40 results on '"Schweiger, Alexander"'
Search Results
2. TOP-140 Evolution of clinical presentation, treatment and prognosis of patients with alveolar echinococcosis treated at the university hospital Zurich: a 50-year experience
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Deibel, Ansgar, primary, Kindler, Yannick, additional, Mita, Rubens, additional, Ghafoor, Soleen, additional, Schwabedissen, Cordula Meyer zu, additional, Schweiger, Alexander, additional, Grimm, Felix, additional, Reinehr, Michael, additional, Weber, Achim, additional, Reiner, Cäcilia, additional, Kremer, Andreas E., additional, Petrowsky, Henrik, additional, Clavien, Pierre-Alain, additional, Deplazes, Peter, additional, von Felten, Stefanie, additional, and Mullhaupt, Beat, additional
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- 2024
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3. Povidone Iodine vs Chlorhexidine Gluconate in Alcohol for Preoperative Skin Antisepsis: A Randomized Clinical Trial.
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Widmer, Andreas F., Atkinson, Andrew, Kuster, Stefan P., Wolfensberger, Aline, Klimke, Steffi, Sommerstein, Rami, Eckstein, Friedrich S., Schoenhoff, Florian, Beldi, Guido, Gutschow, Christian A., Marschall, Jonas, Schweiger, Alexander, and Jent, Philipp
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ASEPSIS & antisepsis ,CHLORHEXIDINE ,POVIDONE-iodine ,CLINICAL trials ,SURGICAL site infections ,ABDOMINAL surgery - Abstract
Key Points: Question: Is preoperative skin antisepsis with povidone iodine in alcohol noninferior to chlorhexidine gluconate in alcohol to prevent surgical site infections after cardiac or abdominal surgery? Findings: In this randomized clinical trial that included 3360 patients, surgical site infections after cardiac or abdominal surgery were identified in 80 patients (5.1%) in the povidone iodine group vs 97 (5.5%) in the chlorhexidine gluconate group, a difference of 0.4% that met the predefined noninferiority margin of an absolute difference of 2.5%. Meaning: Povidone iodine was noninferior compared with chlorhexidine gluconate as preoperative skin antisepsis in preventing surgical site infections after cardiac or abdominal surgery. Importance: Preoperative skin antisepsis is an established procedure to prevent surgical site infections (SSIs). The choice of antiseptic agent, povidone iodine or chlorhexidine gluconate, remains debated. Objective: To determine whether povidone iodine in alcohol is noninferior to chlorhexidine gluconate in alcohol to prevent SSIs after cardiac or abdominal surgery. Design, Setting, and Participants: Multicenter, cluster-randomized, investigator-masked, crossover, noninferiority trial; 4403 patients undergoing cardiac or abdominal surgery in 3 tertiary care hospitals in Switzerland between September 2018 and March 2020 were assessed and 3360 patients were enrolled (cardiac, n = 2187 [65%]; abdominal, n = 1173 [35%]). The last follow-up was on July 1, 2020. Interventions: Over 18 consecutive months, study sites were randomly assigned each month to either use povidone iodine or chlorhexidine gluconate, each formulated in alcohol. Disinfectants and skin application processes were standardized and followed published protocols. Main Outcomes and Measures: Primary outcome was SSI within 30 days after abdominal surgery and within 1 year after cardiac surgery, using definitions from the US Centers for Disease Control and Prevention's National Healthcare Safety Network. A noninferiority margin of 2.5% was used. Secondary outcomes included SSIs stratified by depth of infection and type of surgery. Results: A total of 1598 patients (26 cluster periods) were randomly assigned to receive povidone iodine vs 1762 patients (26 cluster periods) to chlorhexidine gluconate. Mean (SD) age of patients was 65.0 years (39.0-79.0) in the povidone iodine group and 65.0 years (41.0-78.0) in the chlorhexidine gluconate group. Patients were 32.7% and 33.9% female in the povidone iodine and chlorhexidine gluconate groups, respectively. SSIs were identified in 80 patients (5.1%) in the povidone iodine group vs 97 (5.5%) in the chlorhexidine gluconate group, a difference of 0.4% (95% CI, −1.1% to 2.0%) with the lower limit of the CI not exceeding the predefined noninferiority margin of −2.5%; results were similar when corrected for clustering. The unadjusted relative risk for povidone iodine vs chlorhexidine gluconate was 0.92 (95% CI, 0.69-1.23). Nonsignificant differences were observed following stratification by type of surgical procedure. In cardiac surgery, SSIs were present in 4.2% of patients with povidone iodine vs 3.3% with chlorhexidine gluconate (relative risk, 1.26 [95% CI, 0.82-1.94]); in abdominal surgery, SSIs were present in 6.8% with povidone iodine vs 9.9% with chlorhexidine gluconate (relative risk, 0.69 [95% CI, 0.46-1.02]). Conclusions and Relevance: Povidone iodine in alcohol as preoperative skin antisepsis was noninferior to chlorhexidine gluconate in alcohol in preventing SSIs after cardiac or abdominal surgery. Trial Registration: ClinicalTrials.gov Identifier: NCT03685604 This multicenter, cluster-randomized, noninferiority trial investigates the effectiveness of povidone iodine vs chlorhexidine gluconate in alcohol as preoperative skin antisepsis in preventing surgical site infections in adults undergoing abdominal or cardiac surgery. [ABSTRACT FROM AUTHOR]
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- 2024
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4. Surveillance of catheter-associated bloodstream infections: development and validation of a fully automated algorithm.
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Catho, Gaud, Fortchantre, Loïc, Teixeira, Daniel, Galas-Haddad, Murielle, Boroli, Filippo, Chraïti, Marie-Noëlle, Abbas, Mohamed, Harbarth, Stephan, Buetti, Niccolò, Balmelli, Carlo, Berthod, Delphine, Jent, Philipp, Marschall, Jonas, Sax, Hugo, Schlegel, Matthias, Schweiger, Alexander, Senn, Laurence, Sommerstein, Rami, Tschudin-Sutter, Sarah, and Troillet, Nicolas
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CENTRAL line-associated bloodstream infections ,CATHETER-related infections ,VASCULAR catheters ,INTENSIVE care units ,ELECTRONIC health records - Abstract
Background: Most surveillance systems for catheter-related bloodstream infections (CRBSI) and central line-associated bloodstream infections (CLABSI) are based on manual chart review. Our objective was to validate a fully automated algorithm for CRBSI and CLABSI surveillance in intensive care units (ICU). Methods: We developed a fully automated algorithm to detect CRBSI, CLABSI and ICU-onset bloodstream infections (ICU-BSI) in patients admitted to the ICU of a tertiary care hospital in Switzerland. The parameters included in the algorithm were based on a recently performed systematic review. Structured data on demographics, administrative data, central vascular catheter and microbiological results (blood cultures and other clinical cultures) obtained from the hospital's data warehouse were processed by the algorithm. Validation for CRBSI was performed by comparing results with prospective manual BSI surveillance data over a 6-year period. CLABSI were retrospectively assessed over a 2-year period. Results: From January 2016 to December 2021, 854 positive blood cultures were identified in 346 ICU patients. The median age was 61.7 years [IQR 50–70]; 205 (24%) positive samples were collected from female patients. The algorithm detected 5 CRBSI, 109 CLABSI and 280 ICU-BSI. The overall CRBSI and CLABSI incidence rates determined by automated surveillance for the period 2016 to 2021 were 0.18/1000 catheter-days (95% CI 0.06–0.41) and 3.86/1000 catheter days (95% CI: 3.17–4.65). The sensitivity, specificity, positive predictive and negative predictive values of the algorithm for CRBSI, were 83% (95% CI 43.7–96.9), 100% (95% CI 99.5–100), 100% (95% CI 56.5–100), and 99.9% (95% CI 99.2–100), respectively. One CRBSI was misclassified as an ICU-BSI by the algorithm because the same bacterium was identified in the blood culture and in a lower respiratory tract specimen. Manual review of CLABSI from January 2020 to December 2021 (n = 51) did not identify any errors in the algorithm. Conclusions: A fully automated algorithm for CRBSI and CLABSI detection in critically-ill patients using only structured data provided valid results. The next step will be to assess the feasibility and external validity of implementing it in several hospitals with different electronic health record systems. [ABSTRACT FROM AUTHOR]
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- 2024
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5. Association between perioperative prophylaxis with cefuroxime plus metronidazole or amoxicillin/clavulanic acid and surgical site infections in paediatric uncomplicated appendectomy: a Swiss retrospective cohort study.
