PubAnnotation

Id	Subject	Object	Predicate	Lexical cue
T1	320-430	Epistemic_statement	denotes	These permissions are granted for free by Elsevier for as long as the COVID-19 resource centre remains active.
T2	841-950	Epistemic_statement	denotes	All Australian hospitals can participate in the survey which has been collecting prescribing data since 2011.
T3	1679-1942	Epistemic_statement	denotes	The antimicrobials with the highest percentage of inappropriate prescribing were cefaclor (58%) Kenacomb (gramicidin-neomycin-nystatin) (56%) and dapsone (50%), although there were only small number of these antimicrobials prescribed, (26, 18 and 2 respectively).
T4	2827-2973	Epistemic_statement	denotes	of patients with critical illness, but economical and resistant impact of de-escalation strategies for bloodstream infections was rarely reported.
T5	4548-4759	Epistemic_statement	denotes	However, lower antibiotic cost (mean: 212.1 vs. 395.6 US$, P < 0.001) and less complications of bloodstream infections due to resistant pathogens (0% vs. 5.1%, P = 0.004) was observed in the de-escalation group.
T6	5127-5261	Epistemic_statement	denotes	Background: Surgery is to have no time to lose, however, how to effectively manage the use of prophylactic antibiotics is a challenge.
T7	5388-5450	Epistemic_statement	denotes	To multi-oriented check can not affect the conduct of surgery.
T8	5451-5664	Epistemic_statement	denotes	The establishment of auxiliary mechanisms intimate reminders, and more humane management, Not only can educate the use of the correct concept of antibiotics, but also to improve of rational antibiotic utilization.
T9	6296-6365	Epistemic_statement	denotes	From here, we can see the effectiveness of management is significant.
T10	6574-6720	Epistemic_statement	denotes	Should we continue to implement contact precautions and environmental cleaning for MRSA Hui-Yun Liang 1 , Iig-Ling Chen 1 , Hung-Jen Tang 1,2,3 *.
T11	6721-7217	Epistemic_statement	denotes	Background: Increased drug resistance is one of the most important issues of global concern, effective way to stop the transmission of drug-resistant strains must have antibiotics stewardship and isolation protection measures, Strains of MRSA were first found in the 1960s there is evidence that concerted efforts that include surveillance cultures, contact precautions and isolation in hospitals can reduce MRSA, but the implementation of isolation measures need to spend the manpower and costs.
T12	7738-8008	Epistemic_statement	denotes	For the first isolated of MRSA patient must immediately check the use of antibiotics and related medical behavior, and the unit who isolated of MRSA to the hand hygiene audit, environment cleaning and disinfection of the joint inspection when the patient was discharged.
T13	8878-8946	Epistemic_statement	denotes	1 Pharmacy, St. Joseph Hospital, 2 Home Medicine, St Joseph Hostipal
T14	8947-9157	Epistemic_statement	denotes	Purpose: Overuse of antibiotics should induce increase number antibiotic resistant bacteria and its side effects, there is evidence to suggest that proper use of antibiotic helps control quality and efficiency.
T15	9158-9266	Epistemic_statement	denotes	Build up censor mechanisms with pharmacist and infection specialist can increase clinical take care quality.
T16	10631-11066	Epistemic_statement	denotes	Results: Ranking of result of inappropriate antibiotic prescriptions of pharmacist and infection specialist first item is wrong adjust of renal function, although the doctors can adjust antibiotic dose by dose calculate formulars, but during the procedure of censor meeting following within 24 hour after prescription, will helps the doctors use sensible and proper antibiotics and improve communication between pharmacist and doctors.
T17	11067-11131	Epistemic_statement	denotes	On the other hands, can hoist safety of use antibiotic patients.
T18	12423-12563	Epistemic_statement	denotes	Univariable and multivariable analysis of clinical parameters affecting FQ-R showed no factor associated with FQ resistance of rectal flora.
T19	12564-12729	Epistemic_statement	denotes	The clinical parameters associated with infectious complications after prostate biopsy were operation history within 6 months (RR 6.60; 95% CI 1.99-21.8, p = 0.002).
T20	12730-12967	Epistemic_statement	denotes	Conclusion: Prevalence of FQ-R rectal flora from the rectum before transrectal prostate biopsy was 48.1% and most common FQ-R bacteria was E. coli (39%) However, antibiotic resistance of rectal flora cannot predicted by clinical factors.
T21	12968-13100	Epistemic_statement	denotes	So Risk based approach cannot recommended and we should consider targeted antibiotic prophylaxis or extended antibiotic prophylaxis.
T22	13101-13274	Epistemic_statement	denotes	The relationship between antibiotic consumption and antibiotic resistance of Pseudomonas aeruginosa Wei-Lung Tsai 1 , Meng-Chiao Lin 1 , Chun-Hsiang Yu 2 , Chun-Ming Lee 2 .
T23	13275-13442	Epistemic_statement	denotes	1 Department of Pharmacy, St. Joseph's Hospital, 2 Department of Internal Medicine, St. Joseph's Hospital Background: Antimicrobial resistance is a global concern now.
T24	13608-13723	Epistemic_statement	denotes	Diversify the use of antimicrobial agents seems to be effective in reducing the growth of antimicrobial resistance.
T25	13724-13922	Epistemic_statement	denotes	Methods: Using retrospective study to evaluate the correlation of anti-pseudomonal antibiotic comsumption and antimicrobial resistance of pseudomonas aeruginosa by Pearson's correlation coefficient.
T26	14541-14730	Epistemic_statement	denotes	The Correlation between antibiotics and their susceptibility was modestly negatively correlated with Ciprofloxacin (r = −0.36, p = 0.034) and Piperacillin/tazobactam (r = −0.40, p = 0.015).
T27	14731-14838	Epistemic_statement	denotes	The others, although showed negatively correlated, but p-values (>0.05) were not statistically significant.
T28	14839-14976	Epistemic_statement	denotes	Conclusion: Our study shows only modestly correlation between anti-pseudomonal antimicrobial usage and pseudomonas aeruginosa resistance.
T29	15774-15940	Epistemic_statement	denotes	We sought to assess for non-clinical factors associated with antibiotics prescribing in a 1600-bed adult acute-care hospital's emergency department (ED) in Singapore.
T30	16249-16394	Epistemic_statement	denotes	Multivariable logistic regression models were constructed to assess for independent non-clinical factors associated with antibiotics prescribing.
T31	16965-17103	Epistemic_statement	denotes	Those who expected to receive antibiotics (41.0%) were more likely than those who didn't (30.1%) to be prescribed antibiotics (P = 0.070).
T32	17332-17630	Epistemic_statement	denotes	After adjusting for age, pre-existing comorbidities, and presenting complaint of fever, expectations for antibiotics (aOR 1.60, 95% CI 0.94-2.72, P = 0.086) and a higher educational level (aOR 1.63, 95% CI 0.94-2.83, P = 0.085) were marginally-significantly associated with antibiotics prescribing.
T33	17847-18057	Epistemic_statement	denotes	Conclusion: Patients' higher educational levels and expectations for antibiotics, regardless of whether they were explicitly informed to their physicians, were associated with increased antibiotics prescribing.
T34	18058-18203	Epistemic_statement	denotes	Further studies are warranted to better understand the influence of non-clinical factors such as these on antibiotic prescribing decision making.
T35	18204-18414	Epistemic_statement	denotes	Investigation the relationships of MDR (multi-drug resistant) pathogens isolated and defined daily dosing (DDD) of antibiotics prescription in one teaching hospital at Mid-Taiwan Chung-Hsin Liao, Frank San Fan.
T36	18743-18842	Epistemic_statement	denotes	So, we want to investigate the relationships of MDR pathogens and antibiotics used in our hospital.
T37	20189-20391	Epistemic_statement	denotes	This study aims to estimate pediatric antimicrobial resistance, bloodstream infection rates and pathogens, and to describe the antimicrobial prescribing pattern by monthly point prevalence survey (PPS).
T38	22151-22394	Epistemic_statement	denotes	Methods: Limitations of broad-spectrum antibiotics therapy are applied to inpatients and outpatients in order to supervise and control prescribing systems by requesting integrated and enclosed information such as clinical and relevant reasons.
T39	22395-22502	Epistemic_statement	denotes	Futhermore, the rationale for antibiotics utilization should be shown comprehensively in the form provided.
T40	23444-23607	Epistemic_statement	denotes	Conclusion: Our results present the tendency towards improving susceptibility level of broad-spectrum antibiotics, although the number of MDR-GNB still quite high.
T41	23709-23894	Epistemic_statement	denotes	Department of Pharmacy, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Hualien, Taiwan, R.O.C Background: The launch of a new antibiotic has become rare in recent years.
T42	24017-24135	Epistemic_statement	denotes	As a response to these challenges, optimal use of antibiotics, control the resistance rate is now we need to confront.
T43	24698-24946	Epistemic_statement	denotes	Background: To prevent increasing antibiotic resistance among microbes, antibiotic stewardship program (ASP) has been performed in the outpatient clinic (OPD), wards and surgical prophylaxis, but the emergency department (ED) has not been included.
T44	24947-25036	Epistemic_statement	denotes	However, empiric antibiotics have often been prescribed to patients during their ED stay.
T45	25138-25300	Epistemic_statement	denotes	As a result, we compare the differences of initial antibiotic regimens between ED and ward to evaluate whether the empiric antibiotics has been continued in ward.
T46	25301-25400	Epistemic_statement	denotes	Methods: We conducted retrospective review of medical records within March 1, 2016 to May 31, 2016.
T47	26500-26695	Epistemic_statement	denotes	In consideration of grades of staffs in wards who applied the same antibiotic as in ED, there were 80.57% of PGY-1, 75% of R4, 70.89% of R2, 69.9% of R1, 60% of R5, 52.27% of NP and 37.93% of R3.
T48	27534-27610	Epistemic_statement	denotes	In our hospital, no recommendation exists for broad-spectrum antibiotic use.
T49	27611-27780	Epistemic_statement	denotes	The aim of this study was to describe the modalities of broad spectrum antibiotic prescriptions in an infectious diseases department and confront them to the guidelines.
T50	28673-28743	Epistemic_statement	denotes	The broad-spectrum antibiotic was first line prescribed in 58 (59.2%).
T51	30718-30935	Epistemic_statement	denotes	The results of the present study demonstrate that the measurement of serum concentrations of daptomycin needs to be performed rapidly or the samples collected from patients should be stored in freezers until analysis.
T52	31052-31165	Epistemic_statement	denotes	The daptomycin elimination from living body and its pharmacokinetics may be affected by the instability in serum.
T53	31474-31624	Epistemic_statement	denotes	To ensure the optimal antibacterial efficacy and to avoid the potential toxicities, various dosing methods have been developed for non-obese patients.
T54	31625-31705	Epistemic_statement	denotes	However, the available information is scant when it comes to the obese patients.
T55	33295-33487	Epistemic_statement	denotes	Conclusion: Lower dose per kg was needed to achieve therapeutic range in obese patients which may imply the PK change of vancomycin clearance doesn't correlate linearly with total body weight.
T56	33488-33645	Epistemic_statement	denotes	Therefore, when empirically giving the guideline recommended initial dose of 30-45 mg/kg/day, lower daily dose per kg might be considered for obese patients.
T57	34192-34326	Epistemic_statement	denotes	Conclusion: Our study showed that drug reaction with eosinophilia and systemic symptoms (DRESS) syndrome is a severe and rare disease.
T58	34327-34382	Epistemic_statement	denotes	Clinically, It seems to be an autoimmune-like reaction.
T59	34383-34432	Epistemic_statement	denotes	Corticotherapy should not be systematically used.
T60	35265-35407	Epistemic_statement	denotes	However, there have been a few reports describing the effect of these antimicrobials and antifungals on human drugmetabolizing CYP activities.
T61	35711-36028	Epistemic_statement	denotes	Results: Inhibition of amoxicillin, ampicillin, and piperacillin at 0.5 or 1 mM concentration was not observed for CYP2C9, CYP2D6, CYP3A4 and CYP3A5, however, amoxicillin and piperacillin inhibited CYP2C8-mediated aminopyrine N-demethylation at 50% inhibitory concentration (IC 50 ) of 0.83 and 1.14 mM, respectively.
T62	36791-36963	Epistemic_statement	denotes	Conclusion: The interactions between these three penicillin-based antibiotics and other drugs that are metabolized by CYPs investigated would not be clinically significant.
T63	36964-37050	Epistemic_statement	denotes	Ketoconazole and miconazole might inhibit CYP2C8 in addition to other CYPs clinically.
T64	37797-37868	Epistemic_statement	denotes	A stepwise resistance selection will be conducted at 1×, 2× and 4× MIC.
T65	39698-39809	Epistemic_statement	denotes	And thus the interference of LPS assembly by a small molecule inhibitor would result in antibacterial activity.
T66	40493-40640	Epistemic_statement	denotes	Conclusion: Our novel chemical class of LpxC inhibitors provide the potential as new antibacterial agents for treatment of Gramnegative infections.
T67	43179-43389	Epistemic_statement	denotes	These mutations induce a complex gene regulation cascade leading to the synthesis and addition of the 4-amino-4-deoxy-L-arabinose (L-Ara4N) to lipid A of the membrane inducing therefore the colistin resistance.
T68	43390-43500	Epistemic_statement	denotes	However, in 2015, it has been described for the first time, a plasmid-mediated colistin resistance gene mcr-1.
T69	44299-44455	Epistemic_statement	denotes	These plasmids can be distinguished into three groups according to their sizes ranged from 6.36-Kb to 369.3-Kb and their %GC content ranged from 41% to 50%.
T70	45423-45508	Epistemic_statement	denotes	Campylobacter could be potential source of new phosphoethanolamine transferase genes.
T71	46177-46276	Epistemic_statement	denotes	Mechanisms of resistance to colistin are complex and misunderstood, particularly in these bacteria.
T72	46816-47048	Epistemic_statement	denotes	Among the group of mutated genes, we selected those that were already known to be putatively involved in antimicrobial peptide resistance and we realized a SIFT score to predict the probability mutation could alter protein function.
T73	47968-48253	Epistemic_statement	denotes	Transcriptomic analysis of genes belonging to arnBCADTEF operon showed significant decrease in mRNA expression level of tested genes in the susceptible strain, supporting that addition L-Ara4N in the outer membrane of lipid A moiety can explain the increase in colistin susceptibility.
T74	48625-48721	Epistemic_statement	denotes	However, it is certainly not the only one because lots of enigmas on colistin resistance remain.
T75	48722-48876	Epistemic_statement	denotes	Other genes that were absent in the susceptible strain could be linked to colistin resistance including a whole operon involved in sialic acid metabolism.
T76	49034-49191	Epistemic_statement	denotes	Bacterial defense system and antimicrobial peptides coexist for a long time, and mechanisms of resistance to colistin are complex and implied a lot of genes.
T77	50028-50113	Epistemic_statement	denotes	Previous studies have demonstrated that macrolides influence P. aeruginosa virulence.
T78	50114-50266	Epistemic_statement	denotes	However, most studies evaluated the regulatory effects of macrolides on P. aeruginosa virulence factors after treatment over a short period (<48 hours).
T79	51606-51779	Epistemic_statement	denotes	These findings exhibit that long-term, low-dose macrolide exposure may gradually reduce the pathogenicity of P. aeruginosa via timedependent inhibition of virulence factors.
T80	51780-51966	Epistemic_statement	denotes	We suggest that longterm, low-dose macrolide treatment for chronic airway infection should be administered for at least 2 months or more to achieve optimal effects against P. aeruginosa.
T81	51967-52066	Epistemic_statement	denotes	isolates is associated with carbapenem treatment of ESBL-and/or AmpC-producing bacterial infection.
T82	53284-53437	Epistemic_statement	denotes	Few isolates with normal PCR sizes of both genes demonstrated carbapenem resistance, suggesting involvement of other mehcanism for carbapenem resistance.
T83	53438-53593	Epistemic_statement	denotes	Conclusion: Both ESBL and non-ESBL producing isolates could develop carbapenem resistance associated with carbapenem types and ompK35 and ompK36 mutations.
T84	54014-54300	Epistemic_statement	denotes	The methodology for synthesizing, screening for both ribosomal binding/selectivity and bacterial growth inhibition, and rapid analysis of the data provides a systematic method for identification of bacterial ribosome specific antibacterials that can evade bacterial resistance pathways.
T85	56513-56669	Epistemic_statement	denotes	Patients with prior exposure to fluoroquinolones (FQs) were more likely than non-exposed patients to have moxifloxacin-resistant isolates (14/22, 63.6% v.s.
T86	56854-57031	Epistemic_statement	denotes	In recent years, multidrug-resistant K. pneumoniae (MDRKP) is rapidly increasing because of antibiotics overuse and it has been implicated in a variety of nosocomial infections.
T87	57032-57212	Epistemic_statement	denotes	MDRKP cause a problem in the clinical treatment of patients and some references demonstrate that antibody-immune response is essential for host defense against bacterial pathogens.
T88	57490-57787	Epistemic_statement	denotes	Methods: Fully Human Monoclonal Antibodies from Single Peripheral Blood B Cell Using K. pneumoniae (KP) as a sorting model, we established a platform technology that can obtain human mAbs against KP directly from each single human plasma or memory B cell by cloning the VH and VL variable regions.
T89	58744-58885	Epistemic_statement	denotes	In vitro opsonophagocytic assays demonstrate that twenty anti-KP antibodies can increase the antibody-mediated phagocytosis in K. pneumoniae.
T90	58886-59025	Epistemic_statement	denotes	Our results suggest that the selected antibodies can be potential lead drugs for further testing in a K. pneumoniae infection animal model.
T91	59026-59105	Epistemic_statement	denotes	The recombinant Abs might play a crucial role in treatment of MDR-KP infection.
T92	59373-59592	Epistemic_statement	denotes	The natural chemopreventive compounds isothiocyanates (ITCs) are widely found in cruciferous vegetables have been shown to possess cancer chemopreventive efficacy, antioxidative properties and immunomodulatory activity.
T93	59593-59719	Epistemic_statement	denotes	ITCs such as allyl isothiocyanate and benzyl isothiocyanate are revealed to be bactericidal through an unidentified mechanism.
T94	59720-59903	Epistemic_statement	denotes	Our previous study indicated that sulforaphane (4-methylsulfinybutyl isothiocyanate) significantly reduced the growth of Staphylococcus aureus, Escherichia coli and Vibrio vulnificus.
T95	59904-60008	Epistemic_statement	denotes	Though ITCs are effective in bacteria killing, the application of ITCs on MDR bacteria is still unknown.
T96	60621-60864	Epistemic_statement	denotes	BITC treatment also inhibited MDR E coli growth, this inhibition could be reversed by adding thiol reducing agents including N-acetyl cysteine (NAC), L-Glutathione (GSH), Dithiothreitol (DTT) and 2-mercaptoethanol (2-ME) to the culture medium.
T97	61022-61189	Epistemic_statement	denotes	Yet, differences in key properties have been noted between suppliers of antibiotics with the same denomination (INN), even if all approved by local health authorities.
T98	61767-61877	Epistemic_statement	denotes	Samples were prepared following manufacturer's recommendation and exposed to fixed temperatures for up to 8 h.
T99	61878-62120	Epistemic_statement	denotes	Results: A summary of key results is presented in the Table Product Mimicking administration by motor-activated pumps for extended or continuous administration in Intensive Care Units for severely-ill patients (drug dissolved in 0.9% NaCl);
T100	62121-62356	Epistemic_statement	denotes	Background: It is suggested that susceptibility results for cephalosporins be reported according to the minimum inhibitory concentration (MIC), regardless of whether or not the isolate produces an extended-spectrum β-lactamases (ESBL).
T101	62357-62471	Epistemic_statement	denotes	The revised breakpoint MIC defining susceptibility to cefotaxime (1 mg/L) might be a surrogate for ESBL detection.
T102	62472-62568	Epistemic_statement	denotes	Cefotaxime-resistant Enterobacteriaceae are challenging organisms with little treatment options.
T103	62569-62764	Epistemic_statement	denotes	Carbapenems such as imipenem, ertapenem or meropenem are frequently used, but the emergence of carbapenem resistant Enterobacteriaceae is a concern issue, which may hinder the use of carbapenems.
T104	62765-62872	Epistemic_statement	denotes	Although, cephamycins such flomoxef are effective against cefotaxime-resistant Enterobacteriaceae in vitro,
T105	62873-62986	Epistemic_statement	denotes	there are a few clinical data demonstrating effect against bloodstream infection (BSI) caused by these organisms.
T106	63582-63998	Epistemic_statement	denotes	After adjustments in the multivariate model, patients with severe sepsis (adjusted OR = 3.84, 95% CI = 1.16-12.78, P = 0.03), high BSI mortality score (adjusted OR = 5.59, 95% CI = 2.37-13.21, P < 0.01), ultimately or rapid fatal co-morbidity (adjusted OR = 10.60, 95% CI = 3.43-32.75, P < 0.01) and pneumonia (adjusted OR = 10.11, 95% CI = 3.43-29.81, P < 0.01) were independently associated with 28-days mortality.
T107	64343-64465	Epistemic_statement	denotes	However, the length of hospitalization stay was shorter in the ertapenem group (10.2 ± 8.5 vs. 14.6 ± 9.4 days, P < 0.01).
T108	64466-64692	Epistemic_statement	denotes	Conclusion: Ertapenem therapy is associated with shorter time of hospitalization than flomoxef therapy following flomoxef-susceptibile, cefotaxime-resistant Enterobacteriaceae BSI in adult patients with both guarded prognosis.
T109	65094-65288	Epistemic_statement	denotes	However, the Kaplan-Meier curve for 30-days mortality reveled patients in initial high maintenance teicoplanin dosage group had better survival than those in initial daptomycin group (p = 0.02).
T110	65792-66089	Epistemic_statement	denotes	Exclusion criteria: Patients excluded if medical records incomplete, receiving dialysis, had history of chronic kidney disease (CKD) (Stage IV or higher) or recent history of acute kidney injury (defined as increase in sCr of 0.5 mg/dL or greater or increase of sCr of 1mg/ dL or greater for CKD).
T111	66583-66712	Epistemic_statement	denotes	Secondary endpoint was association of nephrotoxicity with potential confounding factors that may increase risk of nephrotoxicity.
T112	67591-67917	Epistemic_statement	denotes	Abstracts of the 30th ICC 2017 / International Journal of Antimicrobial Agents 50 S2 (2017) S69-S278 S86 Background: Tissue stroma is known to be important in regulating Hp-mediated inflammation, but the molecular basis of its interaction with Hp and its potential crosstalk with dendritic cells (DCs) remain to be determined.
T113	67918-68045	Epistemic_statement	denotes	To this end, the potential crosstalk between H. pylori (Hp) infected gastric stromal cells (Hp-GSCs) and DCs were investigated.
T114	68708-68965	Epistemic_statement	denotes	Further, PGE 2 from Hp-GSCs was discovered to possess the priming effect, which could be inhibited, by anti-COLEC12 (Collectin subfamily member 12) blocking Abs, COLEC12 knockdown or when alpha3-fucosyltransferase-null ( futB; HP0651) strain of Hp was used.
T115	69063-69215	Epistemic_statement	denotes	Furthermore, Hp-GSCs-conditioned DCs were able to induce the expression of IL-17 from CD4 + T cells, which could be inhibited by IL-23-neutralizing Abs.
T116	69216-69378	Epistemic_statement	denotes	Conclusion: These results suggested the importance of COLEC12 as a receptor involved in Hp-stromal cell interaction and its subsequent conditioning effect on DCs.
T117	70559-70641	Epistemic_statement	denotes	Further research was carried out in appropriate medium in 200L batch fermentation.
T118	70730-70874	Epistemic_statement	denotes	The exo-1, 4-β-D glucanase secreted by recombinant E. coli represents an appealing potential for both research and textile industry application.
T119	71613-71816	Epistemic_statement	denotes	Although it was generally recognized that the molecular chaperone DnaK system is highly conserved within the Three Domains of life, investigation on the molecular chaperone system in Archaea are limited.
T120	72704-72940	Epistemic_statement	denotes	Results: The ATPase kinetic assay revealed that substrate ATP hydrolytic velocity in phospho-mimic type MpDnaK was similar with the wild-type which suggested that the phosphorylation on Ser518 did not affect the ATP hydrolytic activity.
T121	72941-73164	Epistemic_statement	denotes	Further structure modeling analysis revealed the phosphorylated Ser518 is located in the lid domain of MpDnaK which relate to the open/close of the substrate binding pocket and initiate/terminate the disaggregation process.
T122	73394-73521	Epistemic_statement	denotes	The shorter distance may contribute more stable conformation for lid closing and promote more efficient disaggregation process.
T123	73522-73664	Epistemic_statement	denotes	This analytical result suggest that post-translational phosphorylation may involve the regulation of the substrate binding and disaggregation.
T124	73665-73917	Epistemic_statement	denotes	Conclusion: The phosphorylation on Ser518 did not affect the ATP hydrolytic activity of MpDnaK, whereas the PTM-phosphorylation on lid domain-Ser518 promote the lid-substrate binding pocket interaction, which may further enhance the refolding activity.
T125	74579-74643	Epistemic_statement	denotes	Therapeutic prospect of UPS inhibitor is promising and valuable.
T126	76109-76267	Epistemic_statement	denotes	Taiwan area is small, so little arable land can be used, if the land is subjected to heavy metal pollution and water irrigation, have accumulated in the soil.
T127	77231-77303	Epistemic_statement	denotes	The ion in the mixed solution, zinc ions can be degraded by this strain.
T128	77304-77755	Epistemic_statement	denotes	Experiment that starch medium than in sawdust medium, can provide more nutrients, prompting the white rot fungi to produce catalase, may be because in adversity, this strain can secrete more peroxide dismutase to help themselves to resist adversity and sawdust medium, Although the activity of SOD in sawdust medium was low, the degradation rate was better, and it could buffer the pH value of polar acid, and stable and sustained supply of nutrients.
T129	78052-78223	Epistemic_statement	denotes	We recently reported that CDT can overcome the radioresistance of prostate cancer (PCa) cells by intervening in the repair of radiation-induced double-strand breaks (DSB).
T130	78224-78349	Epistemic_statement	denotes	However, the detailed mechanisms underlying the effects of CDT on radioresistance in PCa cells require further investigation.
T131	78866-79124	Epistemic_statement	denotes	We further showed that CDT prevents the formation of autophagosomes via decreased high-mobility group box 1 (HMGB1) expression and the inhibition of acidic vesicular organelle (AVO) formation, which are associated with enhanced radiosensitivity in PCa cells.
T132	79878-79987	Epistemic_statement	denotes	The ability of bacterial adherence to biotic or abiotic substrate is an essential step for biofilm formation.
T133	79988-80102	Epistemic_statement	denotes	Such adherence can be mediated by bacterial fimbriae, which are also important virulence factors in many bacteria.
T134	80103-80204	Epistemic_statement	denotes	In enterobacteria, cyclic AMP (cAMP) receptor protein (CRP) plays a vital role as a global regulator.
T135	80634-80764	Epistemic_statement	denotes	Results & Conclusion: Our preliminary data indicated that the gene KPN_00353 encoding EIIA homolog up-regulates biofilm formation.
T136	80765-80852	Epistemic_statement	denotes	Thus, our purpose is to clarify how the CRP-cAMP complex mediate the biofilm formation.
T137	81369-81430	Epistemic_statement	denotes	Then, we will examine the importance of CRP in K. pneumoniae.
T138	82295-82347	Epistemic_statement	denotes	The regulation of P. mirabilis T6SS remains unclear.
T139	82691-82794	Epistemic_statement	denotes	We investigated whether Crp can bind directly to T6SS promoter region using a DNaseI footprinting assy.
T140	83089-83170	Epistemic_statement	denotes	We also purified the possible toxin to assess its function in killing of E. coli.
T141	83722-83847	Epistemic_statement	denotes	T6SS contributed to growth predominance over crp mutant and E. coli, suggesting P. mirabilis T6SS as an antibacterial weapon.
T142	84059-84213	Epistemic_statement	denotes	Background: The antimicrobial peptide, epinecidin-1 (Epi), was identified from Epinephelus coioides and may have clinical application for treating sepsis.
T143	84214-84460	Epistemic_statement	denotes	Epi has been shown to ameliorate antibiotic-resistant bacteria-induced sepsis in mice, but further evaluation in mixed-flora models and a description of the protective mechanisms are essential to establish this peptide as a potential therapeutic.
T144	85591-85719	Epistemic_statement	denotes	Conclusion: Overall, our results demonstrate that Epi is a promising therapeutic agent for endotoxemia and polymicrobial sepsis.
T145	87943-88014	Epistemic_statement	denotes	Thirty-five adverse events were judged as related to study medications.
T146	88117-88268	Epistemic_statement	denotes	Conclusion: This study indicated that the combination of cefoperazone/sulbactam was not inferior to cefepime when used to treat patients with HAP/HCAP.
T147	89152-89253	Epistemic_statement	denotes	However, there have been only a few reports about the influence on risk and prognosis factors of IPD.
T148	90210-90466	Epistemic_statement	denotes	In the multivariate analysis, several independent risk factors of IPD, including malignant tumors [odds ratio (OR), 19.60; 95% confidence interval (CI), 4.58-84.04; p = 0.0001], and initial qSOFA (OR, 19.90; 95% CI, ; p = 0.0009), were associated with IPD.
T149	90597-90673	Epistemic_statement	denotes	Conclusion: High initial qSOFA could be a risk and prognostic factor of IPD.
T150	90674-90812	Epistemic_statement	denotes	We might suspect IPD earlier by using qSOFA and lead to the improvement of prognosis, because qSOFA was extremely easy scoring on bedside.
T151	90813-90913	Epistemic_statement	denotes	Background: Anaerobes are rare causes of spinal infections and constitute less than 4% of all cases.
T152	92263-92484	Epistemic_statement	denotes	Conclusion: In summary, P. micra spinal infection should be considered in patients with a medical history of dental problem or work acccompanied with an insidious onset of back/neck pain and elevated inflammation markers.
T153	92652-92734	Epistemic_statement	denotes	Department of Intensive Care Medicine, Chi-Mei Medical Center, Tainan City, Taiwan
T154	92735-92848	Epistemic_statement	denotes	Background: Invasive pulmonary aspergillosis (IPA) in severe complicated influenza A has been reported in Taiwan.
T155	94071-94104	Epistemic_statement	denotes	However, spiking fever was noted.
T156	94428-94509	Epistemic_statement	denotes	Conclusion: IPA may complicate influenza pneumonia in a previously healthy adult.
T157	94760-94843	Epistemic_statement	denotes	Antibiotics for bacterial co-infection and antifungal therapy should be considered.
T158	94844-94943	Epistemic_statement	denotes	Finally, corticosteroids in patients with influenza may pose a risk for invasive fungal infections.
T159	95394-95461	Epistemic_statement	denotes	Hematemesis can occur in CMV esophagitis, gastritis and duodenitis.
T160	96403-96531	Epistemic_statement	denotes	However, bloody stool persisted, repeated colonoscopy showed the same lesions and diluted bosmin was injected with hemoclipping.
T161	97567-97639	Epistemic_statement	denotes	CMV colitis in patients with plasmacytoma is quite rare but challenging.
T162	97763-97910	Epistemic_statement	denotes	Although ganciclovir resulted in symtomatic improvement of blood stool, but hallow organ perforation developed, suggesting colon ulcer perforation.
T163	97911-97959	Epistemic_statement	denotes	Concurrent Aspergillus pneumonia was unexpected.
T164	98096-98240	Epistemic_statement	denotes	Department of Intensive Care Medicine, Chi Mei Medical Center, Tainan, Taiwan; Department of Medicine, Taipei Medical University, Taipei, Taiwan
T165	98241-98410	Epistemic_statement	denotes	Background: Aspergillus-associated infection might comprise up to 23-29% of severe influenza patients from the community throughout stay in an intensive care unit (ICU).
T166	98411-98493	Epistemic_statement	denotes	In Taiwan, cases of severe influenza with aspergillosis are increasingly reported.
T167	99277-99389	Epistemic_statement	denotes	A chest computed tomography (CT) without contrast showed a right lower lung consolidation, suggesting pneumonia.
T168	99468-99570	Epistemic_statement	denotes	Results: Despite promptly starting antibiotics, intermittent fevers and progressive dyspnea persisted.
T169	99571-99641	Epistemic_statement	denotes	Blood culture grew anaerobes in preliminary reports on hospital day 3.
T170	99694-99856	Epistemic_statement	denotes	However, his dyspnea and fevers did not resolve after switching to imipenem, and a follow-up CT scan on the hospital day 5 showed a worsening bilateral pneumonia.
T171	99921-100090	Epistemic_statement	denotes	An ambulatory ultrasonography examination of the persistently painful right neck revealed an intravascular mass in right internal jugular vein, suggestive of thrombosis.
T172	100875-101010	Epistemic_statement	denotes	In a young patient with acute pharyngitis accompanied with signs of septic embolization, Lemierre syndrome should always be considered.
T173	101011-101211	Epistemic_statement	denotes	Background: Mycoplasma hominis, a well known cause of neonatal infection, has been reported as a pathogen in urogenital infections in adults; however, central nervous system (CNS) infections are rare.
T174	101212-101361	Epistemic_statement	denotes	We report here the first case of M. hominis meningitis in China, post neurosurgical treatment for an intracerebral haemorrhage in a 79-year-old male.
T175	101362-101684	Epistemic_statement	denotes	Case presentation: We describe a 79-year-old who developed M. hominis meningitis after neurosurgical treatment and was successfully treated with combined azithromycin and minocycline therapy of two weeks' duration, despite delayed treatment because the Gram stain of cerebrospinal fluid (CSF) yielded no visible organisms.
T176	102148-102408	Epistemic_statement	denotes	Conclusion: Both our patient findings and the literature review, highlighted the pathogenic potential of M. hominis together with the challenges prompted by rare infectious diseases in particular for developing countries labs with limited diagnostic resources.
T177	102514-102613	Epistemic_statement	denotes	Background: Fungi of the order Mucorales are ubiquitous in nature but rarely cause human infection.
T178	102614-102741	Epistemic_statement	denotes	However, because of the rising amount of immunocompromised patients, the incidence of invasive fungal infection also increased.
T179	102825-102915	Epistemic_statement	denotes	Here we report the first case in Taiwan and review the literature of the previous reports.
T180	103302-103383	Epistemic_statement	denotes	Broad-spectrum antibiotic was initiated but the clinical improvement was limited.
T181	104215-104296	Epistemic_statement	denotes	And the number of previously rarely, opportunistic infection will rise with time.
T182	104297-104504	Epistemic_statement	denotes	Obtain the adequate sample and make the right diagnosis will reverse the potentially life-threatening infection of the patients and is of paramount importance to achieve long-term survival in these patients.
T183	106436-106610	Epistemic_statement	denotes	Suggest clinicians evaluate the necessity of posaconazole prevention for AML patients with induction chemotherapy according to disease severity or the risk rate of infection.
T184	106720-106785	Epistemic_statement	denotes	Therefore, we need more cases to evaluate the long-term efficacy.
T185	108296-108420	Epistemic_statement	denotes	CMV infection did not directly affected graft survival rate, but if immunocompromised patients can be due to patient expire.
T186	108421-108515	Epistemic_statement	denotes	CMV infection with renal transplant recipients should be closely monitor and active treatment.
T187	109101-109178	Epistemic_statement	denotes	The epidemiology of pneumocystis colonization among such patients is unknown.
T188	109179-109347	Epistemic_statement	denotes	The aim of this study was to estimate the incidence of Pneumocystis colonization and risk factors of Pneumocystis pneumonia among newly diagnosed HIV-infected patients.
T189	110000-110337	Epistemic_statement	denotes	Pneumocystis colonization was associated with a lower CD4 count (median [IQR]: 144 (42-308) cells/mm 3 vs. 320 (169-492) cells/mm 3 ; P = 0.007), a higher HIV plasma viral load (1.97 × 10 5 [1.02 × 10 5 -4.24 × 10 5 ] vs. 3.59 × 10 4 (1.28 × 10 4 -7.89 × 10 4 ) HIV RNA copies/mL; P < 0.001), and receipt of steroid treatment (P = 0.03).
T190	110484-110653	Epistemic_statement	denotes	By the Kaplan-Meier analysis, the cases of Pneumocystis colonization were associated with a higher risk of PJP than those without colonization (Log-rank test, P = 0.04).
T191	110654-110795	Epistemic_statement	denotes	Conclusion: Pneumocystis colonization is not uncommon in newly diagnosed HIV-infected patients and associated with an increasing risk of PJP.
T192	112081-112199	Epistemic_statement	denotes	Clinical data will be obtained from a standardized medical chart abstraction by use of uniform data abstraction forms.
T193	112849-112998	Epistemic_statement	denotes	Conclusion: The diabetic was risk factor associated with asymptomatic bacteriuria and developing UTIs among participants with chronic kidney disease.
T194	114352-114545	Epistemic_statement	denotes	However, acute hepatitis (S-GOT, 1377 U/L and S-GPT, 1696 U/L), elevated bilirubin (total, 7.77 mg/dL and direct, 5.85 mg/dL) and severe coagulopathy ( prothrombin time, 31.6 seconds) occurred.
T195	114953-115033	Epistemic_statement	denotes	However, worsening water diarrhea relapsed and episodes of hypotension occurred.
T196	115548-115605	Epistemic_statement	denotes	Blood and stool CMV-PCR might help presumptive diagnosis.
T197	115606-115722	Epistemic_statement	denotes	However, the possibility of CMV colitis alone, following or coexisting with amebic colitis was difficult to discern.
T198	115723-115842	Epistemic_statement	denotes	CMV activity might be enhanced by steroids, which therapy should be careful in HIV patients even without low CD4 count.
T199	116113-116206	Epistemic_statement	denotes	Background: Mycobacterium abscessus is extremely difficult to treat and considered incurable.
T200	117568-117664	Epistemic_statement	denotes	The patient could not tolerate ciprofloxacin, which was changed to levofloxacin and doxycycline.
T201	118468-118586	Epistemic_statement	denotes	Conclusion: Patients of M abscessus lung disease could have coexisting or previous history of MAC pulmonary infection.
T202	118587-118714	Epistemic_statement	denotes	Anti-IFN-γ autoantibodies may play a role in mycobacterial infections, particularly in persons without predisposing conditions.
T203	118715-118954	Epistemic_statement	denotes	Patients with M. abscessus pulmonary disease should be treated with multidrug anti-mycobacterial therapy based on susceptibility test results whenever available, and surgical resection may offer a more favorable response in selected cases.
T204	119359-119476	Epistemic_statement	denotes	It is associated with a wide spectrum of clinical manifestations in both immunocompetent and immunocompromised hosts.
T205	120432-120538	Epistemic_statement	denotes	He was started on azithromycin, rifabutin and ethambutol for possible MAC, although HIV test was negative.
T206	120750-120853	Epistemic_statement	denotes	He remained febrile, and anti-NTM treatment was switched to tigecycline and meropenem for possible RGM.
T207	121716-121847	Epistemic_statement	denotes	Conclusion: M. mucogenicum is often of no clinical significance, but it can cause systemic illness even in an immunocompetent host.
T208	121848-121961	Epistemic_statement	denotes	The basis of combination antimicrobial therapy should be based on susceptibility test results whenever available.
T209	121962-122005	Epistemic_statement	denotes	The optimal duration of therapy is unknown.
T210	122438-122545	Epistemic_statement	denotes	In many cases, the prevalence of the concomitant hepatopathy is higher when associated with SLE than alone.
T211	122546-122667	Epistemic_statement	denotes	Use of these drugs in patients with previous HBV infection can result in severe liver damage if the virus is reactivated.
T212	122979-123041	Epistemic_statement	denotes	Baraclude was started, however bloody stools passage occurred.
T213	124187-124267	Epistemic_statement	denotes	Brain image could not be performed due to unstable oxygenation and hemodynamics.
T214	124379-124542	Epistemic_statement	denotes	Conculsion: Liver dysfunction in the presence of SLE can be caused by many factors, but when at the time of SLE onset, either SLE itself or drugs can be the cause.
T215	124543-124649	Epistemic_statement	denotes	The features of liver dysfunction and its causes need to be elucidated and considered before treating SLE.
T216	124846-125384	Epistemic_statement	denotes	1 Division of Infectious Diseases, 2 Division of Rheumatology and Immunology, 3 Division of Chest Medicine, 4 Department of Internal Medicine, 5 Department of Intensive Care Medicine, and 6 Department of Laboratory Medicine, Buddhist Tzu Chi General Hospital, Hualien, Taiwan Background: Eosinophilic granulomatosis with polyangiitis (EGPA; also known as Churg-Strauss syndrome) usually presents as recurrent asthma that cannot be controlled without systemic steroids, which, unfortunately, increases the risk of opportunistic infections.
T217	127638-127807	Epistemic_statement	denotes	Conclusions: Opportunistic infections should be considered when fever with abnormal procalcitonin and CRP levels persists despite that EGPA was grossly under controlled.
T218	127808-127876	Epistemic_statement	denotes	Cardiac involvement may lead to life-threatening arrhythmia in EGPA.
T219	127877-128217	Epistemic_statement	denotes	Background: Cytomegalovirus (CMV) infection is increasingly recognized in critically ill immunocompetent patients because of previous studies demonstrated an association between CMV disease and increased mortality rates, prolonged intensive care unit and hospital length of stay, prolonged mechanical ventilation, and nosocomial infections.
T220	128218-128394	Epistemic_statement	denotes	Molecular assays are now considered to be the "gold standard" for assessment of human CMV infection and disease in those at risk from severe associated clinical manifestations.
T221	128395-128546	Epistemic_statement	denotes	The nucleic acid sequence-based amplification assay, CMV pp67 late Gene transcripts (CMVpp67) is suggested by published reports for reliable prognosis.
T222	128857-129088	Epistemic_statement	denotes	Results: Under the univariate analysis, patients with positive CMV pp67 are associated with higher proportion of sepsis (56.2:83.3%, p = 0.036), longer ICU lengths of stay ( p = 0.004), and longer hospitalization days ( p = 0.002).
T223	129089-129248	Epistemic_statement	denotes	However, after considering all the variables in the multivariate analysis, there were no statistical significances among all the variables and CMV pp67 status.
T224	129249-129373	Epistemic_statement	denotes	In addition, we also found that CMV pp67 status was not associated with the mortality rate (OR = 0.07, 95%CI = <0.001-9.09).
T225	129374-129693	Epistemic_statement	denotes	But those who died were associated with more different antibiotics use (OR = 2.3, 95%CI = 1.05-5.05), higher percentage of vasopressor use (OR = 206.5, 95%CI = 5.52->999.99), higher prevalence of end stage renal disease (OR = 195.1, 95%CI = 2.27->999.99) but shorter hospitalization days (OR = 0.96, 95%CI = 0.93-1.00).
T226	129694-129962	Epistemic_statement	denotes	Conclusion: In conclusion, in our cross sectional study, within critically ill patients, there were no correlation of positive CMV pp67 with the characteristics we assumed to be; therefore, we couldn't tell if there is any parameter with higher positive CMV pp67 rate.
T227	130035-130190	Epistemic_statement	denotes	Owing to controversial results compared to previous studies, further larger sample size studies are necessary to develop more accurate correlation results.
T228	130191-130490	Epistemic_statement	denotes	Background: The establishment of bacterial species identification through gene sequencing triggered an increase in the reported cases of non-tuberculous mycobacterial infection caused by new bacterial species, which prompted the urgent need for the establishment of diagnosis and treatment regimens.
T229	130627-130810	Epistemic_statement	denotes	Granular patterns were observed dominantly in the rightlung, along with bronchodilation and partial cavitary lesion, which led to the suggested diagnosis of pulmonary mycobacteriosis.
T230	132308-132418	Epistemic_statement	denotes	There are reports of chemotherapies using CAM/RFP/EB and INH/RFP/EB, suggesting the treatments' effectiveness.
T231	132419-132651	Epistemic_statement	denotes	A probable case of Mycobacterium gordonae infection presenting as cervical lymphadenopathy and fever of unknown origin Sy-harn Lian 1 , Lih-shinn Wang 1,2 , Jen-jyh Lee 1,3 , Ying-huei Chen 4 , Huei-jen Chao 4 , Chia-jung Chiang 5 .
T232	134235-134527	Epistemic_statement	denotes	The survey of Streptococcus A, Cryptococcus, M. pneumoniae, syphilis, HIV, CMV and HSV, revealed unremarkable results, and no infectious sources were identified despite the investigations by the dermatologist, gynecologist, otolaryngologist, dentist and gallium-67-labeled leukocyte scanning.
T233	135225-135375	Epistemic_statement	denotes	However, the patient became afebrile with rifampicin, ethambutol and isoniazid treatment, and the cervical lymphadenopathy resolved a few weeks later.
T234	135376-135530	Epistemic_statement	denotes	All the associated symptoms were gone and the patient cured without relapse with a total of 11months of the anti-NTM treatment and 12 months of follow-up.
T235	135531-135621	Epistemic_statement	denotes	Conclusion: The most effective treatment regimen for M. gordonae has not been established.
T236	135622-135727	Epistemic_statement	denotes	However, the clinical response to specific antimycobacterial therapy indicates possible disease presence.
T237	135728-135777	Epistemic_statement	denotes	The recommended duration of therapy is not known.
T238	135963-136035	Epistemic_statement	denotes	Department of Laboratory Medicine, St. Martin De Porres Hospital, Taiwan
T239	136036-136261	Epistemic_statement	denotes	Background: The GeneXpert test is a new automated molecular test which detects the DNA in Mycobacterium Tuberculosis (MTB), as well as testing for the genetic mutations associated with resistance to the drug Rifampicin (RIF).
T240	136460-136613	Epistemic_statement	denotes	WHO recommended that the test should be used as the initial diagnosis test in individuals suspected of having Multi-Drug Resistant Tuberculosis (MDR TB).
T241	140124-140256	Epistemic_statement	denotes	However, due to persistant poor healing wound, antibiotics was adjusted to rifabutin, ciprofloxacin, clarithromycin and doxycycline.
T242	140831-141060	Epistemic_statement	denotes	Conclusion: In immunocompromised host with ulcerating skin lesion, M. haemophilum infection should be taken into consideration, especially when AFB is seen by direct microscopy while routine mycobacterial cultures remain sterile.
T243	141592-141753	Epistemic_statement	denotes	We have determined that 18 (24.0%) isolates were determined to have a unique pattern and 57 (76.0%) were clustered pattern strains (classifying into 6 clusters).
T244	143072-143168	Epistemic_statement	denotes	Diagnosis may be delayed in this group of patients as they often present with atypical symptoms.
T245	144072-144166	Epistemic_statement	denotes	Of concern, a large majority of patients with pulmonary TB were smear negative (39 out of 60).
T246	145506-145629	Epistemic_statement	denotes	Efforts to decrease active TB rates in this group of immunocompromised patients can reduce patient morbidity and mortality.
T247	146241-146364	Epistemic_statement	denotes	This study aims to clarify the relationship between serum ferritin levels and the development of severe dengue in children.
