The state of the bats in North America.

The world's rich diversity of bats supports healthy ecosystems and important ecosystem services. Maintaining healthy biological systems requires prompt identification of threats to biodiversity and immediate action to protect species, which for wide-ranging bat species that span geopolitical boundaries warrants international coordination. Anthropogenic forces drive the threats to bats throughout North America and the world.

Needleless connector nursing care - Current practices, knowledge, and attitudes: An Australian perspective.

Background: Inappropriate needleless connector (NC) care is associated with device failure from catheter occlusion and patient blood stream infections (BSIs). This can be attributed to a lack of knowledge of connector designs and flushing, clamping, and syringe disconnection techniques. This study aimed to assess nurses' practice, knowledge, attitudes, and key influencers on appropriate care of NCs in an Australian facility and compare these with studies undertaken in the United States in 2011.

Peripheral intravenous catheter needleless connector decontamination study-Randomized controlled trial.

Background: Needleless connectors (NCs) were introduced to reduce health care work needlestick injuries (NSIs). If not decontaminated prior to use, NCs can be a portal for patient blood stream infections. The optimal disinfectant, and its application duration, for NC decontamination has not been empirically established.

The coordinated action of PPR4 and EMB2654 on each intron half mediates trans-splicing of rps12 transcripts in plant chloroplasts.

The pentatricopeptide repeat proteins PPR4 and EMB2654 have been shown to be required for the trans-splicing of plastid rps12 transcripts in Zea mays (maize) and Arabidopsis, respectively, but their roles in this process are not well understood. We investigated the functions of the Arabidopsis and Oryza sativa (rice) orthologs of PPR4, designated AtPPR4 (At5g04810) and OsPPR4 (Os4g58780). Arabidopsis atppr4 and rice osppr4 mutants are embryo-lethal and seedling-lethal 3 weeks after germination, respectively, showing that PPR4 is essential in the development of both dicot and monocot plants.

Microorganisms present on peripheral intravenous needleless connectors in the clinical environment.

The aim of this study was to quantify culturable microorganisms on needleless connectors (NCs) attached to peripheral intravenous catheters in hospitalized adult medical patients. Half (50%) of 40 NCs were contaminated with microorganisms commonly found on the skin or mouth. Staphylococcus capitis and Staphylococcus epidermidis were most commonly isolated.

Mycobacterium Chelonae associated with rapid erosion of non-sutured laparoscopic gastric band.

Introduction: To describe a case of rapidly eroded laparoscopic placed non-sutured gastric band secondary to Mycobacterium chelonae.

Presentation Of Case: A 65 year old male, who had undergone laparoscopic gastric banding two months prior for morbid obesity, presented to the clinic complaining of abdominal pain and night time fever of 4days duration. Urgent gastroscopy revealed eroded gastric band which was removed laparoscopically.

First report of Entamoeba histolytica infection from Timor-Leste--acute amoebic colitis and concurrent late development of amoebic liver abscess in returned travellers to Australia.

This communication reports invasive amoebic colitis and late onset amoebic liver abscess in three members of a group of 12 Australian travellers to Timor-Leste (TL). This is the first report of Entamoeba histolytica infection from TL. Clinicians in Australia need to consider amoebiasis in the differential diagnosis in travellers returning with colitis, abdominal pain and fever.

Poor compliance with community-acquired pneumonia antibiotic guidelines in a large Australian private hospital emergency department.

Aims: This study evaluated guideline concordance and time to administration of antibiotics in community-acquired pneumonia (CAP) in a private Australian emergency department (ED). Two key components in the management of CAP are timely administration and appropriate choice of antibiotic therapy. The use of antibiotics outside of guidelines can potentially increase rates of antibiotic resistance.

A hierarchical spatial modelling approach to investigate MRSA transmission in a tertiary hospital.

Background: Most hospitals have a hierarchical design with beds positioned within cubicles and cubicles positioned within wards. Transmission of MRSA may be facilitated by patient proximity and thus the spatial arrangements of beds, cubicles and wards could be important in understanding MRSA transmission risk. Identifying high-risk areas of transmission may be useful in the design of more effective, targeted MRSA interventions.

Routine versus clinically indicated replacement of peripheral intravenous catheters: a randomised controlled equivalence trial.

Background: The millions of peripheral intravenous catheters used each year are recommended for 72-96 h replacement in adults. This routine replacement increases health-care costs and staff workload and requires patients to undergo repeated invasive procedures. The effectiveness of the practice is not well established.

Perceptions of healthcare professionals regarding the main challenges and barriers to effective hospital infection control in Mongolia: a qualitative study.

Background: It is not fully understood why healthcare decision-makers of developing countries often give low priority to infection control and why they are unable to implement international guidelines. This study aimed to identify the main perceived challenges and barriers that hinder the effective implementation of infection control programmes in Mongolia.

Methods: In 2008, qualitative research involving 4 group and 55 individual interviews was conducted in the capital city of Mongolia and two provincial centres.