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Bielicki, Isabella, Schmid, Hanna, Atkinson, Andrew, Kahlert, Christian R., Berger, Christoph, Troillet, Nicolas, Marschall, Jonas, Bielicki, Julia A., Swissnoso, Balmelli, Carlo, Eisenring, Marie-Christine, Harbarth, Stephan, Pittet, Didier, Sax, Hugo, Schlegel, Matthias, Schweiger, Alexander, Senn, Laurence, Sommerstein, Rami, Sutter, Sarah Tschudin, and Gysin, Danielle Vuichard
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APPENDECTOMY ,SURGICAL site infections ,CLAVULANIC acid ,AMOXICILLIN ,CEFUROXIME ,METRONIDAZOLE - Abstract
Objective: We aimed to evaluate the association between post-appendectomy SSI rates and the two most commonly used regimens for perioperative antimicrobial prophylaxis in Swiss children. Methods: We conducted a retrospective cohort study, analysing data from the Swiss national SSI surveillance database with a study period from 2014 to 2018. All hospitals undertaking paediatric appendectomies in Switzerland participate in the surveillance. We compared the cumulative incidence and odds of post-appendectomy SSI within 30 days of surgery in children ≤ 16 years of age undergoing appendectomy for uncomplicated appendicitis and receiving perioperative antimicrobial prophylaxis with cefuroxime plus metronidazole or with amoxicillin/clavulanic acid using multivariable adjusted logistic regression and propensity-score matching. Results: A total of 6207 cases were recorded in the study time frame. Overall SSI cumulative incidence was 1.9% (n = 119). 4256 children (54.9% male, median (IQR) age 12 [10, 14] years) received either cefuroxime plus metronidazole (n = 2348, 53.8% male) or amoxicillin/clavulanic acid (n = 1491, 57.0% male). SSI cumulative incidence was 1.1% (25/2348) among children receiving cefuroxime plus metronidazole and 2.8% (42/1491, p < 0.001) when receiving amoxicillin/clavulanic acid. The administration of cefuroxime plus metronidazole was associated with statistically significantly lower SSI odds compared to amoxicillin/clavulanic acid (aOR 0.35, 95%CI [0.20, 0.61], p < 0.001), and this was confirmed upon propensity-score matching. Conclusion: We found lower odds of post-appendectomy SSI in children receiving cefuroxime plus metronidazole compared to amoxicillin/clavulanic acid. Treating amoxicillin/clavulanic acid as the baseline, only 55 children need to receive cefuroxime plus metronidazole perioperative prophylaxis to avert one SSI. Existing guidelines recommending amoxicillin/clavulanic acid may need to be revised. Trial registration ISRCTN47727811, registered retrospectively. [ABSTRACT FROM AUTHOR]
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- 2023
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6. Predictive performance of automated surveillance algorithms for intravascular catheter bloodstream infections: a systematic review and meta-analysis.
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Januel, Jean-Marie, Lotfinejad, Nasim, Grant, Rebecca, Tschudin-Sutter, Sarah, Schreiber, Peter W., Grandbastien, Bruno, Jent, Philipp, Lo Priore, Elia, Scherrer, Alexandra, Harbarth, Stephan, Catho, Gaud, Buetti, Niccolò, Swissnoso, Balmelli, Carlo, Berthod, Delphine, Marschall, Jonas, Sax, Hugo, Schlegel, Matthias, Schweiger, Alexander, and Senn, Laurence
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CENTRAL venous catheters ,MICROBIAL cultures ,CATHETER-related infections ,ALGORITHMS ,CENTRAL line-associated bloodstream infections - Abstract
Background: Intravascular catheter infections are associated with adverse clinical outcomes. However, a significant proportion of these infections are preventable. Evaluations of the performance of automated surveillance systems for adequate monitoring of central-line associated bloodstream infection (CLABSI) or catheter-related bloodstream infection (CRBSI) are limited. Objectives: We evaluated the predictive performance of automated algorithms for CLABSI/CRBSI detection, and investigated which parameters included in automated algorithms provide the greatest accuracy for CLABSI/CRBSI detection. Methods: We performed a meta-analysis based on a systematic search of published studies in PubMed and EMBASE from 1 January 2000 to 31 December 2021. We included studies that evaluated predictive performance of automated surveillance algorithms for CLABSI/CRBSI detection and used manually collected surveillance data as reference. We estimated the pooled sensitivity and specificity of algorithms for accuracy and performed a univariable meta-regression of the different parameters used across algorithms. Results: The search identified five full text studies and 32 different algorithms or study populations were included in the meta-analysis. All studies analysed central venous catheters and identified CLABSI or CRBSI as an outcome. Pooled sensitivity and specificity of automated surveillance algorithm were 0.88 [95%CI 0.84–0.91] and 0.86 [95%CI 0.79–0.92] with significant heterogeneity (I
2 = 91.9, p < 0.001 and I2 = 99.2, p < 0.001, respectively). In meta-regression, algorithms that include results of microbiological cultures from specific specimens (respiratory, urine and wound) to exclude non-CRBSI had higher specificity estimates (0.92, 95%CI 0.88–0.96) than algorithms that include results of microbiological cultures from any other body sites (0.88, 95% CI 0.81–0.95). The addition of clinical signs as a predictor did not improve performance of these algorithms with similar specificity estimates (0.92, 95%CI 0.88–0.96). Conclusions: Performance of automated algorithms for detection of intravascular catheter infections in comparison to manual surveillance seems encouraging. The development of automated algorithms should consider the inclusion of results of microbiological cultures from specific specimens to exclude non-CRBSI, while the inclusion of clinical data may not have an added-value. Trail Registration Prospectively registered with International prospective register of systematic reviews (PROSPERO ID CRD42022299641; January 21, 2022). https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42022299641 [ABSTRACT FROM AUTHOR]- Published
- 2023
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7. Improved hand hygiene compliance after eliminating mandatory glove use from contact precautions—Is less more?
