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2.
Strahlenther Onkol ; 198(10): 919-925, 2022 10.
Artigo em Inglês | MEDLINE | ID: mdl-36006436

RESUMO

PURPOSE: Preoperative stereotactic radiosurgery (SRS) of brain metastases may achieve similar local control and better leptomeningeal control rates than postoperative fractionated stereotactic radiotherapy (FSRT) in patients treated with elective metastasectomy. To plan a multicentre trial of preoperative SRS compared with postoperative FSRT, a survey of experts was conducted to determine current practice. METHODS: A survey with 15 questions was distributed to the DEGRO Radiosurgery and Stereotactic Radiotherapy Working Group. Participants were asked under what circumstances they offered SRS, FSRT, partial and/or whole brain radiotherapy before or after resection of a brain metastasis, as well as the feasibility of preoperative stereotactic radiosurgery and neurosurgical resection within 6 days. RESULTS: Of 25 participants from 24 centres, 22 completed 100% of the questions. 24 respondents were radiation oncologists and 1 was a neurosurgeon. All 24 centres have one or more dedicated radiosurgery platform and all offer postoperative FSRT. Preoperative SRS is offered by 4/24 (16.7%) centres, and 9/24 (37.5%) sometimes recommend single-fraction postoperative SRS. Partial brain irradiation is offered by 8/24 (33.3%) centres and 12/24 (50%) occasionally recommend whole-brain irradiation. Two centres are participating in clinical trials of preoperative SRS. SRS techniques and fractionation varied between centres. CONCLUSION: All responding centres currently offer postoperative FSRT after brain metastasectomy. Approximately one third offer single-fraction postoperative SRS and four already perform preoperative SRS. With regard to potential co-investigators, 18 were identified for the PREOP­2 multicentre trial, which will randomise between preoperative SRS and postoperative FSRT.


Assuntos
Neoplasias Encefálicas , Radioterapia (Especialidade) , Radiocirurgia , Encéfalo , Neoplasias Encefálicas/radioterapia , Neoplasias Encefálicas/secundário , Neoplasias Encefálicas/cirurgia , Fracionamento da Dose de Radiação , Humanos , Radiocirurgia/métodos
3.
Ann R Coll Surg Engl ; 103(2): 96-103, 2021 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-33559543

RESUMO

INTRODUCTION: Adaptation is vital to ensure successful healthcare recovery during the COVID-19 pandemic. Hand trauma represents the most common acute emergency department presentation internationally. This study prospectively evaluates the COVID-19 related patient risk, when undergoing management within one of the largest specialist tertiary referral centres in Europe, which rapidly implemented national COVID-19 safety guidelines. MATERIALS AND METHODS: A prospective cohort study was undertaken in all patients referred to the integrated hand trauma service, during the UK COVID-19 pandemic peak (April-May 2020); all were evaluated for 30-day COVID-19 related death. Random selection was undertaken for patients with hand trauma who either underwent non-operative (control group) or operative (surgery group) management; these groups were prospectively followed-up within a controlled cohort study design and telephoned at 30 days following first intervention (control group) or postoperatively (surgery group). RESULTS: Of 731 referred patients (566 operations), there were no COVID-19 related deaths. Both groups were matched for sex, age, ethnicity, body mass index, comorbidities, smoking, preoperative/first assessment COVID-19 symptoms, pre- and postoperative/first assessment isolation and positive COVID-19 contact (p > 0.050). There were no differences in high service satisfaction (10/10 compared with 10/10; p = 0.067) and treatment outcome (10/10 compared with 10/10; p = 0.961) scores, postoperative/first assessment symptoms (1%, 1/100 compared with 0.8%, 2/250; p = 1.000) or proportion of positive tests (7.1%, 1/14 compared with 2.2%, 2/92; p = 0.349), between the control (n = 100) and surgery (n = 250) groups. CONCLUSION: These data support continued and safe service provision and no increased risk to patients who require surgical management. Such findings are vital for healthcare providers when considering service adaptations to reinstate patient treatment.


