Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 62
Filtrar
1.
Neth Heart J ; 31(1): 29-35, 2023 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-35781784

RESUMO

BACKGROUND: In their latest guidelines for infective endocarditis (IE) (2015), the European Society of Cardiology (ESC) introduced the implementation of the Endocarditis Team (ET) to facilitate the management of IE. This study presents our experiences and the diagnostic and therapeutic impact of the ET on the management of IE. METHODS: From 2016-2020, data of all patients with suspected IE referred to the ET were prospectively collected. The final diagnosis was defined by the ET as either rejected, possible or definite IE. Diagnostic impact was scored as any change in initial diagnosis, the frequency of additional diagnostic tests advised by the ET and any change in diagnosis after these tests. Therapeutic impact was scored as any change in antibiotic therapy or change from conservative to invasive therapy or vice versa. RESULTS: A total of 321 patients (median age 67 [55-77] years, 71% male) were enrolled. The final diagnosis was rejected IE in 47 (15%), possible IE in 34 (11%) and definite IE in 240 (75%) patients. A change of initial diagnosis was seen in 53/321(17%) patients. Additional microbiological tests were advised in 69/321 (21%) patients, and additional imaging tests in 136/321 (42%) patients, which resulted in subsequent change in diagnosis in 23/321 (7%) patients. Any change in antibiotic treatment was advised in 135/321 (42%) patients, and change from initial conservative to additional surgical treatment in 15/321 (5%) patients. CONCLUSION: The ET had a clear impact on the therapeutic policy for patients with suspected IE and is useful in the management of this life-threatening disease. Broad implementation is warranted.

2.
J Econ Entomol ; 107(1): 1-10, 2014 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-24665679

RESUMO

Theory indicates that landscape composition affects transmission of vector-borne crop diseases, but few empirical studies have investigated how landscape composition affects plant disease epidemiology. Since 2006, Bemisia tabaci (Gennadius) has vectored the cucurbit yellow stunting disorder virus (CYSDV) to cantaloupe and honeydew melons (Cucumis melo L.) in the southwestern United States and northern Mexico, causing significant reductions in yield of fall melons and increased use of insecticides. Here, we show that a landscape-based approach allowing simultaneous assessment of impacts of local (i.e., planting date) and regional (i.e., landscape composition) factors provides valuable insights on how to reduce crop disease risks. Specifically, we found that planting fall melon fields early in the growing season, eliminating plants germinating from seeds produced by spring melons after harvest, and planting fall melon fields away from cotton and spring melon fields may significantly reduce the incidence of CYSDV infection in fall melons. Because the largest scale of significance of the positive association between abundance of cotton and spring melon fields and CYSDV incidence was 1,750 and 3,000 m, respectively, reducing areas of cotton and spring melon fields within these distances from fall melon fields may decrease CYSDV incidence. Our results indicate that landscape-based studies will be fruitful to alleviate limitations imposed on crop production by vector-borne diseases.


Assuntos
Produtos Agrícolas/virologia , Cucumis melo/virologia , Hemípteros/virologia , Insetos Vetores/virologia , Doenças das Plantas/virologia , Animais , Arizona , Geografia
3.
Clin Microbiol Infect ; 6(5): 239-45, 2000 May.
Artigo em Inglês | MEDLINE | ID: mdl-11168119

RESUMO

OBJECTIVES: To determine the diversity of pulsed-field gel electrophoresis (PFGE) types among epidemic strains of methicillin-resistant Staphylococcus aureus (MRSA) recovered in Belgium, France, Germany and The Netherlands over the period 1981-94. METHODS: MRSA strains collected in a multicenter survey in Belgium (n = 171) and from reference laboratories in neighboring countries (n = 102) were characterized by PFGE analysis using the SmaI enzyme. RESULTS: In total, 32 PFGE types were found. Epidemic PFGE type 1, first recognized in 1984, accounted for 82% of Belgian strains (87% of hospitals) and 51% of European MRSA strains. Four other internationally epidemic PFGE types (types 8, 10, 11 and 12) were less widely disseminated and more recently detected (1991-94), each recovered from two or three countries. International spread of two PFGE types was linked to transfer of colonized patients to Dutch hospitals from another country where this type was frequently recovered. CONCLUSIONS: Genotypic analysis indicated widespread distribution of several outbreak-associated MRSA strains over large European regions, which was in some instances related to interhospital patient transfer. These findings underscore the need for standardized international surveillance and control of MRSA transmission between healthcare institutions across Europe.