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Cusini, Alexia, Nydegger, Doris, Kaspar, Tanja, Schweiger, Alexander, Kuhn, Rolf, and Marschall, Jonas
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- 2015
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8. Role of pet dogs and cats in the transmission of helminthic zoonoses in Europe, with a focus on echinococcosis and toxocarosis
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Deplazes, Peter, van Knapen, Frans, Schweiger, Alexander, and Overgaauw, Paul A.M.
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- 2011
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9. Nosocomial Infections in Dialysis Access
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Schweiger, Alexander, primary, Trevino, Sergio, additional, and Marschall, Jonas, additional
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- 2015
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10. Livestock-associated methicillin-resistant staphylococcus aureus in humans, Europe
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van Cleef, Brigitte A.G.L., Monnet, Dominique L., Voss, Andreas, Krziwanek, Karina, Allerberger, Franz, Struelens, Marc, Zemlickova, Helena, Skov, Robert L., Vuopio-Varkila, Jaana, Cuny, Christiane, Friedrich, Alexander W., Spiliopoulou, Iris, Paszti, Judit, Hardardottir, Hjordis, Rossney, Angela, Pan, Angelo, Pantosti, Annalisa, Borg, Michael, Grundmann, Hajo, Mueller-Premru, Manica, Olsson-Liljequist, Barbro, Widmer, Andreas, Harbarth, Stephan, Schweiger, Alexander, Unal, Serhat, and Kluytmans, Jan A.J.W.
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Cross infection -- Research -- Genetic aspects ,Staphylococcus aureus infections -- Identification and classification -- Genetic aspects -- Research ,Nosocomial infections -- Research -- Genetic aspects ,Cattle -- Diseases and pests -- Genetic aspects -- Research ,Health - Abstract
Livestock-associated methicillin-resistant Staphylococcus aureus (MRSA) was first associated with human disease in 2003, when a MRSA clone associated with a reservoir in pigs and cattle was isolated from a human. [...]
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- 2011
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11. Human alveolar echinococcosis after fox population increase, Switzerland
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Schweiger, Alexander, Ammann, Rudolf W., Candinas, Daniel, Clavien, Pierre-Alain, Eckert, Johannes, Gottstein, Bruno, Halkic, Nerman, Muellhaupt, Beat, Prinz, Bettina Mareike, Reichen, Juerg, Tarr, Philip E., Torgerson, Paul R., and Deplazes, Peter
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Echinococcosis -- Risk factors ,Epidemics -- Switzerland ,Epidemics -- Risk factors ,Epidemics -- Research ,Foxes -- Diseases - Abstract
We analyzed databases spanning 50 years, which included retrospective alveolar echinococcosis (AE) case-finding studies and databases of the 3 major centers for treatment of AE in Switzerland. A total of [...]
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- 2007
12. Comparison of Functionalized Lithium Dihydrobis(azolyl)borates with Their Corresponding Azolates as Environmentally Friendly Red Pyrotechnic Coloring Agents
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Dufter, Alicia M. W., primary, Klapötke, Thomas M., additional, Rusan, Magdalena, additional, Schweiger, Alexander, additional, and Stierstorfer, Jörg, additional
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- 2020
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13. De retour de voyage avec une escarre
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Frick, Sven, primary, Schweiger, Alexander, additional, and Bodmer, Michael, additional
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- 2020
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14. Zurück von der Reise mit Eschar
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Frick, Sven, primary, Schweiger, Alexander, additional, and Bodmer, Michael, additional
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- 2020
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15. Corrigendum to 'Alveolar echinococcosis: From a deadly disease to a well-controlled infection. Relative survival and economic analysis in Switzerland over the last 35 years' [J Hepatol 49 (2008) 72-77]
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Torgerson, Paul R, Schweiger, Alexander, Deplazes, Peter, Pohar, Maja, Reichen, Jürg, Ammann, Rudolf W, Tarr, Philip E, Halkic, Nermin, Müllhaupt, Beat, University of Zurich, and Müllhaupt, Beat
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10219 Clinic for Gastroenterology and Hepatology ,610 Medicine & health ,2721 Hepatology - Published
- 2018
16. Change in staff perspectives on indwelling urinary catheter use after implementation of an intervention bundle in seven Swiss acute care hospitals: results of a before/after survey study
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Niederhauser, Andrea; https://orcid.org/0000-0003-0107-5613, Züllig, Stephanie, Marschall, Jonas, Schweiger, Alexander, John, Gregor; https://orcid.org/0000-0002-1548-7339, Kuster, Stefan P, Schwappach, David L B; https://orcid.org/0000-0001-8668-3065, Niederhauser, Andrea; https://orcid.org/0000-0003-0107-5613, Züllig, Stephanie, Marschall, Jonas, Schweiger, Alexander, John, Gregor; https://orcid.org/0000-0002-1548-7339, Kuster, Stefan P, and Schwappach, David L B; https://orcid.org/0000-0001-8668-3065
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OBJECTIVE To evaluate changes in staff perspectives towards indwelling urinary catheter (IUC) use after implementation of a 1-year quality improvement project. DESIGN Repeated cross-sectional survey at baseline (October 2016) and 12-month follow-up (October 2017). SETTING Seven acute care hospitals in Switzerland. PARTICIPANTS The survey was targeted at all nursing and medical staff members working at the participating hospitals at the time of survey distribution. A total of 1579 staff members participated in the baseline survey (T) (49% response rate) and 1527 participated in the follow-up survey (T) (47% response rate). INTERVENTION A multimodal intervention bundle, consisting of an evidence-based indication list, daily re-evaluation of ongoing catheter need and staff training, was implemented over the course of 9 months. MAIN OUTCOME MEASURES Staff knowledge (15 items), perception of current practices and culture (scale 1-7), self-reported responsibilities (multiple-response question) and determinants of behaviour (scale 1-7) before and after implementation of the intervention bundle. RESULTS The mean number of correctly answered knowledge questions increased significantly between the two survey periods (T: 10.4, T: 11.0; p<0.001). Self-reported responsibilities with regard to IUC management by nurses and physicians changed only slightly over time. Perception of current practices and culture in regard to safe urinary catheter use increased significantly (T: 5.3, T: 5.5; p<0.001). Significant changes were also observed for determinants of behaviour (T: 5.3, T: 5.6; p<0.001). CONCLUSION We found small but significant changes in staff perceptions after implementation of an evidence-based intervention bundle. Efforts now need to be targeted at sustaining and reinforcing these changes, so that restrictive use of IUCs becomes an integral part of the hospital culture.
