scholarly journals The role of hospital environment and the hands of medical staff in the transmission of the Clostridioides (Clostridium) difficile infection

2019 ◽  
Vol 70 (6) ◽  
pp. 739-745
Author(s):  
Monika Kabała ◽  
Małgorzata Aptekorz ◽  
Gajane Martirosian
Keyword(s):  
Clostridium Difficile ◽  
Medical Staff ◽  
Hospital Environment

scholarly journals Physicians` awareness level assessment of the epidemiology and diagnosis features of nosocomial infection caused by Clostridium difficile in a multidisciplinary hospitals

2021 ◽  
Author(s):  
Alla Lokotkova
Keyword(s):  
Clostridium Difficile ◽  
Clostridium Difficile Infection ◽  
Clinical Manifestations ◽  
Low Frequency ◽  
Antibiotic Use ◽  
Hospital Environment ◽  
Laboratory Diagnostics ◽  
Important Place ◽  
Lack Of Physicians

Background. Clostridium difficile has an important place among healthcare associated infections pathogens , mainly due to the widespread and inappropriate antibiotics use. Over the past 10 years an incidence of this infection has increased in the USA and European countries. Unfortunately, Clostridium difficile infection cases in the Russian Federation are almost not register, probably due to the lack of physicians awareness and underestimation of the pathogen role in the etiology of nosocomial infections. The study purpose is to study the different specialties physicians awareness of patients` Clostridium difficile infections development in multidisciplinary hospitals. Materials and methods. A questionnaire survey of 115 physicians of two multidisciplinary hospitals in Kazan was carried out. The questionnaire included 15 questions related to etiology, transmission mechanism, risk factors, clinical presentation, diagnosis and prevention of C. difficile infection. Statistical data processing was carried out in MS Excel. Results. A low level of physicians` awareness on this issue was revealed. 92.2% of physicians did not have any Clostridium difficile infection cases in their practice. 31.3% of respondents underestimate the role of antibiotic use as the main risk factor for the development of the disease; at the same time, there are frequent cases of unreasonable prescription of antibiotics. 32.2% of the respondents are poorly informed about diagnosis methods of clostridiosis. 20% of physicians deny the role of bacteria carriers as a source of infection. 77.4% of respondents indicated the alimentary route as the main route of infection transmission. Only 38.2% of respondents noted the hospital environment objects as a possible factor in the transmission of Clostridium difficile. Conclusions. There is no alertness regarding antibiotic-associated diarrhea caused by Clostridium difficile infection among multidisciplinary hospital physicians. Insufficient knowledge of epidemiology, clinical manifestations, laboratory diagnostics of Clostridium difficile infection are factors that determine the low frequency of its detection and, accordingly, impede the implementation of required anti-epidemic measures. There is a need to include Clostridium difficile infection issues in professional development programs for medical workers. It is advisable to develop and implement Clostridium difficile infection control.

scholarly journals UnderstandingClostridium difficileColonization

2018 ◽  
Vol 31 (2) ◽  
Author(s):  
Monique J. T. Crobach ◽  
Jonathan J. Vernon ◽  
Vivian G. Loo ◽  
Ling Yuan Kong ◽  
Séverine Péchiné ◽  
...  
Keyword(s):  
Health Care ◽  
Clostridium Difficile ◽  
Hospital Environment ◽  
Clinical Implications ◽  
Comprehensive Overview ◽  
Content Type ◽  
Risk Of Progression ◽  
Alternative Sources ◽  
Associated Risk Factors

SUMMARYClostridium difficileis the main causative agent of antibiotic-associated and health care-associated infective diarrhea. Recently, there has been growing interest in alternative sources ofC. difficileother than patients withClostridium difficileinfection (CDI) and the hospital environment. Notably, the role ofC. difficile-colonized patients as a possible source of transmission has received attention. In this review, we present a comprehensive overview of the current understanding ofC. difficilecolonization. Findings from gut microbiota studies yield more insights into determinants that are important for acquiring or resisting colonization and progression to CDI. In discussions on the prevalence ofC. difficilecolonization among populations and its associated risk factors, colonized patients at hospital admission merit more attention, as findings from the literature have pointed to their role in both health care-associated transmission ofC. difficileand a higher risk of progression to CDI once admitted.C. difficilecolonization among patients at admission may have clinical implications, although further research is needed to identify if interventions are beneficial for preventing transmission or overcoming progression to CDI.

