[The use of the DOS and Delirium Prevalence: a quantitative longitudinal study at a Swiss-German central hospital]

The use of the DOS and Delirium Prevalence: a quantitative longitudinal study at a Swiss-German central hospital Abstract: Background: With a prevalence of 12-64%, delirium is a common complication in acute care, associated with negative outcomes such as increased mortality and prolonged length of stay. Many hospitals have guidelines to improve the delirium management. The Delirium Observation Screening Scale (DOS) Score is collected in the study hospital from all patients ≥ 70 years at each shift for at least 3 days. Delirium is diagnosed by a physician and coded according to ICD-10. Purpose: Evaluation of the delirium screening with the DOS according to internal guideline in terms of number of DOS assessments performed, prevalence of delirium (DOS score ≥ 3 points, CD-10 code delirium). Method: This retrospective quantitative single-centre longitudinal study used 2017 and 2018 data of 10046 cases. Statistical analysis methods were used to analyse prevalence of delirium and subgroup comparisons. Results: At least one DOS score was documented in 92% of cases aged ≥ 70-years (n = 5038). DOS implementation varied between 60% in the early, 49% in the late and 38% in the night shift. The prevalence of delirium was 12% according to DOS score ≥ 3 and 4% according to physician diagnosis of a delirium. Cases with a DOS score ≥ 3 were significantly older, more often female, had more comorbidities and were depressed. Conclusions: DOS is performed in most patients when indicated. The DOS implementation frequency varied depending on the shift.

Epidemiologie reifzelliger T- und NK-Zell-Lymphome in Deutschland - Eine repräsentative Querschnittanalyse von GKV-Routinedaten: Epidemiology of mature T/NK-cell lymphomas in Germany - A representative cross-sectional study based on SHI claims data

Hintergrund

Primäre kutane Lymphome sind seltene lymphoproliferative Neoplasien und gehören zur heterogenen Gruppe der Non‐Hodgkin‐Lymphome. Sie umfassen ein klinisch und histologisch breites Spektrum an Manifestationsformen, wobei kutane T‐Zell‐Lymphome (CTCL) mit 73% am häufigsten sind. Aufgrund der Seltenheit der Erkrankungen sind bevölkerungsbasierte Untersuchungen zur Versorgungssituation und Epidemiologie kaum vorhanden.

Patienten und Methodik

Auf Basis anonymisierter, alters‐ und geschlechtsadjustierter GKV‐Routinedaten von circa fünf Millionen gesetzlich Krankenversicherten wurde im Sechsjahreszeitraum (2012–2017) eine retrospektive Analyse zur Bestimmung von Prävalenz, Inzidenz und Letalität von Patienten mit reifzelligen T/NK‐Zell Lymphomen in Deutschland durchgeführt.

Ergebnisse

Insgesamt 1336 T‐Zell‐Lymphom‐Patienten konnten im Beobachtungszeitraum identifiziert werden. Die Sechsjahres‐Prävalenz liegt demnach zwischen 27,35 und 43,58 pro 100 000 Einwohner. Die Patienten waren zu 65% männlich mit einem durchschnittlichen Alter von 66 Jahren (SD 15). Es verstarben 246 Patienten (circa 20 %) innerhalb der 6 Jahre, pro Jahr bis zu 7 %. Die ermittelte Inzidenz bei 153 identifizierten Patienten im Jahr 2017 liegt bei 3,65 bis 3,92 pro 100 000 Einwohner.

Schlussfolgerungen

Erstmalig in Deutschland wurden mithilfe von Abrechnungsdaten der gesetzlichen Krankenversicherung (GKV‐Routinedaten), valide epidemiologische Erkenntnisse von Patienten mit reifzelligen T‐ und NK‐Zell Lymphomen gewonnen. Weitere Analysen für tiefergehende Einblicke in die Versorgung der Patienten mit dieser seltenen Erkrankung sind wünschenswert.