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- 2019
17. Änderung der Wahrnehmungen von Pflegepersonal und Ärzteschaft zum restriktiven Umgang mit Kathetern nach Umsetzung eines Qualitätsverbesserungsprojekts
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Niederhauser, Andrea, Züllig, Stephanie, Marschall, Jonas, Schweiger, Alexander, and Schwappach, David
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ddc: 610 ,610 Medical sciences ,Medicine - Abstract
Hintergrund: Transurethrale Dauerkatheter (auch Blasenkatheter) kommen im Spitalalltag häufig zum Einsatz. Blasenkatheter sind ein wesentlicher Risikofaktor für nosokomiale Infektionen und nicht-infektiöse Komplikationen wie Hämaturie als Folge einer Schleimhautverletzung. Der Umgang[zum vollständigen Text gelangen Sie über die oben angegebene URL], 17. Deutscher Kongress für Versorgungsforschung (DKVF)
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- 2018
18. Change in staff perspectives on indwelling urinary catheter use after implementation of an intervention bundle in seven Swiss acute care hospitals: results of a before/after survey study
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Niederhauser, Andrea, primary, Züllig, Stephanie, additional, Marschall, Jonas, additional, Schweiger, Alexander, additional, John, Gregor, additional, Kuster, Stefan P, additional, and Schwappach, David LB, additional
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- 2019
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19. 2135. Costs vs. Earnings in Colon Surgery and Coronary Artery Bypass Grafting Under a Prospective Payment System: Sufficient Financial Incentives to Reduce Surgical Site Infections?
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Juchler, Fabrice, primary, Roth, Jan, additional, Schweiger, Alexander, additional, Dangel, Marc, additional, Gugliotta, Massimo, additional, Battegay, Manuel, additional, Eckstein, Friedrich, additional, Kettelhack, Christoph, additional, Abshagen, Christian, additional, Hug, Balthasar L, additional, Boyce, John M, additional, and Widmer, Andreas F, additional
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- 2018
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20. 2116. Impact of an Evidence-Based Intervention on Urinary Catheter Utilization in Switzerland
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Schweiger, Alexander, primary, Kuster, Stefan, additional, Maag, Judith, additional, Züllig, Stephanie, additional, Atkinson, Andrew, additional, Bertschy, Sonja, additional, Bortolin, Emmanuelle, additional, John, Gregor, additional, Sax, Hugo, additional, Schwappach, David, additional, and Marschall, Jonas, additional
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- 2018
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21. Corrigendum to “Alveolar echinococcosis: From a deadly disease to a well-controlled infection. Relative survival and economic analysis in Switzerland over the last 35 years” [J Hepatol 49 (2008) 72–77]
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Torgerson, Paul R., primary, Schweiger, Alexander, additional, Deplazes, Peter, additional, Pohar, Maja, additional, Reichen, Jürg, additional, Ammann, Rudolf W., additional, Tarr, Philip E., additional, Halkic, Nermin, additional, and Müllhaupt, Beat, additional
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- 2018
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22. Antimicrobial prophylaxis administration after umbilical cord clamping in cesarean section and the risk of surgical site infection: a cohort study with 55,901 patients.
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Sommerstein, Rami, Marschall, Jonas, Atkinson, Andrew, Surbek, Daniel, Dominguez-Bello, Maria Gloria, Troillet, Nicolas, Widmer, Andreas F., Swissnoso, Balmelli, Carlo, Eisenring, Marie-Christine, Harbarth, Stephan, Pittet, Didier, Sax, Hugo, Schlegel, Matthias, Schweiger, Alexander, Senn, Laurence, and Zanetti, Giorgio
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SURGICAL site infections ,CESAREAN section ,UMBILICAL cord clamping ,ANTIBIOTIC prophylaxis ,COHORT analysis ,EXPERIMENTAL design ,PREVENTIVE medicine - Abstract
Background: The World Health Organization (WHO) recommends administration of surgical antimicrobial prophylaxis (SAP) in cesarean section prior to incision to prevent surgical site infections (SSI). This study aimed to determine whether SAP administration following cord clamping confers an increased SSI risk to the mother. Methods: Study design: Cohort. Setting: 75 participating Swiss hospitals, from 2009 to 2018. Participants: A total of 55,901 patients were analyzed. Main outcome measures: We assessed the association between SAP administration relative to incision and clamping and the SSI rate, using generalized linear multilevel models, adjusted for patient characteristics, procedural variables, and health-care system factors. Results: SAP was administered before incision in 26′405 patients (47.2%) and after clamping in 29,496 patients (52.8%). Overall 846 SSIs were documented, of which 379 (1.6% [95% CI, 1.4–1.8%]) occurred before incision and 449 (1.7% [1.5–1.9%]) after clamping (p = 0.759). The adjusted odds ratio for SAP administration after clamping was not significantly associated with an increased SSI rate (1.14, 95% CI 0.96–1.36; p = 0.144) when compared to before incision. Supplementary and subgroup analyses supported these main results. Conclusions: This study did not confirm an increased SSI risk for the mother in cesarean section if SAP is given after umbilical cord clamping compared to before incision. [ABSTRACT FROM AUTHOR]
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- 2020
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23. Impact of an evidence-based intervention on urinary catheter utilization, associated process indicators, and infectious and non-infectious outcomes.
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Schweiger, A., Kuster, S.P., Maag, J., Züllig, S., Bertschy, S., Bortolin, E., John, G., Sax, H., Limacher, A., Atkinson, A., Schwappach, D., Marschall, J., Schweiger, Alexander, Kuster, Stefan P, Maag, Judith, Züllig, Stephanie, Bertschy, Sonja, Bortolin, Emmanuelle, John, Gregor, and Sax, Hugo
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Background: Multi-centre intervention studies tackling urinary catheterization and its infectious and non-infectious complications are lacking.Aim: To decrease urinary catheterization and, consequently, catheter-associated urinary tract infections (CAUTIs) and non-infectious complications.Methods: Before/after non-randomized multi-centre intervention study in seven hospitals in Switzerland. Intervention bundle consisting of: (1) a concise list of indications for urinary catheterization; (2) daily evaluation of the need for ongoing catheterization; and (3) education on proper insertion and maintenance of urinary catheters. The primary outcome was urinary catheter utilization. Secondary outcomes were CAUTIs, non-infectious complications and process indicators (proportion of indicated catheters and frequency of catheter evaluation).Findings: In total, 25,880 patients were included in this study [13,171 at baseline (August-October 2016) and 12,709 post intervention (August-October 2017)]. Catheter utilization decreased from 23.7% to 21.0% (P=0.001), and catheter-days per 100 patient-days decreased from 17.4 to 13.5 (P=0.167). CAUTIs remained stable at a low level with 0.02 infections per 100 patient-days (baseline) and 0.02 infections (post intervention) (P=0.98). Measuring infections per 1000 catheter-days, the rate was 1.02 (baseline) and 1.33 (post intervention) (P=0.60). Non-infectious complications decreased significantly, from 0.79 to 0.56 events per 100 patient-days (P<0.001), and from 39.4 to 35.4 events per 1000 catheter-days (P=0.23). Indicated catheters increased from 74.5% to 90.0% (P<0.001). Re-evaluations increased from 168 to 624 per 1000 catheter-days (P<0.001).Conclusion: A straightforward bundle of three evidence-based measures reduced catheter utilization and non-infectious complications, whereas the proportion of indicated urinary catheters and daily evaluations increased. The CAUTI rate remained unchanged, albeit at a very low level. [ABSTRACT FROM AUTHOR]- Published
- 2020
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24. Risk of SARS-CoV-2 transmission by aerosols, the rational use of masks, and protection of healthcare workers from COVID-19.
