Survey of parents' attitudes to the recommended Haemophilus influenzae type b vaccine program.

A survey was conducted in a general pediatric practice to determine parents'' attitudes to and compliance with the recommended Haemophilus influenzae type b vaccine program. Of 133 families surveyed 127 (95%) responded to the questionnaire. About one third of the parents did not have their children vaccinated. The decision against vaccination was made despite parent education, follow-up telephone contact and the pediatrician''s expressed support of the vaccine program. Most of the respondents (86%) had no previous knowledge of the vaccine. The factor of greatest concern was the possibility of an adverse reaction. This concern was significantly more common among the parents who decided not to have their children vaccinated than among those who had their children vaccinated (chi 2 = 6.52, p less than 0.025). One third of the parents who indicated that they intended to have their children vaccinated required a telephone reminder. The findings suggest a need for public education about the vaccine, with particular emphasis directed at allaying fears about side effects.     

Prevalence of HBsAg and anti HBs in hospital personnel

Of the 473 employees of a Prague hospital, examined for the presence of hepatitis B surface antigen (HBsAg) and the antibody to it (anti HBs), 23 (4.9%) were shown to have the antigen and 88 (18.6%) to have the antibody. No differences were found in the prevalence of HBsAg and anti HB according to sex and age, but the percentage of persons with antibodies increased with increasing length of occupation. Significantly higher levels of antibodies were found in persons having direct contact with the patients or their excretions (nurses, laboratory assistants). Positive serological findings were more frequent in employees with a history of falling ill with hepatitis after entering employment in the health services than in persons without this history. In the serological evidence of hepatitis B according to work place, those working in biochemical and haematological laboratories and in the blood transfusion department took first place, followed by persons employed in medical and surgical departments.     

Respiratory syncytial virus: its transmission in the hospital environment

Respiratory syncytial virus (RSV) over the past two decades has been recognized as the most important cause of lower respiratory tract disease in infants and young children. Recently, it has also been identified as a major nosocomial hazard on pediatric wards. The potential for RSV to spread on such wards is underlined by several singular characteristics of RSV. It arrives in yearly epidemics and is highly contagious in all age groups. Immunity is of short duration, allowing repeated infections to occur. Thus, during an epidemic 20--40 percent of infants admitted for other conditions may acquire nosocomial RSV infection, as well as 50 percent of the ward personnel. The usual infection control procedures for respiratory illnesses have had limited success in controlling the spread of RSV. This may be due in part to the modes of transmission of RSV. Inoculation occurs mainly through the eye and nose, rather than the mouth. This may be via large-particle aerosols or droplets, requiring close contact. The virus, however, does not seem capable of traversing distances by small-particle aerosols. Nevertheless, it is able to remain infectious on various environmental surfaces, suggesting fomites as a source of spread. Indeed, inoculation after touching such contaminated surfaces can occur, and may be a major second means of spread, in hospitals as well as in families.     

Epidemiology and prophylaxis of the hospital contamination of medical personnel with viruses of hepatitis B and C

Medical personnel is one of the main risk groups with respect to hospital infections for which hepatitis B and C are professional pathology. The degree of the risk of contamination of the personnel greatly depends on the character, urgency and duration of professional activity, accuracy in following the rules of personal safety while working with infected material, the proportion of patients contaminated with viruses of hepatitis B and C in specialized departments, the epidemiological danger of therapeutic and diagnostic methods, the possibility of reliable disinfection and sterilization of the equipment. In the system of measures aimed at preventing the infection of the medical personnel a special role belongs to the specific immunoprophylaxis of hepatitis B. Prolonged experience in the immunization of the medical personnel of a big hospital demonstrates a high immunological and epidemiological efficiency of the use of vaccine against hepatitis B, produced by the Research and Manufacturing Complex "Combiotech", Russia.     

Are the recommended allowances for dietary antioxidants adequate?

Recommended dietary allowances are standards for maintaining health. Claims that intakes substantially above the allowances may provide protection from xenobiotics and prevent diseases, including cancer, are examined critically for five nutrients that have antioxidant potential. Major criticism is directed at the failure of epidemiologists to recognize that for many of these nutrients, metabolic differences among individuals preclude a direct relationship between dietary intake and plasma or tissue concentration. Also, the fact that no differences in disease incidence have been described within various species of animals that have markedly different metabolic patterns for some of these nutrients has not been considered. It is concluded that the experimental and epidemiological evidence to data that increased intakes of certain nutrients will have beneficial effects on human health are tenuous.     

Biodiversity and concentration of airborne fungi in a hospital environment

The biodiversity and concentration of airborne fungi were monitored over a period of 6 months in a special-care unit of a hospital. Air sampling was performed in a corridor that was also accessible to visitors and in an adjacent bone-marrow transplantation (BMT) unit using an air sampler and two isolation media. Altogether, 98 fungal species could be identified, among them Aspergillus fumigatus and A. terreus as well as 48 other species reported as potential pathogens. The average contamination values of the corridor air ranged from 124 to 485 cfu m⁻³. Neither the degree of fungal air contamination nor the species composition inside the special care unit differed from those found in the corridor. By means of data obtained with a light-activated sensor, a possible influence of human activities on diurnal changes of fungal propagule concentration was shown. This revised version was published online in July 2006 with corrections to the Cover Date.     