Assuntos
COVID-19/epidemiologia , Infecção Hospitalar/epidemiologia , Traumatismos da Mão/terapia , Procedimentos Cirúrgicos Operatórios , Adulto , Idoso , Amputação Traumática/terapia , Estudos de Casos e Controles , Estudos de Coortes , Feminino , Fraturas Ósseas/terapia , Traumatismos da Mão/epidemiologia , Articulação da Mão , Humanos , Luxações Articulares/terapia , Lacerações/terapia , Masculino , Pessoa de Meia-Idade , Segurança do Paciente , Satisfação do Paciente , Traumatismos dos Nervos Periféricos/terapia , SARS-CoV-2 , Traumatismos dos Tendões/terapia , Centros de Atenção Terciária , Resultado do Tratamento , Reino Unido/epidemiologia
4.
Transbound Emerg Dis ; 65(3): 711-718, 2018 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-29250924

RESUMO

Infections caused by non-tuberculous mycobacteria (NTM) are reported as emerging disease in many countries worldwide. The occurrence of NTM in different hosts and their implication as obligate or opportunistic pathogen remain largely unclear. Lymph nodes and faecal samples of clinically healthy Swiss cattle at slaughter were analysed for the presence of NTM. Based on the examined lymph nodes, NTM were detected in 20% of 108 cattle originating from different premises. The 22 isolates belonged to five different species of Mycobacteria (M. avium subsp. hominissuis, M. kansasii, M. persicum, "M. lymphaticum" and M. europaeum). M. avium subsp. hominissuis (63%) and M. kansasii (18%) thereby predominated and were found in lymph nodes with and without macroscopic changes. Moreover, M. persicum found in two cattle has recently been described as a human pathogen and is closely related to M. kansasii. Amongst cattle with lymph nodes positive for mycobacteria, viable NTM were occasionally also detected in bovine faeces. However, the isolated NTM species from lymph nodes and respective faecal samples (M. hassiacum, M. phlei and M. vaccae) did not coincide. Moreover, NTM species identified amongst isolates from the slaughterhouse environment clearly differed from those from lymph nodes and faecal samples, excluding cross-contamination of the tissue specimens through the environment or laboratory processing. Assuming that some NTM interfere with the detection of bovine tuberculosis (bTB), the present findings in healthy animals emphasize the need of more specific diagnostic tools for bTB eradication programs.


Assuntos
Matadouros , Fezes/microbiologia , Linfonodos/microbiologia , Micobactérias não Tuberculosas/isolamento & purificação , Animais , Bovinos , Infecções por Mycobacterium não Tuberculosas/diagnóstico , Micobactérias não Tuberculosas/classificação
5.
Br J Surg ; 104(12): 1634-1639, 2017 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-29044488

RESUMO

BACKGROUND: Nail-bed injuries are the most common hand injury in children. Surgical dogma is to replace the nail plate after repairing the nail bed. Recent evidence suggests this might increase infection rates and returns to clinic. The aim of this feasibility trial was to inform the design and conduct of a definitive trial comparing replacing or discarding the nail plate after nail-bed repair. METHODS: This study recruited participants from four hand units in the UK between April and July 2015. Participants were children under the age of 16 years with a nail-bed injury requiring surgery. They were randomized to either having the nail plate replaced or discarded after nail-bed repair. The follow-up method was also allocated randomly (postal versus clinic). Information was collected on complications at 2 weeks and 30 days, and on nail-plate appearance at 4 months using the Zook classification. Two possible approaches to follow-up were also piloted and compared. RESULTS: During the recruitment phase, there were 156 potentially eligible children. Sixty were randomized in just over 3 months using remote web-based allocation. By 2 weeks, there were two infections, both in children with replaced nail plates. The nail-replaced group also experienced more complications. There was no evidence of a difference in return rates between postal and clinic follow-up. CONCLUSION: Recruitment was rapid and nail-bed repair appeared to have low complication and infection rates in this pilot trial. The findings have led to revision of the definitive trial protocol, including the mode and timing of follow-up, and modification of the Zook classification.


Assuntos
Unhas/lesões , Unhas/cirurgia , Procedimentos de Cirurgia Plástica , Adolescente , Antibacterianos/uso terapêutico , Criança , Pré-Escolar , Estudos de Viabilidade , Feminino , Humanos , Lactente , Masculino , Dor/etiologia , Projetos Piloto , Complicações Pós-Operatórias , Estudos Prospectivos , Procedimentos de Cirurgia Plástica/efeitos adversos , Infecção da Ferida Cirúrgica/tratamento farmacológico
7.
J Food Prot ; 75(8): 1483-5, 2012 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-22856574

RESUMO

Hepatitis E virus (HEV) and Salmonella bacteria are zoonotic pathogens that can be acquired by foodborne transmission because food animals, for example pigs, are recognized as a reservoir. The objectives of this study were to determine the seroprevalence of anti-HEV immunoglobulin G (IgG) and anti-Salmonella antibodies from healthy pigs at slaughter in Switzerland, a country with a good health status of pig herds (e.g., eradication of enzootic pneumonia) compared with those of many countries in the European Union, and a rate of importation of live pigs that is very low (<1%). Based on pooled (diaphragm muscles from 3 to 5 animals per producer) meat juice samples, 120 (60%) of 200 and 8 (4%) of 200 samples were positive for anti-HEV IgG and anti-Salmonella antibodies, respectively. HEV seems to be highly prevalent among fattening pigs in Switzerland, whereas the low seroprevalence of anti-Salmonella IgG has not changed in recent years.