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Sommerstein, Rami, Fux, Christoph Andreas, Vuichard-Gysin, Danielle, Abbas, Mohamed, Marschall, Jonas, Balmelli, Carlo, Troillet, Nicolas, Harbarth, Stephan, Schlegel, Matthias, Widmer, Andreas, Swissnoso, Eisenring, Marie-Christine, Pittet, Didier, Sax, Hugo, Schweiger, Alexander, Senn, Laurence, Widmer, Andreas F., and Zanetti, Giorgio
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COVID-19 ,SARS-CoV-2 ,AEROSOLS ,INFECTION control ,VIRUS diseases - Abstract
Objectives: To determine the risk of SARS-CoV-2 transmission by aerosols, to provide evidence on the rational use of masks, and to discuss additional measures important for the protection of healthcare workers from COVID-19. Methods: Literature review and expert opinion. Short conclusion: SARS-CoV-2, the pathogen causing COVID-19, is considered to be transmitted via droplets rather than aerosols, but droplets with strong directional airflow support may spread further than 2 m. High rates of COVID-19 infections in healthcare-workers (HCWs) have been reported from several countries. Respirators such as filtering face piece (FFP) 2 masks were designed to protect HCWs, while surgical masks were originally intended to protect patients (e.g., during surgery). Nevertheless, high quality standard surgical masks (type II/IIR according to European Norm EN 14683) appear to be as effective as FFP2 masks in preventing droplet-associated viral infections of HCWs as reported from influenza or SARS. So far, no head-to-head trials with these masks have been published for COVID-19. Neither mask type completely prevents transmission, which may be due to inappropriate handling and alternative transmission pathways. Therefore, compliance with a bundle of infection control measures including thorough hand hygiene is key. During high-risk procedures, both droplets and aerosols may be produced, reason why respirators are indicated for these interventions. [ABSTRACT FROM AUTHOR]
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- 2020
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25. Costs versus earnings in colon surgery and coronary artery bypass grafting under a prospective payment system: Sufficient financial incentives to reduce surgical site infections?
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Juchler, Fabrice, primary, Roth, Jan A., additional, Schweiger, Alexander, additional, Dangel, Marc, additional, Gugliotta, Massimo, additional, Battegay, Manuel, additional, Eckstein, Friedrich S., additional, Kettelhack, Christoph, additional, Abshagen, Christian, additional, Hug, Balthasar L., additional, Boyce, John M., additional, and Widmer, Andreas F., additional
- Published
- 2018
- Full Text
- View/download PDF
26. Temporal trends and epidemiology of Staphylococcus aureus surgical site infection in the Swiss surveillance network: a cohort study
- Author
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Abbas, M., primary, Aghayev, E., additional, Troillet, N., additional, Eisenring, M.-C., additional, Kuster, S.P., additional, Widmer, A.F., additional, Harbarth, S., additional, Balmelli, Carlo, additional, Eisenring, Marie-Christine, additional, Harbarth, Stephan, additional, Kuster, Stefan P., additional, Marschall, Jonas, additional, Spicher, Virginie Masserey, additional, Pittet, Didier, additional, Ruef, Christian, additional, Sax, Hugo, additional, Schlegel, Matthias, additional, Schweiger, Alexander, additional, Troillet, Nicolas, additional, Widmer, Andreas F., additional, and Zanetti, Giorgio, additional
- Published
- 2018
- Full Text
- View/download PDF
27. Vorgehensmodell zur Einführung von Prozessmanagement in einem Unternehmen im TGA Anlagenbau
- Author
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Schweiger, Alexander and Schweiger, Alexander
- Abstract
Das Ziel dieser Arbeit liegt auf der Entwicklung eines Vorgehensmodelles zur Einführung von Prozessmanagement in einem Unternehmen im TGA Anlagenbau (Technische Gebäudeausrüstung). Der wesentliche Fokus umfasst dabei die Erhebung theoretischer und branchenspezifischer Anforderungen sowie die Adaptierung von Prozessmanagement auf das Branchenumfeld des Bauwesen, insbesondere auf Unternehmen im TGA Anlagenbau. Dazu wird basierend auf dem Prozesslebenszyklus nach Wagner/Patzak, ein phasenorientiertes Vorgehensmodell entwickelt, welches methodisch durch die Prinzipien des Lean Managements gestützt wird und den organisatorischen Wandel im Rahmen des Change Management Prozesses begleitet. Das Vorgehensmodell wird durch die praktische Anwendung in einem branchenspezifischen Unternehmen verifiziert. Dabei werden neben den Erfolgsfaktoren bei der Einführung von Prozessmanagement, vor allem die Notwendigkeit eines ganzheitlichen Kulturwandels in der Branche und die damit verbundenen Potenziale der Prozessorientierung im Bauwesen verdeutlicht.*****The aim of this thesis is the deployment of a process model for the implementation of process management for a company in building service engineering (building facilities). The main purpose is the compilation of theoretical and sector-specific requirements as well as the adaption of process management to the building industry environment, especially for companies in building service engineering. Based on the process life cycle according to Wagner/Patzak, a process model will be developed, which follows the principles of the Lean Management and goes along with the organizational change in the context of Change Management processes. The process model will be reviewed and verified through practical applications in an industry-specific environment. Next to the critical factors for success concerning the implementation of process management, the necessity of a cultural change in the industry segment and resulting potentials of process or
- Published
- 2017
28. Toxoplasma gondii infection in Kyrgyzstan: seroprevalence, risk factor analysis, and estimate of congenital and AIDS-related toxoplasmosis
- Author
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Minbaeva, Gulnara, Schweiger, Alexander, Bodosheva, Aigerim, Kuttubaev, Omurbek, Hehl, Adrian B., Tanner, Isabelle, Ziadinov, Iskender, Torgerson, Paul R., Deplazes, Peter, McLeod, Rima, and University of Zurich
- Subjects
Male ,Rural Population ,10078 Institute of Parasitology ,Urban Population ,Antibodies, Protozoan ,HIV Infections ,Serology ,Pregnancy ,Risk Factors ,Seroepidemiologic Studies ,Zoonoses ,Surveys and Questionnaires ,600 Technology ,Child ,education.field_of_study ,biology ,Incidence (epidemiology) ,lcsh:Public aspects of medicine ,Middle Aged ,Socioeconomic Aspects of Health ,Infectious Diseases ,Child, Preschool ,Medicine ,Female ,Public Health ,Toxoplasma ,Toxoplasmosis ,Research Article ,Neglected Tropical Diseases ,Disease Ecology ,Adult ,lcsh:Arctic medicine. Tropical medicine ,Adolescent ,lcsh:RC955-962 ,Population ,Enzyme-Linked Immunosorbent Assay ,610 Medicine & health ,Young Adult ,Environmental health ,medicine ,Parasitic Diseases ,Seroprevalence ,Humans ,Risk factor ,education ,Kyrgyzstan ,Aged ,AIDS-Related Opportunistic Infections ,business.industry ,Public Health, Environmental and Occupational Health ,Infant, Newborn ,Toxoplasma gondii ,Infant ,lcsh:RA1-1270 ,2739 Public Health, Environmental and Occupational Health ,2725 Infectious Diseases ,biology.organism_classification ,medicine.disease ,Cross-Sectional Studies ,Immunoglobulin G ,Immunology ,570 Life sciences ,Rural area ,business ,Infectious Disease Modeling - Abstract
