Outbreak of Methicillin‐resistant Staphylococcus aureus in a Hospital Center for Children's and Women's Health in a Swedish County

The objective of this study was to investigate a sudden increase in methicillin‐resistant Staphylococcus aureus (MRSA) cases primarily in one maternity ward at the Center for Children's and Women's Health at Linköping University Hospital, Sweden. Approximately 300 individuals including patients, their family members, and healthcare workers were screened for MRSA. The antibiotic susceptibility was tested and isolates polymerase chain reaction (PCR)‐positive for the mecA gene were spa typed. Isolates with the same antibiogram and spa type were further whole genome sequenced. Compliance to current cleaning and hygiene routines was also controlled, and environmental samples collected. The results showed that a total of 13 individuals were involved in the outbreak. It was caused by a t386 MRSA strain (ST‐1, NCBI‐accession AB505628) with additional resistance to erythromycin and clindamycin. All cases were epidemiologically connected to the index patient, who had recently emigrated from a high‐endemic area for MRSA. With improved cleaning and better compliance to basic hygiene routines, no further cases were reported. This study demonstrates how rapid an MRSA strain can disseminate in a ward with susceptible patients and insufficient cleaning and hygiene. For a better control of MRSA, clinical cultures and screening samples need to be obtained early and more extensively than according to the current recommendations.     

Enterocolitis due to Yersinia enterocolitica in South Australia.

From August 1976 to July 1977, all faecal specimens (3298) sent to the Enteric Department of the Institute of Medical and Veterinary Science, Adelaide were selectively cultured for Yersinia enterocolitica. Yersinia enterocolitica was isolated from three patients with diarrhoea, one of whom acquired her infection overseas. These organisms were not isolated from faecal or lymph node material collected from a limited number of sheep and pigs found to have enteritis at the time of slaughter. Enteric infection due to Yersinia enterocolitica does not appear to be common in Australia and selective culture methods using cold enrichment techniques do not appear to be justified especially in laboratories handling specimens derived mainly from adults.     

Plesiomonas shigelloides in South Australia

Plesiomonas shigelloides, a motile, oxidase-positive, Gram-negative rod that may possess shigella antigens, was isolated from the faeces of 36 children and two adults. In 13 children the organism was thought to be possibly the cause of enteritis and in eight children there was no evidence of intestinal disease. In nine children with gastroenteritis other enteropathogenic bacteria were found in addition, and six children had intestinal disease due, or possibly due, to other factors. Only four of the 38 strains had shigella antigens.     

AKAMAI project: Teleradiology in the pacific

Journal of Digital Imaging -     

Mitochondrial DNA analysis of Sporothrix schenckii in South Africa and Australia.

Clinical isolates of Sporothrix schenckii were investigated for mitochondrial DNA (mtDNA) types using restriction fragment length polymorphism patterns with HaeIII. The 62isolates in South Africa comprised Types 3 (9.7%), 4 (1.6%), 11 (9.7%), 17 (77.4%) and 23 (1.6%) while the 23 Australian isolates comprised Types 3 (26.0%), 4 (56.5%), 7 (8.6%) and 21 (8.6%). In a phylogenetic tree based on the sequence divergence of mtDNA, the mtDNA types were clustered into two groups, A and B. The results suggested that isolates in South Africa mainly belong to Group A and isolates in Australia mainly belong to Group B.     

儿童医院多重耐药菌耐药情况分析

目的 了解本院多重耐药菌（MDROs）的分布情况及耐药情况,为本院医院感染控制和临床合理使用抗菌药物提供依据。方法 收集2015年1月~6月住院患儿细菌感染的临床分离菌株,依据2011年CLSL标准的常规鉴定和纸片扩散法,测定菌株对抗菌药物的敏感性,采用WHONET 5.5软件对收集到的细菌监测资料进行统计分析。结果 共检测出病原菌1330株,其中MDROs130株;检出前三位的MDROs为ESBLs阳性大肠埃希菌76株（58.50%）、耐甲氧西林金黄色葡萄球菌（MRSA）32株（24.60%）、ESBLs阳性克雷伯氏菌22株（16.90%）;检出MDROs前三位的科室依次是新生儿科、PICU、综合内科;MDR-GP对克林霉素、红霉素及β-内酰胺类抗菌药物耐药率较高,MDR-GN对头孢三代、常用抗革兰氏阴性菌的青霉素类抗菌药物耐药率较高。结论 本院MDROs的医院感染的防控重点在收治感染性疾病的内科。本院MDROs革兰氏阴性菌对红霉素、克林霉素,耐药率高于成人医院,儿童感染的MRSA的检出率低于成人医院,耐药率相似。     