Assuntos
Anticorpos Antibacterianos/sangue , Anticorpos Antivirais/sangue , Hepatite E/veterinária , Salmonelose Animal/epidemiologia , Doenças dos Suínos/epidemiologia , Matadouros , Animais , Reservatórios de Doenças/veterinária , Hepatite E/epidemiologia , Vírus da Hepatite E/imunologia , Humanos , Imunoglobulina G/sangue , Saúde Pública , Salmonella/imunologia , Estudos Soroepidemiológicos , Suínos , Suíça/epidemiologia
8.
Zoonoses Public Health ; 59(6): 408-15, 2012 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-22348425

RESUMO

Faecal samples were collected from 573 slaughtered cattle aged between three and 24 months in seven abattoirs. After enrichment (mTSB with novobiocin), samples were screened by real-time PCR first for stx and if positive, tested for the top-five Shiga toxin-producing Escherichia coli (STEC) serogroups using PCR assays targeting genes specific for serogroups O26, O103, O111, O145 and O157. Of 563 samples with available results, 74.1% tested positive for stx genes. Amongst them, the serogroups O145, O103, O26, O157 and O111 were detected in 41.9%, 25.9%, 23.9%, 7.8% and 0.8%, respectively. From 95 O26, 166 O145 and 30 O157 PCR-positive samples, 17 O26, 28 O145 and 12 O157 strains were isolated by colony hybridization after immunomagnetic separation. The 17 O26 strains were eae-positive, but only nine strains harboured stx (eight possessing stx1 and one stx2). Of the 28 O145 strains, ten were eae-positive including four harbouring stx1 or stx2, whereas 18 were negative for stx and eae. Five of the 12 O157 strains harboured stx2 and eae, did not ferment sorbitol, and were identified as STEC O157:H7/H⁻. The other seven O157 strains were negative for stx and eae or positive only for eae. Shiga toxin genes and the top-five STEC serogroups were frequently found in young Swiss cattle at slaughter, but success rates for strain isolation were low and only few strains showed a virulence pattern of human pathogenic STEC.


Assuntos
Doenças dos Bovinos/microbiologia , Infecções por Escherichia coli/veterinária , Reação em Cadeia da Polimerase em Tempo Real/métodos , Toxinas Shiga/genética , Escherichia coli Shiga Toxigênica/isolamento & purificação , Matadouros , Adesinas Bacterianas/genética , Animais , Bovinos , Doenças dos Bovinos/epidemiologia , Infecções por Escherichia coli/epidemiologia , Infecções por Escherichia coli/microbiologia , Proteínas de Escherichia coli/genética , Fezes/microbiologia , Proteínas Hemolisinas/genética , Humanos , Antígenos O/genética , Sorotipagem , Escherichia coli Shiga Toxigênica/genética , Escherichia coli Shiga Toxigênica/patogenicidade , Sorbitol/metabolismo , Suíça/epidemiologia , Virulência
9.
Br J Anaesth ; 108(1): 89-99, 2012 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-22037222

RESUMO

BACKGROUND: Brain tissue partial oxygen pressure (Pbt(O(2))) and near-infrared spectroscopy (NIRS) are novel methods to evaluate cerebral oxygenation. We studied the response patterns of Pbt(O(2)), NIRS, and cerebral blood flow velocity (CBFV) to changes in arterial pressure (AP) and intracranial pressure (ICP). METHODS: Digital recordings of multimodal brain monitoring from 42 head-injured patients were retrospectively analysed. Response latencies and patterns of Pbt(O(2)), NIRS-derived parameters [tissue oxygenation index (TOI) and total haemoglobin index (THI)], and CBFV reactions to fluctuations of AP and ICP were studied. RESULTS: One hundred and twenty-one events were identified. In reaction to alterations of AP, ICP reacted first [4.3 s; inter-quartile range (IQR) -4.9 to 22.0 s, followed by NIRS-derived parameters and CBFV (10.9 s; IQR: -5.9 to 39.6 s, 12.1 s; IQR: -3.0 to 49.1 s, 14.7 s; IQR: -8.8 to 52.3 s for THI, CBFV, and TOI, respectively), with Pbt(O(2)) reacting last (39.6 s; IQR: 16.4 to 66.0 s). The differences in reaction time between NIRS parameters and Pbt(O(2)) were significant (P<0.001). Similarly when reactions to ICP changes were analysed, NIRS parameters preceded Pbt(O(2)) (7.1 s; IQR: -8.8 to 195.0 s, 18.1 s; IQR: -20.6 to 80.7 s, 22.9 s; IQR: 11.0 to 53.0 s for THI, TOI, and Pbt(O(2)), respectively). Two main patterns of responses to AP changes were identified. With preserved cerebrovascular reactivity, TOI and Pbt(O(2)) followed the direction of AP. With impaired cerebrovascular reactivity, TOI and Pbt(O(2)) decreased while AP and ICP increased. In 77% of events, the direction of TOI changes was concordant with Pbt(O(2)). CONCLUSIONS: NIRS and transcranial Doppler signals reacted first to AP and ICP changes. The reaction of Pbt(O(2)) is delayed. The results imply that the analysed modalities monitor different stages of cerebral oxygenation.


