Improving follow-up testing in children with Shiga toxin-producing Escherichia coli through provision of a provider information sheet

2020 ◽  
Vol 26 (6) ◽  
pp. 479
Author(s):  
Jack X. Pang ◽  
Jaskaran Singh ◽  
Stephen B. Freedman ◽  
Jianling Xie ◽  
Jia Hu
Keyword(s):  
Escherichia Coli ◽  
Shiga Toxin ◽  
Laboratory Testing ◽  
Laboratory Tests ◽  
Healthcare Delivery ◽  
Healthcare Providers ◽  
Information Sheet ◽  
Positive Stool ◽  
Intervention Zone

The aim of this study was to improve follow-up laboratory testing for children infected by Shiga toxin-producing Escherichia coli (STEC) through the provision of an information sheet to healthcare providers in the province of Alberta, Canada. An information sheet recommending the performance of laboratory tests, every 24–48h until 3 days after diarrhoea resolves or the platelet count stabilises or begins to rise, was sent to all physicians who ordered a STEC-positive stool test as of 1 November 2016. The information sheet was only distributed to physicians in one of the province’s five healthcare delivery zones (i.e. intervention zone). Medical records for children aged <18 years with laboratory confirmed STEC-positive stool samples between November 2014 and November 2018 were reviewed to determine the performance of recommended laboratory tests. Post-intervention, follow-up testing in all categories increased significantly for cases that occurred in the intervention zone, with odds ratios (OR) ranging from 3.02 (95% CI: 1.35–6.78) to 3.94 (95% CI: 1.70–9.16) when compared with pre-intervention. No increase in any of the laboratory testing categories was detected outside of the intervention zone. The provision of a targeted information sheet to healthcare providers improved the monitoring of STEC-infected children.

scholarly journals From Farm to Table: Follow-Up of Shiga Toxin-Producing Escherichia coli Throughout the Pork Production Chain in Argentina

2016 ◽  
Vol 7 ◽  
Author(s):  
Rocío Colello ◽  
María E. Cáceres ◽  
María J. Ruiz ◽  
Marcelo Sanz ◽  
Analía I. Etcheverría ◽  
...  
Keyword(s):  
Escherichia Coli ◽  
Shiga Toxin ◽  
Production Chain ◽  
Pork Production

scholarly journals Microbial Safety and Sanitary Quality of Strawberry Primary Production in Belgium: Risk Factors for Salmonella and Shiga Toxin-Producing Escherichia coli Contamination

2015 ◽  
Vol 81 (7) ◽  
pp. 2562-2570 ◽  
Author(s):  
Stefanie Delbeke ◽  
Siele Ceuppens ◽  
Claudia Titze Hessel ◽  
Irene Castro ◽  
Liesbeth Jacxsens ◽  
...  
Keyword(s):  
Risk Factors ◽  
Escherichia Coli ◽  
Shiga Toxin ◽  
Irrigation Water ◽  
Multivariable Logistic Regression Analysis ◽  
Content Type ◽  
E Coli ◽  
Production And Consumption

ABSTRACTStrawberries are an important fruit in Belgium in both production and consumption, but little information is available about the presence ofSalmonellaand Shiga toxin-producingEscherichia coli(STEC) in these berries, the risk factors in agricultural production, and possible specific mitigation options. In 2012, a survey was undertaken of three soil and three soilless cultivation systems in Belgium. NoSalmonellaspp. were isolated. No STEC was detected in the strawberry samples (0 of 72), but STEC was detected by PCR in 11 of 78 irrigation water and 2 of 24 substrate samples. Culture isolates were obtained for 2 of 11 PCR-positive irrigation water samples and 2 of 2 substrate samples. Multivariable logistic regression analysis revealed elevated genericE. colinumbers (the odds ratio [OR] for a 1 log increase being 4.6) as the most important risk factor for STEC, together with the berry-picking season (elevated risk in summer). The presence of genericE. coliin the irrigation water (≥1 CFU per 100 ml) was mainly influenced by the type of irrigation water (collected rainfall water stored in ponds was more often contaminated than groundwater pumped from boreholes [OR = 5.8]) and the lack of prior treatment (untreated water versus water subjected to sand filtration prior to use [OR = 19.2]). The follow-up study in 2013 at one of the producer locations indicated cattle to be the most likely source of STEC contamination of the irrigation water.