Frequent Occurrence of Microtubuloreticular Complexes Encountered during Routine Ultrastructural Examination at a Children's Hospital

Prompted by our impression that microtubuloreticular complexes (MTRC) are frequently observed during electron microscopy at the Red Cross War Memorial Children's Hospital, Cape Town, we reviewed all specimens submitted for routine ultra-structural examination during a 1-year period. Our impression was confirmed. MTRC were present in a high proportion of cases, especially in vascular endothelium of renal biopsies. As all 9 cases of hepatitis B-associated membranous glomerulonephritis were positive for MTRC., we also reviewed the previous 20 cases with this diagnosis and these were also all positive. Hepatitis B-associated membranous glomerulonephritis is common in our region. MTRC are probably induced by a supposedly uncommon heat labile alpha-interferon. Elevated serum levels of this interferon are known to occur in systemic lupus erythematosus and acquired immunodeficiency syndrome. We propose that children with intercurrent infection in our region frequently respond with alpha-interferon, promoting MTRC formation.     

Frequent Occurrence of Microtubuloreticular Complexes Encountered during Routine Ultrastructural Examination at a Children's Hospital

Prompted by our impression that microtubuloreticular complexes (MTRC) are frequently observed during electron microscopy at the Red Cross War Memorial Children's Hospital, Cape Town, we reviewed all specimens submitted for routine ultra-structural examination during a 1-year period. Our impression was confirmed. MTRC were present in a high proportion of cases, especially in vascular endothelium of renal biopsies. As all 9 cases of hepatitis B-associated membranous glomerulonephritis were positive for MTRC., we also reviewed the previous 20 cases with this diagnosis and these were also all positive. Hepatitis B-associated membranous glomerulonephritis is common in our region. MTRC are probably induced by a supposedly uncommon heat labile alpha-interferon. Elevated serum levels of this interferon are known to occur in systemic lupus erythematosus and acquired immunodeficiency syndrome. We propose that children with intercurrent infection in our region frequently respond with alpha-interferon, promoting MTRC formation.     

DNA relatedness and biochemical features of Campylobacter spp. isolated in central and South Australia.

Investigations of the etiology of diarrhea in patients in South Australia and the Northern Territory showed that Campylobacter spp. other than Campylobacter jejuni and C. coli were common in children. Campylobacters which were hippurate positive, nitrate negative, and susceptible to cephalothin and polymyxins were shown to be closely related to C. jejuni by DNA studies. Thermotolerant catalase-negative campylobacters were also isolated. These were H2S negative and biochemically resembled the catalase-negative or weak strains found in dogs in Sweden. DNA studies showed these campylobacters to be distinct from C. sputorum subsp. sputorum and to form a homogeneous group distinct from the enteropathogenic catalase-positive campylobacters. Preliminary studies suggest that these campylobacters are related to the Swedish catalase-negative or weak strains.     

数字医学图像传输协议(DICOM)分析及在远程放射系统中的应用

数字医学图像传输协议 ( Digital image comm unication in m edicine,DICOM)主要是由 ACR和 NEMA联合提出的旨在解决医疗设备之间互连的一种通讯标准 ,目前已成为业界公认的标准。把 DICOM应用于远程放射系统具有很重要的意义 ,特别是在幅员辽阔的我国有更加突出的意义。简要地概述了 DICOM3 .0的主要内容及突出特征 ,并就其在 PACS、远程放射系统的开发策略、组成结构和几个关键问题进行了讨论