[Prevalence of neuropsychiatric symptoms of people with dementia in long-term care units: A secondary analysis]

Prevalence of neuropsychiatric symptoms of people with dementia in long-term care units: A secondary analysis Abstract: Background: In a progress of dementia, most people develop neuropsychiatric symptoms. However, there is little knowledge about the prevalence of these symptoms and their specific characteristics in long-term care. Aims: A differentiated investigation of the prevalence and characteristics of neuropsychiatric symptoms in people with dementia in a long-term care setting. Methods: The prevalence of neuropsychiatric symptoms of people with dementia in a long-term care setting was examined using a secondary analysis of cross-sectional data from the research projects LebenQD I and II and FallDem. The data were collected using the neuropsychiatric inventory - nursing home version. The analysis included data from 699 people with dementia from a total of 21 long-term care facilities in North Rhine-Westphalia. Results: The symptoms agitation/aggression (36%), depression/dysphoria (33%), apathy/indifference (33%), irritability/lability (30%) and aberrant motor behaviour show the highest prevalence. The symptoms hallucinations (9%) and euphoria/elation (6%) have the lowest prevalence. Conclusions: The high prevalence of specific neuropsychiatric symptoms and their characteristics in people with dementia illustrates the need for care-related or psychosocial interventions to counteract the reasons for the occurrence of the symptoms.

A five-year retrospective study on ascarid infections in dogs in southern Italy

INTRODUCTION

A 5-year retrospective analysis of ascarid infections (Toxocara canis and Toxascaris leonina) in dogs from southern Italy was performed to update the epidemiological scenario of these parasites and to identify the risk factors which may favour these infections in animals in this study area. A total of 8,149 dogs, referred to our labs for copromicroscopic analysis using the FLOTAC technique, was considered. A sub-sample of 500 faecal samples were analysed also with the Mini-FLOTAC technique. Of the overall dog samples analysed, 9,2 % (95 % CI = 8,6-9,8) resulted positive for T. canis while 0,5 % (95 % CI = 0,4-0,7) resulted positive for T. leonina. Co-infections with T. canis and T. leonina were found in 0,1 % of dogs (95 % CI = 0,0-0,1). The results obtained by the FLOTAC and Mini-FLOTAC examinations showed a nearly perfect k agreement (k = 0,99, P < 0,001) between these two techniques. Chi-square test showed positivity to T. canis and T. leonina significantly (P < 0,001) associated with dogs housed outdoor (i.e., that lived in garden or in kennel). Moreover, the positivity for T. canis was significantly associated (P < 0,001) also with age (i.e., puppies), as shown by the logistic regression. The decreasing overall prevalence both for T. canis and T. leonina during the years of monitoring, showed that, as suggested by the European Scientific Counsel Companion Animal Parasites, the regular diagnosis could contribute to an efficient control of these parasites.

[Prevalence of claw disorders in swiss cattle farms]

INTRODUCTION

The project «Healthy claws - the foundation for the future» aims to establish a Swiss national claw health monitoring based on digital recordings by claw trimmers during claw trimming. To assess claw health on the participating farms, between-herd prevalence, within-herd prevalence and cow prevalence of all claw disorders based on the «ICAR Claw Health Atlas» were calculated during this study. Claw trimmers underwent an intensive training and examination in order to ensure data quality. To guarantee the representativity of the prevalences, only farm claw trimmings were considered, where ≥ 80 % of the cows in a herd were trimmed. The calculations were based on 7108 cows and 403 heifers from 238 farms, during the period from February 2020 to February 2021. At least one claw disorder was present in 99,2 % of the farms, with 49,6 % of the heifers and 77,7 % of the cows having at least one claw disorder. The high prevalence is seen as a result of all ICAR claw disorders being considered, whereas not all of them are painful and consequently not all of them cause lameness. The absence of lameness assessment limits the evaluation of existing herd problems. High between-herd and cow prevalences were observed for the following claw disorders: heel horn erosion (92,9 %/64,7 %), digital dermatitis (55,9 %/20,7 %), white line disease (81,5 %/17,7 %) and sole hemorrhage (66,4 %/11,6 %). Asymmetric claws, corkscrew claws, scissor claws, horn fissure, interdigital phlegmon, swelling of the coronet and/or bulb and toe necrosis had low prevalences. The proportion of cows treated with a hoof block (0,5 %) was comparatively small in regard of the cows suffering from ulcers (5,6 %) and white line abscesses (2,5 %). The median within-herd prevalence of digital dermatitis was 5,6 %, with a maximal within-herd prevalence of 87,5 %. Despite the contagious nature of digital dermatitis, no increase of between-herd and cow prevalence has been observed in the past ten years throughout Switzerland. Based on this data, the Swiss claw health situation can be monitored, compared over time and improved in the future.