T248	148644-148826	Epistemic_statement	denotes	Conclusion: KFD should be suspected in children with febrile cervical lymphadenopathy, especially when concomitant with leukopenia, monocytosis and past Epstein-Barr virus infection.
T249	148954-149033	Epistemic_statement	denotes	Our results suggest EBV may not have causative role in the pathogenesis of KFD.
T250	149619-149808	Epistemic_statement	denotes	The aim of this study is to study the epidemiology of RSV and non-RSV acute bronchiolitis and the effectiveness of Palivizumab, a monoclonal antibody produced by recombinant DNA technology.
T251	150881-151054	Epistemic_statement	denotes	Fever of unknown origin as the first manifestation of malignancies in Albanian adults Migena Qato, Najada Como, Arjan Harxhi, Pellumb Pipero, Iris Koshovari, Dhimiter Kraja.
T252	153085-153186	Epistemic_statement	denotes	Conclusion: We identified 17 types of febrile tumors, with fever as the first clinical manifestation.
T253	153789-153853	Epistemic_statement	denotes	Faculty of Medicine, University Hospital Center "Mother Theresa"
T254	153854-153975	Epistemic_statement	denotes	Background: Patients of hemodialysis actually represent a target group closely related to infection by hepatitis C virus.
T255	155576-155689	Epistemic_statement	denotes	Conclusion: HCV infection in hemodyalisis patients remains the major cause of chronic liver and its complication.
T256	155690-155936	Epistemic_statement	denotes	Each of our patients evidenced a mild clinical form of hepatitisprobably related to immunocompromised status and HD procedure and the adverse effects of peginterferon therapy appeared minimal compared to the efficacy of treatment in our patients.
T257	155937-156021	Epistemic_statement	denotes	Nevertheless, at the end, the HCV infection negatively impacts survival on dialysis.
T258	156204-156424	Epistemic_statement	denotes	1 Division of Infectious Diseases, Department of ascertain whether the clinical presentation and outcome for patients with this disease differ for those infected with a gramnegative as compared to gram-positive pathogen.
T259	157809-157882	Epistemic_statement	denotes	However, VZV-caused pneumonia is quite rare comparing to the skin lesion.
T260	158675-158862	Epistemic_statement	denotes	Although pulmonary involvement of VZV is uncommon, we should be kept in mind in order to prevent patient from severe VZV pneumonia causing disaster which often require ventilator support.
T261	158863-159261	Epistemic_statement	denotes	The Background: Diclofenac, one of non-steroidal anti-inflammatory drugs (NSAIDs), was reported to be associated with the alleviation in the severity of Clostridium difficile infection (CDI), due to its inhibitory effect on phospholipase A2 and cyclooxygenase-2 (Cox-2), which play important roles in disruption of epithelial integrity and gut inflammatory response induced by C. difficile toxin A.
T262	159262-159338	Epistemic_statement	denotes	The aim of this study is to investigate the impact of NSAID exposure on CDI.
T263	160241-160460	Epistemic_statement	denotes	Besides, treatment with diclofenac at either dose can decrease the bacterial burden of C. difficile in the cecum and stool, and also reverse the ratio of Firmicutes to Bacteroidetes in the microbiota of cecum and stool.
T264	161140-161202	Epistemic_statement	denotes	However, dizziness and ataxia developed about one month later.
T265	161602-161712	Epistemic_statement	denotes	Discussion: Our problem was how to avoid metronidazole related encephalopathy when re-challenge metronidazole.
T266	161835-161870	Epistemic_statement	denotes	We thought suppository form (supp.)
T267	162054-162150	Epistemic_statement	denotes	Hepatic first-pass elimination of metronidazole may partially avoid after rectal administration.
T268	162536-162634	Epistemic_statement	denotes	And we also need to consider site of infection, severity of infection and bioavailability of drug.
T269	163123-163333	Epistemic_statement	denotes	Salmonella osteomyelitis is an uncommon extraintestinal manifestation and especially rare in patients without predisposing factors such as sickle cell disease, systemic lupus erythematosus or immunocompromised.
T270	164316-164394	Epistemic_statement	denotes	Conclusion: Salmonella osteomyelitis is rarely seen in immunocompetent adults.
T271	164655-164751	Epistemic_statement	denotes	Further studies are needed to investigate this approach in patients of salmonella osteomyelitis.
T272	166207-166385	Epistemic_statement	denotes	In addition, the IAI Enterobacteriaceae isolates harboring the bla CMY-2 and bla DHA-1 alleles were associated with high community-acquired rates (38.0% and 42.6%, respectively).
T273	167202-167332	Epistemic_statement	denotes	Brugada syndrome had been widely discussed but the prevalence has not been well studied, and the risk factors are still in debate.
T274	167774-167974	Epistemic_statement	denotes	Two days before the admission, he had a new onset of intermittent retrosternal pain which was not aggravated by exertion or relieved at rest, and could be radiated to upper back and last 5-10 minutes.
T275	169176-169336	Epistemic_statement	denotes	Conclusion: Brugada electrocardiographic changes has not yet been associated with Influenza in current medicine, only two case reports were found on the Pubmed.
T276	169337-169536	Epistemic_statement	denotes	However, this time we had genetic with clinical evidence shows that Infuenza A may had related to induce Brugada syndrome, which gives more information in study groups for Brugada syndrome in Taiwan.
T277	169694-169949	Epistemic_statement	denotes	Infectious Diseases Departament UHC "Mother Theresa" Tirane Introduction: Affect of visceral organs during herpes zoster is rare phenomena, althought very important because can occur diagnostic and therapeutic errors, exacerbated the progress of diseases.
T278	170060-170240	Epistemic_statement	denotes	He presents vesicular eruption in the sacral region including 4 dermatomes, associated with urinary retension and combustion, preceded by pain of lower limbs started a week before.
T279	171727-171858	Epistemic_statement	denotes	Patients with history of wild animals contacts should be considered as having an infection caused by an uncommon zoonotic pathogen.
T280	172698-172894	Epistemic_statement	denotes	He was diagnosed of upper gastrointestinal (GI) bleeding and a systemic infection with unknown source, and was given PRBC and platelet transfusion, pantoprazole, tranexamic acid, and terlipressin.
T281	173127-173218	Epistemic_statement	denotes	Because of previous S. equinus bacteremia, the patient might have a unique contact history.
T282	174343-174547	Epistemic_statement	denotes	1 School of Medicine, Tzu Chi University, Hualien, Taiwan, 2 Division of Infectious Diseases, Department of Internal Medicine, 3 Department of Radiology, Buddhist Tzu Chi General Hospital, Hualien, Taiwan
T283	174548-174651	Epistemic_statement	denotes	Background: Primary sternal osteomyelitis (PSO) is rare, yet potentially carries a devastating outcome.
T284	174652-174791	Epistemic_statement	denotes	It is generally caused by Staphylococcus aureus, but can be caused by S. epidermidis, gramnegative bacilli, and Mycobacterium tuberculosis.
T285	174792-174899	Epistemic_statement	denotes	Clinicians need to consider PSO when a patient presents with anterior chest pain, swelling, and bacteremia.
T286	175571-175640	Epistemic_statement	denotes	Liver abscess was considered as a possible source, but not confirmed.
T287	176423-176469	Epistemic_statement	denotes	However, the infection wasn't well controlled.
T288	176532-176615	Epistemic_statement	denotes	Conclusion: Due to rare clinical experiences, we have no standard approach for PSO.
T289	176616-176700	Epistemic_statement	denotes	However, the presentation of PSO is insidious, and a diagnosis can often be delayed.
T290	176701-176783	Epistemic_statement	denotes	PSO should be borne in mind when a patient presents with an anterior wall abscess.
T291	176923-177109	Epistemic_statement	denotes	Background: Purpura fulminans is a rare syndrome of intravascular thrombosis and hemorrhagic infarction accompanied by vascular collapse and disseminated intravascular coagulation (DIC).
T292	177110-177193	Epistemic_statement	denotes	It is typically associated with meningococcal infection and is rapidly progressive.
T293	178811-178897	Epistemic_statement	denotes	Amputation of the hands was also suggested, but the family refused further management.
T294	178973-179097	Epistemic_statement	denotes	Conclusion: Purpura fulminans is rare and most commonly occurs in babies and small children, but can be more rare in adults.
T295	179745-179808	Epistemic_statement	denotes	Cough, abdominal fullness and body weight loss were associated.
T296	180780-180989	Epistemic_statement	denotes	He was extubation successfully and discharge on the 42th day of hospitalization Conclusion: Histoplasmosis is a rare disease in Taiwan, and few microbiologically documented cases have been previously reported.
T297	180990-181139	Epistemic_statement	denotes	It is commonly diagnosed in areas of endemicity but frequently overlooked in areas of nonendemicity due to a low index of suspicion among physicians.
T298	181140-181322	Epistemic_statement	denotes	In HIV-infected patient who present with thrombocytopenia, hemophagocytotic syndrome and cavitary pulmonary lesion, a differential diagnosis of histoplasmosis should be kept in mind.
T299	181701-181911	Epistemic_statement	denotes	Despite use of variety of diagnostic techniques, however, SAE remains a clinical diagnosis and could represent a variety of pathophysiological processes that are both related and unrelated to coexistent sepsis.
T300	182629-182704	Epistemic_statement	denotes	These findings indicated SAE, which is associated with extracranial sepsis.
T301	182705-182775	Epistemic_statement	denotes	The pathophysiology is thought to involve blood-brain-barrier leakage.
T302	182978-183118	Epistemic_statement	denotes	The diffuse and severe white matter abnormalities like those we observed in our patient are rare and have been associated with poor outcome.
T303	183119-183230	Epistemic_statement	denotes	This case shows that severe encephalopathy with extensive white matter lesions might be a reversible condition.
T304	183231-183360	Epistemic_statement	denotes	Clinicians should realize that this condition and give cautious eyes to the first signs of improvement of the clinical condition.
T305	183609-183699	Epistemic_statement	denotes	Department of Laboratory Medicine, Taipei Hospital, Ministry of Health and Welfare, Taiwan
T306	183700-183845	Epistemic_statement	denotes	Background: Clostridium difficile (CD) is a common cause of hospital-acquired diarrhea, which is usually associated with previous antibiotic use.
T307	183846-183982	Epistemic_statement	denotes	C. difficile-associated diarrhea (CDAD) is most strongly associated with fluoroquinolones, cephalosporins, carbapenems, and clindamycin.
T308	184036-184293	Epistemic_statement	denotes	Clostridium difficile should be considered in diarrhea cases with a history of antibiotic use within the last 8 weeks (community-associated CDI) or with a hospital stay of at least 3 days, regardless of the duration of antibiotic use (hospitalacquired CDI).
T309	185008-185119	Epistemic_statement	denotes	Results: Over 7 months, we can calculate the laboratories' expenses were 37% less than if combined assay alone.
T310	185656-185803	Epistemic_statement	denotes	Conclusion: Our study suggested one or two-step algorithm for the detection of CD infection is a reliable, cost-effective, and timesaving strategy.
T311	186055-186181	Epistemic_statement	denotes	Also proved that C. difficile strains appear to produce the cell wall-associated enzyme glutamate dehydrogenase antigen (GDH).
T312	186182-186613	Epistemic_statement	denotes	Clinical characteristics of bacteraemia caused by Burkholderia cepacia complex species and antimicrobial susceptibility of the isolates in a medical centre in Taiwan Ying-Chun Chien 1 *, Chun-Hsing Liao 2 , Wang-Huei Sheng 1 , Jung-Yien Chien 1 , Yu-Tsung Huang 2,3 , Chong-Jen Yu 1 , Po-Ren Hsueh 1, 3 Background: Data about bacteraemia caused Burkholderia cepacia complex (BCC) among patients without cystic fibrosis are limited.
T313	188203-188423	Epistemic_statement	denotes	Conclusion: Correct identification of BCC complex to species level is important because different BCC complex species was associated with different outcomes of bacteraemia and exhibited different susceptibility patterns.
T314	188878-189124	Epistemic_statement	denotes	Traditionally, initial syphilis screening begins with the nontreponemal test (traditional algorithm); however, recent advancements in instrumentation have enabled more automated and objective approaches to the treponemal test (reverse algorithm).
T315	189125-189257	Epistemic_statement	denotes	The reverse algorithm for initial syphilis screening was limited to enzyme immunoassay (EIA) or chemiluminescence immunoassay (CIA).
T316	190212-190375	Epistemic_statement	denotes	However, the false-negative rate of Mediace ® TPLA was 2.27% (1 of 44), whereas that of Lumipulse ® presto TP was 0% and that of Architect Syphilis TP ® was 2.27%.
T317	190576-190744	Epistemic_statement	denotes	Because Mediace ® TPLA has various advantages such as low cost, high IgM-detection power, and easy operability, it should be recommended for the initial screening test.
T318	191079-191168	Epistemic_statement	denotes	In previous studies, this bacterium can survive in hard situation for 3 months or longer.
T319	191169-191252	Epistemic_statement	denotes	In clinical, if we don't disinfect complete, it will provide a chance to spread it.
T320	191253-191377	Epistemic_statement	denotes	So, if we had a efficient method that can culture this bacterium from environment, it would be useful for infection control.
T321	191964-192032	Epistemic_statement	denotes	That's to say, this broth can be a selective broth for C. difficile.
T322	192720-192952	Epistemic_statement	denotes	The case is presented to highlight the identification of this rare pathogenic organism in the laboratory from the samples collected and to start the treatment early for better prognosis since the mortality is high without treatment.
T323	193855-193994	Epistemic_statement	denotes	Conclusion: Urinary tract infection is common in diabetics, and in a diabetic patient B. pseudomallei, a rare pathogen can cause infection.
T324	193995-194135	Epistemic_statement	denotes	This organism can be overlooked in routine cultures as contaminant especially if the bacterial growth on the culture plate is polymicrobial.
T325	194253-194438	Epistemic_statement	denotes	Melioidosis caused by should be considered in the differential diagnosis in diabetic men with urinary tract infection, especially if they come from areas where melioidosis is prevalent.
T326	194663-195017	Epistemic_statement	denotes	1 Division of Infectious Disease, Jen-Ai Hospital, 2 Department of Infection Control, Jen-Ai Hospital Background: Taiwan CDC promoted the TB preventive program which introducing international recommended new LTBI diagnostic tests such as IGRAs (Interferon-γ release assays) and treatment prescription for TB contacts of all age groups from March 1, 2016.
T327	195018-195193	Epistemic_statement	denotes	IGRAs have been widely used for the diagnosis of latent and active tuberculosis in adults, but their role in diagnosing LTBI in children younger than 5 years remains debating.
T328	195584-195764	Epistemic_statement	denotes	Clinical diagnostic questions, according to the Oxford Level of Evidence 2011, systematic review (SR) of cross-sectional studies with reference standard would be the best evidence.
T329	195961-196077	Epistemic_statement	denotes	Probably due to blood draws can be more difficult in young kids, or other considerations such as cost-effectiveness.
T330	196078-196276	Epistemic_statement	denotes	However, this Level 1 evidence showed that the diagnostic performance of IGRAs were slightly higher than TST and can be used as supporting assays to detect LTBI in children above the age of 5 years.
T331	196623-196747	Epistemic_statement	denotes	It may also cause gastrointestinal perforation after starting chemotherapy, resulting from its good response to the therapy.
T332	198134-198494	Epistemic_statement	denotes	Conclusion: According to our experience, it was suggested that curative resection is not mandatory in patients undergoing surgery for gastrointestinal perforation and it is important to start chemotherapy in the early postoperative period and select a safer surgical procedure, such as limited surgery, flexibly assessing the necessity of removing the lesions.
T333	200111-200294	Epistemic_statement	denotes	However, only the value of PCT was higher in IBI group than other bacterial groups (13.11 ± 38.01 vs. 1.26 ± 1.65 in MBI, 1.10 ± 1.87 in TBI, and 1.69 ± 2.06 in MI, P < 0.05 for all).
T334	201114-201185	Epistemic_statement	denotes	1 Show Chwan Memorial Hospital, 2 Departments of Medical Laboratory, 3
T335	201186-201292	Epistemic_statement	denotes	Background: The increasing emergence of antibiotic-resistant nosocomial infections is a worldwide concern.
T336	201564-201617	Epistemic_statement	denotes	This is a challenge for clinicians to treat patients.
T337	202426-202519	Epistemic_statement	denotes	However, most antibiotics that target Gram-negative bacteria were not very effective against.
T338	202713-202810	Epistemic_statement	denotes	However, despite the high mortality rate, the rate of appropriate antibiotic use was notably low.
T339	202811-202999	Epistemic_statement	denotes	Clinicians should pay attention to the disease progression and evaluate the response to current antibiotics, and if possible, consider using effective antibiotics based on culture reports.
T340	204733-204818	Epistemic_statement	denotes	The extent of co-resistance may impact the choice of empirical antimicrobial therapy.
T341	204976-205217	Epistemic_statement	denotes	National Institute of Infectious Diseases and Vaccinology, National Health Research Institutes Background: A. calcoaceticus-A baumannii (ACB) complex comprises four genospecies: A. baumannii, A. calcoaceticus, A. nosocomialis, and A. pittii.
T342	207214-207310	Epistemic_statement	denotes	Conclusion: The prevalence of carbapenem resistance in A. baumannii remains very high in Taiwan.
T343	207906-208202	Epistemic_statement	denotes	Escherichia coli is often resistant to multiple antimicrobial agents and is often associated with the production of extended-spectrum β-lactamases (ESBLs), which are frequently described as a part of complex integrons, facilitate their horizontal transfer to other related and unrelated microbes.
T344	208203-208457	Epistemic_statement	denotes	The aim of this study was to define the current prevalence and phenotypes of 100 multidrug-resistant (MDR) E. coli isolates from clinical specimens in central Taiwan and to investigate associations between multidrug resistance and existence of integrons.
T345	210042-210255	Epistemic_statement	denotes	The data suggest that multiple and complex mechanisms involving mobile genetic elements in class 1 and class 2 integrons and antibiotic resistance have been developed in the evolution of E. coli strains in Taiwan.
T346	210993-211156	Epistemic_statement	denotes	However, clinical characteristics of patients with bloodstream infections (BSI) due to metallo β-lactamase (MBL)-producing Enterobacteriaceae are not well studied.
T347	213082-213135	Epistemic_statement	denotes	However, the all-cause 30-day mortality rate was 50%.
T348	213136-213290	Epistemic_statement	denotes	Conclusion: This study showed MBL-producing Enterobacteriaceae BSI was fatal, although rare, in patients with severe disease and longterm hospitalization.
T349	213291-213471	Epistemic_statement	denotes	Further research is necessary to study the appropriate treatment options for MBL-producing BSI, including levofloxacin treatment based on antimicrobial susceptibility test results.
T350	213732-213903	Epistemic_statement	denotes	Our study will investigate the carriage rates of S. aureus and MRSA of surgical HCWs in our hospital, and have a molecular epidemiology analysis for all S. aureus strains.
T351	214714-214770	Epistemic_statement	denotes	However, the difference was not significant (P = 0.812).
T352	215644-215760	Epistemic_statement	denotes	The PFGE denderogram gave the popular gene groups of S. aureus, which might help the surgical sit infection control.
T353	216174-216282	Epistemic_statement	denotes	The data of toxin gene or ribotype distribution of toxigenic C. difficile isolates in Taiwan remain limited.
T354	217214-217416	Epistemic_statement	denotes	Metronidazole and vancomycin resistance, though rare, was present in 1.2% and 2.0%, respectively, of toxigenic isolates, and of note there were 9 isolates resistant to both metronidazole and vancomycin.
T355	217417-217636	Epistemic_statement	denotes	Irrespective of toxigenic or non-toxigenic isolates, MIC 90 of doxycycline (8 μg/mL) was higher than that of tigecycline (≤0.0625 μg/mL), suggestive of more potent antibacterial activity of tigecycline than doxycycline.
T356	218516-218618	Epistemic_statement	denotes	Differential factors associated with colonization of different MRSA clones have not been well studied.
T357	218619-218807	Epistemic_statement	denotes	We sought to compare and contrast factors associated with colonization with various MRSA clones among patients contemporaneously hospitalized across acute and subacute healthcare settings.
T358	219217-219409	Epistemic_statement	denotes	To account for clustering, multivariable 2-level multinomial regression models were constructed to assess for factors associated with colonization of major MRSA clones, using SAS Proc Glimmix.
T359	219527-219635	Epistemic_statement	denotes	Sequence type ( However, the groin was 7 times as likely as the nares to be colonized with ST45 (aOR 7.19, .
T360	219773-219909	Epistemic_statement	denotes	Regardless of healthcare facility, contact precautions should be taken for recent MRSA-colonizers/infected to prevent MRSA transmission.
T361	220315-220456	Epistemic_statement	denotes	Epidemiology of MRSA nasal colonization in a range of HCWs have been studied, and yet out-ofhospital health care providers have limited data.
T362	220457-220644	Epistemic_statement	denotes	This study aims to characterize the risk factors and molecular epidemiologic characteristics of MRSA colonization in out-of-hospital health care providers and HCWs in a teritary hospital.
T363	222011-222148	Epistemic_statement	denotes	Conclusion: The findings suggest that there is substantial colonization of MRSA among in-hospital and out-hospital health care providers.
T364	222149-222243	Epistemic_statement	denotes	Implementations of infection control strategies should be applied high priority in those HCWs.
T365	223383-223460	Epistemic_statement	denotes	We set out to characterize GBS isolated from adults in Portugal in 2009-2015.
T366	224400-224487	Epistemic_statement	denotes	Macrolide resistance was associated with CC1 ( p < 0.001) and serotype Ib ( p < 0.001).
T367	225612-225714	Epistemic_statement	denotes	There were rare studies on the infections in LTCFs and pathogens if these residents were hospitalized.
T368	225715-225900	Epistemic_statement	denotes	This study aims to investigate the clinical characteristics, pathogens and antimicrobial susceptibility from LTCF residents who were hospitalized due to urinary tract infections (UTIs).
T369	227738-227807	Epistemic_statement	denotes	Empirical antimicrobial therapy might be optimized in these patients.
T370	228180-228301	Epistemic_statement	denotes	Generally, these species are non-pathogens but it can sometime induce infectious diseases especially in compromised host.
T371	228302-228543	Epistemic_statement	denotes	The purpose of this study was to assess the molecular typing of Enterococcus faecium which isolated from single site to evaluate the association and/or differentiation of genotype, infection site, patient group and antimicrobial sensitivity.
T372	228852-229001	Epistemic_statement	denotes	Retrospectively analysed with the patients background and/or infection site by medical records to characterize with the correlation between genotype.
T373	229854-229932	Epistemic_statement	denotes	However, all isolates were sensitive to linezolid, vancomycin and teicoplanin.
T374	230056-230266	Epistemic_statement	denotes	Conclusion: These results clearly suggested the correlation of genotype and infection site of the E. faecium and need to be further analysis of detailed virulence/antimicrobial resistant genes in each genotype.
T375	231549-231786	Epistemic_statement	denotes	Fever (95.5%), diarhea (87.4%), vomiting (25.6%) and bloody stool (15.1%) were the most common symptoms for Salmobella infections and abdominal pain (( p < 0.041)were associated with Salmonella Serogroup D1 (17%) and C1 (19%) infections.
T376	233332-233401	Epistemic_statement	denotes	However, major disadvantage of MLST is high-cost and labor-intensity.
T377	234231-234348	Epistemic_statement	denotes	Results: We chose the fasta-format text files as the raw data which should be called to the spreadsheet for analysis.
T378	234349-234540	Epistemic_statement	denotes	For process of the raw data calling, all the fasta files in the specified folder was automatically loaded, which takes most of the running time, however, is the main advantage of our program.
T379	234541-234703	Epistemic_statement	denotes	The running-time of the whole process was 10 minutes per 50 strains, which is much faster than the manual typing method, which would generally take several hours.
T380	234883-234998	Epistemic_statement	denotes	Conclusion: MLST is a good method for epidemiologic evaluation, however, labor-intensity is the major disadvantage.
T381	235102-235165	Epistemic_statement	denotes	Also, this program may prevent clerical error of manual typing.
T382	235166-235260	Epistemic_statement	denotes	Excel-based macros can be used by anyone, and can be constructed through uncomplicated coding.
T383	235261-235324	Epistemic_statement	denotes	This might be useful for the large scale epidemiologic studies.
T384	236046-236139	Epistemic_statement	denotes	However, the concentration of bleach is not routinely checked in the daily cleaning practice.
T385	236140-236312	Epistemic_statement	denotes	The aim of this study is to investigate the concentrations of various brands of bleaches used in hospital, and ensure the optimal concentration of bleaches can be achieved.
T386	236414-236554	Epistemic_statement	denotes	The bleaches were diluted with tap water to a presumed concentration of 500 PPM, according to the procedures suggested by the manufacturers.
T387	236744-236801	Epistemic_statement	denotes	The concentrations of the bleaches could decay gradually.
T388	236900-236967	Epistemic_statement	denotes	For quality assurance, the manufacturers should focus on 3 aspects.
T389	237311-237492	Epistemic_statement	denotes	Could the HOCl as a high level disinfection solution for environment cleaning Wen-Jun Yeh 1 , Fu-Chieh Chang 1 , Ya-Ling Chen 1 , Chang-Pan Liu 1,2 , Nan-Chang Chiu 3 , Hsin Chi 3 .
T390	237645-237689	Epistemic_statement	denotes	In vitro, this production can kill pathogen.
T391	237775-237883	Epistemic_statement	denotes	As we know, if this can kill pathogen from surface, then we could not culture any pathogen from the surface.
T392	238582-238686	Epistemic_statement	denotes	Conclusion: In this study, the HOCl solution function were not good enough to replace chlorine solution.
T393	238735-238876	Epistemic_statement	denotes	So, according to this study, we didn't suggest the hospital use HOCl solution as a High level disinfection solution for environment Cleaning.
T394	238983-239054	Epistemic_statement	denotes	Department of Laboratory Medicine, Chang Gung Memorial Hospital, Chiayi
T395	239055-239135	Epistemic_statement	denotes	Background: The quality of meals provided in hospitals is essential to patients.
T396	239136-239242	Epistemic_statement	denotes	The nosocomial food contamination can cause various food-borne illnesses of patients and healthcare staff.
T397	239348-239471	Epistemic_statement	denotes	We examine whether the regulation is enough to monitor the food safety base on our experience about non-conformity in 2016.
T398	239978-240216	Epistemic_statement	denotes	However, the result revealed that 1150 MPN/g of coli-form bacteria in the meals was more than the threshold (1000 MPN/g) from the regulation "Sanitation Standard for General Foods" approved by Food and Drug Administration (FDA) in Taiwan.
T399	240825-241030	Epistemic_statement	denotes	We suggest that the regulation about pathogens isolated from reusable and disposable tableware should be considered and established in hospitals to improve the food safety of patients and healthcare staff.
T400	241294-241453	Epistemic_statement	denotes	If the data was under 200 CFU/mL higher than 50 CFU/mL, clinical staff or engineer have to find the possible reason that caused the data higher than 50 CFU/mL.
T401	241558-241690	Epistemic_statement	denotes	And after finding the possible origin, we did some change, then the result showed its useful that no cases present after the change.
T402	241691-241777	Epistemic_statement	denotes	Methods: In this study, we drew a picture to check the possible site of the RO system.
T403	242236-242293	Epistemic_statement	denotes	After checked the data, we tried to find possible source.
T404	242478-242560	Epistemic_statement	denotes	So we suggested the clinical staff clean the space that empty the space of outlet.
T405	242561-242644	Epistemic_statement	denotes	Thanks to the supporting of nurse, there are no more culture positive data present.
T406	243080-243143	Epistemic_statement	denotes	In clinical, we suggested to use the disposable wipe for clean.
T407	243530-243596	Epistemic_statement	denotes	After 48 hours incubated, we can check the bacteria growth or not.
T408	244769-244851	Epistemic_statement	denotes	The traps are evaluated after the test feasibility of inspection for the next day.
T409	245765-245958	Epistemic_statement	denotes	Conclusion: From the experimental results that whether the postharvest petri dish is immediately sent to the bacterial chamber culture or after the inspection of the petri dish every other day.
T410	246089-246157	Epistemic_statement	denotes	Can get a good environment for the deployment of chemotherapy drugs.
T411	246580-246735	Epistemic_statement	denotes	However, the comparative application methods and contamination assessment techniques is unknown, and no consensus exists around benchmarks for cleanliness.
T412	246736-246926	Epistemic_statement	denotes	We sought to determine whether implement environment clean separation management measures in a medical intensive care unit (MICU) could reduce the density of healthcare associated infection.
T413	247923-248288	Epistemic_statement	denotes	Within the study period, the value of pass increase from 13% to 53%, the value of fail decrease from 47% to 20%; numerical difference trend of the pass value increase from −7% to 20% and fail value decrease from 13% to −20%, showing the use of different color disposable wipes and the correct wiping method or wiping process can improve the environment cleanliness.
T414	248555-248635	Epistemic_statement	denotes	However, there is no decline of the density of health-care associated infection.
T415	248718-249107	Epistemic_statement	denotes	Infection Control Office; Clinical Laboratory Department Background: According to 2006 New Hospital Accreditation: The Surgery and Anesthesia departments should regularly implement bacteriological examination, yet relevant literatures did not suggest regular inspections, and these inspections should be implemented only when associated epidemiology data was required to confirm outbreaks.
T416	249108-249352	Epistemic_statement	denotes	However, in consideration of healthcare quality and patient safety, infection control (IC) team had routinely collected and cultured surgical hand scrub water samples from total 4 faucets in our operation room (OR) by IC technician every month.
T417	249799-250104	Epistemic_statement	denotes	Improvement measures were subsequently developed and implemented as described below: (1) Check and wipe off the dust on the surface of UV lamp every week to avoid penetration reduction that might affect germicidal efficacy (executed by sanitary staff, and included the practice in the routine clean work).
T418	250105-250270	Epistemic_statement	denotes	(2) Staffs should always be aware of the status of UVGL, and once UV system is in alarm, beeping, immediately report to the OR leader nurse to call the manufacturer.
T419	250601-250700	Epistemic_statement	denotes	It is generally thought that UVGL has sustained germicidal intensity until the lamp is full dimmed.
T420	250757-250847	Epistemic_statement	denotes	In fact, its germicidal ability is associated with Irradiation intensity (I) and Time (T).
T421	250848-250952	Epistemic_statement	denotes	Therefore, the dust and grease on the surface of UV lamp may reduce penetration and germicidal efficacy.
T422	250953-251128	Epistemic_statement	denotes	Hopefully, the experience sharing can remind IC healthcare workers of the link between decay of UV lamp and incomplete sterilization that is closely related to patient safety.
T423	251685-251844	Epistemic_statement	denotes	So, we made some provisions for this problem, including changing RO membrane, disinfection of pipeline every week, and sampling RO dialysis after disinfection.
T424	252246-252350	Epistemic_statement	denotes	Conclusion: After typhoon, sampling of RO dialysate for bacterial count should be performed immediately.
T425	252679-252850	Epistemic_statement	denotes	1 Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan, 2 Center for Infection Control, National Taiwan University Hospital, Taipei, Taiwan
T426	252851-253010	Epistemic_statement	denotes	Background: Healthcare-associated infections caused by multidrug-resistant (MDR) pathogens are significantly associated with increased mortality and morbidity.
T427	253011-253101	Epistemic_statement	denotes	Environmental cleaning can reduce transmission of these pathogens but is often inadequate.
T428	253102-253284	Epistemic_statement	denotes	Adjunctive, no touch methods are warranted to enhance the effectiveness of disinfection particularly in hospital settings where healthcare-associated infections are of major concern.
T429	255089-255252	Epistemic_statement	denotes	Conclusions: The Hyper Light P3 device was effective in killing MDR pathogens and could be considered as an adjunctive method in disinfecting hospital environment.
T430	255253-255437	Epistemic_statement	denotes	Urinary tract infections associated with cross-contamination of ureteroscopes Jung-Hui Chen 1 , Mei-Hua Lin 1 , Wei-Rong Huang 1 , Yi-Ching Hsieh 1 , Chun-Yi Lee 1,2 , Mei Huang 1,2 *.
T431	255572-255758	Epistemic_statement	denotes	Cleaning and disinfection of the ureteroscopes used for the sterile procedure should follow standardized guidelines to prevent iatrogenic infections associated with cross-contaminations.
T432	256578-256698	Epistemic_statement	denotes	Further investigation revealed that ureteroscope cleaning staffs didn't performe in accordance with standard procedures.
T433	257283-257370	Epistemic_statement	denotes	But 4 cases of infection appeared when the problem ureteroscope was re-used on 22 June.
T434	257371-257523	Epistemic_statement	denotes	Therefore, prompted another investigation which indicated that the ureteroscope was suspected to be damaged and should no longer be used on any patient.
T435	257524-257683	Epistemic_statement	denotes	Conclusion: Contaminated ureteroscope could lead to transmission of infections resulting in increased healthcare cost and even life-threatening adverse events.
T436	257861-258044	Epistemic_statement	denotes	Investigation of a suspected outbreak of nontuberculous mycobacteria infected associated with bronchoscopy Chun-Ming Lee 1 , Hsiu-Tzu Chiang 2 , Fu-Chieh Chang 2 , Chang-Pan Liu 2,3 .
T437	258318-258426	Epistemic_statement	denotes	However, treatment of the towels with disinfectants in the washing process hardly removes the contamination.
T438	258543-258631	Epistemic_statement	denotes	However, there are few reports about the bacterial contaminations for the steamed towel.
T439	259510-259600	Epistemic_statement	denotes	Accordingly, we recommend the use of disposable hand towels for treatment in beauty salon.
T440	259999-260050	Epistemic_statement	denotes	This recommendation is based with limited evidence.
T441	261631-261782	Epistemic_statement	denotes	Although the magnitude of the Hawthorne effect has been described in several studies, subgroup analysis of the Hawthorne effect has not been clear yet.
T442	262895-263028	Epistemic_statement	denotes	Conclusion: The heterogenicity of the Hawthorne effect in hand hygiene may influence the interpretation of overt observation results.
T443	263029-263143	Epistemic_statement	denotes	We suggest covert observation be performed at least once in health facilities in which HH observation are routine.
T444	263144-263258	Epistemic_statement	denotes	Realizing the heterogenicity of the Hawthorne effect may help identify target population with lower HH compliance.
T445	264339-264607	Epistemic_statement	denotes	The main problems identified to such as lack of awareness and knowledge regarding hand hygiene timing, the boundaries between patient care and non-patient care areas are not well-defined, steps for hand hygiene are not performed properly… and other seven major issues.
T446	264717-265330	Epistemic_statement	denotes	In-ward medication dispensing procedure was changed to distinct patient care and non-patient care areas, the importance of hand hygiene was promoted to health-care workers at ward or division meetings, standard hand-washing was repeatedly demonstrated by hand hygiene auditors to reinforce hand hygiene compliance, and crossaudits were conducted by infection control link nurses/hand hygiene representatives on a monthly basis to assess compliance of Five Moments for Hand Hygiene and Seven Steps of Hand Washing in the Intermediate Care Nursery, with provision of feedback to the teams for continual improvement.
T447	265896-266107	Epistemic_statement	denotes	We hope that this model can be extended to other pediatric units to enhance the quality of care, reduce healthcare resource consumption and social costs, and ensure the safety of patients and healthcare workers.
T448	266444-266537	Epistemic_statement	denotes	Therefore, the attitudes of healthcare staffs and hospital workers perform an essential role.
T449	266538-266680	Epistemic_statement	denotes	The purpose of the survey was to discover the relationship between hand hygiene compliance and attitudes of the employees in a local hospital.
T450	267930-268049	Epistemic_statement	denotes	By contrast to hand hygiene compliances, just 67% staffs completed hand washing process while they provided healthcare.
T451	268387-268431	Epistemic_statement	denotes	Virtually, they are difficult to perform it.
T452	268486-268573	Epistemic_statement	denotes	However, a regularly hand hygiene training and handwashing audit programs are required.
T453	269790-269927	Epistemic_statement	denotes	Our implementing measures are as followings: (1) Educate the staff with symptoms should keep aerosol and contact isolation, rest at home.
T454	269928-270020	Epistemic_statement	denotes	(2) The other staff who took care of these patients should wear masks and keep hand hygiene.
T455	270021-270091	Epistemic_statement	denotes	(3) The environment that the patients worked should enhance cleansing.
T456	270092-270187	Epistemic_statement	denotes	(4) Watch out for the possible symptoms of infection and informed infection control department.
T457	270251-270348	Epistemic_statement	denotes	Conclusion: Norovirusis a very contagious virus, it can live in stool or vomitus for a long time.
T458	270780-270884	Epistemic_statement	denotes	We hoped to share this special experience to prevent possible clusters and save the resources and costs.
T459	271633-271794	Epistemic_statement	denotes	(1) Patient and their family: The poster was posted to remind individuals suffering from fever, cough, and cold should wear a mask, or educate them not to visit.
T460	271976-272127	Epistemic_statement	denotes	(2) Health professionals: The staff should take three-hour lessons to strengthen his or her knowledge regarding infection control and reporting system.
T461	272275-272339	Epistemic_statement	denotes	The staff should be arranged off if his or her BT is above 37.5.
T462	272340-272392	Epistemic_statement	denotes	The staff could on duty after no fever for 24 hours.
T463	272513-272575	Epistemic_statement	denotes	Validity period of all healthcare products should be examined.
T464	272576-272727	Epistemic_statement	denotes	Staff should take at least one-hour lesson of needlestick and sharps injuries prevention yearly; new staff should complete this course in three months.
T465	273096-273196	Epistemic_statement	denotes	If there was diarrhea or vomiting, it is important to strengthen environment clean and disinfection.
T466	273197-273315	Epistemic_statement	denotes	(4) Suspected cases: The suspected patients should be held on isolated rooms in order to decrease contact with others.
T467	273316-273376	Epistemic_statement	denotes	Related library tests or examinations should be followed up.
T468	273380-273445	Epistemic_statement	denotes	Patients and visitors can compliance with hand hygiene and masks.
T469	274056-274683	Epistemic_statement	denotes	1 Jianan Psychiatric Center, 2 Chang Hua hospital Background: Environmental cleansing was a key point in the prevention of medical care, psychiatric patients generally had poor personal hygiene and habits, therefore while infectious disease occurred, indirect easy to make the environment contaminated by bacteria, when cleaning staff cannot effectively clean the disinfection environment, and contact with the patient with a infectious disease, would increase the medical care-related infections, in order to put an end to the breeding of infectious diseases, environmental cleansing to improve intervention is very important.
T470	275831-276170	Epistemic_statement	denotes	Results: After the improvement of environmental cleanliness, the incidence of upper respiratory tract infection from 2.8‰ down to 2.24‰, cleaning staff also expressed that through the in-service education, unified cleaning appliances and management, can more clearly implement the environmental clean disinfection of the operating process.
T471	277032-277077	Epistemic_statement	denotes	Five out of 9 cases were M. chelonae complex.
T472	277494-277694	Epistemic_statement	denotes	All specimen (N = 4) from the filtered water of 3 automatic washing machines and tap water culture showed growth of NTM, however, the strain was different from the outbreak M. chelonae complex strain.
T473	278474-278573	Epistemic_statement	denotes	This study was intended to analysis the possible cause of VRE transmission and to prevent outbreak.
T474	278869-279084	Epistemic_statement	denotes	Therefore, once culture result of multidrugresistant organism (MDRO) was obtained after patient transferred out of ICU, the ward can't accomplish the terminal cleaning according to the standard of MDRO-exposed ward.
T475	280030-280170	Epistemic_statement	denotes	In this study, all four isolates of VRE were from different site and the antibiogram was also different, which means outbreak is not likely.
T476	280171-280373	Epistemic_statement	denotes	During the investigation and intervention measurements, we found that reduction of healthcare associated infection can be achieved by improvement of hand hygiene and making sure of environment cleaning.
T477	281901-282246	Epistemic_statement	denotes	Results: Through the intervention investigation, the daily monitoring of the epidemic and return to the Health Bureau, a comprehensive staff health monitoring log, and the implementation of measures, including strengthening the environment disinfection, unnecessary time should be fully wear masks, strengthen the implementation of hand hygiene.
T478	282346-282496	Epistemic_statement	denotes	Conclusion: Medical personnel when there is a history of exposure to influenza respiratory symptoms should seek medical diagnosis and early treatment.
T479	282497-282563	Epistemic_statement	denotes	Personnel should implement abnormal body temperature notification.
T480	282564-282830	Epistemic_statement	denotes	In order to provide a safe medical environment, the Infection control division by monitoring temperature feedback system and daily active surveillance, as soon as possible to find the ward and unit influenza abnormal cluster events and early control of the epidemic.
T481	285595-285754	Epistemic_statement	denotes	However, in 2010 the studies also a policy for the CL bundle is often present but frequently not well implemented by National Healthcare Safety Network (NHSN).
T482	286580-286721	Epistemic_statement	denotes	However, sampling a total of 15 cases of exposure to hazard among those in January 1, 2015 to March 31, 2015, only 3 cases to get the CLABSI.
T483	286722-287005	Epistemic_statement	denotes	In view of this situation, interview doctors and nurses, found that in the same system hazers caused by the various states, have the same or different reaction practices to maintain their system and can implement functions continue to work, and may reduce the risk of patient injury.
T484	287006-287438	Epistemic_statement	denotes	In the other hand, the SOEA can clarify the relationship between the various elements of central catheter care systems, combined with resilience engineering to understand HealthCare worker that how to respond the system in daily hazards, and under the anticipated and unanticipated occurrence of various adaptively adjust its central catheter combined practices, rather than blindly follow, and to maintain patient safety practices.
T485	287439-287653	Epistemic_statement	denotes	Conclusion: Applying SOEA in addition to the ability to the structure of the system can complete presentation, including relevance of the system, orderly, purposeful, providing system improve important information.
T486	287654-287904	Epistemic_statement	denotes	SOEA analysis of the resilience of the system, allowing the HealthCare worker to understand the occurrence and learning control method reaction only after full cognitive system structure in order to achieve the goal to Building a Safer Health System.
T487	289311-289408	Epistemic_statement	denotes	All of them agreed "the doctors should evaluate the necessity of catheter for patient every day."
T488	290037-290133	Epistemic_statement	denotes	However, 63.8% of the respondents conisdered that the bunde care would increase their work load.
T489	290134-290259	Epistemic_statement	denotes	Most of the study subjects (108, 78.3%) admitted the bundle program would fail, if the practioners did not take it seriously.
T490	290260-290388	Epistemic_statement	denotes	Conclusion: All respondents recognized CVC bundle care program would reduce the risk of catheter-related bloodstream infections.
T491	290389-290501	Epistemic_statement	denotes	However, most of the practitioners worried that heavy workload would be an obstacle to practice the bundle care.
T492	290739-290874	Epistemic_statement	denotes	Background: Elizabethkingia meningoseptica is a ubiquitous pathogen that could be found in clinical environment and equipment surfaces.
T493	290990-291116	Epistemic_statement	denotes	Increasing frequency of human infection, especially from healthcare associated infections, had been reported in recent decade.
T494	291117-291217	Epistemic_statement	denotes	However, efforts of infection control of outbreak caused by E. meningoseptica remains less reported.
T495	292464-292641	Epistemic_statement	denotes	There was no linkage to the environmental isolates of the other two clusters indicate the possibility of cross transmission by healthcare personnel (Cluster 1 and 2, Figure 1 ).
T496	292865-292986	Epistemic_statement	denotes	Our results demonstrate potential transmission of E. meningoseptica via medical environment and person-to-person contact.
T497	292987-293096	Epistemic_statement	denotes	Vigorous infection control measures should be applied to prevent spreading of E. meningoseptica at hospitals.
T498	295284-295485	Epistemic_statement	denotes	Outbreak of surgical site infections related to mastectomy with/ without reconstruction at a medical center Ju-Chun Lo 1 , Ying-Ying Chang 2 , Ya-Hui Huang 1 , Jann-Tay Wang 1,2 , Wang-Huei Sheng 1,2 .
T499	296516-296784	Epistemic_statement	denotes	In order to realize the cause for the unusually increased SSI, an outbreak investigation was conducted to analyze the probable factors, including staff's daily work, environment and equipment cleaning, the operation procedures, and post-operation wound care processes.
T500	297525-297637	Epistemic_statement	denotes	Conclusion: A timely implemented outbreak investigation and effective intervention can stop the outbreak of SSI.

