Anaerobic bacteremia has reemerged as a significant clinical problem. Although there are probably multiple reasons for this change, the increasing number of patients with complex underlying diseases makes the clinical context for anaerobic infections less predictable than it once was. Anaerobic blood cultures should be routinely performed in medical centers with a patient population similar to ours.
Background: The purpose of this study was to identify global trends in Listeria monocytogenes epidemiology using ProMED reports. ProMED is a publicly available, global outbreak reporting system that uses both informal and formal sources. In the context of Listeria , ProMED reports on atypical findings such as higher than average case counts, events from unusual sources, and multinational outbreaks. Methods: Keywords “ Listeria ” and “listeriosis” were utilized in the ProMED search engine covering the years 1996–2018. Issue date, countries involved, source, suspected and confirmed case counts, and fatalities were extracted. Data unique to each event, including commentary by content experts, were evaluated. When multiple reports regarding the same outbreak or recall were obtained, the last report pertaining to that outbreak was utilized. Rates of Listeria events over time were compared using a normal approximation to the Poisson distribution; p < 0.05 was considered to be statistically significant. Results: From 1996 through 2018, 123 Listeria events were identified in the ProMED database. Eighty-one events (65%) were associated with two or more human cases (outbreak events), 13 events (11%) were associated with only one human case (sporadic cases), and 29 events (24%) were precautionary food product recalls due to the presence of bacterial contamination without associated human cases. The implicated food vehicle was identified in 69 (85%) outbreak events and in 10 (77%) sporadic case events. Listeria contaminated foods were identified in all precautionary recall events. Overall, 28 events (23%) implicated novel food vehicles/sources. Events associated with novel food vehicles increased over the study period ( p < 0.02), as did international events with more than one country involved ( p < 0.02). Ten reports (8%) described hospital-acquired events. Conclusions: This study demonstrates the use of publicly available data to document Listeria epidemiological trends, particularly in settings where foodborne disease surveillance is weak or nonexistent. Over the last decade, an increasing number of events have been associated with foods not traditionally recognized as vehicles for Listeria transmission, and a rise in international events was noted. Informing high-risk individuals such as pregnant women and immunocompromised individuals of safe food handling practices is warranted. To ensure timely recall of contaminated food products, open data sharing and communication across borders is critical. Changes in food production and distribution, and improved diagnostics may have contributed to the observed changes.
Hospital-acquired infections (HAIs) are a major concern to healthcare systems around the world. They are associated with significant morbidity and mortality, in addition to increased hospitalization costs. Recent outbreaks, including those caused by the Middle East respiratory syndrome coronavirus and Ebola virus, have highlighted the importance of infection control. Moreover, HAIs, especially those caused by multidrug-resistant Gram-negative rods, have become a top global priority. Although adequate approaches and guidelines have been in existence for many years and have often proven effective in some countries, the implementation of such approaches in low- and middle-income countries (LMICs) is often restricted due to limited resources and underdeveloped infrastructure. While evidence-based infection prevention and control (IPC) principles and practices are universal, studies are needed to evaluate simplified approaches that can be better adapted to LMIC needs, in order to guide IPC in practice. A group of experts from around the world attended a workshop held at the 17th International Congress on Infectious Diseases in Hyderabad, India in March 2016, to discuss the existing IPC practices in LMICs, and how best these can be improved within the local context.
Data from digital disease surveillance tools such as ProMED and HealthMap can complement the field surveillance during ongoing outbreaks. Our aim was to investigate the use of data collected through ProMED and HealthMap in real-time outbreak analysis. We developed a flexible statistical model to quantify spatial heterogeneity in the risk of spread of an outbreak and to forecast short term incidence trends. The model was applied retrospectively to data collected by ProMED and HealthMap during the 2013–2016 West African Ebola epidemic and for comparison, to WHO data. Using ProMED and HealthMap data, the model was able to robustly quantify the risk of disease spread 1–4 weeks in advance and for countries at risk of case importations, quantify where this risk comes from. Our study highlights that ProMED and HealthMap data could be used in real-time to quantify the spatial heterogeneity in risk of spread of an outbreak.
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