[Establishment of key indicators and limit values for assessment of claw health of cattle in Switzerland]

INTRODUCTION

Herd medicine is a field of buiatrics characterized by regular and systematic visits by the veterinarian to improve the health and performance of the animals, the quality of animal products and finally the satisfaction of the farm staff. Internationally established key indicators, such as age at first calving, heat recognition rate or the percentage of cows with clinical mastitis per month (%),26 have been available for a long time in the areas of fertility and udder health. These key indicators help veterinarians to recognize and define health problems at herd level at an early stage and to work out measures for their improvement. Such key indicators are currently lacking in the field of claw health, hence making standardized identification of problem farms considerably more difficult. Considering the permanent negative influence of claw health problems on fertility, performance and overall animal welfare, it becomes clear how valuable claw health indicators will be in the future. The aim of this study was, therefore, to develop both primary and secondary indicators of claw health and to define corresponding limit values for Switzerland. Based on a literature search, several primary and secondary indicators were developed (1˚K: Herd problem Yes/No, 2˚K: Classification of the problem). These were discussed in an expert panel consisting of practicing veterinarians, staff of the Swiss bovine herd health service and university professors with regard to their possible practical implementation and relevance. Finally, 3 primary and 10 secondary indicators were judged to be suitable to assess a herd with regard to claw health. The primary key indicators were: proportion of cows leaving the herd due to a claw problem, proportion of lame cows of a herd, and proportion of cattle with at least one claw disease. The corresponding provisional limit values (exceeding the value = problem) for Switzerland were worked out by means of surveys among farmers, hoof trimmers, veterinary students and veterinarians. In addition, recommendations from the literature and current prevalence studies were used to adapt the defined limit values to the situation on Swiss farms. In the coming years, the claw health project «Gesunde Klauen - das Fundament für die Zukunft» will collect current prevalence values of claw diseases, and the limit values will then be adjusted and specified accordingly.

[Meditation in Deutschland: Eine national repräsentative Umfrage]

Hintergrund: Zunehmende Evidenz weist auf positive Wirkungen der Meditation bei psychischen und körperlichen Symptomen hin. Ziel dieser national repräsentativen Umfrage war die Erhebung der Lebenszeitprävalenz und Punktprävalenz der Meditations-Praxis in Deutschland, der Gründe für Meditation und der wahrgenommenen Veränderungen durch die Meditation. Methoden: In dieser national repräsentativen Umfrage mit 2'126 TeilnehmerInnen ab 14 Jahren wurde im April und Mai 2018 die derzeitige und frühere Meditations-Praxis erhoben. Unterschiede zwischen soziodemographischen Subgruppen wurden mittels Chi-Quadrat-Tests analysiert. Ergebnisse: Die Lebenszeitprävalenz der Meditations-Praxis lag bei 15,1%, die Punkt-Prävalenz bei 6,6%. Eine höhere Prävalenz war assoziiert mit weiblichem Geschlecht (p < 0,001), erwerbsfähigem Alter (p = 0,015), Abitur/Hochschulabschluss (p = 0,002) und Berufs-tätigkeit (p = 0,027). Die durchschnittliche Dauer der Meditations-Praxis betrug 47,1 Monate. Die häufigsten Gründe zu meditieren waren Verbesserungen des geistigen Befindens (71,1%), der geistigen Leistungsfähigkeit (50,3%), bei regelmäßig Meditierenden auch des körperlichen Befindens (59,3%). Positive Veränderungen durch die Meditations-Praxis berichteten 95,8%, insbesondere größere Ausgeglichenheit, Entspannung und Wohlbefinden. Weitere 12,4% der aktuell nicht meditierenden Befragten konnten sich vorstellen, in den nächsten 12 Monaten mit Meditation zu beginnen. Außerdem praktizierten 5,6% der Befragten Yoga; 46,6% der aktuell Yoga Praktizierenden meditierten auch, und 39,0% der aktuell Meditierenden übten auch Yoga. Schlussfolgerung: Geschätzte 15,7 Millionen Menschen in Deutschland meditieren aktuell oder sind daran interessiert, mit Meditation zu beginnen. Frauen und berufstätige Personen mit Abitur/Hochschulabschluss im erwerbsfähigen Alter meditieren häufiger. Über 95% der Praktizierenden berichten positive Veränderungen durch die Meditation.