T1

320-430

Epistemic_statement

denotes

These permissions are granted for free by Elsevier for as long as the COVID-19 resource centre remains active.

T2

841-950

Epistemic_statement

denotes

All Australian hospitals can participate in the survey which has been collecting prescribing data since 2011.

T3

1679-1942

Epistemic_statement

denotes

The antimicrobials with the highest percentage of inappropriate prescribing were cefaclor (58%) Kenacomb (gramicidin-neomycin-nystatin) (56%) and dapsone (50%), although there were only small number of these antimicrobials prescribed, (26, 18 and 2 respectively).

T4

2827-2973

Epistemic_statement

denotes

of patients with critical illness, but economical and resistant impact of de-escalation strategies for bloodstream infections was rarely reported.

T5

4548-4759

Epistemic_statement

denotes

However, lower antibiotic cost (mean: 212.1 vs. 395.6 US$, P < 0.001) and less complications of bloodstream infections due to resistant pathogens (0% vs. 5.1%, P = 0.004) was observed in the de-escalation group.

T6

5127-5261

Epistemic_statement

denotes

Background: Surgery is to have no time to lose, however, how to effectively manage the use of prophylactic antibiotics is a challenge.

T7

5388-5450

Epistemic_statement

denotes

To multi-oriented check can not affect the conduct of surgery.

T8

5451-5664

Epistemic_statement

denotes

The establishment of auxiliary mechanisms intimate reminders, and more humane management, Not only can educate the use of the correct concept of antibiotics, but also to improve of rational antibiotic utilization.

T9

6296-6365

Epistemic_statement

denotes

From here, we can see the effectiveness of management is significant.

T10

6574-6720

Epistemic_statement

denotes

Should we continue to implement contact precautions and environmental cleaning for MRSA Hui-Yun Liang 1 , Iig-Ling Chen 1 , Hung-Jen Tang 1,2,3 *.

T11

6721-7217

Epistemic_statement

denotes

Background: Increased drug resistance is one of the most important issues of global concern, effective way to stop the transmission of drug-resistant strains must have antibiotics stewardship and isolation protection measures, Strains of MRSA were first found in the 1960s there is evidence that concerted efforts that include surveillance cultures, contact precautions and isolation in hospitals can reduce MRSA, but the implementation of isolation measures need to spend the manpower and costs.

T12

7738-8008

Epistemic_statement

denotes

For the first isolated of MRSA patient must immediately check the use of antibiotics and related medical behavior, and the unit who isolated of MRSA to the hand hygiene audit, environment cleaning and disinfection of the joint inspection when the patient was discharged.

T13

8878-8946

Epistemic_statement

denotes

1 Pharmacy, St. Joseph Hospital, 2 Home Medicine, St Joseph Hostipal

T14

8947-9157

Epistemic_statement

denotes

Purpose: Overuse of antibiotics should induce increase number antibiotic resistant bacteria and its side effects, there is evidence to suggest that proper use of antibiotic helps control quality and efficiency.

T15

9158-9266

Epistemic_statement

denotes

Build up censor mechanisms with pharmacist and infection specialist can increase clinical take care quality.

T16

10631-11066

Epistemic_statement

denotes

Results: Ranking of result of inappropriate antibiotic prescriptions of pharmacist and infection specialist first item is wrong adjust of renal function, although the doctors can adjust antibiotic dose by dose calculate formulars, but during the procedure of censor meeting following within 24 hour after prescription, will helps the doctors use sensible and proper antibiotics and improve communication between pharmacist and doctors.

T17

11067-11131

Epistemic_statement

denotes

On the other hands, can hoist safety of use antibiotic patients.

T18

12423-12563

Epistemic_statement

denotes

Univariable and multivariable analysis of clinical parameters affecting FQ-R showed no factor associated with FQ resistance of rectal flora.

T19

12564-12729

Epistemic_statement

denotes

The clinical parameters associated with infectious complications after prostate biopsy were operation history within 6 months (RR 6.60; 95% CI 1.99-21.8, p = 0.002).

T20

12730-12967

Epistemic_statement

denotes

Conclusion: Prevalence of FQ-R rectal flora from the rectum before transrectal prostate biopsy was 48.1% and most common FQ-R bacteria was E. coli (39%) However, antibiotic resistance of rectal flora cannot predicted by clinical factors.

T21

12968-13100

Epistemic_statement

denotes

So Risk based approach cannot recommended and we should consider targeted antibiotic prophylaxis or extended antibiotic prophylaxis.

T22

13101-13274

Epistemic_statement

denotes

The relationship between antibiotic consumption and antibiotic resistance of Pseudomonas aeruginosa Wei-Lung Tsai 1 , Meng-Chiao Lin 1 , Chun-Hsiang Yu 2 , Chun-Ming Lee 2 .

T23

13275-13442

Epistemic_statement

denotes

1 Department of Pharmacy, St. Joseph's Hospital, 2 Department of Internal Medicine, St. Joseph's Hospital Background: Antimicrobial resistance is a global concern now.

T24

13608-13723

Epistemic_statement

denotes

Diversify the use of antimicrobial agents seems to be effective in reducing the growth of antimicrobial resistance.

T25

13724-13922

Epistemic_statement

denotes

Methods: Using retrospective study to evaluate the correlation of anti-pseudomonal antibiotic comsumption and antimicrobial resistance of pseudomonas aeruginosa by Pearson's correlation coefficient.

T26

14541-14730

Epistemic_statement

denotes

The Correlation between antibiotics and their susceptibility was modestly negatively correlated with Ciprofloxacin (r = −0.36, p = 0.034) and Piperacillin/tazobactam (r = −0.40, p = 0.015).

T27

14731-14838

Epistemic_statement

denotes

The others, although showed negatively correlated, but p-values (>0.05) were not statistically significant.

T28

14839-14976

Epistemic_statement

denotes

Conclusion: Our study shows only modestly correlation between anti-pseudomonal antimicrobial usage and pseudomonas aeruginosa resistance.

T29

15774-15940

Epistemic_statement

denotes

We sought to assess for non-clinical factors associated with antibiotics prescribing in a 1600-bed adult acute-care hospital's emergency department (ED) in Singapore.

T30

16249-16394

Epistemic_statement

denotes

Multivariable logistic regression models were constructed to assess for independent non-clinical factors associated with antibiotics prescribing.

T31

16965-17103

Epistemic_statement

denotes

Those who expected to receive antibiotics (41.0%) were more likely than those who didn't (30.1%) to be prescribed antibiotics (P = 0.070).

T32

17332-17630

Epistemic_statement

denotes

After adjusting for age, pre-existing comorbidities, and presenting complaint of fever, expectations for antibiotics (aOR 1.60, 95% CI 0.94-2.72, P = 0.086) and a higher educational level (aOR 1.63, 95% CI 0.94-2.83, P = 0.085) were marginally-significantly associated with antibiotics prescribing.

T33

17847-18057

Epistemic_statement

denotes

Conclusion: Patients' higher educational levels and expectations for antibiotics, regardless of whether they were explicitly informed to their physicians, were associated with increased antibiotics prescribing.

T34

18058-18203

Epistemic_statement

denotes

Further studies are warranted to better understand the influence of non-clinical factors such as these on antibiotic prescribing decision making.

T35

18204-18414

Epistemic_statement

denotes

Investigation the relationships of MDR (multi-drug resistant) pathogens isolated and defined daily dosing (DDD) of antibiotics prescription in one teaching hospital at Mid-Taiwan Chung-Hsin Liao, Frank San Fan.

T36

18743-18842

Epistemic_statement

denotes

So, we want to investigate the relationships of MDR pathogens and antibiotics used in our hospital.

T37

20189-20391

Epistemic_statement

denotes

This study aims to estimate pediatric antimicrobial resistance, bloodstream infection rates and pathogens, and to describe the antimicrobial prescribing pattern by monthly point prevalence survey (PPS).

T38

22151-22394

Epistemic_statement

denotes

Methods: Limitations of broad-spectrum antibiotics therapy are applied to inpatients and outpatients in order to supervise and control prescribing systems by requesting integrated and enclosed information such as clinical and relevant reasons.

T39

22395-22502

Epistemic_statement

denotes

Futhermore, the rationale for antibiotics utilization should be shown comprehensively in the form provided.

T40

23444-23607

Epistemic_statement

denotes

Conclusion: Our results present the tendency towards improving susceptibility level of broad-spectrum antibiotics, although the number of MDR-GNB still quite high.

T41

23709-23894

Epistemic_statement

denotes

Department of Pharmacy, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Hualien, Taiwan, R.O.C Background: The launch of a new antibiotic has become rare in recent years.

T42

24017-24135

Epistemic_statement

denotes

As a response to these challenges, optimal use of antibiotics, control the resistance rate is now we need to confront.

T43

24698-24946

Epistemic_statement

denotes

Background: To prevent increasing antibiotic resistance among microbes, antibiotic stewardship program (ASP) has been performed in the outpatient clinic (OPD), wards and surgical prophylaxis, but the emergency department (ED) has not been included.

T44

24947-25036

Epistemic_statement

denotes

However, empiric antibiotics have often been prescribed to patients during their ED stay.

T45

25138-25300

Epistemic_statement

denotes

As a result, we compare the differences of initial antibiotic regimens between ED and ward to evaluate whether the empiric antibiotics has been continued in ward.

T46

25301-25400

Epistemic_statement

denotes

Methods: We conducted retrospective review of medical records within March 1, 2016 to May 31, 2016.

T47

26500-26695

Epistemic_statement

denotes

In consideration of grades of staffs in wards who applied the same antibiotic as in ED, there were 80.57% of PGY-1, 75% of R4, 70.89% of R2, 69.9% of R1, 60% of R5, 52.27% of NP and 37.93% of R3.

T48

27534-27610

Epistemic_statement

denotes

In our hospital, no recommendation exists for broad-spectrum antibiotic use.

T49

27611-27780

Epistemic_statement

denotes

The aim of this study was to describe the modalities of broad spectrum antibiotic prescriptions in an infectious diseases department and confront them to the guidelines.

T50

28673-28743

Epistemic_statement

denotes

The broad-spectrum antibiotic was first line prescribed in 58 (59.2%).

T51

30718-30935

Epistemic_statement

denotes

The results of the present study demonstrate that the measurement of serum concentrations of daptomycin needs to be performed rapidly or the samples collected from patients should be stored in freezers until analysis.

T52

31052-31165

Epistemic_statement

denotes

The daptomycin elimination from living body and its pharmacokinetics may be affected by the instability in serum.

T53

31474-31624

Epistemic_statement

denotes

To ensure the optimal antibacterial efficacy and to avoid the potential toxicities, various dosing methods have been developed for non-obese patients.

T54

31625-31705

Epistemic_statement

denotes

However, the available information is scant when it comes to the obese patients.

T55

33295-33487

Epistemic_statement

denotes

Conclusion: Lower dose per kg was needed to achieve therapeutic range in obese patients which may imply the PK change of vancomycin clearance doesn't correlate linearly with total body weight.

T56

33488-33645

Epistemic_statement

denotes

Therefore, when empirically giving the guideline recommended initial dose of 30-45 mg/kg/day, lower daily dose per kg might be considered for obese patients.

T57

34192-34326

Epistemic_statement

denotes

Conclusion: Our study showed that drug reaction with eosinophilia and systemic symptoms (DRESS) syndrome is a severe and rare disease.

T58

34327-34382

Epistemic_statement

denotes

Clinically, It seems to be an autoimmune-like reaction.

T59

34383-34432

Epistemic_statement

denotes

Corticotherapy should not be systematically used.

T60

35265-35407

Epistemic_statement

denotes

However, there have been a few reports describing the effect of these antimicrobials and antifungals on human drugmetabolizing CYP activities.

T61

35711-36028

Epistemic_statement

denotes

Results: Inhibition of amoxicillin, ampicillin, and piperacillin at 0.5 or 1 mM concentration was not observed for CYP2C9, CYP2D6, CYP3A4 and CYP3A5, however, amoxicillin and piperacillin inhibited CYP2C8-mediated aminopyrine N-demethylation at 50% inhibitory concentration (IC 50 ) of 0.83 and 1.14 mM, respectively.

T62

36791-36963

Epistemic_statement

denotes

Conclusion: The interactions between these three penicillin-based antibiotics and other drugs that are metabolized by CYPs investigated would not be clinically significant.

T63

36964-37050

Epistemic_statement

denotes

Ketoconazole and miconazole might inhibit CYP2C8 in addition to other CYPs clinically.

T64

37797-37868

Epistemic_statement

denotes

A stepwise resistance selection will be conducted at 1×, 2× and 4× MIC.

T65

39698-39809

Epistemic_statement

denotes

And thus the interference of LPS assembly by a small molecule inhibitor would result in antibacterial activity.

T66

40493-40640

Epistemic_statement

denotes

Conclusion: Our novel chemical class of LpxC inhibitors provide the potential as new antibacterial agents for treatment of Gramnegative infections.

T67

43179-43389

Epistemic_statement

denotes

These mutations induce a complex gene regulation cascade leading to the synthesis and addition of the 4-amino-4-deoxy-L-arabinose (L-Ara4N) to lipid A of the membrane inducing therefore the colistin resistance.

T68

43390-43500

Epistemic_statement

denotes

However, in 2015, it has been described for the first time, a plasmid-mediated colistin resistance gene mcr-1.

T69

44299-44455

Epistemic_statement

denotes

These plasmids can be distinguished into three groups according to their sizes ranged from 6.36-Kb to 369.3-Kb and their %GC content ranged from 41% to 50%.

T70

45423-45508

Epistemic_statement

denotes

Campylobacter could be potential source of new phosphoethanolamine transferase genes.

T71

46177-46276

Epistemic_statement

denotes

Mechanisms of resistance to colistin are complex and misunderstood, particularly in these bacteria.

T72

46816-47048

Epistemic_statement

denotes

Among the group of mutated genes, we selected those that were already known to be putatively involved in antimicrobial peptide resistance and we realized a SIFT score to predict the probability mutation could alter protein function.

T73

47968-48253

Epistemic_statement

denotes

Transcriptomic analysis of genes belonging to arnBCADTEF operon showed significant decrease in mRNA expression level of tested genes in the susceptible strain, supporting that addition L-Ara4N in the outer membrane of lipid A moiety can explain the increase in colistin susceptibility.

T74

48625-48721

Epistemic_statement

denotes

However, it is certainly not the only one because lots of enigmas on colistin resistance remain.

T75

48722-48876

Epistemic_statement

denotes

Other genes that were absent in the susceptible strain could be linked to colistin resistance including a whole operon involved in sialic acid metabolism.

T76

49034-49191

Epistemic_statement

denotes

Bacterial defense system and antimicrobial peptides coexist for a long time, and mechanisms of resistance to colistin are complex and implied a lot of genes.

T77

50028-50113

Epistemic_statement

denotes

Previous studies have demonstrated that macrolides influence P. aeruginosa virulence.

T78

50114-50266

Epistemic_statement

denotes

However, most studies evaluated the regulatory effects of macrolides on P. aeruginosa virulence factors after treatment over a short period (<48 hours).

T79

51606-51779

Epistemic_statement

denotes

These findings exhibit that long-term, low-dose macrolide exposure may gradually reduce the pathogenicity of P. aeruginosa via timedependent inhibition of virulence factors.

T80

51780-51966

Epistemic_statement

denotes

We suggest that longterm, low-dose macrolide treatment for chronic airway infection should be administered for at least 2 months or more to achieve optimal effects against P. aeruginosa.

T81

51967-52066

Epistemic_statement

denotes

isolates is associated with carbapenem treatment of ESBL-and/or AmpC-producing bacterial infection.

T82

53284-53437

Epistemic_statement

denotes

Few isolates with normal PCR sizes of both genes demonstrated carbapenem resistance, suggesting involvement of other mehcanism for carbapenem resistance.

T83

53438-53593

Epistemic_statement

denotes

Conclusion: Both ESBL and non-ESBL producing isolates could develop carbapenem resistance associated with carbapenem types and ompK35 and ompK36 mutations.

T84

54014-54300

Epistemic_statement

denotes

The methodology for synthesizing, screening for both ribosomal binding/selectivity and bacterial growth inhibition, and rapid analysis of the data provides a systematic method for identification of bacterial ribosome specific antibacterials that can evade bacterial resistance pathways.

T85

56513-56669

Epistemic_statement

denotes

Patients with prior exposure to fluoroquinolones (FQs) were more likely than non-exposed patients to have moxifloxacin-resistant isolates (14/22, 63.6% v.s.

T86

56854-57031

Epistemic_statement

denotes

In recent years, multidrug-resistant K. pneumoniae (MDRKP) is rapidly increasing because of antibiotics overuse and it has been implicated in a variety of nosocomial infections.

T87

57032-57212

Epistemic_statement

denotes

MDRKP cause a problem in the clinical treatment of patients and some references demonstrate that antibody-immune response is essential for host defense against bacterial pathogens.

T88

57490-57787

Epistemic_statement

denotes

Methods: Fully Human Monoclonal Antibodies from Single Peripheral Blood B Cell Using K. pneumoniae (KP) as a sorting model, we established a platform technology that can obtain human mAbs against KP directly from each single human plasma or memory B cell by cloning the VH and VL variable regions.

T89

58744-58885

Epistemic_statement

denotes

In vitro opsonophagocytic assays demonstrate that twenty anti-KP antibodies can increase the antibody-mediated phagocytosis in K. pneumoniae.

T90

58886-59025

Epistemic_statement

denotes

Our results suggest that the selected antibodies can be potential lead drugs for further testing in a K. pneumoniae infection animal model.

T91

59026-59105

Epistemic_statement

denotes

The recombinant Abs might play a crucial role in treatment of MDR-KP infection.

T92

59373-59592

Epistemic_statement

denotes

The natural chemopreventive compounds isothiocyanates (ITCs) are widely found in cruciferous vegetables have been shown to possess cancer chemopreventive efficacy, antioxidative properties and immunomodulatory activity.

T93

59593-59719

Epistemic_statement

denotes

ITCs such as allyl isothiocyanate and benzyl isothiocyanate are revealed to be bactericidal through an unidentified mechanism.

T94

59720-59903

Epistemic_statement

denotes

Our previous study indicated that sulforaphane (4-methylsulfinybutyl isothiocyanate) significantly reduced the growth of Staphylococcus aureus, Escherichia coli and Vibrio vulnificus.

T95

59904-60008

Epistemic_statement

denotes

Though ITCs are effective in bacteria killing, the application of ITCs on MDR bacteria is still unknown.

T96

60621-60864

Epistemic_statement

denotes

BITC treatment also inhibited MDR E coli growth, this inhibition could be reversed by adding thiol reducing agents including N-acetyl cysteine (NAC), L-Glutathione (GSH), Dithiothreitol (DTT) and 2-mercaptoethanol (2-ME) to the culture medium.

T97

61022-61189

Epistemic_statement

denotes

Yet, differences in key properties have been noted between suppliers of antibiotics with the same denomination (INN), even if all approved by local health authorities.

T98

61767-61877

Epistemic_statement

denotes

Samples were prepared following manufacturer's recommendation and exposed to fixed temperatures for up to 8 h.

T99

61878-62120

Epistemic_statement

denotes

Results: A summary of key results is presented in the Table Product Mimicking administration by motor-activated pumps for extended or continuous administration in Intensive Care Units for severely-ill patients (drug dissolved in 0.9% NaCl);

T100

62121-62356

Epistemic_statement

denotes

Background: It is suggested that susceptibility results for cephalosporins be reported according to the minimum inhibitory concentration (MIC), regardless of whether or not the isolate produces an extended-spectrum β-lactamases (ESBL).

T101

62357-62471

Epistemic_statement

denotes

The revised breakpoint MIC defining susceptibility to cefotaxime (1 mg/L) might be a surrogate for ESBL detection.

T102

62472-62568

Epistemic_statement

denotes

Cefotaxime-resistant Enterobacteriaceae are challenging organisms with little treatment options.

T103

62569-62764

Epistemic_statement

denotes

Carbapenems such as imipenem, ertapenem or meropenem are frequently used, but the emergence of carbapenem resistant Enterobacteriaceae is a concern issue, which may hinder the use of carbapenems.

T104

62765-62872

Epistemic_statement

denotes

Although, cephamycins such flomoxef are effective against cefotaxime-resistant Enterobacteriaceae in vitro,

T105

62873-62986

Epistemic_statement

denotes

there are a few clinical data demonstrating effect against bloodstream infection (BSI) caused by these organisms.

T106

63582-63998

Epistemic_statement

denotes

After adjustments in the multivariate model, patients with severe sepsis (adjusted OR = 3.84, 95% CI = 1.16-12.78, P = 0.03), high BSI mortality score (adjusted OR = 5.59, 95% CI = 2.37-13.21, P < 0.01), ultimately or rapid fatal co-morbidity (adjusted OR = 10.60, 95% CI = 3.43-32.75, P < 0.01) and pneumonia (adjusted OR = 10.11, 95% CI = 3.43-29.81, P < 0.01) were independently associated with 28-days mortality.

T107

64343-64465

Epistemic_statement

denotes

However, the length of hospitalization stay was shorter in the ertapenem group (10.2 ± 8.5 vs. 14.6 ± 9.4 days, P < 0.01).

T108

64466-64692

Epistemic_statement

denotes

Conclusion: Ertapenem therapy is associated with shorter time of hospitalization than flomoxef therapy following flomoxef-susceptibile, cefotaxime-resistant Enterobacteriaceae BSI in adult patients with both guarded prognosis.

T109

65094-65288

Epistemic_statement

denotes

However, the Kaplan-Meier curve for 30-days mortality reveled patients in initial high maintenance teicoplanin dosage group had better survival than those in initial daptomycin group (p = 0.02).

T110

65792-66089

Epistemic_statement

denotes

Exclusion criteria: Patients excluded if medical records incomplete, receiving dialysis, had history of chronic kidney disease (CKD) (Stage IV or higher) or recent history of acute kidney injury (defined as increase in sCr of 0.5 mg/dL or greater or increase of sCr of 1mg/ dL or greater for CKD).

T111

66583-66712

Epistemic_statement

denotes

Secondary endpoint was association of nephrotoxicity with potential confounding factors that may increase risk of nephrotoxicity.

T112

67591-67917

Epistemic_statement

denotes

Abstracts of the 30th ICC 2017 / International Journal of Antimicrobial Agents 50 S2 (2017) S69-S278 S86 Background: Tissue stroma is known to be important in regulating Hp-mediated inflammation, but the molecular basis of its interaction with Hp and its potential crosstalk with dendritic cells (DCs) remain to be determined.

T113

67918-68045

Epistemic_statement

denotes

To this end, the potential crosstalk between H. pylori (Hp) infected gastric stromal cells (Hp-GSCs) and DCs were investigated.

T114

68708-68965

Epistemic_statement

denotes

Further, PGE 2 from Hp-GSCs was discovered to possess the priming effect, which could be inhibited, by anti-COLEC12 (Collectin subfamily member 12) blocking Abs, COLEC12 knockdown or when alpha3-fucosyltransferase-null ( futB; HP0651) strain of Hp was used.

T115

69063-69215

Epistemic_statement

denotes

Furthermore, Hp-GSCs-conditioned DCs were able to induce the expression of IL-17 from CD4 + T cells, which could be inhibited by IL-23-neutralizing Abs.

T116

69216-69378

Epistemic_statement

denotes

Conclusion: These results suggested the importance of COLEC12 as a receptor involved in Hp-stromal cell interaction and its subsequent conditioning effect on DCs.

T117

70559-70641

Epistemic_statement

denotes

Further research was carried out in appropriate medium in 200L batch fermentation.

T118

70730-70874

Epistemic_statement

denotes

The exo-1, 4-β-D glucanase secreted by recombinant E. coli represents an appealing potential for both research and textile industry application.

T119

71613-71816

Epistemic_statement

denotes

Although it was generally recognized that the molecular chaperone DnaK system is highly conserved within the Three Domains of life, investigation on the molecular chaperone system in Archaea are limited.

T120

72704-72940

Epistemic_statement

denotes

Results: The ATPase kinetic assay revealed that substrate ATP hydrolytic velocity in phospho-mimic type MpDnaK was similar with the wild-type which suggested that the phosphorylation on Ser518 did not affect the ATP hydrolytic activity.

T121

72941-73164

Epistemic_statement

denotes

Further structure modeling analysis revealed the phosphorylated Ser518 is located in the lid domain of MpDnaK which relate to the open/close of the substrate binding pocket and initiate/terminate the disaggregation process.

T122

73394-73521

Epistemic_statement

denotes

The shorter distance may contribute more stable conformation for lid closing and promote more efficient disaggregation process.

T123

73522-73664

Epistemic_statement

denotes

This analytical result suggest that post-translational phosphorylation may involve the regulation of the substrate binding and disaggregation.

T124

73665-73917

Epistemic_statement

denotes

Conclusion: The phosphorylation on Ser518 did not affect the ATP hydrolytic activity of MpDnaK, whereas the PTM-phosphorylation on lid domain-Ser518 promote the lid-substrate binding pocket interaction, which may further enhance the refolding activity.

T125

74579-74643

Epistemic_statement

denotes

Therapeutic prospect of UPS inhibitor is promising and valuable.

T126

76109-76267

Epistemic_statement

denotes

Taiwan area is small, so little arable land can be used, if the land is subjected to heavy metal pollution and water irrigation, have accumulated in the soil.

T127

77231-77303

Epistemic_statement

denotes

The ion in the mixed solution, zinc ions can be degraded by this strain.

T128

77304-77755

Epistemic_statement

denotes

Experiment that starch medium than in sawdust medium, can provide more nutrients, prompting the white rot fungi to produce catalase, may be because in adversity, this strain can secrete more peroxide dismutase to help themselves to resist adversity and sawdust medium, Although the activity of SOD in sawdust medium was low, the degradation rate was better, and it could buffer the pH value of polar acid, and stable and sustained supply of nutrients.

T129

78052-78223

Epistemic_statement

denotes

We recently reported that CDT can overcome the radioresistance of prostate cancer (PCa) cells by intervening in the repair of radiation-induced double-strand breaks (DSB).

T130

78224-78349

Epistemic_statement

denotes

However, the detailed mechanisms underlying the effects of CDT on radioresistance in PCa cells require further investigation.

T131

78866-79124

Epistemic_statement

denotes

We further showed that CDT prevents the formation of autophagosomes via decreased high-mobility group box 1 (HMGB1) expression and the inhibition of acidic vesicular organelle (AVO) formation, which are associated with enhanced radiosensitivity in PCa cells.

T132

79878-79987

Epistemic_statement

denotes

The ability of bacterial adherence to biotic or abiotic substrate is an essential step for biofilm formation.

T133

79988-80102

Epistemic_statement

denotes

Such adherence can be mediated by bacterial fimbriae, which are also important virulence factors in many bacteria.

T134

80103-80204

Epistemic_statement

denotes

In enterobacteria, cyclic AMP (cAMP) receptor protein (CRP) plays a vital role as a global regulator.

T135

80634-80764

Epistemic_statement

denotes

Results & Conclusion: Our preliminary data indicated that the gene KPN_00353 encoding EIIA homolog up-regulates biofilm formation.

T136

80765-80852

Epistemic_statement

denotes

Thus, our purpose is to clarify how the CRP-cAMP complex mediate the biofilm formation.

T137

81369-81430

Epistemic_statement

denotes

Then, we will examine the importance of CRP in K. pneumoniae.

T138

82295-82347

Epistemic_statement

denotes

The regulation of P. mirabilis T6SS remains unclear.

T139

82691-82794

Epistemic_statement

denotes

We investigated whether Crp can bind directly to T6SS promoter region using a DNaseI footprinting assy.

T140

83089-83170

Epistemic_statement

denotes

We also purified the possible toxin to assess its function in killing of E. coli.

T141

83722-83847

Epistemic_statement

denotes

T6SS contributed to growth predominance over crp mutant and E. coli, suggesting P. mirabilis T6SS as an antibacterial weapon.

T142

84059-84213

Epistemic_statement

denotes

Background: The antimicrobial peptide, epinecidin-1 (Epi), was identified from Epinephelus coioides and may have clinical application for treating sepsis.

T143

84214-84460

Epistemic_statement

denotes

Epi has been shown to ameliorate antibiotic-resistant bacteria-induced sepsis in mice, but further evaluation in mixed-flora models and a description of the protective mechanisms are essential to establish this peptide as a potential therapeutic.

T144

85591-85719

Epistemic_statement

denotes

Conclusion: Overall, our results demonstrate that Epi is a promising therapeutic agent for endotoxemia and polymicrobial sepsis.

T145

87943-88014

Epistemic_statement

denotes

Thirty-five adverse events were judged as related to study medications.

T146

88117-88268

Epistemic_statement

denotes

Conclusion: This study indicated that the combination of cefoperazone/sulbactam was not inferior to cefepime when used to treat patients with HAP/HCAP.

T147

89152-89253

Epistemic_statement

denotes

However, there have been only a few reports about the influence on risk and prognosis factors of IPD.

T148

90210-90466

Epistemic_statement

denotes

In the multivariate analysis, several independent risk factors of IPD, including malignant tumors [odds ratio (OR), 19.60; 95% confidence interval (CI), 4.58-84.04; p = 0.0001], and initial qSOFA (OR, 19.90; 95% CI, ; p = 0.0009), were associated with IPD.

T149

90597-90673

Epistemic_statement

denotes

Conclusion: High initial qSOFA could be a risk and prognostic factor of IPD.

T150

90674-90812

Epistemic_statement

denotes

We might suspect IPD earlier by using qSOFA and lead to the improvement of prognosis, because qSOFA was extremely easy scoring on bedside.

T151

90813-90913

Epistemic_statement

denotes

Background: Anaerobes are rare causes of spinal infections and constitute less than 4% of all cases.

T152

92263-92484

Epistemic_statement

denotes

Conclusion: In summary, P. micra spinal infection should be considered in patients with a medical history of dental problem or work acccompanied with an insidious onset of back/neck pain and elevated inflammation markers.

T153

92652-92734

Epistemic_statement

denotes

Department of Intensive Care Medicine, Chi-Mei Medical Center, Tainan City, Taiwan

T154

92735-92848

Epistemic_statement

denotes

Background: Invasive pulmonary aspergillosis (IPA) in severe complicated influenza A has been reported in Taiwan.

T155

94071-94104

Epistemic_statement

denotes

However, spiking fever was noted.

T156

94428-94509

Epistemic_statement

denotes

Conclusion: IPA may complicate influenza pneumonia in a previously healthy adult.

T157

94760-94843

Epistemic_statement

denotes

Antibiotics for bacterial co-infection and antifungal therapy should be considered.

T158

94844-94943

Epistemic_statement

denotes

Finally, corticosteroids in patients with influenza may pose a risk for invasive fungal infections.

T159

95394-95461

Epistemic_statement

denotes

Hematemesis can occur in CMV esophagitis, gastritis and duodenitis.

T160

96403-96531

Epistemic_statement

denotes

However, bloody stool persisted, repeated colonoscopy showed the same lesions and diluted bosmin was injected with hemoclipping.

T161

97567-97639

Epistemic_statement

denotes

CMV colitis in patients with plasmacytoma is quite rare but challenging.

T162

97763-97910

Epistemic_statement

denotes

Although ganciclovir resulted in symtomatic improvement of blood stool, but hallow organ perforation developed, suggesting colon ulcer perforation.

T163

97911-97959

Epistemic_statement

denotes

Concurrent Aspergillus pneumonia was unexpected.

T164

98096-98240

Epistemic_statement

denotes

Department of Intensive Care Medicine, Chi Mei Medical Center, Tainan, Taiwan; Department of Medicine, Taipei Medical University, Taipei, Taiwan

T165

98241-98410

Epistemic_statement

denotes

Background: Aspergillus-associated infection might comprise up to 23-29% of severe influenza patients from the community throughout stay in an intensive care unit (ICU).

T166

98411-98493

Epistemic_statement

denotes

In Taiwan, cases of severe influenza with aspergillosis are increasingly reported.

T167

99277-99389

Epistemic_statement

denotes

A chest computed tomography (CT) without contrast showed a right lower lung consolidation, suggesting pneumonia.

T168

99468-99570

Epistemic_statement

denotes

Results: Despite promptly starting antibiotics, intermittent fevers and progressive dyspnea persisted.

T169

99571-99641

Epistemic_statement

denotes

Blood culture grew anaerobes in preliminary reports on hospital day 3.

T170

99694-99856

Epistemic_statement

denotes

However, his dyspnea and fevers did not resolve after switching to imipenem, and a follow-up CT scan on the hospital day 5 showed a worsening bilateral pneumonia.

T171

99921-100090

Epistemic_statement

denotes

An ambulatory ultrasonography examination of the persistently painful right neck revealed an intravascular mass in right internal jugular vein, suggestive of thrombosis.

T172

100875-101010

Epistemic_statement

denotes

In a young patient with acute pharyngitis accompanied with signs of septic embolization, Lemierre syndrome should always be considered.

T173

101011-101211

Epistemic_statement

denotes

Background: Mycoplasma hominis, a well known cause of neonatal infection, has been reported as a pathogen in urogenital infections in adults; however, central nervous system (CNS) infections are rare.

T174

101212-101361

Epistemic_statement

denotes

We report here the first case of M. hominis meningitis in China, post neurosurgical treatment for an intracerebral haemorrhage in a 79-year-old male.

T175

101362-101684

Epistemic_statement

denotes

Case presentation: We describe a 79-year-old who developed M. hominis meningitis after neurosurgical treatment and was successfully treated with combined azithromycin and minocycline therapy of two weeks' duration, despite delayed treatment because the Gram stain of cerebrospinal fluid (CSF) yielded no visible organisms.

T176

102148-102408

Epistemic_statement

denotes

Conclusion: Both our patient findings and the literature review, highlighted the pathogenic potential of M. hominis together with the challenges prompted by rare infectious diseases in particular for developing countries labs with limited diagnostic resources.

T177

102514-102613

Epistemic_statement

denotes

Background: Fungi of the order Mucorales are ubiquitous in nature but rarely cause human infection.

T178

102614-102741

Epistemic_statement

denotes

However, because of the rising amount of immunocompromised patients, the incidence of invasive fungal infection also increased.

T179

102825-102915

Epistemic_statement

denotes

Here we report the first case in Taiwan and review the literature of the previous reports.

T180

103302-103383

Epistemic_statement

denotes

Broad-spectrum antibiotic was initiated but the clinical improvement was limited.

T181

104215-104296

Epistemic_statement

denotes

And the number of previously rarely, opportunistic infection will rise with time.

T182

104297-104504

Epistemic_statement

denotes

Obtain the adequate sample and make the right diagnosis will reverse the potentially life-threatening infection of the patients and is of paramount importance to achieve long-term survival in these patients.

T183

106436-106610

Epistemic_statement

denotes

Suggest clinicians evaluate the necessity of posaconazole prevention for AML patients with induction chemotherapy according to disease severity or the risk rate of infection.

T184

106720-106785

Epistemic_statement

denotes

Therefore, we need more cases to evaluate the long-term efficacy.

T185

108296-108420

Epistemic_statement

denotes

CMV infection did not directly affected graft survival rate, but if immunocompromised patients can be due to patient expire.

T186

108421-108515

Epistemic_statement

denotes

CMV infection with renal transplant recipients should be closely monitor and active treatment.

T187

109101-109178

Epistemic_statement

denotes

The epidemiology of pneumocystis colonization among such patients is unknown.

T188

109179-109347

Epistemic_statement

denotes

The aim of this study was to estimate the incidence of Pneumocystis colonization and risk factors of Pneumocystis pneumonia among newly diagnosed HIV-infected patients.

T189

110000-110337

Epistemic_statement

denotes

Pneumocystis colonization was associated with a lower CD4 count (median [IQR]: 144 (42-308) cells/mm 3 vs. 320 (169-492) cells/mm 3 ; P = 0.007), a higher HIV plasma viral load (1.97 × 10 5 [1.02 × 10 5 -4.24 × 10 5 ] vs. 3.59 × 10 4 (1.28 × 10 4 -7.89 × 10 4 ) HIV RNA copies/mL; P < 0.001), and receipt of steroid treatment (P = 0.03).

T190

110484-110653

Epistemic_statement

denotes

By the Kaplan-Meier analysis, the cases of Pneumocystis colonization were associated with a higher risk of PJP than those without colonization (Log-rank test, P = 0.04).

T191

110654-110795

Epistemic_statement

denotes

Conclusion: Pneumocystis colonization is not uncommon in newly diagnosed HIV-infected patients and associated with an increasing risk of PJP.

T192

112081-112199

Epistemic_statement

denotes

Clinical data will be obtained from a standardized medical chart abstraction by use of uniform data abstraction forms.

T193

112849-112998

Epistemic_statement

denotes

Conclusion: The diabetic was risk factor associated with asymptomatic bacteriuria and developing UTIs among participants with chronic kidney disease.

T194

114352-114545

Epistemic_statement

denotes

However, acute hepatitis (S-GOT, 1377 U/L and S-GPT, 1696 U/L), elevated bilirubin (total, 7.77 mg/dL and direct, 5.85 mg/dL) and severe coagulopathy ( prothrombin time, 31.6 seconds) occurred.

T195

114953-115033

Epistemic_statement

denotes

However, worsening water diarrhea relapsed and episodes of hypotension occurred.

T196

115548-115605

Epistemic_statement

denotes

Blood and stool CMV-PCR might help presumptive diagnosis.

T197

115606-115722

Epistemic_statement

denotes

However, the possibility of CMV colitis alone, following or coexisting with amebic colitis was difficult to discern.

T198

115723-115842

Epistemic_statement

denotes

CMV activity might be enhanced by steroids, which therapy should be careful in HIV patients even without low CD4 count.

T199

116113-116206

Epistemic_statement

denotes

Background: Mycobacterium abscessus is extremely difficult to treat and considered incurable.

T200

117568-117664

Epistemic_statement

denotes

The patient could not tolerate ciprofloxacin, which was changed to levofloxacin and doxycycline.

T201

118468-118586

Epistemic_statement

denotes

Conclusion: Patients of M abscessus lung disease could have coexisting or previous history of MAC pulmonary infection.

T202

118587-118714

Epistemic_statement

denotes

Anti-IFN-γ autoantibodies may play a role in mycobacterial infections, particularly in persons without predisposing conditions.

T203

118715-118954

Epistemic_statement

denotes

Patients with M. abscessus pulmonary disease should be treated with multidrug anti-mycobacterial therapy based on susceptibility test results whenever available, and surgical resection may offer a more favorable response in selected cases.

T204

119359-119476

Epistemic_statement

denotes

It is associated with a wide spectrum of clinical manifestations in both immunocompetent and immunocompromised hosts.

T205

120432-120538

Epistemic_statement

denotes

He was started on azithromycin, rifabutin and ethambutol for possible MAC, although HIV test was negative.

T206

120750-120853

Epistemic_statement

denotes

He remained febrile, and anti-NTM treatment was switched to tigecycline and meropenem for possible RGM.

T207

121716-121847

Epistemic_statement

denotes

Conclusion: M. mucogenicum is often of no clinical significance, but it can cause systemic illness even in an immunocompetent host.

T208

121848-121961

Epistemic_statement

denotes

The basis of combination antimicrobial therapy should be based on susceptibility test results whenever available.

T209

121962-122005

Epistemic_statement

denotes

The optimal duration of therapy is unknown.

T210

122438-122545

Epistemic_statement

denotes

In many cases, the prevalence of the concomitant hepatopathy is higher when associated with SLE than alone.

T211

122546-122667

Epistemic_statement

denotes

Use of these drugs in patients with previous HBV infection can result in severe liver damage if the virus is reactivated.

T212

122979-123041

Epistemic_statement

denotes

Baraclude was started, however bloody stools passage occurred.

T213

124187-124267

Epistemic_statement

denotes

Brain image could not be performed due to unstable oxygenation and hemodynamics.

T214

124379-124542

Epistemic_statement

denotes

Conculsion: Liver dysfunction in the presence of SLE can be caused by many factors, but when at the time of SLE onset, either SLE itself or drugs can be the cause.

T215

124543-124649

Epistemic_statement

denotes

The features of liver dysfunction and its causes need to be elucidated and considered before treating SLE.

T216

124846-125384

Epistemic_statement

denotes

1 Division of Infectious Diseases, 2 Division of Rheumatology and Immunology, 3 Division of Chest Medicine, 4 Department of Internal Medicine, 5 Department of Intensive Care Medicine, and 6 Department of Laboratory Medicine, Buddhist Tzu Chi General Hospital, Hualien, Taiwan Background: Eosinophilic granulomatosis with polyangiitis (EGPA; also known as Churg-Strauss syndrome) usually presents as recurrent asthma that cannot be controlled without systemic steroids, which, unfortunately, increases the risk of opportunistic infections.

T217

127638-127807

Epistemic_statement

denotes

Conclusions: Opportunistic infections should be considered when fever with abnormal procalcitonin and CRP levels persists despite that EGPA was grossly under controlled.

T218

127808-127876

Epistemic_statement

denotes

Cardiac involvement may lead to life-threatening arrhythmia in EGPA.

T219

127877-128217

Epistemic_statement

denotes

Background: Cytomegalovirus (CMV) infection is increasingly recognized in critically ill immunocompetent patients because of previous studies demonstrated an association between CMV disease and increased mortality rates, prolonged intensive care unit and hospital length of stay, prolonged mechanical ventilation, and nosocomial infections.

T220

128218-128394

Epistemic_statement

denotes

Molecular assays are now considered to be the "gold standard" for assessment of human CMV infection and disease in those at risk from severe associated clinical manifestations.

T221

128395-128546

Epistemic_statement

denotes

The nucleic acid sequence-based amplification assay, CMV pp67 late Gene transcripts (CMVpp67) is suggested by published reports for reliable prognosis.

T222

128857-129088

Epistemic_statement

denotes

Results: Under the univariate analysis, patients with positive CMV pp67 are associated with higher proportion of sepsis (56.2:83.3%, p = 0.036), longer ICU lengths of stay ( p = 0.004), and longer hospitalization days ( p = 0.002).

