ABSTRACT
Multiple organizations track neurosurgical surgical-site infection (SSI) rates, but significant variation exists among reporting criteria. We report our center's experience with the variation in cases captured by 2 major definitions. Standardization could support improvement activities and SSI reduction.
Subject(s)
Hydrocephalus , Surgical Wound Infection , Humans , Surgical Wound Infection/epidemiology , Surgical Wound Infection/prevention & control , Hydrocephalus/surgeryABSTRACT
A quasi-experimental study performed in a pediatric hematology-oncology unit demonstrated that whole-room ultraviolet-C disinfection was associated with a significant reduction in hospital-onset Clostridioides difficile infection (P< .01, trend and level), but not healthcare-associated viral respiratory infections (P= .06 for trend, P= .36 for level) or central line-associated bloodstream infections (P> 0.75, trend and level).
Subject(s)
Clostridioides difficile , Cross Infection , Child , Cross Infection/prevention & control , Disinfection , Hospitals , Humans , Ultraviolet RaysABSTRACT
In 2006, nearly 6,000 mumps cases were reported in the United States, 795 of which occurred in Illinois. In Chicago, 1 healthcare institution experienced ongoing transmission for 4 weeks. This study examines the outbreak epidemiology and quantifies the financial affect on this organization. This retrospective cohort study was conducted through case and exposure identification, interviews, medical record reviews, and immunologic testing of blood specimens. Nine mumps cases resulted in 339 exposures, 325 (98%) among employees. During initial investigation, 186 (57%) of the exposed employees had evidence of mumps immunity. Physicians made up the largest group of noncompliers (55%) with mumps immunity testing. The cost to the institution was $262,788 or $29,199 per mumps case. The outbreak resulted in substantial staffing and financial challenges for the institution that may have been minimized with readily accessible electronic employee vaccination records and adherence to infection control recommendations.
Subject(s)
Academic Medical Centers , Disease Outbreaks , Mumps/epidemiology , Personnel, Hospital/statistics & numerical data , Academic Medical Centers/economics , Academic Medical Centers/statistics & numerical data , Antibodies, Viral/blood , Chicago/epidemiology , Cohort Studies , Disease Outbreaks/prevention & control , Electronic Health Records , Humans , Infection Control/methods , Interviews as Topic , Mumps/economics , Mumps/transmission , Mumps/virology , Mumps virus/immunology , Occupational ExposureABSTRACT
Actin cross-linking domains (ACDs) are distinct domains found in several bacterial toxins, including the Vibrio cholerae MARTX toxin. The ACD of V. cholerae (ACD(Vc)) catalyses the formation of an irreversible iso-peptide bond between lysine 50 and glutamic acid 270 on two actin molecules in an ATP- and Mg/Mn(2+)-dependent manner. In vivo, cross-linking depletes the cellular pool of G-actin leading to actin cytoskeleton depolymerization. While the actin cross-linking reaction performed by these effector domains has been significantly characterized, the ACD(Vc) catalytic site has remained elusive due to lack of significant homology to known proteins. Using multiple genetic approaches, we have identified regions and amino acids of ACD(Vc) required for full actin cross-linking activity. Then, using these functional data and structural homology predictions, it was determined that several residues demonstrated to be important for ACD(Vc) activity are conserved with active-site residues of the glutamine synthetase family of enzymes. Thus, the ACDs are a family of bacterial toxin effectors that may be evolutionarily related to ligases involved in amino acid biosynthesis.