lnu.sePublications
Change search
Refine search result
1 - 24 of 24
CiteExportLink to result list
Permanent link
Cite
Citation style
  • apa
  • harvard1
  • ieee
  • modern-language-association-8th-edition
  • vancouver
  • Other style
More styles
Language
  • de-DE
  • en-GB
  • en-US
  • fi-FI
  • nn-NO
  • nn-NB
  • sv-SE
  • Other locale
More languages
Output format
  • html
  • text
  • asciidoc
  • rtf
Rows per page
  • 5
  • 10
  • 20
  • 50
  • 100
  • 250
Sort
  • Standard (Relevance)
  • Author A-Ö
  • Author Ö-A
  • Title A-Ö
  • Title Ö-A
  • Publication type A-Ö
  • Publication type Ö-A
  • Issued (Oldest first)
  • Issued (Newest first)
  • Created (Oldest first)
  • Created (Newest first)
  • Last updated (Oldest first)
  • Last updated (Newest first)
  • Disputation date (earliest first)
  • Disputation date (latest first)
  • Standard (Relevance)
  • Author A-Ö
  • Author Ö-A
  • Title A-Ö
  • Title Ö-A
  • Publication type A-Ö
  • Publication type Ö-A
  • Issued (Oldest first)
  • Issued (Newest first)
  • Created (Oldest first)
  • Created (Newest first)
  • Last updated (Oldest first)
  • Last updated (Newest first)
  • Disputation date (earliest first)
  • Disputation date (latest first)
Select
The maximal number of hits you can export is 250. When you want to export more records please use the Create feeds function.
  • 1.
    Abrahamsson, Daria
    et al.
    Linnaeus University, Faculty of Health, Social Work and Behavioural Sciences, School of Health and Caring Sciences.
    Miller, Sofi
    Linnaeus University, Faculty of Health, Social Work and Behavioural Sciences, School of Health and Caring Sciences.
    MRSA – EN FÖLJETONG UTAN SLUT: Effekter av olika åtgärder i smittskyddsarbete mot MRSA 2010Independent thesis Basic level (degree of Bachelor), 15 credits / 22,5 HE creditsStudent thesis
    Abstract [sv]

    Bakgrund: Multiresistenta bakterier, däribland MRSA, är idag ett globalt samhällsproblem. Infektioner förorsakade av MRSA skapar ett onödigt lidande för patienter med utdragen vårdtid som i värsta fall kan resultera i ökad dödlighet. Enligt Smittskyddsinstitutet (2010) drabbades 1479 patienter förra året i Sverige. Med få verksamma antibiotika måste andra åtgärder tillämpas, så som basala hygienrutiner, screening, isoleringsvård och utökad städning av sjukhusmiljön. Det är dock viktigt att utvärdera åtgärdernas effekter för att kunna utföra smittskyddsarbete på bästa möjliga sätt.

    Syfte: Syftet var att undersöka effekterna av olika åtgärder i smittskyddsarbetet mot MRSA.

    Metod: Litteraturstudie med kvantitativ ansats baserad på tio vetenskapliga original artiklar. Analysen gjordes enligt Forsberg och Wengströms (2008) riktlinjer för meta-analys.

    Resultat: Studien visar att MRSA förekommer i kliniska miljöer samt förutom hos patienten även hos vårdpersonal. Förebyggande åtgärder som bland annat noggrann städning, basala hygienrutiner och screening hade varierande effekt och reducerade MRSA- förekomsten bäst i kombination. I vissa fall kunde brister i vårdpersonalens följsamhet (compliance) av hygienrutiner ses.

    Slutsats: För att reducera MRSA- förekomst och spridning är det viktigt att implementera de åtgärder som finns idag och som visat sig har effekt. För att genomföra detta krävs det att vårdpersonalens följsamhet blir bättre.

     

     

  • 2. Ambjörnsson, Joakim
    et al.
    Jonsson, Anders
    University of Borås, Sweden.
    Strömsöe, Annelie
    Andersson, Henrik
    University of Borås, Sweden.
    Bång, Angela
    University of Borås, Sweden.
    Bremer, Anders
    University of Borås, Sweden.
    Prehospital suspicion and identification of adult septic patients: Experiences of a screening tool2016In: 2nd Global Conference on Emergency Nursing and Trauma Care, Melia Sitges, September 22-24, 2016, 2016Conference paper (Refereed)
    Abstract [en]

    Introduction: Sepsis is life threatening and requires urgent healthcare to reduce suffering and death. Therefore it is important that septic patients are identified early to enable treatment. Aim: To investigate to what extent EMS personnel identified patients with sepsis using the “BAS 90-30-90” model, and to describe assessments and medical procedures that were undertaken by the personnel.

    Methods: This was a retrospective study where 185 EMS medical records were reviewed. The inclusion was based on patients who were later diagnosed with sepsis in the hospital.

    Results: A physician assessed the patients in 74 of the EMS cases, which lead to exclusion of these records in regard to the EMS personnel’s ability to identify sepsis. The personnel documented suspicion of severe sepsis in eight (n=8) of the remaining 111 records (7.2%). The proportion of patients ˃65 years of age was 73% (n=135) of which 37% (n=50) were over 80 years old. Thirty-nine percent (39%, n=72) were females. The personnel documented blood pressure in 91% (n=168), respiratory rate in 76% (n=140), saturation in 100% (n=185), temperature in 76% (n=141), and heart rate in 94% (n=174) of the records. Systolic blood pressure <90 mmHg was documented in 14,2% (n=24), respiratory rate ˃30 in 36% (n=50), saturation <90 in 49%  (n=91), temperature >38°C in 37.6% (n=53), and heart rate ˃90 in 70% (n=121) of the records. Documented medical procedures and treatments were intravenous lines (70%, n=130), intravenous fluids (10%, n=19) and administration of oxygen (72%, n=133).

