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Wonodi CB Deloria-Knoll M Feikin DR DeLuca AN Driscoll AJ Mo?si JC Johnson HL Murdoch DR O'Brien KL Levine OS Scott JA;Pneumonia Methods Working Group PERCH Site Investigators 《Clinical infectious diseases》2012,54(Z2):S124-S131
As a case-control study of etiology, the Pneumonia Etiology Research for Child Health (PERCH) project also provides an opportunity to assess the risk factors for severe pneumonia in hospitalized children at 7 sites. We identified relevant risk factors by literature review and iterative expert consultation. Decisions for inclusion in PERCH were based on comparability to published data, analytic plans, data collection costs and logistic feasibility, including interviewer time and subject fatigue. We aimed to standardize questions at all sites, but significant variation in the economic, cultural, and geographic characteristics of sites made it difficult to obtain this objective. Despite these challenges, the depth of the evaluation of multiple risk factors across the breadth of the PERCH sites should furnish new and valuable information about the major risk factors for childhood severe and very severe pneumonia, including risk factors for pneumonia caused by specific etiologies, in developing countries. 相似文献
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Cherry JD Tan T Wirsing von K?nig CH Forsyth KD Thisyakorn U Greenberg D Johnson D Marchant C Plotkin S 《Clinical infectious diseases》2012,54(12):1756-1764
Existing clinical case definitions of pertussis are decades old and based largely on clinical presentation in infants and children, yet an increasing burden is borne by adolescents and adults who may manifest distinct signs/symptoms. Therefore, a "one-size-fits-all" clinical case definition is no longer appropriate. Seeking to improve pertussis diagnosis, the Global Pertussis Initiative (GPI) developed an algorithm that delineates the signs/symptoms of pertussis most common to 3 age groups: 0-3 months, 4 months to 9 years, and ≥10 years. These case definitions are based on clinical presentation alone, but do include recommendations on laboratory diagnostics. Until pertussis can be accurately diagnosed, its burden will remain underestimated, making the introduction of epidemiologically appropriate preventive strategies difficult. The proposed definitions are intended to be widely applicable and to encourage the expanded use of laboratory diagnostics. Determination of their utility and their sensitivity and/or specificity versus existing case definitions is required. 相似文献
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Hilty M Betsch BY B?gli-Stuber K Heiniger N Stadler M Küffer M Kronenberg A Rohrer C Aebi S Endimiani A Droz S Mühlemann K 《Clinical infectious diseases》2012,55(7):967-975
Background.?Studies about transmission rates of extended-spectrum β-lactamase (ESBL)-producing Enterobacteriaceae in hospitals and households are scarce. Methods.?Eighty-two index patients with new carriage of ESBL-producing Escherichia coli (ESBL-Ec; n?=?72) or ESBL-producing Klebsiella pneumoniae (ESBL-Kp; n?=?10) and their hospital (n?=?112) and household (n?=?96) contacts were studied prospectively from May 2008 through September 2010. Isolates were phenotypically and molecularly characterized (sequencing of bla genes, repetitive extragenic palindromic polymerase chain reaction, pulse-field gel electrophoresis, and multilocus sequence typing). Transmission was defined as carriage of a clonally-related ESBL producer with identical bla(ESBL) gene(s) in the index patient and his or her contact(s). Results.?CTX-M-15 was the most prevalent ESBL in ESBL-Ec (58%) and ESBL-Kp (70%) in the index patients. Twenty (28%) ESBL-Ec isolates were of the hyperepidemic clone ST131. In the hospital, transmission rates were 4.5% (ESBL-Ec) and 8.3% (ESBL-Kp) and the incidences of transmissions were 5.6 (Ec) and 13.9 (Kp) per 1000 exposure days, respectively. Incidence of ESBL-Kp hospital transmission was significantly higher than that of ESBL-Ec (P?.0001), despite implementation of infection control measures in 75% of ESBL-Kp index patients but only 22% of ESBL-Ec index patients. Detection of ESBL producers not linked to an index patient was as frequent (ESBL-Ec, 5.7%; ESBL-Kp, 16.7%) as nosocomial transmission events. In households, transmission rates were 23% for ESBL-Ec and 25% for ESBL-Kp. Conclusions.?Household outweighs nosocomial transmission of ESBL producers. The effect of hospital infection control measures may differ between different species and clones of ESBL producers. 相似文献
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King LA Nogareda F Weill FX Mariani-Kurkdjian P Loukiadis E Gault G Jourdan-DaSilva N Bingen E Macé M Thevenot D Ong N Castor C No?l H Van Cauteren D Charron M Vaillant V Aldabe B Goulet V Delmas G Couturier E Le Strat Y Combe C Delmas Y Terrier F Vendrely B Rolland P de Valk H 《Clinical infectious diseases》2012,54(11):1588-1594
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