Assuntos
Infecção Hospitalar/epidemiologia , Surtos de Doenças , Infecções Estafilocócicas/epidemiologia , Staphylococcus aureus/classificação , Tipagem de Bacteriófagos , Bélgica/epidemiologia , DNA Bacteriano/análise , DNA-Citosina Metilases , Eletroforese em Gel de Campo Pulsado , Europa (Continente)/epidemiologia , Humanos , Resistência a Meticilina , Epidemiologia Molecular , Estudos Multicêntricos como Assunto , Staphylococcus aureus/genética
4.
Int J Food Microbiol ; 52(1-2): 67-75, 1999 Nov 01.
Artigo em Inglês | MEDLINE | ID: mdl-10573393

RESUMO

Rectal contents and tonsils from Dutch slaughter pigs collected immediately after slaughter were examined for the presence of verocytotoxin (VT)-producing Escherichia coli (VTEC) of serogroup O157 (O157 VTEC). In addition, fresh fecal material from poultry layer flocks and turkey flocks collected on poultry farms was examined for the presence of O157 VTEC. E. coli O157 strains were isolated from two (1.4%) of 145 pigs. The strains were isolated from samples of rectal contents, all samples of tonsils being negative. While all 501 fecal samples from chicken flocks were found negative, E. coli O157 strains were isolated from six (1.3%) of 459 pooled fecal samples from turkey flocks. One of the porcine isolates and one of the turkey isolates contained the VT2 gene, the E. coli attaching-and-effacing gene, as well as the enterohemorrhagic E. coli hemolysin gene. Production of VT was confirmed by cytotoxicity tests on Vero cells. Based on these characteristics, the two stains were regarded as potentially pathogenic for humans. The porcine and the turkey isolate were further characterized as being of phage types 4 and 14, respectively. While biochemically typical of E. coli O157, the remaining six isolates were nonverocytotoxigenic and negative for both the E. coli attaching-and-effacing gene and the enterohemorrhagic E. coli hemolysin gene. All eight E. coli O157 isolates did not carry genes that encode E. coli heat-labile and heat-stable enterotoxins. It was concluded that pigs and poultry can be a source of O157 VTEC strains characteristic of those causing illness in man. The extent to which pigs and poultry play a role in the epidemiology of human O157 VTEC infection needs further research.


Assuntos
Toxinas Bacterianas/biossíntese , Infecções por Escherichia coli/veterinária , Escherichia coli O157/isolamento & purificação , Doenças das Aves Domésticas/microbiologia , Doenças dos Suínos/microbiologia , Matadouros , Testes de Aglutinação , Animais , Anticorpos Antibacterianos/química , Tipagem de Bacteriófagos , Galinhas , Chlorocebus aethiops , Análise por Conglomerados , Eletroforese em Gel de Campo Pulsado , Infecções por Escherichia coli/microbiologia , Escherichia coli O157/metabolismo , Escherichia coli O157/patogenicidade , Fezes/microbiologia , Feminino , Separação Imunomagnética , Antígenos O/análise , Tonsila Palatina/microbiologia , Reação em Cadeia da Polimerase , Reto/microbiologia , Toxina Shiga I , Suínos , Perus , Células Vero
5.
J Infect ; 38(3): 185-90, 1999 May.
Artigo em Inglês | MEDLINE | ID: mdl-10424800

RESUMO

OBJECTIVES: To investigate and stop the spread of an outbreak of Streptococcus pyogenes infection in a district general hospital, involving 19 patients and two nurses over a 20-day period. METHODS: All suspected persons were investigated using conventional bacteriological techniques, followed by M, T and exotoxin gene-typing of the isolates in a national reference laboratory. RESULTS: 11 patients and both nurses were associated with the acute surgical ward on one floor of the hospital. They were infected with serotype M 9/T B3264, a strain with apparently low virulence, which has not been previously associated with outbreaks. Two other patients on the same floor each had different types and there were two clusters of another S. pyogenes serotype on other floors, each involving two patients. Two (unrelated) patients yielded other types of S. pyogenes. The patients were not seriously ill but had some delay in wound healing. CONCLUSIONS: The value of typing the isolates of S. pyogenes in this outbreak was in defining which patients were involved. No added value could be ascribed to the exotoxin gene-typing results.