T223

129089-129248

Epistemic_statement

denotes

However, after considering all the variables in the multivariate analysis, there were no statistical significances among all the variables and CMV pp67 status.

T224

129249-129373

Epistemic_statement

denotes

In addition, we also found that CMV pp67 status was not associated with the mortality rate (OR = 0.07, 95%CI = <0.001-9.09).

T225

129374-129693

Epistemic_statement

denotes

But those who died were associated with more different antibiotics use (OR = 2.3, 95%CI = 1.05-5.05), higher percentage of vasopressor use (OR = 206.5, 95%CI = 5.52->999.99), higher prevalence of end stage renal disease (OR = 195.1, 95%CI = 2.27->999.99) but shorter hospitalization days (OR = 0.96, 95%CI = 0.93-1.00).

T226

129694-129962

Epistemic_statement

denotes

Conclusion: In conclusion, in our cross sectional study, within critically ill patients, there were no correlation of positive CMV pp67 with the characteristics we assumed to be; therefore, we couldn't tell if there is any parameter with higher positive CMV pp67 rate.

T227

130035-130190

Epistemic_statement

denotes

Owing to controversial results compared to previous studies, further larger sample size studies are necessary to develop more accurate correlation results.

T228

130191-130490

Epistemic_statement

denotes

Background: The establishment of bacterial species identification through gene sequencing triggered an increase in the reported cases of non-tuberculous mycobacterial infection caused by new bacterial species, which prompted the urgent need for the establishment of diagnosis and treatment regimens.

T229

130627-130810

Epistemic_statement

denotes

Granular patterns were observed dominantly in the rightlung, along with bronchodilation and partial cavitary lesion, which led to the suggested diagnosis of pulmonary mycobacteriosis.

T230

132308-132418

Epistemic_statement

denotes

There are reports of chemotherapies using CAM/RFP/EB and INH/RFP/EB, suggesting the treatments' effectiveness.

T231

132419-132651

Epistemic_statement

denotes

A probable case of Mycobacterium gordonae infection presenting as cervical lymphadenopathy and fever of unknown origin Sy-harn Lian 1 , Lih-shinn Wang 1,2 , Jen-jyh Lee 1,3 , Ying-huei Chen 4 , Huei-jen Chao 4 , Chia-jung Chiang 5 .

T232

134235-134527

Epistemic_statement

denotes

The survey of Streptococcus A, Cryptococcus, M. pneumoniae, syphilis, HIV, CMV and HSV, revealed unremarkable results, and no infectious sources were identified despite the investigations by the dermatologist, gynecologist, otolaryngologist, dentist and gallium-67-labeled leukocyte scanning.

T233

135225-135375

Epistemic_statement

denotes

However, the patient became afebrile with rifampicin, ethambutol and isoniazid treatment, and the cervical lymphadenopathy resolved a few weeks later.

T234

135376-135530

Epistemic_statement

denotes

All the associated symptoms were gone and the patient cured without relapse with a total of 11months of the anti-NTM treatment and 12 months of follow-up.

T235

135531-135621

Epistemic_statement

denotes

Conclusion: The most effective treatment regimen for M. gordonae has not been established.

T236

135622-135727

Epistemic_statement

denotes

However, the clinical response to specific antimycobacterial therapy indicates possible disease presence.

T237

135728-135777

Epistemic_statement

denotes

The recommended duration of therapy is not known.

T238

135963-136035

Epistemic_statement

denotes

Department of Laboratory Medicine, St. Martin De Porres Hospital, Taiwan

T239

136036-136261

Epistemic_statement

denotes

Background: The GeneXpert test is a new automated molecular test which detects the DNA in Mycobacterium Tuberculosis (MTB), as well as testing for the genetic mutations associated with resistance to the drug Rifampicin (RIF).

T240

136460-136613

Epistemic_statement

denotes

WHO recommended that the test should be used as the initial diagnosis test in individuals suspected of having Multi-Drug Resistant Tuberculosis (MDR TB).

T241

140124-140256

Epistemic_statement

denotes

However, due to persistant poor healing wound, antibiotics was adjusted to rifabutin, ciprofloxacin, clarithromycin and doxycycline.

T242

140831-141060

Epistemic_statement

denotes

Conclusion: In immunocompromised host with ulcerating skin lesion, M. haemophilum infection should be taken into consideration, especially when AFB is seen by direct microscopy while routine mycobacterial cultures remain sterile.

T243

141592-141753

Epistemic_statement

denotes

We have determined that 18 (24.0%) isolates were determined to have a unique pattern and 57 (76.0%) were clustered pattern strains (classifying into 6 clusters).

T244

143072-143168

Epistemic_statement

denotes

Diagnosis may be delayed in this group of patients as they often present with atypical symptoms.

T245

144072-144166

Epistemic_statement

denotes

Of concern, a large majority of patients with pulmonary TB were smear negative (39 out of 60).

T246

145506-145629

Epistemic_statement

denotes

Efforts to decrease active TB rates in this group of immunocompromised patients can reduce patient morbidity and mortality.

T247

146241-146364

Epistemic_statement

denotes

This study aims to clarify the relationship between serum ferritin levels and the development of severe dengue in children.

T248

148644-148826

Epistemic_statement

denotes

Conclusion: KFD should be suspected in children with febrile cervical lymphadenopathy, especially when concomitant with leukopenia, monocytosis and past Epstein-Barr virus infection.

T249

148954-149033

Epistemic_statement

denotes

Our results suggest EBV may not have causative role in the pathogenesis of KFD.

T250

149619-149808

Epistemic_statement

denotes

The aim of this study is to study the epidemiology of RSV and non-RSV acute bronchiolitis and the effectiveness of Palivizumab, a monoclonal antibody produced by recombinant DNA technology.

T251

150881-151054

Epistemic_statement

denotes

Fever of unknown origin as the first manifestation of malignancies in Albanian adults Migena Qato, Najada Como, Arjan Harxhi, Pellumb Pipero, Iris Koshovari, Dhimiter Kraja.

T252

153085-153186

Epistemic_statement

denotes

Conclusion: We identified 17 types of febrile tumors, with fever as the first clinical manifestation.

T253

153789-153853

Epistemic_statement

denotes

Faculty of Medicine, University Hospital Center "Mother Theresa"

T254

153854-153975

Epistemic_statement

denotes

Background: Patients of hemodialysis actually represent a target group closely related to infection by hepatitis C virus.

T255

155576-155689

Epistemic_statement

denotes

Conclusion: HCV infection in hemodyalisis patients remains the major cause of chronic liver and its complication.

T256

155690-155936

Epistemic_statement

denotes

Each of our patients evidenced a mild clinical form of hepatitisprobably related to immunocompromised status and HD procedure and the adverse effects of peginterferon therapy appeared minimal compared to the efficacy of treatment in our patients.

T257

155937-156021

Epistemic_statement

denotes

Nevertheless, at the end, the HCV infection negatively impacts survival on dialysis.

T258

156204-156424

Epistemic_statement

denotes

1 Division of Infectious Diseases, Department of ascertain whether the clinical presentation and outcome for patients with this disease differ for those infected with a gramnegative as compared to gram-positive pathogen.

T259

157809-157882

Epistemic_statement

denotes

However, VZV-caused pneumonia is quite rare comparing to the skin lesion.

T260

158675-158862

Epistemic_statement

denotes

Although pulmonary involvement of VZV is uncommon, we should be kept in mind in order to prevent patient from severe VZV pneumonia causing disaster which often require ventilator support.

T261

158863-159261

Epistemic_statement

denotes

The Background: Diclofenac, one of non-steroidal anti-inflammatory drugs (NSAIDs), was reported to be associated with the alleviation in the severity of Clostridium difficile infection (CDI), due to its inhibitory effect on phospholipase A2 and cyclooxygenase-2 (Cox-2), which play important roles in disruption of epithelial integrity and gut inflammatory response induced by C. difficile toxin A.

T262

159262-159338

Epistemic_statement

denotes

The aim of this study is to investigate the impact of NSAID exposure on CDI.

T263

160241-160460

Epistemic_statement

denotes

Besides, treatment with diclofenac at either dose can decrease the bacterial burden of C. difficile in the cecum and stool, and also reverse the ratio of Firmicutes to Bacteroidetes in the microbiota of cecum and stool.

T264

161140-161202

Epistemic_statement

denotes

However, dizziness and ataxia developed about one month later.

T265

161602-161712

Epistemic_statement

denotes

Discussion: Our problem was how to avoid metronidazole related encephalopathy when re-challenge metronidazole.

T266

161835-161870

Epistemic_statement

denotes

We thought suppository form (supp.)

T267

162054-162150

Epistemic_statement

denotes

Hepatic first-pass elimination of metronidazole may partially avoid after rectal administration.

T268

162536-162634

Epistemic_statement

denotes

And we also need to consider site of infection, severity of infection and bioavailability of drug.

T269

163123-163333

Epistemic_statement

denotes

Salmonella osteomyelitis is an uncommon extraintestinal manifestation and especially rare in patients without predisposing factors such as sickle cell disease, systemic lupus erythematosus or immunocompromised.

T270

164316-164394

Epistemic_statement

denotes

Conclusion: Salmonella osteomyelitis is rarely seen in immunocompetent adults.

T271

164655-164751

Epistemic_statement

denotes

Further studies are needed to investigate this approach in patients of salmonella osteomyelitis.

T272

166207-166385

Epistemic_statement

denotes

In addition, the IAI Enterobacteriaceae isolates harboring the bla CMY-2 and bla DHA-1 alleles were associated with high community-acquired rates (38.0% and 42.6%, respectively).

T273

167202-167332

Epistemic_statement

denotes

Brugada syndrome had been widely discussed but the prevalence has not been well studied, and the risk factors are still in debate.

T274

167774-167974

Epistemic_statement

denotes

Two days before the admission, he had a new onset of intermittent retrosternal pain which was not aggravated by exertion or relieved at rest, and could be radiated to upper back and last 5-10 minutes.

T275

169176-169336

Epistemic_statement

denotes

Conclusion: Brugada electrocardiographic changes has not yet been associated with Influenza in current medicine, only two case reports were found on the Pubmed.

T276

169337-169536

Epistemic_statement

denotes

However, this time we had genetic with clinical evidence shows that Infuenza A may had related to induce Brugada syndrome, which gives more information in study groups for Brugada syndrome in Taiwan.

T277

169694-169949

Epistemic_statement

denotes

Infectious Diseases Departament UHC "Mother Theresa" Tirane Introduction: Affect of visceral organs during herpes zoster is rare phenomena, althought very important because can occur diagnostic and therapeutic errors, exacerbated the progress of diseases.

T278

170060-170240

Epistemic_statement

denotes

He presents vesicular eruption in the sacral region including 4 dermatomes, associated with urinary retension and combustion, preceded by pain of lower limbs started a week before.

T279

171727-171858

Epistemic_statement

denotes

Patients with history of wild animals contacts should be considered as having an infection caused by an uncommon zoonotic pathogen.

T280

172698-172894

Epistemic_statement

denotes

He was diagnosed of upper gastrointestinal (GI) bleeding and a systemic infection with unknown source, and was given PRBC and platelet transfusion, pantoprazole, tranexamic acid, and terlipressin.

T281

173127-173218

Epistemic_statement

denotes

Because of previous S. equinus bacteremia, the patient might have a unique contact history.

T282

174343-174547

Epistemic_statement

denotes

1 School of Medicine, Tzu Chi University, Hualien, Taiwan, 2 Division of Infectious Diseases, Department of Internal Medicine, 3 Department of Radiology, Buddhist Tzu Chi General Hospital, Hualien, Taiwan

T283

174548-174651

Epistemic_statement

denotes

Background: Primary sternal osteomyelitis (PSO) is rare, yet potentially carries a devastating outcome.

T284

174652-174791

Epistemic_statement

denotes

It is generally caused by Staphylococcus aureus, but can be caused by S. epidermidis, gramnegative bacilli, and Mycobacterium tuberculosis.

T285

174792-174899

Epistemic_statement

denotes

Clinicians need to consider PSO when a patient presents with anterior chest pain, swelling, and bacteremia.

T286

175571-175640

Epistemic_statement

denotes

Liver abscess was considered as a possible source, but not confirmed.

T287

176423-176469

Epistemic_statement

denotes

However, the infection wasn't well controlled.

T288

176532-176615

Epistemic_statement

denotes

Conclusion: Due to rare clinical experiences, we have no standard approach for PSO.

T289

176616-176700

Epistemic_statement

denotes

However, the presentation of PSO is insidious, and a diagnosis can often be delayed.

T290

176701-176783

Epistemic_statement

denotes

PSO should be borne in mind when a patient presents with an anterior wall abscess.

T291

176923-177109

Epistemic_statement

denotes

Background: Purpura fulminans is a rare syndrome of intravascular thrombosis and hemorrhagic infarction accompanied by vascular collapse and disseminated intravascular coagulation (DIC).

T292

177110-177193

Epistemic_statement

denotes

It is typically associated with meningococcal infection and is rapidly progressive.

T293

178811-178897

Epistemic_statement

denotes

Amputation of the hands was also suggested, but the family refused further management.

T294

178973-179097

Epistemic_statement

denotes

Conclusion: Purpura fulminans is rare and most commonly occurs in babies and small children, but can be more rare in adults.

T295

179745-179808

Epistemic_statement

denotes

Cough, abdominal fullness and body weight loss were associated.

T296

180780-180989

Epistemic_statement

denotes

He was extubation successfully and discharge on the 42th day of hospitalization Conclusion: Histoplasmosis is a rare disease in Taiwan, and few microbiologically documented cases have been previously reported.

T297

180990-181139

Epistemic_statement

denotes

It is commonly diagnosed in areas of endemicity but frequently overlooked in areas of nonendemicity due to a low index of suspicion among physicians.

T298

181140-181322

Epistemic_statement

denotes

In HIV-infected patient who present with thrombocytopenia, hemophagocytotic syndrome and cavitary pulmonary lesion, a differential diagnosis of histoplasmosis should be kept in mind.

T299

181701-181911

Epistemic_statement

denotes

Despite use of variety of diagnostic techniques, however, SAE remains a clinical diagnosis and could represent a variety of pathophysiological processes that are both related and unrelated to coexistent sepsis.

T300

182629-182704

Epistemic_statement

denotes

These findings indicated SAE, which is associated with extracranial sepsis.

T301

182705-182775

Epistemic_statement

denotes

The pathophysiology is thought to involve blood-brain-barrier leakage.

T302

182978-183118

Epistemic_statement

denotes

The diffuse and severe white matter abnormalities like those we observed in our patient are rare and have been associated with poor outcome.

T303

183119-183230

Epistemic_statement

denotes

This case shows that severe encephalopathy with extensive white matter lesions might be a reversible condition.

T304

183231-183360

Epistemic_statement

denotes

Clinicians should realize that this condition and give cautious eyes to the first signs of improvement of the clinical condition.

T305

183609-183699

Epistemic_statement

denotes

Department of Laboratory Medicine, Taipei Hospital, Ministry of Health and Welfare, Taiwan

T306

183700-183845

Epistemic_statement

denotes

Background: Clostridium difficile (CD) is a common cause of hospital-acquired diarrhea, which is usually associated with previous antibiotic use.

T307

183846-183982

Epistemic_statement

denotes

C. difficile-associated diarrhea (CDAD) is most strongly associated with fluoroquinolones, cephalosporins, carbapenems, and clindamycin.

T308

184036-184293

Epistemic_statement

denotes

Clostridium difficile should be considered in diarrhea cases with a history of antibiotic use within the last 8 weeks (community-associated CDI) or with a hospital stay of at least 3 days, regardless of the duration of antibiotic use (hospitalacquired CDI).

T309

185008-185119

Epistemic_statement

denotes

Results: Over 7 months, we can calculate the laboratories' expenses were 37% less than if combined assay alone.

T310

185656-185803

Epistemic_statement

denotes

Conclusion: Our study suggested one or two-step algorithm for the detection of CD infection is a reliable, cost-effective, and timesaving strategy.

T311

186055-186181

Epistemic_statement

denotes

Also proved that C. difficile strains appear to produce the cell wall-associated enzyme glutamate dehydrogenase antigen (GDH).

T312

186182-186613

Epistemic_statement

denotes

Clinical characteristics of bacteraemia caused by Burkholderia cepacia complex species and antimicrobial susceptibility of the isolates in a medical centre in Taiwan Ying-Chun Chien 1 *, Chun-Hsing Liao 2 , Wang-Huei Sheng 1 , Jung-Yien Chien 1 , Yu-Tsung Huang 2,3 , Chong-Jen Yu 1 , Po-Ren Hsueh 1, 3 Background: Data about bacteraemia caused Burkholderia cepacia complex (BCC) among patients without cystic fibrosis are limited.

T313

188203-188423

Epistemic_statement

denotes

Conclusion: Correct identification of BCC complex to species level is important because different BCC complex species was associated with different outcomes of bacteraemia and exhibited different susceptibility patterns.

T314

188878-189124

Epistemic_statement

denotes

Traditionally, initial syphilis screening begins with the nontreponemal test (traditional algorithm); however, recent advancements in instrumentation have enabled more automated and objective approaches to the treponemal test (reverse algorithm).

T315

189125-189257

Epistemic_statement

denotes

The reverse algorithm for initial syphilis screening was limited to enzyme immunoassay (EIA) or chemiluminescence immunoassay (CIA).

T316

190212-190375

Epistemic_statement

denotes

However, the false-negative rate of Mediace ® TPLA was 2.27% (1 of 44), whereas that of Lumipulse ® presto TP was 0% and that of Architect Syphilis TP ® was 2.27%.

T317

190576-190744

Epistemic_statement

denotes

Because Mediace ® TPLA has various advantages such as low cost, high IgM-detection power, and easy operability, it should be recommended for the initial screening test.

T318

191079-191168

Epistemic_statement

denotes

In previous studies, this bacterium can survive in hard situation for 3 months or longer.

T319

191169-191252

Epistemic_statement

denotes

In clinical, if we don't disinfect complete, it will provide a chance to spread it.

T320

191253-191377

Epistemic_statement

denotes

So, if we had a efficient method that can culture this bacterium from environment, it would be useful for infection control.

T321

191964-192032

Epistemic_statement

denotes

That's to say, this broth can be a selective broth for C. difficile.

T322

192720-192952

Epistemic_statement

denotes

The case is presented to highlight the identification of this rare pathogenic organism in the laboratory from the samples collected and to start the treatment early for better prognosis since the mortality is high without treatment.

T323

193855-193994

Epistemic_statement

denotes

Conclusion: Urinary tract infection is common in diabetics, and in a diabetic patient B. pseudomallei, a rare pathogen can cause infection.

T324

193995-194135

Epistemic_statement

denotes

This organism can be overlooked in routine cultures as contaminant especially if the bacterial growth on the culture plate is polymicrobial.

T325

194253-194438

Epistemic_statement

denotes

Melioidosis caused by should be considered in the differential diagnosis in diabetic men with urinary tract infection, especially if they come from areas where melioidosis is prevalent.

T326

194663-195017

Epistemic_statement

denotes

1 Division of Infectious Disease, Jen-Ai Hospital, 2 Department of Infection Control, Jen-Ai Hospital Background: Taiwan CDC promoted the TB preventive program which introducing international recommended new LTBI diagnostic tests such as IGRAs (Interferon-γ release assays) and treatment prescription for TB contacts of all age groups from March 1, 2016.

T327

195018-195193

Epistemic_statement

denotes

IGRAs have been widely used for the diagnosis of latent and active tuberculosis in adults, but their role in diagnosing LTBI in children younger than 5 years remains debating.

T328

195584-195764

Epistemic_statement

denotes

Clinical diagnostic questions, according to the Oxford Level of Evidence 2011, systematic review (SR) of cross-sectional studies with reference standard would be the best evidence.

T329

195961-196077

Epistemic_statement

denotes

Probably due to blood draws can be more difficult in young kids, or other considerations such as cost-effectiveness.

T330

196078-196276

Epistemic_statement

denotes

However, this Level 1 evidence showed that the diagnostic performance of IGRAs were slightly higher than TST and can be used as supporting assays to detect LTBI in children above the age of 5 years.

T331

196623-196747

Epistemic_statement

denotes

It may also cause gastrointestinal perforation after starting chemotherapy, resulting from its good response to the therapy.

T332

198134-198494

Epistemic_statement

denotes

Conclusion: According to our experience, it was suggested that curative resection is not mandatory in patients undergoing surgery for gastrointestinal perforation and it is important to start chemotherapy in the early postoperative period and select a safer surgical procedure, such as limited surgery, flexibly assessing the necessity of removing the lesions.

T333

200111-200294

Epistemic_statement

denotes

However, only the value of PCT was higher in IBI group than other bacterial groups (13.11 ± 38.01 vs. 1.26 ± 1.65 in MBI, 1.10 ± 1.87 in TBI, and 1.69 ± 2.06 in MI, P < 0.05 for all).

T334

201114-201185

Epistemic_statement

denotes

1 Show Chwan Memorial Hospital, 2 Departments of Medical Laboratory, 3

T335

201186-201292

Epistemic_statement

denotes

Background: The increasing emergence of antibiotic-resistant nosocomial infections is a worldwide concern.

T336

201564-201617

Epistemic_statement

denotes

This is a challenge for clinicians to treat patients.

T337

202426-202519

Epistemic_statement

denotes

However, most antibiotics that target Gram-negative bacteria were not very effective against.

T338

202713-202810

Epistemic_statement

denotes

However, despite the high mortality rate, the rate of appropriate antibiotic use was notably low.

T339

202811-202999

Epistemic_statement

denotes

Clinicians should pay attention to the disease progression and evaluate the response to current antibiotics, and if possible, consider using effective antibiotics based on culture reports.

T340

204733-204818

Epistemic_statement

denotes

The extent of co-resistance may impact the choice of empirical antimicrobial therapy.

T341

204976-205217

Epistemic_statement

denotes

National Institute of Infectious Diseases and Vaccinology, National Health Research Institutes Background: A. calcoaceticus-A baumannii (ACB) complex comprises four genospecies: A. baumannii, A. calcoaceticus, A. nosocomialis, and A. pittii.

T342

207214-207310

Epistemic_statement

denotes

Conclusion: The prevalence of carbapenem resistance in A. baumannii remains very high in Taiwan.

T343

207906-208202

Epistemic_statement

denotes

Escherichia coli is often resistant to multiple antimicrobial agents and is often associated with the production of extended-spectrum β-lactamases (ESBLs), which are frequently described as a part of complex integrons, facilitate their horizontal transfer to other related and unrelated microbes.

T344

208203-208457

Epistemic_statement

denotes

The aim of this study was to define the current prevalence and phenotypes of 100 multidrug-resistant (MDR) E. coli isolates from clinical specimens in central Taiwan and to investigate associations between multidrug resistance and existence of integrons.

T345

210042-210255

Epistemic_statement

denotes

The data suggest that multiple and complex mechanisms involving mobile genetic elements in class 1 and class 2 integrons and antibiotic resistance have been developed in the evolution of E. coli strains in Taiwan.

T346

210993-211156

Epistemic_statement

denotes

However, clinical characteristics of patients with bloodstream infections (BSI) due to metallo β-lactamase (MBL)-producing Enterobacteriaceae are not well studied.

T347

213082-213135

Epistemic_statement

denotes

However, the all-cause 30-day mortality rate was 50%.

T348

213136-213290

Epistemic_statement

denotes

Conclusion: This study showed MBL-producing Enterobacteriaceae BSI was fatal, although rare, in patients with severe disease and longterm hospitalization.

T349

213291-213471

Epistemic_statement

denotes

Further research is necessary to study the appropriate treatment options for MBL-producing BSI, including levofloxacin treatment based on antimicrobial susceptibility test results.

T350

213732-213903

Epistemic_statement

denotes

Our study will investigate the carriage rates of S. aureus and MRSA of surgical HCWs in our hospital, and have a molecular epidemiology analysis for all S. aureus strains.

T351

214714-214770

Epistemic_statement

denotes

However, the difference was not significant (P = 0.812).

T352

215644-215760

Epistemic_statement

denotes

The PFGE denderogram gave the popular gene groups of S. aureus, which might help the surgical sit infection control.

T353

216174-216282

Epistemic_statement

denotes

The data of toxin gene or ribotype distribution of toxigenic C. difficile isolates in Taiwan remain limited.

T354

217214-217416

Epistemic_statement

denotes

Metronidazole and vancomycin resistance, though rare, was present in 1.2% and 2.0%, respectively, of toxigenic isolates, and of note there were 9 isolates resistant to both metronidazole and vancomycin.

T355

217417-217636

Epistemic_statement

denotes

Irrespective of toxigenic or non-toxigenic isolates, MIC 90 of doxycycline (8 μg/mL) was higher than that of tigecycline (≤0.0625 μg/mL), suggestive of more potent antibacterial activity of tigecycline than doxycycline.

T356

218516-218618

Epistemic_statement

denotes

Differential factors associated with colonization of different MRSA clones have not been well studied.

T357

218619-218807

Epistemic_statement

denotes

We sought to compare and contrast factors associated with colonization with various MRSA clones among patients contemporaneously hospitalized across acute and subacute healthcare settings.

T358

219217-219409

Epistemic_statement

denotes

To account for clustering, multivariable 2-level multinomial regression models were constructed to assess for factors associated with colonization of major MRSA clones, using SAS Proc Glimmix.

T359

219527-219635

Epistemic_statement

denotes

Sequence type ( However, the groin was 7 times as likely as the nares to be colonized with ST45 (aOR 7.19, .

T360

219773-219909

Epistemic_statement

denotes

Regardless of healthcare facility, contact precautions should be taken for recent MRSA-colonizers/infected to prevent MRSA transmission.

T361

220315-220456

Epistemic_statement

denotes

Epidemiology of MRSA nasal colonization in a range of HCWs have been studied, and yet out-ofhospital health care providers have limited data.

T362

220457-220644

Epistemic_statement

denotes

This study aims to characterize the risk factors and molecular epidemiologic characteristics of MRSA colonization in out-of-hospital health care providers and HCWs in a teritary hospital.

T363

222011-222148

Epistemic_statement

denotes

Conclusion: The findings suggest that there is substantial colonization of MRSA among in-hospital and out-hospital health care providers.

T364

222149-222243

Epistemic_statement

denotes

Implementations of infection control strategies should be applied high priority in those HCWs.

T365

223383-223460

Epistemic_statement

denotes

We set out to characterize GBS isolated from adults in Portugal in 2009-2015.

T366

224400-224487

Epistemic_statement

denotes

Macrolide resistance was associated with CC1 ( p < 0.001) and serotype Ib ( p < 0.001).

T367

225612-225714

Epistemic_statement

denotes

There were rare studies on the infections in LTCFs and pathogens if these residents were hospitalized.

T368

225715-225900

Epistemic_statement

denotes

This study aims to investigate the clinical characteristics, pathogens and antimicrobial susceptibility from LTCF residents who were hospitalized due to urinary tract infections (UTIs).

T369

227738-227807

Epistemic_statement

denotes

Empirical antimicrobial therapy might be optimized in these patients.

T370

228180-228301

Epistemic_statement

denotes

Generally, these species are non-pathogens but it can sometime induce infectious diseases especially in compromised host.

T371

228302-228543

Epistemic_statement

denotes

The purpose of this study was to assess the molecular typing of Enterococcus faecium which isolated from single site to evaluate the association and/or differentiation of genotype, infection site, patient group and antimicrobial sensitivity.

T372

228852-229001

Epistemic_statement

denotes

Retrospectively analysed with the patients background and/or infection site by medical records to characterize with the correlation between genotype.

T373

229854-229932

Epistemic_statement

denotes

However, all isolates were sensitive to linezolid, vancomycin and teicoplanin.

T374

230056-230266

Epistemic_statement

denotes

Conclusion: These results clearly suggested the correlation of genotype and infection site of the E. faecium and need to be further analysis of detailed virulence/antimicrobial resistant genes in each genotype.

T375

231549-231786

Epistemic_statement

denotes

Fever (95.5%), diarhea (87.4%), vomiting (25.6%) and bloody stool (15.1%) were the most common symptoms for Salmobella infections and abdominal pain (( p < 0.041)were associated with Salmonella Serogroup D1 (17%) and C1 (19%) infections.

T376

233332-233401

Epistemic_statement

denotes

However, major disadvantage of MLST is high-cost and labor-intensity.

T377

234231-234348

Epistemic_statement

denotes

Results: We chose the fasta-format text files as the raw data which should be called to the spreadsheet for analysis.

T378

234349-234540

Epistemic_statement

denotes

For process of the raw data calling, all the fasta files in the specified folder was automatically loaded, which takes most of the running time, however, is the main advantage of our program.

T379

234541-234703

Epistemic_statement

denotes

The running-time of the whole process was 10 minutes per 50 strains, which is much faster than the manual typing method, which would generally take several hours.

T380

234883-234998

Epistemic_statement

denotes

Conclusion: MLST is a good method for epidemiologic evaluation, however, labor-intensity is the major disadvantage.

T381

235102-235165

Epistemic_statement

denotes

Also, this program may prevent clerical error of manual typing.

T382

235166-235260

Epistemic_statement

denotes

Excel-based macros can be used by anyone, and can be constructed through uncomplicated coding.

T383

235261-235324

Epistemic_statement

denotes

This might be useful for the large scale epidemiologic studies.

T384

236046-236139

Epistemic_statement

denotes

However, the concentration of bleach is not routinely checked in the daily cleaning practice.

T385

236140-236312

Epistemic_statement

denotes

The aim of this study is to investigate the concentrations of various brands of bleaches used in hospital, and ensure the optimal concentration of bleaches can be achieved.

T386

236414-236554

Epistemic_statement

denotes

The bleaches were diluted with tap water to a presumed concentration of 500 PPM, according to the procedures suggested by the manufacturers.

T387

236744-236801

Epistemic_statement

denotes

The concentrations of the bleaches could decay gradually.

T388

236900-236967

Epistemic_statement

denotes

For quality assurance, the manufacturers should focus on 3 aspects.

T389

237311-237492

Epistemic_statement

denotes

Could the HOCl as a high level disinfection solution for environment cleaning Wen-Jun Yeh 1 , Fu-Chieh Chang 1 , Ya-Ling Chen 1 , Chang-Pan Liu 1,2 , Nan-Chang Chiu 3 , Hsin Chi 3 .

T390

237645-237689

Epistemic_statement

denotes

In vitro, this production can kill pathogen.

T391

237775-237883

Epistemic_statement

denotes

As we know, if this can kill pathogen from surface, then we could not culture any pathogen from the surface.

T392

238582-238686

Epistemic_statement

denotes

Conclusion: In this study, the HOCl solution function were not good enough to replace chlorine solution.

T393

238735-238876

Epistemic_statement

denotes

So, according to this study, we didn't suggest the hospital use HOCl solution as a High level disinfection solution for environment Cleaning.

T394

238983-239054

Epistemic_statement

denotes

Department of Laboratory Medicine, Chang Gung Memorial Hospital, Chiayi

T395

239055-239135

Epistemic_statement

denotes

Background: The quality of meals provided in hospitals is essential to patients.

T396

239136-239242

Epistemic_statement

denotes

The nosocomial food contamination can cause various food-borne illnesses of patients and healthcare staff.

T397

239348-239471

Epistemic_statement

denotes

We examine whether the regulation is enough to monitor the food safety base on our experience about non-conformity in 2016.

T398

239978-240216

Epistemic_statement

denotes

However, the result revealed that 1150 MPN/g of coli-form bacteria in the meals was more than the threshold (1000 MPN/g) from the regulation "Sanitation Standard for General Foods" approved by Food and Drug Administration (FDA) in Taiwan.

T399

240825-241030

Epistemic_statement

denotes

We suggest that the regulation about pathogens isolated from reusable and disposable tableware should be considered and established in hospitals to improve the food safety of patients and healthcare staff.

T400

241294-241453

Epistemic_statement

denotes

If the data was under 200 CFU/mL higher than 50 CFU/mL, clinical staff or engineer have to find the possible reason that caused the data higher than 50 CFU/mL.

T401

241558-241690

Epistemic_statement

denotes

And after finding the possible origin, we did some change, then the result showed its useful that no cases present after the change.

T402

241691-241777

Epistemic_statement

denotes

Methods: In this study, we drew a picture to check the possible site of the RO system.

T403

242236-242293

Epistemic_statement

denotes

After checked the data, we tried to find possible source.

T404

242478-242560

Epistemic_statement

denotes

So we suggested the clinical staff clean the space that empty the space of outlet.

T405

242561-242644

Epistemic_statement

denotes

Thanks to the supporting of nurse, there are no more culture positive data present.

T406

243080-243143

Epistemic_statement

denotes

In clinical, we suggested to use the disposable wipe for clean.

T407

243530-243596

Epistemic_statement

denotes

After 48 hours incubated, we can check the bacteria growth or not.

T408

244769-244851

Epistemic_statement

denotes

The traps are evaluated after the test feasibility of inspection for the next day.

T409

245765-245958

Epistemic_statement

denotes

Conclusion: From the experimental results that whether the postharvest petri dish is immediately sent to the bacterial chamber culture or after the inspection of the petri dish every other day.

T410

246089-246157

Epistemic_statement

denotes

Can get a good environment for the deployment of chemotherapy drugs.

T411

246580-246735

Epistemic_statement

denotes

However, the comparative application methods and contamination assessment techniques is unknown, and no consensus exists around benchmarks for cleanliness.

T412

246736-246926

Epistemic_statement

denotes

We sought to determine whether implement environment clean separation management measures in a medical intensive care unit (MICU) could reduce the density of healthcare associated infection.

T413

247923-248288

Epistemic_statement

denotes

Within the study period, the value of pass increase from 13% to 53%, the value of fail decrease from 47% to 20%; numerical difference trend of the pass value increase from −7% to 20% and fail value decrease from 13% to −20%, showing the use of different color disposable wipes and the correct wiping method or wiping process can improve the environment cleanliness.

T414

248555-248635

Epistemic_statement

denotes

However, there is no decline of the density of health-care associated infection.

T415

248718-249107

Epistemic_statement

denotes

Infection Control Office; Clinical Laboratory Department Background: According to 2006 New Hospital Accreditation: The Surgery and Anesthesia departments should regularly implement bacteriological examination, yet relevant literatures did not suggest regular inspections, and these inspections should be implemented only when associated epidemiology data was required to confirm outbreaks.

T416

249108-249352

Epistemic_statement

denotes

However, in consideration of healthcare quality and patient safety, infection control (IC) team had routinely collected and cultured surgical hand scrub water samples from total 4 faucets in our operation room (OR) by IC technician every month.

T417

249799-250104

Epistemic_statement

denotes

Improvement measures were subsequently developed and implemented as described below: (1) Check and wipe off the dust on the surface of UV lamp every week to avoid penetration reduction that might affect germicidal efficacy (executed by sanitary staff, and included the practice in the routine clean work).

T418

250105-250270

Epistemic_statement

denotes

(2) Staffs should always be aware of the status of UVGL, and once UV system is in alarm, beeping, immediately report to the OR leader nurse to call the manufacturer.

T419

250601-250700

Epistemic_statement

denotes

It is generally thought that UVGL has sustained germicidal intensity until the lamp is full dimmed.

T420

250757-250847

Epistemic_statement

denotes

In fact, its germicidal ability is associated with Irradiation intensity (I) and Time (T).

T421

250848-250952

Epistemic_statement

denotes

Therefore, the dust and grease on the surface of UV lamp may reduce penetration and germicidal efficacy.

T422

250953-251128

Epistemic_statement

denotes

Hopefully, the experience sharing can remind IC healthcare workers of the link between decay of UV lamp and incomplete sterilization that is closely related to patient safety.

T423

251685-251844

Epistemic_statement

denotes

So, we made some provisions for this problem, including changing RO membrane, disinfection of pipeline every week, and sampling RO dialysis after disinfection.

T424

252246-252350

Epistemic_statement

denotes

Conclusion: After typhoon, sampling of RO dialysate for bacterial count should be performed immediately.

T425

252679-252850

Epistemic_statement

denotes

1 Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan, 2 Center for Infection Control, National Taiwan University Hospital, Taipei, Taiwan

T426

252851-253010

Epistemic_statement

denotes

Background: Healthcare-associated infections caused by multidrug-resistant (MDR) pathogens are significantly associated with increased mortality and morbidity.

T427

253011-253101

Epistemic_statement

denotes

Environmental cleaning can reduce transmission of these pathogens but is often inadequate.

T428

253102-253284

Epistemic_statement

denotes

Adjunctive, no touch methods are warranted to enhance the effectiveness of disinfection particularly in hospital settings where healthcare-associated infections are of major concern.

T429

255089-255252

Epistemic_statement

denotes

Conclusions: The Hyper Light P3 device was effective in killing MDR pathogens and could be considered as an adjunctive method in disinfecting hospital environment.

T430

255253-255437

Epistemic_statement

denotes

Urinary tract infections associated with cross-contamination of ureteroscopes Jung-Hui Chen 1 , Mei-Hua Lin 1 , Wei-Rong Huang 1 , Yi-Ching Hsieh 1 , Chun-Yi Lee 1,2 , Mei Huang 1,2 *.

T431

255572-255758

Epistemic_statement

denotes

Cleaning and disinfection of the ureteroscopes used for the sterile procedure should follow standardized guidelines to prevent iatrogenic infections associated with cross-contaminations.

T432

256578-256698

Epistemic_statement

denotes

Further investigation revealed that ureteroscope cleaning staffs didn't performe in accordance with standard procedures.

T433

257283-257370

Epistemic_statement

denotes

But 4 cases of infection appeared when the problem ureteroscope was re-used on 22 June.

T434

257371-257523

Epistemic_statement

denotes

Therefore, prompted another investigation which indicated that the ureteroscope was suspected to be damaged and should no longer be used on any patient.

T435

257524-257683

Epistemic_statement

denotes

Conclusion: Contaminated ureteroscope could lead to transmission of infections resulting in increased healthcare cost and even life-threatening adverse events.

T436

257861-258044

Epistemic_statement

denotes

Investigation of a suspected outbreak of nontuberculous mycobacteria infected associated with bronchoscopy Chun-Ming Lee 1 , Hsiu-Tzu Chiang 2 , Fu-Chieh Chang 2 , Chang-Pan Liu 2,3 .

T437

258318-258426

Epistemic_statement

denotes

However, treatment of the towels with disinfectants in the washing process hardly removes the contamination.

T438

258543-258631

Epistemic_statement

denotes

However, there are few reports about the bacterial contaminations for the steamed towel.

T439

259510-259600

Epistemic_statement

denotes

Accordingly, we recommend the use of disposable hand towels for treatment in beauty salon.

T440

259999-260050

Epistemic_statement

denotes

This recommendation is based with limited evidence.

T441

261631-261782

Epistemic_statement

denotes

Although the magnitude of the Hawthorne effect has been described in several studies, subgroup analysis of the Hawthorne effect has not been clear yet.

T442

262895-263028

Epistemic_statement

denotes

Conclusion: The heterogenicity of the Hawthorne effect in hand hygiene may influence the interpretation of overt observation results.

T443

263029-263143

Epistemic_statement

denotes

We suggest covert observation be performed at least once in health facilities in which HH observation are routine.

T444

263144-263258

Epistemic_statement

denotes

Realizing the heterogenicity of the Hawthorne effect may help identify target population with lower HH compliance.

T445

264339-264607

Epistemic_statement

denotes

The main problems identified to such as lack of awareness and knowledge regarding hand hygiene timing, the boundaries between patient care and non-patient care areas are not well-defined, steps for hand hygiene are not performed properly… and other seven major issues.

T446

264717-265330

Epistemic_statement

denotes

In-ward medication dispensing procedure was changed to distinct patient care and non-patient care areas, the importance of hand hygiene was promoted to health-care workers at ward or division meetings, standard hand-washing was repeatedly demonstrated by hand hygiene auditors to reinforce hand hygiene compliance, and crossaudits were conducted by infection control link nurses/hand hygiene representatives on a monthly basis to assess compliance of Five Moments for Hand Hygiene and Seven Steps of Hand Washing in the Intermediate Care Nursery, with provision of feedback to the teams for continual improvement.

T447

265896-266107

Epistemic_statement

denotes

We hope that this model can be extended to other pediatric units to enhance the quality of care, reduce healthcare resource consumption and social costs, and ensure the safety of patients and healthcare workers.

T448

266444-266537

Epistemic_statement

denotes

Therefore, the attitudes of healthcare staffs and hospital workers perform an essential role.

T449

266538-266680

Epistemic_statement

denotes

The purpose of the survey was to discover the relationship between hand hygiene compliance and attitudes of the employees in a local hospital.

T450

267930-268049

Epistemic_statement

denotes

By contrast to hand hygiene compliances, just 67% staffs completed hand washing process while they provided healthcare.

T451

268387-268431

Epistemic_statement

denotes

Virtually, they are difficult to perform it.

T452

268486-268573

Epistemic_statement

denotes

However, a regularly hand hygiene training and handwashing audit programs are required.

T453

269790-269927

Epistemic_statement

denotes

Our implementing measures are as followings: (1) Educate the staff with symptoms should keep aerosol and contact isolation, rest at home.

T454

269928-270020

Epistemic_statement

denotes

(2) The other staff who took care of these patients should wear masks and keep hand hygiene.

T455

270021-270091

Epistemic_statement

denotes

(3) The environment that the patients worked should enhance cleansing.

T456

270092-270187

Epistemic_statement

denotes

(4) Watch out for the possible symptoms of infection and informed infection control department.

T457

270251-270348

Epistemic_statement

denotes

Conclusion: Norovirusis a very contagious virus, it can live in stool or vomitus for a long time.

T458

270780-270884

Epistemic_statement

denotes

We hoped to share this special experience to prevent possible clusters and save the resources and costs.

T459

271633-271794

Epistemic_statement

denotes

(1) Patient and their family: The poster was posted to remind individuals suffering from fever, cough, and cold should wear a mask, or educate them not to visit.

T460

271976-272127

Epistemic_statement

denotes

(2) Health professionals: The staff should take three-hour lessons to strengthen his or her knowledge regarding infection control and reporting system.

T461

272275-272339

Epistemic_statement

denotes

The staff should be arranged off if his or her BT is above 37.5.

T462

272340-272392

Epistemic_statement

denotes

The staff could on duty after no fever for 24 hours.

T463

272513-272575

Epistemic_statement

denotes

Validity period of all healthcare products should be examined.

T464

272576-272727

Epistemic_statement

denotes

Staff should take at least one-hour lesson of needlestick and sharps injuries prevention yearly; new staff should complete this course in three months.

T465

273096-273196

Epistemic_statement

denotes

If there was diarrhea or vomiting, it is important to strengthen environment clean and disinfection.

T466

273197-273315

Epistemic_statement

denotes

(4) Suspected cases: The suspected patients should be held on isolated rooms in order to decrease contact with others.

T467

273316-273376

Epistemic_statement

denotes

Related library tests or examinations should be followed up.

T468

273380-273445

Epistemic_statement

denotes

Patients and visitors can compliance with hand hygiene and masks.

T469

274056-274683

Epistemic_statement

denotes

1 Jianan Psychiatric Center, 2 Chang Hua hospital Background: Environmental cleansing was a key point in the prevention of medical care, psychiatric patients generally had poor personal hygiene and habits, therefore while infectious disease occurred, indirect easy to make the environment contaminated by bacteria, when cleaning staff cannot effectively clean the disinfection environment, and contact with the patient with a infectious disease, would increase the medical care-related infections, in order to put an end to the breeding of infectious diseases, environmental cleansing to improve intervention is very important.

T470

275831-276170

Epistemic_statement

denotes

Results: After the improvement of environmental cleanliness, the incidence of upper respiratory tract infection from 2.8‰ down to 2.24‰, cleaning staff also expressed that through the in-service education, unified cleaning appliances and management, can more clearly implement the environmental clean disinfection of the operating process.

T471

277032-277077

Epistemic_statement

denotes

Five out of 9 cases were M. chelonae complex.

T472

277494-277694

Epistemic_statement

denotes

All specimen (N = 4) from the filtered water of 3 automatic washing machines and tap water culture showed growth of NTM, however, the strain was different from the outbreak M. chelonae complex strain.

T473

278474-278573

Epistemic_statement

denotes

This study was intended to analysis the possible cause of VRE transmission and to prevent outbreak.