The Role of Social Support in Concussion Disclosure in United States Air Force Academy Cadets: A Mixed Methods Approach

2021 ◽  
Author(s):  
Michelle L Weber Rawlins ◽  
Brian R Johnson ◽  
Emily R Jones ◽  
Johna K Register-Mihalik ◽  
Craig Foster ◽  
...  
Keyword(s):  
United States ◽  
Social Support ◽  
Mixed Methods ◽  
Air Force ◽  
Medical Staff ◽  
United States Air Force ◽  
Medical Attention ◽  
Air Force Academy ◽  
Mixed Methods Approach

ABSTRACT Introduction United States Air Force Academy (USAFA) cadets are at risk for sustaining concussions; however, several factors inhibit disclosure. We aimed to better understand the role of social support in concussion disclosure. Methods and Materials We used a mixed methods approach with an electronic survey and interviews. The survey used a 9-point Likert scale (1 = strongly disagree and 9 = strongly agree) to assess concussion disclosure. Survey items asked cadets whom they felt most comfortable disclosing a concussion or bell-ringer/ding to, how quickly they would seek medical attention for a suspected concussion or bell-ringer/ding, whether cadets would be generally supportive/unsupportive of another cadet disclosing a concussion to medical staff, and whether other cadets important to them would be generally supportive/unsupportive if they reported a concussion to medical staff. Two multivariate linear regressions, one for concussion and one for bell-ringers/dings, were calculated to determine whether cadet choice of the person they felt most comfortable disclosing a concussion or bell-ringer/ding to predicted whether they would immediately seek medical attention for either condition. Choice of person included Air Officer Commanding (AOC)/Academy Military Trainer (AMT), upper classmen, cadet who had recovered from a concussion, cadet, closest friend, teammate, and squadmate. Descriptive analyses assessed whether cadets felt supported or unsupported by other cadets and by those who were important to them concerning concussion reporting. Thirty-four semi-structured interviews were conducted with cadets to explore their views on concussion disclosure. Results Increased comfort with disclosing a suspected concussion to an AOC/AMT had higher agreement seeking medical attention (β = 0.28, P < .001). For every 1-point increase in being comfortable disclosing a potential bell-ringer/ding to an AOC/AMT (β = 0.272, P < .001), squadmate (β = 0.241, P = .002), and teammate (β = −0.182, P = .035), agreement for seeking medical attention immediately increased 0.27, increased 0.24, and decreased 0.18, respectively. Interviews indicated cadets would often speak to a peer before seeking medical attention. Conclusions Our results suggested that cadets felt comfortable reporting a suspected concussion or bell-ringer/ding to various peers and that those peers would be supportive of that choice, indicating social support. Future interventions should include educating cadets that peers may come to them, especially if they are AOCs/AMTs or squadmates.

scholarly journals Cyclic Diguanylate Regulates Virulence Factor Genes via Multiple Riboswitches inClostridium difficile

mSphere ◽  
2018 ◽  
Vol 3 (5) ◽  
Author(s):  
Robert W. McKee ◽  
Carissa K. Harvest ◽  
Rita Tamayo
Keyword(s):  
Gene Expression ◽  
Clostridium Difficile ◽  
Biofilm Formation ◽  
Toxin Production ◽  
Intestinal Colonization ◽  
Cyclic Diguanylate ◽  
Signaling Molecule ◽  
Content Type ◽  
Surface Motility

