Canadian Journal of Infectious Diseases最新文献

{"title":"Immunization and autism links: Ethics in research.","authors":"Joanne Embree","doi":"10.1155/2004/423497","DOIUrl":"https://doi.org/10.1155/2004/423497","url":null,"abstract":"","PeriodicalId":31111,"journal":{"name":"Canadian Journal of Infectious Diseases","volume":"15 2","pages":"73-4"},"PeriodicalIF":0.0,"publicationDate":"2004-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1155/2004/423497","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"27192886","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Translocation of Clostridium difficile toxin B across polarized Caco-2 cell monolayers is enhanced by toxin A.","authors":"Tim Du,&nbsp;Michelle J Alfa","doi":"10.1155/2004/292580","DOIUrl":"https://doi.org/10.1155/2004/292580","url":null,"abstract":"<p><p>Clostridium difficile is the etiological agent of antibiotic-associated diarrhea; the most common form of nosocomial infectious diarrhea. The basis for the shock-like systemic symptoms observed in severe cases of this infection are not known. It is hypothesized that the invasion of C difficile toxins A and/or B from the gut mucosa may contribute to these symptoms.A polarized tissue culture model employing Caco-2 cells grown on transwell inserts was established to study the translocation of purified C difficile toxins A and B. C difficile toxins were (125)I labelled and inoculated onto confluent polarized Caco-2 cell monolayers to study translocation dynamics. Electrical resistance measurements were used to monitor monolayer confluence and tight junction integrity. Samples were taken from the apical and basal sides of the insert, as well as the insert itself, and tested using the human foreskin fibroblasts cell cytotoxicity assay to monitor partitioning of the radiolabelled toxins. Toxin A produced a 50% reduction in electrical resistance in 3 h whereas the same concentration of toxin B required at least 7 h to achieve the same effect. Both toxins A and B were able to translocate across confluent monolayers of Caco-2 cells. The combination of toxin A and B together was synergistic with respect to promoting the translocation of toxin B. Although the addition of toxin A resulted in a 100% increase in the amount of toxin B able to translocate, no increases in toxin A translocation were observed. These findings suggest a model of pathogenesis in which C difficile toxin A facilitates the translocation of toxin B from the gut into submucosal areas where it may play a role in inflammatory damage.</p>","PeriodicalId":31111,"journal":{"name":"Canadian Journal of Infectious Diseases","volume":"15 2","pages":"83-8"},"PeriodicalIF":0.0,"publicationDate":"2004-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1155/2004/292580","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"27192890","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Patient safety: What does it all mean?","authors":"Lynn B Johnston,&nbsp;John M Conly","doi":"10.1155/2004/789840","DOIUrl":"https://doi.org/10.1155/2004/789840","url":null,"abstract":"1Queen Elizabeth II Health Sciences Centre and Dalhousie University, Halifax, Nova Scotia; 2Departments of Pathology and Laboratory Medicine, Medicine, and Microbiology and Infectious Diseases, University of Calgary, Calgary, Alberta Correspondence and reprints: Dr Lynn Johnston, Department of Medicine, Room 5014 ACC, Queen Elizabeth II Health Sciences Centre, 1278 Tower Road, Halifax, Nova Scotia B3H 2Y9. Telephone 902-473-5553, fax 902-473-7394, e-mail ljohnsto@dal.ca Received and accepted March 25, 2004 Anumber of articles have appeared in the medical literature over the past four years on the topic of patient safety, including a series in the New England Journal of Medicine in 2002 and 2003 (1). There has been considerable media interest, with a number of reports on medical errors and their associated consequences. The Royal College of Physicians and Surgeons of Canada sponsored a National Steering Committee on Patient Safety that published its report in 2002 (2). The committee made 19 recommendations intended to improve patient safety in Canadian health care (2). In 2003, the government of Canada committed $10 million/year for implementation of the recommendations, including support for the creation of a Canadian Patient Safety Institute (3). The Canadian Council on Health Services Accreditation has indicated its commitment to playing a major role in improving patient safety through accreditation (4). The Canadian Institutes for Health Information and Health Research have jointly funded the Canadian Adverse Events Study, examining the extent of adverse events in acute care hospitals with results expected to be published in 2004. This study includes 20 teaching, community and small hospitals in five provinces (British Columbia, Alberta, Ontario, Quebec and Nova Scotia). Clearly, patient safety has become a very relevant topic. From a historical perspective, Elihu Schimmel in 1964 (5) wrote that recent medical progress