Background HIV-prevalence, as well as incidence of zoonotic parasitic diseases like cystic echinococcosis, has increased in the Kyrgyz Republic due to fundamental socio-economic changes after the breakdown of the Soviet Union. The possible impact on morbidity and mortality caused by Toxoplasma gondii infection in congenital toxoplasmosis or as an opportunistic infection in the emerging AIDS pandemic has not been reported from Kyrgyzstan. Methodology/Principal Findings We screened 1,061 rural and 899 urban people to determine the seroprevalence of T. gondii infection in 2 representative but epidemiologically distinct populations in Kyrgyzstan. The rural population was from a typical agricultural district where sheep husbandry is a major occupation. The urban population was selected in collaboration with several diagnostic laboratories in Bishkek, the largest city in Kyrgyzstan. We designed a questionnaire that was used on all rural subjects so a risk-factor analysis could be undertaken. The samples from the urban population were anonymous and only data with regard to age and gender was available. Estimates of putative cases of congenital and AIDS-related toxoplasmosis in the whole country were made from the results of the serology. Specific antibodies (IgG) against Triton X-100 extracted antigens of T. gondii tachyzoites from in vitro cultures were determined by ELISA. Overall seroprevalence of infection with T. gondii in people living in rural vs. urban areas was 6.2% (95%CI: 4.8–7.8) (adjusted seroprevalence based on census figures 5.1%, 95% CI 3.9–6.5), and 19.0% (95%CI: 16.5–21.7) (adjusted 16.4%, 95% CI 14.1–19.3), respectively, without significant gender-specific differences. The seroprevalence increased with age. Independently low social status increased the risk of Toxoplasma seropositivity while increasing numbers of sheep owned decreased the risk of seropositivity. Water supply, consumption of unpasteurized milk products or undercooked meat, as well as cat ownership, had no significant influence on the risk for seropositivity. Conclusions We present a first seroprevalence analysis for human T. gondii infection in the Kyrgyz Republic. Based on these data we estimate that 173 (95% CI 136–216) Kyrgyz children will be born annually to mothers who seroconverted to toxoplasmosis during pregnancy. In addition, between 350 and 1,000 HIV-infected persons are currently estimated to be seropositive for toxoplasmosis. Taken together, this suggests a substantial impact of congenital and AIDS-related symptomatic toxoplasmosis on morbidity and mortality in Kyrgyzstan., Author Summary A serological study on toxoplasmosis was undertaken in a rural and urban population in Kyrgyzstan. The observed seroprevalence was adjusted because of differences between age and gender stratifications in the study group compared to population census figures. This gave an estimated seroprevalence in rural and urban populations of 5.1% and 16.4% respectively. In our analysis we determined the risk-factors for infection in the rural population to be age, low social-status and low number of sheep owned. While the seroprevalence in this rural population was relatively low, the seroprevalence found in the urban population of Bishkek correlated better with international data. Extrapolating from our data, about 173 seroconversions during pregnancy may be expected annually in Kyrgyzstan. In addition, considering a prevalence of HIV-Toxoplasma-co-infection between 7/100,000 (official HIV-prevalence data) and 19.4/100,000 (UNAIDS-estimates), 350–1,000 people are at risk for AIDS-related toxoplasmosis. Therefore, in the face of the rising prevalence of HIV infection education of medical personnel on treatment and prevention of toxoplasmosis is recommended.
- Published
- 2013
29. Fellkontamination mit Eiern von zoonotischen Helminthen bei Hof- und Haushunden sowie bei Füchsen
- Author
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Nagy, Anina, Ziadinov, Iskenderali, Schweiger, Alexander, Schnyder, Manuela, Deplazes, Peter, University of Zurich, and Deplazes, Peter
- Subjects
10078 Institute of Parasitology ,600 Technology ,3404 Small Animals ,570 Life sciences ,biology ,610 Medicine & health - Published
- 2011
- Full Text
- View/download PDF
30. Campylobacter concisus Pseudo-Outbreak Caused by Improved Culture Conditions
- Author
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Casanova, Carlo, primary, Schweiger, Alexander, additional, von Steiger, Niklaus, additional, Droz, Sara, additional, and Marschall, Jonas, additional
- Published
- 2015
- Full Text
- View/download PDF
31. Antibiotic susceptibility of Clostridium difficile is similar worldwide over two decades despite widespread use of broad-spectrum antibiotics: an analysis done at the University Hospital of Zurich
- Author
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Büchler, Andrea C, Rampini, Silvana K, Stelling, Simon, Ledergerber, Bruno, Peter, Silke, Schweiger, Alexander, Ruef, Christian, Zbinden, Reinhard, Speck, Roberto F, Büchler, Andrea C, Rampini, Silvana K, Stelling, Simon, Ledergerber, Bruno, Peter, Silke, Schweiger, Alexander, Ruef, Christian, Zbinden, Reinhard, and Speck, Roberto F
- Abstract
Background Clostridium difficile infection (CDI) remains a major health problem worldwide. Antibiotic use, in general, and clindamycin and ciprofloxacin, in particular, have been implicated in the pathogenesis of CDI. Here, we hypothesized that antibiotics that are highly active in vitro against C. difficile are less frequently associated with CDI than others. The primary goals of our study were to determine if antibiotic susceptibility and CDI are associated and whether the antimicrobial susceptibility of C. difficile changed over the years.Methods and resultsWe examined a large panel of C. difficile strains collected in 2006¿2008 at the University Hospital of Zurich. We found that the antimicrobial susceptibilities to amoxicillin/clavulanate, piperacillin/tazobactam, meropenem, clindamycin, ciprofloxacin, ceftriaxone, metronidazole and vancomycin were similar to those reported in the literature and that they are similar to those reported in other populations over the last two decades. Antibiotic activity did not prevent CDI. For example, thre use of meropenem, which is highly active against all strains tested, was a clear risk factor for CDI. Most of the antibiotics tested also showed a higher minimum inhibitory concentration distribution than that of EUCAST. All strains were susceptible to metronidazole. One strain was resistant to vancomycin.ConclusionsAntibiotic susceptibilities of the collection of C. difficile from the University Hospital of Zurich are similar to those reported by others since the 1980. Patients treated with carbapenems and cephalosporins had the highest risk of developing CDI irrespective of the antimicrobial activity of carbapenems.
