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Rehnstam-Holm, A.-S. & Axelsson, C. (2017). ESBL resistance patterns among environmental and clinical bacterial isolates. In: : . Paper presented at Focused Meeting 2017: Antimicrobial Resistance and One Health 29 - 30 August 2017.
Open this publication in new window or tab >>ESBL resistance patterns among environmental and clinical bacterial isolates
2017 (English)Conference paper, Oral presentation with published abstract (Other academic)
Abstract [en]

Objectives

We have studied the phenotypic and genetic pattern among Extended Spectrum Beta-lactamase (ESBL) producing bacteria in the aquatic environment, and have compared the result with clinical samples from the same area.

Methods

Water samples have been collected at three different sites in the Helge river, Kristianstad community, Sweden. The first station is located before the outlet from the municipal sewage plant, the second just after the outlet and the third close to the Baltic Sea. Cultured bacterial isolates from the water and clinical isolates were analysed for phenotypic expression of ESBL related genes using the MAST-test, and genetically by PCR analyses of a set of ESBL genes, i.e. blaCTX-M, blaSHV, blaTEM, and blaOXA  

Results

Both clinical and environmental ESBL isolates were dominated by Escherichia coli and Klebsiella pneumoniae. Highest abundance of environmental ESBL isolates were obtained from the station close to the sewage outlet, the lowest close to the Baltic Sea. The gene cluster blaCTX-M was the most common among all isolates (65%), followed by blaTEM (30%).  The blaOXA and blaSHV genes were more common in clinical isolates.

Conclusion

A majority of the ESBL bacteria were mediated by chromosomal genes, dominated by blaCTX-M. However, blaOXA .and blaSHV were more common in clinical isolates. Further genetic analyses will be performed on more isolates, and on total bacterial community DNA.

 

National Category
Natural Sciences
Identifiers
urn:nbn:se:hkr:diva-17536 (URN)
Conference
Focused Meeting 2017: Antimicrobial Resistance and One Health 29 - 30 August 2017
Available from: 2017-10-17 Created: 2017-10-17 Last updated: 2017-10-17Bibliographically approved
Alsterlund, R., Axelsson, C. & Olsson-Liliequist, B. (2012). Long-term carriage of extended-spectrum beta-lactamase-producing Escherichia Coli. Scandinavian Journal of Infectious Diseases, 44(1), 51-54
Open this publication in new window or tab >>Long-term carriage of extended-spectrum beta-lactamase-producing Escherichia Coli
2012 (English)In: Scandinavian Journal of Infectious Diseases, ISSN 0036-5548, E-ISSN 1651-1980, Vol. 44, no 1, p. 51-54Article in journal (Refereed) Published
Abstract [en]

In 2009 we described an outbreak caused by extended-spectrum beta-lactamase (ESBL)-producing Escherichia coli in southern Sweden that occurred during 2005–2006. An important finding from the investigation was the long carriage times of the ESBL-producing E. coli in several of the patients, which in some cases exceeded 30 months. Here we report findings from the continued follow-up of bacterial carriage. In September 2010, 5 of the 42 patients still carried the bacteria after a median of 58 months (range 41–59 months), 18 had had repeatedly negative cultures after shedding bacteria for a median of 7.5 months (range 0–39 months), 16 had died while still shedding the bacteria for a median of 9 months (range 0–38 months), and 3 had been lost to follow-up.

Keywords
ESBL-producing Escherichia coli, PFGE, long-term carriage, outbreak
National Category
Infectious Medicine
Identifiers
urn:nbn:se:hkr:diva-8857 (URN)10.3109/00365548.2011.592987 (DOI)000298297200010 ()21736509 (PubMedID)
Available from: 2012-01-09 Created: 2012-01-09 Last updated: 2017-12-08Bibliographically approved
Westergren, A., Torfadóttir, Ó., Ulander, K., Axelsson, C. & Lindholm, C. (2010). Malnutrition prevalence and precision in nutritional care: an intervention study in one teaching hospital in Iceland. Journal of Clinical Nursing, 19(13-14), 1830-1837
Open this publication in new window or tab >>Malnutrition prevalence and precision in nutritional care: an intervention study in one teaching hospital in Iceland
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2010 (English)In: Journal of Clinical Nursing, ISSN 0962-1067, E-ISSN 1365-2702, Vol. 19, no 13-14, p. 1830-1837Article in journal (Refereed) Published
Abstract [en]