Assuntos
Pressão Sanguínea/fisiologia , Circulação Cerebrovascular/fisiologia , Traumatismos Craniocerebrais/fisiopatologia , Pressão Intracraniana/fisiologia , Consumo de Oxigênio/fisiologia , Adulto , Algoritmos , Química Encefálica/fisiologia , Interpretação Estatística de Dados , Feminino , Escala de Coma de Glasgow , Hemodinâmica/fisiologia , Humanos , Masculino , Monitorização Fisiológica , Estudos Prospectivos , Espectroscopia de Luz Próxima ao Infravermelho , Ultrassonografia Doppler Transcraniana
10.
J Hand Surg Eur Vol ; 37(4): 304-9, 2012 May.
Artigo em Inglês | MEDLINE | ID: mdl-22007097

RESUMO

This study reports the results of Swanson replacement of 131 DIP joints for painful osteoarthritis and two for ongoing pain after injury. Thirty-seven arthroplasties (28 patients) were carried out with extensor tendon division and repair, and postoperative immobilization for 8 weeks. Ninety-four (60 patients) were then carried out without tendon division, allowing immediate mobilization. At assessment after a mean period of 57 months, the mean postoperative range of movement was 39°, and the mean extensor lag was 11°, with significant improvement of both in both operative groups. The severity of pain improved significantly following surgery. All but one patient were satisfied with the cosmetic result of replacement. The overall complication rate was 7/131(5%). Three joints developed cellulitis and one developed osteomyelitis, requiring subsequent fusion. Two joints had subsequent fusions because of persistent lateral instability and marked ulnar deviation and one had a persistent mallet-type deformity, corrected by tendon shortening.


Assuntos
Artroplastia de Substituição , Traumatismos dos Dedos/complicações , Articulações dos Dedos/cirurgia , Osteoartrite/cirurgia , Dor/cirurgia , Adulto , Idoso , Idoso de 80 Anos ou mais , Agendamento de Consultas , Artroplastia de Substituição/efeitos adversos , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Medição da Dor , Adulto Jovem
11.
Schweiz Arch Tierheilkd ; 153(2): 63-9, 2011 Feb.
Artigo em Alemão | MEDLINE | ID: mdl-21274832

RESUMO

Staphylococcus aureus and coagulase negative staphylococci (CNS) were isolated from ovine and caprine mastitis milk samples originating from more than 40 Swiss farms. CNS dominated as causal microorganisms of mastitis in small ruminants. By restriction fragment length polymorphism (RFLP) analysis of the groEL gene and sequencing of 16S rDNA, various CNS species were identified, albeit certain of them predominated. For susceptibility testing of mastitis pathogens to selected antibiotics, minimal inhibitory concentrations were determined. Of the 67 S. aureus and 208 CNS strains, 31.3 % and 8.2 % were resistant to penicillin, 29.9 % and 1.0 % to ampicillin, 1.5 % and 10.6 % to erythromycin, and 3.0 % and 7.7 % to tetracycline, respectively. Moreover, 10 CNS strains (4.8 %) were resistant to oxacillin and one CNS strain to sulfamethoxazole/trimethoprim. The results obtained describe for the first time the resistance situation of mastitis pathogens from sheep and goats in Switzerland. However, accompanying and preventing measures are also of importance in mastitis control of small ruminants.


