Clinical microbiology and infection : the official publication of the European Society of Clinical Microbiology and Infectious Diseases
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Clin. Microbiol. Infect. · Jun 2011
Review Historical ArticleInsights gained from palaeomicrobiology into ancient and modern tuberculosis.
The direct detection of ancient Mycobacterium tuberculosis molecular biomarkers has profoundly changed our understanding of the disease in ancient and historical times. Initially, diagnosis was based on visual changes to skeletal human remains, supplemented by radiological examination. ⋯ We now realize that the incidence of past tuberculosis was greater than previously estimated, as M. tuberculosis biomarkers can be found in calcified and non-calcified tissues with non-specific or no visible pathological changes. Modern concepts of the origin and evolution of M. tuberculosis are informed by the detection of lineages of known location and date.
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Clin. Microbiol. Infect. · Jun 2011
ReviewMolecular epidemiology of multidrug-resistant strains of Mycobacterium tuberculosis.
Genotyping of Mycobacterium tuberculosis has been extensively used for investigating epidemics of multidrug-resistant strains of M. tuberculosis, in order to identify the factors involved in the transmission of such strains and determine effective control programmes to limit their expansion at both the individual and population levels. Here, we review the methods currently used to study the molecular epidemiology of multidrug-resistant M. tuberculosis strains, and the insights provided by these techniques regarding global trends and the transmission dynamics of multidrug-resistant tuberculosis at a world scale.
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Clin. Microbiol. Infect. · Jun 2011
The MRSA-import in ICUs is an important predictor for the occurrence of nosocomial MRSA cases.
Nosocomial infections with methicillin-resistant Staphylococcus aureus (MRSA) account for increased morbidity, mortality and healthcare costs in critically ill patients worldwide. The intensive care unit (ICU) component of the German surveillance system for nosocomial infections (Krankenhaus-Infektions-Surveillance-System, KISS) has been supplemented with a module targeting the surveillance of multiresistant pathogens [Multiresistente Erreger (MRE)-KISS] in order to account for the increasing burden of antibiotic-resistant bacteria. The aim of this study was to assess the association between structural and organizational characteristics of ICUs and the number of nosocomial MRSA cases. ⋯ Multivariable analysis using negative binominal regression models shows that a stay on a medical ICU has a protective effect (incidence rate ratio, 0.42; 95% confidence interval, 0.24-0.74; p = 0.003), whereas the imported MRSA incidence is significantly associated with the number of nosocomial MRSA cases (incidence rate ratio, 1.74; 95% confidence interval, 1.23-2.45; p = 0.002). Structure and process parameters do not show any effect. ICU type and imported MRSA incidence should be considered for benchmarking between hospitals.
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Clin. Microbiol. Infect. · Jun 2011
Lower incidence of catheter-related bloodstream infection in subclavian venous access in the presence of tracheostomy than in femoral venous access: prospective observational study.
Guidelines for the prevention of catheter-related bloodstream infection (CRBSI) recommend subclavian rather than femoral venous access to minimize the risk of CRBSI. However, they do not address the issue of CRBSI with subclavian venous access in the presence of tracheostomy, where the incidence of CRBSI has been found to be higher than without tracheostomy. In this study, we found lower CRBSI in subclavian venous access in the presence of tracheostomy than in femoral venous access (3.9 vs. 10.1 CRBSI per 1000 catheter-days; odds ratio = 0.39; 95% confidence interval ≤0.001-0.91; p 0.03).