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Fürnkranz U, Walochnik J. Nosocomial Infections: Do Not Forget the Parasites! Pathogens 2021; 10:pathogens10020238. [PMID: 33669761 PMCID: PMC7923136 DOI: 10.3390/pathogens10020238] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2021] [Revised: 02/08/2021] [Accepted: 02/17/2021] [Indexed: 01/03/2023] Open
Abstract
Nosocomial infections (NIs) pose an increasing threat to public health. The majority of NIs are bacterial, fungal, and viral infections; however, parasites also play a considerable role in NIs, particularly in our increasingly complex healthcare environment with a growing proportion of immunocompromised patients. Moreover, parasitic infections acquired via blood transfusion or organ transplantation are more likely to have severe or fatal disease outcomes compared with the normal route of infection. Many of these infections are preventable and most are treatable, but as the awareness for parasitic NIs is low, diagnosis and treatment are often delayed, resulting not only in higher health care costs but, importantly, also in prolonged courses of disease for the patients. For this article, we searched online databases and printed literature to give an overview of the causative agents of parasitic NIs, including the possible routes of infection and the diseases caused. Our review covers a broad spectrum of cases, ranging from widely known parasitic NIs, like blood transfusion malaria or water-borne cryptosporidiosis, to less well-known NIs, such as the transmission of Strongyloides stercoralis by solid organ transplantation or nosocomial myiasis. In addition, emerging NIs, such as babesiosis by blood transfusion or person-to-person transmitted scabies, are described.
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Boccolini D, Menegon M, Di Luca M, Toma L, Severini F, Marucci G, D'Amato S, Caraglia A, Maraglino FP, Rezza G, Romi R, Gradoni L, Severini C. Non-imported malaria in Italy: paradigmatic approaches and public health implications following an unusual cluster of cases in 2017. BMC Public Health 2020; 20:857. [PMID: 32503526 PMCID: PMC7275312 DOI: 10.1186/s12889-020-08748-9] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2019] [Accepted: 04/21/2020] [Indexed: 11/28/2022] Open
Abstract
BACKGROUND The European region achieved interruption of malaria transmission during the 1970s. Since then, malaria control programs were replaced by surveillance systems in order to prevent possible re-emergence of this disease. Sporadic cases of non-imported malaria were recorded in several European countries in the past decade and locally transmitted outbreaks of Plasmodium vivax, most probably supported by Anopheles sacharovi, have been repeatedly reported from Greece since 2009. The possibility of locally-transmitted malaria has been extensively studied in Italy where the former malaria vector An. labranchiae survived the control campaign which led to malaria elimination. In this study, we present paradigmatic cases that occurred during a 2017 unusual cluster, which caused strong concern in public opinion and were carefully investigated after the implementation of the updated malaria surveillance system. METHODS For suspected locally-transmitted malaria cases, alerts to Ministry of Health (MoH) and the National Institute of Health (ISS) were mandated by the Local Health Services (LHS). Epidemiological investigations on the transmission modes and the identification of possible infection's source were carried out by LHS, MoH and ISS. Entomological investigations were implemented locally for all suspected locally-transmitted cases that occurred in periods suitable to anopheline activity. Molecular diagnosis by nested-PCR for the five human Plasmodium species was performed to support microscopic diagnosis. In addition, genotyping of P. falciparum isolate was carried out to investigate putative sources of infection and transmission modalities. RESULTS In 2017, a cluster of seven non-imported cases was recorded from August through October. Among them, P. ovale curtisi was responsible of one case whereas six cases were caused by P. falciparum. Two cases were proved to be nosocomial while the other five were recorded as cryptic at the end of epidemiological investigations. CONCLUSIONS The epidemiological evidence shows that the locally acquired events are sporadic, often remain unresolved and classified as cryptic ones despite investigative efforts. The "cluster" of seven non-imported cases that occurred in 2017 in different regions of Italy therefore represents a conscious alert that should lead us to maintain a constant level of surveillance in a former malaria endemic country.
