| 1. |
- Ahlstrand, Erik, et al.
(författare)
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Glycopeptide resistance in coagulase-negative staphylococci isolated in blood cultures from patients with hematological malignancies during three decades
- 2011
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Ingår i: European Journal of Clinical Microbiology and Infectious Diseases. - : Springer Science and Business Media LLC. - 0934-9723 .- 1435-4373. ; 30:11, s. 1349-1354
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Tidskriftsartikel (refereegranskat)abstract
- The aim of this study was to determine if there was a long-term increase in glycopeptide minimum inhibitory concentration (MIC) values, MIC creep, among bloodstream isolates of Staphylococcus epidermidis and S. haemolyticus isolated from patients with hematological malignancies. We conducted a retrospective single-center study where all positive blood cultures of S. epidermidis (n = 387) and S. haemolyticus (n = 19) isolated from patients with hematological malignancies during three decades, 1980 to 2009, were re-evaluated for the presence of reduced susceptibility to vancomycin and teicoplanin. Three different methods for the detection of reduced susceptibility to glycopeptides were used; standard Etest, macromethod Etest, and glycopeptide resistance detection (GRD) Etest. The median MIC value for vancomycin was 2 mg/L. MIC values for vancomycin and teicoplanin did not show any statistically significant increase during the study period. The presence of heterogeneously glycopeptide-intermediate staphylococci (hGIS) was analyzed among 405 coagulase-negative staphylococci (CoNS) isolates. hGIS were found in 31-45% of the CoNS isolates by the macromethod Etest and in 53-67% by the GRD Etest during the three decades. In conclusion, we did not observe any long-term glycopeptide MIC creep determined by the standard Etest, although a high and increasing proportion of heterogeneous vancomycin resistance was observed.
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| 2. |
- Ahlstrand, Erik, 1974-, et al.
(författare)
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Long-term molecular epidemiology of staphylococcus epidermidis blood culture isolates from patients with hematological malignancies
- 2014
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Ingår i: PLOS ONE. - San Francisco, USA : Public Library Science. - 1932-6203. ; 9:6
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Tidskriftsartikel (refereegranskat)abstract
- Staphylococcus epidermidis is an important cause of bloodstream infections in patients with hematological malignancies. Knowledge of the long-term epidemiology of these infections is limited. We surveyed all S. epidermidis blood culture isolates from patients treated for hematological malignancies at the University Hospital of Orebro, Sweden from 1980 to 2009. A total of 373 S. epidermidis isolates were identified and multilocus sequence typing, staphylococcal chromosome cassette mec (SCCmec) typing and standard antibiotic susceptibility testing were employed to characterize these isolates. The majority of the isolates 361/373 (97%) belonged to clonal complex 2, and the 373 isolates were divided into 45 sequence types (STs); Simpson's Diversity Index was 0.56. The most prevalent STs were ST2 (243/373, 65%) and ST215 (28/373, 8%). Ninety three percent (226/243) of the ST2 isolates displayed either SCCmec type III or IV. ST2 and 215 were isolated during the entire study period, and together these STs caused temporal peaks in the number of positive blood cultures of S. epidermidis. Methicillin resistance was detected in 213/273 (78%) of all isolates. In the two predominating STs, ST2 and ST215, methicillin resistance was detected in 256/271 isolates (95%), compared with 34/100 (34%) in other STs (p<0.001). In conclusion, in this long-term study of patients with hematological malignancies, we demonstrate a predominance of methicillin-resistant ST2 among S. epidermidis blood culture isolates.
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| 3. |
- Duberg, Ann-Sofi, et al.