- Published
- 2014
32. Antibiotic susceptibility of Clostridium difficile is similar worldwide over two decades despite widespread use of broad-spectrum antibiotics: an analysis done at the University Hospital of Zurich
- Author
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Büchler, Andrea C, primary, Rampini, Silvana K, additional, Stelling, Simon, additional, Ledergerber, Bruno, additional, Peter, Silke, additional, Schweiger, Alexander, additional, Ruef, Christian, additional, Zbinden, Reinhard, additional, and Speck, Roberto F, additional
- Published
- 2014
- Full Text
- View/download PDF
33. Livestockassociated methicillin- resistant staphylococcus aureus in humans, Europe
- Author
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van Cleef, Brigitte A G L, Monnet, Dominique Louis, Voss, Andreas, Krziwanek, Karina, Allerberger, Franz, Struelens, Marc, Zemlickova, Helena, Skov, Robert, Vuopio-Varkila, Jaana, Cuny, Christina, Friedrich, Alexander W, Spiliopoulou, Iris, Pászti, Judit, Hardardottir, Hjordis, Rossney, Angela, Pan, Angelo, Pantosti, Annalisa, Borg, Michael, Grundmann, Hajo, Mueller-Premru, Manica, Olsson-Liljequist, Barbro, Widmer, Andreas, Harbarth, Stephan Jürgen, Schweiger, Alexander, Unal, Serhat, Kluytmans, Jan, van Cleef, Brigitte A G L, Monnet, Dominique Louis, Voss, Andreas, Krziwanek, Karina, Allerberger, Franz, Struelens, Marc, Zemlickova, Helena, Skov, Robert, Vuopio-Varkila, Jaana, Cuny, Christina, Friedrich, Alexander W, Spiliopoulou, Iris, Pászti, Judit, Hardardottir, Hjordis, Rossney, Angela, Pan, Angelo, Pantosti, Annalisa, Borg, Michael, Grundmann, Hajo, Mueller-Premru, Manica, Olsson-Liljequist, Barbro, Widmer, Andreas, Harbarth, Stephan Jürgen, Schweiger, Alexander, Unal, Serhat, and Kluytmans, Jan
- Abstract
To estimate the proportion of methicillin-resistant Staphylococcus aureus (MRSA) isolates from humans that were sequence type (ST) 398, we surveyed 24 laboratories in 17 countries in Europe in 2007. Livestock-associated MRSA ST398 accounted for only a small proportion of MRSA isolates from humans; most were from the Netherlands, Belgium, Denmark, and Austria., SCOPUS: ar.j, info:eu-repo/semantics/published
- Published
- 2011
34. Livestock-associated Methicillin-ResistantStaphylococcus aureus in Humans, Europe
- Author
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van Cleef, Brigitte A.G.L., primary, Monnet, Dominique L., additional, Voss, Andreas, additional, Krziwanek, Karina, additional, Allerberger, Franz, additional, Struelens, Marc, additional, Zemlickova, Helena, additional, Skov, Robert L., additional, Vuopio-Varkila, Jaana, additional, Cuny, Christiane, additional, Friedrich, Alexander W., additional, Spiliopoulou, Iris, additional, Pászti, Judit, additional, Hardardottir, Hjordis, additional, Rossney, Angela, additional, Pan, Angelo, additional, Pantosti, Annalisa, additional, Borg, Michael, additional, Grundmann, Hajo, additional, Mueller-Premru, Manica, additional, Olsson-Liljequist, Barbro, additional, Widmer, Andreas, additional, Harbarth, Stephan, additional, Schweiger, Alexander, additional, Unal, Serhat, additional, and Kluytmans, Jan A.J.W., additional
- Published
- 2011
- Full Text
- View/download PDF
35. Alveolar echinococcosis: From a deadly disease to a well-controlled infection. Relative survival and economic analysis in Switzerland over the last 35 years
- Author
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Torgerson, Paul R., primary, Schweiger, Alexander, additional, Deplazes, Peter, additional, Pohar, Maja, additional, Reichen, Jürg, additional, Ammann, Rudolf W., additional, Tarr, Philip E., additional, Halkik, Nerman, additional, and Müllhaupt, Beat, additional
- Published
- 2008
- Full Text
- View/download PDF
36. Successful intestinal Echinococcus multilocularis oncosphere invasion and subsequent hepatic metacestode establishment in resistant RccHan™:WIST rats after pharmacological immunosuppression.
- Author
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ARMUA-FERNANDEZ, MARIA TERESA, JOEKEL, DEBORAH, SCHWEIGER, ALEXANDER, EICHENBERGER, RAMON MARC, MATSUMOTO, JUN, and DEPLAZES, PETER
- Subjects
ECHINOCOCCUS multilocularis ,IMMUNOSUPPRESSION ,HOST specificity (Biology) ,ECHINOCOCCOSIS ,LABORATORY rats - Abstract
Susceptibility/resistance to larval Echinococcus multilocularis infection varies greatly depending on host species and strains. Whereas several mice strains and non-human primates are highly susceptible to alveolar echinococcosis, rats and most of humans are considered as more resistant. In this study, we aimed to elucidate factors responsible for host resistance in rats (Experiments A–D). (A) The parasite establishment was not observed in immunocompetent Wistar rats orally inoculated with sodium hypochlorite resistant eggs with/without pig bile, or activated/non-activated oncospheres (NAO). Peritoneal inoculation with NAO or metacestode tissue allowed the parasite establishment in rats. (B) T-cell-deficient athymic nude rats showed complete resistance against the metacestode establishment after oral inoculation with parasite eggs. This finding suggests that T-cell-independent parasite clearance occurred in the animals during early phase of the parasite invasion. Finally, Wistar rats that received pharmacological immunosuppression using either dexamethasone (DMS) alone or methotrexate (MTX) i.p. alone or a combination of these compounds were orally inoculated with the parasite's eggs. As a result (D), successful establishment of metacestode with protoscoleces was observed in all 3 rats treated with DMS (s.c.) alone or in all 6 rats treated with DMS (s.c.) plus MTX but not in 8 rats with MTX alone, suggesting that factors affected by DMS treatment are responsible to regulate the parasite invasion and establishment. [ABSTRACT FROM PUBLISHER]
- Published
- 2016
- Full Text
- View/download PDF
37. Toxoplasma gondii Infection in Kyrgyzstan: Seroprevalence, Risk Factor Analysis, and Estimate of Congenital and AIDS-Related Toxoplasmosis.
