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Prevention of nosocomial aspergillosis:-A multidisciplinary approach
FIS 98 Abstracts THE DESIGN, DEVELOPMENT AND RUNNING OF A WEBSITE FOR MEDICAL EDUCATION: THE ASPERGILLUS WEBSITE AS AN EXAMPLE. E. Prebble. M.J. Anderson and D.W. Denning Department of Medicine, University of Manchester, Manchester, U.K. The Aspergillus web site was launched by the Fungal Research Trust in April 1998 and is hosted at the University ofManchester (http://www.aspergillus.man.ac.uk). Thesite primarily aims to provide comprehensive medical and scientific information, in addition to a platform for discussion, about pathogenic Aspergilli. The site is focused towards scientific researchers and clinicians. However, the site also contains a lay person’s description of Aspergiiius in many different languages and the lay public is welcome to use the site’s facilities. We will discuss the plus and minus points in the design and running of websites for medical purposes, for example the design of the front page, registration, insurance and disclaimers, copyright, databases, links to other sites; discussion groups, audio/video services and the need for constant updates. We will also discuss the services we are planning to run and some of the site’s statistics.
PREVENTION OF NOSOCOMIAL ASPERGILLOSIS:A MULTIDISCIPLINARY APPROACH. F Fitzpatrick, S F’rout, A Gilleece, WW Hall, LE Fenelon and OM Murphy. Dept. of Clinical Microbiology, StVincents Hospital, Dublin, Ireland. The association between building works and outbreaks of aspergillosis is well established, Guidelines for the prevention of nosocomial aspergillosis have been issued by the CDC; however in our experience implementation of these can prove dit3icuIt. In anticipation of major renovation in an area adjacent to our Liver Transplant and Oncology units, the Infection Control Team (ICT) formulated recommendations aimed at protecting these patients. Despite this, three cases of aspergillus colonisation were identitied in the liver transplant unit during the works period. Further investigation revealed that: (a) Work thought to be insignificant, had commenced three weeks prior to the plamted date and prior to implementation of the recommendations. (b) Intolerable working conditions for staff resulted in failure to comply with the recommended window closures. (c) Confusion existed over whose responsibility it was to ensurethat all recommendations were enacted. experience has led us to conclude that: (a) The ICT should be involved in the early stages of all building work in the hospital. (b) Engineers/Builders should be educated regarding current best practice, require regular updating, and need to work closely with the ICT. (c) The extra costs incurred by environmental sealing, air filtration, prophylaxis, and providing a tolerable working environment for staff, should be included in the initial planning budget. Our
THE SAFETY AND PHARMACOKfNETICS OF ZD0870, A NOVEL AZOLE ANTIFUNGAL AGENT Moss PJ, *Smith RP, *Yates RA; Regional Infectious Disease Unit, University Hospital, Aintree; *Zeneca Pharmaceuticals, Alderley Park, UK
Qbjectives: ZD0870 is a novel azole antifimgal drug with excehent activity against Candida species. It is potentially cardiotoxic, and the pharmacokinetics in man need to be clarified. Metho& Single doses of ZD0870 in oral and intravenous form were administered to healthy volunteers. The single-dose pharmacokinetics were defined for each subject. The parameters derived were used to model the likely results of administering a multiple-dose regimen. The same subjects were then given a 7 day course of ZD0870 and further sampling performed. The observed kinetics were compared with the results of modelling. Results: The pharmacokinetics displayed consideable inter- and intra-subject variability. Afler intravenous administration some subjects exhibited a redistribution phase leading to transient high plasma levels. With all routes of administration there was unpredicted accumulation of ZD0870 in the body. The decrease in drug clearance appeared to be time- rather than concentration-dependent, Conclusions: These results, which suggest a time-dependent inhibitory process affecting the metabolism of ZD0870 as well as confirming highly variable kinetics, suggest that it will be difficult to define a safe dosing regimen for ZD0870.
HIV-l SEROPOSITIVY IN ANTE-NATAL WOIMEN IN UGANDA SHOWS A DECLINE FG. Rushambuza, Mersey and North Wales Blood Ccntre, Liverpool, UK. Uganda was the first subsaharan African country to acknowledge that it had a serious problem with the HIV epidemic. The government introduced general and specific measures to combat the spread of HIV. The most important general measures included the introduction of universal primary education and the economic and political empowerment of women. The specific measures included the promotion of condom use and of monogamy and the implementation of HIV/AIDS awareness through leaflets, TV, film, radio and drama. Serological surveys for anti-HIV- I antibodies amongst sentinel groups, including antenatal women, STD clinic attenders and blood donors were started. Statistics have been collected and analysed yearly since 1985. These show that AlDS in Uganda is predominantly a disease of the economically most productive group (age 19-40 years) and that it occurs at an earlier age amongst women. An important finding has been that HIV-l seropositivity rates amongst women attending antenatal clinics peaked at about 30% m 1904 but has since shown a yearly decline and is now about 14.5”/0. Similar declines have occurred amongst STD clonic attenders and blood donors.
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PREVENTION OF NOSOCOMIAL ASPERGILLOSIS:A MULTIDISCIPLINARY APPROACH. F Fitzpatrick, S F’rout, A Gilleece, WW Hall, LE Fenelon and OM Murphy. Dept. of Clinical Microbiology, StVincents Hospital, Dublin, Ireland. The association between building works and outbreaks of aspergillosis is well established, Guidelines for the prevention of nosocomial aspergillosis have been issued by the CDC; however in our experience implementation of these can prove dit3icuIt. In anticipation of major renovation in an area adjacent to our Liver Transplant and Oncology units, the Infection Control Team (ICT) formulated recommendations aimed at protecting these patients. Despite this, three cases of aspergillus colonisation were identitied in the liver transplant unit during the works period. Further investigation revealed that: (a) Work thought to be insignificant, had commenced three weeks prior to the plamted date and prior to implementation of the recommendations. (b) Intolerable working conditions for staff resulted in failure to comply with the recommended window closures. (c) Confusion existed over whose responsibility it was to ensurethat all recommendations were enacted. experience has led us to conclude that: (a) The ICT should be involved in the early stages of all building work in the hospital. (b) Engineers/Builders should be educated regarding current best practice, require regular updating, and need to work closely with the ICT. (c) The extra costs incurred by environmental sealing, air filtration, prophylaxis, and providing a tolerable working environment for staff, should be included in the initial planning budget. Our
THE SAFETY AND PHARMACOKfNETICS OF ZD0870, A NOVEL AZOLE ANTIFUNGAL AGENT Moss PJ, *Smith RP, *Yates RA; Regional Infectious Disease Unit, University Hospital, Aintree; *Zeneca Pharmaceuticals, Alderley Park, UK
Qbjectives: ZD0870 is a novel azole antifimgal drug with excehent activity against Candida species. It is potentially cardiotoxic, and the pharmacokinetics in man need to be clarified. Metho& Single doses of ZD0870 in oral and intravenous form were administered to healthy volunteers. The single-dose pharmacokinetics were defined for each subject. The parameters derived were used to model the likely results of administering a multiple-dose regimen. The same subjects were then given a 7 day course of ZD0870 and further sampling performed. The observed kinetics were compared with the results of modelling. Results: The pharmacokinetics displayed consideable inter- and intra-subject variability. Afler intravenous administration some subjects exhibited a redistribution phase leading to transient high plasma levels. With all routes of administration there was unpredicted accumulation of ZD0870 in the body. The decrease in drug clearance appeared to be time- rather than concentration-dependent, Conclusions: These results, which suggest a time-dependent inhibitory process affecting the metabolism of ZD0870 as well as confirming highly variable kinetics, suggest that it will be difficult to define a safe dosing regimen for ZD0870.
HIV-l SEROPOSITIVY IN ANTE-NATAL WOIMEN IN UGANDA SHOWS A DECLINE FG. Rushambuza, Mersey and North Wales Blood Ccntre, Liverpool, UK. Uganda was the first subsaharan African country to acknowledge that it had a serious problem with the HIV epidemic. The government introduced general and specific measures to combat the spread of HIV. The most important general measures included the introduction of universal primary education and the economic and political empowerment of women. The specific measures included the promotion of condom use and of monogamy and the implementation of HIV/AIDS awareness through leaflets, TV, film, radio and drama. Serological surveys for anti-HIV- I antibodies amongst sentinel groups, including antenatal women, STD clinic attenders and blood donors were started. Statistics have been collected and analysed yearly since 1985. These show that AlDS in Uganda is predominantly a disease of the economically most productive group (age 19-40 years) and that it occurs at an earlier age amongst women. An important finding has been that HIV-l seropositivity rates amongst women attending antenatal clinics peaked at about 30% m 1904 but has since shown a yearly decline and is now about 14.5”/0. Similar declines have occurred amongst STD clonic attenders and blood donors.
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