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- Qureshi, K., et al.
(författare)
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Breast milk reduces the risk of illness in children of mothers with cholera: observations from an epidemic of cholera in Guinea-Bissau
- 2006
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Ingår i: Pediatr Infect Dis J. ; 25:12, s. 1163-6
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Forskningsöversikt (refereegranskat)abstract
- BACKGROUND: A protective effect of breastfeeding against cholera has been demonstrated in areas endemic of cholera. To assess the protection offered by breast milk from mothers living in an area that had been free from cholera for 7 years, we investigated mothers with cholera and their children during an epidemic with Vibrio cholerae El Tor in the capital of Guinea-Bissau. METHODS: Eighty mothers with clinical cholera and their children were identified, and interviewed. Blood samples for vibriocidal and antitoxin antibodies were collected from mother-and-child pairs. Breast milk samples were collected from lactating mothers.Cholera was defined as acute watery diarrhea during the epidemic and a vibriocidal reciprocal titer of 20 or above. RESULTS: Three (7%) of 42 breastfed children had cholera as defined above compared with 9 (24%) of 38 nonbreastfed children (RR for breastfed children, 0.19; 95% CI, 0.04-0.91, adjusted for age). The 3 breastfed children who developed cholera received milk containing lower concentrations of anticholera toxin IgA/total IgA (median, 2.0 units/mL) than 14 children who had serologic signs of colonization but did not develop the disease (median, 17.4 units/mL). CONCLUSIONS: The protective effect of breast milk against cholera is not confined to endemic areas. Lactating mothers with cholera should receive supportive care to continue breastfeeding.
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- Soes, L. M., et al.
(författare)
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Risk factors for Clostridium difficile infection in the community: a case-control study in patients in general practice, Denmark, 2009-2011
- 2014
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Ingår i: Epidemiology and Infection. - 0950-2688. ; 142:7, s. 1437-1448
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Tidskriftsartikel (refereegranskat)abstract
- To identify risk factors for Clostridium difficile infection (CDI) in Danish patients consulting general practice with gastrointestinal symptoms, a prospective matched case-control study was performed; cases (N=259) had positive cultures for toxigenic C. difficile and controls (N=455) negative cultures. Data were analysed by conditional logistic regression. In patients aged 2 years (138 cases), hospitalization [odds ratio (OR) 84, 95% confidence interval (CI) 31-23], consumption of beef (OR 55, 95% CI 20-15), phenoxymethylpenicillin (OR 15, 95% CI 27-82), dicloxacillin (OR 27, 95% CI 36-211), and extended spectrum penicillins (OR 92, 95% CI 19-45) were associated with CDI. In patients aged <2 years none of these were associated with CDI, but in a subgroup analysis contact with animals was associated with CDI (OR 81, 95% CI 10-64). This study emphasizes narrow-spectrum penicillins, and suggests beef consumption, as risk factors for CDI in adults, and indicates a different epidemiology of CDI in infants.
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| 3. |
- Soes, L. M., et al.
(författare)
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The incidence and clinical symptomatology of Clostridium difficile infections in a community setting in a cohort of Danish patients attending general practice
- 2014
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Ingår i: European Journal of Clinical Microbiology & Infectious Diseases. - : Springer Science and Business Media LLC. - 1435-4373 .- 0934-9723. ; 33:6, s. 957-967
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Tidskriftsartikel (refereegranskat)abstract
- Clostridium difficile infection (CDI) is gradually being recognised as a cause of morbidity in the community. We investigated the incidence and clinical characteristics of CDI in a community setting and characterised the C. difficile strains by toxin gene profiling and polymerase chain reaction (PCR) ribotyping. Patients included in the study had attended general practice, primarily because of diarrhoea; CDI patients (259 patients; 121 < 2 years of age) had positive cultures for toxigenic C. difficile and non-CDI patients (455 patients) were culture-negative. Outcome variables included the frequency and duration of diarrhoea, vomiting, stomach ache, fever > 38 A degrees C, weight loss and sick leave. Data were analysed by logistic regression. CDI patients < 2 and a parts per thousand yen2 years of age with C. difficile as the only enteropathogen in the faecal sample reported slimy stools (65 % vs. 62 %), stomach ache (60 % vs. 75 %), weight loss (50 % vs. 76 %) and duration of diarrhoea > 15 days (59 % vs. 73 %) as the predominant symptoms. CDI patients a parts per thousand yen2 years old reported duration of diarrhoea > 15 days more often compared to non-CDI patients (73 % vs. 27 %, p < 0.0001). The annual incidence of CDI was 518 and 23/100,000 for patients < 2 and a parts per thousand yen2 years of age, respectively, and 46/100,000 in the subgroup of patients a parts per thousand yen60 years of age. CDI was characterised by stomach ache and persistent diarrhoea, often leading to weight loss. This emphasises the importance of diagnosing CDI not only in hospitalised patients, but also in individuals a parts per thousand yen2 years of age attending general practice because of gastrointestinal symptoms, especially in the elderly, where the incidence of CDI is high.
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| 9. |
- Mahillo-Fernandez, I, et al.
(författare)
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Surgery and risk of sporadic Creutzfeldt-Jakob disease in Denmark and Sweden: registry-based case-control studies
- 2008
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Ingår i: Neuroepidemiology. - : S. Karger AG. - 1423-0208 .- 0251-5350. ; 31:4, s. 229-240
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Tidskriftsartikel (refereegranskat)abstract
- <i>Background:</i> Epidemiologic evidence of surgical transmission of sporadic Creutzfeldt-Jakob disease (sCJD) remains controversial. <i>Methods:</i> From Danish and Swedish registries we selected 167 definite and probable sCJD cases (with onset between 1987 and 2003) and 3,059 controls (835 age-, sex-, and residence-matched, and 2,224 unmatched). Independent of case/control status, surgical histories were obtained from National Hospital Discharge Registries. Surgical procedures were categorized by body system group and lag time to onset of sCJD. Exposure frequencies were compared using logistic regression. <i>Results:</i> A history of any major surgery, conducted ≧20 years before sCJD onset, was more common in cases than both matched (OR = 2.44, 95% CI = 1.46–4.07) and unmatched controls (OR = 2.25, 95% CI = 1.48–3.44). This observation was corroborated by a linear increase in risk per surgical discharge (OR = 1.57, 95% CI = 1.13–2.18; OR = 1.50, 95% CI = 1.18–1.91). Surgery of various body systems, including peripheral vessels, digestive system and spleen, and female genital organs, was significantly associated with increased sCJD risk. <i>Conclusions:</i> A variety of major surgical procedures constitute a risk factor for sCJD following an incubation period of many years. A considerable number of sCJD cases may originate from health care-related accidental transmission.
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