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Affiliation(s)
- Daniela Boccolini
- Dipartimento Malattie Infettive, Istituto Superiore di Sanità, Viale Regina Elena 299, 00161, Rome, Italy.
| | - Michela Menegon
- Dipartimento Malattie Infettive, Istituto Superiore di Sanità, Viale Regina Elena 299, 00161, Rome, Italy
| | - Marco Di Luca
- Dipartimento Malattie Infettive, Istituto Superiore di Sanità, Viale Regina Elena 299, 00161, Rome, Italy
| | - Luciano Toma
- Dipartimento Malattie Infettive, Istituto Superiore di Sanità, Viale Regina Elena 299, 00161, Rome, Italy
| | - Francesco Severini
- Dipartimento Malattie Infettive, Istituto Superiore di Sanità, Viale Regina Elena 299, 00161, Rome, Italy
| | - Gianluca Marucci
- Dipartimento Malattie Infettive, Istituto Superiore di Sanità, Viale Regina Elena 299, 00161, Rome, Italy
| | - Stefania D'Amato
- Ministero della Salute, Direzione Generale della Prevenzione Sanitari, Ufficio 5 - Prevenzione delle Malattie Trasmissibili e Profilassi Internazionale, Rome, Italy
| | - Anna Caraglia
- Ministero della Salute, Direzione Generale della Prevenzione Sanitaria, Ufficio 1 - Affari generali e segreteria tecnico-organizzativa, Rome, Italy
| | - Francesco Paolo Maraglino
- Ministero della Salute, Direzione Generale della Prevenzione Sanitari, Ufficio 5 - Prevenzione delle Malattie Trasmissibili e Profilassi Internazionale, Rome, Italy
| | - Giovanni Rezza
- Dipartimento Malattie Infettive, Istituto Superiore di Sanità, Viale Regina Elena 299, 00161, Rome, Italy
| | - Roberto Romi
- Dipartimento Malattie Infettive, Istituto Superiore di Sanità, Viale Regina Elena 299, 00161, Rome, Italy
| | - Luigi Gradoni
- Dipartimento Malattie Infettive, Istituto Superiore di Sanità, Viale Regina Elena 299, 00161, Rome, Italy
| | - Carlo Severini
- Dipartimento Malattie Infettive, Istituto Superiore di Sanità, Viale Regina Elena 299, 00161, Rome, Italy.
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Dettenkofer M, Frank U, Just HM, Lemmen S, Scherrer M. Epidemiologische Grundlagen nosokomialer Infektionen. PRAKTISCHE KRANKENHAUSHYGIENE UND UMWELTSCHUTZ 2018. [PMCID: PMC7123496 DOI: 10.1007/978-3-642-40600-3_3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Viele Faktoren tragen zu erhöhten nosokomialen Infektionsraten bei. Der Anteil alter Patienten mit chronischen Krankheiten und Immunsupprimierter steigt. Fortschritte in Diagnostik und Therapie resultieren immer häufiger in invasiven Eingriffen. Antibiotikaresistenzen und Folgen nosokomialer Infektionen erfordern daher eine verlässliche Epidemiologie. Konsequenzen nosokomialer Infektionen betreffen einerseits Patienten (Morbidität und Letalität), aber auch das Gesundheitswesen, dem zusätzliche, teilweise vermeidbare finanzielle Belastungen entstehen.
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Affiliation(s)
- Markus Dettenkofer
- Gesundheitsverbund Landkreis Konstanz, Institut für Krankenhaushygiene & Infektionsprävention, Radolfzell, Germany
| | - Uwe Frank
- Sektion Krankenhaus- und Umwelthygiene, Universitätsklinikum Heidelberg, Heidelberg, Germany
| | | | - Sebastian Lemmen
- Zentralbereich für Krankenhaushygiene, Universitätsklinikum Aachen, Aachen, Germany
| | - Martin Scherrer
- Stabsstelle Techn. Krankenhaushygiene, Universitätsklinikum Heidelberg, Heidelberg, Germany
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Healthcare-Associated Transmission of Plasmodium falciparum in New York City. Infect Control Hosp Epidemiol 2015; 37:113-5. [PMID: 26498730 DOI: 10.1017/ice.2015.236] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
A patient with no risk factors for malaria was hospitalized in New York City with Plasmodium falciparum infection. After investigating all potential sources of infection, we concluded the patient had been exposed to malaria while hospitalized less than 3 weeks earlier. Molecular genotyping implicated patient-to-patient transmission in a hospital setting. Infect. Control Hosp. Epidemiol. 2015;37(1):113-115.