Assessing Sexual Dysfunction, Part 1: Male Sexual Dysfunction

2016 ◽  
Vol 21 (2) ◽  
pp. 3-8
Author(s):  
Seth D. Cohen ◽  
Steven Mandel ◽  
David B. Samadi
Keyword(s):  
Sexual Dysfunction ◽  
Health Care Professionals ◽  
Laboratory Testing ◽  
Aging Male ◽  
Testosterone Deficiency ◽  
Subjective Complaint ◽  
Validated Questionnaire ◽  
Male Sexual Dysfunction ◽  
Multiple Health

Abstract To properly assess men and women with sexual dysfunction, evaluators should take a biopsychosocial approach that may require consultation with multiple health care professionals from various fields in order to get to the root of the sexual dysfunction; this multidisciplinary methodology offers the best chance of successful treatment. For males, this article focuses on erectile dysfunction (ED) and hypogonadism. The initial evaluation of ED involves a thorough case history, preferably taken from the patient and partner, physical examination, and proper laboratory and diagnostic tests, including an acknowledgment of the subjective complaint. The diagnosis is established on the basis of an individual's report of the consistent inability to attain and maintain an erection sufficient to permit satisfactory sexual intercourse. Initial workups for ED should entail a detailed history that can be obtained from a validated questionnaire such as the International Index of Erectile Function and the Sexual Health Inventory for Men. Hypogonadism is evaluated using the validated Androgen Deficiency in the Aging Male questionnaire and laboratory testing for testosterone deficiency. Treatments logically can begin with the least invasive and then progress to more invasive strategies after appropriate counseling. The last and most important treatment component when caring for men with sexual dysfunction—and, arguably, the least practiced—is close follow-up.

Knowledge and Communication of the National Core Standards Tool

2018 ◽  
Vol 20 (2) ◽  
Author(s):  
Winnie Thembisile Maphumulo ◽  
Busisiwe Bhengu
Keyword(s):  
Pearson Correlation ◽  
Healthcare Delivery ◽  
Healthcare Providers ◽  
Sampling Technique ◽  
Quality Of Healthcare ◽  
Survey Study ◽  
Public Healthcare ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Professional Nurses

The National Department of Health in South Africa has introduced the National Core Standards (NCS) tool to improve the quality of healthcare delivery in all public healthcare institutions. Knowledge of the NCS tool is essential among healthcare providers. This study investigated the level of knowledge on NCS and how the NCS tool was communicated among professional nurses. This was a cross-sectional survey study. Purposive sampling technique was used to select hospitals that only offered tertiary services in KwaZulu-Natal. Six strata of departments were selected using simple stratified sampling. The population of professional nurses in the selected hospitals was 3 050. Systematic random sampling was used to recruit 543 participants. The collected data were analysed using SPSS version 25. The study showed that only 16 (3.7%) respondents had knowledge about NCS, using McDonald’s standard of learning outcome measured criteria regarding the NCS tool. The Pearson correlation coefficient between the communication and knowledge was r = 0.055. The results revealed that although the communication scores for the respondents were high their knowledge scores remained low. This study concluded that there is a lack of knowledge regarding the NCS tool and therefore healthcare institutions need to commit themselves to the training of professional nurses regarding the NCS tool. The findings suggest that healthcare institutions implement the allocation of incentives for nurses that attend the workshops for NCS.

scholarly journals Association of Ct Values from Real-Time PCR with Culture in Microbiological Clearance Samples for Shiga Toxin-Producing Escherichia coli (STEC)

2020 ◽  
Vol 8 (11) ◽  
pp. 1801
Author(s):  
Michael Bording-Jorgensen ◽  
Brendon D. Parsons ◽  
Gillian A.M. Tarr ◽  
Binal Shah-Gandhi ◽  
Colin Lloyd ◽  
...  
Keyword(s):  
Escherichia Coli ◽  
Real Time ◽  
Shiga Toxin ◽  
Real Time Pcr ◽  
Gene Detection ◽  
Culture Positivity ◽  
Hands On ◽  
Culture Independent ◽  
Chromogenic Agar ◽  
Stool Samples

Shiga toxin-producing Escherichia coli (STEC) are associated with acute gastroenteritis worldwide, which induces a high economic burden on both healthcare and individuals. Culture-independent diagnostic tests (CIDT) in frontline microbiology laboratories have been implemented in Alberta since 2019. The objectives of this study were to determine the association between gene detection and culture positivity over time using STEC microbiological clearance samples and also to establish the frequency of specimen submission. Both stx genes’ amplification by real-time PCR was performed with DNA extracted from stool samples using the easyMAG system. Stools were inoculated onto chromogenic agar for culture. An association between gene detection and culture positivity was found to be independent of which stx gene was present. CIDT can provide rapid reporting with less hands-on time and technical expertise. However, culture is still important for surveillance and early cluster detection. In addition, stool submissions could be reduced from daily to every 3–5 days until a sample is negative by culture.