Assuntos
Cabras , Staphylococcus aureus , Animais , Anti-Infecciosos , Coagulase , Feminino , Mastite Bovina , Testes de Sensibilidade Microbiana/veterinária , Leite , Ovinos , Staphylococcus aureus/genética
12.
Zoonoses Public Health ; 58(5): 343-9, 2011 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-20849461

RESUMO

Using different typing methods (MLST, spa-, SCCmec- and agr-typing), PFGE and DNA microarray-based chip analysis, we characterized 20 MRSA strains isolated from livestock and veterinarians. PFGE analysis after macrorestriction with EagI provided seven different band patterns, which could be grouped into four clusters. One cluster consisted of all MRSA ST398 strains isolated from pigs, calves, mastitis milk and two veterinarians. One strain of ST398 from a veterinarian and the two strains of ST1 and ST8 formed the three other clusters. Antimicrobial susceptibility testing showed that 15 of 20 strains were resistant to ampicillin, cefoxitin, clindamycin, erythromycin, oxacillin, penicillin and tetracycline. All strains were susceptible to rifampin and vancomycin, 19 were susceptible to ciprofloxacin and 18 were susceptible to sulphamethoxazole/trimethoprim. Genes encoding different enterotoxins, leukotoxins and haemolysins were found in certain strains.


Assuntos
Antibacterianos/farmacologia , Farmacorresistência Bacteriana Múltipla/genética , Gado/microbiologia , Staphylococcus aureus Resistente à Meticilina/classificação , Infecções Estafilocócicas/veterinária , Animais , Técnicas de Tipagem Bacteriana , Bovinos , Análise por Conglomerados , Enterotoxinas/genética , Exotoxinas/genética , Feminino , Genótipo , Humanos , Mastite Bovina/microbiologia , Staphylococcus aureus Resistente à Meticilina/efeitos dos fármacos , Staphylococcus aureus Resistente à Meticilina/isolamento & purificação , Testes de Sensibilidade Microbiana/veterinária , Leite/microbiologia , Análise de Sequência com Séries de Oligonucleotídeos , Infecções Estafilocócicas/epidemiologia , Infecções Estafilocócicas/microbiologia , Suínos , Suíça/epidemiologia , Médicos Veterinários
13.
Eur J Neurol ; 18(5): 711-8, 2011 May.
Artigo em Inglês | MEDLINE | ID: mdl-21054682

RESUMO

BACKGROUND: A decrease in arterial compliance of the internal carotid artery has been associated with an increased risk in ipsilateral ischaemic stroke. However, so far, no technique has been validated to monitor the compliance of intracerebral arteries (Ca) in patients with carotid artery disease. In this study, we sought to monitor Ca in patients with unilateral symptomatic disease and to determine its variations during changes in PaCO(2). METHODS: We studied 18 patients with unilateral symptomatic internal carotid artery stenosis >50% or occlusion. Patients underwent monitoring of arterial blood pressure (ABP) and middle cerebral artery cerebral blood flow velocities (CBFV) during baseline, hyperventilation and 5%CO(2) inhalation. Ca was calculated from pulsatile amplitudes of ABP and Cerebral arterial blood volume, extracted from the CBFV waveform using a new mathematical model. RESULTS: At baseline, the decrease in Ca on the diseased side was correlated with the degree of stenosis (r = -0.35; P = 0.01). During hypocapnia, Ca was lower compared to baseline on the normal side (P = 0.004) and on the diseased side (P = 0.04). Ca reactivity, reflecting the changes in Ca per changes in 1 mmHg PaCO(2), was lower on the diseased side between baseline and hypocapnia (3.4 vs. 2.6%; P = 0.04). During hypercapnia, no changes in Ca on the diseased (P = 0.8) nor on the normal sides (P = 0.2) were observed. CONCLUSIONS: The decrease in cerebral arterial compliance the side of stenosis/occlusion was correlated with the severity of the internal carotid artery disease. Further studies are needed to determine whether Ca may improve the prediction of ischaemic events in symptomatic and asymptomatic patients.


Assuntos
Artéria Carótida Interna/fisiopatologia , Estenose das Carótidas/diagnóstico , Estenose das Carótidas/fisiopatologia , Circulação Cerebrovascular/fisiologia , Complacência (Medida de Distensibilidade)/fisiologia , Monitorização Fisiológica/métodos , Idoso , Dióxido de Carbono/metabolismo , Artéria Carótida Interna/patologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade
14.
Euro Surveill ; 15(16)2010 Apr 22.
Artigo em Inglês | MEDLINE | ID: mdl-20430001

RESUMO

A total of 2,662 samples, collected from March to September 2009 in Switzerland, were tested for the presence of meticillin-resistant Staphylococcus aureus (MRSA). The collection comprised nasal swabs from 148 pig farmers, 133 veterinarians, 179 slaughterhouse employees, 800 pigs, 300 calves, 400 cattle, 100 pooled neck skin swabs from chicken carcasses, and 460 food samples of animal origin. Moreover, 142 S. aureus strains, isolated from bovine mastitis milk, were included in the study. Twenty samples (< 1%; four veterinarians, 10 pigs, three calves, one young bull, and two mastitis milk samples) tested positive for MRSA. Genotyping of the MRSA strains was performed by multilocus sequence typing, spa- and SCCmec-typing, and revealed ST398 (n=18), ST8 (n=1), ST 1 (n=1), spa types t011 (n=7), t034 (n=11), t064 (n=1), t127 (n=1), and SCCmec types IV (n=4) and V (n=16). The 20 MRSA strains were subjected to antibiotic susceptibility testing and pulsed-field gel electrophoresis using the restriction enzyme EagI. Supplementary PCR reactions were performed to investigate the presence of Panton-Valentine leukocidin and staphylococcal enterotoxins A to D.


