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1.
Chia-Ying Liu Chih-Cheng Lai Hsiu-Tzy Chiang Min-Chi Lu Ling-Fang Wang Tsai-Ling Tsai Mei-Yu Kang Yi-Ni Jan Yi-Ting Lo Wen-Chien Ko Shu-Hui Tseng Chun-Ming Lee Po-Ren Hsueh 《Journal of microbiology, immunology, and infection》2019,52(1):62-74
Background/purpose
This study investigated the distribution and persistence of multidrug resistant organisms (MDROs) including methicillin-resistant Staphylococcus aureus (MRSA), carbapenem-resistant Enterobacteriaceae (CRE), carbapenem-resistant Pseudomonas aeruginosa (CRPA), and multidrug-resistant Acinetobacter baumannii (MDRAB) in six long-term care facilities (LTCFs).Methods
We investigated the distribution of MDROs in residents of six LTCFs and their environments from January to December 2016 (intervention period). Active surveillance of colonization of MDROs was performed by culturing rectal and nasal swab samples from the residents every three months. Multilocus sequence typing (MLST) was conducted, and genes for panton-valentine leukocidin (PVL) from MRSA isolates were determined.Results
A total of 521 samples were positive for MDROs, and MRSA was the most common organism (65.1%), followed by MDRAB (11.3%), carbapenem-resistant Klebsiella pneumoniae (11.1%), carbapenem-resistant Escherichia coli (4.6%), and carbapenem-resistant P. aeruginosa (2.1%, n = 11). By a linear regression model, positive MRSA isolates from the environment were found to be statistically significant and associated with the number of colonized LTCF residents (p = 0.01), while the timing of the surveillance culture was not (p = 0.227). The main MLST types associated with PVL-production were sequence type (ST) 59, (40.0%, 24/60), ST30 (21.4%, 3/14), ST8 (87.5%, 14/16), and ST45 (3.6%, 1/28). The susceptibility rates of tetracycline (96.7%), trimethoprim-sulfamethoxazole (96.7%), and ciprofloxacin (81.7%) were statistically significant and higher in MRSA ST59, compared to the rates in MRSA ST45 isolates.Conclusions
MRSA was the most commonly colonized MDRO, both in the LTCF residents and in the environment, followed by MDRAB and carbapenem-resistant K. pneumoniae. 相似文献2.
Epidemiology and molecular characterization of Streptococcus pyogenes recovered from scarlet fever patients in central Taiwan from 1996 to 1999 总被引:1,自引:0,他引:1
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Chiou CS Liao TL Wang TH Chang HL Liao JC Li CC 《Journal of clinical microbiology》2004,42(9):3998-4006
One hundred seventy-nine Streptococcus pyogenes isolates recovered from scarlet fever patients from 1996 to 1999 in central Taiwan were characterized by emm, Vir, and pulsed-field gel electrophoresis (PFGE) typing methods. The protocols for Vir and PFGE typing were standardized. A database of the DNA fingerprints for the isolates was established. Nine emm or emm-like genes, 19 Vir patterns, and 26 SmaI PFGE patterns were detected among the isolates. Among the three typing methods, PFGE was the most discriminatory. However, it could not completely replace Vir typing because some isolates with identical PFGE patterns could be further differentiated into several Vir patterns. The prevalent emm types were emm4 (n = 81 isolates [45%]), emm12 (n = 64 [36%]), emm1 (n = 14 [8%]), and emm22 (n = 13 [7%]). Some emm type isolates could be further differentiated into several emm-Vir-PFGE genotypes; however, only one genotype in each emm group was usually predominant. DNA from nine isolates was resistant to SmaI digestion. Further PFGE analysis with SgrAI showed that the SmaI digestion-resistant strains could be derived from indigenous strains by horizontal transfer of exogenous genetic material. The emergence of the new strains could have resulted in an increase in scarlet fever cases in central Taiwan since 2000. The emm sequences, Vir, and PFGE pattern database will serve as a basis for information for the long-term evolutionary study of local S. pyogenes strains. 相似文献
3.
