Objective
To elucidate the relationship between CpG-induced activation of innate immunity and pregnancy outcome.
Design
An animal model-based study.
Setting
Academic.
Animal(s)
Pregnant nonobese diabetic (NOD) mice were compared with nonimmunodeficient mice.
Intervention(s)
We mimic toll-like receptor 9 (TLR9) activation using CpG ODN administration in pregnant wild-type (WT) and natural killer (NK) cell–deficient NOD mice.
Main Outcome Measure(s)
Evaluation of fetal resorption and preterm birth in pregnant mice; flow-cytometric analysis and ELISA detection.
Result(s)
CpG-induced fetal resorption or preterm birth was observed steadily only in NOD mice but not in WT mice. Concurrently, CpG treatment triggered amplification of uterine macrophages and neutrophils. Moreover, CpG induced a substantial increase of serum mouse keratinocyte-derived cytokine (mKC) and tumor necrosis factor-α (TNF-α) that were produced by uterine CD11b+F4/80+ cells but not by NK or CD11b+Gr-1+ cells. In addition, depletion of F4/80+ cells abrogated a CpG-induced increase in TNF-α production and improved pregnancy outcomes in NOD mice treated with CpG.
Conclusion(s)
These results provide evidence that CpG-driven innate immune activation may lead to activation and amplification of macrophages followed by their migration to fetomaternal microenvironment, up-regulated TNF-α production, and consequent adverse pregnancy outcomes.
Context:Hand hygiene (HH) is the most important measure to prevent hospital-acquired infections but the compliance is still low.Aims:To assess the compliance, identify factors influencing compliance and to study the knowledge, attitude and perceptions associated with HH among health care workers (HCW).Settings and Design:Cross-sectional study conducted in 42 bedded Medical (Pulmonary, Medicine and Stroke) intensive care units (ICU) of a tertiary care hospital.Materials and Methods:HCWs (doctors and nurses) were observed during routine patient care by observers posted in each ICU and their HH compliance was noted. Thereafter, questionnaire regarding knowledge, perception and attitudes toward HH was filled by each HCW.Statistical Analysis:Percentages and χ2 test.Results:The overall compliance was 43.2% (394/911 opportunities). It was 68.9% (31/45) in the intensivists, 56.3% (18/32) in attending physicians, 40.0% (28/70) in the postgraduate residents and 41.3% (301/728) in the nurses. Compliance was inversely related to activity index. Compliance for high, medium and low risk of cross-transmission was 38.8% (67/170), 43.8% (175/401) and 44.7% (152/340), respectively.Conclusions:Compliance of the study group is affected by the activity index (number of opportunities they come across per hour) and professional status. The HCWs listed less knowledge, lack of motivation, increased workload as some of the factors influencing HH.
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