European journal of clinical microbiology & infectious diseases : official publication of the European Society of Clinical Microbiology
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Eur. J. Clin. Microbiol. Infect. Dis. · Jan 2017
Review Meta AnalysisAntimicrobial-coated sutures to decrease surgical site infections: a systematic review and meta-analysis.
To investigate the effectiveness of antimicrobial-coated sutures compared with non-coated sutures in reducing surgical site infection (SSI) and develop recommendations for World Health Organization (WHO) SSI prevention guidelines. We searched Medline, Embase, Cinahl, Cochrane Central Register of Controlled Trials, and WHO Global Health from 1990-16/02/2015 with language restricted to English, Spanish, and French. Meta-analysis was performed with a random-effects model. ⋯ Quality of RCT evidence was moderate, and OBS evidence was very low quality. Triclosan-coated sutures may reduce SSI risk. However, the available evidence is of moderate/low quality, and many studies had conflicts of interest.
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Eur. J. Clin. Microbiol. Infect. Dis. · Sep 2015
ReviewMolecular studies on ancient M. tuberculosis and M. leprae: methods of pathogen and host DNA analysis.
Humans have evolved alongside infectious diseases for millennia. Despite the efforts to reduce their incidence, infectious diseases still pose a tremendous threat to the world population. Fast development of molecular techniques and increasing risk of new epidemics have resulted in several studies that look to the past in order to investigate the origin and evolution of infectious diseases. ⋯ This review examines the molecular methods used to screen for the presence of M. tuberculosis and M. leprae ancient DNA (aDNA) and their differentiation in ancient human remains. Examples of recent studies, mainly from Europe, that employ the newest techniques of molecular analysis are also described. Moreover, we present a specific approach based on assessing the likely immunological profile of historic populations, in order to further elucidate the influence of M. tuberculosis and M. leprae on historical human populations.
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Eur. J. Clin. Microbiol. Infect. Dis. · May 2015
Review Comparative StudyA systematic review of matrix-assisted laser desorption/ionisation time-of-flight mass spectrometry compared to routine microbiological methods for the time taken to identify microbial organisms from positive blood cultures.
Bloodstream infections are a significant source of mortality and morbidity. Patient outcomes are improved by rapid identification of the causative pathogen and administration of appropriate antimicrobial therapy. Matrix-assisted laser desorption/ionisation time-of-flight (MALDI-TOF) mass spectrometry has recently emerged as an alternative to microbiological identification. ⋯ The observational studies reviewed provide evidence of potentially substantial time savings of MALDI-TOF in pathogen identification and instigation of appropriate therapy, which may also reduce hospital stay. Due to the small number of studies, all at relatively high risk of bias, this cannot be considered as definitive evidence of the impact of MALDI-TOF. More and better evidence, including impact on patient health and cost-effectiveness, is required.
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Eur. J. Clin. Microbiol. Infect. Dis. · May 2015
Review Meta AnalysisEfficacy of interventions to improve hand hygiene compliance in neonatal units: a systematic review and meta-analysis.
Healthcare-associated infections (HCAIs) cause significant morbidity and mortality in neonatal intensive care units (NICUs). Meticulous hand hygiene is the most effective strategy to prevent HCAI. However, hand hygiene compliance (HHC) is low, especially in ICUs. ⋯ OR 1.55; 95 % CI 1.13-2.11). Strategies to improve HHC in NICUs seem to be more effective when they include performance feedback at the personal or group levels. Randomised controlled trials (RCTs) specifically assessing the benefits of performance feedback in improving HHC are needed.
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Eur. J. Clin. Microbiol. Infect. Dis. · Oct 2014
ReviewDevelopments for improved diagnosis of bacterial bloodstream infections.
Bloodstream infections (BSIs) are associated with high mortality and increased healthcare costs. Optimal management of BSI depends on several factors including recognition of the disease, laboratory tests and treatment. Rapid and accurate identification of the etiologic agent is crucial to be able to initiate pathogen specific antibiotic therapy and decrease mortality rates. ⋯ These approaches include protein-based (MALDI-TOF mass spectrometry) and nucleic acid-based (polymerase chain reaction [PCR]) identification from subculture, blood cultures, and whole blood to decrease time to results. Pathogen enrichment and DNA isolation methods, to enable optimal pathogen DNA recovery from whole blood, are described. In addition, the use of biomarkers as patient pre-selection tools for molecular assays are discussed.