Aim. The aim of this study was to explore the point prevalence of malnutrition and the targeting of nutritional interventions in relation to undernutrition risk before and after an intervention. Background. Malnutrition risk and the precision in targeting nutritional treatment are indicators of quality of care. Knowledge regarding the in-hospital prevalence of malnutrition and nutritional treatment is meagre for Iceland. Design. Pre- and postintervention study. Methods. The study was performed during one day in 2006 (March) and one day in 2007 (April). In total, 95 (89%) and 92 (88%) patients agreed to participate. Moderate/high undernutrition risk was defined as the occurrence of at least two of the following: involuntary weight loss, body mass index below limit and eating difficulties according to Minimal Eating Observation Form - Version II. Being overweight was graded based on body mass index. Specific nutritional care actions were recorded. Intervention: A five-point programme for nutrition and eating was implemented. Results. Moderate/high risk for undernutrition was found in 25 and 17% in the two years (ns, not significant). A high body mass index was found in 53 and 54% (ns). The number of patients with a documented body mass index significantly increased between the two surveys (1 and 30%, p-value < 0 center dot 0005). The use of oral supplements increased from 11-40% (p < 0 center dot 0005) and especially among those at no/low undernutrition risk, with ingestion or deglutition difficulties (p < 0 center dot 0005 in both cases) but not among those with appetite and energy problems (ns). Conclusion. Implementing a nutritional programme does not necessarily affect the number of in-patients with malnutrition, but it is likely to increase the precision of nutritional care to some extent. Relevance to clinical practice. Greater efforts need to be taken to increase the precision of nutritional care among patients at moderate/high undernutrition risk and among those with appetite and energy problems.

Keywords
Iceland, MEOF-II, nurses, nursing, overweight, undernutrition
National Category
Nutrition and Dietetics
Identifiers
urn:nbn:se:hkr:diva-7205 (URN)10.1111/j.1365-2702.2009.03179.x (DOI)000278802400008 ()20920010 (PubMedID)
Available from: 2010-09-06 Created: 2010-09-06 Last updated: 2017-12-12Bibliographically approved
Westergren, A., Hedin, G. & Axelsson, C. (2009). Långvarig och akut smärta: hos patienter och boende: en studie genomförd av studenter på sjuksköterskeprogrammet. Kristianstad
Open this publication in new window or tab >>Långvarig och akut smärta: hos patienter och boende: en studie genomförd av studenter på sjuksköterskeprogrammet
2009 (Swedish)Report (Other academic)
Abstract [sv]

Syftet med studien var att kartlägga smärta och smärtbehandling hos patienter på sjukhus och hos boende i särskilt och ordinärt boende.

Metod: Datainsamlingen utfördes av sjuksköterskestudenter under verksamhetsförlagd utbildning på sjukhus och i särskilt/ordinärt boende våren 2009. Även kliniska adjunkter/kliniska lärare var behjälpliga vid datainsamlingen. Studenterna fick genom datainsamlingen träning i att ge information till personal och patienter/boende, sammanställa resultatet från enheten, samt att återrapportera och reflektera över resultaten. Studien genomfördes ej som en totalundersökning, m.a.o. det är ett urval av respondenter som kommit att ingå i resultatet.

 Resultat:

Totalt genomfördes 419 stycken smärtbedömningar. Av respondenterna uppgav 35% att de hade långvarig smärta och 14% att de hade akut smärta. Personer med långvarig smärta var äldre (76 år respektive 69 år), oftare kvinnor (67% respektive 53%) och bodde i störst utsträckning i särskilt/ordinärt boende (37% respektive 17%) än de med akut smärta. Respondenterna med akut smärta angav oftare att personalen frågade om de hade ont (84% respektive73%) medan personerna med långvarig smärta i större utsträckning angav att de i det längsta försökte låta bli att visa att de hade ont (akut smärta: 43%, respektive långvarig smärta 59%). De vanligaste strategierna vid akut smärta var att be om något för smärtan (84%), lägga sig och vila (78%), eller att försöka tänka på något annat (64%). De vanligaste strategierna vid långvarig smärta var att lägga sig och vila (83%), be om något för smärtan (73%) eller att försöka tänka på något annat (70%). Av de studenter som utvärderade sin medverkan (n=51) upplevde 74% att de fick bättre vetenskaplig förståelse 51%  ett ökat intresse för smärtbedömning och 55% ökade kunskaper om ämnet smärta.