Assuntos
Agricultura/estatística & dados numéricos , Galinhas/microbiologia , Carne/microbiologia , Resistência a Meticilina , Staphylococcus aureus Resistente à Meticilina/isolamento & purificação , Nariz/microbiologia , Suínos/microbiologia , Médicos Veterinários/estatística & dados numéricos , Animais , Portador Sadio/microbiologia , Estudos de Casos e Controles , Bovinos , Doenças dos Bovinos/epidemiologia , Doenças dos Bovinos/microbiologia , Feminino , Contaminação de Alimentos/estatística & dados numéricos , Microbiologia de Alimentos , Humanos , Mastite Bovina/microbiologia , Staphylococcus aureus Resistente à Meticilina/classificação , Staphylococcus aureus Resistente à Meticilina/genética , Leite/microbiologia , Vigilância da População , Doenças das Aves Domésticas/epidemiologia , Doenças das Aves Domésticas/microbiologia , Prevalência , Medição de Risco/métodos , Fatores de Risco , Especificidade da Espécie , Intoxicação Alimentar Estafilocócica/epidemiologia , Intoxicação Alimentar Estafilocócica/microbiologia , Infecções Estafilocócicas/epidemiologia , Infecções Estafilocócicas/microbiologia , Infecções Estafilocócicas/veterinária , Doenças dos Suínos/epidemiologia , Doenças dos Suínos/microbiologia , Suíça/epidemiologia
15.
J Food Prot ; 73(1): 88-91, 2010 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-20051209

RESUMO

Food is an important vehicle for transmission of Shiga toxin-producing Escherichia coli (STEC). To assess the potential public health impact of STEC in Swiss raw milk cheese produced from cow's, goat's, and ewe's milk, 1,422 samples from semihard or hard cheese and 80 samples from soft cheese were examined for STEC, and isolated strains were further characterized. By PCR, STEC was detected after enrichment in 5.7% of the 1,502 raw milk cheese samples collected at the producer level. STEC-positive samples comprised 76 semihard, 8 soft, and 1 hard cheese. By colony hybridization, 29 STEC strains were isolated from 24 semihard and 5 soft cheeses. Thirteen of the 24 strains typeable with O antisera belonged to the serogroups O2, O22, and O91. More than half (58.6%) of the 29 strains belonged to O:H serotypes previously isolated from humans, and STEC O22:H8, O91:H10, O91:H21, and O174:H21 have also been identified as agents of hemolytic uremic syndrome. Typing of Shiga toxin genes showed that stx(1) was only found in 2 strains, whereas 27 strains carried genes encoding for the Stx(2) group, mainly stx(2) and stx(2vh-a/b). Production of Stx(2) and Stx(2vh-a/b) subtypes might be an indicator for a severe outcome in patients. Nine strains harbored hlyA (enterohemorrhagic E. coli hemolysin), whereas none tested positive for eae (intimin). Consequently, semihard and hard raw milk cheese may be a potential source of STEC, and a notable proportion of the isolated non-O157 STEC strains belonged to serotypes or harbored Shiga toxin gene variants associated with human infections.


Assuntos
Queijo/microbiologia , Contaminação de Alimentos/análise , Toxinas Shiga/biossíntese , Escherichia coli Shiga Toxigênica , Animais , Bovinos , Queijo/análise , Qualidade de Produtos para o Consumidor , Fermentação , Microbiologia de Alimentos , Cabras , Humanos , Leite/microbiologia , Prevalência , Sorotipagem , Ovinos , Toxinas Shiga/genética , Escherichia coli Shiga Toxigênica/classificação , Escherichia coli Shiga Toxigênica/isolamento & purificação , Escherichia coli Shiga Toxigênica/metabolismo , Escherichia coli Shiga Toxigênica/patogenicidade , Especificidade da Espécie , Virulência
16.
Schweiz Arch Tierheilkd ; 151(7): 329-31, 2009 Jul.
Artigo em Alemão | MEDLINE | ID: mdl-19565455

RESUMO

Four hours after the consumption of raw goat milk, three Swiss children came down with emesis and diarrhea in July 2008. First investigations showed that the milk originated from a goat suffering from clinical mastitis (Staphylococcus aureus). In the milk sample from the untreated left udder, Staphylococcus aureus counts reached 5.0 x 10(7) CFU ml(-1). By PCR, the gene for the staphylococcal enterotoxin D was found in isolated strains. The consumption of raw milk is rarely associated with Staphylococcus aureus intoxications. Due to the flora naturally present in raw milk, Staphylococcus aureus normally cannot multiply sufficiently. However, in the present case, high Staphylococcus aureus counts were already present in the milk due to the mastitis of the goat. This amount sufficed to cause a Staphylococcus aureus intoxication in the children.