T474

278869-279084

Epistemic_statement

denotes

Therefore, once culture result of multidrugresistant organism (MDRO) was obtained after patient transferred out of ICU, the ward can't accomplish the terminal cleaning according to the standard of MDRO-exposed ward.

T475

280030-280170

Epistemic_statement

denotes

In this study, all four isolates of VRE were from different site and the antibiogram was also different, which means outbreak is not likely.

T476

280171-280373

Epistemic_statement

denotes

During the investigation and intervention measurements, we found that reduction of healthcare associated infection can be achieved by improvement of hand hygiene and making sure of environment cleaning.

T477

281901-282246

Epistemic_statement

denotes

Results: Through the intervention investigation, the daily monitoring of the epidemic and return to the Health Bureau, a comprehensive staff health monitoring log, and the implementation of measures, including strengthening the environment disinfection, unnecessary time should be fully wear masks, strengthen the implementation of hand hygiene.

T478

282346-282496

Epistemic_statement

denotes

Conclusion: Medical personnel when there is a history of exposure to influenza respiratory symptoms should seek medical diagnosis and early treatment.

T479

282497-282563

Epistemic_statement

denotes

Personnel should implement abnormal body temperature notification.

T480

282564-282830

Epistemic_statement

denotes

In order to provide a safe medical environment, the Infection control division by monitoring temperature feedback system and daily active surveillance, as soon as possible to find the ward and unit influenza abnormal cluster events and early control of the epidemic.

T481

285595-285754

Epistemic_statement

denotes

However, in 2010 the studies also a policy for the CL bundle is often present but frequently not well implemented by National Healthcare Safety Network (NHSN).

T482

286580-286721

Epistemic_statement

denotes

However, sampling a total of 15 cases of exposure to hazard among those in January 1, 2015 to March 31, 2015, only 3 cases to get the CLABSI.

T483

286722-287005

Epistemic_statement

denotes

In view of this situation, interview doctors and nurses, found that in the same system hazers caused by the various states, have the same or different reaction practices to maintain their system and can implement functions continue to work, and may reduce the risk of patient injury.

T484

287006-287438

Epistemic_statement

denotes

In the other hand, the SOEA can clarify the relationship between the various elements of central catheter care systems, combined with resilience engineering to understand HealthCare worker that how to respond the system in daily hazards, and under the anticipated and unanticipated occurrence of various adaptively adjust its central catheter combined practices, rather than blindly follow, and to maintain patient safety practices.

T485

287439-287653

Epistemic_statement

denotes

Conclusion: Applying SOEA in addition to the ability to the structure of the system can complete presentation, including relevance of the system, orderly, purposeful, providing system improve important information.

T486

287654-287904

Epistemic_statement

denotes

SOEA analysis of the resilience of the system, allowing the HealthCare worker to understand the occurrence and learning control method reaction only after full cognitive system structure in order to achieve the goal to Building a Safer Health System.

T487

289311-289408

Epistemic_statement

denotes

All of them agreed "the doctors should evaluate the necessity of catheter for patient every day."

T488

290037-290133

Epistemic_statement

denotes

However, 63.8% of the respondents conisdered that the bunde care would increase their work load.

T489

290134-290259

Epistemic_statement

denotes

Most of the study subjects (108, 78.3%) admitted the bundle program would fail, if the practioners did not take it seriously.

T490

290260-290388

Epistemic_statement

denotes

Conclusion: All respondents recognized CVC bundle care program would reduce the risk of catheter-related bloodstream infections.

T491

290389-290501

Epistemic_statement

denotes

However, most of the practitioners worried that heavy workload would be an obstacle to practice the bundle care.

T492

290739-290874

Epistemic_statement

denotes

Background: Elizabethkingia meningoseptica is a ubiquitous pathogen that could be found in clinical environment and equipment surfaces.

T493

290990-291116

Epistemic_statement

denotes

Increasing frequency of human infection, especially from healthcare associated infections, had been reported in recent decade.

T494

291117-291217

Epistemic_statement

denotes

However, efforts of infection control of outbreak caused by E. meningoseptica remains less reported.

T495

292464-292641

Epistemic_statement

denotes

There was no linkage to the environmental isolates of the other two clusters indicate the possibility of cross transmission by healthcare personnel (Cluster 1 and 2, Figure 1 ).

T496

292865-292986

Epistemic_statement

denotes

Our results demonstrate potential transmission of E. meningoseptica via medical environment and person-to-person contact.

T497

292987-293096

Epistemic_statement

denotes

Vigorous infection control measures should be applied to prevent spreading of E. meningoseptica at hospitals.

T498

295284-295485

Epistemic_statement

denotes

Outbreak of surgical site infections related to mastectomy with/ without reconstruction at a medical center Ju-Chun Lo 1 , Ying-Ying Chang 2 , Ya-Hui Huang 1 , Jann-Tay Wang 1,2 , Wang-Huei Sheng 1,2 .

T499

296516-296784

Epistemic_statement

denotes

In order to realize the cause for the unusually increased SSI, an outbreak investigation was conducted to analyze the probable factors, including staff's daily work, environment and equipment cleaning, the operation procedures, and post-operation wound care processes.

T500

297525-297637

Epistemic_statement

denotes

Conclusion: A timely implemented outbreak investigation and effective intervention can stop the outbreak of SSI.

T501

299204-299350

Epistemic_statement

denotes

Conclusion: Our experience has shown that the implementation of VAP bundle, can be effective in reducing ventilator-associated pneumonia occurred.

T502

299850-299927

Epistemic_statement

denotes

Every more one day use of urinary catheter can increase UTI rate by 3% to 8%.

T503

300826-301065

Epistemic_statement

denotes

In order to promote the facility and procedure method, use the appropriate disposable urinary catheter package which can facilitate health care providers to apply and shorten the duration of catheterization, also reduce contamination rate.

T504

301066-301419

Epistemic_statement

denotes

There is utilization of 2% chlorhexidine for disinfection, preconnection of urinary catheter and urine collecting bag, using sealed valve designed urine collection bag if urine specimen is necessary to be obtained which can avoid for damaging the closed circuit, wiping the catheter opening with alcohol based paper before and after collection of urine.

T505

301954-302111

Epistemic_statement

denotes

Although the utilization rate is not differed from previous rate, the UTI incidence is reduced significantly after implementation of current UTI bundle care.

T506

302808-302874

Epistemic_statement

denotes

Therefore, catheter related UTI rate can be reduced significantly.

T507

304081-304524

Epistemic_statement

denotes

Effectiveness of insertion and maintenance bundles to prevent central-line-associated bloodstream infections in critically ill patients: experiences and challenges in a medical intensive care unit Ya-Wen Chang 1 *, Miao-Fang Tai Background: To determine the effectiveness of a care bundle, with a novel line maintenance procedure, in reducing the rate of central line-associated bloodstream infection (CLABSI) in the intensive care unit (ICU).

T508

305778-305910

Epistemic_statement

denotes

The length of ICU stay and catheter duration was associated with a higher risk of infection associated to these devices ( p < 0.05).

T509

306730-306807

Epistemic_statement

denotes

1 Infection Control Office, 2 Department of Orthopedics, 3 Operating Room, 4

T510

306808-307015

Epistemic_statement

denotes

Background: The annual rate of surgical site infection associated with orthopedic operation in our hospital was 1.43‰ (25/17468) in 2015, which increased by 0.91‰ when compared with 0.52‰ (9/ 17128) in 2014.

T511

309849-309925

Epistemic_statement

denotes

Bundle care has been proven to effectively reduce CAUTI in many literatures.

T512

309926-310014

Epistemic_statement

denotes

Well-structured infection control programs are imperative in order to the prevent CAUTI.

T513

312689-312772

Epistemic_statement

denotes

It remains unclear whether daily bathing with 2% chlorhexidine can reduce the risk.

T514

312773-312981

Epistemic_statement

denotes

The aim of this study is to compare the incidence of healthcare-associated bloodstream infection (HABSI) between patients using of 2% CHG daily bath and those using general antibacterial cleansers daily bath.

T515

314709-314839

Epistemic_statement

denotes

We recommend routine adoption of this simple and low-cost intervention to reduce BSI among patients with hematological malignancy.

T516

315921-316091

Epistemic_statement

denotes

All the pathogen specimen will compare with RAPD (Random amplified polymorphic DNA) to reconstruct ribonucleic acid and to distinguish whether the strains were identical.

T517

316611-316670

Epistemic_statement

denotes

The outbreak of surgical site infection has been confirmed.

T518

317202-317291

Epistemic_statement

denotes

It can be well explained that our efforts for this outbreak are effective and successful.

T519

319066-319135

Epistemic_statement

denotes

The team expected that these measures would alleviate the CAUTI rate.

T520

320105-320239

Epistemic_statement

denotes

Therefore, clinical nurses should regularly receive the latest information to enhance their expertise and improve health care quality.

T521

320349-320485

Epistemic_statement

denotes

ChiMei Medical Center Intensive Care Unit Background: Lung infections can be severe consequences of chemotherapy-induced immune defects.

T522

320643-320696

Epistemic_statement

denotes

Diagnosis is difficult and frequently time-consuming.

T523

321772-321839

Epistemic_statement

denotes

However, sudden onset of PEA and apnea with cyanosis were occurred.

T524

322335-322454

Epistemic_statement

denotes

However, unstable hemodynamic was done with renal, liver function failure, condition poor response, discharged on 6/11.

T525

322809-323004

Epistemic_statement

denotes

The ideal treatment duration has not yet been defined and depends on the extension of the disease, the patient's response to treatment, the base disease and the patient's immunological condition.

T526

323005-323053

Epistemic_statement

denotes

In some cases, lifelong therapy may be required.

T527

324609-325042

Epistemic_statement

denotes

In response, we invited external infection control experts to train hospital medical personnel on how to provide bundle care, modify daily VAP care standards (e.g., raising bedhead to 30°-45°, adopting daily sedation cessation, using 0.2-0.12% chlorhexidine gluconate for oral care, draining ventilators water, and washing hands), provide training, develop a daily care assessment form, and establish an information sharing platform.

T528

325423-325607

Epistemic_statement

denotes

We found that when bedheads were raised to 30°-45°, alert conscious patients could not fall asleep and experienced sacrum pain; accordingly, these patients refused this care procedure.

T529

326173-326465

Epistemic_statement

denotes

1 Infection Control Office, 2 Dean Chamber, 3 Infectious Diseases, 4 Department of Nursing, 5 Respiratory Room Background: We implemented an invasive medical intervention bundle care quality improvement program in 2015-2016, the VAP had remarkably decreased from 3.10‰ (2011) to 0.65‰ (2015).

T530

328224-328391

Epistemic_statement

denotes

Conclusion: Bundle care is an effective measure for promoting medical care quality, monthly meeting and surveillance system should be applied to evaluate its efficacy.

T531

329006-329142

Epistemic_statement

denotes

The aim of the study was to evaluate the antiplaque efficacy by using oral care with 0.2% CHG gel in an adult intensive care unit (ICU).

T532

330129-330250

Epistemic_statement

denotes

Conclusion: Oral hygiene care with 0.2% CHG gel can significantly lower the MQHPI score in adult critically ill patients.

T533

330251-330367

Epistemic_statement

denotes

Further largescaled investigations are warranted to evaluate whether it had impact on reducing the incidence of VAP.

T534

330699-330847

Epistemic_statement

denotes

Background: According to previous studies, there were many evidences suggested that bundle care can reduce healthcare related infection effectively.

T535

330848-330953

Epistemic_statement

denotes

However, clinical staff didn't know the meaning of bundle care clearly and didn't obey the measures well.

T536

330954-331057

Epistemic_statement

denotes

That's why we implemented ventilation-associated pneumonia (VAP) bundle care since June 1, 2015 to now.

T537

331058-331175

Epistemic_statement

denotes

In the beginning, the accuracy of bundle care was only 76.6%, which may cause in low compliance rates of bundle care.

T538

331232-331309

Epistemic_statement

denotes

The lack of recognition can affect the compliance of performing the measures.

T539

332496-332642

Epistemic_statement

denotes

Conclusion: Improving recognition of clinical staffs can enhance compliance rates of bundle care, leading to reduced healthcare related infection.

T540

332643-332726

Epistemic_statement

denotes

So, we will still follow this study and hope to achieve the goal of zero tolerance.

T541

333084-333287

Epistemic_statement

denotes

Background: The empirical combination of both a beta-lactam and glycopeptide to counter potential staphylococcal pathogens may improve the clinical outcomes for cases of Staphylococcus aureus bacteremia.

T542

334748-334927

Epistemic_statement

denotes

Conclusion: Cephalosporin-glycopeptide combinations at clinically achievable concentrations can exhibit in vitro synergistic antibacterial activity against clinical MRSA isolates.

T543

336541-336699

Epistemic_statement

denotes

Such combinations were not influenced by the inoculum size of ESBL E. coli and K. pneumoniae and could be a therapeutic option for treating severe infections.

T544

338164-338388

Epistemic_statement

denotes

Among patients, in-hospital mortality was independently and significantly associated with APACHE II score (odds ratio (OR), 1.2825; 95% CI, 1.1123 ± 1.4788) and achieving clinical success (OR, 0.003; 95% CI, 0.0003 ± 0.409).

T545

338538-338640

Epistemic_statement

denotes

These results suggest that doripenem may be judiciously used for the treatment of patients with HCAIs.

T546

340146-340361

Epistemic_statement

denotes

Then, we intervene infection control measures such as using computer reminder to reduce usage of urinary catheterization, that can be attributed to obvious decrease in the rate of urinary catheter utilization ratio.

T547

341976-342098

Epistemic_statement

denotes

The correlation of HAI events counted with and without the HAUTI surveillance system in different department is displayed.

T548

343621-343824

Epistemic_statement

denotes

Based on chi-square test, the null hypothesis was that the operation of neurosurgery in different operating rooms, and postoperative surgical site infection (SSI) chance was the same during construction.

T549

344065-344204

Epistemic_statement

denotes

From the control chart was not difficult to find that SSI (0.92%) had exceeded 2 times the standard deviation of the control chart in July.

T550

345155-345271

Epistemic_statement

denotes

The result of the survey was no correlation between postoperative infection and construction work of operating room.

T551

345272-345505

Epistemic_statement

denotes

Conclusion: Here is the suggestion, surgery room if the construction plan, it should notice surgeon to evaluate the surgical schedule postponed or canceled, or to make a mandatory stop disposed of operating by the surgical committee.

T552

345506-345647

Epistemic_statement

denotes

Moreover, after the completion of the construction, it should to commission qualified manufacturers for dust detection and bacteria sampling.

T553

347062-347154

Epistemic_statement

denotes

Antimicrobials use should be monitored carefully, especially carbapenems and aminoglycoside.

T554

347155-347331

Epistemic_statement

denotes

Further study on bigger population with carbapenems use would be needed to confirm the association between using carbapenems in monotherapy and the risk to get CRPA infections.

T555

347567-347614

Epistemic_statement

denotes

Taipei Hospital, Ministry of Health and Welfare

T556

347615-347824

Epistemic_statement

denotes

Background: Catheter-associated urinary tract infections (CAUTI) are one of the most common health care-associated infections; thus, CAUTI reduction metrics have been included in the Health and Human Services.

T557

348053-348147

Epistemic_statement

denotes

The aim of this study was to reduce the incidence of CAUTI by the introduction of bundle care.

T558

348607-348821

Epistemic_statement

denotes

Third, maintain the quality of urinary catheter, including regularly empty urinary drainage bags into a clean container, and urinary drainage bags should be placed lower than the bladder level but not on the floor.

T559

348822-348960

Epistemic_statement

denotes

Lastly, the physician checked the necessity of using catheter every day, and the catheter was removed as soon as possible if not required.

T560

349560-349795

Epistemic_statement

denotes

Conclusion: Our study demonstrated that the catheter-associated urinary tract infections can be effectively reduced through the implementation of CAUTI bundle bare coupled with the establishment of the management organizational system.

T561

350447-350623

Epistemic_statement

denotes

So the aim of this project was to upgrade knowledge, improve the compliance rate and the correctness of bundle care, and reduce the infection rate for the patients in our unit.

T562

351904-352123

Epistemic_statement

denotes

Conclusion: With effective implementation, the ventilator associated-pneumonia infection risks can be lowered, mortality and days of hospitalization reduced, protecting patients from disease and ensuring patient safety.

T563

353078-353256

Epistemic_statement

denotes

Results: Through the analyzed of statistical, we found the top 3 bacteria were: E.coli, candida spp, Enterococcus spp, and the 51% (106/206) UTI cases were associated with foley.

T564

353301-353398

Epistemic_statement

denotes

Conclusion: According to our analyze, the foley used or not would not arise the ratio of HAI-UTI.

T565

353399-353475

Epistemic_statement

denotes

That's to say, if we can execute the UTI bundle, we still can avoid the UTI.

T566

353476-353651

Epistemic_statement

denotes

Otherwise, according to our analyze, the E.coli was the popular bacteria in UTI, so if we can prove the AST data for doctor, the doctor can quickly treat and avoid bacteremia.

T567

354360-354456

Epistemic_statement

denotes

associated HAI at a major medical center and teaching hospital in northern Taiwan were enrolled.

T568

354683-354781

Epistemic_statement

denotes

associated HAI has increased from 0.05 episode per 1000 inpatientdays to 0.08 episode ( p = .001).

T569

358137-358230

Epistemic_statement

denotes

Once the cluster infection develops, it is difficult to estimate the further harm and impact.

T570

359963-360116

Epistemic_statement

denotes

In this presentation, our experience about outbreak of Citrobacter koseri related urinary tract infection after bed bath was rare to be mentioned before.

T571

360117-360198

Epistemic_statement

denotes

Transmission of enterobacteriae via equipment and environment should be reminded.

T572

360900-361183

Epistemic_statement

denotes

According to the empirical medical literature, it can be seen that the combination of care measures can effectively reduce CAUTI, so the unit to promote the prevention of urinary tract infection combined care measures, hoping to reduce the rate, to provide high-quality medical care.

T573

361286-361657

Epistemic_statement

denotes

According to the literature, five nursing measures were established: (1) Daily assessment of whether the catheter can be removed; (2) Hand hygiene should be performed when care of the catheter; (3) Daily check the catheter for fixation; (4) Confirm the catheter drainage system to maintain a closed, sterile and smooth; (5) Clean the urethra with soap or water every day.

T574

361658-361724

Epistemic_statement

denotes

Use checklist daily to check whether or not all care is performed.

T575

362876-362930

Epistemic_statement

denotes

Not much is known about tigecycline resistance in CNS.

T576

362931-363014

Epistemic_statement

denotes

This study is aimed to exploring tigecycline resistance in CNS from central Taiwan.

T577

363867-364031

Epistemic_statement

denotes

In S. haemolyticus, 9 isolates (23.7%) were interpreted as susceptible using broth microdilution method, however, they were regarded as resistant by Vitek 2 method.

T578

364271-364531

Epistemic_statement

denotes

Background: The goal of this performance improvement study was to evaluate the effect of a targeted intervention to decrease catheter-associated urinary tract infections (CAUTIs) and urinary catheter utilization by implementing quality improvement initiatives.

T579

364996-365567

Epistemic_statement

denotes

The implemented CAUTI prevention bundle that included: setting clear expectations for indications for indwelling urinary catheter use (an indwelling catheter policy which included criteria for catheter use); catheter insertion using aseptic technique and sterile equipment; acatheter maintenance; hand hygiene; documentation of catheter placement); daily assessment of the continued need for indwelling urinary catheter by physician; audit of checklists, checking insertion procedures and reviewing with supervisors were done by a multidisciplinary team once a fortnight.

T580

366176-366334

Epistemic_statement

denotes

Conclusion: Increased compliance to recommended catheter associated urinary tract infections preventive practices reduced the incidence of CAUTI in ICU units.

T581

366335-366417

Epistemic_statement

denotes

It is simple and effective and is recommended as a part of patient safety culture.

T582

369788-369947

Epistemic_statement

denotes

To prevent the occurrence of measles or rubella among young hospital staffs during patient care, MMR vaccination should be advised for the seronegative staffs.

T583

371150-371381

Epistemic_statement

denotes

(2) Formulate the rules of those patients who were transferred from nursing home should implement contact isolation, and the skin should be checked such as: fingers, palms, wrist, armpit, hip, around the navel, genitourinary parts.

T584

371382-371447

Epistemic_statement

denotes

If any abnormality are found we should consult the dermatologist.

T585

371981-372227

Epistemic_statement

denotes

In order to reduce the spread of scabies, the implementation of longterm care institutions patients with contact isolation on his own initiative and skin assessment is very important, and the setting of information reminding system can also help.

T586

374021-374144

Epistemic_statement

denotes

Most patients had one or more of the known risk factors associated with colonization with vancomycin-resistant enterococci.

T587

374341-374459

Epistemic_statement

denotes

However, when clustered cases of colonization occurred, they were then associated with an increased rate of infection.

T588

374460-374626

Epistemic_statement

denotes

Routine surveillance for VRE together with other measures can control VRE infection and colonization, even where VRE is endemic, and where facilities are constrained.

T589

374627-374781

Epistemic_statement

denotes

Evidence of colonization of patient's means it can be empirical precaution and thus provide patient safety by minimizing the risk of nosocomial infection.

T590

376476-376570

Epistemic_statement

denotes

To lessen the impact of this infection, very strict infection control measures should be done.

T591

376571-376613

Epistemic_statement

denotes

No more new case reported by 9th November.

T592

376800-376928

Epistemic_statement

denotes

Background: According to WHO's report, healthcare associated infections (HAIs) is the most frequent adverse event in healthcare.

T593

377310-377497

Epistemic_statement

denotes

Of all infection control methods, hand hygiene remains one of the most fundamental and critical part, thus hand hygiene compliance rate was set as threshold and monitored for improvement.

T594

377688-377860

Epistemic_statement

denotes

Pearson correlation analysis was used to investigate the correlation between hand hygiene compliance rate, and overall and ICUs' HAIs incidence per thousand inpatient-days.

T595

378837-379027

Epistemic_statement

denotes

Pearson correlation showed hand hygiene compliance rate has significantly strong correlation with ICU HAI rate (r = −0.843, p = 0.035), but not with overall HAI rate (r = −0.532, p = 0.277).

T596

379621-379920

Epistemic_statement

denotes

Conclusion: Although the BCC improvement program did not reduce the BCC rate to be below 3%, yet the use of 2% CHG to execute skin disinfection did decrease the BCC rate, shorten the waiting time of skin disinfection, increase working efficiency of medical staffs, and elevate quality of healthcare.

T597

381675-381822

Epistemic_statement

denotes

It can be seen that the correct rate of combination of respirator-associated pneumonia infection is associated with a decrease in respiratory rate.

T598

382349-382526

Epistemic_statement

denotes

Effect of the implemention of multidimentional infection control measures on healthcare associated infections in an intensive care unit Ya-Ling Lee, Chiung-Hui Ho, Tzu-Ting Kuo.

T599

382779-382929

Epistemic_statement

denotes

We hypothesized that the infection control response may have had a secondary benefit of reducing incidence of healthcare associated infections (HAIs).

T600

384110-384243

Epistemic_statement

denotes

Results: After implementation, the trend of UTI showed reversely downward although the trend of HAP was as same as before ( Figure) .

T601

385591-385646

Epistemic_statement

denotes

Special attention should be given on infection control.

T602

385647-385729

Epistemic_statement

denotes

Carriers could have the risk of spreading MRSA/resistant species in the community.

T603

387587-387809

Epistemic_statement

denotes

But, From December 2016 to January 2017, the number of bacteria and more than the standard(100 cfu/ mL), may be due to lack of ice machine pipeline sterilization equipment and ice machine surrounding environment pollution.

T604

388097-388287

Epistemic_statement

denotes

The hospital provides safe food for the staff and the public, use teamwork to develop a standard operating process and check for the extent to which the problem and the staff can be matched.

T605

388288-388435

Epistemic_statement

denotes

Therefore, we will continue to monitor the number of bacteria, and to assess the increase in E. coli flora test, to ensure food safety and hygiene.

T606

388436-388730

Epistemic_statement

denotes

To explore the practical utility of chlorhexidine gel in clinical care unit Shu-Yuan Kuo 1 *, Yu-Hsiu Lin 1 , Yee Huangku 1 , Pak-On Leung 2 , Mei-Fe Sie 3 , Jyh-Jou Chen 4 Conclusion: We concluded that in addition to early ART, safe sex education should be enhanced in HIV prevention campaign.

T607

388731-388845

Epistemic_statement

denotes

Evidence-based assessment of mortality of patients infected with carbapenem-resistant Klebsiella pneumoniae (CRKP)

T608

388846-389032

Epistemic_statement

denotes

Background: Carbapenem resistant K. pneumoniae (CRKP) has aroused widespread attention due to its very limited therapeutic options, and in recent years this strain has increased rapidly.

T609

389033-389178

Epistemic_statement

denotes

Though it seems inferable that drug resistance is associated with higher mortality in general, but some other studies found no such relationship.

T610

391189-391275

Epistemic_statement

denotes

The association between pulmonary tuberculosis and cancer is interesting and distinct.

T611

392655-392775

Epistemic_statement

denotes

Conclusion: As a result, physicians should be aware of the risk of developing pulmonary tuberculosis in cancer patients.

T612

394621-394758

Epistemic_statement

denotes

Conclusion: The gut microbiome was influenced by the antimicrobial prophylaxis in surgery, and the probiotics might reduce the influence.

T613

394907-395008

Epistemic_statement

denotes

1 Division of Infectious Disease, Jen-Ai Hospital, 2 Department of Infection Control, Jen-Ai Hospital

T614

395009-395169

Epistemic_statement

denotes

Background: Elective laparoscopic cholecystectomy may result in surgical site infections (SSI), which may increase length of hospital stay and healthcare costs.

T615

397151-397245

Epistemic_statement

denotes

Two or more doses of antibiotic prophylaxis should be recommended for such patients (Level 1).

T616

397759-397816

Epistemic_statement

denotes

They always share their food or can't control themselves.

T617

398204-398656

Epistemic_statement

denotes

1 Derchen Women and Children Hospital, Kaoshiung, Taiwan, 2 Infection Control Center, National Taiwan University Hospital, Taipei, Taiwan, 3 Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan, 4 Department of Family Medicine, National Taiwan University Hospital, Taipei, Taiwan, 5 School of Public Health, National Taiwan University, Taipei, Taiwan, 6 Department of Agronomy, National Taiwan University, Taipei, Taiwan

T618

398657-398814

Epistemic_statement

denotes

Background: Healthcare-associated bloodstream infection (HABSI) may worsen clinical outcomes among hospitalized patients, especially in geriatric population.

T619

398815-398922

Epistemic_statement

denotes

We aim to known the characteristic and search the prognostic factors regarding HABSI of geriatric patients.

T620

399286-399391

Epistemic_statement

denotes

Prognostic factors associated with 30-day mortality were identified through multiple logistic regression.

T621

399574-399888

Epistemic_statement

denotes

Background: Needle and sharp injuries is the most common occupational injury in the hospital, hepatitis B virus (HBV), hepatitis C virus (HCV), syphilis, human immunodeficiency virus (HIV) is a common cause of occupational exposure to health care workers, Infection can cause physical and psychological discomfort.

T622

400492-400713

Epistemic_statement

denotes

The only safety needle is not the only needle, It also contains special needles for inspection, and the promotion of safety tools also includes changes in the use of habits, will also affect the occurrence of acupuncture.

T623

400714-400881

Epistemic_statement

denotes

It is still the industry for the special safety needle research and development and medical staff habits, period can reduce the incidence of needle and sharp injuries.

T624

401073-401207

Epistemic_statement

denotes

The project is needed to complete the catheter placement checklist and daily care table, which is a big burden for the clinical staff.

T625

401208-401609

Epistemic_statement

denotes

However, comparing of before and after the implementation of the project, arrangements for staff to fill out the cognitive questionnaire, it was found that the implementation of CAUTI Bundle for the patient is meaningful and recognized, but if the form of information can reduce the burden of paper work, can increase the implementation of combined care of health care workers to implement the wishes.

T626

401980-402324

Epistemic_statement

denotes

In the future when opening of the doctor's advice, then jumping out of the doctor's account and checking the table, you can immediately know the number of days placed, and to assess the reasons for indwelling, a substantial reduction in clinical staff to fill out the time of the paper form, and missed the fill or assessment of the phenomenon.

T627

402325-402553

Epistemic_statement

denotes

In addition, with the project to give the quarterly report, the information program can be transferred out of materials of physician and cares, significantly reduce the quarterly report of the typing time, and paper consumption.

T628

403040-403205

Epistemic_statement

denotes

As of May 2017, the physician form completion rate has been as high as 70%, caregiver form completion rate of 98% or more, a substantial increase in completion rate.

T629

403206-403380

Epistemic_statement

denotes

Conclusion: Combination care is not difficult for health care workers, the difficulty is the time spent to fill out the form, and the time of find physician to fill the form.

T630

403381-403502

Epistemic_statement

denotes

The effective use of information programs can indeed increase the implementation of medical care for health care workers.

T631

403503-403926

Epistemic_statement

denotes

Scoring systems for identifying hospitalized critical patients at risk of imipenem-resistant gram-negative bacilli septicemia at sepsis onset I -Ling Chen 1 , Cing-Ling Tai Background: The emergence of carbapenem resistance among Gram-negative bacilli (GNB) has been increasingly reported worldwide and is a matter of great concern, since it complicates both empirical and guided treatment for severe critical ill patients.

T632

403927-404034

Epistemic_statement

denotes

Inappropriate administration of empirical antibacterial may increase the mortality rate of septic patients.

T633

405104-405268

Epistemic_statement

denotes

Conclusion: This score might help clinicians to stratify the risk of IR-GNB septicemia infection when deciding empirical therapy for these patients at sepsis onset.

T634

405724-405880

Epistemic_statement

denotes

It may lead to treatment failure and drug resistance occured if the patient was not assessed by chest X-ray examination and bacteriological testing on time.

T635

406597-406704

Epistemic_statement

denotes

So, the health care division can enhance the case to remind the sputum test and side effects of medication.

T636

406810-406939

Epistemic_statement

denotes

It can really improve the continuity of tuberculosis assessment using the electronic message board and Line information software.

T637

407267-407450

Epistemic_statement

denotes

Conclusion: The application of information technology can improve the continuity of stage assessment to remind patients to perform chest X-ray examination and bacteriological testing.

T638

407451-407657

Epistemic_statement

denotes

However, the case take medicine regular although, but there are treatment failure occurred such as three case CXR deterioration and the sputum smear turned positive in four case before the end of treatment.

T639

407658-407744

Epistemic_statement

denotes

Medical staff should pay attention to precaution the Line leaked personal information.

T640

408321-408359

Epistemic_statement

denotes

And 3 surgical data can automatically.

T641

408622-408846

Epistemic_statement

denotes

Conclusion: Through this experience to prove that the integration of medical information system, can reduce the burden on clinical staff, automatically bring the information to avoid multiple input caused by inconsistencies.

T642

408847-408969

Epistemic_statement

denotes

genomes, the T. pallidum Amoy strain owns eight strain-specific genes, however, miss ten universal genes in other genomes.

T643

408970-409081

Epistemic_statement

denotes

For instance, the Amoy strain loss some tpr family genes, which likely answer for the increasing immune escape.

T644

409082-409317

Epistemic_statement

denotes

Interestingly, we also identified the 23S rRNA A2059G mutation in the Amoy stain, which is the first report outside of its initial identification in Czech Republic and is different from the frequent A2058G mutation identified in China.

T645

410789-410954

Epistemic_statement

denotes

The Vitek 2 Compact system could not identify 11 C. nivariensis and one C. bracarensis isolate and misidentified the remaining C. nivarensis strain as "C. glabrata".

T646

411163-411275

Epistemic_statement

denotes

The performance of MALDI-TOF may be improved by adding mass spectral profiles (MSPs) into the current databases.

T647

411276-411346

Epistemic_statement

denotes

The antifungal susceptibility profile of isolates should be monitored.

T648

411347-411436

Epistemic_statement

denotes

More researches are needed to study its effectiveness and its role as first-line therapy.

T649

412932-413067

Epistemic_statement

denotes

All three C. curvata isolates had high caspofungin (>8 mg/L) and fluconazole MICs (8 mg/L) and could be defined as multidrug-resistant.

T650

413556-413835

Epistemic_statement

denotes

Although liposomal amphotericin B (L-AmB) or an echinocandin class agent is administered as an emperical antifungal therapy in such patients, adverse events including breakthrough infections despite treatment and substantial drug toxicity have been becoming significant problems.

T651

413836-413937

Epistemic_statement

denotes

There is therefore a critical need for antifungal treatment strategies to overcome these impediments.

T652

415258-415386

Epistemic_statement

denotes

One patient revealed a persistent fever probably due to cytomegalovirus infection, which subsided by ganciclovir administration.

T653

415387-415665

Epistemic_statement

denotes

Conclusion: Although the number of patients studied was limited, sequential therapy with MF and L-AmB seems to be an encouraging antifungal treatment strategy for those with hematologic malignancies who experience antibiotics-refractory neutropenia after cytotoxic chemotherapy.

T654

415666-415722

Epistemic_statement

denotes

Further investigation in large-scale studies are needed.

T655

415723-415823

Epistemic_statement

denotes

Background: Azole-resistant Aspergillus fumigatus (ARAF) has become a growing public health concern.

T656

415824-415983

Epistemic_statement

denotes

International consensus suggests that empirical therapy for A. fumigatus aspergillosis should be guided by the local clinical and environmetal resistance rate.

T657

416787-417007

Epistemic_statement

denotes

The partial least square-discriminate analysis (PLS-DA) were performed, and the scores of the first two components were plotted to visualize how well the relevant metabolites could identify the death and survival groups.

T658

417493-417609

Epistemic_statement

denotes

The identified potential markers to predict day 14 mortality were phenylalanine, deuteroporphyrin IX, and hippurate.

T659

417931-418069

Epistemic_statement

denotes

However, overall, patients with 3HP experienced significantly lower rates for the permanent discontinuation of treatment compared with 9H.

T660

418070-418230

Epistemic_statement

denotes

Further evaluation of factors facilitating treatment completion of LTBI will be crucial to achieving our End TB goal, reducing incidence to 32/ 100,000 by 2020.

T661

418231-418521

Epistemic_statement

denotes

Surveillance of severe community-acquired pneumonia of unknown etiologyresult from unknown pathogen detection/ investigation group (UPDIG), Taiwan Tsung-Pei Tsou 1 *, Wan-Chin Chen 2 , Min-Nan Hung 3 , Sung-Hsi Wei 4,5 , Hsin-Chun Lee 3 , Chia-Ping Su 2 , Jung-Jung Mu 6 , Ming-Tsan Liu 6 .

T662

418698-418811

Epistemic_statement

denotes

Patients with pathogen identified by means of antigen detection will be classified as having a possible etiology.

T663

418812-418974

Epistemic_statement

denotes

Background: Staphylococcus aureus is an important human pathogen that can also asymptomatically colonize the nares of between 20% and 40% of the adult population.

T664

418975-419136

Epistemic_statement

denotes

Methicillin-resistant strains (MRSA,) which may also display resistance to multiple other drugs, are a major cause of healthcare associated infections worldwide.

T665

419137-419378

Epistemic_statement

denotes

There is increasing concern that strains of S. aureus in the clinical setting can also harbour genes (qacA/B and smr) for reduced susceptibility to commonly used antiseptics and disinfectants, such as benzalkonium chloride and chlorhexidine.

T666

419379-419580

Epistemic_statement

denotes

It is well recognised that elderly subjects residing in long-term care facilities (LTCF) can act as reservoirs of MRSA, but little is known of its prevalence in healthy elderly living in the community.

T667

420294-420418

Epistemic_statement

denotes

There was a significant association between methicillin resistance and presence of qacA/B genes ( p = 0.034; CI 1.024-14.8).

T668

420694-420839

Epistemic_statement

denotes

The presence of biocide resistance genes is of concern as multi-drug resistant strains with resistance to biocides may be difficult to eradicate.

T669

420840-420951

Epistemic_statement

denotes

Tolerance to biocides may contribute to persistence of MRSA in the community as well as the healthcare setting.

T670

420952-421186

Epistemic_statement

denotes

Continued monitoring of such strains is essential, as well as education on the proper use of biocides and antiseptics to prevent residue remaining in the environment which could act as a facilitator for induction of biocide tolerance.

T671

422020-422258

Epistemic_statement

denotes

Conclusion: Although the role of plasma exchange in management of Weil's disease is not well defined, our experience shows that combined antibiotics and plasma exchange may be helpful in severe leptospirosis with pulmonary renal syndrome.

T672

423652-423804

Epistemic_statement

denotes

Laboratory studies revealed platelet count of 9,000/uL, elevated D-dimer and fibrinogen, which could not explain DIC as the cause of bleeding diathesis.

T673

425338-425532

Epistemic_statement

denotes

Epidemiology of sepsis in children: a nationwide cohort study Conclusion: BCG-osteitis/osteomyelitis is more strongly correlated with the vaccination of newborns than with that of older infants.

T674

425533-425769

Epistemic_statement

denotes

The question of whether postponing BCG vaccination could lead to decreased risk of BCG-osteitis/osteomyelitis without increasing TB meningitis, BCG-lymphadenitis, and injection site suppuration in young infants needs careful evaluation.

T675

426176-426340

Epistemic_statement

denotes

Many studies in North America, Europe and Oceania revealed the relationship between HIV and low BMD, and there were still few studies about that in Asian countries.

T676

428623-428668

Epistemic_statement

denotes

1 Section of Infectious Diseases, Taipei City

T677

428669-428837

Epistemic_statement

denotes

Background: The short-term and long-term effect of highly active antiretroviral therapy (HAART) exposure on incident tuberculosis (TB) has not been extensively studied.

T678

429182-429224

Epistemic_statement

denotes

Few studies have described these patients.

T679

429225-429401

Epistemic_statement

denotes

The study aimed to assess the etiologic pathogens, sites of infection, mortality rate and the factors associated with the mortality in HIV-infected patients who had bacteremia.

T680

430687-430998

Epistemic_statement

denotes

Medical Laboratory Science and Biotechnology, National Cheng Kung University, Tainan, Taiwan Background: Dengue virus (DENV), a mosquito-borne flavivirus, is responsible for ∼390 million infections annually, and leads to dengue fever or potentially lethal dengue hemorrhagic fever (DHF) or shock syndrome (DSS).

T681

431090-431205

Epistemic_statement

denotes

During dengue infection, DENV nonstructural protein 1 (NS1) can be secreted into blood and causes vascular leakage.

T682

431206-431295

Epistemic_statement

denotes

However, whether NS1 is involved in the pathogenesis of thrombocytopenia remains unclear.

T683

431296-431394

Epistemic_statement

denotes

In this study, we hypothesized that NS1 may play a critical role of DENV-induced thrombocytopenia.

T684

431395-431621

Epistemic_statement

denotes

Methods: To verify this hypothesis, freshly isolated platelets from healthy donors were treated with DENV type 1 recombinant NS1 from drosophila and were evaluated for markers of activation, cytokine secretion and aggregation.

T685

431622-431697

Epistemic_statement

denotes

Results: We found that NS1 could bind to toll-like receptor 4 of platelets.

T686

431921-432045

Epistemic_statement

denotes

Conclusion: Taken together, our results demonstrate that NS1 could directly bind to platelet and induce platelet activation.

T687

432046-432156

Epistemic_statement

denotes

These results suggest that NS1 may contribute to the pathogenesis of thrombocytopenia during dengue infection.

T688

432602-432718

Epistemic_statement

denotes

The neurotropic nature of HEVA71 can cause severe infection and complications including encephalitis and even death.

T689

432719-432945

Epistemic_statement

denotes

Due to the lack of effective antivirals to curb HEVA71 infections, this study adopted an approach of identifying potential therapeutic agents through reverse genetics and high throughput screen of a flavonoid compound library.

T690

433311-433451

Epistemic_statement

denotes

Downstream secondary assays reaffirmed that MARVAS09 can disrupt viral protein and viral RNA synthesis through reducing HEV71 IRES activity.

T691

433452-433632

Epistemic_statement

denotes

Further studies deduced that MARVAS09 was a narrow-spectrum antiviral, which is only effective against human enteroviruses but not chikungunya virus or herpes simplex type 1 virus.

T692

433921-434107

Epistemic_statement

denotes

Conclusion: In conclusion, MARVAS09 is a potent antiviral against HEVA71 and possibly other human enteroviruses which can be further developed as a potential clinical antiviral for HFMD.

T693

434432-434580

Epistemic_statement

denotes

Patients with chronic obstructive pulmonary disease (COPD) are immunocompromised, but HHV-8 seroprevalence in COPD patients has not been documented.

T694

436293-436479

Epistemic_statement

denotes

For antiviral resistance, R292K substitution in the NA (neuraminidase) protein was found in the A/Taiwan/1/2017 virus, suggesting that this virus had developed resistance to oseltamivir.

T695

436729-436897

Epistemic_statement

denotes

Conclusion: The signatures of high avian pathogenicity and oseltamivir resistance is of a concern and may have implication on clinical management and antiviral therapy.

T696

436898-437145

Epistemic_statement

denotes

Current guideline that specifies neuraminidase inhibitors (NAIs) as drug of choice to treat patients infected with avian influenza A (H7N9) virus, should be revised based on geographic distribution of resistance, especially in Asia-Pacific region.

T697

438920-438998

Epistemic_statement

denotes

Conclusion: This study is still in progress, the conclution remaining unclear.

T698

438999-439104

Epistemic_statement

denotes

However, naturally occurring RAVs to DAAs pre-exist in treatment-naive HCV genotype 1b-infected patients.

T699

439105-439178

Epistemic_statement

denotes

Clinicians should consider RAVs before start DAA-based antiviral therapy.

T700

439857-439977

Epistemic_statement

denotes

However, his ARDS improved soon after Oseltamivir (Tamiflu) and intra-venous Peramivir (Rapiacta) were continued in use.

T701

440126-440168

Epistemic_statement

denotes

His ET tube could be removed 1 week later.

T702

440169-440220

Epistemic_statement

denotes

He became stable and could be discharged on day 14.

T703

440221-440415

Epistemic_statement

denotes

Discussion: (1) This patient suffered from severe respiratory complications induced by influenza but could get well soon after proper prompt use (within 24 hours) of the neuraminidase inhibitor.

T704

440544-440624

Epistemic_statement

denotes

In our patient, his fever subsided after Peramivir use and no need for ECMO use.

T705

440625-440725

Epistemic_statement

denotes

It seemed that Oseltamivir and Peramivir could be used together and had no antagonism to each other.

T706

440726-440855

Epistemic_statement

denotes

After Peramivir binds to NA enzyme, they are not easily dissociated, and Peramivir can inhibit the NA activity for longer period.

T707

440856-441068

Epistemic_statement

denotes

Reactivation of cytomegalovirus during the hospital course of sepsis and its association with outcome Hsin-Pai Chen 1 , Ping-Liang Hung 2 , Wan-Huai Teo 3 , Yuan-Ming Lee 4 , Yu-Jiun Chan 5 , Cheng-Yu Chen 2,6 *.

T708

441069-441174

Epistemic_statement

denotes

Accumulating evidence suggests that CMV reactivates in critically ill patients such as those with sepsis.

T709

441175-441360

Epistemic_statement

denotes

Controversy exists with respect to the association between CMV reactivation and outcome of sepsis, and how the virus reactivates during the course of sepsis were not fully investigated.

T710

441361-441517

Epistemic_statement

denotes

In this study, we systemically investigated the reactivation pattern of CMV during the course of sepsis and correlated the results to the outcome of sepsis.

T711

441799-441923

Epistemic_statement

denotes

Patients' clinical characteristics and survival within 28 days were recorded and correlated to the results of CMV detection.

T712

442360-442511

Epistemic_statement

denotes

Detection of CMV on day 1 was associated with a lower 28-day survival rate compared with those whose blood was negative for CMV on day 1 ( p = 0.0057).

T713

442742-442840

Epistemic_statement

denotes

Early reactivation of CMV during the initial phase of sepsis was associated with a poorer outcome.

T714

442841-442933

Epistemic_statement

denotes

Interaction between CMV and host monocytes may play a role in the pathophysiology of sepsis.

T715

443118-443225

Epistemic_statement

denotes

Background: Viruses infect all Three Domains of life, however the knowledge of archaeal viruses is limited.

T716

443553-443634

Epistemic_statement

denotes

However, almost none methanoarchaeal virus was reported for the past two decades.