- Author
-
Gulnara Minbaeva, Schweiger, Alexander, Aigerim Bodosheva, Omurbek Kuttubaev, Hehl, Adrian B., Tanner, Isabelle, Ziadinov, Iskender, Torgerson, Paul R., and Deplazes, Peter
- Abstract
Background: HIV-prevalence, as well as incidence of zoonotic parasitic diseases like cystic echinococcosis, has increased in the Kyrgyz Republic due to fundamental socio-economic changes after the breakdown of the Soviet Union. The possible impact on morbidity and mortality caused by Toxoplasma gondii infection in congenital toxoplasmosis or as an opportunistic infection in the emerging AIDS pandemic has not been reported from Kyrgyzstan. Methodology/Principal Findings: We screened 1,061 rural and 899 urban people to determine the seroprevalence of T. gondii infection in 2 representative but epidemiologically distinct populations in Kyrgyzstan. The rural population was from a typical agricultural district where sheep husbandry is a major occupation. The urban population was selected in collaboration with several diagnostic laboratories in Bishkek, the largest city in Kyrgyzstan. We designed a questionnaire that was used on all rural subjects so a risk-factor analysis could be undertaken. The samples from the urban population were anonymous and only data with regard to age and gender was available. Estimates of putative cases of congenital and AIDS-related toxoplasmosis in the whole country were made from the results of the serology. Specific antibodies (IgG) against Triton X-100 extracted antigens of T. gondii tachyzoites from in vitro cultures were determined by ELISA. Overall seroprevalence of infection with T. gondii in people living in rural vs. urban areas was 6.2% (95%CI: 4.8–7.8) (adjusted seroprevalence based on census figures 5.1%, 95% CI 3.9–6.5), and 19.0% (95%CI: 16.5–21.7) (adjusted 16.4%, 95% CI 14.1–19.3), respectively, without significant gender-specific differences. The seroprevalence increased with age. Independently low social status increased the risk of Toxoplasma seropositivity while increasing numbers of sheep owned decreased the risk of seropositivity. Water supply, consumption of unpasteurized milk products or undercooked meat, as well as cat ownership, had no significant influence on the risk for seropositivity. Conclusions: We present a first seroprevalence analysis for human T. gondii infection in the Kyrgyz Republic. Based on these data we estimate that 173 (95% CI 136–216) Kyrgyz children will be born annually to mothers who seroconverted to toxoplasmosis during pregnancy. In addition, between 350 and 1,000 HIV-infected persons are currently estimated to be seropositive for toxoplasmosis. Taken together, this suggests a substantial impact of congenital and AIDS-related symptomatic toxoplasmosis on morbidity and mortality in Kyrgyzstan. [ABSTRACT FROM AUTHOR]
- Published
- 2013
- Full Text
- View/download PDF
38. Campylobacter concisusPseudo-Outbreak Caused by Improved Culture Conditions
- Author
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Casanova, Carlo, Schweiger, Alexander, von Steiger, Niklaus, Droz, Sara, and Marschall, Jonas
- Abstract
ABSTRACTAn unusual increase in the number of Campylobacter concisusisolates found in stool cultures provoked an outbreak investigation at Bern University Hospital. No epidemiological links were found between the cases, and the Campylobacterisolates were clonally unrelated. A change in culture conditions to a hydrogen-rich atmosphere enhancing growth of C. concisuswas deemed responsible for this pseudo-outbreak.
- Published
- 2015
- Full Text
- View/download PDF
39. Nosocomial infections in dialysis access.
- Author
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Schweiger A, Trevino S, and Marschall J
- Subjects
- Anti-Bacterial Agents therapeutic use, Arteriovenous Shunt, Surgical adverse effects, Cross Infection etiology, Cross Infection prevention & control, Guideline Adherence, Humans, Patient Safety, Renal Dialysis instrumentation, Renal Dialysis methods, Risk Factors, Vascular Grafting adverse effects, Cross Infection epidemiology, Renal Dialysis adverse effects, Renal Insufficiency, Chronic therapy, Vascular Access Devices microbiology
- Abstract
Nosocomial infections in patients requiring renal replacement therapy have a high impact on morbidity and mortality. The most dangerous complication is bloodstream infection (BSI) associated with the vascular access, with a low BSI risk in arteriovenous fistulas or grafts and a comparatively high risk in central venous catheters. The single most important measure for preventing BSI is therefore the reduction of catheter use by means of early fistula formation. As this is not always feasible, prevention should focus on educational efforts, hand hygiene, surveillance of dialysis-associated events, and specific measures at and after the insertion of catheters. Core measures at the time of insertion include choosing the optimal site of insertion, the use of maximum sterile barrier precautions, adequate skin antisepsis, and the choice of catheter type; after insertion, access care needs to ensure hub disinfection and regular dressing changes. The application of antimicrobial locks is reserved for special situations. Evidence suggests that bundling a selection of the aforementioned measures can significantly reduce infection rates. The diagnosis of central line-associated BSI (CLABSI) is based on clinical signs and microbiological findings in blood cultures ideally drawn both peripherally and from the catheter. The prompt installation of empiric antibiotic treatment covering the most commonly encountered organisms is key regarding CLABSI treatment. Catheter removal is recommended in complicated cases or if cultures yield Staphylococcus aureus, enterococci, Pseudomonas or fungi. In other cases, guide wire exchange or catheter salvage strategies with antibiotic lock solutions may be acceptable alternatives., (© 2015 S. Karger AG, Basel.)
- Published
- 2015
- Full Text
- View/download PDF
40. [Hair coat contamination with zoonotic helminth eggs of farm and pet dogs and foxes].
- Author
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Nagy A, Ziadinov I, Schweiger A, Schnyder M, and Deplazes P
- Subjects
- Animals, Dog Diseases transmission, Dogs, Echinococcus multilocularis isolation & purification, Female, Helminthiasis, Animal transmission, Humans, Male, Toxocara isolation & purification, Zoonoses parasitology, Zoonoses transmission, Animals, Domestic parasitology, Dog Diseases parasitology, Foxes parasitology, Hair parasitology, Helminthiasis, Animal parasitology, Pets parasitology
- Abstract
Infections of dogs with Toxocara canis and Echinococcus multilocularis pose an infection-risk particularly for contact persons. We examined specimens of hair coat and faeces of 124 farm dogs, 118 household dogs, 49 kennel dogs, 15 puppies from two litters, and 46 red foxes. Microscopically identified eggs of Toxocara or taeniids were further investigated by species-specific PCRs. In farm dogs, eggs of E. multilocularis or T. canis were identified in each 2.4% of faecal samples, eggs of T. cati (gastrointestinal passage) in 7.3%, respectively. Household dogs excreted eggs of T. canis (0.8%) and of T. cati (2.5%). In kennel dogs, eggs of T. canis (4.1%), but not of T. cati were detectable. Coat samples contaminated with eggs of Toxocara spp. were found from farm dogs (5.6%), household dogs (1.7%) and kennel dogs (2.0%). Taeniid eggs were isolated from the coat samples from only two farm dogs (1.6%); a molecular species determination was not achieved. In six intrauterinely infected puppies, Toxocara-eggs were found in 17/38 samples taken within six weeks. No intact Toxocara eggs could be isolated from the coat of nine puppies from a second litter 13 days after deworming. Of the 46 red foxes investigated (dissection and faecal samples) 13 (28.3%) were infected with E. multilocularis and 20 (43.5%) with Toxocara. Eggs of taeniids and Toxocara were found in 13% (in three cases confirmed as E. multilocularis) and 21.7%, respectively, of the coat samples. None of the retrieved Toxocara eggs in the coat samples were embryonated. Thus, an infection of humans through the transmission of E. multilocularis eggs after direct contact with dogs or foxes is conceivable, whereas a corresponding infection risk by Toxocara eggs must be critically challenged.
- Published
- 2011
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