    Conclusion: The EMS personnel identified only a few septic patients with the help of the BAS 90-30-90 model when all three criteria would be met for severe sepsis. Either advanced age (>65 years), fever (>38°C) or tachypnea (˃20 breaths/min) appeared to increase the personnel’s suspicion of sepsis. Oxygen, but not intravenous fluids, was given in an adequate way.

  • 3.
    Andersson, Henrik
    et al.
    University of Borås, Sweden.
    Axelsson, Christer
    University of Borås, Sweden.
    Larsson, Anna
    South Älvsborg's Hospital, Sweden.
    Bremer, Anders
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences. University of Borås, Sweden.
    Gellerstedt, Martin
    University West, Sweden.
    Bång, Angela
    University of Borås, Sweden;University of Gothenburg, Sweden.
    Herlitz, Johan
    University of Borås, Sweden.
    Ljungström, Lars
    Skaraborg Hospital, Sweden.
    The early chain of care in bacteraemia patients: early suspicion, treatment and survival in prehospital emergency care2018In: American Journal of Emergency Medicine, ISSN 0735-6757, E-ISSN 1532-8171, Vol. 36, no 12, p. 2211-2218Article in journal (Refereed)
    Abstract [en]

    Introduction

    Bacteraemia is a first stage for patients risking conditions such as septic shock. The primary aim of this study is to describe factors in the early chain of care in bacteraemia, factors associated with increased chance of survival during the subsequent 28 days after admission to hospital. Furthermore, the long-term outcome was assessed.

    Methods

    This study has a quantitative design based on data from Emergency Medical Services (EMS) and hospital records.

    Results

    In all, 961 patients were included in the study. Of these patients, 13.5% died during the first 28 days. The EMS was more frequently used by non-survivors. Among patients who used the EMS, the suspicion of sepsis already on scene was more frequent in survivors. Similarly, EMS personnel noted the ESS code “fever, infection” more frequently for survivors upon arriving on scene. The delay time from call to the EMS and admission to hospital until start of antibiotics was similar in survivors and non-survivors. The five-year mortality rate was 50.8%. Five-year mortality was 62.6% among those who used the EMS and 29.5% among those who did not (p < 0.0001).

    Conclusion

    This study shows that among patients with bacteraemia who used the EMS, an early suspicion of sepsis or fever/infection was associated with improved early survival whereas the delay time from call to the EMS and admission to hospital until start of treatment with antibiotics was not. 50.8% of all patients were dead after five years.

  • 4.
    Atterby, Clara
    et al.
    Uppsala University.
    Ramey, Andrew M.
    US Geological Survey, USA.
    Hall, Gabriel Gustafsson
    Uppsala University.
    Järhult, Josef
    Uppsala University.
    Börjesson, Stefan
    National Veterinary Institute.
    Bonnedahl, Jonas
    Linnaeus University, Faculty of Health and Life Sciences, Department of Biology and Environmental Science. Kalmar County Hospital.
    Increased prevalence of antibiotic-resistant E. coli in gulls sampled in Southcentral Alaska is associated with urban environments2016In: Infection Ecology & Epidemiology, ISSN 2000-8686, E-ISSN 2000-8686, Vol. 6, no 1, p. 1-7, article id 32334Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Antibiotic-resistant bacteria pose challenges to healthcare delivery systems globally; however, limited information is available regarding the prevalence and spread of such bacteria in the environment. The aim of this study was to compare the prevalence of antibiotic-resistant bacteria in large-bodied gulls (Larus spp.) at urban and remote locations in Southcentral Alaska to gain inference into the association between antibiotic resistance in wildlife and anthropogenically influenced habitats.

    METHODS: Escherichia coli was cultured (n=115 isolates) from fecal samples of gulls (n=160) collected from a remote location, Middleton Island, and a more urban setting on the Kenai Peninsula.

    RESULTS: Screening of E. coli from fecal samples collected from glaucous-winged gulls (Larus glaucescens) at Middleton Island revealed 8% of isolates were resistant to one or more antibiotics and 2% of the isolates were resistant to three or more antibiotics. In contrast, 55% of E. coli isolates derived from fecal samples collected from large-bodied gulls (i.e. glaucous, herring [Larus argentatus], and potentially hybrid gulls) on the Kenai Peninsula were resistant to one or more antibiotics and 22% were resistant to three or more antibiotics. In addition, total of 16% of the gull samples from locations on the Kenai Peninsula harbored extended-spectrum cephalosporin-resistant E. coli isolates (extended-spectrum beta-lactamases [ESBL] and plasmid-encoded AmpC [pAmpC]), in contrast to Middleton Island where no ESBL- or pAmpC-producing isolates were detected.

    CONCLUSION: Our findings indicate that increased prevalence of antibiotic resistance is associated with urban environments in Southcentral Alaska and presumably influenced by anthropogenic impacts. Further investigation is warranted to assess how migratory birds may maintain and spread antimicrobial-resistant bacteria of relevance to human and animal health.