T717

444497-444594

Epistemic_statement

denotes

Background: Chronic active EBV disease (CAEBV) is a rare and fatal complication of EBV infection.

T718

445475-445587

Epistemic_statement

denotes

Later, however, even adding pip/tazo treatment for possible nosocomial infection, the patient was still febrile.

T719

447204-447326

Epistemic_statement

denotes

National Centre for Antimicrobial Stewardship, The Peter Doherty Institute for Infection and Immunity, Melbourne, VIC 3000

T720

447327-447516

Epistemic_statement

denotes

Background: There have been many studies supportive of the use of appropriately administered surgical antimicrobial prophylaxis in reducing surgical site and other postoperative infections.

T721

447517-447741

Epistemic_statement

denotes

Guidance for the appropriate use of surgical antimicrobial prophylaxis in Australia is available via national prescribing guidelines and suggested principles of antimicrobial prescribing in regard to surgical procedures are:

T722

447742-447875

Epistemic_statement

denotes

• only prescribe prophylaxis if there is a clear need • the use of topical antimicrobials is not recommended for surgical prophylaxis

T723

447876-448036

Epistemic_statement

denotes

The use of topical antimicrobials for prophylaxis during surgical procedures has been a practice commonly utilised by surgeons with limited evidence of benefit.

T724

448254-448437

Epistemic_statement

denotes

Using data from the 67 hospitals that participated in this pilot, the procedure groups for which topical antimicrobials were prescribed and appropriateness of these will be described.

T725

448646-448816

Epistemic_statement

denotes

Due to reported poor documentation of the use of topical antimicrobials in surgical procedures, this would represent an underestimate of the true proportion of their use.

T726

448817-448979

Epistemic_statement

denotes

There were several procedures for which prophylaxis was prescribed with little to no evidence for their use highlighting areas where practices should be reviewed.

T727

449307-449551

Epistemic_statement

denotes

However, facing up to the constantly detection of the various multi drug resistance microorganisms, brings out that the rigor examinations and the control execution effectiveness of the antibiotic needs to be reviewed and improved all the time.

T728

449552-449660

Epistemic_statement

denotes

Coordination from the antibiotics stewardship and the database system can make the control more effectively.

T729

449858-450274

Epistemic_statement

denotes

Methods: Our hospital has utilizing the database systems to assist executing in the antibiotic medication control, the infectious disease specialist would follow the "laboratory reports" and "current medical orders" at the analysis systems to exam then provide the professional commends especially before the report of the blood culture, it could only approved three days of antibiotics for the upgrade or downgrade.

T730

450275-450425

Epistemic_statement

denotes

The quick identification of the equipments and methods can shorten the reporting time, so that clinicians can choose the appropriate anti-auxiliaries.

T731

451063-451245

Epistemic_statement

denotes

Conclusion: The original use of antibiotics is for the treatment of bacterial infection, but must pay attention to the use of the period and follow the rules and the recommendations.

T732

451246-451439

Epistemic_statement

denotes

To avoid the occurrence of bacteria cause by the filter pressure of orthodontic, need to pay attention to monitoring or induced bacterial resistance to follow up, Surely it should be monitored.

T733

451697-451783

Epistemic_statement

denotes

Background: Candidemia is one of the severe infections associated with a poor outcome.

T734

451784-452085

Epistemic_statement

denotes

Integration of rapid species identification via matrix-assisted laser desorption/ionization time-of-flight mass spectrometry (MALDI-TOF-MS) with antimicrobial stewardship intervention (ASI) has the potential to early customization of appropriate antifungal therapy and improvement in patient outcomes.

T735

452955-453180

Epistemic_statement

denotes

Of note, the sepsis-related mortality rate (17.2% vs. 27.6%; P = 0.038), 30-day crude mortality rate (27.2% vs. 39.5%; P = 0.028), in-hospital crude mortality (39.1% vs. 46.1%; P = 0.246) were lower in the intervention group.

T736

453181-453395

Epistemic_statement

denotes

Conclusion: MALDI-TOF-MS in adjunction with ASI can result in rapid species identification, early initiation of optimal antifungal therapy, and most importantly a better clinical outcome for adults with candidemia.

T737

453883-454042

Epistemic_statement

denotes

KP can produce infection at a variety of sites, with the risk being increased in patients with impaired host defenses (e.g., diabetes mellitus, liver abscess).

T738

454747-454935

Epistemic_statement

denotes

However, she started to have redness of left eye within 24 hr then she had sudden pain, eyelid swelling and conjunctival chemosis was found and endogenous KP endophthalmitis was suspected.

T739

455592-455723

Epistemic_statement

denotes

Although, the left eye no bacteria could be cultured and blindness, but stable hemodynamic status and transferred to ordinary ward.

T740

455881-455940

Epistemic_statement

denotes

However, a negative culture does not exclude the diagnosis.

T741

456100-456222

Epistemic_statement

denotes

Eye culture of the positive rate is low, even less than 30%, so usually as long as the clinical symptoms can be diagnosed.

T742

457406-457673

Epistemic_statement

denotes

Since no obvious rise in fluoroquinolones use occurred, the increasing trend in resistance which might be caused by the spread of highly epidemic fluoroquinolone-resistant uropathogenic E. coli clonal groups, particularly in older men, requires further investigation.

T743

458414-458633

Epistemic_statement

denotes

In DTC-carbapenem, its higher rate of mortality and relapse may relate to the patients' characteristics of more percentage of DM (45.7%), malignancy (45.7%), immunosuppression (42.9%), and nosocomial bacteremia (25.7%).

T744

458911-458997

Epistemic_statement

denotes

Next-step, we should take comorbid conditions and disease severity into consideration.

T745

458998-459086

Epistemic_statement

denotes

Recruiting more patients validated by Charlson score should be done in the future study.

T746

459087-459197

Epistemic_statement

denotes

Invasive pulmonary aspergillus with lung fibrosis, probably the sequelae of influenza infection Chia-Chen Hsu.

T747

459198-459245

Epistemic_statement

denotes

Chi Mei Medical Center, Intensive Care Medicine

T748

459246-459341

Epistemic_statement

denotes

Background: Fatal invasive pulmonary aspergillosis (IPA) may follow viral influenza infections.

T749

460207-460291

Epistemic_statement

denotes

However, refractory hypoxemia was noticed so lung recruitment therapy was performed.

T750

460868-460977

Epistemic_statement

denotes

However, desaturation and profound shock developed despite of vasopressor and aggressive fluid resuscitation.

T751

461174-461269

Epistemic_statement

denotes

Conclusion: In summary, Aspergillus is a potential complication of severe influenza infections.

T752

461270-461411

Epistemic_statement

denotes

Progressive pulmonary infection after the initial diagnosis of influenza should raise the suspicion of superinfections including Aspergillus.

T753

463955-464154

Epistemic_statement

denotes

Notably, although analysis of carbapenems consumption showed an increase based on the values measured by AUD and DOT after 2013, no increase was noted in the carbapenems resistance for P. aeruginosa.

T754

464155-464255

Epistemic_statement

denotes

The AUD/DOT ratio of carbapenems might contribute decreased carbapenems resistance in P. aeruginosa.

T755

464256-464357

Epistemic_statement

denotes

Previous studies also showed that high plasma concentration of linezolid may induce thrombocytopenia.

T756

464358-464535

Epistemic_statement

denotes

Only few studies demonstrated the relationship between plasma concentration and clinical outcomes, and to our knowledge, no research was conducted in the Han Chinese population.

T757

464536-464645

Epistemic_statement

denotes

This study aimed to investigate the association between concentration of linezolid, AEs and clinical outcome.

T758

466616-466811

Epistemic_statement

denotes

Higher trough concentration was associated with thrombocytopenia and leukopenia; however, no significant difference was observed between linezolid concentration and other AEs or clinical outcome.

T759

466812-466926

Epistemic_statement

denotes

Dose adjustment tailored by TDM may be considered to prevent linezolid associated thrombocytopenia and leukopenia.

T760

467668-467819

Epistemic_statement

denotes

Limitation of staff and equipment available, there were many patients refer to medical center (59%) and transfer back to long term care facility later.

T761

468218-468334

Epistemic_statement

denotes

1 Department of Pharmacy, 2 Infection control Unit, 3 Infection control Unit, Hospital Wanita dan Kanak kanak, Sabah

T762

468335-468520

Epistemic_statement

denotes

Background: Since the first reported case of Extended spectrum beta lactamase (ESBL) in 1983, these resistant beta-lactamases has been reported worldwide and its presence is ubiquitous.

T763

468521-468633

Epistemic_statement

denotes

Cefuroxime is one of the cephalosporin that has been implicated in the emergence of ESBL gram negative organism.

T764

468634-468832

Epistemic_statement

denotes

The ESBL rate in paediatric surgical ward in Hospital Wanita and Kanak-kanak Sabah (HWKKS) was alarmingly high from our surveillance study and it could be linked with the common usage of cefuroxime.

T765

469937-470196

Epistemic_statement

denotes

However, the creatinine clearance decreased after vancomycin treatment, comparing with baseline (before treatment), were a significant difference in the total dose of vancomycin treatment (≧14 g or <14 g) and the vancomycin trough level (≧15 mg/L or <15 m/L).

T766

470197-470345

Epistemic_statement

denotes

Conclusion: This study demonstrates the higher vancomycin cumulative dosage and trough level were associated with higher incidence of kidney injury.

T767

470346-470577

Epistemic_statement

denotes

Further studies should be performed to evaluate the correlation between dosage and trough level to treatment response, and assess the applicability of high dose regimen of vancomycin in Taiwanese population based on IDSA guideline.

T768

470779-470948

Epistemic_statement

denotes

Background: A part of Escherichia coli most frequently isolated as a causative agent on urinary tract infection is a strain called UPEC (Uropathogenic Escherichia coli).

T769

472246-472337

Epistemic_statement

denotes

However, even if PAC is added, it did not affect to expression of biofilm genes of E. coli.

T770

472698-472786

Epistemic_statement

denotes

Therefore, we need to further investigate how PAC affects quorum-sensing intermolecular.

T771

473340-473512

Epistemic_statement

denotes

Due to the limitations of antibiotics selection for multidrug resistance gram-negative bacteria (MDR-G(-)) infected pneumonia, the risk of infection mortality is very high.

T772

473766-473840

Epistemic_statement

denotes

However, the uncertainty effectiveness and safety need more investigation.

T773

474758-474877

Epistemic_statement

denotes

Conclusion: In the study, iv injection of colistin in patients with complex infection was still better than inhalation.

T774

474878-475039

Epistemic_statement

denotes

At present, iv injection of colstin treating hospital acquired pneumonia (HAP) or ventilator acquired pneumonia (VAP) was still recommended as the primary route.

T775

475040-475202

Epistemic_statement

denotes

Since the patients used colistin with very complicated infections, the effectiveness and safety may need the largescale clinical studies to approve in the future.

T776

475717-475966

Epistemic_statement

denotes

This study has been performed in order to analyze the epidemiological, clinical and chronological features of betalactams hypersensitivity, to evaluate the skin tests value, and to establish a practical approach exploring such drug hypersensitivity.

T777

476192-476241

Epistemic_statement

denotes

Skin tests were performed as recommended by ENDA.

T778

477152-477229

Epistemic_statement

denotes

The diagnosis was confirmed using skin tests and a possible dreg rechallenge.

T779

477230-477304

Epistemic_statement

denotes

To improve these findings, drug provocation test would be a reliable tool.

T780

477305-477596

Epistemic_statement

denotes

PS 296 ATP has antimicrobial activity based on the chelating action of the ferric ions and shows its combined effect with anti-Mycobacterium avium complex drugs Yutaka Tatano 1 *, Yuichi Kanehiro 2 , Seiko Yamabe 2 , Chiaki Sano 2 , Toshiaki Shimizu 4 , Hideki Yagi 1 , Haruaki Tomioka 2,5 .

T781

478002-478115

Epistemic_statement

denotes

However, whether ATP directly exhibits antimicrobial effects against intracellular mycobacteria is still unknown.

T782

480071-480188

Epistemic_statement

denotes

Thus, ATP is promising as an adjunctive agent for chemotherapy against mycobacterial infections using anti-MAC drugs.

T783

480748-480883

Epistemic_statement

denotes

As conventional antibiotics are not sufficient to treat MRSA infections, a new antibiotic with novel action mechanism is highly needed.

T784

481031-481115

Epistemic_statement

denotes

Here, we aim to uncover the synergistic antibacterial mechanism of this combination.

T785

482467-482625

Epistemic_statement

denotes

Conclusion: The findings provide strong evidences that HRCA7's prooxidant activity plays an important role in the synergistic bactericidal effect with SC5005.

T786

482626-482719

Epistemic_statement

denotes

This combination could be further developed as a topical medication for MRSA skin infections.

T787

483900-484016

Epistemic_statement

denotes

Background: Antibiotic therapy is the recommended choice for nontuberculous mycobacteria (NTM) infections currently.

T788

484185-484372

Epistemic_statement

denotes

Several previous studies suggest that single extracts or formulations of traditional Chinese medicine (TCM) alone or in combination with antibiotics may treat common bacterial infections.

T789

484373-484473

Epistemic_statement

denotes

Therefore, synergistic combination therapy with antibiotics plus TCM could be an effective solution.

T790

484474-484605

Epistemic_statement

denotes

This study is to provide an evidence for combination of TCM and antibiotics which may yield synergy in treatment of NTM infections.

T791

486192-486309

Epistemic_statement

denotes

Combination treatment with the TCM formulation plus antibiotics could have a synergistic antibacterial effect on NTM.

T792

487071-487160

Epistemic_statement

denotes

It is major problem that multi drug resistant E. coli have been emergence and increasing.

T793

488141-488304

Epistemic_statement

denotes

The ratio of quinolone-resistants from inpatients have no change between 2008 and 2016, however, the ratio of them from outpatients have been increasing, oviously.

T794

489686-489740

Epistemic_statement

denotes

However, we detected the strain was sensitive to CTRX.

T795

489741-489855

Epistemic_statement

denotes

Conclusion: We indicated the mutation of PBP2 was significantly associated with decreased susceptibiliies to CFIX.

T796

489956-490091

Epistemic_statement

denotes

This study suggested that the resistance mechanism of CTRX is not only due to the mutation of PBP2 but also by a complicated mechanism.

T797

490528-490623

Epistemic_statement

denotes

However, the carbapenem resistant mechanisms of Acinetobacter nosocomialis were rarely studied.

T798

492417-492544

Epistemic_statement

denotes

The plasmid contributes to carbapenem resistance and may spread between Acinetobacter baumannii and Acinetobacter nosocomialis.

T799

492545-492667

Epistemic_statement

denotes

Background: Carbapenem resistance is a serious global concern and efforts to find novel resistance mechanisms is on-going.

T800

493220-493387

Epistemic_statement

denotes

We developed a K. pneumoniae network system (KlebsiellaNet) covering 88% of 5316 coding genes of Klebsiella pneumoniae HS11286 strain with 161,507 co-functional links.

T801

493388-493505

Epistemic_statement

denotes

The putative candidate genes were shortlisted comparing the WGS, transcriptome analysis and the use of KlebsiellaNet.

T802

493844-493956

Epistemic_statement

denotes

14 putative candidate genes were short-listed for further analysis ( p < 0.05) among the 78 putative candidates.

T803

494258-494321

Epistemic_statement

denotes

Interestingly, the transporter was specific to meropenem alone.

T804

495383-495529

Epistemic_statement

denotes

Results: The resistance phenotype of JA3, was found to produce a β-lactamase that conferred resistance to oxyimino-cephalosporins and cephamycins.

T805

495530-495663

Epistemic_statement

denotes

Resistance arising from production of a betalactamase could be transferred by conjugation with an IncW plasmid pJA3 into E. coli J53.

T806

496413-496644

Epistemic_statement

denotes

The presence of the resistance region in this isolates, with diverse genetic determinants of resistance and mobile element, may further contribute to the emergence and spread of the gene, both at a chromosomal or/and plasmid level.

T807

496996-497147

Epistemic_statement

denotes

Despite proper antibacterial treatment, recurrent UTIs are secondary infections caused by the same strain of E. coli that caused the primary infection.

T808

497148-497312

Epistemic_statement

denotes

The first-line agents for the treatment of UTIs are fluoroquinolones (FQs); however, in recent years, FQresistant E. coli have been increasingly reported worldwide.

T809

497313-497493

Epistemic_statement

denotes

Proanthocyanidins (PACs), which are abundant in cranberries, have been used for the prevention of UTIs for over a century; however, the mechanism underlying this effect is unknown.

T810

498827-499062

Epistemic_statement

denotes

Because flagella-mediated motility has been suggested to be essential for UPEC to disseminate into the upper urinary tract, we propose that inhibition of flagellamediated motility may be a key mechanism through which PAC prevents UTIs.

T811

499063-499245

Epistemic_statement

denotes

The in vitro anti-adhesive and anti-invasive activity of cranberry-derived PAC against UPEC suggests that its presence in urine can reduce bacterial colonization and UTI advancement.

T812

499252-499414

Epistemic_statement

denotes

Clinical manifestations include gastroenteritis, cellulitis, soft tissue infections, and a series of clinical syndromes that appear in immunocompromised patients.

T813

499845-499993

Epistemic_statement

denotes

However, the contributions of RND efflux genes in development of multidrug resistant Aeromonas strains have not been evaluated in clinical settings.

T814

501184-501319

Epistemic_statement

denotes

More studies are needed to elucidate whether over expression of efflux systems confer intrinsic resistance to antibiotics in Aeromonas.

T815

501568-501706

Epistemic_statement

denotes

Background: The emergence of multiple-drug resistant bacteria, including Salmonella, has been a serious threat to public health worldwide.

T816

501707-501841

Epistemic_statement

denotes

On top of that, Salmonella is capable of avoiding antibiotic attack after invading into host cells, leading to a problem in treatment.

T817

501842-501983

Epistemic_statement

denotes

Thus, a novel therapeutic intervention to eradicate intracellular bacteria as well as to reduce the incidence of resistance is highly needed.

T818

503042-503246

Epistemic_statement

denotes

The result of MIC assay indicated that these compounds have no inhibitory activity on bacteria in growth medium, suggesting that the suppression of intracellular bacteria is via a host-targeted mechanism.

T819

503539-503675

Epistemic_statement

denotes

AR-12 represents a promising scaffold for the development of novel hosttargeted antibacterial agents for the treatment of salmonellosis.

T820

503676-503797

Epistemic_statement

denotes

Background: Clinical antibiotic failure may result from bacterial resistance but also from persistent forms of infection.

T821

505133-505393

Epistemic_statement

denotes

Conclusion: Intracellular forms of the clinical isolates obtained from patients with persistent infections are significantly less eradicated than the reference strain, suggesting a state of less responsiveness to moxifloxacin in the phagolysosomal environment.

T822

505394-505470

Epistemic_statement

denotes

A potential link with therapeutic failure in vivo remains to be established.

T823

505560-505737

Epistemic_statement

denotes

1 Chung Shan Hospital Infection Control Committee Leader, 2 Department of Medicine, 3 Laboratory of Department, 4 Chairman of the Committee, 5 Chung Shan Hospital Superintendent

T824

505738-505872

Epistemic_statement

denotes

Background: Antimicrobial resistance (AMR) is a major global public health problem both in hospital and community acquired infections.

T825

506052-506254

Epistemic_statement

denotes

The antibiotics educational interventional program is designed to deliver the correct knowledge regarding the appropriate use of antibiotics in order to reduce the possibility of antibiotics resistance.

T826

506605-506708

Epistemic_statement

denotes

Results suggested that most participants have the correct knowledge after the educational intervention.

T827

506919-507085

Epistemic_statement

denotes

Importantly, the educational intervention improved the knowledge of antibiotics use but have very limited influence on the attitude and behaviors of the participants.

T828

507086-507252

Epistemic_statement

denotes

The study suggested that a suitable way to deliver the correct knowledge regarding the use of antibiotics to the public is still an issue of concern to the authority.

T829

508936-509067

Epistemic_statement

denotes

Low ciprofloxacin DC as observed after Cipro DPI administration does not appear to select for resistance with the organisms tested.

T830

509217-509324

Epistemic_statement

denotes

We aimed to evaluate the association between use of fluoroquinolone and gastrointestinal tract perforation.

T831

509872-510043

Epistemic_statement

denotes

Current use of fluoroquinolone was associated with the greatest increase in risk of gastrointestinal perforations after DRS score adjustment (RR, 1.90; 95% CI, 1.62-2.22).

T832

510193-510356

Epistemic_statement

denotes

Current use of macrolide, an active comparator, was not associated with a significant increased risk of gastrointestinal perforation (RR, 1.11, 95% CI, 0.15-7.99).

T833

510357-510521

Epistemic_statement

denotes

To mitigate selection bias, we have also excluded people who have never used fluoroquinolone before or people with infectious colitis, enteritis or gastroenteritis.

T834

510522-510646

Epistemic_statement

denotes

In both of the analysis, a higher risk of gastrointestinal perforation was still associated with the use of fluoroquinolone.

T835

510647-510842

Epistemic_statement

denotes

Conclusion: We found that use of fluoroquinolones was associated with a non-negligible increased risk of gastrointestinal perforation, and physicians should be aware of this possible association.

T836

512434-512573

Epistemic_statement

denotes

To increase the quality of molecular DST, we need to establish high quality genome database for DR-TB strains with reliable phenotypic DST.

T837

512574-512659

Epistemic_statement

denotes

We will show the more detailed results of the DR-TB gene analysis including MIC data.

T838

514273-514518

Epistemic_statement

denotes

Among the 59 pairs of genes, LOC7999 mRNA was positively correlated with lncRNA RP11-160E2.16, RP11-160E2.11, RP11-160E2.19, respectively; NKX1-1 mRNA was positively correlated with lncRNA RP11-1398P2.1, RP11-160E2.19, XLOC_003422, respectively.

T839

514519-514642

Epistemic_statement

denotes

The following five mRNAs were correlated with two differential lncRNAs, namely DUSP16, AP000349.1, FAM115C, TIMM8A, SMCHD1.

T840

514643-514959

Epistemic_statement

denotes

GO analysis revealed that the differentially expressed coding genes were mainly involved in the biological processes, and among them, the most significant association was observed in defense response to fungus, defense response to bacterium, killing cells of other organism and disruption of cells of other organism.

T841

515104-515172

Epistemic_statement

denotes

were found out to be associated with differentially expressed mRNAs.

T842

515571-515752

Epistemic_statement

denotes

In addition, the inactivation of rgg enhances the ability to resistance stress conditions, which is thought to provide survival advantage to bacteria against the host immune system.

T843

515842-516006

Epistemic_statement

denotes

In this study, we aims to further elucidate whether CovS participates in the regulation of the rgg expression through modulating the levels of CovR phosphorylation.

T844

516007-516083

Epistemic_statement

denotes

Methods: CovS has been shown to have both kinase and phosphatase activities.

T845

516084-516297

Epistemic_statement

denotes

To elucidate how CovS influences on the CovR phosphorylation status and to regulate the rgg, the kinase and phosphatase activities were inactivated by the site-directed mutagenesis (H280A and T284A, respectively).

T846

516736-516947

Epistemic_statement

denotes

The results showed that the expression of rgg is decreased significantly in the CovS H280A strain; however, the expression of rgg is increased gradually in the CovS T284A strain compared to the wild-type strain.

T847

516948-517060

Epistemic_statement

denotes

These results suggest that CovS regulates the expression of rgg through differential phosphorylation level CovR.

T848

517971-518132

Epistemic_statement

denotes

The aim of this study was to explore how CDT regulates HMGB1-mediated autophagy and what DAMP triggers RAGE's mobilization to lipid rafts to induce inflammatory.

T849

518429-518611

Epistemic_statement

denotes

Results: Our study showed that CDT induces RAGE expression, but suppresses that of HMGB1, indicating that DAMPs other than HMGB1 trigger RAGE activation in the inflammatory response.

T850

519368-519518

Epistemic_statement

denotes

Apart from biofilm formation, this bacterium is able to produce different virulence factors which will help in drug resistance and nutritional uptake.

T851

519519-519601

Epistemic_statement

denotes

To overcome this problem, there is a need to establish alternative antimicrobials.

T852

520791-520930

Epistemic_statement

denotes

We suggest that this compound can be used in treating P. aeruginosa either as food supplement or in developing new antibiotic combinations.

T853

520931-521113

Epistemic_statement

denotes

Background: Colistin resistance (CR) in Gram negative bacteria is a worldwide concern that increased recently with the discovery and spread of mcr-1 and mcr-2 plasmid-mediated genes.

T854

521277-521608

Epistemic_statement

denotes

Recently, one efflux pump inhibitor (EPI), the carbonyl cyanide 3-chlorophenylhydrazone (CCCP) showed an ability to reverse colistin resistance in colistin resistant Gram negative bacteria (Klebsiella pneumoniae, Pseudomonas aeruginosa, Stenotrophomonas maltophilia and Acinetobacter baumannii) with an unknown mechanism of action.

T855

522153-522574

Epistemic_statement

denotes

We studied a collection of 103 strains including 24 mcr-1 CR strains (19 Escherichia coli, 4 K. pneumoniae, 1 Enterobacter cloacae), 6 with a known mechanism of resistance (PmrA, PmrB, mgrB) for which 4 associated with mcr-1, 46 with unknown mechanism (Enterobacter spp., E. coli, Klebsiella spp., Salmonella enterica) and 27 intrinsically resistant Enterobacteriaceae (Serratia marcescens, Proteus spp., Providencia spp.

T856

523002-523124

Epistemic_statement

denotes

Genomic analysis is ongoing to identify the efflux pump(s) that could be involved in this mechanism of action due to CCCP.

T857

523546-523660

Epistemic_statement

denotes

Genomic analyses are ongoing to identify such pumps that could be further targeted by specific EPIs in the future.

T858

525586-525776

Epistemic_statement

denotes

Phylogenetic analysis based on the amino acid of AblA2 from archaea and bacteria indicated that this halophilic methanoarchaeal ablA2 may be horizontally transferred from Deltaprotebacteria.

T859

526513-526802

Epistemic_statement

denotes

Conclusion: Through genomic, transcriptomic and phylogenetic analysis, we identified two lysine 2,3-aminomutases genes (AblA) in Methanoarchaea: which AblA1 functions as compatible solute synthesis gene and AblA2 may function as translational modification that involve in PTM-β-lysylation.

T860

528875-528968

Epistemic_statement

denotes

This may indicate that Methanoculleus strains are prevailing methane producers in cold seeps.

T861

528969-529086

Epistemic_statement

denotes

In addition, endemic and potential new species of methanoarchaea from cold seep regions were collected in this study.

T862

529802-529955

Epistemic_statement

denotes

Reactive oxygen species (ROS), generated by NADPH oxidase upon RANKL stimulation, has been demonstrated to play a key role in osteoclast differentiation.

T863

529956-530178

Epistemic_statement

denotes

Our previous studies have shown that Ganoderma neojaponicum water extract (GNES) increased heme oxygenase-1 (HO-1) protein expression and decreased hydrogen peroxide-induced oxidative stress in murine RAW264.7 macrophages.

T864

530415-530518

Epistemic_statement

denotes

The results showed that GNES could inhibit RANKLinduced ROS production and the formation of osteoclast.

T865

530891-531037

Epistemic_statement

denotes

Conclusion: Our data suggested that GNES inhibited osteoclastogenesis through downregulation of RANKL-induced ROS production by HO-1 upregulation.

T866

531221-531618

Epistemic_statement

denotes

1 Institute of Medical Sciences, College of Medicine, Tzu-Chi University, Hualien, Taiwan, 2 Department of Laboratory Medicine and Biotechnology, Tzu-Chi University, Hualien, Taiwan 1, , also known as trimethylene glycol, a multifunctional valuable organic compound, recently has been used in various industry field, such as the synthesis of biodegradable polyesters, polyurethanes and polyethers.

T867

531872-532082

Epistemic_statement

denotes

Aerobically, glycerol can be uptaken into bacterial cell through glycerol facilitator protein (GlpF), then will be phosphorylated by glycerol kinase (GlpK) to become glycerol-3-P, for being further metabolized.

T868

532277-532347

Epistemic_statement

denotes

Unphosphorylated Crr protein can bind to GlpK to inhibit its function.

T869

532348-532489

Epistemic_statement

denotes

In previous study we found that KPN00353, a novel KpEIIA, could inhibit 1,3-PD production in Klebsiella pneumoniae by direct binding to GlpK.

T870

532796-533001

Epistemic_statement

denotes

We found that the unphosphorylated KPN00353 could bind stronger to KpGlpK than the phosphorylated form, resulting in higher nonuptaken glycerol concentration in the used medium and lower 1,3-PD production.

T871

533595-533647

Epistemic_statement

denotes

The regulation of P. mirabilis T6SS remains unclear.

T872

534010-534124

Epistemic_statement

denotes

We investigated whether the regulators can bind directly to T6SS promoter region using a DNaseI footprinting assy.

T873

534435-534513

Epistemic_statement

denotes

We also purified the possible toxin to assess its function in E. coli killing.

T874

535113-535245

Epistemic_statement

denotes

T6SS contributed to growth predominance over regulator mutants and E. coli, suggesting P. mirabilis T6SS as an antibacterial weapon.

T875

535246-535320

Epistemic_statement

denotes

Background: Rapid diagnosis of Bacteremia is critical for sepsis patients.

T876

536990-537309

Epistemic_statement

denotes

Introducing VirtuO™ in ER solves the problem of delayed entry including the time for transportation of blood culture bottles from ER to microbiology room and avoids the need of manpower for transportation in evening and night shifts, while loading blood specimens into blood culture system can be performed immediately.

T877

537310-537460

Epistemic_statement

denotes

The intervention resulted in faster blood culture results, and therefore would be helpful for treatment of sepsis patients and antibiotic stewardship.

T878

539826-540057

Epistemic_statement

denotes

Conclusion: Non-inferiority of 6 days of IV-to-oral, once-daily 200 mg tedizolid phosphate to 10 days of IV-to-oral, twice-daily 600mg linezolid in early clinical response was inconclusive at 48-72 hours after treatment initiation.

T879

540887-541123

Epistemic_statement

denotes

As refractory/severe CDI becomes more frequent and the drug of choice, fidaxomicin, is not available in most hospitals in many countries, we may need to consider an alternative treatment, such as tigecycline, for NAP1/BI/027 strain CDI.

T880

541622-541755

Epistemic_statement

denotes

Both of our cases can be classified as severe complicated CDI because they had consciousness change accompanied with severe bandemia.

T881

542255-542389

Epistemic_statement

denotes

Tigecycline combined with either metronidazole or vancomycin appears to be a reasonable therapy for severe and severe-complicated CDI.

T882

542991-543139

Epistemic_statement

denotes

Further, E. faecium strains with high minimum inhibitory concentrations (MIC) of daptomycin (DAP) have recently been a problem in clinical practice.

T883

543839-544047

Epistemic_statement

denotes

However, independent predictors associated with E. faecium bacteremia in the multivariate analysis were the use of quinolones ( p = 0.025), malignancy ( p = 0.021), and prolonged hospitalization ( p = 0.016).

T884

544219-544314

Epistemic_statement

denotes

Conclusion: Careful use of DAP is crucial when administering therapy for E. faecium bacteremia.

T885

545211-545289

Epistemic_statement

denotes

Clinical and laboratory findings were suggestive of Fitz-Hugh-Curtis Syndrome.

T886

545409-545573

Epistemic_statement

denotes

Conclusion: Fitz-Hugh-Curtis Syndrome should be included as a differential diagnosis in women with right upper quadrant pain, especially at their reproductive ages.

T887

545702-545939

Epistemic_statement

denotes

Department of Intensive Care Medicine, Chi Mei Medical Center, Tainan, Taiwan; Department of Medicine, Taipei Medical University, Taipei, Taiwan Background: Invasive pulmonary aspergillosis (IPA) might occur in severe influenza patients.

T888

545940-546012

Epistemic_statement

denotes

In Taiwan, cases of severe influenza with IPA are increasingly reported.

T889

546117-546292

Epistemic_statement

denotes

However, GM antigen could be positive in infections caused by other filamentous fungi, such as Penicillium and Curvularia species, and careful clinical correlation is advised.

T890

547600-547643

Epistemic_statement

denotes

However, dyspnea became air-hunger pattern.

T891

547833-547928

Epistemic_statement

denotes

Conclusion: Aspergillus GM positive has been found in patients with severe influenza in Taiwan.

T892

548173-548209

Epistemic_statement

denotes

Voriconazole also appears promising.

T893

548210-548314

Epistemic_statement

denotes

Our case highlights that positive Aspergillus GM testing could occur in other invasive fungal infection.

T894

548315-548453

Epistemic_statement

denotes

Therefore, GM assay must be interpreted with caution due to cross reactions to other fungi, which might need different antifungal therapy.

T895

548454-548562

Epistemic_statement

denotes

Background: Invasive pulmonary aspergillosis (IPA) might comprise up to 23-29% of severe influenza patients.

T896

548799-548893

Epistemic_statement

denotes

However, detailed evidence of epidemiological linkage between PM 2.5 and IPA has been limited.

T897

548894-549094

Epistemic_statement

denotes

Therefore, we compare the correlation of PM 2.5 (as monthly average level) by different exposure periods and critical level to the development of IPA among severe influenza and non-influenza patients.

T898

549670-549779

Epistemic_statement

denotes

Spearman's correlation was used to measure the strength of epidemiological association between two variables.

T899

549871-550145

Epistemic_statement

denotes

Monthly average PM 2.5 level and exposure to monthly critical level of >30 μg/m 3 within previous 1-2 months has significant correlation with the development of IPA in severe influenza patients, but has no significant correlation with IPA in non-influenza patients (Table) .

T900

550254-550437

Epistemic_statement

denotes

Conclusion: PM 2.5 exposure within previous 1-2 months, particularly above critical level, may be positively correlated with the development of IPA in the setting of severe influenza.

T901

551136-551366

Epistemic_statement

denotes

In the two cases taking IFN-γ profile study, anti-IFN-γ auto-antibodies were not detected in plasma; however, IFN-γ levels in whole blood were both lower compared with control group, which might be indicative of immune deficiency.

T902

551367-551622

Epistemic_statement

denotes

Conclusion: Most patients with multiple sites of lymphadenopathy could be controlled well with medications after excision; however, CNS involvement may cause more complicated clinical course, which need intensive medical care and may even cause mortality.

T903

551623-551763

Epistemic_statement

denotes

Lab tests for Toxoplasma antibody is usually a rapid tool for detection but has its limitation especially in patients with immunodeficiency.

T904

551764-551861

Epistemic_statement

denotes

IFN-γ profile could provide information of patients' immune status in disseminated toxoplasmosis.

T905

552073-552202

Epistemic_statement

denotes

However, to our knowledge, this is the first report of subdural effusion secondary to meningococcemia and meningitis in an adult.

T906

552203-552269

Epistemic_statement

denotes

Early detection and appropriate treatment may improve the outcome.

T907

554206-554385

Epistemic_statement

denotes

Conclusion: Our patient may have partially responded to the switch in prophylaxis from fluconazole to posaconazole, which paradoxically may have made the diagnosis more difficult.

T908

554510-554622

Epistemic_statement

denotes

On histopathologic examination, it was difficult to distinguish Volvariella volvacea from other invasive moulds.

T909

554753-554942

Epistemic_statement

denotes

Volvariella volvacea is an emerging and potentially fatal cause of invasive fungal infection in patients with haematologic malignancies, for which prompt diagnosis and treatment is crucial.

T910

555861-555963

Epistemic_statement

denotes

However, the tissue prove of brain and liver was not performed due to patient's will and complication.

T911

555964-556066

Epistemic_statement

denotes

However, the patient's condition and image study showed improve after the Voriconazole was prescribed.

T912

556151-556337

Epistemic_statement

denotes

Background: Gastrointestinal (GI) bleeding is more common in patients with end stage renal disease (ESRD) and is associated with higher mortality than in Cytomegalovirus (CMV) infection.

T913

556338-556424

Epistemic_statement

denotes

CMV disease may occur in ESRD patients without the presence of overt immunodeficiency.

T914

556492-556577

Epistemic_statement

denotes

Clinicians should be aware of this possibility in ESRD patients who have GI symptoms.

T915

557720-557832

Epistemic_statement

denotes

However, echocardiography showed no evidence of hypokinease so medication use after clinical condition improved.

T916

558424-558539

Epistemic_statement

denotes

Discussion: CMV can be established as a potential infection, which can lead to reactivation with immunosuppression.

T917

558540-558633

Epistemic_statement

denotes

It can affect almost any organ system, gastrointestinal tract involvement is the most common.

T918

558634-558874

Epistemic_statement

denotes

Because of the rare occurrence of CMV-associated fatal multiple gastric and duodenal bleeding, high index suspicion is needed in immunocompromised patients with gastrointestinal bleeding for early diagnosis and possible beneficial outcomes.

T919

559064-559246

Epistemic_statement

denotes

1 Division of Infectious Diseases, Department of Internal Medicine, 2 Department of Laboratory Medicine, 3 Department of Pathology, Buddhist Tzu Chi General Hospital, Hualien, Taiwan

T920

559247-559308

Epistemic_statement

denotes

Background: Histoplasma capsulatum are rarely seen in Taiwan.

T921

560283-560349

Epistemic_statement

denotes

Lymph node biopsy was not feasible due to severe thrombocytopenia.

T922

561022-561127

Epistemic_statement

denotes

Conclusion: Histoplasmosis is rarely seen in Taiwan and only a limited number of cases had been reported.

T923

561128-561233

Epistemic_statement

denotes

It could be missed by laboratories if incubation for recovery of fungi is shorter than four to six weeks.

T924

561234-561374

Epistemic_statement

denotes

It would be advisable for laboratories to review their culture policies and extend fungal culture incubation to at least four weeks or more.

T925

561375-561477

Epistemic_statement

denotes

Slow growing mold would be underestimated by a short incubation time for fungus in service laboratory.

T926

563140-563276

Epistemic_statement

denotes

Results: According to the preliminary results, the within-run and between-run precisions of the method were 6.2% and 9.9%, respectively.

T927

563674-563812

Epistemic_statement

denotes

Brain computed tomography scan was arranged at that hospital and the family was told that the patient might have cerebrovascular accident.

T928

565121-565211

Epistemic_statement

denotes

Sulfamethoxazole/trimethoprim treatment was initiated for possible cerebral toxoplasmosis.

T929

565466-565537

Epistemic_statement

denotes

However, the patient had septic shock, and his condition went downhill.

T930

566015-566190

Epistemic_statement

denotes

Negative results of Toxoplasma immunoglobulin M and immunoglobulin G levels could not exclude the diagnosis of Toxoplasma infection, which were correlated with previous study.

T931

567067-567197

Epistemic_statement

denotes

After admission, antibiotic therapy was used, including piperacillin/tazobactam and levofloxacin for possible bacterial pneumonia.

T932

567238-567356

Epistemic_statement

denotes

As intensive care was continued, the thrombocytopenia around 11∼19 × 10 3 /uL persisted, even pneumonia seemed better.

T933

567407-567460

Epistemic_statement

denotes

However, persistent thrombocytopenia was still noted.

T934

568183-568280

Epistemic_statement

denotes

CMV-related organ disease should be suspected in patients with CD4+ cell number lower than 50/μL.

T935

568455-568652

Epistemic_statement

denotes

Other cases may experience worsening pulmonary infection due to CMV pneumonitis by the use of steroids, which therapy should be careful in the patients with a high HIV viral load and low CD4 count.

T936

568653-568717

Epistemic_statement

denotes

However, tachypnea and fever were noted on post-operative day 4.

T937

569665-569789

Epistemic_statement

denotes

Conclusion: This case demonstrates leptospiriosis may progressed to Weil's disease and acute disseminated encephalomyelitis.

T938

569930-569965

Epistemic_statement

denotes

Early diagnosis may be challenging.

T939

569966-570035

Epistemic_statement

denotes

In this case, CNS symptoms may be confused with drug-induced seizure.

T940

570276-570429

Epistemic_statement

denotes

As a conclusion, in patients with multiple organ failure after major operation, Weil's disease and ADEM should be considered as a differential diagnosis.

T941

570430-570686

Epistemic_statement

denotes

Co-infections of Mycobacterium tuberculosis and nontuberculous Mycobacterium: difficulty in diagnosis and treatment Lih-shinn Wang 1,2 , Chia-ching Jackie Wang 8 , Xin-yi Zheng 3 , Jen-jyh Lee 1,3 , Teng-Yi Lin 4 , Yung-hsiang Hsu 1,5 , Cheng-lung Ku 6,7 .

T942

570932-571029

Epistemic_statement

denotes

MABC is considered highly drug-resistant; it is extremely difficult to treat and often incurable.

T943

571084-571141

Epistemic_statement

denotes

massiliense is rare, and optimal therapy remains unknown.

T944

574162-574311

Epistemic_statement

denotes

A trivalent (Ia, Ib, III) GBS vaccine might prevent 69.6% of early-onset disease, 92.2% of late-onset disease, and 91.3% of GBS meningitis in Taiwan.

T945

574450-574624

Epistemic_statement

denotes

1 Department of Pediatrics, Taichung Veterans General Hospital, Taichung, Taiwan, 2 Chung Shan Medical University, Taichung, Taiwan, 3 Hung Kuang University, Taichung, Taiwan

T946

574625-574746

Epistemic_statement

denotes

Background: Cavernous sinus thrombosis (CST) is a rare infective disease and it was associated with high mortality rates.

T947

574747-574830

Epistemic_statement

denotes

CST can result from infection of any of the tissues drained by the cavernous sinus.

T948

574831-574959

Epistemic_statement

denotes

The purpose of this study was to review rare case of CST secondary to sphenoid sinusitis, which is under-researched in children.

T949

576125-576234

Epistemic_statement

denotes

The management of CST should the use of intravenous antibiotic therapy combined with endonasal sinus surgery.

T950

576235-576310

Epistemic_statement

denotes

The early use of anticoagulation can reduce morbidity and mortality in CST.

T951

576311-576366

Epistemic_statement

denotes

Corticosteroid treatments for CST remain controversial.

T952

577854-578075

Epistemic_statement

denotes

Risk factors included animal contact and consumption of raw dairy products, which were significantly associated with brucellosis, exposure to vectors in endemic areas,professional exposure and travels outside the country.

T953

578617-578872

Epistemic_statement

denotes

The correlation of these pathogens to the specific clinical manifestation and epidemiological data allowed a better recognition of these infectious nosologies features in our country, and may also lead to the development of targeted prevention strategies.

T954

579040-579149

Epistemic_statement

denotes

However, studies regaring the optimal treatment for Acinetobacter baumannii bacteremic pneumonia are limited.

T955

579926-580139

Epistemic_statement

denotes

Those with ventilator-associated pneumonia were more likely to receive colistin-based treatment rather than sulbactam-base treatment (odds ratio [OR], 7.935; 95% confidence interval [CI], 2.157-29.187; p = 0.002).

T956

580561-580678

Epistemic_statement

denotes

More severe diseases (higher APACHE II scores) were independently associated with higher 14-day and 28-day mortality.

T957

580679-580843

Epistemic_statement

denotes

Further largescale prospective studies are needed to investigate the clinical efficacy of these two regimens for the treatment of A. baumannii bacteremic pneumonia.

T958

581276-581480

Epistemic_statement

denotes

This study was undertaken to ascertain whether the clinical presentation and outcome for patients with this disease differ for those infected with culturenegative as compared to culture-positive pathogen.

T959

582837-582909

Epistemic_statement

denotes

We still need more data to confirm those above findings in our hospital.

T960

582933-583026

Epistemic_statement

denotes

However, it is a rare cause of spontaneous bacterial peritonitis (SBP) in cirrhotic patients.

T961

583395-583585

Epistemic_statement

denotes

Based on the patient's history, physical examination and the results of paracentesis, spontaneous bacterial peritonitis was suggested and blood cultures were positive for Campylobacter coli.

T962

583675-583720

Epistemic_statement

denotes

Results: SBP caused by Campylobacter is rare.

T963

583721-583812

Epistemic_statement

denotes

The first case report of SBP caused by Campylobacter was presented by Targan et al in 1976.

T964

583874-583969

Epistemic_statement

denotes

Three of the five patients were associated with peritonitis and bacteremia as the present case.

T965

583970-584133

Epistemic_statement

denotes

Main underlying conditions are related to liver disease (34%), including alcohol abuse (27%), cirrhosis (20%), cancer (33%), diabetes (21%) and chemotherapy (19%).