has brought dramatic advances in methods of diagnosis and treatment but, with each new advance, reports of adverse reactions have soon followed. As a chief resident, he undertook a prospective study of the type and frequency of complications (‘episodes’) occurring in response to medical care. Episodes occurring as a result of errors were excluded. There were 240 episodes in 198 of 1014 (19.5%) patients. The majority of episodes (49.6%) were reactions to therapeutic drugs, 9.6% were hospital acquired infections, 20% were life threatening or fatal, and 6.7% were fatal. Antimicrobials were associated with 29.4% of adverse reactions to medications. Six of the 16 deaths (37.5%) were in patients with hospital-acquired infections. Thirty-six years later, the Institute of Medicine (IOM) in the United States published To Err is Human: Building a Safer Health System (6). In it, they estimated that between 44,000 and 98,000 Americans die each year as a result of medical errors. These numbers were extrapolated from the results of three stud","PeriodicalId":31111,"journal":{"name":"Canadian Journal of Infectious Diseases","volume":"15 2","pages":"75-7"},"PeriodicalIF":0.0,"publicationDate":"2004-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1155/2004/789840","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"27192888","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical outcome with oral linezolid and rifampin following recurrent methicillin-resistant Staphylococcus aureus bacteremia despite prolonged vancomycin treatment.","authors":"Jon-David Schwalm,&nbsp;Philippe El-Helou,&nbsp;Christine H Lee","doi":"10.1155/2004/768765","DOIUrl":"https://doi.org/10.1155/2004/768765","url":null,"abstract":"<p><p>Drug-resistant Gram-positive bacteria, especially Staphylococcus aureus, are emerging as the predominant organisms involved in both nosocomial and community-acquired infections. Since the 1980s, vancomycin has been the first-line antibiotic used to treat methicillin- resistant S aureus. However, allergy and intolerance to vancomycin, the increasing number of vancomycin clinical failures and the existence of vancomycin intermediate-susceptible isolates of S aureus suggest that new antibiotics are needed. This paper reports the only known case of a successful clinical outcome with long term oral linezolid and rifampin therapy in the management of recurrent and persistent methicillin-resistant S aureus bacteremia with metastatic infections despite prolonged vancomycin use. More than two years since the initiation of linezolid and rifampin, the study patient has been clinically well with no evidence of adverse drug reactions including cytopenia and hepatic toxicities. Physicians must be aware of the novel developments in antibiotic therapy to treat drug-resistant bacterial infections.</p>","PeriodicalId":31111,"journal":{"name":"Canadian Journal of Infectious Diseases","volume":"15 2","pages":"97-100"},"PeriodicalIF":0.0,"publicationDate":"2004-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1155/2004/768765","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"27192167","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Myiasis in an urban setting: A case report.","authors":"Gerry Predy,&nbsp;Mary Angus,&nbsp;Lance Honish,&nbsp;Charles E Burnett,&nbsp;Andrew Stagg","doi":"10.1155/2004/978427","DOIUrl":"https://doi.org/10.1155/2004/978427","url":null,"abstract":"<p><p>Myiasis is considered to be a condition only found in tropical, developing countries. However, this paper reports a case identified in an urban, North American setting. The clinical presentation is discussed along with the underlying comorbidities and social determinants.</p>","PeriodicalId":31111,"journal":{"name":"Canadian Journal of Infectious Diseases","volume":"15 1","pages":"51-2"},"PeriodicalIF":0.0,"publicationDate":"2004-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1155/2004/978427","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"27192408","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Residential water heater temperature: 49 or 60 degrees Celsius?","authors":"Benoît Lévesque,&nbsp;Michel Lavoie,&nbsp;Jean Joly","doi":"10.1155/2004/109051","DOIUrl":"https://doi.org/10.1155/2004/109051","url":null,"abstract":"here are two opposing risks when it comes to water tem-perature inside domestic water heaters; exposure toLegionella, the bacteria responsible for Legionnaires’ disease(pulmonary legionellosis), and the risk of scalding. In 1986,this dilemma was the subject of an editorial in the CanadianMedical Association Journal(1). A few months ago, Safe KidsCanada launched a media campaign aimed at preventingscalding by lowering domestic hot water temperature to 49°Cat the tap (2). Among the means considered to reach thisobjective, Safe Kids Canada, with the support of some publichealth organizations, suggests and seems to favour lowering thetemperature setting of domestic hot water heaters to 49°C.Like other authors (3,4), including the World HealthOrganization (WHO) who published a recent monograph onthe Legionella problem in drinking water (3), we believe thatthere is evidence for the transmission of legionellosis throughthe drinking water distribution systems in private homes. Thisis a serious illness associated with high death rates (up to 12%).Primary groups at risk (the elderly, smokers, the immunocom-promised and patients suffering from chronic respiratory ill-nesses), are groups who include a large proportion of thepopulation at home. Although we support prevention againsttap water scalds, we are against setting water heater thermo-stats at 49°C because we believe this could facilitate prolifera-tion of Legionella inside the tank and increase the risk oflegionellosis.Domestic water heaters, particularly electric devices, can cer-tainly be contaminated by Legionella. In Quebec, a study of 211homes (178 electric water heaters, 33 oil or gas water heaters)found Legionella contamination in 40% of electric water heaters.No water heaters using fossil fuels were contaminated (5). Theauthors concluded that, because of design variables, use of anelectric water heater was the most significant factor leading toLegionella contamination in hot water (5) in the home.The clinical and epidemiological significance of this find-ing is much debated. However, in a case-control study of spo-radic cases of community-acquired legionellosis, Straus et al(6) concluded that the residential drinking water supply wasresponsible for a substantial proportion of sporadic cases ofLegionnaires’ disease. These findings are supported by Stout et al(7) in a study of 20 Pittsburgh patients with culture-confirmed Legionnaires’ disease. A link with residential drink-ing water contamination was established for eight (40%)patients. This included three private homes (one singledwelling, two multidwellings), two senior-citizen homes, twoout-patient hospital clinics, and one industrial plant. Theauthors concluded that drinking water distribution systemswere a significant source of transmission of Legionnaires’ dis-ease (7).The importance of Legionnaire’s disease is underestimatedbecause it is difficult to diagnose and because it is reportedthrough a passive surveillance system. In an active s","PeriodicalId":31111,"journal":{"name":"Canadian Journal of Infectious Diseases","volume":"15 1","pages":"11-2"},"PeriodicalIF":0.0,"publicationDate":"2004-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1155/2004/109051","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"27191785","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Measurement of antibiotic consumption: A practical guide to the use of the Anatomical Thgerapeutic Chemical classification and Definied Daily Dose system methodology in Canada.","authors":"James M Hutchinson,&nbsp;David M Patrick,&nbsp;Fawziah Marra,&nbsp;Helen Ng,&nbsp;William R Bowie,&nbsp;Laurie Heule,&nbsp;Mark Muscat,&nbsp;Dominique L Monnet","doi":"10.1155/2004/389092","DOIUrl":"https://doi.org/10.1155/2004/389092","url":null,"abstract":"<p><p>Despite the global public health importance of resistance of microorganisms to the effects of antibiotics, and the direct relationship of consumption to resistance, little information is available concerning levels of consumption in Canadian hospitals and out-patient settings. The present paper provides practical advice on the use of administrative pharmacy data to address this need. Focus is made on the use of the Anatomical Therapeutic Chemical classification and Defined Daily Dose system. Examples of consumption data from Canadian community and hospital settings, with comparisons to international data, are used to incite interest and to propose uses of this information. It is hoped that all persons responsible for policy decisions regarding licensing, reimbursement, prescribing guidelines, formulary controls or any other structure pertaining to antimicrobial use become conversant with the concepts of population antibiotic consumption and that this paper provides them with the impetus and direction to begin accurately measuring and comparing antibiotic use in their jurisdictions.</p>","PeriodicalId":31111,"journal":{"name":"Canadian Journal of Infectious Diseases","volume":"15 1","pages":"29-35"},"PeriodicalIF":0.0,"publicationDate":"2004-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1155/2004/389092","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"27191790","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The management of infection and colonization due to methicillin-resistant Staphylococcus aureus: A CIDS/CAMM position paper.","authors":"Andrew E Simor,&nbsp;Mark Loeb","doi":"10.1155/2004/531434","DOIUrl":"https://doi.org/10.1155/2004/531434","url":null,"abstract":"<p><p>Methicillin-resistant Staphylococcus aureus (MRSA) is being seen with greater frequency in most hospitals and other health care facilities across Canada. The organism may cause life-threatening infections and has been associated with institutional outbreaks. Several studies have confirmed that MRSA infection is associated with increased morbidity and mortality compared with infections caused by susceptible strains, even when the presence of comorbidities is accounted for. Treatment of MRSA infection is complicated by the fact that these organisms are resistant to multiple antimicrobial agents, so treatment options are limited. The effectiveness of decolonization therapy (attempting to eradicate MRSA carriage) is also uncertain. This paper reviews the medical management of MRSA infections, discusses the potential role of decolonization and provides an overview of evidence to support recommended infection control practices.