51
|
Seah XFV, Ngeow JHA, Thoon KC, Tee WSN, Maiwald M, Chong CY, Tan NWH. Infant With Invasive Nontyphoidal Salmonellosis and Mastitis. Glob Pediatr Health 2015; 2:2333794X15591568. [PMID: 27335967 PMCID: PMC4784604 DOI: 10.1177/2333794x15591568] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
|
52
|
|
53
|
Meyer K, Zientek N, Maiwald M, Kraemer B, Esche E, Müller D, Wozny G. Eine robuste Prozessanalytik für die CO 2-Abtrennung industrieller Gasströme basierend auf Online-NMR- und -Raman-Spektroskopie. CHEM-ING-TECH 2014. [DOI: 10.1002/cite.201450076] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
|
54
|
Zientek N, Meyer K, Dalitz F, Kraume M, Guthausen G, Maiwald M. Neue Möglichkeiten für die Prozessanalytik mit gekoppelter 1H- und 19F-Medium-Resolution-NMR-Spektroskopie. CHEM-ING-TECH 2014. [DOI: 10.1002/cite.201450687] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
|
55
|
Ruhnke N, Müller A, Eppich B, Maiwald M, Sumpf B, Erbert G, Tränkle G. 400 mW external cavity diode laser with narrowband emission at 445 nm. OPTICS LETTERS 2014; 39:3794-3797. [PMID: 24978739 DOI: 10.1364/ol.39.003794] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
A high-power external cavity diode laser (ECDL) system with narrowband emission is presented. The system is based on a commercially available high-power GaN laser diode. For the ECDL, a maximum optical output power of 400 mW in continuous-wave operation with narrowband emission is achieved. Longitudinal mode selection is realized by using a surface diffraction grating in Littrow configuration. A spectral width of 20 pm at 445 nm with a side-mode suppression ratio larger than 40 dB is achieved. This concept enables diode laser systems suitable for subsequent nonlinear frequency conversion into the UV spectral range.
Collapse
|
56
|
Maiwald M, Chan ESY. Pitfalls in evidence assessment: the case of chlorhexidine and alcohol in skin antisepsis. J Antimicrob Chemother 2014; 69:2017-21. [PMID: 24777898 DOI: 10.1093/jac/dku121] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022] Open
Abstract
Chlorhexidine has attracted increasing attention for its role in skin antisepsis in recent years. It was tested in several prominent clinical trials and subsequently recommended in important guidelines for blood culture collection, vascular catheter insertion and surgical skin preparation. We noticed and subsequently reported a widespread misinterpretation of evidence surrounding chlorhexidine and its role in skin antisepsis. Multiple clinical trial reports and systematic reviews that had assessed the clinical efficacy of chlorhexidine/alcohol combinations for skin antisepsis had attributed efficacy solely to the chlorhexidine component. This misinterpretation was carried over into the tertiary literature, including evidence-based guidelines. Here we discuss some of the scientific, ethical, patient safety and infection control implications of this misinterpretation, as well as broader implications for evidence-based medicine.
Collapse
|
57
|
Maiwald M, Petney TN, Assam PN, Chan ESY. Use of statistics as another factor leading to an overestimation of chlorhexidine's role in skin antisepsis. Infect Control Hosp Epidemiol 2014; 34:872-3. [PMID: 23838237 DOI: 10.1086/671282] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
|
58
|
Harbarth S, Maiwald M, Dancer SJ. The environment and healthcare-acquired infections: why accurate reporting and evaluation of biological plausibility are important. Infect Control Hosp Epidemiol 2014; 34:996-7. [PMID: 23917919 DOI: 10.1086/671741] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
|
59
|
Heudorf U, Mischler D, Bobyk D, Bornhofen B, Maiwald M, Merbs R, Mühlhaus R, Wendel L. [MRSA bloodstream infections according to the German obligation for notification - data and experience of the MDRO Network Rhine-Main, Germany, 2011]. DAS GESUNDHEITSWESEN 2013; 76:385-91. [PMID: 23954986 DOI: 10.1055/s-0033-1349871] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
BACKGROUND Since July 1st, 2009 in accord with the statuary order based on the German law for infectious diseases (Infektionsschutzgesetz), MRSA in blood and liquor have to be notified to the public health authorities. The aim of this extension of the notification to report is to improve the surveillance of nosocomial infections and the prevention of nosocomial MRSA infections. In this paper data of the notifications in the year 2011 within the MDRO-Net Rhine-Main, an association of 7 public health authorities in the region, are reported in order to investigate whether the aims of the obligation for notification could be achieved. RESULTS In 2011, 138 MRSA bloodstream infections, including 1 MRSA in liquor culture, were notified to the 7 health protection authorities, resulting in an incidence rate of 5.6/100,000 inhabitants. In urban regions with more hospitals available, the incidence rate was higher than in rural districts with less medical facilities (6.9 vs. 4.4/100,000 inhabitants). Only 46 (35%) of the patients with MRSA cultured in their blood had been detected via anamnesis as patients on risk for MRSA, and 59 (45%) had been screened for MRSA on admission. The incidence rate in the different hospitals was 0.041 ± 0.031/1,000 patient days (range 0-0.145/1,000 patient days). CONCLUSIONS For the first time, data on notification of MRSA cultures in blood specimen are published from a whole MRE Network in Germany encompassing >2.1 million inhabitants. Incidence rates per 100,000 inhabitants alone do not seem adequate to cope with the aims of the obligation for notification. Instead, reference to patient days in the respective clinic enables an external comparison to other medical institutions in the region and is a better base for discussion with these institutions on improvements of surveillance, screening and hygiene.
