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To control an outbreak of Shewanella algae and S. putrefaciens infections by identifying the risk factors for infection and transmission.
Design.
Matched case-control study.
Setting.
A university-affiliated tertiary acute care hospital in Seoul, Republic of Korea, with approximately 1,600 beds.
Patients.
From June 20, 2003, to January 16, 2004, a total of 31 case patients with Shewanella colonization or infection and 62 control patients were enrolled in the study.
Interventions.
Requirement to use single-use measuring cups and standard precautions (including hand washing before and after patient care and use of gloves).
Results.
S. algae or S. putrefaciens was isolated from blood, for 9 (29.0%) of 31 patients who acquired one of the organisms; from bile, for 8 (25.8%), and from ascitic fluid, for 8 (25.8%). The attack rate of this outbreak was 5.8% (31 patients infected or colonized, of 534 potentially exposed on ward A) and the pathogenicity of the two species together was 77.4% (24 patients infected, of 31 who acquired the pathogens). The estimated incubation period for Shewanella acquisition was 3–49 days. Using logistic analysis, we identified the following risk factors: presence of external drainage catheters in the hepatobiliary system (odds ratio [OR], 20; P < .001), presence of hepatobiliary disease (OR, 6.4; P < .001), admission to the emergency department of the hospital (OR, 2.9; P = .039), wound classification of “contaminated” or “dirty or infected” (OR, 16.5; P = .012), an American Society of Anesthesiologists score of 3 or higher (OR, 8.0; P = .006), duration of stay in ward A (OR, 1.1; P < .001), and, for women, an age of 60–69 years (OR, 13.3; P = .028). A Shewanella isolate was recovered from the surface of a shared measuring cup, and 12 isolates of S. algae showed the same pulsed-field gel electrophoresis pattern.
Conclusions.
This Shewanella outbreak had a single-source origin and spread by contact transmission via a contaminated measuring cup. Shewanella species are emerging as potentially serious human pathogens in hospitals and could be included in hospital infection surveillance systems.
NiCr films were thermally evaporated on the Mn-Ni-Co-O thick-film substrates. The NiCr/Mn-Ni-Co-O bi-layer systems were tested in a thermal shock chamber with three temperature differences of 150, 175 and 200°C. The systems were considered to have failed when the sheet resistance of NiCr films changed by 30% relative to an initial value. As the cyclic repetition of thermal shock increased, the sheet resistance of NiCr coatings increased. The Coffin-Manson equation was applied to the failure mechanism of cracking of NiCr coatings and the SEM observation of cracks and delamination in NiCr coatings due to thermal cycling agreed well with the failure mechanism.
We fabricated the high performance a-Si:H TFT using the N2 plasma treated APCVD SiO2 as a gate insulator. The effects of N2 plasma treatment on the APCVD SiO2 were investigated by XPS and SIMS Measurements. And the formation of the oxynitride interface layer between a-Si:H and APCVD SiO2 was found in the a-Si:H TFT. From our experimental results, It May be concluded that most nitrogen atoms, which were incorporated by the exposure of SiO2 layer to N2 plasma, exist, not bonded to other atoms, near the surface of the SiO2 layer and during the sequential deposition of a-Si:H on the N2 plasma treated APCVD SiO2 layer Si-N bonds are formed, resulting in the oxynitride layer in the interface region. This explains the high performance a-Si:H TFT with the N2 plasma treated APCVD SiO2 gate insulator.
We fabricated the high performance a-Si:H TFT using the N2 plasma treated APCVD SiO2 as a gate insulator. The effects of N2 plasma treatment on the APCVD SiO2 were investigated by XPS and SIMS measurements. And the formation of the oxynitride interface layer between a-Si:H and APCVD SiO2 was found in the a-Si:H TFT. From our experimental results, It may be concluded that most nitrogen atoms, which were incorporated by the exposure of SiO2 layer to N2 plasma, exist, not bonded to other atoms, near the surface of the SiO2 layer and during the sequential deposition of a-Si:H on the N2 plasma treated APCVD SiO2 layer Si-N bonds are formed, resulting in the oxynitride layer in the interface region. This explains the high performance a-Si:H TFT with the N2 plasma treated APCVD SiO2 gate insulator.
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