T966

585208-585368

Epistemic_statement

denotes

However, after 6 days of antibiotic therapy with Doripenem (500 mg every 8 hours) as an empirical therapy for ESBL-E. coli and target therapy for P. aeruginosa.

T967

586914-587040

Epistemic_statement

denotes

There were rare case reports talking about candida fungal ball in urinary bladder with severe complication, mainly candidemia.

T968

587041-587176

Epistemic_statement

denotes

This is the first case in our acknowledge discussed about invasive urinary bladder C.glabrata mixed infection with severe complication.

T969

587177-587294

Epistemic_statement

denotes

There should be some aggressive invasive procedure performed to treat selected C. glabrata urinary bladder infection.

T970

587552-587723

Epistemic_statement

denotes

Metronidazole and vancomycin are therapeutic choices for CDI but their use was associated with colonization of vancomycin-resistant enterococci and a high recurrence rate.

T971

587724-587876

Epistemic_statement

denotes

Doxycycline shows promising in vitro antibactieral activity against clinical C. difficile isolates and can achieve a high concentration in bowel tissue.

T972

587877-587943

Epistemic_statement

denotes

However, the efficacy of doxycycline in treating CDI is not clear.

T973

588120-588365

Epistemic_statement

denotes

To evaluate whether doxycycline will faciliate the proliferation of C. difficile in intestines, the ex vivo assay was performed for the growth of C. difficile by coculturing with cecum content from the mice after oral doxycycline administration.

T974

589284-589826

Epistemic_statement

denotes

Besides, doxycycline therapy showed non-inferior to metronidazole or vancomycin therapy, according to body weight loss in mice with CDAD (doxycycline vs. metronidazole: 1.11 ± 0.56 kg vs. Hospital Center "Mother Theresa", Service of Infectious Diseases, 3 University Hospital Center "Mother Theresa", Service of Reanimation and Anesthesia, 4 University Hospital Center "Mother Theresa", SID Background: Although Tetanus is currently a relatively rare infectious disease it remains a high mortality disease (20-30%) with high management costs.

T975

590945-591240

Epistemic_statement

denotes

Causes of death are mainly due to paralysis and artificial ventilation complications, which apply to severe forms such as severe brain damage as a consequence / side effect of treatment, cerebral thrombosis 1 case, pneumothorax 1 case, staphylococcal pneumonia 1 case, pulmonary embolism 1 case.

T976

591991-592191

Epistemic_statement

denotes

Background: Information regarding the use of MALDI-TOF MS as an alternative to conventional laboratory methods for the rapid and reliable identification of anaerobe in blood isolates is still limited.

T977

592192-592311

Epistemic_statement

denotes

The aim of this study was to assess the performance of MALDI-TOF MS in identification of anaerobes from blood cultures.

T978

593301-593372

Epistemic_statement

denotes

and GPAC, and only 11 of them could not be identified using the method.

T979

593521-593725

Epistemic_statement

denotes

The extensive development of a database, not only frequently isolated anaerobic species, but also newly recognized and taxonomically rearranged genera and species, should be well continuously established.

T980

593957-594104

Epistemic_statement

denotes

Background: Myeloma patients may present clinical signs such as hypercalcemia, anemia, renal dysfunction and bone disability when inital diagnosis.

T981

594105-594222

Epistemic_statement

denotes

However, infection is still a significant cause of morbidity and the leading cause of death in patients with myeloma.

T982

594392-594533

Epistemic_statement

denotes

Methods: A 66-year-old businessperson was informed stage II chronic renal impairment possibly due to uncontrolled hypertension for two years.

T983

596542-596975

Epistemic_statement

denotes

1 School of Medicine, Tzu Chi University, Hualien, Taiwan, 2 Division of Infectious Diseases, 3 Division of Chest Medicine, Department of Internal Medicine, 4 Department of Laboratory Medicine, 5 Department of Radiology, 6 Department of Pathology, Buddhist Tzu Chi General Hospital, Hualien, Taiwan Background: Serratia marcescens, which can produce a red pigment, prodiogiosum, has been regarded as a harmless gramnegative bacillus.

T984

597749-597833

Epistemic_statement

denotes

However, 3 days after discharge, he came back due to massive "hemoptysis" of 150 mL.

T985

598283-598347

Epistemic_statement

denotes

However, he had a fever of 37.9°C, tachycardia and leukocytosis.

T986

598414-598619

Epistemic_statement

denotes

S. marcescens lung abscess was the final diagnosis, and "hemoptysis" was considered as "pseudo-hemoptysis" when repeat sputum grew the same organism which could produce prodiogiosum, mimicking fresh blood.

T987

598986-599080

Epistemic_statement

denotes

Conclusion: Hemoptysis is common in patients of TB or aspergillosis, but rare in lung abscess.

T988

599081-599116

Epistemic_statement

denotes

S. marcescens lung abscess is rare.

T989

599117-599233

Epistemic_statement

denotes

But if the presenting symptom is "hemoptysis", it could be the red pigment, prodiogiosum, produced by S. marcescens.

T990

599234-599384

Epistemic_statement

denotes

Splenic abscess: an uncommon entity with potentially life threatening Mei-Chun Lee 1,3 , Chien-Hung Lu 1 , Wei-Ying Lee 1 , Chun-Ming Lee 2,3,4,5,6 *.

T991

599385-599455

Epistemic_statement

denotes

Background: Splenic abscess is rare with potentially life threatening.

T992

599496-599658

Epistemic_statement

denotes

The aim of this study is to review the clinical features, microbiologic etiologies, treatments, and outcomes of patients with splenic abscesses in recent 5 years.

T993

600764-600860

Epistemic_statement

denotes

Conclusion: We noted mortality may be more related to patients with underlying immunodeficiency.

T994

601056-601177

Epistemic_statement

denotes

Background: Association between psoriasis and leptospirosis has been previously mentioned but seldom cases were reported.

T995

602684-602836

Epistemic_statement

denotes

Current research suggests that the inflammatory mechanisms are immune based and most likely initiated and maintained primarily by T cells in the dermis.

T996

603081-603196

Epistemic_statement

denotes

Cytokines produced in response to infection have been proposed to be involved in the pathogenesis of leptospirosis.

T997

603880-604050

Epistemic_statement

denotes

To reveal the characteristics of bacteremic pneumonia caused by ESBL-producing organisms is extremely important for clinicians, yet few studies have effectively achieved.

T998

604051-604227

Epistemic_statement

denotes

The aim of this study is to evaluate the correlation between sputum isolation of ESBL-producing Escherichia coli and Klebsiella pneumoniae and outcomes of bacteremic pneumonia.

T999

605606-605965

Epistemic_statement

denotes

About the impact of sputum isolation of ESBL-producing E. coli and K. pneumoniae on clinical course, inappropriate empirical therapy was initiated more often (62.1% vs15%, P = 0.0001), and associated with 60-day mortality (37.9% vs7.5%, P = 0.0026) Conclusion: ESBL-producing bacteremic pneumonia was associated with comorbidities and severity of the disease.

T1000

605966-606039

Epistemic_statement

denotes

Appropriate empirical therapy could lead to the improvement of prognosis.

T1001

607353-607488

Epistemic_statement

denotes

Physical examination reported no prominent findings except a 1 cm knife cut wound on his left hand, which happened at work 2 weeks ago.

T1002

608603-608711

Epistemic_statement

denotes

Conclusion: Previous studies have reported that myocarditis can result from M. pneumoniae and leptospirosis.

T1003

608712-608827

Epistemic_statement

denotes

However, antigenic mimicry between Leptospire and Mycoplasma could play a role in biologic false positive reaction.

T1004

608828-608918

Epistemic_statement

denotes

Physicians should be careful when a patient presents risk factors of Leptospira infection.

T1005

608919-609137

Epistemic_statement

denotes

Mycobacterium abscessus complex pneumonia and possible progressive multifocal leukoencephalopathy (PML) as a presentation of AIDS Yu-Hui Lin 1 , Soon-Hian Teh 2 , Lih-shinn Wang 1,2 , Chia-jung Chiang 3 , Yi-wen Wu 2 .

T1006

609138-609547

Epistemic_statement

denotes

1 School of Medicine, Buddhist Tzu Chi University, Hualien, Taiwan, 2 Division of Infectious Diseases, Department of Internal Medicine, Buddhist Tzu Chi General Hospital, Hualien, Taiwan, 3 Ministry of Health and Welfare Chest Hospital, Tainan, Taiwan Background: M. abscessus complex (MABC) is a group of rapidly growing non-tuberculous mycobacteria (NTM) species that can cause pulmonary infections in AIDS.

T1007

610273-610330

Epistemic_statement

denotes

The patient was admitted to treat possible NTM pneumonia.

T1008

611134-611225

Epistemic_statement

denotes

Further study of the sputum culture confirmed MABC by an official mycobacterium laboratory.

T1009

611711-611794

Epistemic_statement

denotes

Conclusion: MABC infections are difficult to treat because of multidrug resistance.

T1010

611795-611914

Epistemic_statement

denotes

MAC and MABC co-infection is possible, and MAC may need to treat empirically when CD4 counts are extremely low in AIDS.

T1011

613236-613390

Epistemic_statement

denotes

The highly aggregation of RT078 cells was examined and shown neither correlated with the growth rate of bacterial population nor the formation of biofilm.

T1012

613391-613554

Epistemic_statement

denotes

The results of this study suggested the C. difficile RT078 had the distinct physiological phenotype that could be observed easily without further molecular typing.

T1013

613555-613816

Epistemic_statement

denotes

Klebsiella pneumoniae liver abscess associated with Guillain-Barré syndrome: first case in Taiwan Background: Antecedent infections are common with Guillain-Barré syndrome (GBS), and are thought to trigger the immune response that leads to acute polyneuropathy.

T1014

613948-614054

Epistemic_statement

denotes

However, there are no report about the Klebsiella pneumoniae primary liver abscess could also lead to GBS.

T1015

614677-614870

Epistemic_statement

denotes

However, bilateral lower leg muscle power and deep tendon reflex (DTR) decreased quickly from distal to proximal, progression of difficulty in defecation and urination during the hospilitation.

T1016

615175-615284

Epistemic_statement

denotes

Three month later, He could walk and defecate normally when he came back to out patient department follow up.

T1017

615616-615688

Epistemic_statement

denotes

Thus, we could boldly associate his GBS with K.pneumoniae liver abscess.

T1018

615689-615895

Epistemic_statement

denotes

This is the first reported case of Guillain-Barré syndrome in Taiwan associated with K.pneumoniae liver abscess which should be kept in mind when making a diagnosis of acute onset of bilateral leg weakness.

T1019

616028-616082

Epistemic_statement

denotes

However, there was no respiratory or urinary symptoms.

T1020

616219-616308

Epistemic_statement

denotes

However, watery diarrhea was noted since 5/8 night, and CRP level elevated to 45.28 mg/L.

T1021

617162-617420

Epistemic_statement

denotes

Conclusion: Clostridium difficile is a kind of normal bacteria in human intestinal tract, the use of antibiotics will lead to other intestinal bacteria to reduce the normal therefore cause a lot of breeding and cause disease and severe electrolyte imbalance.

T1022

618305-618356

Epistemic_statement

denotes

However there are limited data from Southeast Asia.

T1023

619517-619711

Epistemic_statement

denotes

After excluding 41 patients with concomitant infections, the presence of fever >38.0°C 48 hours before culture was also not associated with bacteriuria >10 3 CFU/mL (95%CI 0.67 to 5.1; p = 0.3).

T1024

619712-619990

Epistemic_statement

denotes

Urine WBC counts were significantly raised in patients with positive urine cultures ( p = 0.0001) (247 ± 357/hpf ) compared to negative urine cultures (11 ± 16/hpf ), suggesting that urine microscopy should be used as a screen for urine culturing even for hospitalised patients.

T1025

620642-620746

Epistemic_statement

denotes

Conclusion: This pilot audit is limited by the small sample size and presence of concomitant infections.

T1026

620747-620919

Epistemic_statement

denotes

Larger studies are needed to confirm our findings so we can effectively target therapies for patients with UTI without exacerbating the problem of antimicrobial resistance.

T1027

621225-621464

Epistemic_statement

denotes

The application of matrix-assisted laser desorption/ionization time-of-flight mass spectrometry (MALDI-TOF MS) directly to blood culture (BC) broth has a potential to identify bloodstream infection earlier and facilitate timely management.

T1028

622675-622941

Epistemic_statement

denotes

Comparison between different bottle types, the results indicated that the BACTEC™ Lytic/ 10 Anaerobic/F culture vials exhibited the best performance among the three (BACTECTM Plus Aerobic/F: 87.4%; BACTECTM Lytic/10 Anaerobic/F: 92.1%; BACTECTM Myco/F Lytic: 80.0%).

T1029

623299-623501

Epistemic_statement

denotes

1 Division of Infectious Disease, Jen-Ai Hospital, 2 Department of Infection Control, Jen-Ai Hospital Background: Accurate and earlier detection of TB, and TB drug resistance is critical for TB control.

T1030

623502-623604

Epistemic_statement

denotes

Mycobacterial culture is considered as the best reference standard but is relatively complex and slow.

T1031

625188-625321

Epistemic_statement

denotes

Nonetheless, this test may be valuable as an add-on test following smear microscopy in patients previously found to be smearnegative.

T1032

625322-625462

Epistemic_statement

denotes

For rifampicin resistance detection, Xpert ® MTB/RIF provides accurate results and can allow rapid initiation of MDR-TB treatment (Level 1).

T1033

625801-625968

Epistemic_statement

denotes

Rhodotorula species as infrequent yeast pathogens increasingly cause invasive infections such as fungemia, meningitis, ocular infection, peritonitis, and endocarditis.

T1034

627845-628052

Epistemic_statement

denotes

Conclusion: Although indeterminate Western Blot may be present in acute and early HIV infections, confirmation of HIV infection still need more information such as HIV RNA viral loads, PCR or seroconversion.

T1035

628053-628196

Epistemic_statement

denotes

For most clinicians, negative Western Blot usually excludes HIV/AIDS, and may ignore the fact of window period present in acute HIV infections.

T1036

628197-628339

Epistemic_statement

denotes

In high risk population, the diagnosis of acute and early HIV infections can be made by obtaining exposure history or a presentation of a STD.

T1037

628500-628610

Epistemic_statement

denotes

Background: Clostridium difficile infection (CDI) is associated with long-term or multiple use of antibiotics.

T1038

628708-628808

Epistemic_statement

denotes

The difficulty of diagnosis and the strain diversity make early treatment and isolation a challenge.

T1039

629937-630069

Epistemic_statement

denotes

Conclusion: Patients suspected infected with Clostridium difficile can be diagnosed and treated by rapid molecular biology analysis.

T1040

630998-631438

Epistemic_statement

denotes

Results: After exclusion of 15 (7.1%) samples with processing errors, the overall sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) of this platform for identification of Gram-positive cocci species were 87.0% ( Background: Multidrug-resistant Gram-negative bacteria, particularly E. coli producing extended spectrum beta-lactamase (ESBL) and/or carbapenemase causes global public health concern.

T1041

633866-634021

Epistemic_statement

denotes

Hospitalized patients and receiving treatment for other conditions may be susceptible to infection, especially those with severely impaired immune systems.

T1042

635365-635516

Epistemic_statement

denotes

The drug sensitivity of S. maltophilia should be monitored and analyzed to assist the clinical Physicians choose a reasonable treatment of antibiotics.

T1043

636012-636234

Epistemic_statement

denotes

While the prevalence of multidrug resistant organism were closely monitored in the hospitals in Taiwan, the prevalence of colonization with these organisms in the community, especially among the adults, is largely unknown.

T1044

637829-637894

Epistemic_statement

denotes

The prevelance rate of nasal carriage of MRSA remains stationary.

T1045

638739-638851

Epistemic_statement

denotes

According to the in vitro data, the combination of fosfomycin and meropenem is a potentially alternative choice.

T1046

639035-639116

Epistemic_statement

denotes

1 IHibiki AMR Laboratory, Kitakyushu, Japan, 2 Fukuoka Shin Mizumaki Hospital, 3

T1047

639117-639244

Epistemic_statement

denotes

Background: Staphylococcus saprophyticus is one of major uropathogens that causes acute uncomplicated urinary tract infections.

T1048

639245-639360

Epistemic_statement

denotes

However, few data about antimicrobial susceptibility against S. saprophyticus isolates in Japan have been reported.

T1049

639991-640107

Epistemic_statement

denotes

The isolates from male patients were not isolated in 2011 to 2013, however, in 2014 to 2016 they accounted for 8.9%.

T1050

641567-641677

Epistemic_statement

denotes

However, it is considered that we have to continue survey of antimicrobial susceptibility in S. saprophyticus.

T1051

642995-643127

Epistemic_statement

denotes

We could analyze the isolation rates and trend of drug-resistant pattern of the above bacteria from January, 2015 to February, 2017.

T1052

643701-643788

Epistemic_statement

denotes

However, VRE increased from 1.9% to 23.9% (means: 13.0%), which showed an upward trend.

T1053

643882-644058

Epistemic_statement

denotes

However, the increased isolation rate of VRE highlighted the need to reinforce further monitoring of VRE infection, which is the key point of infection control in our hospital.

T1054

644059-644182

Epistemic_statement

denotes

Epidemiological analysis of multi-drug resistant pathogens could assist clinicians in choosing the appropriate antibiotics.

T1055

645839-645955

Epistemic_statement

denotes

No growth was found in 16% of patients, which may be due to antibiotic use before arriving at the tertiary hospital.

T1056

646030-646113

Epistemic_statement

denotes

Therefore, TMP-SMX may be a preferential treatment for MRSA in outpatient settings.

T1057

646164-646273

Epistemic_statement

denotes

Because no suitable oral antibiotic exists for CRPA, inpatient treatment should be considered in these cases.

T1058

646274-646595

Epistemic_statement

denotes

Background: Previous studies have suggested that sequence type 59 (ST59) predominates among borderline-oxacillin resistant mecA-positive Staphylococcus aureus (BORSA) (minimum inhibitory concentrations of oxacillin, 0.5-4 μg/mL) isolates, and clinical data related to bacteremia caused by BORSA ST45 isolates are limited.

T1059

648891-649101

Epistemic_statement

denotes

Incident HIV diagnosis was associated with male gender (adjusting hazard ratio: aHR = 8.5, 95% CI: 1.9-38.1), attending hospital-based VCT clinics (7.8, 1.1-58.3) and male-male sexual behaviors (8.4, 1.5-46.7).

T1060

651116-651317

Epistemic_statement

denotes

Conclusion: Our present study indicated further increase of nonvaccine serotypes following the use of conjugate vaccines, associated with increase of antimicrobial resistance in the dominant serotypes.

T1061

651458-651556

Epistemic_statement

denotes

However, in absence of abscess or open wound, it is difficult to establish the bacterial etiology.

T1062

651626-651902

Epistemic_statement

denotes

In recent few years, community-acquired MRSA (methicillin-resistant Staphylococcus aureus) increases gradually in Taiwan, whether antibiotics against MRSA and MSSA (methicillin-susceptible Staphylococcus aureus) should be prescribed at the same time become a clinical dilemma.

T1063

651903-652079

Epistemic_statement

denotes

Herein, we conduct a study to establish epidemiologic data and evaluates the association between treatment response and nasal carriage status in adult patients with cellulitis.

T1064

652566-652711

Epistemic_statement

denotes

No specific background factors, such as age, underlying disease, patients' sources and so on, can be identified to predict their carriage status.

T1065

652987-653100

Epistemic_statement

denotes

However, once the pus formation, we noted the pus culture result was correlated with their nasal carriage status.

T1066

653101-653195

Epistemic_statement

denotes

The limitation of our study was small case number in patient group of nasal MRSA colonization.

T1067

653297-653392

Epistemic_statement

denotes

No specific factor can be identified to predict a MRSA nasal carrier in this group of patients.

T1068

653393-653565

Epistemic_statement

denotes

However, whether a patient is a nasal MRSA carrier or not, there is no different in their treatment response to antibiotics, empiric antibiotics against MRSA is not needed.

T1069

653889-653965

Epistemic_statement

denotes

However, the types of carbapenemase involved varies from country to country.

T1070

654784-655021

Epistemic_statement

denotes

In addition, in this study, the clonal complex of related isolates was defined by eBURST based on the assigned sequence types for 2014 isolates in this study and the sequence types for 2013 isolates in previous study (Low et al., 2017) .

T1071

655721-655896

Epistemic_statement

denotes

Finally, based on the eBURST analysis, the isolates from 2014 have been grouped into two clonal complexes while all 8 sequence types of 2013 isolates appeared to be singleton.

T1072

655967-656115

Epistemic_statement

denotes

The increasing cases of CRKp in this hospital might be due to the emergence of CRKp harboring various carbapenemases coupled with the loss of porin.

T1073

656607-656690

Epistemic_statement

denotes

Most cases of salmonellosis are mild; however, sometimes it can be lifethreatening.

T1074

656852-656989

Epistemic_statement

denotes

Antimicrobial resistance is a public health concern and Salmonella is one of the microorganisms in which some resistant has been emerged.

T1075

658551-658655

Epistemic_statement

denotes

However, in children and elderly patients, the associated dehydration become severe and lifethreatening.

T1076

658869-658984

Epistemic_statement

denotes

Background: The HOCl was a weak acid which can production anions then interacted to the cell wall or cell membrane.

T1077

659481-659670

Epistemic_statement

denotes

According to previous studies, these bacteria can live in the surface of hospital over 3 months, and once the staff touch the surface, it would be a chance to infect patient by any actions.

T1078

660400-660504

Epistemic_statement

denotes

That's to say, these CRABs could live in the surface, and not only one train were presented on this ICU.

T1079

660505-660661

Epistemic_statement

denotes

Conclusion: In this case, even the CRAB were not the same, but we still found the possible chance that would cause infection once the staff don't take care.

T1080

660662-660749

Epistemic_statement

denotes

Besides that, we suggested that it's better to use the disposable gel for Bronchoscopy.

T1081

661065-661362

Epistemic_statement

denotes

Besides, Table 1 also showed non-high-risk ward sections was free from MDRO, indicating high-risk ward sections should be regularly monitored, and supervised implementation of environment cleaning and disinfection to ensure better cleanliness in hospital environment and better healthcare quality.

T1082

662373-662516

Epistemic_statement

denotes

In 2015 they suddenly raised, yet through infection control interventions, CRAB decreased in 2016 again (the results were listed in Figure 1 ).

T1083

662611-662720

Epistemic_statement

denotes

In addition to promotion of Antibiotic Stewardship Program, more attention should be paid to MDRO monitoring.

T1084

663322-663470

Epistemic_statement

denotes

Background: Mobile nursing cart is a trend for modern nursing practice, which can enhance the working efficiency and reduce the processing mistakes.

T1085

663471-663568

Epistemic_statement

denotes

But the mobile devices might become the media for transmission of multi-drug resistant organisms.

T1086

663569-663806

Epistemic_statement

denotes

This study aims to investigate the adequacy and accessibility of surface disinfection process for nursing cart, which can provide the experience for establishing standard operation processes of environmental cleanliness and disinfection.

T1087

664834-664959

Epistemic_statement

denotes

We demonstrated the devices could be the media of bacterial transmission and might result in healthcare associated infection.

T1088

665041-665262

Epistemic_statement

denotes

The small parts of the automatic endoscope reprocessor may cause the positive results of repeated microbiological monitoring of gastrointestinal endoscopes after high-level disinfection Che-Yi Hung 1 *, Shu-Shia Chang 2 .

T1089

665263-665337

Epistemic_statement

denotes

1 Kuang Tien General Hospital, 2 Kuang Tien General Hospital, Dajia Branch

T1090

665338-665475

Epistemic_statement

denotes

Background: Contaminated endoscopes have been linked to more outbreaks of healthcare-associated infections than any other medical device.

T1091

665476-665575

Epistemic_statement

denotes

Microbiological surveillance may help in monitoring the effectiveness of GI endoscope disinfection.

T1092

666390-666500

Epistemic_statement

denotes

A fishbone diagram was used to identify possible causes of a problem and to sort ideas into useful categories.

T1093

666655-666767

Epistemic_statement

denotes

The fishbone diagram showed that the root causes of the positive cultures may be job rotation and old equipment.

T1094

666826-666918

Epistemic_statement

denotes

However, 6 (60.0%) positive cultures were obtained from endoscopes processed with the EW-30.

T1095

666919-667123

Epistemic_statement

denotes

The fact was found that the joints of the water/air channel and the instrument/suction channel in the AER were damaged and could not allow the circulation of the fluid under pressure through the channels.

T1096

668701-668851

Epistemic_statement

denotes

Conclusion: Some environmental surfaces in the monitoring showed unqualified cleanliness, which means clean work have not been thoroughly implemented.

T1097

669039-669102

Epistemic_statement

denotes

Clean environment is associated with better healthcare quality.

T1098

669191-669377

Epistemic_statement

denotes

Correlation between first line anti-tuberculosis drugs and hepatitis Background: According to American Society for Microbiology, blood culture contamination rate should be lower than 3%.

T1099

669714-669885

Epistemic_statement

denotes

The possible causes were as follows: (1) Results: Blood culture contamination rates of November and December were 1.6% and 2.6%, respectively, and both were lower than 3%.

T1100

670565-670632

Epistemic_statement

denotes

1 National Taiwan University Hospital, 2 National Taiwan University

T1101

670633-670755

Epistemic_statement

denotes

Background: Improvement of environmental cleaning in hospitals has been shown to decrease cross-transmission of pathogens.

T1102

670940-671033

Epistemic_statement

denotes

However, few published data are available regarding the interpretation of fluorescent marker.

T1103

672172-672306

Epistemic_statement

denotes

Our evaluation provide the surfaces with fluorescent marker totally cleaning could offer objective standards for hospital cleanliness.

T1104

672307-672396

Epistemic_statement

denotes

Strengthen the reliable wipe off of high-touch surfaces can improve the cleaning quality.

T1105

672397-672535

Epistemic_statement

denotes

Further studies are necessary to establish the association of cleanliness and microbial transmission and healthcare-associated infections.

T1106

673027-673145

Epistemic_statement

denotes

However, we found the compliance rate have reached the plateau during the period from 2012 to 2014 (76%, 73% and 74%).

T1107

674167-674290

Epistemic_statement

denotes

Results: The total number of hand hygiene opportunities observed by ICLN were 1262 (Part 1) and 1248 (Part 2) respectively.

T1108

674291-674509

Epistemic_statement

denotes

There is no significant variation (75.9% vs 74.1% P = 0.320) between hand hygiene compliance rate in the first part of hand hygiene observation and the observation performed by ICN in previous quarter before the study.

T1109

674780-674890

Epistemic_statement

denotes

The lesions of Tuberculosis are sometimes non-classical, leading to difficulties in making clinical diagnosis.

T1110

674987-675140

Epistemic_statement

denotes

The diagnosis of Tuberculosis mainly depends on chest X-ray, TB/AFB, and TB/culture so that the patients can be diagnosed and receive treatments in time.

T1111

676218-676426

Epistemic_statement

denotes

Conclusion: Some patients with Tuberculosis may spread mycobacterium tuberculosis in hospitals before their diagnosis is confirmed, thus, increasing the risk of exposure to infections for staffs and patients.

T1112

677321-677482

Epistemic_statement

denotes

Further investigation revealed that ward cleaner is responsible for cleaning the bed and that nursing staff are responsible for cleaning the medical instruments.

T1113

677483-677583

Epistemic_statement

denotes

But as the cot sides of a bed may be moved, it was unclear whose role it was to clean the cot sides.

T1114

677584-677712

Epistemic_statement

denotes

Transmission to patients is however more likely to occur in "near-patient" areas such as the hospital bed and patient equipment.

T1115

677713-677978

Epistemic_statement

denotes

While cleaning of soiled linens room and floors is usually done by the ward cleaner, which cleans these "nearpatient" areas is greyer and may be carried out by nursing staff, ward cleaner or healthcare assistants; depending on the nature of equipment to be cleaned.

T1116

677979-678102

Epistemic_statement

denotes

Most importantly on "near-patient" areas, this can be an important niche for transmission of multidrug resistant organisms.

T1117

679543-679758

Epistemic_statement

denotes

In the case hospital, the contamination rate of blood culture constantly remained as high as 7.6% (CLSI <3%), which would influence a physician in making correct diagnosis and choosing suitable antimicrobial agents.

T1118

679759-679849

Epistemic_statement

denotes

Therefore, how to reduce the contamination rate of blood culture becomes a critical issue.

T1119

681268-681357

Epistemic_statement

denotes

However healthcare worker compliance with optimal practices remains low in most settings.

T1120

683884-684290

Epistemic_statement

denotes

Background: In order to maintain the quality of bacterial culture tracing, infection control medical staff regularly participate the infection control training course and implementation in clinical related business, such as notification the positive results of bacterial culture, and the significant abnormalities of legal infectious pathogens, so that patients can receive effective treatment immediately.

T1121

684513-685179

Epistemic_statement

denotes

Methods: Bacterial culture notification mechanism, the pathogen of bacteria included in this monitoring system, then the pathogenic bacteria strains to monitor the infection cases,to avoid the spread of infection and to avoid cluster infection occurred, through the TNIS system to provide the reporting function, the hospital can analyze the medical care-related infection, the results of the bacterial culture and the antibiotic resistance distribution of the hospital, as a reference for the internal review and improvement, to assist the hospital in developing appropriate monitoring mechanisms and methods, to enhance the quality of nosocomial infection control.

T1122

685180-685485

Epistemic_statement

denotes

As long as the patient test report in the presence of bacterial culture positive, the laboratory will be informed to send a newsletter to the Infection Control Center, Medical, Pharmacy, Abnormal culture results will tabulation, and in the sense of the meeting to review whether the absence of negligence.

T1123

685486-685952

Epistemic_statement

denotes

Results: From January 1 to May 31 2017, there was one abnormal information data, three set sputum culture has sent to the laboratory on March 9 to 13, the data found abnormal on March 13, and this report has registered on the March 16, and send messages to doctor, pharmaceutical, infection control center, the relevant report sent to the Infection Control Center, to notify the ward and provided a district area care immediately after received this abnormal report.

T1124

686046-686376

Epistemic_statement

denotes

Conclusion: The establishment of a mechanism for the prevention of bacterial culture can prevent the spread of infectious diseases in the hospital, to speed up the diagnosis of infectious diseases by the physician's expertise, for the understanding of the domestic epidemic, rapid and correct diagnosis of the patient's condition.

T1125

687014-687185

Epistemic_statement

denotes

In addition, by analyzing the contaminated parts, and referring it to prior put-on and take-off procedures, a better procedure and instruction manual could be figured out.

T1126

688979-689819

Epistemic_statement

denotes

Sudden changes in the cause of the KPC, further analysis of the cause of the abnormal events, contact isolation measures and environmental cleanliness, so infection control intervention measures in addition to the original hand hygiene and contact isolation measures and environmental clean, the other for high-risk cases and Has been identified in the case of centralized care, the second occurrence of MDROs abnormal events, suspected bursts of bacteria for the CRAB, monitoring the cause of this event may be due to the unit space can not clean the bed and equipment into the care area, in the bed Abnormalities in the process, so the infection control measures for the collection of the original collection area is not collected, to strengthen the detection of the same ROOM is to increase the non-CRAB environmental cleaning frequency.

T1127

690126-690457

Epistemic_statement

denotes

It is found that the combination of MDROs is suspected to be in the group, and each time the MDROs are detected in the unit, the analysis of the abnormal events is discussed with the care unit, and the main reason for the occurrence of the event is possible, Combined care work, can still effectively solve the outbreake of events.

T1128

690628-690718

Epistemic_statement

denotes

As a result, the compliance rate of hand hygiene and contact isolation can not reach 100%.

T1129

690866-691223

Epistemic_statement

denotes

In addition, for the detection of MDROs must be concentrated to receive, from the two abnormal event handling still need to consider all the staff, infection control requirements in a holistic manner to consider the most efficient way to solve this problem, by this experience is used as a reference for dealing with suspected the MDROs outbreake of events.

T1130

692686-692812

Epistemic_statement

denotes

Conclusion: Product C was the most preferred hand gel and should be considered as alternative to current hand hygiene product.

T1131

693207-693397

Epistemic_statement

denotes

Conclusion: Multi-modal interventions with nursing-driven base are essential in reduced CAUTI and point extension make successful experiences to duplicate in other units and other hospitals.

T1132

693973-694107

Epistemic_statement

denotes

This study aims to explore the profile, recognized pathogens and predicted prognostic factors for mortality of bloodstream infections.

T1133

696041-696148

Epistemic_statement

denotes

Far Eastern Memorial Hospital Background: Mechanical intubation is an essential part for critical patients.

T1134

696149-696337

Epistemic_statement

denotes

Ventilator associated pneumonia (VAP) is an important complication of intubation, which will increase hospitalization cost, prolonged hospital stay and potentially threaten patient's life.

T1135

696338-696415

Epistemic_statement

denotes

Bundle intervention is proposed to effectively decrease the incidence of VAP.

T1136

696705-696795

Epistemic_statement

denotes

(2) Background: Many critically ill patients can survive by use of mechanical ventilation.

T1137

696796-697001

Epistemic_statement

denotes

However, these patients have serious clinical condition, and are immune-compromised status, many health care associated infections like ventilator-associated pneumonia (VAP) will be the major complication.

T1138

697276-697371

Epistemic_statement

denotes

The incidence of VAP is related to length of hospital stay, duration of mechanical ventilation.

T1139

697634-697779

Epistemic_statement

denotes

In our hospital, incidence VAP in intensive care unit is 0.69-1.72‰ from 2014 to 2016 which is expected to achieve zero tolerance in coming year.

T1140

697780-697908

Epistemic_statement

denotes

However, there are many new health care personnel in these year, multiple health care measures are not fulfilled for our target.

T1141

698027-698138

Epistemic_statement

denotes

Fortunately, we can participate in this program, and strengthen to prevent VAP with application of bundle care.

T1142

699069-699257

Epistemic_statement

denotes

Conclusion: Evidence based strategy for bundle care seems to be simple, but how to develop, promote, and implement the strategy and counter checking of these measures are more significant.

T1143

699258-699461

Epistemic_statement

denotes

Implementation of VAP bundle care will prevent and reduce VAP incidence, decrease the duration of ventilator use and the average length of hospital stay, and decrease the patient morbidity and mortality.

T1144

699988-700087

Epistemic_statement

denotes

recommended the use of 16Fr or other size, the rest of the situation can be considered using 14 Fr.

T1145

701205-701290

Epistemic_statement

denotes

The result can be as a reference to continuously improve the quality of medical care.

T1146

702368-702504

Epistemic_statement

denotes

By further analyzing the cases, it can be found no more than 3 cases per season and they individually occurred in every different month.

T1147

702505-702682

Epistemic_statement

denotes

Zero infection maintained in the latest season shows that if daily evaluation of extubation can be put into effect, it is definitely able to improve the quality of medical care.

T1148

705425-705519

Epistemic_statement

denotes

However, nebulizers are potential sources of microbial contamination of the respiratory tract.

T1149

705520-705654

Epistemic_statement

denotes

Small-volume nebulizers medications for administering bronchodilators, including hand-held nebulizers, can produce bacterial aerosols.

T1150

705655-705979

Epistemic_statement

denotes

Ultrasonic hand-held nebulizers have been associated with nosocomial pneumonia Methods: In order to understand the suitability and influence of the ultrasonic nebulizers used in treatment of respiratory diseases of paediatric patients, we conducted a systematic literature review of the articles published before April 2017.

T1151

706165-706281

Epistemic_statement

denotes

Results: After 24 hours of usage, the Burkholderia cepacia complex (Bcc) can be isolated from ultrasonic nebulizers.

T1152

706402-706616

Epistemic_statement

denotes

The Evidence-based medicine literature suggests that appropriate maintenance of ultrasonic nebulizers is crucial for preventing Bcc contamination of nebulizers and subsequent respiratory tract and blood infections.

T1153

706617-706680

Epistemic_statement

denotes

New contamination control measures were implemented as follows:

T1154

706681-706844

Epistemic_statement

denotes

(1) Availability of ultrasonic nebulizers was strictly limited to <5 d. At that time, the devices were returned to the medical engineering section for maintenance.

T1155

707366-707522

Epistemic_statement

denotes

Moreover, additional maintenance procedures are required for instrument maintenance, so it is recommended to use a single use and disposable jet nebulizers.

T1156

707523-707677

Epistemic_statement

denotes

In regards of patient's safety, cost consideration and therapeutic effectiveness, it is recommended to implement the cleaning and disinfection procedures.

T1157

707678-707841

Epistemic_statement

denotes

In order to make the best treatment of spray therapy, the right equipment such as mouth tube or mask, should be chosen to fit children's age and cognitive ability.

T1158

710173-710315

Epistemic_statement

denotes

The value of Fisher's Exact Test, P > 0.05(=), shows deploying Care Bundle can lower down the density but there is still room for improvement.

T1159

710359-710444

Epistemic_statement

denotes

The possible reason can be related to the specific patients being received and cured.

T1160

710750-710933

Epistemic_statement

denotes

Background: Ventilator-associated pneumonia (VAP) is a common healthcare-associated infection in intensive care units, which can cause patients to have severe morbidity and mortality.

T1161

712468-712526

Epistemic_statement

denotes

Infection Control Center, Chi Mei Medical Center, Liouying

T1162

712527-713109

Epistemic_statement

denotes

Background: Urinary tract infections (UTIs) are one of the most common medical care-related infections, accounting for about 40%, of which about 70% is associated with the use of the catheter, and the hospital is involved in the Department of Health and Welfare Medical treatment care quality improvement program to promote the catheter-related urinary tract combination of care measures, through the clinical field audit, found the problem, the feedback unit to improve, to reduce the urinary tract-related urinary tract infection, improve medical quality, protection Patient safe.

T1163

713444-713893

Epistemic_statement

denotes

Results: Before the promotion of the program (from January to June in 2015), the general hospital CAUTI density of 0.7‰, intensive care unit of 1.9‰, in July 2015 to start the field audit, catheter placement and care compliance and CAUTI infection density Table 1 shows that although the audit compliance rate increased, but the intensive care unit CAUTI density increased by 38.7%, the general ward CAUTI density is flat before the plan to promote.

T1164

714271-714706

Epistemic_statement

denotes

Conclusion: Leading to catheter-associated urinary tract infection may be a large number of factors, as soon as possible to remove the catheter, aseptic technique operation and daily care is necessary to perform a ring, through the audit, regular feedback, into the unit staff in-service education and evaluation indicators, and Continuous tracking, period can effectively reduce the catheterassociated urinary tract infection density.

T1165

715896-716113

Epistemic_statement

denotes

Remind early assessment of the possibility of removal of the catheter: remind the card of catheterization in bed-side, remind the days of catheterization in chart, and remind the days of catheterization in HIS system.

T1166

716117-716323

Epistemic_statement

denotes

The implementation of the standard catheter care: To design new catheter fixed stickers,out of bed patients to use convenience pants which could hide urine bag, 3 M hooks affixed to keep urine bag smoothly.

T1167

717705-718154

Epistemic_statement

denotes

In 2017, the infection rate of ventilator associated pneumonia was increased, so the establishment of this project, Interprofessional collaborative practice to reduce the incidence of ventilator associated pneumonia and the days of mechanical ventilation used in the intensive care unit, thereby reducing mortality, hospital days and health care costs Methods: Further research with a larger cohort study could help to clarify these characteristics.

T1168

720323-720418

Epistemic_statement

denotes

The survival time was analyzed to show whether there was a difference in the occurrence of VAP.

T1169

721365-721525

Epistemic_statement

denotes

It is recommended that future studies may be necessary to increase the sample size, to determine the effectiveness of 0.2% CHG in reducing the incidence of VAP.

T1170

721526-721656

Epistemic_statement

denotes

The findings suggest that 0.2% CHG can be used for oral care to reduce patient oral bacteria and delay the time of VAP occurrence.

T1171

721832-722007

Epistemic_statement

denotes

Background: Since New Delhi metallo-β-lactamase-1 (NDM-1) was first detected, several variants have been further identified that differ by one or two amino acid substitutions.

T1172

722282-722616

Epistemic_statement

denotes

Although polymyxin B and colistin ( polymyxin E) offer limited treatment options for multidrug-resistant (MDR) organisms carrying NDM-9, the emergence of the plasmid-mediated colistin resistance gene mcr-1 (for mobilised colistin resistance gene) conferring resistance to colistin ( polymyxin E) may attenuate the utility of colistin.

T1173

723510-723671

Epistemic_statement

denotes

Despite TZP being resumed for UTI complicated by sepsis syndrome, her clinical condition rapidly deteriorated and the patient's family requested supportive care.

T1174

723890-724188

Epistemic_statement

denotes

Conclusion: The present case indicates the possibility of coproduction of MCR-1 and NDM-9 among clinical isolates and indicates the importance of surveillance of colistin-and carbapenem-resistant Enterobacteriaceae isolates and associated genes in humans, with special reference to MCR-1 and NDM-9.

T1175

725740-725858

Epistemic_statement

denotes

A process surveillance checklist can be helpful for understanding which parts of the bundle care require improvements.

T1176

727286-727394

Epistemic_statement

denotes

The synergistic effect seems to be similar for doxycycline and tigecycline based combinations with amikacin.

T1177

727395-727559

Epistemic_statement

denotes

Conclusion: The antibacterial activity of doxycycline can be enhanced by the addition of amikacin and is observed against most multidrug-resistant E. coli isolates.

T1178

730699-730840

Epistemic_statement

denotes

Conclusion: Evaluation of urinary catheter extraction provided physicians or nurses to assess and remove of the catheter as soon as possible.

T1179

730841-731185

Epistemic_statement

denotes

There are many factors that affect CAUTI, It is recommended that the future continue to promote multi-faceted measures such as through teamwork to reduce unnecessary catheter indwelling; and to more attention to bladder function assessment, Continuing to reduce catheter use and resuscitation rates, and hope to be able to reduce CAUTI finally.

T1180

731557-731734

Epistemic_statement

denotes

Intervention of respirator-associated pneumonia combined with compliance with the rate of compliance audits, can effectively reduce the respiratory rate of pneumonia associated.

T1181

732816-733048

Epistemic_statement

denotes

Conclusion: The establishment of regular feedback and audit mechanism is very important, and then through teamwork, can effectively improve the compliance rate, thereby reducing the respiration rate of respiratory-related pneumonia.

T1182

733049-733165

Epistemic_statement

denotes

So the third phase of the hospital compliance rate of up to 91.4%, can reduce the respiration of 24.5% of pneumonia.

T1183

734195-734497

Epistemic_statement

denotes

The incidence of VAP was higher than other hospitals during initial implementation stage and the causes were lack of knowledge of care bundle strategies, low implementation rate, lack of unified mouthwash ingredients, lack of standards and auditing practice, low correction rate (50%) in care practice.

T1184

735928-735976

Epistemic_statement

denotes

However, it was found that was poorly practiced.

T1185

736794-736946

Epistemic_statement

denotes

Conclusion: The implementation of integrated care in the respiratory cause of the relevant pneumonia, can reduce the infection caused by the ventilator.

T1186

737524-737714

Epistemic_statement

denotes

After primary surveying on 20 staffs on the performance of "urinary catheterization," it revealed that, although the knowledge of CAUTI was 90% correct, the performance was only 55% correct.

T1187

738008-738189

Epistemic_statement

denotes

We further stratified patients into critically ill and non-critically ill group, and found appropriate antimicrobial therapy was not associated with survival benefit in both groups.

T1188

738284-738404

Epistemic_statement

denotes

Antimicrobial treatment was not associated with survival benefit in either critically ill or noncritically ill patients.

T1189

738405-738490

Epistemic_statement

denotes

The findings may provide some insight on future antibiotic stewardship interventions.

T1190

738742-738920

Epistemic_statement

denotes

There is no evidence based on replacing timing of foley catheter or urinary drainage bag, the range from a week, two weeks to per month in cilinical standard operation procedure.

T1191

740276-740389

Epistemic_statement

denotes

However, whethere changing urinary drainage bag or not would be not significant in bacteria culture ( p = 0.717).

T1192

742001-742141

Epistemic_statement

denotes

Generally, the isolate numbers from LTCF residents in each surveillance culture correlated with the number of isolates from the environment.

T1193

742348-742455

Epistemic_statement

denotes

However, the MLST typing from the environment cultures could correlate with the culture from the residents.

