To develop prognostic models for improved risk adjustment in surgical site infection surveillance... more To develop prognostic models for improved risk adjustment in surgical site infection surveillance for 5 surgical procedures and to compare these models with the National Nosocomial Infection Surveillance system (NNIS) risk index. In a multicenter cohort study, prospective assessment of surgical site infection and risk factors was performed from 1996 to 2000. In addition, risk factors abstracted from patient files, available in a national medical register, were used. The c-index was used to measure the ability of procedure-specific logistic regression models to predict surgical site infection and to compare these models with models based on the NNIS risk index. A c-index of 0.5 indicates no predictive power, and 1.0 indicates perfect predictive power. Sixty-two acute care hospitals in the Dutch national surveillance network for nosocomial infections. Patients who underwent 1 of 5 procedures for which the predictive ability of the NNIS risk index was moderate: reconstruction of the aorta (n=875), femoropopliteal or femorotibial bypass (n=641), colectomy (n=1,142), primary total hip prosthesis (n=13,770), and cesarean section (n=2,962). The predictive power of the new model versus the NNIS index was 0.75 versus 0.62 for reconstruction of the aorta (P<.01), 0.78 versus 0.58 for femoropopliteal or femorotibial bypass (P<.001), 0.69 versus 0.62 for colectomy (P<.001), 0.64 versus 0.56 for primary total hip prosthesis arthroplasty (P<.001), and 0.70 versus 0.54 for cesarean section (P<.001). Data available from hospital information systems can be used to develop models that are better at predicting the risk of surgical site infection than the NNIS risk index. Additional data collection may be indicated for certain procedures--for example, total hip prosthesis arthroplasty.
Varicella-zoster virus (VZV) can cause severe disease in premature neonates. The fetus receives p... more Varicella-zoster virus (VZV) can cause severe disease in premature neonates. The fetus receives protective maternal VZV-immunoglobulin G (IgG) mainly in the third trimester of pregnancy. Therefore, premature neonates are considered at risk for VZV infection. Administration of varicella-zoster immunoglobulin (VZIG) within 96 hours after exposure effectively prevents severe illness in susceptible patients. The objectives of this study were to define the major determinants of the neonatal VZV-IgG titer and to determine the half-life of transplacentally acquired VZV-IgG. Guidelines provided by the Centers for Disease Control and Prevention for the use of VZIG in (premature) neonates were evaluated. VZV-IgG titers were measured in sera of 221 neonates and 43 mothers using a quantitative enzyme-linked immunosorbent assay. In 27 neonates, VZV-IgG titers were followed for up to 14 weeks. In a linear regression model, the maternal antibody titer was the major determinant of the neonatal tite...
... Reviews and Commentary A NOTE ON THE HISTORY OF THE CALCULATION OF HOSPITAL STATISTICS JAN P.... more ... Reviews and Commentary A NOTE ON THE HISTORY OF THE CALCULATION OF HOSPITAL STATISTICS JAN P. VANDENBROUCKE1 AND CHRISTINA MJE VANDENBROUCKE-GRAULS1 ... at Google Indexer on September 29, 2010 aje.oxfordjournals.org Downloaded from ...
It was recently observed that pig breeders in The Netherlands often carry methicillin-resistant S... more It was recently observed that pig breeders in The Netherlands often carry methicillin-resistant Staphylococus aureus (MRSA). These MRSA strains are related to MRSA strains found in pigs. A case-control study showed that not only pig breeders but also cattle breeders are at risk of carrying MRSA. It is advised to keep pig breeders, if they are admitted to a hospital, in isolation until surveillance cultures are proven negative. This also applies to veterinarians and slaughterhouse personnel. For cattle breeders screening without isolation on admission to a hospital is sufficient.
Italian journal of gastroenterology and hepatology
Helicobacter pylori lipopolysacchararide expresses Lewis x and/or y blood group antigens in mimic... more Helicobacter pylori lipopolysacchararide expresses Lewis x and/or y blood group antigens in mimicry with human gastric epithelial cells. Mimicry may have two diverging roles in pathogenesis. Infection may break tolerance and anti-Lewis antibodies may be induced that bind to gastric mucosa and cause damage. Secondly, mimicry may cause "invisibility" of the pathogen to the host, thus aiding persistence of infection. We demonstrate that Helicobacter pylori induces autoantibodies during infection. In orally infected pigs, these were specific for Lewis epitopes present on parietal cell H+K(+)-ATPase. In contrast, in infected patients the autoantibodies were directed to protein epitopes of H+K(+)-ATPase not induced through mimicry.