  • 5.
    Axelsson, Christer
    et al.
    University of Borås, Sweden.
    Herlitz, Johan
    University of Borås, Sweden.
    Karlsson, Anders
    Älvsborg Hospital, Sweden.
    Sjöberg, Henrik
    Älvsborg Hospital, Sweden.
    Jiménez-Herrera, Maria
    Universitat Rovira I Virgili, Spain.
    Bång, Angela
    University of Borås, Sweden.
    Jonsson, Anders
    University of Borås, Sweden.
    Bremer, Anders
    University of Borås, Sweden.
    Andersson, Henrik
    University of Borås, Sweden.
    Gellerstedt, Martin
    University West, Sweden.
    Ljungström, Lars
    Skaraborg Hospital, Sweden.
    The Early Chain of Care in Patients with Bacteraemia with the Emphasis on the Prehospital Setting2016In: Prehospital and Disaster Medicine, ISSN 1049-023X, E-ISSN 1945-1938, Vol. 31, no 3, p. 272-277Article in journal (Refereed)
    Abstract [en]

    There is a lack of knowledge about the early phase of severe infection. This report describes the early chain of care in bacteraemia as follows: (a) compare patients who were and were not transported by the Emergency Medical Services (EMS); (b) describe various aspects of the EMS chain; and (c) describe factors of importance for the delay to the start of intravenous antibiotics. It was hypothesized that, for patients with suspected sepsis judged by the EMS clinician, the delay until the onset of antibiotic treatment would be shorter.

    All patients in the Municipality of Gothenburg (Sweden) with a positive blood culture, when assessed at the Laboratory of Bacteriology in the Municipality of Gothenburg, from February 1 through April 30, 2012 took part in the survey.

    In all, 696 patients fulfilled the inclusion criteria. Their mean age was 76 years and 52% were men. Of all patients, 308 (44%) had been in contact with the EMS and/or the emergency department (ED). Of these 308 patients, 232 (75%) were transported by the EMS and 188 (61%) had “true pathogens” in blood cultures. Patients who were transported by the EMS were older, included more men, and suffered from more severe symptoms and signs.

    The EMS nurse suspected sepsis in only six percent of the cases. These patients had a delay from arrival at hospital until the start of antibiotics of one hour and 19 minutes versus three hours and 21 minutes among the remaining patients (P =.0006). The corresponding figures for cases with “true pathogens” were one hour and 19 minutes versus three hours and 15 minutes (P =.009).

    Among patients with bacteraemia, 75% used the EMS, and these patients were older, included more men, and suffered from more severe symptoms and signs. The EMS nurse suspected sepsis in six percent of cases. Regardless of whether or not patients with true pathogens were isolated, a suspicion of sepsis by the EMS clinician at the scene was associated with a shorter delay to the start of antibiotic treatment.

  • 6.
    Axelsson Olsson, Diana
    et al.
    Linnaeus University, Faculty of Science and Engineering, School of Natural Sciences.
    Olofsson, Jenny
    Linnaeus University, Faculty of Science and Engineering, School of Natural Sciences.
    Svensson, Lovisa
    Linnaeus University, Faculty of Science and Engineering, School of Natural Sciences.
    Griekspoor, Petra
    Linnaeus University, Faculty of Science and Engineering, School of Natural Sciences.
    Waldenström, Jonas
    Linnaeus University, Faculty of Science and Engineering, School of Natural Sciences.
    Ellström, Patrik
    Clinical Bacteriology, Department of Medical Sciences, Uppsala University and Uppsala University Hospital, SE-751 85 Uppsala, Sweden.
    Olsen, Björn
    Linnaeus University, Faculty of Science and Engineering, School of Natural Sciences.
    Amoebae and algae can prolong the survival of Campylobacter species in co-culture2010In: Experimental parasitology, ISSN 0014-4894, E-ISSN 1090-2449, Vol. 126, p. 59-64Article in journal (Refereed)
    Abstract [en]

    Several species of free-living amoebae can cause disease in humans. However, in addition to the direct pathogenicity of e.g. Acanthamoebae and Naegleria species, they are recognized as environmental hosts, indirectly involved in the epidemiology of many pathogenic bacteria. Although several studies have demonstrated intracellular survival of many different bacteria in these species, the extent of such interactions as well as the implications for the epidemiology of the bacterial species involved, are largely unknown and probably underestimated. In this study, we evaluated eight different unicellular eukaryotic organisms, for their potential to serve as environmental hosts for Campylobacter species. These organisms include four amoebozoas (Acanthamoeba polyphaga, Acanthamoeba castellanii, Acanthamoeba rhysodes and Hartmanella vermiformis), one alveolate (Tetrahymena pyriformis), one stramenopile (Dinobryon sertularia), one eugoenozoa (Euglena gracilis) and one heterolobosea (Naegleria americana). Campylobacter spp. including Campylobacter jejuni, Campylobacter coli and Campylobacter lari are the most common cause of gastroenteritis in the western world. Survival and replication of these three species as well as Campylobacter hyointestinalis were assessed in co-cultures with the eukaryotic organisms. Campylobacter spp. generally survived longer in co-cultures, compared to when incubated in the corresponding growth media. The eukaryotic species that best promoted bacterial survival was the golden algae D. sertularia. Three species of amoebozoas, of the genus Acanthamoeba promoted both prolonged survival and replication of Campylobacter spp. The high abundance in lakes, ponds and water distribution networks of these organisms indicate that they might have a role in the epidemiology of campylobacteriosis, possibly contributing to survival and dissemination of these intestinal pathogens to humans and other animals. The results suggest that not only C. jejuni, but a variety of Campylobacter spp. can interact with different eukaryotic unicellular organisms.

