La mammite bovine à S. aureus se caractérise, dune part, par la persistance dun nombre élevé de cellules inflammatoires (principalement des neutrophiles) dans le lait, et, dautre part, par la persistance de la bactérie dans la glande mammaire. La guérison dune mammite à S. aureus repose donc sur deux facteurs étroitement liés : le retour à une concentration normale de cellules dans le lait et léradication de lorganisme pathogène. Or, laccumulation et lactivation des neutrophiles au site de linfection requiert lexpression de cytokines pro-inflammatoires, telles que lIL-8 et le GM-CSF, et la croissance intra- et extracellulaire de S. aureus est augmentée en présence de cytokines inflammatoires, telles que lIL-1b et le TNF-a. La persistance de cytokines pro-inflammatoires semble donc être défavorable à la guérison dune mammite à S. aureus. Lexpression de la plupart des cytokines pro-inflammatoires est sous la dépendance du facteur nucléaire kB (NF kB). Par conséquent, NF kB pourrait être une cible thérapeutique intéressante pour améliorer ou soigner la mammite à S. aureus. Au début de ce travail aucune étude navait été dédiée au rôle de NF kB dans la mammite. Nous avons par conséquent tenté de clarifier ce rôle, ainsi que le potentiel de NF-kB en tant que cible thérapeutique dans la mammite bovine.

Diss. (sammanfattning) Stockholm : Karolinska institutet, 2007. / Härtill 4 uppsatser.

Bakgrunn: Kontroll og overvåking av institusjonservervede infeksjoner (sykehusinfeksjoner) ble regulert i lov og forskrift i 1996. Helseinstitusjoner ble pålagt å ha infeksjonskontrollprogram. Hensikt: Å beskrive i hvilken utstrekning sykehjem i Akerhus fylke fulgte lovverket med å ha infeksjonskontrollprogram, inkludert infeksjonsforebyggende- og overvåkende tiltak. Metode: To tverrsnittsundersøkelser ble gjennomført i sykehjem i Akershus fylke i 2001 og 2005. En spørreundersøkelse ble utformet i 2001 for å kartlegge infeksjonskontrollprogram, inkludert lovverk, retningslinjer, ansattes helse og opplæring. I 2005 ble spørreundersøkelsen utvidet til å inkludere retningslinjer for meticillin resistente Staphylococcus aureus (MRSA), isolering, samarbeid med mikrobiolgoisk laboratorie og vaksinering. Spørreskjemaet ble sendt til institusjonssjef ved hvert sykehjem i fylket. I tillegg kontrollerte vi om institusjonene deltok i nasjonale prevalens registreringer og om de hadde erfaring med beboere med MRSA ved å benytte Nasjonale Folkehelseinstitutt sin database. Resultater: Antallet sykehjem som hadde etablert infeksjonskontrollprogram hadde steget fra 24 (48%) i 2001 til 45 (80%) i 2005 (Relativ risiko (RR)=1.6, 95% Konfidens interall (KI): 1.2-2.3). Det var en økning i kjennskap til fylkets lokale infeksjonskontrollprogram (RR=1.5, 95% KI: 1.1-2.1). Institusjonssjef vurderte det svært viktig å ha et infeksjonkontrollprogram (gjennomsnitt=6.2, variasjonsbredde 6.0-6.5 på en skala fra 1 til 7). Konklusjon: Det har vært økende oppmerksomhet på infeksjonskontroll og overvåking i sykehjem i Akershus fylke, Norge. Nasjonalt lovverk og gjentatte nasjonale prevalensregistreringer av institusjonservervede infeksjoner kan ha bidratt til dette / Background:In 1996, regulations regarding control and prevention of healthcare-associated infections in all healthcare institutions were implemented in Norway. It became mandatory for all healthcare facilities to have an infection control program. Objective: To describe to what extent long-term care facilities (LTCFs) in Akershus County have implemented infection control programs including guidelines and surveillance. Methods: A repeated, cross-sectional survey was performed among the LTCFs in Akershus County in 2001 and in 2005. A questionnaire was developed in 2001 investigating infection control programs including regulatory issues, guidelines, occupational health and training. In 2005, the questionnaire was expanded to include additional questions regarding policies and guidelines on methicillin-resistant Staphylococcus aureus (MRSA), isolation containment, collaboration with the microbiology laboratory and immunization policies. The questionnaire was sent to the head managing nurse of each LTCF in the county. Additionally, we searched for participation of LTCFs in the national prevalence surveys on healthcare-associated infections and for MRSA positive cases in the databases of Norwegian Institute of Public Health. Results: The number of LTCFs with an infection control program increased from 24 (48%) in 2001 to 45 (80%) in 2005 (Relative risk (RR) =1.6, 95% Confidence interval (CI): 1.2-2.3). There was an increasing knowledge about the county’s infection control program (RR=1.5, 95% CI: 1.1-2.1). The LTCF’s head managing nurses perceived having an infection control program as important (mean=6.2, range 6.0-6.5 on a scale of 1 to 7). Conclusion: There has been an increased attention towards infection control in LTCFs in Akershus County, Norway. National regulations and repeated national prevalence surveys on healthcare-associated infections may have contributed to this improvement. / <p>ISBN 978-91-85721-19-1</p>