scholarly journals Effects of Plant Age and Root Damage on Internalization of Shiga Toxin-Producing Escherichia coli in Leafy Vegetables and Herbs

Horticulturae ◽  
2021 ◽  
Vol 7 (4) ◽  
pp. 68
Author(s):  
Yi-Ju Wang ◽  
Amanda J. Deering ◽  
Hye-Ji Kim
Keyword(s):  
Escherichia Coli ◽  
Plant Species ◽  
Shiga Toxin ◽  
Production Systems ◽  
Plant Age ◽  
Leafy Vegetables ◽  
Root Damage ◽  
Hygiene Practices ◽  
Hydroponic Systems ◽  
Stx1 Gene

Our previous study reported that fresh produce grown in aquaponic and hydroponic systems can pose potential food safety hazards due to an accidental introduction of contaminated fish and cross-contamination between the systems. In this study, we examined the effects of plant species and age on the likelihood and level of internalization of Shiga toxin-producing Escherichia coli (STEC) in aquaponic and hydroponic systems. Four plant species, basil (Ocimum basilicum L. cv. Genovese), cilantro (Coriandrum Sativum L.), lettuce (Lactuca sativa cv. Cherokee), and kale (Brassica oleracea var. sabellica), received root damage treatment as seedlings before transplanting or mature plants at three weeks after transplanting by cutting off 1-cm tips of one-third of the roots. Enrichments and selective media were used for the isolation, and presumptive positive colonies were confirmed by PCR for the presence of stx1 gene in plant tissues, recirculating water, and fish feces collected at four weeks after transplanting. In hydroponic systems, STEC was found neither in the solution nor in the roots and leaves of all four plant species, possibly through improved sanitation and hygiene practices. However, consistent with our previous findings, STEC was found in the water, on the plant roots, and in the fish feces in aquaponic systems, even after thorough sanitation prior to the study. Regardless of plant age, STEC was internalized in the roots of all plant species when the roots were damaged, but there was no difference in the degree of internalization with STEC among plant species. STEC was present in the leaves only when seedlings received root damage treatment and were grown to maturity, indicating that root damage allows STEC to internalize in the roots within a week, but a longer period is required for STEC to internalize into the leaves. We concluded that root damage on seedlings can cause the internalization of E. coli O157:H7 in the edible parts of leafy vegetables and herbs in soilless production systems.

scholarly journals Identifying Patterns of Symptom Distress in Pregnant Women: A Pilot Study

2021 ◽  
Vol 18 (12) ◽  
pp. 6333
Author(s):  
Ching-Fang Lee ◽  
Fur-Hsing Wen ◽  
Yvonne Hsiung ◽  
Jian-Pei Huang ◽  
Chun-Wei Chang ◽  
...  
Keyword(s):  
Pregnant Women ◽  
Healthcare Providers ◽  
First Trimester ◽  
Symptom Distress ◽  
Teaching Hospitals ◽  
Lower Back ◽  
Distress Symptoms ◽  
Related Symptom ◽  
Experienced Symptom

During pregnancy, a woman’s enlarged uterus and the developing fetus lead to symptom distress; in turn, physical and psychological aspects of symptom distress are often associated with adverse prenatal and birth outcomes. This study aimed to identify the trends in the trajectory of these symptoms. This longitudinal study recruited 95 pregnant women, with a mean age of 32 years, from the prenatal wards of two teaching hospitals in northern Taiwan. Symptom distress was measured by a 22-item scale related to pregnancy-induced symptoms. The follow-up measurements began during the first trimester and were taken every two to four weeks until childbirth. More than half of the pregnant women experienced symptom distress manifested in a pattern depicted to be “Decreased then Increased” (56.8%). Other noticeable patterns were “Continuously Increased” (28.4%), “Increased then Decreased” (10.5%) and “Continuously Decreased” (4.2%), respectively. It is worth noting that most pregnant women recorded a transit and increase in their symptom distress, revealed by their total scores, at the second trimester (mean 22.02 weeks) of pregnancy. The participants’ major pregnancy-related distress symptoms were physical and included fatigue, frequent urination, lower back pain, and difficulty sleeping. The mean scores for individual symptoms ranged from 2.32 to 3.61 and were below the “moderately distressful” level. This study provides evidence that could be used to predict women’s pregnancy-related symptom distress and help healthcare providers implement timely interventions to improve prenatal care.

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