  • 7.
    Bengtsson, Daniel
    et al.
    Linnaeus University, Faculty of Health and Life Sciences, Department of Biology and Environmental Science.
    Safi, Kamran
    Max Planck Institute for Ornithology, Germany;University of Konstanz, Germany.
    Avril, Alexis
    Linnaeus University, Faculty of Health and Life Sciences, Department of Biology and Environmental Science.
    Fiedler, Wolfgang
    Max Planck Institute for Ornithology, Germany;University of Konstanz, Germany.
    Wikelski, Martin
    Max Planck Institute for Ornithology, Germany;University of Konstanz, Germany.
    Gunnarsson, Gunnar
    Kristianstad University.
    Elmberg, Johan
    Kristianstad University.
    Tolf, Conny
    Linnaeus University, Faculty of Health and Life Sciences, Department of Biology and Environmental Science.
    Olsen, Björn
    Uppsala University.
    Waldenström, Jonas
    Linnaeus University, Faculty of Health and Life Sciences, Department of Biology and Environmental Science.
    Does influenza A virus infection affect movement behaviour during stopover in its wild reservoir host?2016In: Royal Society Open Science, E-ISSN 2054-5703, Vol. 3, no 2, p. 1-11, article id UNSP 150633Article in journal (Refereed)
    Abstract [en]

    The last decade has seen a surge in research on avian influenza A viruses (IAVs), in part fuelled by the emergence, spread and potential zoonotic importance of highly pathogenic virus subtypes. The mallard (Anas platyrhynchos) is the most numerous and widespread dabbling duck in the world, and one of the most important natural hosts for studying IAV transmission dynamics. In order to predict the likelihood of IAV transmission between individual ducks and to other hosts, as well as between geographical regions, it is important to understand how IAV infection affects the host. In this study, we analysed the movements of 40 mallards equipped with GPS transmitters and three-dimensional accelerometers, of which 20 were naturally infected with low pathogenic avian influenza virus (LPAIV), at a major stopover site in the Northwest European flyway. Movements differed substantially between day and night, as well as between mallards returning to the capture site and those feeding in natural habitats. However, movement patterns did not differ between LPAIV infected and uninfected birds. Hence, LPAIV infection probably does not affect mallard movements during stopover, with high possibility of virus spread along the migration route as a consequence.

  • 8.
    Bonnedahl, Jonas
    et al.
    Linnaeus University, Faculty of Health and Life Sciences, Department of Biology and Environmental Science. Kalmar County Hospital.
    Jarhult, Josef D.
    Uppsala University.
    Antibiotic resistance in wild birds2014In: Upsala Journal of Medical Sciences, ISSN 0300-9734, E-ISSN 2000-1967, Vol. 119, no 2, p. 113-116Article, review/survey (Refereed)
    Abstract [en]

    Wild birds have been postulated as sentinels, reservoirs, and potential spreaders of antibiotic resistance. Antibiotic-resistant bacteria have been isolated from a multitude of wild bird species. Several studies strongly indicate transmission of resistant bacteria from human rest products to wild birds. There is evidence suggesting that wild birds can spread resistant bacteria through migration and that resistant bacteria can be transmitted from birds to humans and vice versa. Through further studies of the spatial and temporal distribution of resistant bacteria in wild birds, we can better assess their role and thereby help to mitigate the increasing global problem of antibiotic resistance.

  • 9.
    Briland, Isabelle
    et al.
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences.
    Svensson, Malinn
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences.
    Ett komplext omhändertagande: - En intervjustudie om akut omhändertagande av svårt sjuka sepsispatienter och patienter med trauma2017Independent thesis Advanced level (degree of Master (One Year)), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background: The population is aging and requires more complex healthcare. This means that in the future, interaction with other healthcare departments is essential. Such interaction would lead to increased demand on the ability to cooperate among healthcare personnel. The intensivecare nurse and the nurse in the emergency department have a close cooperation when managing the acute severely ill patient. A multiprofessional team gives a faster diagnosis and management in the emergency department, which shortens the time to the final instance of care. The members of the team complement each other, increasing patient safety and enabling person-centered care. Increased knowledge with the nursing staff on the acute management in emergency department is essential to be able to enhance the care for the patient in the initial stage, but focus should also be at the nurse’s experience of the acute management to identify risk factors that could pose a negative influence on the patient.Aim: The aim of this study was to describe nurses’ experience of acute management of patients with trauma and patients with severe sepsis or septic shock.Method: The method used was a qualitative, inductive approach where 14 interviews were conducted, seven with nurses from the emergency department and seven intensive care nurses from the intensive care department. The interviews were analysed using a qualitative, manifest content analysis.Result:The analyzation process resulted in five different categories: ‘Communication is A&O’, ‘The importance of knowing one’s role’, ‘Work over the borders’, ‘Working from a clear structure’ and ‘Care on different terms’. Conclusion: There is an unclear structure in the emergency care of patients with severe sepsis or septic shock, which was a result of unclear roles and inadequate communication in the care. It appears to be advantageous to introduce clear guidelines in the emergency care of the patient group with severe sepsis or septic shock, suggestively by checklists or some medical alert like a trauma alarm, and where a multi-professional team interacts around the patient.

  • 10.
    Fagerström, Amanda
    et al.
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences.
    Odén, Paulina
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences.
    Jag är smittad, men jag väljer livet.: En litteraturstudie om HIV-positivas upplevelse av HIV.2016Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
  • 11.
    Hasan, Badrul
    et al.
    Uppsala Univ.
    Melhus, Åsa
    Uppsala Univ.
    Sandegren, Linus
    Uppsala Univ.
    Alam, Munirul
    Int Ctr Diarrhoeal Dis Res, Bangladesh.
    Olsen, Björn
    Linnaeus University, Faculty of Health and Life Sciences, Department of Biology and Environmental Science. Uppsala Univ.
    The Gull (Chroicocephalus brunnicephalus) as an Environmental Bioindicator and Reservoir for Antibiotic Resistance on the Coastlines of the Bay of Bengal2014In: Microbial Drug Resistance, ISSN 1076-6294, E-ISSN 1931-8448, Vol. 20, no 5, p. 466-471Article in journal (Refereed)
    Abstract [en]