BACKGROUND

Increasing evidence suggests positive effects of meditation on mental and physical conditions. The aim of this nationally representative survey was to analyze prevalence and patterns of meditation use in Germany.

METHODS

In this nationally representative survey with 2,126 participants of at least 14 years of age conducted from April to May 2018, current and prior meditation use was assessed. Differences between sociodemographic subgroups were analyzed using chi squared tests.

RESULTS

Lifetime prevalence of meditation use was 15.1%, point prevalence 6.6%. Higher prevalence was associated with female gender (p < 0.001), age 20–59 years (p = 0.015), higher education (p = 0.002), and occupation (p = 0.027). Mean duration of meditation use was 47.1 months. The main reasons for meditation use were improved mental well-being (71.1%), mental capacity (50.3%), and (for regular meditation users) also physical well-being (50.3%). Positive changes due to meditation were reported by 95.8% of meditation users, mainly increased inner calmness, relaxation, and well-being. Another 12.4% of those who were not currently meditating could imagine starting meditation in the next 12 months. Further, 5.6% of participants used yoga; 46.6% of yoga users also used meditation; and 36.0% of meditation users also used yoga.

CONCLUSIONS

An estimated 15.7 million German individuals are currently using meditation or are at least interested in starting to meditate. More than 95% of meditation users report positive changes due to meditation.

[Prevalence and influencing factors of chronic wounds among clients of home care services in Germany]

INTRODUCTION

Chronic or non-healing wounds are a serious problem for both the parties involved and the healthcare system. Currently, there are hardly any reliable data on the prevalence of chronic wounds in outpatient care, although this setting is becoming increasingly important. Therefore, the aim of this study was to determine the prevalence of and the factors associated with chronic wounds in clients cared for by home care services.

METHOD

As part of a cross-sectional study throughout Germany in 2012, a survey was conducted among care recipients provided by home care services. The sample was drawn in a two-step procedure. First, a random sample of home care services was drawn for each federal state, followed by random selection of clients to be interviewed for each service. The aim of the study was to describe the prevalence of chronic wounds and influencing factors such as BMI, age, housing situation, activity and diabetes mellitus. Data collection through questionnaire was carried out by trained nurses.

RESULTS

A total of 144 home care services with 1,296 clients had agreed to participate. With 880 care recipients from 100 home care services finally taking part in the survey, the response rate was 68 %. Of all care recipients examined, 101 had at least one chronic wound; the highest prevalence rates were observed for pressure ulcers (4.6 %) and leg ulcers (4.0 %). Care recipients with diabetes mellitus were more frequently affected by chronic wounds (16.4 %) than non-diabetic recipients (9.5 %). Community-living care recipients (14.1 % chronic wounds; 6.0 % pressure ulcers) and care recipients under the age of 65 (20 % chronic wounds; 9.5 % pressure ulcers) were affected more frequently than care recipients living alone (9.1 % chronic wounds; 3.0 % pressure ulcers) or care recipients older than 65 years (10.5 % chronic wounds; 4.0 % pressure ulcers). In the multivariate calculation, the BMI proved to be the strongest predictor. The prevalence of chronic wounds in the group of obese (BMI>35.3kg/m²) care recipients and those with activity restriction is 44.8 %.

CONCLUSION

In view of the fact that one out of nine care recipients receiving assistance from home care services is affected by at least one non-healing wound, special attention should be paid to the prevention, detection and treatment of chronic wounds. Furthermore, it seems particularly necessary to identify the relevant risk groups in order to be able to initiate adequate and preventive measures at an early stage.

[Differences by geographical information system in prevalence of disease in a farm animal practise]

INTRODUCTION

In the present study, the incidence of diseases in cattle in the area of a veterinary practice was analyzed spatially. Furthermore, the relationship between the incidence of diseases and the distance to geographical elements was investigated. For this study, all cattle farms that were customers of the ambulatory clinic of the animal hospital in Zurich (Tierspital Zürich) were exactly localized on a map. From clinical and treatment data program (Oblon Data®) all services and drugs between January 1st 2013 and December 31st 2013 were evaluated and added as attributes to the according farm. Along with the data of the animals kept on the respective farm, the relationship between prevalences and geographical elements was analyzed. Using these data, it was possible to define fifteen diseases of which incidences were spatially analyzed using a geographic information system (GIS). The results indicate that also on the level of a veterinary practice there are spatial differences in the incidence of diseases to find. However, the majority of diseases occur mainly in regions where the density of animals is also very high. As in earlier findings, this suggests that the size, the management and the proximity of a farm to the next farm (density) have a strong impact. A connection could be found between the distance to the geographical elements street, water and forest and the incidences of gastrointestinal parasitosis, claw disorders, reproduction disorders and cryptosporidiosis.

Wild boar and infectious diseases: evaluation of the current risk to human and domestic animal health in Switzerland: A review

INTRODUCTION

The Eurasian wild boar is widely distributed in Europe and hunting bags reveal a massive increase in the population. Since wild boar and domestic pigs are susceptible to the same pathogens and can infect each other, free-ranging wild boar populations are increasingly considered to be a threat to the pig industry. Switzerland has an outstanding veterinary health situation due to its official free-of-disease status for many diseases, and the role that wildlife could play as a source of infection for domestic animals is of particular concern. This article provides an overview of the current knowledge on wild boar health in Switzerland and discusses the health risk to domestic animals and humans currently posed by wild boar. It places the data in the context of the situation in neighbouring countries. The risk currently posed by wild boar within Switzerland is largely limited to swine brucellosis. The major threat coming from abroad originates from the expansion of African swine fever. To prevent pathogen introduction and transmission between wild boar and domestic pigs, it is essential to pursue efforts in 4 areas: disease surveillance in domestic pigs, biosecurity on pig farms, disease surveillance in wild boar, and sustainable wild boar management.

[Domestic Violence at the University Emergency Department Bern: A Retrospective Analysis from 2006 to 2016]

Domestic Violence at the University Emergency Department Bern: A Retrospective Analysis from 2006 to 2016 Abstract. Domestic Violence (DV) is considered as one of the largest medical risks worldwide. In Switzerland, DV is defined as offence requiring public prosecution since 2004. The present retrospective cohort study aims to investigate cases of DV in one of the largest Swiss emergency departments. The aggressors are predominantly male and either (ex-)partner or (ex-)husband of the victim. The head and the extremities are most often injured. Strangulation was documented in 16 % of the cases. Prevalence in our ED is very low with 0.07 % in 2016 (overall 0.09 % 2006-2016) and much lower compared with international data. We assume that we face many unreported cases and that victims are reluctant to seek medical help. Healthcare professionals should receive regular education in domestic violence, standards of care must be defined, and a sensitive and open-minded communication style is essential.

Prevalence, influencing factors, screening and diagnosis of delirium at stationary hospitalised patients in a Swiss acute Hospital. A pilot study

Background: Deliria have a massive effect on patients, from increased duration of hospitalization to higher mortality. Risk factors such as age, deprivation of substances, immobility as well as stress are known among others. Particularly in vulnerable persons minor factors can lead to a delirium. European studies report a prevalence rate between 17 % and 22 %, but can’t be compared to the Swiss hospital system. No national delirium prevalence data in acute hospitals is known. Aim: On the one hand to measure the delirium prevalence in an acute hospital, to elaborate patient characteristics of delirium patients based on group comparison and to test sensitivity and specifity of the applied instruments, on the other hand to get information about the practicality of the study execution. Method: Delirium point prevalence measurement has been conducted in a prospective cross-sectional study. On one determined day data of patients have been collected by nurses in an acute hospital. Results: A prevalence point rate of 14 % (6 / 43) based on CAM has been identified. Significant differences were found between the groups in respect of age, discipline, number of ICD diagnoses, care dependency and in all the three delirium instruments. Delirium patients were not only longer hospitalized but had almost twice as many ICD diagnosed, were high-maintenance patients and mostly didn’t claim to be in pain. Conclusion: This is the first prevalence study in a Swiss acute hospital. The utilized instruments are reliable and the study execution is practicable and could be conducted with a larger sample. Most known risk factors were confirmed.

Prevalence of humeral head osteochondrosis in the Greater Swiss Mountain dog and the Border Collie in Switzerland

INTRODUCTION

Osteochondrosis (OC) is common in large-breed dogs. According to the breeding guidelines of the Swiss kennel clubs, the shoulder joints are included in the radiographic screening for joint diseases in the Greater Swiss Mountain dog (GSMD) and the Border Collie (BC) since 1993 and 2003, respectively. The aim of this study was to estimate the overall prevalence of humeral head OC in these 2 breeds in Switzerland based on the data of the Swiss National Dysplasia Committees. All radiographs were re-evaluated to assess single radiographic changes. From 1993 and 2003, accordingly, until 2013, the overall prevalence was 14% for the GSMD and 8% for the BC, respectively. Affected joints showed a focally reduced opacity or a flattened/indented contour of the caudal section of the humeral head. Articular flaps were only seen occasionally. Degenerative joint disease was significantly more common in OC affected joints (GSMD: 32%; BC: 20%) than in joints without OC. The present study is the first report on the prevalence of humeral head OC in a large cohort of GSMD and the BC over a long study period. In comparison to other breeds, the herein reported prevalences are in the mid to upper range. Results of the present study should alert veterinarians to the disease in these breeds and may serve as a starting point for further epidemiological and genetic studies.

[Quality of documented diagnosis in primary care - An analysis using the example of thyroid disorders]

BACKGROUND

Routine data of statutory health insurance (SHI) provide a great potential for evaluating the healthcare situation in Germany by providing, e. g., morbidity estimates. In the context of secondary data, analyses based on insurance data were conducted using the outpatient medical billing diagnosis. If, however, medical billing data, which are collected for this primary purpose, are the only source of these morbidity estimates, a limited validity of outpatient medical diagnostic data will have to be assumed or validity will have to be assured. This investigation aimed to analyse the quality of family practitioners' documentation regarding diagnostic data in patients with thyroid disease based on medical records for billing purposes.

METHODS

As part of the pilot study General practitioners' Views on Polypharmacy and its Consequences for Patient Health Care, the medical records of 548 multi-morbid patients with thyroid disease from six general practices in Dresden, Saxony, were analysed with respect to the congruence of prescriptions of thyroid medication and associated thyroid diagnosis. Logistic regression was used to investigate predictors of limited diagnostic data of thyroid disease.

RESULTS

There was insufficient documentation of thyroid diagnoses in 26.8% (n=147) of the included patients diagnosed with or treated for thyroid disease. The proportion of undocumented (1.1 to 35.8%), imprecise (4.6 to 22.3%) and non-specific documented (14.9 to 73.8%) thyroid diagnoses varied in all general practices. Due to undocumented thyroid disease, the corrected prevalence of thyroid diseases summarised for all practices was 5.5 percentage points higher than the originally documented prevalence (29.7 instead of 24.2%). An increasing number of prescribed drugs was a significant predictor for inadequate documentation of thyroid disease (for 5 to 8 routinely taken medications: OR=2.4/p<0.001; for 9 to 12: OR=4.0/p<0.001; for 13 to 20: OR=7.4/p<0.001).

