Aisling Semple graduated from medicine in the National University of Ireland Galway in 2012. She is specialising in paediatrics and has recently achieved membership to the Royal College of Paediatricians in Ireland. She has a special interest in MRSA in the neonatal population and has presented and published, both nationally and internationally on the topic.
Background: Nosocomially acquired methicillin- resistant Staphylococcus aureus (MRSA) is a significant cause of morbidity and mortality in the neonatal intensive care unit (NICU). Current national guidelines recommend active surveillance in the NICU by screening all infants for MRSA carriage on admission to NICU and weekly thereafter, with isolation and decolonisation of affected infants. Following a 4-year period of endemic MRSA despite multiple attempts with standard infection control interventions, an endemic strain MRSA was finally eradicated from a tertiary unit NICU following complete unit refurbishment. Method: Surveillance, colonisation and infection data for a 4-year period pre and 3-year period post NICU refurbishment are described. Clinical and microbiological data were collected on all MRSA colonised and infected infants between 2008 and 2014. Microbiological and molecular typing data are available for all MRSA isolates. All eradication strategies are described. Results: During the 4-year pre-refurbishment period, following routine surveillance, 68 infants were documented to be colonised with MRSA. Almost all strains were from epidemic MRSA 15 clone, EMRSA-15 (Sequence Type 22 Staphylococcal Cassette Chromosome mec IV). Standard infection control eradication strategies including isolation, decontamination, staff education and staff screening failed to impact on colonisation rates. During the 3-year period since complete refurbishment and redesign of the NICU, there have been only 8 cases of MRSA colonised infants in the NICU. Four were already colonised on admission to NICU and clearly not NICU acquired; cross-transmission from one of these cases to one other infant occurred. There were three further, temporally unrelated, sporadic cases of MRSA colonisation. All of the post-refurbishment MRSA isolates were distinct from the previous endemic NICU strain based on Staphylococcal Protein A (spa) typing and pulsed-field gel electrophoresis (PFGE). Conclusion Infrastructure and overcrowding in the NICU contributed significantly to the failure to eradicate endemic MRSA in this setting. Successful eradication was ultimately achieved through complete unit refurbishment.
Pornpun Watcharavitoon has been working as a lecturer at School of Occupational Health and Safety, Institute of Medicine, Suranaree University of Technology, and currently studying in the field of Occupational Medicine and Industrial Hygiene, National Taiwan University (NTU).
The aim of this study is to estimate the expected number of mortality cases for Bangkok residential expose to outdoor air pollution. Road traffic is a significant source of air pollution in Bangkok. Using Bangkok air quality data were collected by Pollution Control Department, BKK, during 1996 - 2009 to calculate current annual mean concentration of PM10 (μg/m3) and mortality rate of disease group from the Ministry of Public Health, Thailand. The expected annual number of deaths from outdoor air pollution can be determined by using the quantitative assessment of the health impact of outdoor air pollution from inhalation exposure (Ostro 2004:WHO, 2004). For short-term exposure to PM10, The annual number of deaths from outdoor air pollution of all-cause mortality at all age, and Respiratory mortality at age< 5 years, in roadside areas were higher than that in residential areas 1,799 deaths/year (95% CI, 1,357 – 2,235), 95 deaths/year (95% CI, 20 -164), and 1,285 deaths/ year (95% CI, 968 – 1,599), 68 deaths/year (95% CI, 14 - 120), respectively. Much more benefits would be gained for long-term exposure to PM2.5, The annual number of deaths from outdoor air pollution of Cardiopulmonary mortality at age> 30 years, and Lung cancer at age> 30 years, in roadside areas were higher than that in residential areas 2,385 deaths/year (95% CI, 966 – 3,509), 200 deaths/year (95% CI, 87 - 280), and 2167 deaths/year (95% CI, 868 – 3,222), 183 deaths/year (95% CI, 78 - 260), respectively. Public exposure to particulate matter is associated with premature mortality. Estimates of the burden of disease attributed to outdoor air pollution can help fix the priority for controlling air pollution by Government policy not only to put control device on vehicle and improved standard combustion technology including fuel quality but also to design land use for develop public transport system to protect human health.