ABSTRACT
BACKGROUND: Meticillin-resistant Staphylococcus pseudintermedius (MRSP) is a multidrug-resistant canine pathogen with a low zoonotic potential. This study investigated MRSP carriage and clearance through topical antimicrobial therapy and household cleaning in dogs recovered from MRSP infection. METHODS: Dogs were swabbed for MRSP carriage; household contamination was assessed using contact plates. Carrier dogs were allocated randomly to receive topical fusidic acid and chlorhexidine/miconazole treatment combined with owners implementing a household hygiene protocol (H&T) or implementation of hygiene alone (H) over three weeks. Carriage-negative dogs were monitored monthly. The relatedness of isolates over time was investigated by pulsed-field gel electrophoresis (PFGE). RESULTS: At inclusion, MRSP carriage was confirmed in 31/46 (67.4%) index dogs and 16/24 (66.7%) contact dogs, and contamination was found in 18/40 (45%) environments. In dogs completing all cycles, interventions cleared carriage in 5/9 (55.6%) dogs in group H&T and 2/6 (33.3%) in group H. Environmental contamination was infrequent but associated with carrier dogs (p = 0.047). Monthly monitoring of initially negative dogs showed intermittent carriage in 9/14 dogs. PFGE-concordance was found among all 34 MRSP isolated from eight index dogs over time. CONCLUSION: MRSP carriage was common in dogs after recovery from infection. Topical antimicrobial therapy temporarily eliminated carriage but recurrence was frequent. Management efforts must include the prevention of recurrent infections and hygiene.
Subject(s)
Anti-Infective Agents , Dog Diseases , Methicillin-Resistant Staphylococcus aureus , Staphylococcal Infections , Animals , Anti-Bacterial Agents/pharmacology , Anti-Bacterial Agents/therapeutic use , Anti-Infective Agents/pharmacology , Dog Diseases/drug therapy , Dog Diseases/prevention & control , Dogs , Methicillin , Methicillin Resistance , Microbial Sensitivity Tests/veterinary , Staphylococcal Infections/drug therapy , Staphylococcal Infections/veterinary , StaphylococcusABSTRACT
The number of midwives practicing in Australia in 1999, were 11,985 and in 2014, 23,862 (Australian Institute of Health & Welfare, 2014 workforce report). Just over 3,000 are registered as a midwife only.
Subject(s)
Career Mobility , Midwifery , Philosophy, Nursing , Australia , Education, Nursing, Continuing , Female , Humans , Midwifery/education , Nurse's Role , Practice Patterns, Nurses' , Professional Autonomy , Societies, NursingABSTRACT
OBJECTIVE: to identify factors affecting women's oral nutrition in labour. DESIGN: literature review (1988-2009). SETTING: Westernised maternity care settings. PARTICIPANTS: women, midwives, obstetricians, anaesthetists and hospitals. MEASUREMENTS AND FINDINGS: when addressing labour stages, the risk categorisation of women and maternal/fetal birthing outcomes, there was a lack of consistent evidence identifying adverse outcomes for mothers/infants when oral nutrition in labour had occurred. KEY CONCLUSIONS: little evidence exists to support the continuance of restrictive practices around oral nutrition in labour for all women. Women's choice is impacted by health practitioners' opinions, experience and practice methods and policy (or lack thereof). Policies are not reflective of current evidence. IMPLICATIONS FOR PRACTICE: women's choices and desires regarding oral nutrition in labour need to be addressed. Clear guidelines/policies need to be established based on current evidence. Midwives need greater exposure to research, as well as involvement in policy development and implementation.