(författare)
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Cause of death in individuals with chronic HBV and/or HCV infection, a nationwide community-based register study
- 2008
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Ingår i: Journal of Viral Hepatitis. - : Wiley. - 1352-0504 .- 1365-2893. ; 15:7, s. 538-550
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Tidskriftsartikel (refereegranskat)abstract
- Studies on chronic viral hepatitis and mortality have often been made on selected populations or in high-endemic countries. The aim of this study was to investigate the causes of death and the mortality rates in the nationwide cohorts of people chronically infected with hepatitis B virus (HBV) and/or hepatitis C virus (HCV) in Sweden, a low-endemic country. All notifications on chronic HBV infection and HCV infection 1990-2003 were linked to the Cause of Death Register. A total of 9517 people with chronic HBV infection, 34 235 people with HCV infection and 1601 with chronic HBV-HCV co-infection were included, and the mean observation times were 6.4, 6.3 and 7.9 years, respectively. The mortality in the cohorts was compared with age- and gender-specific mortality in the general population and standardized mortality ratios (SMR) were calculated. All-cause mortality was significantly increased, SMR 2.3 (HBV), 5.8 (HCV) and 8.5 (HBV-HCV), with a great excess liver-related mortality in all cohorts, SMR 21.7, 35.5 and 46.2, respectively. In HCV and HBV-HCV infected there was an increased mortality due to drug-related psychiatric diagnoses (SMR: 20.7 and 27.6) and external causes (SMR: 12.4 and 11.4), predominantly at younger age. To conclude, this study demonstrated an increased all-cause mortality, with a great excess mortality from liver disease, in all cohorts. In people with HCV infection the highest excess mortality in younger ages was from drug-related and external reasons.PMID: 18397223 [PubMed - indexed for MEDLINE]
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| 4. |
- Henriksson, Catrin, et al.
(författare)
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Knowledge and attitudes toward seeking medical care for AMI-symptoms
- 2011
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Ingår i: International Journal of Cardiology. - : Elsevier BV. - 0167-5273 .- 1874-1754. ; 147:2, s. 224-227
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Tidskriftsartikel (refereegranskat)abstract
- Background: Time is crucial when an acute myocardial infarction (AMI) occurs, but patients often wait before seeking medical care. Aim: To investigate and compare patients' and relatives' knowledge of AMI, attitudes toward seeking medical care, and intended behaviour if AMI-symptoms occur. Methods: The present study was a descriptive, multicentre study. Participants were AMI-patients <= 75 years (n = 364) and relatives to AMI-patients (n = 319). Questionnaires were used to explore the participants' knowledge of AMI and attitudes toward seeking medical care. Results: Both patients and relatives appeared to act more appropriate to someone else's chest pain than to their own. Patients did not have better knowledge of AMI-symptoms than relatives. Women would more often contact someone else before seeking medical care. A greater percentage of elderly (65-75 years), compared to younger individuals, reported that they would call for an ambulance if chest pain occurred. Conclusions: There were only minor differences between patients and relatives, regarding both knowledge and attitudes. It seems easier to act correctly as a bystander than as a patient. Therefore, in order to decrease patients' delay time it is important to educate relatives as well as patients on how to respond to symptoms of an AMI.
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| 5. |
- Landgren, Magnus, et al.
(författare)
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Health before and after adoption from Eastern Europe
- 2006
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Ingår i: Acta Paediatrica. - : Wiley-Blackwell Publishing Inc.. - 0803-5253 .- 1651-2227. ; 95:6, s. 720-725
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Tidskriftsartikel (refereegranskat)abstract
- DESIGN: A population-based study of pre-adoption, arrival and post-adoption health.AIM: To report prenatal and postnatal background factors, morbidity, growth and development in adoptees from Eastern Europe.SUBJECTS AND METHODS: All 99 children born in Eastern Europe between 1990 and 1995 and adopted to western Sweden during 1993-1997 were invited to participate in the study. Altogether, 76 (77%) participated. Medical records from the birth countries, from the examination at arrival and from medical reports made during a mean post-adoption period of 5 years were evaluated.RESULTS: Low birth weight (< or = 2500 g) occurred in 48%. Congenital malformations were found in 22%. The biological mothers of 33% of the children had been considered alcoholics, and 16% of the children's mothers had been diagnosed with a psychiatric disability. A high incidence of infectious diseases, neurodevelopment disorders and growth retardation had been noted during the pre-adoption period. Upon arrival in Sweden 75% were diagnosed with a medical condition, most often an infection. After a 5-year post-adoption period, small head circumference was associated with alcohol exposure during pregnancy and 46% had at least one neurodevelopment or behavioural disorder.CONCLUSION: Adverse prenatal and perinatal factors, congenital malformations and post-adoption neurodevelopment disorders were common. Adoptees and adopters have complex needs for health support and information.
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| 6. |
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| 7. |
- Svensson, Kerstin, et al.
