3 results
Intensive Care Unit Outbreak of Extended-Spectrum β-Lactamase–Producing Klebsiella Pneumoniae Controlled by Cohorting Patients and Reinforcing Infection Control Measures
- C. Laurent, H. Rodriguez-Villalobos, F. Rost, H. Strale, J.-L. Vincent, A. Deplano, M. J. Struelens, B. Byl
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- Journal:
- Infection Control & Hospital Epidemiology / Volume 29 / Issue 6 / June 2008
- Published online by Cambridge University Press:
- 02 January 2015, pp. 517-524
- Print publication:
- June 2008
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- Article
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Objective.
To describe an outbreak of extended-spectrum β-lactamase (ESBL)–producing Klebsiella pneumoniae in the intensive care units (ICUs) of a hospital and the impact of routine and reinforced infection control measures on interrupting nosocomial transmission.
Design.Outbreak report.
Setting.A 31-bed intensive care department (composed of 4 ICUs) in a university hospital in Belgium.
Intervention.After routine infection control measures (based on biweekly surveillance cultures and contact precautions) failed to interrupt a 2-month outbreak of ESBL-producing K. pneumoniae, reinforced infection control measures were implemented. The frequency of surveillance cultures was increased to daily sampling. Colonized patients were moved to a dedicated 6-bed ICU, where they received cohorted care with the support of additional nurses. Two beds were closed to new admissions in the intensive care department. Meetings between the ICU and infection control teams were held every day. Postdischarge disinfection of rooms was enforced. Broad-spectrum antibiotic use was discouraged.
Results.Compared with a baseline rate of 0.44 cases per 1,000 patient-days for nosocomial transmission, the incidence peaked at 11.57 cases per 1,000 patient-days (October and November 2005; rate ratio for peak vs baseline, 25.46). The outbreak involved 30 patients, of whom 9 developed an infection. Bacterial genotyping disclosed that the outbreak was polyclonal, with 1 predominant genotype. Reinforced infection control measures lasted for 50 days. After the implementation of these measures, the incidence fell to 0.08 cases per 1,000 patient-days (rate ratio for after the outbreak vs during the outbreak, 0.11).
Conclusion.These data indicate that, in an intensive care department in which routine screening and contact precautions failed to prevent and interrupt an outbreak of ESBL-producing K. pneumoniae, reinforced infection control measures controlled the outbreak without major disruption of medical care.
6 - Forecasting of polar lows
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- By J. Turner, British Antarctic Survey, High Cross, Madingley Road, Cambridge, CB3 0ET, UK, E. A. Rasmussen, Professor, Department of Geophysics, University of Copenhagen, B. Røsting, Norwegian Meteorological Institute (DNMI), P. O. Box 43, Blindern, N-0313 Oslo, Norway
- Edited by Erik A. Rasmussen, University of Copenhagen, John Turner, British Antarctic Survey, Cambridge
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- Book:
- Polar Lows
- Published online:
- 07 December 2009
- Print publication:
- 17 April 2003, pp 501-574
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Summary
Aspects common to both polar regions
Introduction
Polar lows can have a severe impact on maritime operations and can cause considerable disruption when the more severe systems make landfall. In areas such as the North Sea, there are many gas and oil platforms and it is necessary to have good forecasts of the arrival of severe mesoscale lows to minimize the impact on operations. Within the Antarctic, most of the mesoscale lows are not as vigorous as their counterparts in the north. Nevertheless, they can still cause severe problems during the summer relief operations at the research stations and affect work in the deep field.
Polar low forecasting is an integral part of the general forecasting problem and the results are dependent on the success of the overall forecast. Polar lows often result in a rapid deterioration of the weather at a specific location, and accurate time indications in the forecasts are important. In this chapter we will examine the means by which forecasters attempt to predict the formation and development of mesocyclones and polar lows. The output from numerical weather prediction (NWP) analysis and forecast systems can be used to try and infer where and when mesocyclone developments may take place in a particular region. Satellite imagery and other satellite data are indispensable in identifying and predicting the movement of existing mesoscale vortices a few hours ahead.
4 - Theoretical investigations
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- By A. Van Delden, Institute for Marine and Atmospheric Sciences, Utrecht University, Princetonplein 5, 3584 CC Utrecht, The Netherlands, E. A. Rasmussen, Professor, Department of Geophysics, University of Copenhagen, J. Turner, President of the International Commission on Polar Meteorology and Chairman of the Physical Sciences Standing Scientific Group of the Scientific Committee on Antarctic Research, B. Røsting, Norwegian Meteorological Institute (DNMI), P. O. Box 43, Blindern, N-0313 Oslo, Norway
- Edited by Erik A. Rasmussen, University of Copenhagen, John Turner, British Antarctic Survey, Cambridge
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- Book:
- Polar Lows
- Published online:
- 07 December 2009
- Print publication:
- 17 April 2003, pp 286-404
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Summary
Introduction
During the 1970s, research into the theoretical understanding of high latitude mesocyclones was focused on the basic mechanisms of development of the more intense systems, known as polar lows. The aim was to explain the striking differences between polar lows and other extra-tropical cyclones, namely the small size and rapid growth rates of polar lows, and their favoured formation within cold air masses over the oceans in winter. It will become apparent by the end of this chapter that these fundamental questions have not been completely answered. However, considerable progress has been made, and new areas of research have been opened up regarding the life-cycle of polar lows, and their inter-action with the broadscale atmospheric flow.
The construction of mathematical and theoretical models of mesocyclones is not simple, because there are many types of vortices occurring in the high latitude areas. They vary widely in horizontal and vertical extent, in intensity and in structure. A mesocyclone may be a powerful system, extending through the depth of the troposphere, with intense deep convection and hurricane-force winds, or a weak swirl in the boundary-layer cloud, clearly visible on satellite imagery but with little significant weather at the Earth's surface. The environment in which the vortex forms may differ widely being, for example, a low-level frontal zone, or a flaccid low-pressure region at the centre of a decaying synoptic cyclone.