Assuntos
Leite/microbiologia , Intoxicação Alimentar Estafilocócica/diagnóstico , Staphylococcus aureus/isolamento & purificação , Adolescente , Animais , Criança , Pré-Escolar , Contagem de Colônia Microbiana , Enterotoxinas/análise , Feminino , Doenças das Cabras/diagnóstico , Doenças das Cabras/microbiologia , Cabras , Humanos , Masculino , Mastite/diagnóstico , Mastite/microbiologia , Mastite/veterinária , Reação em Cadeia da Polimerase , Intoxicação Alimentar Estafilocócica/etiologia
17.
Schweiz Arch Tierheilkd ; 151(3): 119-25, 2009 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-19263381

RESUMO

Based on Directive (EC) No 99/2003, monitoring programs on the development of antimicrobial resistance in bacteria from livestock are implemented in many European countries. The aim of the present study was (i) to establish comprehensive baseline data on the antimicrobial resistance situation in Escherichia coli isolates obtained from healthy pigs (pooled fecal samples) originating from 60 Swiss pig-breeding farms, and (ii) to analyze differences in the resistance frequency between Escherichia coli isolates from weaned pigs and sows. Susceptibility testing (disc diffusion method) was performed on 429 isolates from weaned pigs and 431 isolates from sows. Overall, 17.7% of the isolates from weaned pigs and 22.5% of the Escherichia coli isolates from sows were susceptible to all antibiotics tested. Low resistance prevalence was found for amoxicillin, amoxicillin/clavulanic acid, ampicillin, cefquinome, ciprofloxacin, colistin, florfenicol, and gentamicin. The most frequently found resistances were against streptomycin (60.6% of the isolates from weaners and 64.3% of the isolates from sows), sulfonamide (51.5% and 26.9%), tetracycline (35.2% and 22.0%), and trimethoprim (27.5% and 11.1%). With exception of colistin, most resistances were found for those antibiotics commonly used on the farms. Except for ciprofloxacin and streptomycin, isolates from weaned pigs showed higher resistance prevalence than those from sows. This difference was significant for cefquinome, florfenicol, sulfonamide, tetracycline, and trimethoprim (p<0.05).


Assuntos
Antibacterianos/uso terapêutico , Farmacorresistência Bacteriana , Infecções por Escherichia coli/veterinária , Escherichia coli/efeitos dos fármacos , Doenças dos Suínos/tratamento farmacológico , Animais , Relação Dose-Resposta a Droga , Farmacorresistência Bacteriana Múltipla , Escherichia coli/crescimento & desenvolvimento , Infecções por Escherichia coli/tratamento farmacológico , Fezes/microbiologia , Feminino , Masculino , Testes de Sensibilidade Microbiana/veterinária , Suínos , Doenças dos Suínos/microbiologia , Suíça , Resultado do Tratamento
18.
Burns ; 35(1): 80-6, 2009 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-18691820

RESUMO

OBJECTIVE: The current determination of burn depth is based both on a visual and clinical assessment. Confocal-laser-scanning microscopy (CLSM) enables in vivo histomorphological images. We hypothesized that CLSM can differentiate superficial-partial vs. deep-partial thickness burns on a histomorphological level. METHODS: Thirty-eight burn wounds in 14 patients were clinically divided in three groups from superficial (group 1), superficial-partial (group 2) to deep-partial (group 3) thickness burns. CLSM was performed with the Vivascope 1500 (Lucid Inc., Rochester, NY, USA) 24h after burn. The following parameters were assessed: cell size of the granular-layer, thickness of the basal-layer, minimal thickness of the epidermis and number of perfused dermal papillae. RESULTS: Superficial burns resulted in a significant increase of the cell size of the granular-layer and a higher increase of the minimal thickness of the epidermis as in superficial-partial thickness burns. The granular-layer in partial thickness burns was destroyed. Superficial burns had an increased thickness of the basal-layer; in superficial-partial thickness burns the basal-layer was partly destroyed with complete destruction in deep-partial thickness burns. In superficial burns the perfused dermal papillae were increased significantly, while decreased in superficial-partial thickness, and completely destroyed in deep-partial thickness burns up to a depth of 350 microm. CONCLUSIONS: In vivo confocal-laser-scanning microscopy can differentiate superficial-partial vs. deep-partial thickness burns on a histomorphological level.