(författare)
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Landscape epidemiology of tularemia outbreaks in Sweden
- 2009
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Ingår i: Emerging Infectious Diseases. - : Centers for Disease Control and Prevention (CDC). - 1080-6040 .- 1080-6059. ; 15:12, s. 1937-1947
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Tidskriftsartikel (refereegranskat)abstract
- Summer outbreaks of tularemia that occurred from 1995 through 2005 in 2 locations in Sweden affected 441 persons. We performed an epidemiologic investigation of these outbreaks using a novel strategy, involving high-resolution genotyping of Francisella tularensis isolates obtained from 136 patients (using 18 genetic markers developed from 6 F. tularensis genome sequences) and interviews with the patients. Strong spatial associations were found between F. tularensis subpopulations and the places of disease transmission; infection by some subpopulations occurred within areas as small as 2 km(2), indicating unidentified environmental point sources of tularemia. In both locations, disease clusters were associated with recreational areas beside water, and genetic subpopulations were present throughout the tularemia season and persisted over years. High-resolution genotyping in combination with patients' statements about geographic places of disease transmission provided valuable indications of likely sources of infection and the causal genotypes during these tularemia outbreaks.
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| 8. |
- Öhman Sandberg, Ann, 1960-, et al.
(författare)
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Karriärtjänster för lärare – möjlighet eller hinder för skolutveckling?
- 2016
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Rapport (övrigt vetenskapligt/konstnärligt)abstract
- I den här rapporten redovisas resultatet av ett ettårigt forskningsprojekt som syftar till att identifiera hindrande och möjliggörande förutsättningar, dvs. processindikatorer, för hur karriärtjänster för lärare kan bidra till skolutveckling. Forskningsprojektet är genomfört av en forskargrupp från Linköpings universitet på uppdrag av Stockholms stad. Resultatet av forskningsprojektet visar att karriärstegsreformen har uppfattats och implementerats på olika sätt på stadens skolor. De lärare som har tillsatts på karriärtjänsterna uppfattar tillsättningen som ett erkännande av visad undervisningsskicklighet. Karriärtjänsterna har skapat "ringar på vattnet" i form av exempelvis kollegiala lärandeaktiviteter, projektinitiativ i kollegiet men det har inte varit möjligt att visa att det finns pågående utvecklingsprocesser som kan direkt hänföras till karriärstegsreformen. Forskagruppen har identifierat följande hindrande förutsättningar: 1. Det har inte funnits ett medvetet, sammanhållet fokus på organisering och ledning av implementeringen av karriärtjänster varken på förvaltnings- eller på skolnivå. 2. En stark likhetsnorm bland lärare har gjort att karriärstegsreformen skapar spänningar på skolorna, vilket troligtvis har varit hindrande för att uppnå effekter av reformen i form av skolutveckling. 3. Implementeringen av karriärstegsreformen visar över lag låga värden vad gäller de fyra dimensionerna för hållbart utvecklingsarbete: aktivt och delegerat ägarskap, behovsdriven utveckling, delad målbild och kunskap om innehållsfrågan. Forskargruppens slutsats är att låga värden vad gäller de fyra dimensionerna, tillsammans med icke-avsedda effekter (t ex spänningar i kollegiet) sannolikt har varit hindrande för att uppnå förväntade effekter av karriärstegsreformen. Forskargruppen har identifierat följande möjliggörande förutsättningar: 1. Ett aktivt och delegerat ägarskap behöver finnas på alla nivåer för att initiera, genomföra och följa upp implementeringen av reformen. Det innebär exempelvis att skolledningen behöver vara tydlig vad gäller kriterier för tillsättning, uppdragets innehåll och ge karriärlärarna legitimitet och förutsättningar för att med stöd av ledningen driva skolutveckling, 2. Karriärtjänsterna behöver svara mot vad alla berörda parter uppfattar vara den egna skolans behov, 3. Alla nivåer behöver dela målbild av vad som ska uppnås genom implementeringen av karriärstegsreformen 4. Implementeringen av karriärstegsreformen behöver utformas så att den skapar förutsättning för rörlighet både internt på den egna skolan och mellan stadens skolor, 5. Reformarbetet på skolorna behöver aktivt följas upp av förvaltningen och utfallet behöver användas för att vidareutveckla implementeringen av reformen. Det behöver därför finnas ett organiserat, ständigt pågående, lärande om reformens syfte, innehåll och genomförande.
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