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Improving Clinical Decision Making and Safety of Point-of-Care Glucose Testing in the Hospital Setting. POINT OF CARE 2014. [DOI: 10.1097/poc.0000000000000023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Lanini S, Garbuglia AR, Puro V, Solmone M, Martini L, Arcese W, Nanni Costa A, Borgia P, Piselli P, Capobionchi MR, Ippolito G. Hospital cluster of HBV infection: molecular evidence of patient-to-patient transmission through lancing device. PLoS One 2012; 7:e33122. [PMID: 22412991 PMCID: PMC3295785 DOI: 10.1371/journal.pone.0033122] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2011] [Accepted: 02/10/2012] [Indexed: 01/13/2023] Open
Abstract
INTRODUCTION In western countries the transmission of hepatitis B virus (HBV) transmission through multi-patients lancing devices has been inferred since early '90s, however no study has ever provided biological evidence which directly link these device with HBV cross-infection. Here we present results of an outbreak investigation which could associate, by molecular techniques, the use of lancing device on multiple patients with HBV transmission in an Italian oncohematology unit. METHODS The outbreak investigation was designed as a retrospective cohort study to identify all potential cases. All cases identified were eventually confirmed through molecular epidemiology techniques. Audit of personnel including extensive review of infection control measures and reviewing personnel's tests for HBV was done identify transmission route. RESULTS Between 4 May 2006 and 21 February 2007, six incident cases of HBV infection were reported among 162 patients admitted in the oncohematology. The subsequent molecular instigation proved that 3 out 6 incident cases and one prevalent cases (already infected with HBV at the admission) represented a monophyletic cluster of infection. The eventual environmental investigation found that an identical HBV viral strain was present on a multi-patients lancing device in use in the unit and the inferential analysis showed a statistically significant association between undergoing lancing procedures and the infection. DISCUSSION This investigation provide molecular evidence to link a HBV infection cluster to multi-patients lancing device and highlights that patients undergoing capillary blood sampling by non-disposable lancing device may face an unacceptable increased risk of HBV infection. Therefore we believe that multi-patients lancing devices should be banned from healthcare settings and replace with disposable safety lancets that permanently retract to prevent the use of the same device on multiple patients. The use of non-disposable lancing devices should be restricted to individual use at patients' home.
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Affiliation(s)
- Simone Lanini
- National Institute for Infectious Diseases Lazzaro Spallanzani, Rome, Italy.
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Kwak YG, Lee SO, Kim TH, Choo EJ, Jeon MH, Jun JB, Kim KM, Jeong JS, Kim YS. The use of multidose vials and fingerstick blood sampling devices in Korean emergency departments and intensive care units. Int J Nurs Pract 2012; 18:77-83. [PMID: 22257334 DOI: 10.1111/j.1440-172x.2011.01994.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
This study was performed to compare compliance with standard precautions for the use of multidose vials (MDVs) and fingerstick devices in emergency departments (EDs) and intensive care units (ICUs). Between December 2007 and February 2008, 389 nurses from the EDs or ICUs of six university-affiliated hospitals in Korea were asked to complete the questionnaire. A total of 338 (86.9%) nurses completed the survey, corresponding to 159 of 184 ED and 179 of 205 ICU nurses. A comparison of MDV use in EDs and ICUs indicated a significant difference only in disinfection of the rubber septum of heparin vials; 88.1% of ED nurses and 96.6% of ICU nurses stated that they always disinfected the rubber septum of heparin vials whenever drawing medication (P = 0.003). The use of separate fingerstick devices for each patient (71.7% vs. 54.5%) and disinfection of these devices after each use (36.5% vs. 26.0%) were more common in ED nurses. The rate of good hand hygiene was lower in ED nurses, both before (43.7% vs. 74.3%) and after (64.6% vs. 91.6%) the use of fingerstick devices (P < 0.001 for both). There is a need to improve compliance with standard precautions, especially hand hygiene, in EDs.