Collapse
|
60
|
Khalafallah A, Maiwald M, Hannan T, Abell S, Staker J, Supperamohan A. Early implementation of antifungal therapy in the management of febrile neutropenia is associated with favourable outcome during induction chemotherapy for acute leukaemias. Intern Med J 2012; 42:131-6. [PMID: 22151972 DOI: 10.1111/j.1445-5994.2011.02638.x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
BACKGROUND Mortality related to induction chemotherapy during the treatment of acute leukaemias (AL) has been estimated at 5-20%, and this increases with age. Fungal infection remains one of the major causes of morbidity and mortality and is considered an obstacle to the successful management of acute leukaemias. METHODS We retrospectively analysed all patients treated for acute leukaemias at a single institution between July 2006 and January 2009, to assess the impact of early antifungal therapy on outcome during induction chemotherapy. There were 44 episodes of induction chemotherapy, with a median age of patients of 61 years (range 18-81), including 29 patients with acute myeloid leukaemia, 9 with acute lymphoblastic leukaemia and 6 with relapsed AL. The median age was 61 years (range 18-81), and 20 patients were over the age of 60 years. RESULTS All patients who developed febrile neutropenia received broad-spectrum antibiotics. Early empirical antifungal treatment was commenced with voriconazole (15 patients) or caspofungin (12 patients) if the febrile neutropenia did not resolve after 72 h of antibiotic therapy, in conjunction with radiological changes consistent with possible fungal infection. None of the patients succumbed during induction chemotherapy. The 120-day mortality rate after the induction therapy was 2.2%, without any incidence of invasive fungal disease. CONCLUSION Our analysis shows that early empirical treatment for fungal infection with voriconazole or caspofungin is associated with a favourable outcome of induction therapy for acute leukaemias. Further studies to confirm this finding are warranted.
Collapse
|
61
|
Maiwald M, Chan ESY. The forgotten role of alcohol: a systematic review and meta-analysis of the clinical efficacy and perceived role of chlorhexidine in skin antisepsis. PLoS One 2012; 7:e44277. [PMID: 22984485 PMCID: PMC3434203 DOI: 10.1371/journal.pone.0044277] [Citation(s) in RCA: 124] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2012] [Accepted: 07/31/2012] [Indexed: 11/18/2022] Open
Abstract
Background Skin antisepsis is a simple and effective measure to prevent infections. The efficacy of chlorhexidine is actively discussed in the literature on skin antisepsis. However, study outcomes due to chlorhexidine-alcohol combinations are often attributed to chlorhexidine alone. Thus, we sought to review the efficacy of chlorhexidine for skin antisepsis and the extent of a possible misinterpretation of evidence. Methods We performed a systematic literature review of clinical trials and systematic reviews investigating chlorhexidine compounds for blood culture collection, vascular catheter insertion and surgical skin preparation. We searched PubMed, CINAHL, the Cochrane Library, the Agency for Healthcare Research and Quality website, several clinical trials registries and a manufacturer website. We extracted data on study design, antiseptic composition, and the following outcomes: blood culture contamination, catheter colonisation, catheter-related bloodstream infection and surgical site infection. We conducted meta-analyses of the clinical efficacy of chlorhexidine compounds and reviewed the appropriateness of the authors′ attribution. Results In all three application areas and for all outcomes, we found good evidence favouring chlorhexidine-alcohol over aqueous competitors, but not over competitors combined with alcohols. For blood cultures and surgery, we found no evidence supporting chlorhexidine alone. For catheters, we found evidence in support of chlorhexidine alone for preventing catheter colonisation, but not for preventing bloodstream infection. A range of 29 to 43% of articles attributed outcomes solely to chlorhexidine when the combination with alcohol was in fact used. Articles with ambiguous attribution were common (8–35%). Unsubstantiated recommendations for chlorhexidine alone instead of chlorhexidine-alcohol were identified in several practice recommendations and evidence-based guidelines. Conclusions Perceived efficacy of chlorhexidine is often in fact based on evidence for the efficacy of the chlorhexidine-alcohol combination. The role of alcohol has frequently been overlooked in evidence assessments. This has broader implications for knowledge translation as well as potential implications for patient safety.