    The presence and frequency of multiresistant bacteria in wild birds act as indicators of the environmental contamination of antibiotic resistance. To explore the rate of contamination mediated by Escherichia coli, 150 fecal samples from the brown-headed gull (Chroicocephalus brunnicephalus) and 8 water samples from the Bay of Bengal area were collected, cultured, and tested for antibiotic susceptibility. Special attention was paid to extended-spectrum beta-lactamase (ESBL)-producing isolates, which were further characterized genetically. Antibiotic resistance was found in 42.3% (36/85) of the E. coli isolates and multidrug resistance in 11.8%. Isolates from the area with a higher human activity were more resistant than those from an area with a lower level of activity. Most frequent was resistance to ampicillin (29.4%), followed by trimethoprim-sulfamethoxazole (24.7%) and quinolones (22.4%). Carriage of ESBL-producing E. coli was relatively high (17.3%) in the gulls, whereas no ESBL producers were found in the water. All ESBL-producing E. coli isolates, but one, carried bla(CTX-M-15) or bla(CTX-M-15)-like genes. A bla(CTX-M-14)-like enzyme was found as an exception. Gulls from two different colonies shared E. coli clones and harbored the clinically relevant sequence types ST10, ST48, and ST131. The high frequency of antibiotic resistance and ESBL production among E. coli isolates from gulls indicates that the environmental contamination of antibiotic resistance has already gone far on the coastlines of the Bay of Bengal. Considering the limited control over the antibiotic consumption and waste from human activities in Bangladesh, there is no easy solution in sight.

  • 12.
    Herlitz, Johan
    et al.
    University of Borås, Sweden;Sahlgrenska University Hospital, Sweden.
    Bång, Angela
    University of Borås, Sweden.
    Wireklint-Sundström, Birgitta
    University of Borås, Sweden.
    Axelsson, Christer
    University of Borås, Sweden.
    Bremer, Anders
    University of Borås, Sweden.
    Hagiwara, Magnus
    University of Borås, Sweden.
    Jonsson, Anders
    University of Borås, Sweden.
    Lundberg, Lars
    University of Borås, Sweden.
    Suserud, Björn-Ove
    University of Borås, Sweden.
    Ljungström, Lars
    Skövde Central Hospital, Sweden.
    Suspicion and treatment of severe sepsis: An overview of the prehospital chain of care2012In: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine, ISSN 1757-7241, E-ISSN 1757-7241, Vol. 20, no 42Article in journal (Refereed)
    Abstract [en]

    Background

    Sepsis is a life-threatening condition where the risk of death has been reported to be even higher than that associated with the major complications of atherosclerosis, i.e. myocardial infarction and stroke. In all three conditions, early treatment could limit organ dysfunction and thereby improve the prognosis.

    Aim

    To describe what has been published in the literature a/ with regard to the association between delay until start of treatment and outcome in sepsis with the emphasis on the pre-hospital phase and b/ to present published data and the opportunity to improve various links in the pre-hospital chain of care in sepsis.

    Methods

    A literature search was performed on the PubMed, Embase (Ovid SP) and Cochrane Library databases.

    Results

    In overall terms, we found a small number of articles (n=12 of 1,162 unique hits) which addressed the prehospital phase. For each hour of delay until the start of antibiotics, the prognosis appeared to become worse. However, there was no evidence that prehospital treatment improved the prognosis.Studies indicated that about half of the patients with severe sepsis used the emergency medical service (EMS) for transport to hospital. Patients who used the EMS experienced a shorter delay to treatment with antibiotics and the start of early goal-directed therapy (EGDT). Among EMS-transported patients, those in whom the EMS staff already suspected sepsis at the scene had a shorter delay to treatment with antibiotics and the start of EGDT.There are insufficient data on other links in the prehospital chain of care, i.e. patients, bystanders and dispatchers.

    Conclusion

    Severe sepsis is a life-threatening condition. Previous studies suggest that, with every hour of delay until the start of antibiotics, the prognosis deteriorates. About half of the patients use the EMS. We need to know more about the present situation with regard to the different links in the prehospital chain of care in sepsis.

  • 13.
    Huang, Yanyan
    et al.
    Memorial University of Newfoundland, Canada.
    Wille, Michelle
    Memorial University of Newfoundland, Canada.
    Benkaroun, Jessica
    Memorial University of Newfoundland, Canada.
    Munro, Hannah
    Memorial University of Newfoundland, Canada.
    Bond, Alexander L.
    Memorial University of Newfoundland, Canada.
    Fifield, David A.
    Newfoundland and Labrador Department of Natural Resources, Canada.
    Robertson, Gregory J.
    Environment Canada, Canada.
    Ojkic, Davor
    University of Guelph, Canada.
    Whitney, Hugh
    Newfoundland and Labrador Department of Natural Resources, Canada.
    Lang, Andrew S.
    Memorial University of Newfoundland, Canada.
    Perpetuation and reassortment of gull influenza A viruses in Atlantic North America2014In: Virology, ISSN 0042-6822, E-ISSN 1096-0341, Vol. 456-457, p. 353-363Article in journal (Refereed)
    Abstract [en]

    Gulls are important hosts of avian influenza A viruses (AIVs) and gull AIVs often contain gene segments of mixed geographic and host lineage origins. In this study, the prevalence of AIV in gulls of Newfoundland, Canada from 2008 to 2011 was analyzed. Overall prevalence was low (30/1645, 1.8%) but there was a distinct peak of infection in the fall. AIV seroprevalence was high in Newfoundland gulls, with 50% of sampled gulls showing evidence of previous infection. Sequences of 16 gull AIVs were determined and analyzed to shed light on the transmission, reassortment and persistence dynamics of gull AIVs in Atlantic North America. Intercontinental and waterfowl lineage reassortment was prevalent. Of particular note were a wholly Eurasian AIV and another with an intercontinental reassortant waterfowl lineage virus. These patterns of geographic and inter-host group transmission highlight the importance of characterization of gull AIVs as part of attempts to understand global AIV dynamics.

