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1.
Foodborne Pathog Dis ; 2024 Mar 07.
Artículo en Inglés | MEDLINE | ID: mdl-38452173

RESUMEN

Shiga toxin-producing Escherichia coli (STEC) are an important cause of bacterial enteric infection. STEC strains cause serious human gastrointestinal disease, which may result in life-threatening complications such as hemolytic uremic syndrome. They have the potential to impact public health due to diagnostic challenges of identifying non-O157 strains in the clinical laboratory. The Wadsworth Center (WC), the public health laboratory of the New York State Department of Health, has isolated and identified non-O157 STEC for decades. A shift from initially available enzyme immunoassay testing to culture-independent diagnostic tests (CIDTs) has increased the uptake of testing at clinical microbiology laboratories. This testing change has resulted in an increased number of specimen submissions to WC. During a 12-year period between 2011 and 2022, WC received 5037 broths and/or stool specimens for STEC confirmation from clinical microbiology laboratories. Of these, 3992 were positive for Shiga toxin genes (stx1 and/or stx2) by real-time PCR. Furthermore, culture methods were utilized to isolate, identify, and characterize 2925 STEC from these primary specimens. Notably, WC observed a >200% increase in the number of STEC specimens received in 2021-2022 compared with 2011-2012 and an 18% increase in the number of non-O157 STEC identified using the same methodologies. During the past decade, the WC testing algorithm has been updated to manage the increase in specimens received, while also navigating the novel COVID-19 pandemic, which took priority over other testing for a period of time. This report summarizes updated methods for confirmation, surveillance, and outbreak detection of STEC and describes findings that may be related to our algorithm updates and the increased use of CIDTs, which is starting to elucidate the true incidence of non-O157 STEC.

2.
Med J Aust ; 193(S8): S104-6, 2010 10 18.
Artículo en Inglés | MEDLINE | ID: mdl-20955136

RESUMEN

The variable life-adjusted display is a graphical, statistical methodology used in Queensland to monitor patient outcomes of clinical indicators. The quality improvement cycle is a systematic approach employed by patient safety and quality programs worldwide to improve patient care. The quality improvement cycle is beneficial to the review and refinement of indicator definitions. Indicators with definitional issues that are not subject to the quality improvement cycle may initially prompt quality improvement opportunities, but are more likely to potentially lead to unnecessary chart and clinical reviews, which will disengage coders and clinicians. Queensland recently used the quality improvement cycle to refine the laparoscopic cholecystectomy complications of surgery indicator definition and several maternity definitions.


Asunto(s)
Mejoramiento de la Calidad , Indicadores de Calidad de la Atención de Salud/normas , Servicio de Cirugía en Hospital/normas , Procedimientos Quirúrgicos Operativos/normas , Gestión de la Calidad Total/organización & administración , Colecistectomía Laparoscópica/estadística & datos numéricos , Episiotomía/estadística & datos numéricos , Humanos , Programas Nacionales de Salud , Evaluación de Resultado en la Atención de Salud , Queensland
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