T1194

742850-742992

Epistemic_statement

denotes

However, the MIC values of tetracycline, trimethoprimsulfamethoxazole, and ciprofloxacin were significantly lower in ST59 as compared to ST45.

T1195

743156-743272

Epistemic_statement

denotes

However, the MLST typing of the environmental stains highly correlated with the colonized strains in LTCF residents.

T1196

743273-743414

Epistemic_statement

denotes

An individualized environmental cleansing policy should be adopted to facilitate the LTCF to reduce the environmental colonization with MRSA.

T1197

744469-744638

Epistemic_statement

denotes

The goal of this study was to apply a bundle for ventilatorassociated pneumonia prevention as a process for quality improvement in a single surgical intensive care unit.

T1198

746075-746387

Epistemic_statement

denotes

In response to VAP bundle interventions, no difference in SICU utilization ( p = 0.32) between the pre-VAP and post-VAP bundle phases was noted, whereas the ventilator utilization was decreased, from 359 ventilator days to 295 ventilator days ( p = 0.19) monthly; the VAP density had remarkably decreased from 1.

T1199

749491-749693

Epistemic_statement

denotes

Results: Among 286 episodes of mechanical ventilation, 18 episodes were complicated with VAE; 6 of ventilator-associated conditions (VAC), 9 of infection-related VAC (IVAC) and 3 of possible VAP (PVAP).

T1200

750239-750412

Epistemic_statement

denotes

Conclusion: Since VAE affects patient's QOL and prognosis, It might be also important to improve malnutrition in VAE patients with nutrition support team for preventing VAE.

T1201

751015-751174

Epistemic_statement

denotes

S. aureus can cause infective endocarditis, septic arthritis and osteomyelitis after bacteremia and in-hospital mortality of infective endocarditis was 22-66%.

T1202

751175-751262

Epistemic_statement

denotes

This important issue is how to prevent the episode of staphylococcus aureus bacteremia.

T1203

751263-751376

Epistemic_statement

denotes

According to previous studies, staphylococcus aureus nasal carrier would follow staphylococcus aureus bacteremia.

T1204

751377-751548

Epistemic_statement

denotes

Therefore, we wonder to know if decreasing nasal carrier rate of staphylococcus aureus in hemodialysis room would reduce the incidence of staphylococcus aureus bacteremia.

T1205

754543-754675

Epistemic_statement

denotes

Seasonal influenza vaccination could see as the health prevention intervention to protection patient before influenza season coming.

T1206

754676-754777

Epistemic_statement

denotes

Tamiflu ® (oseltamivir phosphate) dosing could suggest if an outbreak event was occurred in the ward.

T1207

754778-754935

Epistemic_statement

denotes

Environment clean and disinfection was highly suggested in order to stop drop infection be transformed into contact infection by psychiatric patients' hands.

T1208

755117-755534

Epistemic_statement

denotes

1 Center for Infection Control, National Cheng Kung University Hospital, Tainan, Taiwan, 2 Division of Infectious Diseases, Department of Internal Medicine, National Cheng Kung University Hospital, Tainan, Taiwan, 3 Nursing Department, National Cheng Kung University Hospital, Tainan, Taiwan Background: To promote the quality of hand hygiene skill, several innovative teaching programs has been initiated since 2012.

T1209

756162-756371

Epistemic_statement

denotes

The cleaness of seven main areas (including palms, back of hand, gaps between fingers, knuckles, thumbs, finger nails, wrists of both hands) were measured (+1 for each section) and scored 0 to 7 for each hand.

T1210

756740-756886

Epistemic_statement

denotes

The most missing points were the finger gaps of left hands (122, 39.1%), left hand fingers (116, 37.2%) and gaps between right hands (120, 38.5%).

T1211

757521-757684

Epistemic_statement

denotes

The fluorescent lotion and UV light test can reveal the missing points of hand hygiene skills individually, and help the staff to improve their skills accordingly.

T1212

758325-758448

Epistemic_statement

denotes

There are several problems including incorrect manual cleaning, inappropriate storage, or lack of automated washing device.

T1213

759829-759984

Epistemic_statement

denotes

Conclusion: With quality control circle to perform regular checks and interventions, the quality of endoscope disinfection could be improved significantly.

T1214

760567-760694

Epistemic_statement

denotes

The fatality rate was 7% (1 of 15 patients) among confirmed cases and 5% (2 of 37 patients) among patients with possible cases.

T1215

761643-761717

Epistemic_statement

denotes

The experience would be shared with the medical profession as a reference.

T1216

762055-762399

Epistemic_statement

denotes

To clarify whether each individual case is relavant to one another, interventions adopted were investigation in the ward, proceeding the sampling inspection of environment in the ward where the patients have lived as well as the hands of staffs who worked there, and revising the standard operation procedure of multiple-drug resistant strains.

T1217

763104-763302

Epistemic_statement

denotes

Although the source of infection can't be confirmed, the investigation was continously proceeded and finally found it resulted from the insufficient concentration of bleach formulated by the staffs.

T1218

763488-763641

Epistemic_statement

denotes

This study would be provided to the medical profession as a reference of how to implement the interventions to deal with multiple-drug resistant strains.

T1219

764157-764288

Epistemic_statement

denotes

It can reduce central line-associated bloodstream infections (CLABSI) rate from 1.9/1,000 catheter days to 1.6/1,000 catheter days.

T1220

764696-764859

Epistemic_statement

denotes

Conclusion: Sodium citrate may effective central venous catheter lock solution in hematologic malignancies because of it's antimicrobial and antithrombotic effect.

T1221

764860-764941

Epistemic_statement

denotes

But the evidence was not sufficient,we need to more prospective trails confirmly.

T1222

765217-765568

Epistemic_statement

denotes

1 Center for Infection Control, 2 Occupational Safety and Health Office, 3 Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan Background: Since the increasingly complicated medical environment and the threats of emerging infectious diseases, issues of workplace safety and health promotion are getting more important.

T1223

765683-765898

Epistemic_statement

denotes

Besides continuously enhance the training and education of personnel protection as well as continuous improvement of tools and equipment in the workplace are also expected to avoid the occurrence of accidental NSIs.

T1224

766463-766578

Epistemic_statement

denotes

Closely monitoring on the incidence and analysis on the underlying mechanisms of NSIs were implented simutaneously.

T1225

767102-767273

Epistemic_statement

denotes

However, the occurrence of NSIs made by the incorrect operating of safety devices and safety devices being not activated had increased from 1.94% in 2011 to 8.97% in 2016.

T1226

767274-767390

Epistemic_statement

denotes

Conclusion: The use of SEDs can effectively prevent NSIs but must work correctly with standard operating procedures.

T1227

767479-767606

Epistemic_statement

denotes

Keeping and making a more safety workplace environment with sustained efforts should be ongoing to promote occupational health.

T1228

767725-767940

Epistemic_statement

denotes

Chimei Medical center Intensive care unit Background: Cytomegalovirus (CMV) usually causes an asymptomatic infection or produces mild flulikesymptoms; afterward, it remains latent throughout life and may reactivate.

T1229

768042-768108

Epistemic_statement

denotes

Symptomatic CMV disease can affect almost every organ of the body.

T1230

768109-768225

Epistemic_statement

denotes

Rare manifestations of CMV infections in immunocompetent individuals include thrombocytopenia, and hemolytic anemia.

T1231

768296-768425

Epistemic_statement

denotes

However, massive bloody stool passage was found and pandoscopy revealed esophageal ulcer and the pathology confirm CMV infection.

T1232

769088-769198

Epistemic_statement

denotes

However, recurrence of bloody stool was noted, colonoscopy on 11/21 revealed multiple rectal ulcer s/p biopsy.

T1233

770076-770160

Epistemic_statement

denotes

Therefore, the patient should be offered an antiviral treatment as soon as possible.

T1234

770293-770485

Epistemic_statement

denotes

Repeat endoscopy may be considered if previous study did not meet a conclu gastrointestinal CMV disease should be kept in mind with immunocompromised patient compatible with clinical symptoms.

T1235

770965-771228

Epistemic_statement

denotes

In order to evaluate if the mobile e-nursing carts became the media of multi-drug resistant organism (MDRO) transmission, ATP-bioluminescence and culture were performed to assess the efficacy of surface cleaning in 10 high-touch surfaces of mobile e-nursing cart.

T1236

771445-771557

Epistemic_statement

denotes

After investigation the will of cleaning by questionnaire, it correlated with the convenience of cleaning tools.

T1237

771651-771770

Epistemic_statement

denotes

This study also evaluated the will of medical staff for cleaning the mobile e-nursing cart by different cleaning tools.

T1238

771771-771960

Epistemic_statement

denotes

By the analysis, we try to find out how to increase the will of medical staff for cleaning the mobile e-nursing cart, to make sure the cleaning and to avoid healthcare-associated infection.

T1239

772297-772458

Epistemic_statement

denotes

The use of four different cleaning tools in the e-nursing carts of the vehicle clean, found that different cleaning products can make the surface after cleaning.

T1240

772779-772961

Epistemic_statement

denotes

Conclusion: A cleaning tool with convenience to operation, effective cleaning, lower stimulation to skin and smell will increase the will and frequency of cleaning for medical staff.

T1241

772962-773062

Epistemic_statement

denotes

If medical staff implement the cleaning is more important for the cleaning of mobile e-nursing cart.

T1242

773187-774120

Epistemic_statement

denotes

Improve the integrity of oral care for nurses in the prevention of ventilator-associated pneumonia Shwu-Hwa Leu 1 *, Mei-Ju Su 1 , Li-Yao You 1 , Shu-Chun Chang 1 , Yueh-Chen Fu 1 , Hsia-Ling Wu 1 , Li-Chu Li 1 , Chin-Yu Chen 2 , Tzu-Ping Shih 2 , Wen-Chih Wu 3 , Cho-ching Sun 4 Background: The use of ventilator-associated pneumonia (VAP) for the intensive care unit quality indicators to monitor important items,not only will extend the hospital stay will increase the cost of medical care (Ashraf & Ostrosky-Zeichner, 2012), so there is a systematic introduction to prevent the combination of care, remodel the correct concept of staff care, the implementation of unified and more effective care measures in the combined care, but also to respirator patients with oral care is more important, Expect effective prevention of VAP, improve patient cleaning and comfort, in order to enhance the professional care and service quality.

T1243

774291-774618

Epistemic_statement

denotes

First, the newly transferred personnel to protect the lack of awareness (19.7%); Second, the lack of appropriate care products can be used (21.8%);Third, there is no relevant care operation check mechanism and standard operating practices (16.2%), so the purpose of this project is to improve the integrity of oral care to 95%.

T1244

775692-776126

Epistemic_statement

denotes

Effective teamwork can increase the efficiency of the work, in the process of care, while buy and use the new improved care products, not only more convenient and effective; the current hospital has been promoted to the implementation of the respiratory care ward, To share the unit to promote the implementation of experience, in order to achieve the purpose of maintaining patient safety and improve the quality of medical services.

T1245

776244-776489

Epistemic_statement

denotes

1 Department of Intensive Care Medicine, Chi Mei Medical Center, Tainan, Taiwan, 2 Department of Medicine, Taipei Medical University, Taipei, Taiwan Background: Influenza may cause severe disease that needs care in the intensive care unit (ICU).

T1246

776490-776646

Epistemic_statement

denotes

Viral infections in the ICU often involve the respiratory system and can cause significant morbidity and mortality especially in immunocompromised patients.

T1247

776938-777009

Epistemic_statement

denotes

Both pathogens are often ignored but might be of clinical significance.

T1248

777701-777752

Epistemic_statement

denotes

However, septic shock was noted during stay in RCC.

T1249

778366-778485

Epistemic_statement

denotes

Although associated with a higher morbidity and mortality, the clinical significance of CMV in ICU patients is unknown.

T1250

778486-778608

Epistemic_statement

denotes

Meanwhile, the organism M. morganii with proven pathogenicity could be potentially dangerous and should not be overlooked.

T1251

778718-778800

Epistemic_statement

denotes

It is difficult to discern whether CMV plays a role in post-H1N1 pneumonia status.

T1252

778801-778930

Epistemic_statement

denotes

CMV might be a bystander as no anti-CMV therapy was given, but it might be a contributor associated with prolonged hospital stay.

T1253

780274-780357

Epistemic_statement

denotes

We found that VRE could be found in re-admission of the patients infected with VRE.

T1254

782375-782489

Epistemic_statement

denotes

Unfortunately, reminder interventions can also be easily ignored and catheters may remain in place without action.

T1255

782616-782995

Epistemic_statement

denotes

Methods: I-CARE intervention was performed in August 2015 with coordinated strategy comprised of (1) I-CARE slogan poster: Indication Clean Aseptic Remove-early Easy and smooth (2) team works with focus on nurse driven catheter removal potoca (3) Background: Ambient air may be contaminated with or carry significant levels of a variety of potentially detrimental microorganisms.

T1256

783209-783323

Epistemic_statement

denotes

The aim of this study were to assess microbial colony counts in working ORs in a tertiary referral medical center.

T1257

784256-784476

Epistemic_statement

denotes

Conclusion: Our study demonstrated that free fungi and the number of mean bacterial colonies were far from the suggested levels during surgical activity despite a well-controlled OR ventilation system with a HEPA filter.

T1258

784736-784912

Epistemic_statement

denotes

Next we visited OR in the company of OR head nurse to investigate and to see whether the number of surgical site infections cases show abnormally increase in the past 6 months.

T1259

785014-785101

Epistemic_statement

denotes

These green cotton fibers should be from green cloth used to wrap surgical instruments.

T1260

786289-786390

Epistemic_statement

denotes

1 Division of Infectious Disease, Jen-Ai Hospital, 2 Department of Infection Control, Jen-Ai Hospital

T1261

786391-786543

Epistemic_statement

denotes

Background: Burn injuries are associated with significant death and disability, multiple surgical procedures, prolonged hospitalization, and high costs.

T1262

786544-786729

Epistemic_statement

denotes

Taiwan ICST and French Burn Association suggested that antibiotic prophylaxis should be given as soon on severe burns rather on local infection burns patients or infections not assured.

T1263

786730-786844

Epistemic_statement

denotes

We herein perform a search to provide evidence-based recommendations for prophylactic treatment in burns patients.

T1264

787679-787773

Epistemic_statement

denotes

The limited evidence about the effects of antibiotics was unable to draw reliable conclusions.

T1265

787774-787961

Epistemic_statement

denotes

Therefore, antibiotic prophylaxis is not suggested routinely administrated for all burns patients, which is consistent with Taiwan ICST suggestions and French Burn Association guidelines.

T1266

787962-788188

Epistemic_statement

denotes

Further, 48-72 hours after antibiotic prophylaxis interventions, appropriateness of drug usage should be reassessed, preferably by the results of bacteria cultures, to adjust the applications of antibiotics for burns patients.

T1267

788660-788759

Epistemic_statement

denotes

EMB related blurred vision is most likely to be confused with degenerative diseases in the elderly.

T1268

790675-790799

Epistemic_statement

denotes

Therefore, we could put the end to medical dispute and support a win-win strategy between the patient and medical caregiver.

T1269

790931-791669

Epistemic_statement

denotes

Chiayi Chang Gung Memorial Hospital Infection control commissions Background: Respiratory care center in January 2016 catheterrelated urinary tract infection density of 15.3‰, compared with the previous 6 months average duct-related urinary tract infection density 5.1‰ high; by the chi-square test statistical value of P = 0.0083, field audit found that the implementation of hand Health is not implemented, catheterization process in the urethral disinfection process and disinfection time is not enough, set the urine bag at the exit of the bed along the situation, in recent years found in the import and active combination of infection control measures to help reduce Catheter-related infection, the project will be further explored.

T1270

793155-793491

Epistemic_statement

denotes

According to the literature, it is pointed out that the removal of the catheter is a preventive urinary tract The main cause of infection, but because of the relationship between patients with respiratory care center, the implementation of the catheter in the early removal of the more difficult, but also the resistance of the project.

T1271

793904-794031

Epistemic_statement

denotes

Health-care associated bloodstream infection may result in elevated morbidity, mortality, prolonged admission, and higher cost.

T1272

795217-795429

Epistemic_statement

denotes

Conclusion: An evidence-based bundle care intervention of hemodialysis units may resulted in improved compliance and correct rates of medical staff, and reduced hemodialysis associated bloodstream infection rate.

T1273

795430-795759

Epistemic_statement

denotes

Use of an education programme to encourage hand hygiene with alcohol-based handrub and reduce near-patient environmental contamination in elderly residents in long-term care O'Donoghue Margaret 1 , Yang Lin 1 , Siu Gilman Kit-Hang 2 , Lee Paul Hong 1 , Boost Maureen Valerie 1 , Ho Jacqueline Mei Chi 1 , Suen Lorna Kwai Ping 1 .

T1274

796249-796425

Epistemic_statement

denotes

The role of patients' hands has been neglected both in hospitals and LTCFs even though it has been suggested that they may represent an under-recognized reservoir of pathogens.

T1275

796426-796673

Epistemic_statement

denotes

We aimed to determine if education, regular reminders and improved availability of alcohol based hand rub (ABHR) would increase frequency of hand hygiene by elderly residents in long term care capable of performing hand hygiene without assistance.

T1276

797634-797912

Epistemic_statement

denotes

Conclusion: By adopting directly observed hand hygiene for subjects capable of using ABHR without assistance, it should be possible for all residents of a LTCF to achieve improved hand hygiene on three occasions by introducing this methodology before each of the main mealtimes.

T1277

797913-798069

Epistemic_statement

denotes

For elderly unable to perform hand hygiene by themselves, we propose that HCWs physically assist these patients by rubbing the ABHR on their hands for them.

T1278

798070-798169

Epistemic_statement

denotes

This preliminary study shows promise as an approach to reduce the MDRO problem in the LTCF setting.

T1279

798170-798390

Epistemic_statement

denotes

Background: In order to monitor infectious diseases and avoid potential epidemic outbreaks in Taiwan, our hospital participated in the Epidemic Prevention Cloud Project driven by Center for Disease Control (CDC) in 2016.

T1280

799276-799446

Epistemic_statement

denotes

Results: We could successfully transfer twenty kinds of regulated organisms such as Mycobacterium tuberculosis, Hepatitis C virus, and Streptococcus agalactiae and so on.

T1281

799766-799952

Epistemic_statement

denotes

The goverment could immediately monitor all hospitals report data in Taiwan to effectively analyze recent trends in all kinds of infectious diseases by Epidemic Prevention Cloud Project.

T1282

799953-800053

Epistemic_statement

denotes

The continued surveillance of infectious diseases should be performed and popularized in the future.

T1283

800312-800615

Epistemic_statement

denotes

The quality of catheter care directly influences patients' safety so patients and family members should be incorporated into the gatekeeper model of port-a-cath care to enhance communication between healthcare professionals and patients and quality of care through shared decision-making (SDM) strategy.

T1284

800963-801235

Epistemic_statement

denotes

Results: Patients' condition at home and present condition at admission would be understood through self-assessment of brochure after their admission to hospital; therefore, nurses could provide patients with timely access to relevant information and nursing intervention.

T1285

801557-802032

Epistemic_statement

denotes

Conclusion: Although we worry that giving more information regarding port-a-cath to the patients and family members will increase probability of disputes occurrence between patients and hospital staff if the staff members don't follow the standard of care, it is necessary to incorporate patients and family numbers into the gatekeeper mode to have a better understanding of clinical quality and thereby enhance education training of practice staff to improve patient safety.

T1286

802756-802834

Epistemic_statement

denotes

Information without personal data can be viewed online with access permission.

T1287

803410-803584

Epistemic_statement

denotes

Results: Currently, the information system covers 100% of TB patients under management and 100% high-risk populations which need to be rapidly diagnosed of drug-resistant TB.

T1288

803737-803868

Epistemic_statement

denotes

Automated real-time analysis of indicators can enhance laboratory quality management and facilitate prompt response to occurrences.

T1289

804084-804250

Epistemic_statement

denotes

Conclusion: Our findings indicate that effective, timely and comprehensive information sharing through the web-based "MONITOR" system can improve TB care and control.

T1290

805578-805670

Epistemic_statement

denotes

However, the T. pallidum DNA yields from clots were only 1% at different centrifugal forces.

T1291

805905-806035

Epistemic_statement

denotes

Conclusion: The T. pallidum DNA yield can be significantly improved by red cell lysis pretreatment and appropriate centrifugation.

T1292

806939-807062

Epistemic_statement

denotes

However, additional cost for commercialized MALDI Sepsityper kit (Bruker Daltonics) may be burden to clinical laboratories.

T1293

808730-808879

Epistemic_statement

denotes

We suggest that echinocandin should be started as an empiric antifungal therapy if the blood culture turns positive after 50 h of aerobic incubation.

T1294

809044-809347

Epistemic_statement

denotes

1 Department of Pharmacy, Chi-Mei Medical Center, Tainan, Taiwan, 2 Department of intensive care medicine, Chi-Mei Medical Center, Tainan, Taiwan Background: Patients with hematologic malignancies are at high risk of invasive fungal infections (IFIs), which has been associated with high mortality rate.

T1295

809576-809733

Epistemic_statement

denotes

The aim of this study was to evaluate the effect of echinocandins for the prevention of invasive fungal infections in patients with hematologic malignancies.

T1296

810948-811156

Epistemic_statement

denotes

However, subgroup analysis showed that micafungin is more effective than azoles for prevention of IFIs (RR:0.78, 95% CI 0.61-0.98), and caspofungin has similar effects with azoles (RR:0.94, 95% CI 0.72-1.23).

T1297

811170-811310

Epistemic_statement

denotes

Conclusion: This meta-analysis shows that micafungin might be a better choice for IFI prophylaxis in patients with hematologic malignancies.

T1298

811311-811418

Epistemic_statement

denotes

However, the effectiveness of caspofungin might be mitigated due to the smaller sample size in the studies.

T1299

811491-811592

Epistemic_statement

denotes

Consider the cost and efficacy, micafungin could be suggested as the first choice of IFI prophylaxis.

T1300

811946-812061

Epistemic_statement

denotes

The knowledge of antibiotics susceptibility of different Candida species may help clinicians in treatment planning.

T1301

812562-812865

Epistemic_statement

denotes

C. albicans [n = 21 (42%)] was the most commen species, followed by C. parapsilosis [n = 10 (20%)], C. glabrata [n = 7 (14%)], C. tropicalis [n = 6 (12%)], C. guiliermondii complex [n = 2 (4%)], C. krusei [n = 1 (2%)], C. inconspicua [n = 1 (2%)], C. haemilonii [n = 1 (2%)], C. lusitaniae [n = 1 (2%)].

T1302

813248-813449

Epistemic_statement

denotes

However, C. glabrata (n = 12) was indiscernibly susceptible to Fluconazole and Intraconazole but had susceptible rates to Amphotericin B, Flucytosine, Voriconazole with 100%, 92% and 83%, respectively.

T1303

814330-814489

Epistemic_statement

denotes

The knowledge of the distribution of anti-fungal drug susceptibility of different Candida species in the hospital may help clinicians in prescription planning.

T1304

817322-817395

Epistemic_statement

denotes

However, a higher frequency of vitreous body involvement was experienced.

T1305

817731-817916

Epistemic_statement

denotes

Department of Pharmacy, National Cheng Kung University Hospital, Tainan, Taiwan Background: Fluconazole was amongst the first line of antifungal agent in invasive candidiasis in Taiwan.

T1306

817917-818065

Epistemic_statement

denotes

Different Candida species showed various susceptibilities to fluconazole which dosedependent sensitive of fluconazole posed concern on its efficacy.

T1307

818438-818559

Epistemic_statement

denotes

Logistic regression and Mantel-Haenszel test were utilized to analysis the variant that might influence clinical outcome.

T1308

819267-819449

Epistemic_statement

denotes

Logistic regression found that continue treatment with another 2 weeks after documented clearance was significant associated with survival rate (Odds ratio: 5.6, 95% CI: 2.18-14.38).

T1309

819450-819635

Epistemic_statement

denotes

However, to give fluconazole loading dose and to keep maintenance dose of fluconazole more then 6 mg/kg were showed no significant associated to mortality rate and pathogen eradication.

T1310

819636-819740

Epistemic_statement

denotes

Conclusion: In this study, adequate treatment course of fluconazole is associated with patient survival.

T1311

819741-819923

Epistemic_statement

denotes

Even if different Candida species do not reveal poor clinical outcome, but a new treatment strategy of candidemia for increasing fluconazole-resistance Candida pathogen is necessary.

T1312

819924-820287

Epistemic_statement

denotes

Pulmonary fungal infection due to a Basidiomycete species (Ceriporia lacerata) in a HIV patient Lih-shinn Wang 1 , Chia-ching Jackie Wang 5 , Huei-jen Chao 3 , Siao-ru Lin 3 , Chih-bin Lin 2 , Yung-hsiang Hsu 4 Background: Basidiomycetes are rarely reported as a cause for invasive respiratory infection, despite airborne spores being abundant in the environment.

T1313

821731-821853

Epistemic_statement

denotes

Chest HRCT revealed mixed alveolar and interstitial lesions of bilateral lungs, and patchy consolidation of hilar regions.

T1314

821951-822075

Epistemic_statement

denotes

The patient could not tolerate conventional AmB due to rigors and fevers, and we replaced it with the liposomal formulation.

T1315

822584-822786

Epistemic_statement

denotes

Clinical suspicion and broader recognition of diseases caused by filamentous fungi among clinicians and microbiologists would improve therapeutic experience and selection of better treatment strategies.

T1316

822787-822947

Epistemic_statement

denotes

Background: Candida glabrata species complex includes Candida glabrata sensu stricto and two major cryptic species, Candida nivariensis and Candida bracarensis.

T1317

824093-824280

Epistemic_statement

denotes

All C. nivariensis and C. bracarensis could not be identified to species level by the Vitek MS v2.0 IVD and Bruker Biotyper MS v3.1, but were all correctly identified by the Vitek MS RUO.

T1318

825167-825410

Epistemic_statement

denotes

The use of the Vitek MS RUO system, Bruker ClinProTools software and the addition of MSP to Bruker MS databases representing the local diversity of isolates assisted with achieving differentiation of cryptic species within C. glabrata complex.

T1319

825837-826104

Epistemic_statement

denotes

Previous in vitro studies showed that E. faecalis could inhibit the C. albicans hyphal morphogenesis and reduce its biofilm formation, furthermore co-infection of E. faecalis and C. albicans in mice resulted in less mortality than infection with either species alone.

T1320

826105-826282

Epistemic_statement

denotes

However, in clinical mixed bloodstream infection associated with Candida and Enterococcus is rare but it causes with worse clinical outcomes in immune compromise cancer patient.

T1321

826793-827015

Epistemic_statement

denotes

The drug susceptibilities against antibiotics, ampicillin and gentamicin, and antifungals, caspofungin and amphotericin B, of these microbes will be analyzed to check their phenotypic changes that associate with virulence.

T1322

827388-827569

Epistemic_statement

denotes

Conclusion: The interaction of E. faecalis and C. albicans might alter the antibiotic susceptibility of E. faecalis in patients, no matter presenting in biofilm or planktonic forms.

T1323

827600-827681

Epistemic_statement

denotes

Generally, acute hepatitis caused by LTBI treatment with isoniazid is quite rare.

T1324

827682-827767

Epistemic_statement

denotes

At present, the exact mechanism of Isoniazid related hepatotoxicity is still unclear.

T1325

827768-827903

Epistemic_statement

denotes

It might be related to age, slow acetylation to toxic Hydrazine metabolites, or CYP450 2E1 homozygous wild type (CYP2E1c1/c1 genotype).

T1326

827904-828154

Epistemic_statement

denotes

Conclusion: For adverse events of acute hepatitis induced by LTBI treatment with isoniazid, we recommended to trace liver function 1-2 times every week closely, especially those patients whose liver function fail to recover after quitting medication.

T1327

828155-828430

Epistemic_statement

denotes

In conclusion, during the treatment, paying highly attention to the patient's clinical symptoms with closely tracking the biochemical tests of blood, treating the adverse events in time, are all important to ensure the completion of treatment and achieve the purpose of cure.

T1328

828431-828600

Epistemic_statement

denotes

Spatio-temporal analyses on mild and severe influenza illness and their association with air pollution in Taiwan Pin-wei Shih 1 , Ta-Chien Chan 2 , Chwan-Chuen King 3 *.

T1329

829308-829441

Epistemic_statement

denotes

Therefore, we should understand the spatio-temporal distributions of mild and severe cases of influenza and their associated factors.

T1330

829772-829897

Epistemic_statement

denotes

Finally, we confirmed the strength of the association between the risk factors and the disease by using the regression model.

T1331

830043-830113

Epistemic_statement

denotes

AQI can imply the degree of effect of the air pollution on our health.

T1332

830281-830417

Epistemic_statement

denotes

Such an interaction of weather and air pollution may help us observe that cases of respiratory illness increase after certain time lags.

T1333

830418-830604

Epistemic_statement

denotes

Therefore, the higher incidences of influenza-like illness would occur more frequently in those time periods with poor air quality, and those areas with severe problems of air pollution.

T1334

830605-830906

Epistemic_statement

denotes

Conclusion: We hope that the results from this study involving AQI, local weather, and more implications from epidemiology of mild and severe influenza cases altogether can provide an early warning for harm reduction of influenza-like illness and implementing the most appropriate preventive measures.

T1335

831190-831346

Epistemic_statement

denotes

Health care providers worldwide should consider means to prevent this disease; however, guidelines related this topic differ among industrialized countries.

T1336

831403-831751

Epistemic_statement

denotes

Methods: The guidelines of the United Kingdom's National Institute for Health and Care Excellence (NICE) are the most notable, but do not contain prescription recommendations for prophylactic antibiotics, while the European Society of Cardiology (ESC) recommends antibiotics for only the highest-risk individuals, and only during dental procedures.

T1337

832159-832385

Epistemic_statement

denotes

In addition, the recommendation in the NICE guideline has been changed slightly because an English population-based study revealed higher incidence of endocarditis after the introduction of an aggressive new guideline in 2008.

T1338

832386-832673

Epistemic_statement

denotes

One reason for the many differences among guidelines might be that no randomized control trial has been conducted on the prophylactic effect of antibiotics for individual at risk of endocarditis; therefore, guideline formulating committees do not do not have access to concrete evidence.

T1339

833095-833267

Epistemic_statement

denotes

Results: A historical cohort study reveals indirect evidence for prevention of endocarditis with amoxicilline, which indicates that the UK guidelines might be insufficient.

T1340

833392-833505

Epistemic_statement

denotes

On the basis of current evidence, neither the AHA nor the ESC guidelines can be considered superior to the other.

T1341

833506-833655

Epistemic_statement

denotes

Conclusion: Primary care physicians and dentists should consider prophylaxis against endocarditis during dental procedures as recommended AHA or ESC.

T1342

833898-834143

Epistemic_statement

denotes

Nurse staff played a vital role in maintaining patients' quality of life and effectiveness of treating, preventing or reducing distressing side effects due to chemotherapy and reinforcing knowledge related to chemotherapy and self-care behavior.

T1343

834144-834231

Epistemic_statement

denotes

Currently, staffs often focused on possible side effects of separate chemotherapy drug.

T1344

834232-834368

Epistemic_statement

denotes

However, chemotherapy templates varied from the types of cancer and the side effects depended on the type of chemotherapy being offered.

T1345

834889-835059

Epistemic_statement

denotes

Results: Offering information about potential side effects to the treatment before starting chemotherapy could reduce the discomfort and deterioration in quality of life.

T1346

835196-835402

Epistemic_statement

denotes

Conclusion: The chemotherapy side effects in patients are sometimes different from those recorded in literatures so staff can record the chemotherapy side effects on patients through the assessment process.

T1347

835403-835557

Epistemic_statement

denotes

After analyzing the assessment form, the data can be used to establish guideline for education of the common side effects of chemotherapy order templates.

T1348

836253-836457

Epistemic_statement

denotes

Background: The aim of this study was to determine the prevalence and risk factors of extended spectrum beta-lactamase (ESBL)-producing Escherichia coli (E. coli) in patients with urinary tract infection.

T1349

837756-837900

Epistemic_statement

denotes

Background: Estimation of sepsis source of infections and mortality based on a nationwide database with linkage to death certificate is lacking.

T1350

839032-839172

Epistemic_statement

denotes

SA-degrading bacterial consortiums increased and adapted during four time re-additions of SAs and could efficiently degrade SAs for 75 days.

T1351

839462-839551

Epistemic_statement

denotes

Conclusion: Microbial degradation is a promising process for SA removal in the sediments.

T1352

839613-839662

Epistemic_statement

denotes

MC could be used for SA removal in the sediments.

T1353

842165-842351

Epistemic_statement

denotes

The seasonal variation of scrub typhus cases in I-lan, different from those reported in other area of Taiwan may due to the unique northeast monsoon climate which needed further studies.

T1354

842515-842640

Epistemic_statement

denotes

These findings may provide valuable information in the diagnosis, treatment, and prevention of the disease in the local area.

T1355

842641-842915

Epistemic_statement

denotes

Background: To determine whether intestinal Angiostrongylus cantonensis antigens can induce protective immunity in rats, gut antigens prepared from female adults (FAGP) and somatic antigens prepared from both male (MA) and female (FA) adult worms were used to immunize rats.

T1356

843411-843479

Epistemic_statement

denotes

However, there was a >50% reduction in rats immunized with MA or FA.

T1357

843779-843850

Epistemic_statement

denotes

Serum IgG titers were not directly correlated with protective immunity.

T1358

843851-843964

Epistemic_statement

denotes

An 84 kDa gut membrane protein was strongly recognized by anti-FAGP antibodies, which may be important in anti-A.

T1359

844155-844408

Epistemic_statement

denotes

While the possibility of using FAGP combining with MA or FA antigens as a multi-function vaccine in immune protection against A. cantonensis needs to be further elucidated, we hope that it provides a novel strategy for this parasite vaccine development.

T1360

844413-844541

Epistemic_statement

denotes

Then, we checked whether they received at least twice measlescontaining vaccine from the record of the infection control office.

T1361

844862-845066

Epistemic_statement

denotes

When the vaccination records were kept in the infection control office, assuming the examination cost was $15 per person and the vaccination cost was $70, the expenses of at least $2,210 could be reduced.

T1362

845861-845986

Epistemic_statement

denotes

Since neuraminidases are major virulence proteins they are potential targets for both vaccines and small molecule inhibitors.

T1363

845987-846178

Epistemic_statement

denotes

In this study, we explored the possibility of combining the three neuraminidases together as vaccine antigens to devise a universal protein vaccine to prevent systemic pneumococcal infection.

T1364

846781-846982

Epistemic_statement

denotes

If a specific antineuraminidase serum neutralizes neuraminidase activity, the exposure of Thomsen-Friedenrich antigen (TA) antigen on RBC cells, and the value of fluorescence intensity will be reduced.

T1365

846983-847190

Epistemic_statement

denotes

Results: We observed high (4-6 logarithm fold) IgG class antibody titres against NanA, NanB, and NanC; this indicates that all the three neuraminidases are immunogenic and ideal as antigens for immunization.

T1366

847317-847427

Epistemic_statement

denotes

However, antisera against lectin domains of NanB and NanC were sufficient to neutralize their enzyme activity.

T1367

847856-847974

Epistemic_statement

denotes

We recommend the inclusion of three pneumococcal neuraminidases in future protein vaccine formulations to prevent IPD.

T1368

848268-848500

Epistemic_statement

denotes

Results: The number of isolates recovered in each epidemiological year was constant and similar to that of 2011-12, except 2015-16 but this may be due to the fact that we are still receiving isolates from participating laboratories.

T1369

848586-848766

Epistemic_statement

denotes

Although most isolates expressed capsular types included in PCVs, serotypes not included in any PCV formulation accounted for a significant fraction of the isolates (50%, n = 111).

T1370

849428-849539

Epistemic_statement

denotes

The data presented here emphasizes the potential role of PCV13 in the NIP in further diminishing pediatric IPD.

T1371

849563-849668

Epistemic_statement

denotes

We have previously described our methodology 1 and aim to present results of surveillance data from 2016.

T1372

849669-849988

Epistemic_statement

denotes

Methods: All paediatric cases of febrile convulsions, Encephalitis/ Meningitis/Encephalopathy, Kawasaki Disease, thrombocytopenia, lymphadenitis, Guillain-Barré Syndrome, intussusception admitted to KKH from January-December 2016 were prospectively screened and evaluated for any possible associations with vaccination.

T1373

850096-850306

Epistemic_statement

denotes

A standardised criteria, in accordance with the World Health Organization Uppsala Monitoring Centre (WHO-UMC) definitions was used to identify cases with higher probability of being associated with vaccination.

T1374

850947-851028

Epistemic_statement

denotes

There were no cases of GBS detected that were associated with recent vaccination.

T1375

851393-851466

Epistemic_statement

denotes

No significant safety concerns were detected for most events of interest.

T1376

851579-851762

Epistemic_statement

denotes

Preliminary analysis of the meningitis safety signal suggested that it may be attributable to a wider total increase in aseptic meningitis admissions and unlikely related to vaccines.

T1377

851763-851980

Epistemic_statement

denotes

Prevalence of potential drug-drug interactions in HIV-infected adult on antiretroviral drugs at Faculty of medicine Vajira hospital, Navamindhradhiraj university Kittisak Pholtawornkulchai 1 *, Sirote Luengsupabul 2 .

T1378

851981-852074

Epistemic_statement

denotes

Background: Presentation with multiple tumor is rare and differential diagnosis is important.

T1379

852245-852329

Epistemic_statement

denotes

Results: EBV infection is associated with many tumors and regarded as a tumor virus.

T1380

852438-852598

Epistemic_statement

denotes

Such patients may present with variable aggressiveness and clinical outcomes and may exhibit a more favorable prognosis compared to conventional leiomyosarcoma.

T1381

852599-852720

Epistemic_statement

denotes

Conclusion: As medicine advances, the presence of multiple smooth muscle tumors in HIV-infected patients should be alert.

T1382

852721-852818

Epistemic_statement

denotes

Vigilance and familiarity with distinctive tumor presentations can contribute to early diagnosis.

T1383

852819-853322

Epistemic_statement

denotes

Aminoacid polymorphism in Gag p6 domain alters Galectin-3 promoting effects on viral replication and budding of HIV-1 CRF07_BC isolates from injecting drug users (IDUs) in Taiwan Background: Bell's plasy is an acute peripheral facial nerve affection.Severe pain suggests herpes simplex or zoster infection and may precede a vesicular eruption or/and progression to Ramsey -Hunt syndrome.In half of the herpes zoster infections,vesiculationnot necessarily appears or may be delayed (zoster sine herpete).

T1384

855132-855293

Epistemic_statement

denotes

Considering zoster even without eruption and start antiviral therapy, is important sinceit is thought to be the cause of Bell's palsy in quite a number of cases.

T1385

855294-855392

Epistemic_statement

denotes

Although the number of cases at this study are small to have significant statistically conclusion.

T1386

855497-855628

Epistemic_statement

denotes

The combination of DAA with SOC ( pegylated interferon and ribavirin) is only recommended to patients with tolerance to interferon.

T1387

856037-856145

Epistemic_statement

denotes

This in vitro study examined the potential of combining TG-2349 with DAG181 to reduce HCV replicon colonies.

T1388

857492-857621

Epistemic_statement

denotes

These studies indicated that the combination of TG-2349 and DAG181 has at least an additive, if not synergistic antiviral effect.

T1389

857951-858112

Epistemic_statement

denotes

Lately, KPC-producing bacteria are rapidly increasing in clinical settings and their high drug-resistance is associated with significant morbidity and mortality.

T1390

858229-858373

Epistemic_statement

denotes

Herein, we characterized the novel Klebsiella phage Βφ-N133 (YMC16/01/N133_KPN_BP), which can lyse KPC-producing K. pneumoniae clinical strains.

T1391

860041-860194

Epistemic_statement

denotes

These results showed that Βφ-N133 can facilitate development of alternative antibacterial agents to treat infectious diseases caused by KPC-K. pneumonia.

T1392

860195-860270

Epistemic_statement

denotes

In vivo safety and efficacy of Βφ-N133 will be examined in further studies.

T1393

862359-862569

Epistemic_statement

denotes

Conclusion: During the initial period of CAUTI-Bundle Care plan, our nursing staffs thought that it was not necessary to perform this plan due to the manpower shortage and the limited resources at our hospital.

T1394

862830-862961

Epistemic_statement

denotes

After the systemic strategies, correct execution rate by nursing staff can achieve 100% and CAUTI rate can further reduce by 0.67‰.

T1395

862962-863099

Epistemic_statement

denotes

Our study showed that CAUTI Bundle Care plan can be executed correctly by a series of promoting strategies and further reduce CAUTI rate.

T1396

863186-863236

Epistemic_statement

denotes

By computer assist, the workload could be reduced.

T1397

863570-863692

Epistemic_statement

denotes

1 Respiratory care ward, 2 Respiratory care center, 3 Chief president, Hsiao Chung-Cheng Hospital, New Taipei City, Taiwan

T1398

863693-863869

Epistemic_statement

denotes

Background: Ventilator-associated pneumonia (VAP) prolongs duration of ventilator usage and length of hospital stay and may even result in mortality of critically ill patients.

T1399

864147-864431

Epistemic_statement

denotes

By the bundle care team setup and cross-functional teamwork, the purpose of this plan is to promote implementation rate of bundle care in health care workers, which would further reduce VAP rate to protect the patient safety, improves the care quality, and lowers the healthcare cost.

T1400

865146-865345

Epistemic_statement

denotes

Implementation rate can achieve to 100% in each unit within seven weeks after application of the plan ( Figure 2 ) (six weeks, five weeks and four weeks for general ward, RCC, and ICU, respectively).

T1401

865346-865482

Epistemic_statement

denotes

Conclusion: Based on the psychological theory, a habitual behavior would be acquired through repetition of the action or the experience.

T1402

865483-865659

Epistemic_statement

denotes

At the beginning of the implementation, it took much time to remind and educate the staffs because they did not form a habit to carry out the bundle care in daily practice yet.

T1403

865660-865769

Epistemic_statement

denotes

After the establishment of the habit, the implementation rate can achieve to 100% within five to seven weeks.

T1404

865770-865889

Epistemic_statement

denotes

Different duration to achieve maximized implementation rate could be related to the different bed numbers of each unit.

T1405

865978-866214

Epistemic_statement

denotes

VAP rate did not change much after the application of this plan .The possible explanation for this is that the VAP rate was already low in our hospital before, and that there is not enough time to observe evident change of the VAP rate.

T1406

866215-866366

Epistemic_statement

denotes

Our study showed that, the implementation rate can achieved 100% within seven weeks as a result of systematic propaganda, staff education and training.

T1407

866367-866453

Epistemic_statement

denotes

The bed numbers was the possible issue in the achievement of 100% implementation rate.

T1408

866454-866539

Epistemic_statement

denotes

Future research with longer duration is needed to observe the change of the VAP rate.

T1409

867199-867399

Epistemic_statement

denotes

In order to avoid infection and death of patients, it is recommended that early weaning ventilator and involve the reduction of VAP in hospitalization and the proper management of the patients safety.

T1410

867551-868099

Epistemic_statement

denotes

Intervention projects include education and training, DOPS technical learning activities and improvement of bed equipment, and enhanced 5 combined care modes, including twice daily 0.12% CHG oral care, daily discussion of early removal of endo, patients continuous intravenous sedation with a daily wake-up trial, in which the infusion of sedatives was discontinued, and Level of arousal will be assessed using the Richmond Agitation and Sedation Scale (RASS), head of bed elevation to 30 degrees, and water in the ventilator tubing can be emptied.

T1411

868883-868967

Epistemic_statement

denotes

Not only reduce iatrogenic injury, but also enhance the use of sedative safety care.

T1412

869038-869437

Epistemic_statement

denotes

Conclusion: Through the team resource management, the establishment of VAP bundle care, and design of nursing information system, include slogans tips, so that be able to provide the prompts and operation to ensure that the correctness of the clinical care process and monitoring mechanisms to enhance care accuracy rate, achieving the goal of "zero tolerance" of VAP, to enhance the patient safety.

CORD-19:867ebb2be2d466bcb35e5a7319708eaff39c4799 JSON TXT 9 Projects

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CORD-19:867ebb2be2d466bcb35e5a7319708eaff39c4799 JSONTXT 9 Projects

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CORD-19:867ebb2be2d466bcb35e5a7319708eaff39c4799 JSON TXT 9 Projects