Collapse
|
62
|
Guthausen G, Dalitz F, Zientek N, Nirschl H, Kraume M, Maiwald M. Applikationen der Medium-Resolution-NMR-Spektroskopie in der Prozessanalytik: Potenzial und Herausforderungen. CHEM-ING-TECH 2012. [DOI: 10.1002/cite.201250110] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
|
63
|
Jordan D, Simon J, Fury S, Moss S, Giffard P, Maiwald M, Southwell P, Barton MD, Axon JE, Morris SG, Trott DJ. Carriage of methicillin-resistant Staphylococcus aureus by veterinarians in Australia. Aust Vet J 2011; 89:152-9. [PMID: 21495985 DOI: 10.1111/j.1751-0813.2011.00710.x] [Citation(s) in RCA: 61] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
OBJECTIVE To estimate the prevalence of carriage of methicillin-resistant Staphylococcus aureus (MRSA) among Australian veterinarians. METHODS Individuals attending veterinary conferences in Australia in 2009 were recruited to provide nasal swabs and complete a questionnaire about their professional activities. Swabs were processed by standard methods for detecting MRSA and questionnaire responses were used to group veterinarians according to their areas of major work emphasis (species and practice type). Prevalence was estimated for each of these grouping and contingency tables and regression tree analysis used to explain the variation in MRSA carriage. RESULTS Among the 771 respondents 'industry and government veterinarians' (controls) had the lowest prevalence of MRSA carriage at 0.9%. Veterinarians with horses as a major area of work emphasis had a prevalence of 11.8% (13-fold that of controls) and those whose only major emphasis was horses had a prevalence of 21.4% (23-fold that of controls). Veterinarians with dogs and cats as a major activity had a 4.9% prevalence (5-fold that of controls). Prevalence rates for other major activities (pigs, dairy and beef cattle, avian and wildlife) were also increased, but were estimated from smaller numbers of respondents. Regression tree analysis clearly isolated equine veterinarians and dog and cat practitioners as groups at increased risk of carriage of MRSA. CONCLUSION Carriage of MRSA is a notable occupational health issue for veterinarians in clinical practice in Australia, particularly those who work with horses.
Collapse
|
64
|
Maiwald M, Widmer AF, Rotter ML. Letter 2: Systematic review and meta-analysis of preoperative anti- sepsis with chlorhexidine versus povidone–iodine in clean-contaminated surgery (Br J Surg 2010; 97: 1614–1620). Br J Surg 2011; 98:461-2; author reply 462. [DOI: 10.1002/bjs.7446] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
|
65
|
Anstey JR, Fazio TN, Gordon DL, Hogg G, Jenney AW, Maiwald M, Wilksch JJ. Community-acquired Klebsiella pneumoniae liver abscesses - an "emerging disease" in Australia. Med J Aust 2010; 193:543-5. [PMID: 21034390 DOI: 10.5694/j.1326-5377.2010.tb04042.x] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2010] [Accepted: 08/25/2010] [Indexed: 12/20/2022]
Abstract
Liver abscess due to Klebsiella pneumoniae infection has been widely reported in Asia, but rarely reported in Australia until now. We describe four previously well Asian-born patients who presented across Australia with community-acquired K. pneumoniae liver abscesses. With prompt recognition, appropriate antibiotics and early drainage, outcome is significantly improved, although vigilance for metastatic complications is essential.