To develop prognostic models for improved risk adjustment in surgical site infection surveillance... more To develop prognostic models for improved risk adjustment in surgical site infection surveillance for 5 surgical procedures and to compare these models with the National Nosocomial Infection Surveillance system (NNIS) risk index. In a multicenter cohort study, prospective assessment of surgical site infection and risk factors was performed from 1996 to 2000. In addition, risk factors abstracted from patient files, available in a national medical register, were used. The c-index was used to measure the ability of procedure-specific logistic regression models to predict surgical site infection and to compare these models with models based on the NNIS risk index. A c-index of 0.5 indicates no predictive power, and 1.0 indicates perfect predictive power. Sixty-two acute care hospitals in the Dutch national surveillance network for nosocomial infections. Patients who underwent 1 of 5 procedures for which the predictive ability of the NNIS risk index was moderate: reconstruction of the aorta (n=875), femoropopliteal or femorotibial bypass (n=641), colectomy (n=1,142), primary total hip prosthesis (n=13,770), and cesarean section (n=2,962). The predictive power of the new model versus the NNIS index was 0.75 versus 0.62 for reconstruction of the aorta (P<.01), 0.78 versus 0.58 for femoropopliteal or femorotibial bypass (P<.001), 0.69 versus 0.62 for colectomy (P<.001), 0.64 versus 0.56 for primary total hip prosthesis arthroplasty (P<.001), and 0.70 versus 0.54 for cesarean section (P<.001). Data available from hospital information systems can be used to develop models that are better at predicting the risk of surgical site infection than the NNIS risk index. Additional data collection may be indicated for certain procedures--for example, total hip prosthesis arthroplasty.
Varicella-zoster virus (VZV) can cause severe disease in premature neonates. The fetus receives p... more Varicella-zoster virus (VZV) can cause severe disease in premature neonates. The fetus receives protective maternal VZV-immunoglobulin G (IgG) mainly in the third trimester of pregnancy. Therefore, premature neonates are considered at risk for VZV infection. Administration of varicella-zoster immunoglobulin (VZIG) within 96 hours after exposure effectively prevents severe illness in susceptible patients. The objectives of this study were to define the major determinants of the neonatal VZV-IgG titer and to determine the half-life of transplacentally acquired VZV-IgG. Guidelines provided by the Centers for Disease Control and Prevention for the use of VZIG in (premature) neonates were evaluated. VZV-IgG titers were measured in sera of 221 neonates and 43 mothers using a quantitative enzyme-linked immunosorbent assay. In 27 neonates, VZV-IgG titers were followed for up to 14 weeks. In a linear regression model, the maternal antibody titer was the major determinant of the neonatal tite...
... Reviews and Commentary A NOTE ON THE HISTORY OF THE CALCULATION OF HOSPITAL STATISTICS JAN P.... more ... Reviews and Commentary A NOTE ON THE HISTORY OF THE CALCULATION OF HOSPITAL STATISTICS JAN P. VANDENBROUCKE1 AND CHRISTINA MJE VANDENBROUCKE-GRAULS1 ... at Google Indexer on September 29, 2010 aje.oxfordjournals.org Downloaded from ...
It was recently observed that pig breeders in The Netherlands often carry methicillin-resistant S... more It was recently observed that pig breeders in The Netherlands often carry methicillin-resistant Staphylococus aureus (MRSA). These MRSA strains are related to MRSA strains found in pigs. A case-control study showed that not only pig breeders but also cattle breeders are at risk of carrying MRSA. It is advised to keep pig breeders, if they are admitted to a hospital, in isolation until surveillance cultures are proven negative. This also applies to veterinarians and slaughterhouse personnel. For cattle breeders screening without isolation on admission to a hospital is sufficient.
Italian journal of gastroenterology and hepatology
Helicobacter pylori lipopolysacchararide expresses Lewis x and/or y blood group antigens in mimic... more Helicobacter pylori lipopolysacchararide expresses Lewis x and/or y blood group antigens in mimicry with human gastric epithelial cells. Mimicry may have two diverging roles in pathogenesis. Infection may break tolerance and anti-Lewis antibodies may be induced that bind to gastric mucosa and cause damage. Secondly, mimicry may cause "invisibility" of the pathogen to the host, thus aiding persistence of infection. We demonstrate that Helicobacter pylori induces autoantibodies during infection. In orally infected pigs, these were specific for Lewis epitopes present on parietal cell H+K(+)-ATPase. In contrast, in infected patients the autoantibodies were directed to protein epitopes of H+K(+)-ATPase not induced through mimicry.
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