</p>","PeriodicalId":31111,"journal":{"name":"Canadian Journal of Infectious Diseases","volume":"15 1","pages":"39-48"},"PeriodicalIF":0.0,"publicationDate":"2004-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1155/2004/531434","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"27192409","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Headache, fever and back pain in a 16-year-old boy.","authors":"Alireza Nateghian,&nbsp;Vivek Mehta,&nbsp;John L Robinson","doi":"10.1155/2004/909126","DOIUrl":"https://doi.org/10.1155/2004/909126","url":null,"abstract":"CASE PRESENTATIONA previously healthy 16-year-old boy of East Indian origin wasadmitted to the Stollery Children’s Hospital (SCH) inEdmonton, Alberta in February 2003 for evaluation ofheadache and back pain. Lower back pain had started suddenlynine days earlier, after lifting weights, and had persisted. Athrobbing occipital headache started eight days before admis-sion. The patient thought he had possibly been febrile.There was no known exposure to tuberculosis and no historyof ill contacts. There had been recent travel to California andvisitors from India had been staying in the home. The boy hadalways lived in Canada.One day before admission to the SCH, the boy was evaluatedin a regional hospital because of worsening headache and backpain. Temperature was 38°C, pulse was 84 beats/min, respira-tory rate was 18 breaths/min and blood pressure was 120/80 mmHg.Physical examination revealed a coherent boy in mild dis-tress. He vomited for the first time during the assessment. Hisneck was stiff and a positive Brudzinski sign was present.Fundoscopy was normal. Tympanic membranes, mouth andthroat were normal. No significant lymphadenopathy was not-ed. Chest, cardiac and abdominal examinations were unre-markable. Cranial nerves, sensation, tone, power, coordinationand deep tendon reflexes were normal. On examination of themuskuloskeletal system, there was slight tenderness over thespinus processes of the third and fourth lumbar vertebrae (L3 and L4).A noncontrast brain computerized tomography scan wasnormal. Examination of cerebrospinal fluid (CSF) revealed awhite blood cell count of 6.1 × 10","PeriodicalId":31111,"journal":{"name":"Canadian Journal of Infectious Diseases","volume":"15 1","pages":"53-4"},"PeriodicalIF":0.0,"publicationDate":"2004-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1155/2004/909126","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"27192410","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Three generations of experience and thought in microbiology and infection.","authors":"Morris Goldner","doi":"10.1155/2003/925927","DOIUrl":"https://doi.org/10.1155/2003/925927","url":null,"abstract":"<p><p>Views and comments were sought from Brian Lacey, who was professionally active from the 1930s to the 1970s, Alain Dublanchet, active from the 1960s to the 2000s, and Mark Pallen, active from the 1990s to 2000 and beyond. Professor Lacey was professor of microbiology at the Westminster Medical School, University of London, United Kingdom, for many years and is now retired. Docteur Dublanchet is the long time head of the laboratory of microbiology and virology at the Centre Hospitalier Intercommunal de Villeneuve-Saint-Georges in the greater Paris area. Professor Pallen is currently professor of bacterial genetics at the Medical School, University of Birmingham (United Kingdom); he is a keen enthusiast of genomic studies in the interest of molecular pathogenesis research. All three are medically qualified. Four questions were posed to each:What was the situation like in the infectious disease field when you first started your career?What do you feel have been the most important accomplishments with regard to problems of infectious disease during your period of activity?What do you foresee as the vital matters that still need to be addressed for countering infectious disease?Can infectious disease ever, practically, be eradicated and, if so, how would this be accomplished?</p>","PeriodicalId":31111,"journal":{"name":"Canadian Journal of Infectious Diseases","volume":"14 6","pages":"329-35"},"PeriodicalIF":0.0,"publicationDate":"2003-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1155/2003/925927","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"27192885","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}