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Affiliation(s)
- Yee Gyung Kwak
- Department of Infectious Diseases, Inje University College of Medicine, Busan, Republic of Korea
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Romi R, Boccolini D, D'Amato S, Cenci C, Peragallo M, D'Ancona F, Pompa MG, Majori G. Incidence of malaria and risk factors in Italian travelers to malaria endemic countries. Travel Med Infect Dis 2010; 8:144-54. [DOI: 10.1016/j.tmaid.2010.02.001] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2009] [Revised: 02/01/2010] [Accepted: 02/04/2010] [Indexed: 11/30/2022]
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Kim JY, Kim JS, Park MH, Kang YA, Kwon JW, Cho SH, Lee BC, Kim TS, Lee JK. A locally acquired falciparum malaria via nosocomial transmission in Korea. THE KOREAN JOURNAL OF PARASITOLOGY 2009; 47:269-73. [PMID: 19724701 DOI: 10.3347/kjp.2009.47.3.269] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/06/2009] [Revised: 06/03/2009] [Accepted: 06/09/2009] [Indexed: 11/23/2022]
Abstract
A 57-year old man who was admitted to an emergency room of a tertiary hospital with hemoptysis developed malarial fever 19 days later and then died from severe falciparum malaria 2 days later. He had not traveled outside of Korea for over 30 years. Through intensive interviews and epidemiological surveys, we found that a foreign patient with a recent history of travel to Africa was transferred to the same hospital with severe falciparum malaria. We confirmed through molecular genotyping of the MSP-1 gene that Plasmodium falciparum genotypes of the 2 patients were identical. It is suggested that a breach of standard infection control precautions resulted in this P. falciparum transmission between 2 patients in a hospital environment. This is the first report of a nosocomial transmission of falciparum malaria in Korea.
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Affiliation(s)
- Jung-Yeon Kim
- Division of Malaria and Parasitic Disease, Korea Centers for Disease Control and Prevention (KCDC), Seoul, Korea
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Zoller T, Naucke TJ, May J, Hoffmeister B, Flick H, Williams CJ, Frank C, Bergmann F, Suttorp N, Mockenhaupt FP. Malaria transmission in non-endemic areas: case report, review of the literature and implications for public health management. Malar J 2009; 8:71. [PMID: 19379496 PMCID: PMC2672952 DOI: 10.1186/1475-2875-8-71] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2008] [Accepted: 04/20/2009] [Indexed: 11/10/2022] Open
Abstract
In non-endemic areas, malaria is rare and locally acquired infections, particularly with Plasmodium falciparum, are exceptional events. The diagnosis is, therefore, likely to be delayed or missed in patients without a relevant travel history. This report describes a case of falciparum malaria in Berlin, Germany, in a patient who had not been to an endemic area for more than a decade. Potential routes of vector-related and direct transmission were evaluated, particularly with regard to a possible danger to the public. A review of the literature was conducted regarding possible routes of transmission and their probability assessed. Genotyping of parasite isolates of this and another patient with malaria admitted 16 days before revealed homology between the two strains. In a local entomological survey, anopheline vectors on the hospital grounds as well as in the residential area of both patients were found. Despite intensive investigations, the mode of transmission remained obscure. In this context, possible routes of vector-borne and direct occupational/accidental transmission in a major European city are reviewed and discussed, providing information and guidance in case other similar events occur elsewhere. Examples for investigations and measures to be taken in such a situation are provided. When local malaria transmission within a large non-immune population cannot be ruled out, genotyping of parasite isolates, local entomological surveys, preparedness for secondary cases, expert consultations in a multidisciplinary team and careful information management are essential. Malaria acquired in non-endemic areas remains an unlikely, but possible event for which awareness needs to be maintained.
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Affiliation(s)
- Thomas Zoller
- Medizinische Klinik mit Schwerpunkt Infektiologie und Pneumologie, Charité - Universitätsmedizin Berlin, Augustenburger Platz 1, 13353 Berlin, Germany.
