Background. Antibiotic administration to individuals with Shiga toxin-producing Escherichia coli (STEC) infection remains controversial. We assessed if antibiotic administration to individuals with STEC infection is associated with development of hemolytic uremic syndrome (HUS).Methods. The analysis included studies published up to 29 April 2015, that provided data from patients (1) with STEC infection, (2) who received antibiotics, (3) who developed HUS, and (4) for whom data reported timing of antibiotic administration in relation to HUS. Risk of bias was assessed; strength of evidence was adjudicated. HUS was the primary outcome. Secondary outcomes restricted the analysis to low-risk-of-bias studies employing commonly used HUS criteria. Pooled estimates of the odds ratio (OR) were obtained using random-effects models.Results. Seventeen reports and 1896 patients met eligibility; 8 (47%) studies were retrospective, 5 (29%) were prospective cohort, 3 (18%) were case-control, and 1 was a trial. The pooled OR, including all studies, associating antibiotic administration and development of HUS was 1.33 (95% confidence interval [CI], .89-1.99; I 2 = 42%). The repeat analysis including only studies with a low risk of bias and those employing an appropriate definition of HUS yielded an OR of 2.24 (95% CI, 1.45-3.46; I 2 = 0%).Conclusions. Overall, use of antibiotics was not associated with an increased risk of developing HUS; however, after excluding studies at high risk of bias and those that did not employ an acceptable definition of HUS, there was a significant association. Consequently, the use of antibiotics in individuals with STEC infections is not recommended.
We describe a highly sensitive heterogeneous enzyme-linked immunoassay in which digoxin is used as the model analyte. An excess of enzyme-labeled monovalent antibody is incubated with sample containing the analyte such that all analyte is rapidly and quantitatively bound. Excess antibody that does not acquire a antigen in its binding site is rapidly removed from the mixture by passage through a porous affinity column containing immobilized analyte (or analog), present in vast excess. Only the labeled monovalent antibody that possesses an antigen in its binding site elutes from the column in the unbound fraction. The label present in this fraction is then quantified. Such an assay is extremely sensitive and obviates the limitations imposed by antibody affinity constants on homogeneous and competitive heterogeneous immunoassays. This assay can be performed rapidly and is readily amenable to automation.
SUMMABY. Three lamdry disinfecting processes for woollen blankets were tested in a hospital lamdry against total bacteria. Results were somewhat indefinite owing to a low general level of infeation and the incidence of slight recontamination during drying. Before drying, disinfection was demonstrated. Laboratory simulated launderings on pieces of blanket infected with Pseudomonas pyocyanea showed significant difFerences between the processes. ND P, P PI The figures quoted were selected at random from a larger number. KD, Not done. * 1 and 2, repeat tests.
The value of formaldehyde in the penultimate or last laundering rinse is assessed, using a micrococcus and Eschem'chia coZi as the indicator organisms. Experiments demonstrating a residual disinfecting effect of dry formaldehyde treated blankets against the micrococcus are also described. PREVIOUS WORK (Dickinson, Wagg & Carter, 1962) showed the effectiveness of a long presoak in a 0.5% (w/v) solution of formaldehyde as a means of disinfecting woollen blankets in laundering. This process was too long for routine use and so a much shorter method was developed in which formaldehyde was put in the last rinse lasting for only 14 min.Alder (pers. comm.) showed that blankets treated with steam and formaldehyde in an autoclave at 90" under subatmospheric pressure may show residual disinfectant action in the dry condition. Moreover, Kingston & Noble (1964) have demonstrated the self disinfecting properties of various dry surfaces which slowly evolve formaldehyde. This suggested that the formaldehyde left on the blankets from the new laundering technique might similarly make them self disinfecting, and, indeed, results indicated this, a t least, a t 44% relative humidity (RH). The smell from blankets treated with formaldehyde in the last rinse was objectionable, particularly when the blankets were stored in a confined space, and to avoid this a modified technique with formaldehyde in the penultimate rinse was investigated.Although the residual effect against dry bacteria was less than it was when the formaldehyde was in the last rinse, it was still considerable. It seems likely that the modified technique will prove to be a reasonable compromise, as the smell of formaldehyde was greatly reduced. It is important to note that Alder (pers. comm.) found that the initial smell from his formaldehyde autoclaved blankets disappeared and yet still there was a residual bactericidal effect on stored blankets. Experimental Disinfection in launderingThe Standard Washing Process described previously (Dickinson et al., 1962) was used as a typical laundering procedure. The disinfection process consisted simply of adding the formaldehyde to the penultimate or ultimate rinse extended t o 14 min. After this, the blankets were hydro extracted and tumbler dried.
A hospital trial of wool blankets laundered with a 0*38'$(0 (w/v) solution of formaldehyde in the last but one rinse showed evidence of residual bactericidal action of the blankets. On removal from the beds after a fortnight's use, dirty treated blankets contained down to one tenth of the number of bacteria present on dirty untreated blankets. There were also fewer dirty treated than control blankets on which coagulase positive bacteria could bo detected. Chemical tests showed that the formaldehyde content of the blankets built up to c. 1%. No complaints were received of odour from the blankets.LABORATORY TESTS on formaldehyde laundered wool blankets, infected with micrococci mixed with cotton powder, indicated considerable residual bactericidal action under dry conditions (Dickinson & Wagg, 1967). Ward trials by Alder (pers. comm.) showed residual action by treated wool blanket samples, judged by the total bacterial count obtained from a percussion sampling method. For instance, blanket pieces that had been laundered 6 times with formaldehyde without intermediate use yielded < 60% the number of bacteria obtained from untreated pieces after several days' exposure on an occupied hospital bed. Moreover, there was no adverse patient reaction in ward trials with formaldehyde treated whole blankets.It seemed desirable therefore to investigate the effect of instituting a regular regime of formaldehyde laundering of wool blankets used on beds in a hospital ward.As judged by maceration, the total counts on the treated blankets, immediately after removal from the beds, were always lower than those on similarly used, but untreated, wool blankets. The control blankets were being subjected to regular disinfection by high temperature laundering, and the count from the treated blankets was sometimes only 1110th that from the controls, the effect becoming generally greater as the number of launderings increased. Counts by a percussion sampling technique showed a similar trend, but the numerical differences were smaller. From the second cycle onwards, the number of formaldehyde treated blankets on which coagulase positive organisms could be detected was always less than the number of control blankets.
No abstract
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
hi@scite.ai
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.