Study ObjectivesTo examine associations of social isolation and loneliness with sleep in older adults and whether associations differ for survey and actigraph sleep measures.MethodsThis study used data from the National Social Life, Health, and Aging Project (NSHAP), a nationally representative study of community-dwelling older adults born 1920–1947. A random one-third of participants in 2010–2011 were invited to participate in a sleep study (N = 759) that included survey questions, 72 hours of wrist actigraphy, and a sleep log. Perceived loneliness was measured using three questions from the UCLA Loneliness Scale. An index of social isolation was constructed from nine items that queried social network characteristics and social interactions. We used ordinary least squares and ordinal logistic regression to examine whether sleep measures were associated with loneliness and social isolation adjusted for potential sociodemographic confounders.ResultsSocial isolation and loneliness had a low correlation (Spearman’s correlation = 0.20). Both loneliness and social isolation were associated with actigraphy measures of more disrupted sleep: wake after sleep onset and percent sleep. Neither was associated with actigraph total sleep time. Increased loneliness was strongly associated with more insomnia symptoms and with shorter sleep duration assessed by a single question, but social isolation was not. More isolated individuals spent a longer time in bed.ConclusionsWe found that both loneliness and social isolation were associated with worse actigraph sleep quality, but their associations with self-reported sleep differed. Only loneliness was associated with worse and shorter self-reported sleep. 相似文献
4.
5.
Intra-individual daily and yearly variability in actigraphically recorded sleep measures: the CARDIA study 总被引:2,自引:1,他引:1
STUDY OBJECTIVES: To describe the day-to-day and year-to-year variation in sleep characteristics among early middle-aged adults. DESIGN: Participants wore an Actiwatch (Mini Mitter, Inc) for 3 days on two occasions approximately 1 year apart. PARTICIPANTS: N = 669 participants aged 38-50 years from the Chicago site of the Coronary Artery Risk Development in Young Adults (CARDIA) cohort study. MEASUREMENTS AND RESULTS: Sleep measures included sleep duration, sleep latency, sleep efficiency, and time in bed. For each sleep parameter, total variance was decomposed into between-subject variance, within-subject variance from day to day, and within-subject variance from year to year. The standard deviation was calculated from the variance. Analysis yielded a within-subject daily standard deviation (SD) of 1.26 hours and a within-subject yearly SD of 0.39 hours for sleep duration. Daily SD was 30.7 minutes and yearly SD was 6.3 minutes for within-subject variability of sleep latency. Daily SD was 8.4% and yearly SD was 2.7% for within-subject variability of sleep efficiency. Finally, daily SD was 1.31 hours and yearly SD was 0.52 hours for within-subject variability of time in bed. CONCLUSIONS: For each of the 4 sleep characteristics, nightly variability was much greater than yearly variability, meaning sleep behavior changes little in one year in this cohort of early middle-aged adults, despite large daily fluctuations. These results have important methodological implications, including that single-day measures of sleep may not accurately reflect habitual behavior. 相似文献
6.
Shu-Chen Kuo Pei-Chen Chen Yih-Ru Shiau Hui-Ying Wang Jui-Fen Lai I Wen Huang Tsai-Ling Yang Lauderdale 《Emerging infectious diseases》2014,20(8):1386-1390
Levofloxacin resistance in Haemophilus influenzae has increased significantly in Taiwan, from 2.0% in 2004 to 24.3% in 2010 (p<0.001). Clinical and molecular investigations of 182 levofloxacin-resistant isolates revealed that the increase was mainly the result of the spread of several clones in the elderly population in different regions. 相似文献
7.
Chia-Ying Huang Jui-Fen Lai I-Wen Huang Pei-Chen Chen Hui-Ying Wang Yih-Ru Shiau Ya-Wen Cheng Li-Yun Hsieh Shan-Chwen Chang Tsai-Ling Yang Lauderdale 《Journal of clinical microbiology》2014,52(2):508-516
Our multicenter nationwide surveillance data indicated that erythromycin (ERY) resistance among group A Streptococcus (GAS) isolates in Taiwan declined from 53.1% in 1998 and 2000 to 14.6% in 2002 and 2004 and 10.7% in 2006 to 2010 (P < 0.01). The present study aimed to assess the epidemiology of GAS in Taiwan and identify factors associated with ERY resistance. All 127 ERY-resistant (ERYr) isolates and 128 randomly selected ERY-susceptible (ERYs) isolates recovered from 1998 to 2010 were emm typed. ERYr isolates were also characterized by ERY resistance phenotype and mechanisms and pulsed-field gel electrophoresis (PFGE). Multilocus sequence typing was performed on selected ERYr isolates. The predominant emm types in ERYr isolates were emm22 (n = 33, 26.0%), emm12 (n = 24, 18.9%), emm4 (n = 21, 16.5%), and emm106 (n = 15, 11.8%). In ERYs isolates, emm12 (n = 27, 21.9%), emm1 (n = 18, 14.1%), emm106 (n = 16, 12.5%), and emm11 (n = 9, 7.1%) predominated. The most common ERY resistance phenotype was the M phenotype (resistant to macrolides) (70.9%), with all but one isolate carrying mef(A), followed by the constitutive macrolide-lincosamide-streptogramin B resistance (cMLSB) phenotype (26.8%), with isolates carrying erm(B) or erm(TR). ERYr isolates of the emm12-sequence type 36 (ST36) lineage with the cMLSB phenotype were mostly present before 2004, while those of the emm22-ST46 lineage with the M phenotype predominated in later years. Recovery from respiratory (throat swab) specimens was an independent factor associated with ERY resistance. emm1 and emm11 GAS isolates were significantly associated with ERYs, while emm22 was detected only in ERYr GAS. In addition, emm106 isolates were prevalent among the abscess/pus isolates, whereas emm12 isolates were strongly associated with a respiratory (throat) origin. In addition to identifying factors associated with ERY resistance in GAS, our study provides helpful information on the changing GAS epidemiology in Taiwan. 相似文献
8.