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[Malaria. Statements of the Blood Work Group of the Federal Health Ministry]. Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz 2008; 51:236-49. [PMID: 18259716 PMCID: PMC7095887 DOI: 10.1007/s00103-008-0453-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Willaert B, Vo Mai MP, Caldani C. French Haemovigilance Data on Platelet Transfusion. Transfus Med Hemother 2008; 35:118-121. [PMID: 21512639 PMCID: PMC3076346 DOI: 10.1159/000118887] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2007] [Accepted: 09/13/2007] [Indexed: 11/19/2022] Open
Abstract
SUMMARY: The Agence Française de Securite Sanitaire des Produits de Santé (Afssaps; French Health Products Safety Agency) is responsible, through its hemovigilance unit, for the organization and the functioning of the national hemovigilance network. In accordance with the French law, it receives all data on adverse transfusion reactions regardless of their severity. With the aim of evaluating the tolerance of two kinds of labile blood products (LBP), pooled platelet concentrates (PP) and apheresis platelet concentrates (APC), we screened the French national database from January 1, 2000 to December 31, 2006. We observed that the number of transfusion incident reports is more than twice as high with APC (8.61:1,000 LBP) than with PP (4.21:1,000 LBP). The difference between these two ratios is statistically significant as shown by chi-square test (e = 21.00 with α = 5%). The risk to suffer adverse reactions of any type, except for alloimmunization, is higher with APC, and the major type of diagnosis related to APC is allergic reaction (1:200 APC issued) even if those allergic reactions are rarely serious. The new French National Hemovigilance Commission should impel a working group evaluating this topic and above all the impact of additive solutions which have been used since 2005 to put forward preventives measures.
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Affiliation(s)
- Béatrice Willaert
- Agence Française de Sécurité Sanitaire des Produits de Santé (Afssaps), Saint Denis, France
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Blümel J, Burger R, Drosten C, Gröner A, Gürtler L, Heiden M, Jansen B, Klamm H, Ludwig WD, Montag-Lessing T, Offergeld R, Pauli G, Seitz R, Schlenkrich U, Schottstedt V, Willkommen H, von König KHW. Malaria. Transfus Med Hemother 2008; 35:122-134. [PMID: 21512640 PMCID: PMC3076347 DOI: 10.1159/000118667] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2008] [Accepted: 02/01/2008] [Indexed: 11/19/2022] Open
Affiliation(s)
| | | | | | | | | | | | | | | | | | | | | | | | - Rainer Seitz
- Arbeitskreis Blut, Untergruppe «Bewertung Blutassoziierter Krankheitserreger»
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Gkrania-Klotsas E, Lever AML. An update on malaria prevention, diagnosis and treatment for the returning traveller. Blood Rev 2007; 21:73-87. [PMID: 16815604 DOI: 10.1016/j.blre.2006.03.004] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
The diagnosis of malaria needs to be considered for every returning traveller with a fever. Compliance with prevention, both pharmaceutical and non-pharmaceutical, is essential for every traveller. New tests for diagnosis are now available. Treatment options have recently expanded to include the artemisinin derivatives that used to be unavailable in the western countries.
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Ashley E, McGready R, Proux S, Nosten F. Malaria. Travel Med Infect Dis 2006; 4:159-73. [PMID: 16887738 DOI: 10.1016/j.tmaid.2005.06.009] [Citation(s) in RCA: 37] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2005] [Accepted: 06/21/2005] [Indexed: 05/11/2023]
Abstract
Malaria is increasing worldwide due to the emergence and spread of drug resistant strains. This poses major health and economic problems for the population living in endemic areas and increases the risk of infections in travelers. The diagnosis of malaria relies on a biological proof of infection by microscopy or with a rapid test. The treatment must be initiated without delay preferably with an artemisinin containing regimen. Uncomplicated malaria can be treated with oral drugs while severe infections will be hospitalized and treated with injectables. Special attention will be given to the most susceptible groups: children and pregnant women.