Assuntos
Surtos de Doenças , Infecções Estreptocócicas/epidemiologia , Streptococcus pyogenes/classificação , Adulto , Idoso , Idoso de 80 Anos ou mais , Hospitais Gerais , Humanos , Pessoa de Meia-Idade , Países Baixos/epidemiologia , Reação em Cadeia da Polimerase , Sorotipagem , Infecções Estreptocócicas/microbiologia , Streptococcus pyogenes/genética , Streptococcus pyogenes/isolamento & purificação , Streptococcus pyogenes/patogenicidade , Infecção da Ferida Cirúrgica/microbiologia
6.
Vet Rec ; 135(11): 248-50, 1994 Sep 10.
Artigo em Inglês | MEDLINE | ID: mdl-7810046

RESUMO

During 1990 and 1991, 380 faecal samples were collected from horses with diarrhoea. Sixty-nine (18 per cent) of the samples yielded a positive culture for Salmonella species, and salmonellae were cultured directly from 37 (54 per cent) of these cases. In 32 (46 per cent) of the cases the salmonellae were found after culturing the organism in an enrichment medium. Salmonella typhimurium was isolated from 43 samples, S hadar from three samples, S arizona from two, S enteritidis from two, S virchow from one, S blockley from one and S bareilly from one sample. In 1990, S typhimurium phage type 200 was the predominant phage type, whereas in 1991 phage types 510, 656 and 658 were encountered most often. The antibiotic susceptibility of 53 of the 69 isolates was assessed and 28 of them were resistant to more than three antimicrobial agents. Resistance to streptomycin and the tetracyclines was common, but most of the isolates were sensitive to gentamicin and nitrofurantoin.


Assuntos
Doenças dos Cavalos/microbiologia , Salmonelose Animal , Animais , Técnicas de Tipagem Bacteriana/veterinária , Doenças dos Cavalos/diagnóstico , Cavalos , Hospitais Veterinários , Testes de Sensibilidade Microbiana/veterinária , Países Baixos , Prevalência , Salmonella/classificação , Salmonella/efeitos dos fármacos , Salmonella/isolamento & purificação , Salmonelose Animal/diagnóstico
7.
Ned Tijdschr Geneeskd ; 142(48): 2630-3, 1998 Nov 28.
Artigo em Holandês | MEDLINE | ID: mdl-10028365

RESUMO

Following isolation of a methicillin-resistant Staphylococcus aureus (MRSA) in a patient subjected to amputation below the knee because of a vasculopathy, further investigations were carried out. Nose, throat and wound cultures were taken from staff and patients who had had contact with the index patient. After taking inventory cultures and cleansing of the two wards involved, these wards were quarantined. The bacterial strain was characterized using microbiological standard methods. The MRSA was encountered in a total of nine patients and two nurses. An infection due to this MRSA was found in two patients and one nurse. Eradication in the hospital was successful. MRSA with the same phage type was found in one nurse and one patient in two nearly hospitals and in one patient in a nearby city. Anamnestically, there had been no contact between them. Tracing this sort of outbreak in time is not possible with the current preventive MRSA policy because there are no demonstrable risk groups for a MRSA occurring in the Netherlands. Routine checking for MRSA carriership among nursing personnel and long-staying surgical patients is a possibility to detect spread of this MRSA. It appears advisable to take restrictive measures even against this S. aureus with restricted resistance, because neither penicillins nor cephalosporins are efficacious. In general, more attention should be given to prevention of nosocomial transmission of S. aureus.


Assuntos
Infecção Hospitalar/prevenção & controle , Transmissão de Doença Infecciosa do Paciente para o Profissional , Transmissão de Doença Infecciosa do Profissional para o Paciente , Resistência a Meticilina/genética , Enfermeiras e Enfermeiros , Infecções Estafilocócicas/transmissão , Adulto , Surtos de Doenças/prevenção & controle , Feminino , Humanos , Controle de Infecções/métodos , Países Baixos/epidemiologia , Infecções Estafilocócicas/diagnóstico , Infecções Estafilocócicas/tratamento farmacológico , Infecções Estafilocócicas/epidemiologia , Staphylococcus aureus/genética , Staphylococcus aureus/isolamento & purificação
8.
Ned Tijdschr Geneeskd ; 143(4): 205-8, 1999 Jan 23.
Artigo em Holandês | MEDLINE | ID: mdl-10086143

