested that laboratories should consider adopting this evidence-based reporting consensus for ear swab culture results from primary care patients with otitis externa.

[Current panorama of the teaching of microbiology and parasitology in Spain]. / Panorama actual de la docencia de la especialidad de microbiología y parasitología en España.

The training program of residents in microbiology and parasitology in Spain includes clinical skills, ranging from the diagnostic approach to the patient and adequate sample collection for diagnosis of infectious diseases to antimicrobial therapy and infection control measures. Training also includes new challenges in clinical microbiology that ensure residents' participation in infection control programs of health-care associated infections, training in the resolution of public health problems, and application of new molecular microbiology methods. Specialization in clinical microbiology may be undertaken by graduates in Medicine, Biology, Biochemistry and Chemistry. The training is performed in accredited microbiology laboratories at different hospitals (n = 61) across the country through 4-year residency programs. In the last few years, there has been a major imbalance between the number of intended residents (0.17 per 100,000 inhabitants) and those graduating as specialists in clinical microbiology (0.13 per 100,000 inhabitants), with wide variations across the country. The current tendency in Europe is to strengthen the role of clinical microbiologists as key figures in the diagnosis of infectious diseases and in public health microbiology. Training programs have been hampered by the practice of sending samples for microbiological tests to external, centralized multipurpose laboratories with few clinical microbiologists and without a core curriculum. Essential elements in the training of specialists in clinical microbiology are a close relationship between the laboratory and the clinical center and collaboration with other specialists.

Advances in diagnostics for microbial agents: can clinical validation keep pace with the technical promises?

New technologies are revolutionizing diagnostic microbiology, but implementation of methodological advances in test evaluation has been extraordinarily slow. Published reports frequently fail to clearly distinguish between studies of analytical accuracy and those of clinical diagnostic performance. We argue that the evaluation of sensitivity and specificity, while necessary and occasionally problematic, is often inadequate to define the appropriate role of a new diagnostic test. To determine whether a test adds additional (incremental) value to the diagnostic information already available to the clinician, evaluation studies with a multivariable approach may also be needed. The impact of a test on patient outcome is best measured by a randomized controlled trial, but this may be unnecessary in certain well-defined situations. To improve the quality of published test evaluations close collaboration between clinicians, clinical microbiologists, and epidemiologists, as well as insistence by journal editors on the use of established reporting standards are essential.