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Affiliation(s)
- Elizabeth Ashley
- Shoklo Malaria Research Unit, 68/30 Ban Toong Road, Mae Sot, Tak, 63110 Thailand
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Epidemiologische Grundlagen. PRAKTISCHE KRANKENHAUSHYGIENE UND UMWELTSCHUTZ 2006. [PMCID: PMC7136899 DOI: 10.1007/3-540-34525-6_3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Eine Vielzahl an Faktoren tragen zu erhöhten nosokomialen Infektionsraten bei. Die Lebenserwartung und damit der Anteil alter Patienten mit z. T. chronischen Krankheiten steigen stetig an. Medizinische Fortschritte in Diagnostik und Therapie führen zu einer höheren Anzahl der dafür erforderlichen Eingriffe. Es werden immer häufiger immunsupprimierte Patienten (Infektiologie, Rheumatologie, Hämatologie/Onkologie, Transplantation von Organen usw.) behandelt. Das zunehmende Problem der Antibiotikaresistenz von Erregern und die Konsequenzen nosokomialer Infektionen erfordern eine verlässliche Epidemiologie auf diesem Gebiet. Konsequenzen betreffen einerseits Patienten, bei denen es zu einer erhöhten Morbidität und Letalität durch nosokomiale Infektionen kommt, aber andererseits auch das Gesundheitswesen, dem zusätzliche — vermeidbare? — finanzielle Belastungen entstehen. Evidenzbasierte Empfehlungen, bei denen der jeweilige Einzelfall und die örtlichen Besonderheiten ebenfalls Berücksichtigung finden, sind Voraussetzung für eine sinnvolle und kosteneffektive Vorgehensweise zur Senkung der nosokomialen Infektionsrate. In vielen Studien sind Häufigkeiten und Folgen verschiedener nosokomialer Infektionsarten sowie Maßnahmen zu ihrer Prävention untersucht worden. Um die Qualität solcher Studien und die darauf basierenden Empfehlungen von Experten, die ja oftmals ebenfalls mit Kosten verbunden sind, kritisch beurteilen zu können, ist epidemiologisches Wissen unverzichtbar. Dies beinhaltet selbstverständlich auch die Kenntnis der jeweiligen Erreger solcher Infektionen sowie das Wissen um erregerspezifische Übertragungswege. Die Epidemiologie nosokomialer Infektionen ist daher die Grundlage ihrer eigenen Verbesserung. »Es gibt nicht Kranke und Gesunde, sondern es gibt nur Untersuchte und nicht Untersuchte« (Johannes Rau, ehemaliger Bundespräsident).
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Multicenter Study of the Prevalence of Blood Contamination on Point-of-Care Glucose Meters and Recommendations for Controlling Contamination. POINT OF CARE 2005. [DOI: 10.1097/01.poc.0000189933.35225.77] [Citation(s) in RCA: 30] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Tarantola AP, Rachline AC, Konto C, Houzé S, Lariven S, Fichelle A, Ammar D, Sabah-Mondan C, Vrillon H, Bouchaud O, Pitard F, Bouvet E. Occupational malaria following needlestick injury. Emerg Infect Dis 2004; 10:1878-80. [PMID: 15515245 PMCID: PMC3323262 DOI: 10.3201/eid1010.040277] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [MESH Headings] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/04/2022] Open
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Alweis RL, DiRosario K, Conidi G, Kain KC, Olans R, Tully JL. Serial nosocomial transmission of Plasmodium falciparum malaria from patient to nurse to patient. Infect Control Hosp Epidemiol 2004; 25:55-9. [PMID: 14756221 DOI: 10.1086/502293] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
BACKGROUND Nosocomial transmission of malaria is a rare phenomenon in the United States. OBJECTIVE To describe the probable transmission of Plasmodium falciparum malaria from a patient to a healthcare worker and then from the healthcare worker to another patient. DESIGN Case series. SETTING Two community hospitals in Massachusetts. INTERVENTION Routine medical and supportive care. MEASUREMENTS Clinical and laboratory evaluation. RESULTS A nurse developed falciparum malaria after a needlestick injury from a patient with documented falciparum malaria. Three days prior to her diagnosis, she cared for another patient, who subsequently developed falciparum malaria. That patient's parasite isolate genetically matched the nurse's isolate by two independent DNA fingerprinting techniques. CONCLUSION After extensive evaluation, we believe that a nurse who had acquired falciparum malaria via needlestick subsequently transmitted malaria to another patient via a break in standard precautions. The implications of this mechanism of transmission are discussed.
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Affiliation(s)
- Richard L Alweis
- Department of Medicine, Mount Auburn Hospital, Harvard Medical School, Cambridge, Massachusetts, USA
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