Epithelio- Myoepithelial Carcinoma of Masseteric Space: a Case Report.
Обработка статьи · этапы, ошибки и управление
Ошибки и ограничения
История · было → стало
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van der Lee Sven J, Knol Maria J, Chauhan Ganesh, Satizabal Claudia L, Smith Albert Vernon, Hofer Edith, Bis Joshua C, Hibar Derrek P, Hilal Saima, van den Akker Erik B, Arfanakis Konstantinos, Bernard Manon, Yanek Lisa R, Amin Najaf, Crivello Fabrice, Cheung Josh W, Harris Tamara B, Saba Yasaman, Lopez Oscar L, Li Shuo, van der Grond Jeroen, Yu Lei, Paus Tomas, Roshchupkin Gennady V, Amouyel Philippe, Jahanshad Neda, Taylor Kent D, Yang Qiong, Mathias Rasika A, Boehringer Stefan, Mazoyer Bernard, Rice Ken, Cheng Ching Yu, Maillard Pauline, van Heemst Diana, Wong Tien Yin, Niessen Wiro J, Beiser Alexa S, Beekman Marian, Zhao Wanting, Nyquist Paul A, Chen Christopher, Launer Lenore J, Psaty Bruce M, Ikram M Kamran, Vernooij Meike W, Schmidt Helena, Pausova Zdenka, Becker Diane M, De Jager Philip L, Thompson Paul M, van Duijn Cornelia M, Bennett David A, Slagboom P Eline, Schmidt Reinhold, Longstreth W T, Ikram M Arfan, Seshadri Sudha, Debette Stéphanie, Gudnason Vilmundur, Adams Hieab H H, DeCarli Charles
Аннотация
METHODS: A prospective surveillance of HAIs was initiated in the NICU at the Pauls Stradins Clinical University Hospital (PSCUH) in Latvia on 1/9/2012 and identified an outbreak of A.baumannii. Case definitions for A.baumannii bloodstream infection (BSI) and colonization were implemented; surveillance cultures were obtained from all admitted patients to monitor the rate of colonization; an infection prevention and control team was formed and infection control interventions implemented. Environmental sampling of the NICU and Labour ward was performed. We employed WGS to differentiate phenotypically identical multidrug-resistant A.baumannii (MDRAB) strains from simultaneous intrahospital outbreaks in the adult Intensive Care Unit and NICU.
RESULTS: Between 1/9/2012 and 31/12/2017 the surveillance included 2157 neonates. A total of 17 neonates had A.baumannii BSI, with the highest rate of 30.0 cases per 1000 bed-days in November 2012. Rectal screening samples were positive for A.baumannii-complex in 182 neonates reaching 119.6 per 1000 bed-days in July 2015. All 298 environmental cultures were negative. Two phenotypically identical MDRAB isolates from the simultaneous intrahospital outbreaks were differentiated using WGS, ruling out an inter-ward transmission. Adherence to stringent infection control measures decreased BSI cases but colonization remained persistent. With several relapses, the outbreak was ongoing for four years. No new A.baumannii BSI cases were registered after total environmental decontamination in the NICU in July 2015. Colonization reappeared and persisted until in November 2016 when the ward was temporarily closed, relocated and renovated. No A.baumannii cases were registered after the renovation.
CONCLUSION: The HAI surveillance system successfully detected and facilitated the control of the A.baumannii outbreak. Whole-genome sequencing was found to be a useful method for differentiation of phenotypically identical A.baumannii strains from the intrahospital outbreak. Only multi-modal infection control program, including closure, temporary relocation, and renovation of the ward, restricted the outbreak.