Assuntos
Queimaduras/patologia , Tamanho Celular , Epiderme/patologia , Feminino , Humanos , Masculino , Microscopia Confocal , Índices de Gravidade do Trauma , Cicatrização/fisiologia
19.
J Food Prot ; 71(9): 1934-47, 2008 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-18810883

RESUMO

Electrolyzed water (EW) is gaining popularity as a sanitizer in the food industries of many countries. By electrolysis, a dilute sodium chloride solution dissociates into acidic electrolyzed water (AEW), which has a pH of 2 to 3, an oxidation-reduction potential of >1,100 mV, and an active chlorine content of 10 to 90 ppm, and basic electrolyzed water (BEW), which has a pH of 10 to 13 and an oxidation-reduction potential of -800 to -900 mV. Vegetative cells of various bacteria in suspension were generally reduced by > 6.0 log CFU/ml when AEW was used. However, AEW is a less effective bactericide on utensils, surfaces, and food products because of factors such as surface type and the presence of organic matter. Reductions of bacteria on surfaces and utensils or vegetables and fruits mainly ranged from about 2.0 to 6.0 or 1.0 to 3.5 orders of magnitude, respectively. Higher reductions were obtained for tomatoes. For chicken carcasses, pork, and fish, reductions ranged from about 0.8 to 3.0, 1.0 to 1.8, and 0.4 to 2.8 orders of magnitude, respectively. Considerable reductions were achieved with AEW on eggs. On some food commodities, treatment with BEW followed by AEW produced higher reductions than did treatment with AEW only. EW technology deserves consideration when discussing industrial sanitization of equipment and decontamination of food products. Nevertheless, decontamination treatments for food products always should be considered part of an integral food safety system. Such treatments cannot replace strict adherence to good manufacturing and hygiene practices.


Assuntos
Bactérias/crescimento & desenvolvimento , Desinfetantes/farmacologia , Eletrólise/métodos , Contaminação de Alimentos/prevenção & controle , Água/química , Bactérias/efeitos dos fármacos , Contagem de Colônia Microbiana , Qualidade de Produtos para o Consumidor , Relação Dose-Resposta a Droga , Manipulação de Alimentos/métodos , Microbiologia de Alimentos , Humanos , Concentração de Íons de Hidrogênio , Oxirredução , Água/farmacologia
20.
Vet Microbiol ; 132(1-2): 149-57, 2008 Nov 25.
Artigo em Inglês | MEDLINE | ID: mdl-18514438

RESUMO

To obtain microbiological data from rabbits at slaughter, 500 fecal samples and 500 carcasses samples were examined. All samples tested negative for Listeria and Salmonella. Campylobacter were detected in two fecal samples. Of the 500 fecal samples, 45.8% tested positive for eae (intimin), 1.2% for stx (Shiga toxin), and 1.8% for both eae and stx. By colony hybridization, 56 eae positive Escherichia coli strains were isolated. Among them, 27 strains (48.2%) were of the serotypes O178:H7 and O153:H7, whereas 15 strains (26.8%) belonged to a serogroup that has not yet been described (O(CB10681):H7). All strains possessed intimin beta1 and the translocated intimin receptor (tir) capable of being tyrosine phosphorylated. None of the strains harbored the genes for Shiga toxins, EAST1 (astA), bundlin (bfpA), or the EAF plasmid. Slaughter rabbits therefore constitute a reservoir for certain atypical enteropathogenic Escherichia coli. On rabbit carcasses, average total bacterial counts accounted for 3.3 log CFU cm(-2). Enterobacteriaceae and coagulase positive staphylococci (CPS) were detected on 118 (23.6%) and 153 (30.6%) carcasses, respectively. Enterobacteriaceae and CPS counts of positive samples were mainly <1.5 log CFU cm(-2). Among 153 selected CPS isolates, 98.7% were identified as Staphylococcus aureus. None of the 151 isolated strains harbored the gene for methicillin resistance (mecA). Genes for staphylococcal enterotoxins (SE) were detected in 102 strains. The combinations of seg and sei (53 strains) and sed, seg, sei, and sej (27 strains) dominated.


Assuntos
Bactérias/isolamento & purificação , Microbiologia de Alimentos , Coelhos/microbiologia , Matadouros , Animais , Bactérias/classificação , Fezes/microbiologia
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