Made available in DSpace on 2016-08-19T18:15:59Z (GMT). No. of bitstreams: 1 FLAVIA LOPES CARVALHO.pdf: 442162 bytes, checksum: b9d2b399e741a894bb9550e5094975a0 (MD5) Previous issue date: 2009-11-18 / Co-infection Leishmania-HIV/Aids is a serious public health problem in almost of the world. The visceral leishmaniasis is the clinical form of leishmaniosis hat is most associated with HIV/Aids cases being the co-infection understated, since the leishmaniasis is not AIDS-defining illness. This was a descriptive cross sectional study from March 2006 to December 2008, aiming to investigate the occurrence of co-infection Leishmania-HIV in individuals living with HIV/Aids in a Reference Center in São Luís-MA. The population studied was composed of 287 individuals. It was used a questionnaire to collect demographic, epidemiological and socioeconomic data. The physical examination was performed and biological material for detection of infection by Leishmania chagasi was collected by indirect immunofluorescence technique (IIFT), and laboratory tests (blood count, CD4 and CD8, viral load, myelography) were found in charts. We used the chi-square test to assess association of demographic, socioeconomic and epidemiological variables between women and men, whereas p ≥ 0.05 for significance. Women and men had a statistically significant difference in color, destination of waste, occupation and family income. The presence of pen and near the residence showed statistically significant differences when comparing men and women. The prevalence of infection with Leishmania sp, detected by Montenegro Skin Test (MST) was 1,4%. All co-infected showed RIFI and as well as the bone marrow aspirate (myelogram) positives. This study helped identify the magnitude of the prevalence of co-infection Leishmania/HIV. Thus, we suggest that the anti-Leishmania has to be part of the differential diagnosis of individuals with HIV / AIDS and those public policies are increased for this problem. / A co-infecção Leishmania-HIV/Aids é um sério problema de saúde pública em quase todo o mundo. A Leishmaniose Visceral é a forma clínica das leishmanioses que está mais associada ao HIV/Aids, sendo os casos de co-infecção considerados subestimados, uma vez que, a leishmaniose não se constitui doença definidora de Aids. Foi realizado um estudo descritivo transversal de março de 2006 a dezembro de 2008, com o objetivo de investigar a ocorrência de co-infecção Leishmania-HIV em indivíduos convivendo com HIV/Aids, atendidas em um Centro de Referência em São Luís-MA. A população do estudo foi constituída por 287 indivíduos. A coleta de dados foi feita por meio de um questionário para a obtenção de dados demográficos, socioeconômicos e epidemiológicos, bem como foi realizado exame físico e coleta de material biológico para detecção da infecção por Leishmania sp , por meio da Intradermorreação de Montenegro (IDRM), Reação de Imunofluorescência Indireta (RIFI) e os exames laboratoriais (hemograma, contagem de CD4 e CD8, carga viral, mielograma) foram consultados nos prontuários. Através do teste qui-quadrado foi avaliado as variáveis demográficos, socioeconômicas e epidemiológicas entre mulheres e homens convivendo com HIV/Aids, considerando p ≥ 0,05 de significância. Houve diferença estatística significante na cor da pele, no destino dos dejetos, na ocupação e na renda familiar; como também na presença de chiqueiro em local próximo à residência. A prevalência da infecção por Leishmania sp detectada pela Intradermorreação de Montenegro (IDRM) foi de 1,4% e a prevalência da co-infecção Leishmania-HIV/Aids foi de 4,2%. Todos os co-infectados apresentaram RIFI e o aspirado de medula óssea (mielograma) positivos. Este estudo permitiu conhecer a magnitude da prevalência da co-infecção Leishmania/HIV. Assim, sugerimos que o teste anti-Leishmania seja realizado em todos os indivíduos com HIV/Aids, e que sejam incrementadas políticas públicas voltadas para essa problemática.

The Diploma thesis provides basic information about the incidence of nosocomial infections, especially about the process of spreading infections, their subdivision according various aspects, major means of nosocomial infections, and about methods of surveillance. Investigative part of the thesis is aimed to describe the incidence of nosocomial infection, which can be used as quality indicator of hospital care, including the spectrum of the most frequent etiological microbial agents and their resistance against antibiotic treatment. There were used mixed research methods to process the investigative part of the thesis because the methods were quantitative and qualitative. The analysis of the data represents main part of the thesis. The research was carried out in the district hospital, namely in The Hospital Strakonice, a.s.. There were monitored infections at operation sites, between Jan 1, 2011 and Dec 31, 2011 at the surgical and gynaecology units. There were also monitored infections of the blood stream between Jan 1, 2009 and Dec 31, 2011 at all departments. The research group was formed by inpatients staying in The Hospital Strakonice, a.s., who were after surgical procedure or those, who were catheterized central blood stream in defined time period.