 Konklusion:

Långvarig smärta var vanligast förekommande hos kvinnor och bland äldre personer.

Strategierna för hur personer gör personalen uppmärksam på att man har värk/smärta och för hur man hanterar sin smärta skiljer sig åt beroende på om man har akut eller långvarig smärta. Att delta i datainsamling och andra forskningsaktiviteter har en positiv effekt för sjuksköterskestudenters förståelse av forskning och även för deras intresse för området som studeras.

Abstract [en]

The aim of the study was to map out pain and pain treatment among patients in hospitals and persons in special accommodations as well as in ordinary living.

Method: Nurse students collected the data during their clinical education at hospitals and in special accommodations or in ordinary living. Also the clinical teachers helped out with supporting the students during data collection. The students made assessments of pain where they had their clinical practice during the spring 2009. The students got, though collecting data, a training in how to provide information to the staff and patients/residents, compile results and to give feed-back about the findings to the department. The study was not conducted as a total survey, in other words was a selection of respondents that were included in the results.

Results: In total 419 assessments of pain was made and 35% of respondents reported long standing pain and 14% reported acute pain. The respondents with long standing pain were older (76 years and 69 years respectively), more women (67% and 53% respectively) and more were in special accommodations or in ordinary living (37% and 17% respectively) than among those with acute pain. The respondents with acute pain more often agreed with that the staff asked about if he/she had pain (84% and 73% respective) while the respondents with long standing pain to a greater extent agreed with that they tried to hide their own pain (acute pain: 43% resp. long standing pain: 59%). The most common strategies to handle the pain among those with acute pain was to ask for something to alleviate the pain (84%), lie down and rest (78%) or to try thinking on something else (64%) while it among those with long standing pain was to lie down and rest (83%), ask for something to alleviate the pain (73%) or to try thinking on something else (70%). Of the students that collected the data and reported the findings to the staff 51 also evaluated their participation in the study. Of these, 74% experienced that their understanding for research increased, 51% that their interest för pain assessment had increased and 55% that their knowledge about pain had increased.

 Conclusion:

Long standing pain was most common among women and elderly persons. The strategies used among the participants for making staff aware about the pain, and the strategies to handle once own pain differed depending on weather the pain was acute or long standing. Participating in the data collection and other research activities has a positive effect for nursing students understanding for research and to some extent for their interest in the area under study.

Place, publisher, year, edition, pages
Kristianstad: , 2009. p. 25
Series
Klinisk patientnära forskning, ISSN 1654-1421 ; 24
Keywords
Hospital, pain measurement, pain treatment, special accommodation, student participation, VAS, Sjukhus, smärtbedömning, smärtbehandling, studentmedverkan, särskilt boende, vas-skala
National Category
Nursing Social Sciences Interdisciplinary
Identifiers
urn:nbn:se:hkr:diva-5343 (URN)
Available from: 2009-12-10 Created: 2009-12-01 Last updated: 2018-01-12Bibliographically approved
Ulander, K., Torfadóttir, Ò., Axelsson, C., Westergren, A. & Lindholm, C. (2007). Eating and nutrition. Kristianstad: Högskolan Kristianstad
Open this publication in new window or tab >>Eating and nutrition
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2007 (English)Report (Other academic)
Place, publisher, year, edition, pages
Kristianstad: Högskolan Kristianstad, 2007
Series
Klinisk patientnära forskning, ISSN 1654-1421 ; 19
Keywords
Eating, Nutrition
National Category
Nutrition and Dietetics
Identifiers
urn:nbn:se:hkr:diva-5430 (URN)
Available from: 2009-12-07 Created: 2009-12-07 Last updated: 2014-06-10Bibliographically approved
Organisations
Identifiers
ORCID iD: ORCID iD iconorcid.org/0000-0003-0724-2718

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