ABSTRACTThe intracellular signaling molecule cyclic diguanylate (c-di-GMP) regulates many processes in bacteria, with a central role in controlling the switch between motile and nonmotile lifestyles. Recent work has shown that inClostridium difficile(also calledClostridioides difficile), c-di-GMP regulates swimming and surface motility, biofilm formation, toxin production, and intestinal colonization. In this study, we determined the transcriptional regulon of c-di-GMP inC. difficile,employing overexpression of a diguanylate cyclase gene to artificially manipulate intracellular c-di-GMP. Consistent with prior work, c-di-GMP regulated the expression of genes involved in swimming and surface motility. c-di-GMP also affected the expression of multiple genes encoding cell envelope proteins, several of which affected biofilm formationin vitro. A substantial proportion of the c-di-GMP regulon appears to be controlled either directly or indirectly via riboswitches. We confirmed the functionality of 11 c-di-GMP riboswitches, demonstrating their effects on downstream gene expression independent of the upstream promoters. The class I riboswitches uniformly functioned as “off” switches in response to c-di-GMP, while class II riboswitches acted as “on” switches. Transcriptional analyses of genes 3′ of c-di-GMP riboswitches over a broad range of c-di-GMP levels showed that relatively modest changes in c-di-GMP levels are capable of altering gene transcription, with concomitant effects on microbial behavior. This work expands the known c-di-GMP signaling network inC. difficileand emphasizes the role of the riboswitches in controlling known and putative virulence factors inC. difficile.IMPORTANCEInClostridium difficile, the signaling molecule c-di-GMP regulates multiple processes affecting its ability to cause disease, including swimming and surface motility, biofilm formation, toxin production, and intestinal colonization. In this study, we used RNA-seq to define the transcriptional regulon of c-di-GMP inC. difficile. Many new targets of c-di-GMP regulation were identified, including multiple putative colonization factors. Transcriptional analyses revealed a prominent role for riboswitches in c-di-GMP signaling. Only a subset of the 16 previously predicted c-di-GMP riboswitches were functionalin vivoand displayed potential variability in their response kinetics to c-di-GMP. This work underscores the importance of studying c-di-GMP riboswitches in a relevant biological context and highlights the role of the riboswitches in controlling gene expression inC. difficile.

scholarly journals New class of precision antimicrobials redefines role of Clostridium difficile S-layer in virulence and viability

2017 ◽  
Vol 9 (406) ◽  
pp. eaah6813 ◽  
Author(s):  
Joseph A. Kirk ◽  
Dana Gebhart ◽  
Anthony M. Buckley ◽  
Stephen Lok ◽  
Dean Scholl ◽  
...  
Keyword(s):  
Clostridium Difficile ◽  
New Class

scholarly journals NURSE IN THE POLISH HEALTH CARE SYSTEM

2020 ◽  
Vol 73 (8) ◽  
pp. 1771-1779
Author(s):  
Małgorzata Paszkowska
Keyword(s):  
Health Care ◽  
Health Care System ◽  
Medical Staff ◽  
Medical Profession ◽  
Legal Norms ◽  
The Status ◽  
Medical Order ◽  
Definition Of ◽  
Care System

Nurses are the largest group of Polish medical staff. There are currently approximately 230,000 nurses employed in Poland. There is a statutory profession for many years. Nurses provide health services on the basis of a medical order or on their own. As a result of changes in the law, the scope of their professional competences has been increasing for several years, including to independently administer medicines and issue prescriptions. The purpose of the article is to present and analyze legal norms determining the status of a nurse in the Polish health care system. In addition, the definition of the statutory principles of cooperation between doctors and nurses. The analysis shows that changes in law in recent years have significantly influenced the increase in the role of nurses in the health care system and they are also relevant to the practice of the medical profession.

Sign in / Sign up

Export Citation Format

Share Document