Chung PJ Garfield CF Rathouz PJ Lauderdale DS Best D Lantos J 《Health affairs (Project Hope)》2002,21(2):254-263
The 1998 Master Settlement Agreement (MSA) between tobacco manufacturers and forty-six states bans manufacturers from targeting minors through advertising. To determine how youth targeting in magazine cigarette advertisements changed after the MSA, we analyzed magazine readership and cigarette ads in U.S. magazines from 1997 to 2000. In 2000 all three major manufacturers (Philip Morris, R.J. Reynolds, and Brown and Williamson) failed to comply with the MSA's youth-targeting ban, selectively increasing their youth targeting. Banning all magazine advertising of cigarettes may be necessary to eliminate youth targeting in magazines. 相似文献
9.
Cagney KA Lauderdale DS 《The journals of gerontology. Series B, Psychological sciences and social sciences》2002,57(2):P163-P172
Population-based studies of health often use education as the sole indicator of socioeconomic status (SES); the independent contributions of education and other SES covariates are rarely delineated. Using Wave 1 of the Asset and Health Dynamics Among the Oldest Old study, the authors examined the extent to which educational attainment influences performance on three separate domains of cognitive status by race and Latino ethnicity and introduced controls for wealth and household income. Results indicate that the education effect is minimally weakened after adjusting for wealth; the wealth effect, however, is greatly attenuated after adjusting for education. Blacks and Whites exhibited a similar education--cognition relationship; Latino elderly did not experience commensurate gains in cognitive function with increasing education. Results suggest that although the education--cognition relationship may in part reflect an SES gradient, the association is more likely due to the process and consequences of education itself. 相似文献
10.
Rhodes KV Lauderdale DS Stocking CB Howes DS Roizen MF Levinson W 《Annals of emergency medicine》2001,37(3):284-291
STUDY OBJECTIVE: We evaluate a computer-based intervention for screening and health promotion in the emergency department and determine its effect on patient recall of health advice. METHODS: This controlled clinical trial, with alternating assignment of patients to a computer intervention (prevention group) or usual care, was conducted in a university hospital ED. The study group consisted of 542 adult patients with nonurgent conditions. The study intervention was a self-administered computer survey generating individualized health information. Outcome measures were (1) patient willingness to take a computerized health risk assessment, (2) disclosure of behavioral risk factors, (3) requests for health information, and (4) remembered health advice. RESULTS: Eighty-nine percent (470/542) of eligible patients participated. Ninety percent were black. Eighty-five percent (210/248) of patients in the prevention group disclosed 1 or more major behavioral risk factors including current smoking (79/248; 32%), untreated hypertension (28/248; 13%), problem drinking (46/248; 19%), use of street drugs (33/248; 13%), major depression (87/248; 35%), unsafe sexual behavior (84/248; 33%), and several other injury-prone behaviors. Ninety-five percent of patients in the prevention group requested health information. On follow-up at 1 week, 62% (133/216) of the prevention group patients compared with 27% (48/180) of the control subjects remembered receiving advice on what they could do to improve their health (relative risk 2.3, 95% confidence interval 1.77 to 3.01). CONCLUSION: Using a self-administered computer-based health risk assessment, the majority of patients in our urban ED disclosed important health risks and requested information. They were more likely than a control group to remember receiving advice on what they could do to improve their health. Computer methodology may enable physicians to use patient waiting time for health promotion and to target at-risk patients for specific interventions. 相似文献