Using a checklist to identify barriers to compliance with evidence-based guidelines for central line management: a mixed methods study in Mongolia.

Objectives: This study aimed to determine the extent to which a checklist has potential for identifying barriers to compliance with central line management guidelines, to evaluate the potential utility of checklists to improve the management of central lines in Mongolia, and to define the gap between current and best practices.

Methods: A 22-item checklist was developed based on the Centers for Disease Control and Prevention (CDC, USA) guidelines and existing central line-associated bloodstream infection (CLABSI) checklists. The checklist was used to observe 375 central line procedures performed in the intensive care units of four tertiary hospitals of Mongolia between July and December 2010.

Gaming in infection control: a qualitative study exploring the perceptions and experiences of health professionals in Mongolia.

Background: This study aimed to gain insight into the extent to which gaming is responsible for the underreporting of hospital-acquired infections (HAIs) in Mongolian hospitals, to identify gaming strategies used by health professionals, and to determine how gaming might be prevented.

Methods: Eighty-seven health professionals, including policy- and hospital-level managers, doctors, nurses, and infection control practitioners, were recruited for 55 interviews and 4 group discussions in Mongolia in 2008.

Results: All study participants were aware of gaming, which could occur via the following mechanisms: (1) doctors or nurses concealing HAI by overprescribing antibiotics or discharging patients early; (2) infection control practitioners failing to report HAI cases to hospital directors; and (3) hospital directors preventing reporting of HAI cases to the Ministry of Health.

Patient safety culture: factors that influence clinician involvement in patient safety behaviours.

Objectives: To develop an understanding of the factors that influence patient safety-related behaviours by nurses, doctors and allied health staff employed by Queensland Health, using a theory-driven behavioural model.

Design: Cross-sectional survey analysed with multiple logistic regression.

Setting: Metropolitan, regional and rural public hospitals in Queensland, Australia.

Aciclovir-resistant herpes keratitis.

Herpes simplex virus (HSV) keratitis is a common cause of ocular morbidity. Resistance to aciclovir is probably under recognized. We describe three cases of aciclovir-resistant herpes simplex virus keratitis treated with systemic foscarnet and present a review of the pharmacological options available to manage this condition.

Intradermal versus intramuscular hepatitis B vaccination in hemodialysis patients: a prospective open-label randomized controlled trial in nonresponders to primary vaccination.

Background: Primary hepatitis B virus (HBV) vaccination through the intramuscular (IM) route is less efficacious in dialysis patients than in the general population. Previous studies suggest improved seroconversion with intradermal (ID) vaccination.

Study Design: Prospective open-label randomized controlled trial.

Cost effectiveness of antimicrobial catheters in the intensive care unit: addressing uncertainty in the decision.

Introduction: Some types of antimicrobial-coated central venous catheters (A-CVC) have been shown to be cost effective in preventing catheter-related bloodstream infection (CR-BSI). However, not all types have been evaluated, and there are concerns over the quality and usefulness of these earlier studies. There is uncertainty amongst clinicians over which, if any, A-CVCs to use.

Conjunctival and episcleral Splendore-Hoeppli phenomenon.

The Splendore-Hoeppli phenomenon originally described in 1908 is a rare pathological state with an as yet unknown cause. Reported is the Splendore-Hoeppli phenomenon present in both eyes of a 36-year-old woman. The pathology then proceeded to resolve itself completely within 10 weeks.

Surveillance of healthcare-acquired infections in Queensland, Australia: data and lessons from the first 5 years.

Objective: To present healthcare-acquired infection surveillance data for 2001-2005 in Queensland, Australia.

Design: Observational prospective cohort study.

Setting: Twenty-three public hospitals in Queensland.

Potential effect of excluding variant Creutzfeldt-Jakob disease on the eye donor pool in Australia.

Purpose: To quantitate the likely effect on the available eye donor pool by excluding potential donors who may have had exposure to variant Creutzfeldt-Jakob disease by virtue of spending time in countries where bovine spongiform encephalopathy (BSE) is endemic.

Methods: A telephone survey by systematic sampling from the Brisbane phone directory was undertaken to ascertain the number of potential donors who had resided in the United Kingdom and in other countries.

Results: Between 19% of potential donors would have had to have been excluded by virtue of residing in the United Kingdom for >6 months between 1980 and 1996 and 29% for those who had traveled to any other country in which BSE was identified.

Overcrowding and understaffing in modern health-care systems: key determinants in meticillin-resistant Staphylococcus aureus transmission.

Recent decades have seen the global emergence of meticillin-resistant Staphylococcus aureus (MRSA), causing substantial health and economic burdens on patients and health-care systems. This epidemic has occurred at the same time that policies promoting higher patient throughput in hospitals have led to many services operating at, or near, full capacity. A result has been limited ability to scale services according to fluctuations in patient admissions and available staff, and hospital overcrowding and understaffing.