Collapse
|
66
|
Maiwald M. Vision oder Mission? - Wie neue Technologie aus der Technologie-Roadmap Prozess-Sensoren 2015+ entsteht. CHEM-ING-TECH 2010. [DOI: 10.1002/cite.201050555] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
|
67
|
Maiwald M. Prozessanalytik als Instrument des Informationsmanagements in der Chemischen und Pharmazeutischen Industrie. CHEM-ING-TECH 2010. [DOI: 10.1002/cite.200900137] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
|
68
|
Hergeth WD, Maiwald M. Trends in der Prozessanalytik: Von der Forschung zur industriellen Anwendung. CHEM-ING-TECH 2009. [DOI: 10.1002/cite.200950241] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
|
69
|
Maiwald M, Widmer AF. Are alcohol gels better than liquid hand rubs? CRITICAL CARE : THE OFFICIAL JOURNAL OF THE CRITICAL CARE FORUM 2008; 11:418. [PMID: 17626610 PMCID: PMC2206535 DOI: 10.1186/cc5947] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
|
70
|
Maiwald M, Farmer CJ, Lance DG, Nieuwenhuijs VB, Heath CH, Watson DI, Gordon DL. Surgical antisepsis and the risk of operating theatre fires. ANZ J Surg 2006; 76:422-3. [PMID: 16768711 DOI: 10.1111/j.1445-2197.2006.03736.x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
|
71
|
Maiwald M, Fischer HH, Hasse H. Quantitative hochauflösende Online-NMR-Spektroskopie im Reaktions- und Prozessmonitoring. CHEM-ING-TECH 2004. [DOI: 10.1002/cite.200403389] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
|
72
|
Maiwald M, von Herbay A, Fredricks DN, Ouverney CC, Kosek JC, Relman DA. Cultivation of Tropheryma whipplei from cerebrospinal fluid. J Infect Dis 2003; 188:801-8. [PMID: 12964110 DOI: 10.1086/378073] [Citation(s) in RCA: 42] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2003] [Accepted: 04/17/2003] [Indexed: 11/03/2022] Open
Abstract
Whipple disease (WD) is a systemic disorder caused by the bacterium Tropheryma whipplei. Since the recognition of a bacterial etiology in 1961, many attempts have been made to cultivate this bacterium in vitro. It was eventually isolated, in 2000, from an infected heart valve, in coculture with human fibroblasts. Here we report the isolation of 2 new strains of T. whipplei from cerebrospinal fluid (CSF) of 2 patients with intestinal WD but no neurological signs or symptoms. One culture-positive specimen was obtained before treatment; the other was obtained 12 months after discontinuation of therapy, at a time of intestinal remission. In both cases, 15 passages of the cultures were completed over 17 months. Bacterial growth was measured by quantitative polymerase chain reaction, which suggested a generation time of 4 days. Staining with YO-PRO nucleic-acid dye showed characteristic rod-shaped bacteria arranged in chains. Fluorescent in situ hybridization with a T. whipplei-specific oligonucleotide probe, a broad-range bacterial probe, and a nonspecific nucleic-acid stain indicated that all visible bacteria were T. whipplei. Scanning electron microscopy and transmission electron microscopy showed both intracellular and extracellular bacteria. This first isolation of T. whipplei from CSF provides clear evidence of viable bacteria in the central nervous system in individuals with WD, even after prolonged antibiotic therapy.
Collapse
|
73
|
Maiwald M, Fischer HH, Hasse H. Quantitative hochauflösende Online-NMR-Spektroskopie im Reaktions- und Prozessmonitoring. CHEM-ING-TECH 2003. [DOI: 10.1002/cite.200390194] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
|
74
|
Hassler D, Maiwald M, von Herbay A. [Bacterium with camouflage: the genome of the pathogen of Whipple disease is not decoded]. Dtsch Med Wochenschr 2003; 128:655-6. [PMID: 12698961] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/01/2023]
|
75
|
Abstract
The causative agent of Whipple's disease, Tropheryma whipplei, is a slow-growing bacterium that remains poorly-understood. Genetic characterization of this organism has relied heavily upon rRNA sequence analysis. Pending completion of a complete genome sequencing effort, we have characterized several conserved non-rRNA genes from T. whipplei directly from infected tissue using broad-range PCR and a genome-walking strategy. Our goals were to evaluate its phylogenetic relationships, and to find ways to expand the strain typing scheme, based on rDNA sequence comparisons. The genes coding for the ATP synthase beta subunit (atpD), elongation factor Tu (tuf), heat shock protein GroEL (groEL), beta subunit of DNA-dependent RNA polymerase (rpoB), and RNase P RNA (rnpB) were analyzed, as well as the regions upstream and downstream of the rRNA operon. Phylogenetic analyses with all non-rRNA marker molecules consistently placed T. whipplei within the class, Actinobacteria. The arrangement of genes in the atpD and rpoB chromosomal regions was also consistent with other actinomycete genomes. Tandem sequence repeats were found upstream and downstream of the rRNA operon, and downstream of the groEL gene. These chromosomal sites and the 16S-23S rRNA intergenic spacer regions were examined in the specimens of 11 patients, and a unique combination of tandem repeat numbers and spacer polymorphisms was found in each patient. These data provide the basis for a more discriminatory typing method for T. whipplei.
Collapse
|