Hand Hygiene Practices, Attitudes, and Microbial Hand Populations of Practicing Doctors of Chiropractic.

OBJECTIVE: Hand hygiene practice is important in health care settings to reduce the spread of infection. To date, no hand hygiene study has been conducted with doctors of chiropractic that included microbiological analysis of hand specimens. The primary objective of this study was to examine the relationship between self-reported hand hygiene practices and attitudes of chiropractors with the number and type of pathogenic bacteria and yeast present on their hands. METHODS: In this cross-sectional study, a microbiological analysis of the chiropractor's dominant hand was performed along with completion of a survey concerning practices and attitudes regarding hand hygiene. The relationship between self-reported measures with laboratory findings was conducted using generalized linear modeling. RESULTS: Participants who responded to the survey indicated that hand hygiene was important, and most reported performing hand hygiene before and/or after patient contact. However, 7 (26.9%) participants had multidrug-resistant bacteria isolated from their hands. There was no correlation between the survey responses and hand specimens with the exception of the number of handwashing episodes. From the hand specimens, 16 (45.7%) coagulase-negative staphylococci isolates were oxacillin resistant, and 9 (25.7%) were multidrug resistant. CONCLUSION: This study found that like other health care workers, chiropractors had antimicrobial-resistant bacteria on their hands, some of which were multidrug resistant. Multidrug resistant bacteria have the potential to be transferred to patients and patient contact surfaces. These findings indicate that chiropractic offices could play a role in health care-associated infections. Formal hand hygiene training should be included as part of the chiropractic education curriculum and continuing education for doctors of chiropractic.

Marburgviruses: An Update.

Ebolaviruses have gained much attention recently due to the outbreak from 2014 through 2016. The related marburgviruses also have been responsible for large outbreaks with high case fatality rates. The purpose of this article is to provide the clinical laboratory scientist with a review of the most current developments in marburgvirus research. The PubMed database was reviewed using the keywords "Marburg virus," "Ravn virus," and "marburgviruses," with publication dates from January 1, 2015 through June 20, 2017. The search yielded 345 articles. In total, 52 articles met the inclusion criteria and were reviewed. Advances have been made in the areas of ecology and host reservoir studies, seroprevalence studies, pathology and pathogenesis studies, laboratory assay development, and treatment and vaccine development. Marburgviruses are highly lethal viruses that pose a significant threat to the human population. Although numerous advances have been made, there are still large gaps in knowledge, and it is imperative that scientists gain more information to fully understand virus/host interactions. An approved vaccine and treatment remain elusive.

A Review of the Centers for Disease Control and Prevention's Guidelines for the Clinical Laboratory Diagnosis of Lyme Disease.

OBJECTIVE: The purpose of this paper is to review information regarding the current guidelines for the clinical laboratory diagnosis of Lyme disease as set forth by the Centers for Disease Control and Prevention (CDC) to chiropractic physicians and to discuss the clinical utility of this testing. METHODS: The CDC's website was reviewed to determine what their current recommendations are for the clinical laboratory testing of Lyme disease. RESULTS: The CDC's established guidelines recommend the use of a 2-tiered serologic testing algorithm for the evaluation of patients with suspected Lyme disease. CONCLUSION: This review provides doctors of chiropractic with information to remain current with the CDC's recommended guidelines for Lyme disease testing because patients may present to their office with the associated signs and symptoms of Lyme disease.