RESUMO

OBJECTIVE: To study the spread of methicillin-resistant Staphylococcus aureus (MRSA) in hospitals, especially secondary MRSA infections in relation to the origin of the MRSA strain and the measures taken regarding contact isolation. DESIGN: Secondary data analysis. METHODS: As part of the national MRSA surveillance of the National Institute of Public Health and the Environment, data were collected using questionnaires. The analysis covered the period July 1994-June 1996 and was performed for index cases of secondary infections versus sporadic cases. Possible risk factors were determined. RESULTS: In the study period 30 index cases of (clusters of) secondary infections and 191 sporadic cases were found. The size of the clusters was limited. Strict contact isolation as described in the guidelines of the Dutch Working Group on Infection Prevention prevented secondary infections in most cases. Patients for whom no relation could be found between the MRSA infection and a stay abroad were found to have caused more secondary infections, even when the data were corrected for contact isolation measures.


Assuntos
Infecção Hospitalar/epidemiologia , Hospitais/estatística & dados numéricos , Resistência a Meticilina , Infecções Estafilocócicas/epidemiologia , Staphylococcus aureus/isolamento & purificação , Infecção Hospitalar/prevenção & controle , Coleta de Dados , Feminino , Inquéritos Epidemiológicos , Humanos , Controle de Infecções/métodos , Masculino , Países Baixos/epidemiologia , Fatores de Risco , Vigilância de Evento Sentinela , Infecções Estafilocócicas/prevenção & controle , Staphylococcus aureus/classificação
9.
Ned Tijdschr Geneeskd ; 143(20): 1041-5, 1999 May 15.
Artigo em Holandês | MEDLINE | ID: mdl-10368731

RESUMO

OBJECTIVE: Report of the technical, microbiological and epidemiological investigation following 2 cases of fatal Legionella pneumonia. DESIGN: Descriptive. METHOD: Faced with 2 nosocomial cases in a rehabilitation centre in the South of Limburg, the Netherlands, the water supply was investigated. Water temperatures from different taps were measured. Legionella cultures were made from respiratory patients' specimens, water samples and smears from all mixing taps (used in showers), samples from hot and cold water taps from the infected ward and from the five other wards. The strains were typed by serotyping and polymerase chain reaction. RESULTS: The circulating cold water sometimes warmed up to 40 degrees C (within the Legionella growth range). From the sputum of the 2 male patients with rheumatoid arthritis who died of Legionella pneumonia the same Legionella pneumophila (serotype I) was cultured as from the water supply. Of the showers on the contaminated ward 19% (12/63) were positive for Legionella as were 59% (35/59) of the cold water taps. Cultures from the hot water supply were negative just like control cultures from five other wards and swabs from showerheads and hoses. The cold water tubes ran next to the hot water tubes and the central heating system in the same shaft. On the infected ward patients were absent during the weekends. As one of the subsequent measures, the cold water pipes were relocated to another shaft. CONCLUSION: The combination of an elevated cold water temperature caused by heating along a distance by nearby hot water and heating piping and the regular stasis of water during the weekends when the ward was closed, most probably stimulated the multiplication of Legionella in the water supply. In order to minimize contamination of cold water its temperature must be kept below 20 degrees C. Surveillance of intramural water systems is necessary to prevent nosocomial infections.


Assuntos
Infecção Hospitalar/microbiologia , Legionella pneumophila/isolamento & purificação , Doença dos Legionários/microbiologia , Pneumonia/microbiologia , Microbiologia da Água , Abastecimento de Água/análise , Temperatura Baixa , Infecção Hospitalar/prevenção & controle , Reservatórios de Doenças , Evolução Fatal , Humanos , Doença dos Legionários/complicações , Doença dos Legionários/prevenção & controle , Masculino , Países Baixos , Pneumonia/prevenção & controle , Reação em Cadeia da Polimerase , Centros de Reabilitação , Sorotipagem
10.
Tijdschr Diergeneeskd ; 107(23): 889-95, 1982 Dec 01.
Artigo em Holandês | MEDLINE | ID: mdl-7157325

RESUMO

The skins of slaughtered poultry were studied for the presence of Staphylococcus aureus in eight poultry-processing plants. Bacteriophage typing showed that S. aureus persisted as 'house bacteria' in all slaughter lines under investigation. As a result of this fact, broilers became contaminated with S. aureus during the process of slaughter. The number of S. aureus organisms finding their way to the carcasses may vary from less than 10/g. of skin to greater than 50,000/g. of skin from one day to another when samples are taken. This finding is evidence of the fact that disinfection occurs at irregular intervals. However, the persistence of particular phage types in processing plants also suggests that the apparatus employed cannot be effectively cleansed and disinfected by a simple procedure.


