2 results
Clostridium difficile Infection in Ohio Hospitals and Nursing Homes During 2006
- Robert J. Campbell, Lynn Giljahn, Kim Machesky, Katie Cibulskas-White, Lisa M. Lane, Kyle Porter, John O. Paulson, Forrest W. Smith, L. Clifford McDonald
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- Journal:
- Infection Control & Hospital Epidemiology / Volume 30 / Issue 6 / June 2009
- Published online by Cambridge University Press:
- 02 January 2015, pp. 526-533
- Print publication:
- June 2009
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Context.
Healthcare data suggest that the incidence and severity of Clostridium difficile infection (CDI) in hospitals are increasing. However, the overall burden of disease and the mortality rate associated with CDI, including the contribution from cases of infection that occur in nursing homes, are poorly understood.
Objective.To describe the epidemiology, disease burden, and mortality rate of healthcare-onset CDI.
Methods.In 2006, active public reporting of healthcare-onset CDI, using standardized case definitions, was mandated for all Ohio hospitals and nursing homes. Incidence rates were determined and stratified according to healthcare facility characteristics. Death certificates that listed CDI were analyzed for trends.
Results.There were 14,329 CDI cases reported, including 6,376 cases at 210 hospitals (5,217 initial cases [ie, cases identified more than 48 hours after admission to a healthcare facility in patients who had not had CDI during the previous 6 months] and 1,159 recurrent cases [ie, cases involving patients who had had CDI during the previous 6 months]) and 7,953 cases at 955 nursing homes (4,880 initial and 3,073 recurrent cases). After adjusting for missing data, the estimated total was 18,200 cases of CDI, which included 7,000 hospital cases (5,700 initial and 1,300 recurrent cases) and 11,200 nursing homes cases (6,900 initial and 4,300 recurrent cases). The rate for initial cases was 6.4-7.9 cases/10,000 patient-days for hospitals and 1.7-2.9 cases/10,000 patient-days for nursing homes. The rate for initial cases in nursing homes decreased during the study (P < .001). Nonpediatric hospital status (P = .011), a smaller number of beds (P = .003), and location in the eastern or northeastern region of the state (P = .011) were each independently associated with a higher rate of initial cases in hospitals. Death certificates for 2006 listed CDI among the causes of death for 893 Ohio residents; between 2000 and 2006, this number increased more than 4-fold.
Conclusion.Healthcare-onset CDI represents a major public health threat that, when considered in the context of an increasing mortality rate, should justify a major focus on prevention efforts.
Factors influencing beef eating quality 1. Effects of nutritional regimen and genotype on organoleptic properties and instrumental texture
- K. D. Sinclair, G.E. Lobley, G.W. Horgan, D.J. Kyle, A.D. Porter, K.R. Matthews, C.C. Warkup, C. A. Maltin
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- Journal:
- Animal Science / Volume 72 / Issue 2 / April 2001
- Published online by Cambridge University Press:
- 18 August 2016, pp. 269-277
- Print publication:
- April 2001
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An experiment was conducted to determine if growth rate, as affected by level of feeding, during a 10-or 20-week period prior to slaughter could influence the tenderness and palatability of beef from young (approx. 14 months old at the start of experiment) steers. Steers, comprising 18 Aberdeen Angus (AA), 18 Charolais (CH) and 18 Holstein (HO) purebreds, were allocated, within genotype, to one of three levels of feeding: (a) moderate ((M/M) 750 kJ metabolizable energy (ME) per day per kg M0·75), (b) high ((H/H) 1050 kJ ME per day per kg M0·75) both for 20 weeks; or (c) moderate for the first 10 weeks followed by high for the remaining 10 weeks (M/H). The steers were slaughtered at a fixed age (approx. 19 months old) and samples of m. longissimus lumborum (from all three genotypes) m. vastus lateralis and m. biceps femoris (from AA and CH only) separated, vacuum packed and stored at 2ºC for both 7 and 14 days before freezing. These cuts were subsequently assessed by a 12 member taste panel and texture analysis performed using Volodkevitch-type jaws.
Growth rates during the final 10 weeks of the experimental period differed between dietary regimen (M/M = 0·87; M/H = 1·25; and H/H = 1·02 kg/day; s.e.d. = 0·08; P < 0·001). Steers offered the M/M level of feeding grew more slowly (0·97 kg/day) than those offered the M/H and H/H level of feeding (1·20 kg/day; s.e.d. = 0·06; P < 0·001) over the entire 20 week experimental period. In spite of these differences in growth rate, there were no consistent effects on beef tenderness and general palatability. Mean growth rates for CH, HO and AA steers were 1·21, 1·13 and 1·03 kg/day (s.e.d. = 0·06; P < 0·05). Beef samples from AA steers consistently scored better for various sensory attributes than those from CH and HO steers; this may have been due, in part, to level of carcass fatness and rate of carcass cooling post mortem. Accounting for factors such as genotype within the experimental design and slaughtering animals at a relatively constant age reduced the variance associated with each sensory attribute to 0·6 of that observed in commercial practice. The data suggest that there is little opportunity to improve beef eating quality by increasing growth rate by dietary means in steers provided that moderate levels of gain (equivalent to the UK average) are maintained.