  • 14.
    Jansson, Alexandra
    Linnaeus University, Faculty of Health and Life Sciences, Department of Chemistry and Biomedical Sciences.
    Effekten och potentiella risker med bedaquiline, delamanid och pretomanid vid behandling av multiresistent tuberkulos2019Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Archeological findings of tuberculosis can be found way back to the Stone Age but it wasn’t before the 18th century that Robert Koch discovered that it was Mycobacterium tuberculosis (M. tuberculosis) who caused the disease tuberculosis. Current data indicates that approximately 10 million people are infected with tuberculosis each year and 600 000 new cases of multidrug resistance tuberculosis (MDR-TB) was observed in 2017.  Tuberculosis is a bacterium with a unique cell wall consisting of a high concentration of mycolic acid. The fatty cell wall of the bacteria can act as a barrier against antituberculotic drugs, making the disease difficult to treat. Tuberculosis is a disease who can be spread among people via airborne droplets but only about 10 % of all people who are infected are affected by disease symptoms.  Tuberculosis is usually diagnosed by spot-sputum samples from deep within the airways. Resistance to antituberculotic drugs are detected by culture growth of the bacteria on either a liquid or solid medium. Tuberculosis is treated with a combination of several different drugs such as isoniazide, rifampicine, pyrazinamide and ethambutol. Also called HRZE and is a standard regimen for tuberculosis. If treatment occurs incorrectly or is incomplete the bacteria can develop resistance to these drugs and MDR-TB can emerge. Patients with MDR-TB is usually resistant to either or both isoniazide and rifampicine which makes the disease difficult to treat and another combination of drugs is needed. Bedaquiline, delamanide and pretomanide are newly developed drugs that can hopefully be used in the treatment of MDR-TB.

    The purpose of the thesis was to analyze the efficacy and potential risks with bedaquiline, delamanide and pretomanide in the treatment of MDR-TB. The articles for this literature study were obtained from the two databases PubMed and ClinicalTrials. A total of 7 articles were chosen to analyze the efficacy and potential risks with bedaquiline, delamanide and pretomanid used in treatment in patients with MDR-TB.

    The result obtained from the articles was obtained by primarily analyzing the primary outcome from each article. All articles suggest that bedaquiline, delamanide and pretomanide have a favorable bactericidal efficacy against M. tuberculosis and may shorten the treatment period. However, all of the studied drugs produced numerous side effects such as headaches, nausea, dizziness, hyperuricemia and an extended QT interval. Although all the side effects that occurred in the studies were classified as mild to moderate. Many side effects occurred in the studies and only a few participants participated in each study. However, it was observed that the new combinations with bedaquiline, delamanide and pretomanide can reduce the development of additional drug resistance. Despite some deviations in the studies, bedaquiline, delamanide and pretomanid may be new alternative treatments for MDR-TB. But more studies with a larger study population is needed to ensure the safety profile and efficacy of all of the drugs above. However, bedaquiline, delamanide and pretomanid show promising results in current studies for the future fight against MDR-TB.

  • 15.
    Johansson, Håkan
    et al.
    Linnaeus University, Faculty of Health and Life Sciences, Department of Biology and Environmental Science.
    Ellström, Patrik
    Uppsala University.
    Artursson, Karin
    National Veterinary Institute.
    Berg, Charlotte
    Swedish University of Agricultural Sciences.
    Bonnedahl, Jonas
    Linnaeus University, Faculty of Health and Life Sciences, Department of Biology and Environmental Science. Kalmar County Hospital.
    Hansson, Ingrid
    Swedish University of Agricultural Sciences.
    Hernandez, Jorge
    Uppsala University;Kalmar County Hospital.
    Lopez-Martin, Juana
    Univ Concepcion, Chile.
    Medina-Vogel, Gonzalo
    Univ Andres Bello, Chile.
    Moreno, Lucile
    Univ Concepcion, Chile.
    Olsen, Björn
    Uppsala University.
    Engvall, Eva Olsson
    National Veterinary Institute.
    Skarin, Hanna
    National Veterinary Institute.
    Troell, Karin
    National Veterinary Institute.
    Waldenström, Jonas
    Linnaeus University, Faculty of Health and Life Sciences, Department of Biology and Environmental Science.
    Agren, Joakim
    National Veterinary Institute.
    Gonzalez-Acuna, Daniel
    Univ Concepcion, Chile.
    Characterization of Campylobacter spp. isolated from wild birds in the Antarctic and Sub-Antarctic2018In: PLoS ONE, ISSN 1932-6203, E-ISSN 1932-6203, Vol. 13, no 11, article id e0206502Article in journal (Refereed)
    Abstract [en]

    A lack of knowledge of naturally occurring pathogens is limiting our ability to use the Antarctic to study the impact human-mediated introduction of infectious microorganisms have on this relatively uncontaminated environment. As no large-scale coordinated effort to remedy this lack of knowledge has taken place, we rely on smaller targeted efforts to both study present microorganisms and monitor the environment for introductions. In one such effort, we isolated Campylobacter species from fecal samples collected from wild birds in the Antarctic Peninsula and the sub-Antarctic island of South Georgia. Indeed, in South Georgia, we found Campylobacter lari and the closely related Campylobacter peloridis, but also distantly related human-associated multilocus sequence types of Campylobacter jejuni. In contrast, in the Antarctic Peninsula, we found C. tart and two closely related species, Campylobacter subantarcticus and Campylobacter volucris, but no signs of human introduction. In fact, our finding of human-associated sequence types of C. jejuni in South Georgia, but not in the Antarctic Peninsula, suggests that efforts to limit the spread of infectious microorganisms to the Antarctic have so far been successful in preventing the introduction of C. jejuni. However, we do not know how it came to South Georgia and whether the same mode of introduction could spread it from there to the Antarctic Peninsula.

