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  • 1.
    Alsterlund, Rolf
    et al.
    Department of Infectious Diseases, Central Hospital, Kristianstad.
    Axelsson, Carolina
    Kristianstad University, School of Education and Environment, Avdelningen för Naturvetenskap. Kristianstad University, Forskningsmiljön PRO-CARE.
    Olsson-Liliequist, Barbro
    Unit of Antibiotics and Infection Control, Swedish Institute for Communicable Disease Control, Solna.
    Long-term carriage of extended-spectrum beta-lactamase-producing Escherichia Coli2012In: Scandinavian Journal of Infectious Diseases, ISSN 0036-5548, E-ISSN 1651-1980, Vol. 44, no 1, p. 51-54Article in journal (Refereed)
    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.

  • 2.
    Axelsson, Carolina
    et al.
    Kristianstad University, School of Education and Environment, Avdelningen för Naturvetenskap. Kristianstad University, Research environment Man & Biosphere Health (MABH).
    Rehnstam-Holm, Ann-Sofi
    Kristianstad University, School of Education and Environment, Avdelningen för Naturvetenskap. Kristianstad University, Research environment Man & Biosphere Health (MABH).
    Nilsson, B
    Lund University.
    Optimization of several parameters in order to reduce time in antibiotic susceptibility testing in a clinical laboratory2017Conference paper (Other academic)
    Abstract [en]

    Background - When sepsis or bacteraemia is suspected, patient blood samples are cultivated in blood culture bottles and then further incubated for identification of the organism and antimicrobial susceptibility testing. These methods are slow, identifying causative pathogens in a couple of hours, and antibiotic susceptibility results within 18-36 hours.

    Here we present optimization of several parameters in order to evaluate if the MBT ASTRA™ method can be a rapid tool, used for routine antibiotics susceptibility testing, in a clinical laboratory.

    Methods – MALDI-TOF MS measurements were performed with a Microflex LT/SH bench-top mass spectrometer (Bruker) with standard settings. The resulting spectra were uploaded in the MBT-ASTRA™ software, which normalizes the peaks and determines the AUC and RG values for each setup.

    Results - The bacterial preparation steps generated a new protocol, which reduced time with 30-60 minutes.

    The antibiotics susceptibility test was optimized for 90 minutes incubation time. 200 µl McFarland 0.5 bacterial suspension in broth were incubated in broth at 37°C, with and without 32 µg/ml Cefotaxime, 16 µg/ml Meropenem and 4 µg/ml Ciprofloxacin.

    The suspensions were transferred to 0.45 µm pore size filter membraned 96 well plate. They were centrifuged; washed; fixated and eluted; put on a MALDI-target, and covered by matrix solution. All could be automated with robot, which reduced time with 60 minutes.

    Conclusion – Rapid susceptibility testing becomes more requested with the increase of resistance bacteria causing infections. Our study can be a valuable tool for clinical laboratories striving for reduction in time handling of antibiotic susceptibility testing.

  • 3.
    Rehnstam-Holm, Ann-Sofi
    et al.
    Kristianstad University, School of Education and Environment, Avdelningen för Naturvetenskap. Kristianstad University, Research environment Man & Biosphere Health (MABH).
    Axelsson, Carolina
    Kristianstad University, School of Education and Environment, Avdelningen för Naturvetenskap. Kristianstad University, Research environment Man & Biosphere Health (MABH).
    ESBL resistance patterns among environmental and clinical bacterial isolates2017Conference paper (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.

     

  • 4.
    Rehnstam-Holm, Ann-Sofi
    et al.
    Kristianstad University, Faculty of Natural Science, Research environment Man & Biosphere Health (MABH). Kristianstad University, Faculty of Natural Science, Avdelningen för miljö- och biovetenskap.
    Axelsson, Carolina
    Kristianstad University, Faculty of Natural Science, Research environment Man & Biosphere Health (MABH). Kristianstad University, Faculty of Natural Science, Avdelningen för miljö- och biovetenskap.
    Forskningsanknuten grundutbildning: utbildningsanknuten forskning?2018In: Man and Biosphere Health: en komplett akademisk miljö / [ed] Ann-Sofi Rehnstam-Holm, Kristianstad: Högskolan Kristianstad , 2018, p. 8-15Chapter in book (Other academic)
    Abstract [sv]

    Begreppet forskningsanknuten utbildning kan definieras på ett flertal sätt. Idealt ska studenterna inom sin utbildning stöta på forskning genom att få kännedom om aktuell forskning och vara praktiskt involverade i forskningsprojekt. För att detta ska uppnås bör majoriteten av lärarna vara forskningsaktiva inom för utbildningen relevanta områden och att ett vetenskapligt förhållningssätt till kunskap förmedlar på bästa pedagogiska sätt också detta förankrat i forskning. I den här artikeln ger vi exempel på hur studenter har involverats i våra forskningsprojekt både på högskolan, på universitetssjukhuset i Lund och vid internationella universitet och forskningsstationer.

  • 5.
    Ulander, Kerstin
    et al.
    Kristianstad University, Department of Health Sciences.
    Torfadóttir, Òlina
    Axelsson, Carolina
    Kristianstad University, Department of Health Sciences.
    Westergren, Albert
    Kristianstad University, Department of Health Sciences.
    Lindholm, Christina
    Kristianstad University, Department of Health Sciences.
    Eating and nutrition2007Report (Other academic)
  • 6.
    Westergren, Albert
    et al.
    Kristianstad University College, School of Health and Society.
    Hedin, Gita
    Kristianstad University College, School of Health and Society.
    Axelsson, Carolina
    Kristianstad University College, School of Teacher Education.
    Långvarig och akut smärta: hos patienter och boende: en studie genomförd av studenter på sjuksköterskeprogrammet2009Report (Other academic)
    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.

  • 7.
    Westergren, Albert
    et al.
    Kristianstad University, School of Health and Society, Avdelningen för Hälsovetenskap. Kristianstad University, Research Environment PRO-CARE.
    Torfadóttir, Ólina
    Akureyri Hospital, Iceland.
    Ulander, Kerstin
    Kristianstad University, School of Health and Society.
    Axelsson, Carolina
    Kristianstad University, School of Education and Environment, Avdelningen för Naturvetenskap. Kristianstad University, Research Environment PRO-CARE.
    Lindholm, Christina
    Kristianstad University, School of Health and Society.
    Malnutrition prevalence and precision in nutritional care: an intervention study in one teaching hospital in Iceland2010In: Journal of Clinical Nursing, ISSN 0962-1067, E-ISSN 1365-2702, Vol. 19, no 13-14, p. 1830-1837Article in journal (Refereed)
    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.

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