Clinical significance of the emergence of bacterial resistance in the hospital environment

Antibiotic resistance is an increasing threat in hospitals and both morbidity and mortality from infections are greater when caused by drug-resistant organisms. Whilst hospitals are universally blamed for this increase, there is an insufficient appreciation of external sources of resistance, such as when patients are admitted to hospitals from long-term care facilities in the community. The use of antibiotics in family practice and animal husbandry has also been linked to drug resistance being encountered in the hospital setting. Justifiable hospital antibiotic use, which can be life saving, may lead to 'collateral damage' with the emergence of resistance in non-target bacteria in the bowel, for example, with subsequent spread by cross-infection. At a management level, antibiotic resistance can have a significant impact on the ability of hospitals to maintain services since cohorting of patients and ward closures from outbreaks add to continuing bed shortages and waiting lists. Hospital laboratories must review their standard operating procedures since some resistance mechanisms may be missed by current methods of antibiotic susceptibility testing. With increasing public concern from press reports of 'multiresistant Staphylococcus aureus killer virus' and other drug-resistant organisms, there will inevitably be a push by national authorities for more surveillance data on antibiotic resistance; however, the cost-effectiveness of different surveillance strategies should be considered. Clinical governance and risk management are dominant themes in the National Health Service and hospital hygiene and antibiotic resistance are likely to feature prominently in audits related to these themes in the near future.     

Intelligent Bayes Classifier (IBC) for ENT infection classification in hospital environment

Electronic Nose based ENT bacteria identification in hospital environment is a classical and challenging problem of classification. In this paper an electronic nose (e-nose), comprising a hybrid array of 12 tin oxide sensors (SnO₂) and 6 conducting polymer sensors has been used to identify three species of bacteria, Escherichia coli (E. coli), Staphylococcus aureus (S. aureus), and Pseudomonas aeruginosa (P. aeruginosa) responsible for ear nose and throat (ENT) infections when collected as swab sample from infected patients and kept in ISO agar solution in the hospital environment. In the next stage a sub-classification technique has been developed for the classification of two different species of S. aureus, namely Methicillin-Resistant S. aureus (MRSA) and Methicillin Susceptible S. aureus (MSSA). An innovative Intelligent Bayes Classifier (IBC) based on "Baye's theorem" and "maximum probability rule" was developed and investigated for these three main groups of ENT bacteria. Along with the IBC three other supervised classifiers (namely, Multilayer Perceptron (MLP), Probabilistic neural network (PNN), and Radial Basis Function Network (RBFN)) were used to classify the three main bacteria classes. A comparative evaluation of the classifiers was conducted for this application. IBC outperformed MLP, PNN and RBFN. The best results suggest that we are able to identify and classify three bacteria main classes with up to 100% accuracy rate using IBC. We have also achieved 100% classification accuracy for the classification of MRSA and MSSA samples with IBC. We can conclude that this study proves that IBC based e-nose can provide very strong and rapid solution for the identification of ENT infections in hospital environment.     

Frequency of occurrence of Hepatitis C virus markers and risk factors among hospital personnel in the Novosibirsk region

The occurrence of markers, the genotypic variety of isolates and the profile of risk factors with respect to viral hepatitis C among 629 employees of the Regional Clinical Hospital (RCH) in Novosibirsk and 1,020 employees of the Central District Hospital (CDH) in Iskitim were studied in a cross-sectional investigation. The occurrence of hepatitis C virus (HCV) markers was 5.1% in RCH and 2.2% in CDH. Among the risk factors in the population under study were: the medical history of blood transfusions (TF) with 0 TF, anti-HCV = 2.3%; 1 TF, = 5.7% > 1 TF, = 13.5% (p < 0.001); general anesthesia (GA) with < or = 2 GA, anti-HCV = 2.8%; > 2 GA, = 7.8% (p = 0.002); surgical interventions (SU) with 0 SU, = 1.9%; > 0 SU, = 4.3% (p = 0.012); the intravenous use of drugs (OR = 31.8); age (< or = 25 years, anti-HCV IgG = 8.6% > 25 years, = 4.5%); the number of partners of the opposite sex < or = 4 partners, = 2.4%; > 4 partners, = 6.9%; p < 0.001). The probable risk factors at a working place (pricks and cuts, contamination of mucous membranes with blood and other biological fluids, etc.) proved to be faintly related with the status of HBV infection. HBV isolates detected in the examined persons (35 examinees) were distributed by genotypes as follows: 60% of subtype 1b, 28.6% of subtype 2a/2c, 11.4% of subtype 3a. HBV of genotype 1a was not detected in the examined specimens, while the detection rate of genotype 2a/2c was considerably greater than in specimens obtained in the European and Asian parts of Russia (according to the data reported earlier).     

Identification of pseudomonas species isolated from hospital environment and human sources

[This corrects the article on p. 1535 in vol. 16.].