  • 16. Jääskeläinen, Anne J
    et al.
    Kolehmainen, Pekka
    Voutilainen, Liina
    Hauffe, Heidi C
    Kallio-Kokko, Hannimari
    Lappalainen, Maija
    Tolf, Conny
    Linnaeus University, Faculty of Health and Life Sciences, Department of Biology and Environmental Science.
    Lindberg, A. Michael
    Linnaeus University, Faculty of Health and Life Sciences, Department of Chemistry and Biomedical Sciences.
    Henttonen, Heikki
    Vaheri, Antti
    Tauriainen, Sisko
    Vapalahti, Olli
    Evidence of ljungan virus specific antibodies in humans and rodents, Finland.2013In: Journal of Medical Virology, ISSN 0146-6615, E-ISSN 1096-9071, Vol. 85, no 11, p. 2001-2008Article in journal (Refereed)
    Abstract [en]

    Ljungan virus (LV, genus Parechovirus, family Picornaviridae) is considered currently to be a rodent-borne virus. Despite suggested human disease associations, its zoonotic potential remains unclear. To date, LV antibody prevalence in both humans and rodents has not been studied. In this study, two different LV immunofluorescence assays (LV IFAs) were developed with LV genotypes 1 (LV strain 87-012G) and 2 (LV strain 145SLG), and cross-neutralization and -reaction studies were carried out with LV strain 145SLG. Finally, a panel of 37 Finnish sera was screened for anti-LV antibodies using two different LV IFAs (LV 145SLG and LV 87-012G) and a neutralization (NT) assay (LV 145SLG), and 50 samples from Myodes glareolus by LV IFA (LV 145SLG). The LV seroprevalence study showed 38% and 18% positivity in humans and M. glareolus, respectively. LV IFAs and NT assays were compared, and the results were in good agreement. The data are the first evidence of humans and rodents coming into contact with LV in Finland. Additional studies are required in order to acquire a better understanding of the prevalence, epidemiological patterns and possible disease association of LV infections.

  • 17.
    Lindberg, A Michael
    University of Kalmar, School of Pure and Applied Natural Sciences.
    Generation of full-length single stranded cDNAs from various types of enteroviruses1994In: EUROPIC 94: VIIIth Meeting, Korpilampi, Finland, 1994Conference paper (Refereed)
  • 18.
    Lindberg, Anders Michael
    et al.
    Uppsala University, Sweden.
    Alksnis, Marianne
    Uppsala University, Sweden.
    Stålhandske, Per
    Uppsala University, Sweden.
    Pettersson, Ulf
    Uppsala University, Sweden.
    Molecular biology of coxsackievirus1987Conference paper (Refereed)
  • 19.
    Lindberg, Anders Michael
    et al.
    Uppsala University, Sweden.
    Pettersson, Ulf
    Uppsala University, Sweden.
    Correlation between amino acid conservation in the P1 region of coxsackievirus type B and a model of the three dimensional structure of coxsackievirus B31989Conference paper (Refereed)
  • 20.
    Lindberg, Michael
    Uppsala University, Sweden.
    Molecular biology of coxsackie B virus serotype 31986Conference paper (Refereed)
  • 21.
    Olofsson, Jenny
    et al.
    Uppsala University.
    Griekspoor, Petra
    Linnaeus University, Faculty of Health and Life Sciences, Department of Biology and Environmental Science.
    Olsen, Björn
    Uppsala University.
    Ellström, Patrik
    Uppsala University.
    Axelsson Olsson, Diana
    Linnaeus University, Faculty of Health and Life Sciences, Department of Medicine and Optometry. Uppsala University.
    The abundant free-living amoeba, Acanthamoeba polyphaga, increases the survival of Campylobacter jejuni in milk and orange juice2015In: Infection Ecology & Epidemiology, ISSN 2000-8686, E-ISSN 2000-8686, Vol. 5, article id 28675Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Campylobacter jejuni is a common cause of human bacterial diarrhea in most parts of the world. Most C. jejuni infections are acquired from contaminated poultry, milk, and water. Due to health care costs and human suffering, it is important to identify all possible sources of infection. Unpasteurized milk has been associated with several outbreaks of C. jejuni infection. Campylobacter has been identified on fresh fruit, and other gastrointestinal pathogens such as Salmonella, E. coli O157:H7 and Cryptosporidium have been involved in fruit juice outbreaks. C. jejuni is sensitive to the acidic environment of fruit juice, but co-cultures with the amoeba, Acanthamoeba polyphaga, have previously been shown to protect C. jejuni at low pH.

    METHODS: To study the influence of A. polyphaga on the survival of C. jejuni in milk and juice, the bacteria were incubated in the two products at room temperature and at 4°C with the following treatments: A) C. jejuni preincubated with A. polyphaga before the addition of product, B) C. jejuni mixed with A. polyphaga after the addition of product, and C) C. jejuni in product without A. polyphaga. Bacterial survival was assessed by colony counts on blood agar plates.

    RESULTS: Co-culture with A. polyphaga prolonged the C. jejuni survival both in milk and juice. The effect of co-culture was most pronounced in juice stored at room temperature. On the other hand, A. polyphaga did not have any effect on C. jejuni survival during pasteurization of milk or orange juice, indicating that this is a good method for eliminating C. jejuni in these products.