Assuntos
Aves Domésticas/microbiologia , Pele/microbiologia , Staphylococcus aureus/isolamento & purificação , Matadouros , Animais , Tipagem de Bacteriófagos , Desinfetantes/farmacologia , Desinfecção/normas , Testes de Sensibilidade Microbiana , Staphylococcus aureus/classificação
11.
Tijdschr Diergeneeskd ; 111(1): 9-13, 1986 Jan 01.
Artigo em Holandês | MEDLINE | ID: mdl-3511564

RESUMO

Approximately 20,000 strains of Salmonella were screened annually for resistance to tetracycline, chloramphenicol, kanamycin and ampicillin since 1959, and also to trimethoprim since 1978. Tetracycline-resistant strains increased in human subjects and pigs from 1961. After the ban on incorporation of tetracycline in animal feeds for nutritive purposes in 1974, the proportion of tetracycline-resistant strains in pigs and human subjects decreased. In veal calves, the number of strains of S. typhimurium and S. dublin resistant to multiple drugs increased from 1972. Strains resistant to multiple antibiotics in man were mainly isolated from adoptive children from Indonesia. No further spread of these strains was observed. So far, strains similar to those in calves resistant to multiple drugs were only incidentally isolated from human patients.


Assuntos
Antibacterianos/farmacologia , Salmonella typhimurium/efeitos dos fármacos , Animais , Bovinos/microbiologia , Cloranfenicol/farmacologia , Resistência Microbiana a Medicamentos , Humanos , Canamicina/farmacologia , Suínos/microbiologia , Tetraciclina/farmacologia , Trimetoprima/farmacologia
12.
Tijdschr Diergeneeskd ; 125(5): 143-6, 2000 Mar 01.
Artigo em Holandês | MEDLINE | ID: mdl-10730338

RESUMO

Qualitative tests are used to monitor antimicrobial resistance in bacteria of animal origin in the Netherlands. Quantitative information on trends in resistance is thus not obtained. Moreover, in general a limited panel of antibiotics is tested. The present study describes resistance in zoonotic food-borne pathogens Salmonella, Campylobacter, and Escherichia coli O157 isolated from human clinical cases and from faeces of healthy food animals in 1998 and 1999, as determined with quantitative susceptibility tests. The resistance of the indicator organisms E. coli and Enterococcus faecium isolated from faecal samples of broilers and pigs randomly sampled at slaughterhouses was also determined. For this end, faecal samples from veal calves were sampled in 1996 and 1997 at the three main Dutch veal calf slaughterhouses. In 1998 only a limited number of faecal samples of veal calves were taken at farms. For E. coli and Salmonella the following antibiotics were tested: amoxicillin, amoxicillin-clavulanic acid, piperacillin, cefotaxime, ceftazidime, imipenem, gentamicin, doxycycline, trimethoprim, trimethoprim/sulphamethoxazole, ciprofloxacin, chloramphenicol, florfenicol, carbadox, and flumequine. For E. faecium the following antibiotics were tested: amoxicillin, amoxicillin-clavulanic acid, chloramphenicol, doxycycline, erythromycin, vancomycin, teicoplanin, streptomycin ('high level' > 2000 mg/ml), gentamicin ('high level' > 500 mg/ml), ciprofloxacin, bacitracin, flavofosfolipol, salinomycin, quinupristin-dalfopristin, virginiamycin, tilmicosin, avilamycin, and everninomycin. For Campylobacter the following antibiotics were tested: erythromycin, doxycycline, gentamicin, carbadox, flavofosfolipol, ciprofloxacin, trimethoprim/sulphamethoxazole, amoxicillin, and metronidazole.


Assuntos
Antibacterianos/farmacologia , Bactérias/efeitos dos fármacos , Animais , Campylobacter/efeitos dos fármacos , Bovinos , Resistência Microbiana a Medicamentos , Enterococcus faecium/efeitos dos fármacos , Escherichia coli/efeitos dos fármacos , Fezes/microbiologia , Humanos , Testes de Sensibilidade Microbiana/veterinária , Aves Domésticas , Salmonella/efeitos dos fármacos , Suínos , Zoonoses
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA