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1. Daniele Aparecida Ribeiro. Trânsito de profissionais e pacientes de terapia intensiva entre diferentes hospitais: possível risco de disseminação de micorganismos multirresistentes.

Degree: 2013, Federal University of Uberlândia

A disseminação de microrganismos multirresistentes é um problema mundial de saúde pública. O uso de antimicrobianos em hospitais, sobretudo nas Unidades de Terapia Intensiva induzem e selecionam microrganismos resistentes. Estes são disseminados por meio dos profissionais de saúde e pacientes colonizados que circulam nos espaços intra e inter-hospitalar. O objetivo do presente estudo foi conhecer a frequência com que os pacientes internados em Unidades de Terapia Intensiva e os profissionais de saúde que lhes prestam cuidados diretos transitam entre diferentes instituições e os possíveis indícios de relação causal entre este trânsito e a ocorrência de microrganismos patogênicos e resistências aos antimicrobianos. Foram realizadas entrevistas com profissionais de saúde atuantes nas Unidades de Terapia Intensiva de hospitais de Uberlândia e Patrocínio. Foram também consultados os bancos de dados de microbiologia de cada hospital e os prontuários dos pacientes. Cerca da metade dos profissionais entrevistados prestava assistência em mais de uma instituição e cerca de um quarto também exerciam atividades em outros setores do mesmo hospital. Trezentos e setenta e seis (12,32%) pacientes internados haviam sido transferidos de outras instituições hospitalares e esta percentagem variou conforme os hospitais (p=0,0000). Em todas as Unidades de Terapia Intensiva estudadas as bactérias mais frequentemente isoladas foram: Pseudomonas aeruginosa, Staphylococcus aureus, Staphylococcus coagulase negativa, Acinetobacter baumannii, Klebsiela pneumoniae, Escherichia coli, Enterobacter cloacae e Enterococcus faecalis. A resistência das bactérias aos antimicrobianos foram também semelhantes nos seis hospitais. Conclui-se que os pacientes e principalmente os profissionais de saúde frequentemente transitam entre diferentes setores de um mesmo hospital e entre diferentes hospitais da região estudada. Portanto, este trânsito pode ter importância epidemiológica, o que é sugerido pela similaridade dos microrganismos isolados nos hospitais do presente estudo.

Spread of multidrug-resistant microorganisms is a worldwide public health problem. Antimicrobial use in hospitals, especially in Intensive Care Units (ICU) induces and selects resistant microorganisms. These are disseminated through colonized health professionals and patients circulating in the areas intra and inter- hospitals. The aim of this study is to identify the frequency with which patients admitted to Intensive Care Units and healthcare professionals, who provide direct care to them, move between different institutions and the indicia of possible causal relationship between the transit and the occurrence of pathogens microorganisms and antimicrobial resistance. Interviews were conducted with health professionals working in hospitals Intensive Care Units in the cities of Uberlândia and Patrocínio. Microbiology databases of the each hospital were also consulted as well as patients medical records. About half of the interviewed health professionals provide assistance in more than…

Advisors/Committee Members: Miguel Tanús Jorge, Antônio Carlos Campos Pignatari, Denise Von Dolinger de Brito.

Subjects/Keywords: Infecção hospitalar; Infecção em UTI; Transmissão cruzada; Disseminação de microrganismos multirresistentes; Resistência bacteriana; CIENCIAS DA SAUDE; Hospital infection; Infection in ICU; Cross-transmission; Spread of multiresistant microorganisms; Bacterial resistance

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APA · Chicago · MLA · Vancouver · CSE | Export to Zotero / EndNote / Reference Manager

APA (6th Edition):

Ribeiro, D. A. (2013). Trânsito de profissionais e pacientes de terapia intensiva entre diferentes hospitais: possível risco de disseminação de micorganismos multirresistentes. (Thesis). Federal University of Uberlândia. Retrieved from http://www.bdtd.ufu.br//tde_busca/arquivo.php?codArquivo=5042

Note: this citation may be lacking information needed for this citation format:
Not specified: Masters Thesis or Doctoral Dissertation

Chicago Manual of Style (16th Edition):

Ribeiro, Daniele Aparecida. “Trânsito de profissionais e pacientes de terapia intensiva entre diferentes hospitais: possível risco de disseminação de micorganismos multirresistentes.” 2013. Thesis, Federal University of Uberlândia. Accessed January 16, 2021. http://www.bdtd.ufu.br//tde_busca/arquivo.php?codArquivo=5042.

Note: this citation may be lacking information needed for this citation format:
Not specified: Masters Thesis or Doctoral Dissertation

MLA Handbook (7th Edition):

Ribeiro, Daniele Aparecida. “Trânsito de profissionais e pacientes de terapia intensiva entre diferentes hospitais: possível risco de disseminação de micorganismos multirresistentes.” 2013. Web. 16 Jan 2021.

Vancouver:

Ribeiro DA. Trânsito de profissionais e pacientes de terapia intensiva entre diferentes hospitais: possível risco de disseminação de micorganismos multirresistentes. [Internet] [Thesis]. Federal University of Uberlândia; 2013. [cited 2021 Jan 16]. Available from: http://www.bdtd.ufu.br//tde_busca/arquivo.php?codArquivo=5042.

Note: this citation may be lacking information needed for this citation format:
Not specified: Masters Thesis or Doctoral Dissertation

Council of Science Editors:

Ribeiro DA. Trânsito de profissionais e pacientes de terapia intensiva entre diferentes hospitais: possível risco de disseminação de micorganismos multirresistentes. [Thesis]. Federal University of Uberlândia; 2013. Available from: http://www.bdtd.ufu.br//tde_busca/arquivo.php?codArquivo=5042

Note: this citation may be lacking information needed for this citation format:
Not specified: Masters Thesis or Doctoral Dissertation

2. Sönnergren, Henrik. Electrosurgical plasma-mediated ablation for application in dermal wound and cartilage debridement - Biochemical, microbiological and clinical effects.

Degree: 2015, University of Gothenburg / Göteborgs Universitet

The state of matter known as plasma has in the latest decades been investigated within different areas of medical treatment. The work presented in this thesis has focused on a specific type of plasma-based electrosurgical treatment modality (Coblation®) and its biochemical, microbiological and clinical effects on treatment of cartilage and of dermal wounds. Paper I investigated the biochemical effects of plasma ablation exposure of human articular chondrocytes in vitro. The plasma ablation induced a well-defined area of immediate cell death, an increased chondrocyte proliferation and up-regulation of cytokines IL-6 and IL-8. Paper II investigated the in vitro antimicrobial effect of plasma ablation on Staphylococcus aureus, Streptococcus pyogenes, Pseudomonas aeruginosa, Escherichia coli and Candida albicans. The plasma ablation had a direct microbicidal effect on all strains compared to untreated control and a temperature control. Papers III and IV investigated the bacteria aerosol formation and wound bacteria reduction of debridement using curette, plasma ablation or hydrodebridement in an ex vivo porcine wound model inoculated with S. aureus. Plasma ablation significantly reduced the wound bacterial load, while curette and hydrodebridement resulted in minor or no reduction. Hydrodebridement gave a significant bacterial spread to the operative environment, while plasma ablation and curette debridement did not. Paper IV also used scanning electron microscopy to detect if there was a bacterial biofilm in the porcine wound model. Paper V investigated the effect of debridement using plasma ablation on ulcer healing, wound bacteria colonization, and complications to the treatment, in a clinical case series of 10 patients with venous ulcers. The procedure was fast and easy to perform and gave a clean wound bed. The wound area was significantly reduced with a mean of 44 % and 2 of 17 ulcers healed within 8 weeks. The wound bacterial load was reduced by treatment with 1.5 log CFU/ml. In conclusion, plasma ablation has a direct biochemical effect on chondrocytes indicating an onset of a tissue regeneration response. Plasma ablation can clinically be used for debridement of small ulcers in local anaesthesia. The bactericidal effect seen in vitro and ex vivo was confirmed clinically, which could be of value for the wound healing process. Further clinical studies should evaluate the plasma ablation method for use in other areas, such as in wound debridement prior to skin transplantation, diabetic foot ulcers, and burns.

Subjects/Keywords: ablation techniques; aerosol; antibacterial; arthroscopy; bacterial spread; bactericidal; bipolar radiofrequency; Candida albicans; cartilage; Coblation; debridement; electrosurgery; Escherichia coli; hydrosurgery; plume; Pseudomonas aeruginosa; Staphyloccus aureus; Streptococcus pyogenes

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APA · Chicago · MLA · Vancouver · CSE | Export to Zotero / EndNote / Reference Manager

APA (6th Edition):

Sönnergren, H. (2015). Electrosurgical plasma-mediated ablation for application in dermal wound and cartilage debridement - Biochemical, microbiological and clinical effects. (Thesis). University of Gothenburg / Göteborgs Universitet. Retrieved from http://hdl.handle.net/2077/38384

Note: this citation may be lacking information needed for this citation format:
Not specified: Masters Thesis or Doctoral Dissertation

Chicago Manual of Style (16th Edition):

Sönnergren, Henrik. “Electrosurgical plasma-mediated ablation for application in dermal wound and cartilage debridement - Biochemical, microbiological and clinical effects.” 2015. Thesis, University of Gothenburg / Göteborgs Universitet. Accessed January 16, 2021. http://hdl.handle.net/2077/38384.

Note: this citation may be lacking information needed for this citation format:
Not specified: Masters Thesis or Doctoral Dissertation

MLA Handbook (7th Edition):

Sönnergren, Henrik. “Electrosurgical plasma-mediated ablation for application in dermal wound and cartilage debridement - Biochemical, microbiological and clinical effects.” 2015. Web. 16 Jan 2021.

Vancouver:

Sönnergren H. Electrosurgical plasma-mediated ablation for application in dermal wound and cartilage debridement - Biochemical, microbiological and clinical effects. [Internet] [Thesis]. University of Gothenburg / Göteborgs Universitet; 2015. [cited 2021 Jan 16]. Available from: http://hdl.handle.net/2077/38384.

Note: this citation may be lacking information needed for this citation format:
Not specified: Masters Thesis or Doctoral Dissertation

Council of Science Editors:

Sönnergren H. Electrosurgical plasma-mediated ablation for application in dermal wound and cartilage debridement - Biochemical, microbiological and clinical effects. [Thesis]. University of Gothenburg / Göteborgs Universitet; 2015. Available from: http://hdl.handle.net/2077/38384

Note: this citation may be lacking information needed for this citation format:
Not specified: Masters Thesis or Doctoral Dissertation

3. Six, Anne. Caractérisation moléculaire et fonctionnelle de la protéine Srr2 et rôle dans l’hypervirulence du clone ST-17 de Streptococcus agalactiae : Molecular and functional characterization of Srr2, an ST-17 specific surface protein of Streptococcus agalactiae.

Degree: Docteur es, Microbiologie, 2013, Université Paris Descartes – Paris V

Streptococcus agalactiae est la première cause d’infections invasives chez le nouveau né et, malgré la mise en place de stratégies de prévention, cette bactérie reste le principal agent étiologique des infections néonatales. Les souches de séquence type 17, dites hyper-virulentes, sont particulièrement associées avec les méningites, type d’infection ayant des conséquences lourdes en terme de mortalité et morbidité. Ce clone possède des caractéristiques uniques, telle que la fixation au fibrinogène, ainsi qu’un répertoire de protéines de surface qui lui sont spécifiques. Parmi ces protéines, Srr2 appartient à une famille de larges glycoprotéines streptococcales et staphylococcales impliquées dans la pathogénicité. Un domaine central de Srr2, le domaine BR, est responsable de la fixation spécifique du fibrinogène par le clone ST-17, ainsi qu’au plasminogène et à divers composants de la matrice extracellulaire. Cette protéine promeut ainsi l’adhésion et le franchissement des barrières cellulaires. L’interaction de Srr2 avec les systèmes fibrinolytique et de coagulation de l’hôte favorise la dissémination bactérienne par l’activation de la fibrinolyse, et la persistance de la bactérie dans l’organisme par la formation d’agrégats bactériens. La liaison de Srr2 avec le fibrinogène semble également promouvoir la persistance bactérienne en favorisant l’internalisation et la survie dans les macrophages. Ainsi, la protéine Srr2 confère un avantage pour le processus infectieux du clone ST-17 dans l’hôte, et constitue une cible vaccinale intéressante pour la prévention des infections à S. agalactiae.

Streptococcus agalactiae is the leading cause of invasive infections in neonates. Despite the implementation of prevention strategies, this bacterium remains the main etiological agent of neonatal infections. Hyper-virulent sequence-type 17 strains are particularly associated with meningitis, a type of infection with serious consequences in terms of mortality and morbidity. This clone has unique characteristics, such as fibrinogen binding, and a panel of specific surface proteins. Among these proteins, Srr2 belongs to a family of large streptococcal and staphylococcal glycoproteins involved in pathogenicity. A central domain of Srr2, BR domain, is responsible for the specific binding of fibrinogen by the ST -17 clone and also binds plasminogen and various components of the extracellular matrix. Thereby, it promotes adhesion and crossing of cellular barriers. The interaction of Srr2 with fibrinolytic and coagulation systems of the host could promote bacterial spread through the activation of fibrinolysis and the persistence of the bacteria in the host by the formation of bacterial aggregates. The interaction of Srr2 with fibrinogen also seems to promote bacterial persistence in promoting the internalization and survival of the bacteria in macrophages. Thus, Srr2 confers an advantage to the infectious process of the ST- 17 clone in the host and is an attractive vaccine candidate for the prevention of S. agalactiae infections.

Advisors/Committee Members: Poyart, Claire (thesis director).

Subjects/Keywords: Streptococcus agalactiae; Complexe clonal hyper-virulent; Protéine de surface; Srr2; Fibrinogène; Dissémination; Persistance; Barrière cellulaire; Virulence; Streptococcus agalactiae; Hyper-virulent clonal complex; Surface protein; Srr2; Fibrinogen; Bacterial spread; Persistence; Cellular barrier; Virulence; 616.904 1

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APA · Chicago · MLA · Vancouver · CSE | Export to Zotero / EndNote / Reference Manager

APA (6th Edition):

Six, A. (2013). Caractérisation moléculaire et fonctionnelle de la protéine Srr2 et rôle dans l’hypervirulence du clone ST-17 de Streptococcus agalactiae : Molecular and functional characterization of Srr2, an ST-17 specific surface protein of Streptococcus agalactiae. (Doctoral Dissertation). Université Paris Descartes – Paris V. Retrieved from http://www.theses.fr/2013PA05T038

Chicago Manual of Style (16th Edition):

Six, Anne. “Caractérisation moléculaire et fonctionnelle de la protéine Srr2 et rôle dans l’hypervirulence du clone ST-17 de Streptococcus agalactiae : Molecular and functional characterization of Srr2, an ST-17 specific surface protein of Streptococcus agalactiae.” 2013. Doctoral Dissertation, Université Paris Descartes – Paris V. Accessed January 16, 2021. http://www.theses.fr/2013PA05T038.

MLA Handbook (7th Edition):

Six, Anne. “Caractérisation moléculaire et fonctionnelle de la protéine Srr2 et rôle dans l’hypervirulence du clone ST-17 de Streptococcus agalactiae : Molecular and functional characterization of Srr2, an ST-17 specific surface protein of Streptococcus agalactiae.” 2013. Web. 16 Jan 2021.

Vancouver:

Six A. Caractérisation moléculaire et fonctionnelle de la protéine Srr2 et rôle dans l’hypervirulence du clone ST-17 de Streptococcus agalactiae : Molecular and functional characterization of Srr2, an ST-17 specific surface protein of Streptococcus agalactiae. [Internet] [Doctoral dissertation]. Université Paris Descartes – Paris V; 2013. [cited 2021 Jan 16]. Available from: http://www.theses.fr/2013PA05T038.

Council of Science Editors:

Six A. Caractérisation moléculaire et fonctionnelle de la protéine Srr2 et rôle dans l’hypervirulence du clone ST-17 de Streptococcus agalactiae : Molecular and functional characterization of Srr2, an ST-17 specific surface protein of Streptococcus agalactiae. [Doctoral Dissertation]. Université Paris Descartes – Paris V; 2013. Available from: http://www.theses.fr/2013PA05T038

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