    CONCLUSION: Amoebae-associated C. jejuni in milk and juice might cause C. jejuni infections.

  • 22.
    Sandegren, Linus
    et al.
    Uppsala University.
    Stedt, Johan
    Linnaeus University, Faculty of Health and Life Sciences, Department of Biology and Environmental Science.
    Lustig, Ulrika
    Uppsala University.
    Bonnedahl, Jonas
    Linnaeus University, Faculty of Health and Life Sciences, Department of Biology and Environmental Science. Kalmar County Hospital.
    Andersson, Dan I.
    Uppsala University.
    Jaerhult, Josef D.
    Uppsala University.
    Long-term carriage and rapid transmission of extended spectrum beta-lactamase-producing E-coli within a flock of Mallards in the absence of antibiotic selection2018In: Environmental Microbiology Reports, ISSN 1758-2229, E-ISSN 1758-2229, Vol. 10, no 5, p. 576-582Article in journal (Refereed)
    Abstract [en]

    Wild birds have been suggested as transmitters and reservoirs for antibiotic resistant bacteria. We performed an experimental study investigating carriage time and interindividual transmission of extended spectrum beta-lactamase- (ESBL-)producing Escherichia coli in Mallards (Anas platyrhynchos) to assess if the birds carry the bacteria long enough to transfer them geographically during migration. Mallards were inoculated intraoesophageally with four different strains of ESBL-producing E. coli and kept together in a flock. The ESBL-strains belonged to sequence types previously shown to spread between birds and humans. Culturing from faecal samples showed presence of ESBL-producing E. coli the entire 29 day experimental period. An extensive and rapid transmission of the different ESBL-strains between individuals (including non-inoculated controls) was observed. In necropsy samples, we detected ESBL-strains in the cecum even in faeces-negative birds, indicating that this part of the intestine could function as a reservoir of resistant bacteria. We demonstrate that birds can carry ESBL-producing E. coli for long enough times to travel far during migration and the extensive interindividual transmission suggests spread between individuals in a dense bird population as a mechanism that allow persistence of resistant bacteria.

  • 23.
    Tjernberg, A. Rockert
    et al.
    Kalmar County Hospital ; Örebro university.
    Bonnedahl, Jonas
    Linnaeus University, Faculty of Health and Life Sciences, Department of Biology and Environmental Science. Kalmar County Hospital.
    Inghammar, M.
    Lund university.
    Egesten, A.
    Lund university.
    Kahlmeter, G.
    Cent Hosp Växjö.
    Naucler, P.
    Karolinska Univ Hosp ; Karolinska instutet.
    Henriques-Normark, B.
    Karolinska Univ Hosp ; Karolinska instutet.
    Ludvigsson, J. F.
    Karolinska instutet ; Örebro Univ Hosp ; Univ Nottingham, UK.
    Coeliac disease and invasive pneumococcal disease: a population-based cohort study2017In: Epidemiology and Infection, ISSN 0950-2688, E-ISSN 1469-4409, Vol. 145, no 6, p. 1203-1209Article in journal (Refereed)
    Abstract [en]

    Severe infections are recognized complications of coeliac disease (CD). In the present study we aimed to examine whether individuals with CD are at increased risk of invasive pneumococcal disease (IPD). To do so, we performed a population-based cohort study including 29 012 individuals with biopsy-proven CD identified through biopsy reports from all pathology departments in Sweden. Each individual with CD was matched with up to five controls (n = 144 257). IPD events were identified through regional and national microbiological databases, including the National Surveillance System for Infectious Diseases. We used Cox regression analyses to estimate hazard ratios (HRs) for diagnosed IPD. A total of 207 individuals had a record of IPD whereas 45/29 012 had CD (0.15%) and 162/144 257 were controls (0.11%). This corresponded to a 46% increased risk for IPD [HR 1.46, 95% confidence interval (CI) 1.05-2.03]. The risk estimate was similar after adjustment for socioeconomic status, educational level and comorbidities, but then failed to attain statistical significance (adjusted HR 1.40, 95% CI 0.99-1.97). Nonetheless, our study shows a trend towards an increased risk for IPD in CD patients. The findings support results seen in earlier research and taking that into consideration individuals with CD may be considered for pneumococcal vaccination.

  • 24.
    Wanby, Pär
    et al.
    Kalmar County Hospital, Sweden.
    Olsen, Björn
    Kalmar County Hospital, Sweden.
    Myocarditis in a patient with salmonella and campylobacter enteritis.2001In: Scandinavian Journal of Infectious Diseases, ISSN 0036-5548, E-ISSN 1651-1980, Vol. 33, no 11, p. 860-862Article in journal (Refereed)
    Abstract [en]

    Myocarditis associated with bacterial enteritis has only rarely been described and the pathogenesis is unclear. Herein we report a case where a young adult developed myocarditis during the acute stage of an infection with Salmonella heidelberg and Campylobacter jejunii/coli. The patient's troponin I value was elevated. We suggest that use of cardiac-sensitive troponins may be a useful tool for diagnosis of acute myocarditis in the context of bacterial enteritis. We also suggest the need for further investigation of the pathogenesis of myocarditis associated with enteric pathogens.

1 - 24 of 24
CiteExportLink to result list
Permanent link
Cite
Citation style
  • apa
  • harvard1
  • ieee
  • modern-language-association-8th-edition
  • vancouver
  • Other style
More styles
Language
  • de-DE
  • en-GB
  • en-US
  • fi-FI
  • nn-NO
  • nn-NB
  • sv-SE
  • Other locale
More languages
Output format
  • html
  • text
  • asciidoc
  • rtf