CONCLUSIONS

Due to the limited data quality of outpatient medical billing diagnoses as a basis for morbidity estimates, GPs' diagnostic data should be subjected to regular internal and external diagnostic validation in SHI routine data. Additional case-related interviews with documenting GPs would significantly increase data validity. Also, intelligent e-tools supporting electronic patient documentation could be helpful to improve the quality of primary care documentation.

Nasal carriage of methicillin-resistant Staphylococcus aureus (MRSA) among Swiss veterinary health care providers: detection of livestock- and healthcare-associated clones

We screened a total of 340 veterinarians (including general practitioners, small animal practitioners, large animal practitioners, veterinarians working in different veterinary services or industry), and 29 veterinary assistants for nasal carriage of methicillin-resistant Staphylococcus aureus (MRSA) and Staphylococcus pseudintermedius (MRSP) at the 2012 Swiss veterinary annual meeting. MRSA isolates (n = 14) were detected in 3.8 % (95 % CI 2.1 - 6.3 %) of the participants whereas MRSP was not detected. Large animal practitioners were carriers of livestock-associated MRSA (LA-MRSA) ST398-t011-V (n = 2), ST398-t011-IV (n = 4), and ST398-t034-V (n = 1). On the other hand, participants working with small animals harbored human healthcare-associated MRSA (HCA-MRSA) which belonged to epidemic lineages ST225-t003-II (n = 2), ST225-t014-II (n = 1), ST5-t002-II (n = 2), ST5-t283-IV (n = 1), and ST88-t186-IV (n = 1). HCA-MRSA harbored virulence factors such as enterotoxins, β-hemolysin converting phage and leukocidins. None of the MRSA isolates carried Panton-Valentine leukocidin (PVL). In addition to the methicillin resistance gene mecA, LA-MRSA ST398 isolates generally contained additional antibiotic resistance genes conferring resistance to tetracycline [tet(M) and tet(K)], trimethoprim [dfrK, dfrG], and the aminoglycosides gentamicin and kanamycin [aac(6')-Ie - aph(2')-Ia]. On the other hand, HCA-MRSA ST5 and ST225 mainly contained genes conferring resistance to the macrolide, lincosamide and streptogramin B antibiotics [erm(A)], to spectinomycin [ant(9)-Ia], amikacin and tobramycin [ant(4')-Ia], and to fluoroquinolones [amino acid substitutions in GrlA (S84L) and GyrA (S80F and S81P)]. MRSA carriage may represent an occupational risk and veterinarians should be aware of possible MRSA colonization and potential for developing infection or for transmitting these strains. Professional exposure to animals should be reported upon hospitalization and before medical intervention to allow for preventive measures. Infection prevention measures are also indicated in veterinary medicine to avoid MRSA transmission between humans and animals, and to limit the spread of MRSA both in the community, and to animal and human hospitals.

Lameness and foot lesions in Swiss dairy cows: I. Prevalence

Prevalences of foot lesions and lameness were recorded in 1'449 Swiss dairy cows during routine claw-trimming on 78 farms from June 2010 until February 2011. Lameness was present in 14.8 % of cows and on 80.8 % of investigated farms. Highest prevalences were seen for widened white line (80.7 %/100 %), signalling foot lesion (65.6 %/98.7 %), heel-horn erosion (34.2 %/88.5 %), digital dermatitis complex (29.1 %/73.1 %), severe hemorrhages (27.9 %/87.2 %), and Rusterholz' sole ulcers (11.5 %/74.4 %) at cow and herd level, respectively. Lower prevalences were found for subclinical laminitis (5.4 %/47.4 %), chronic laminitis (3.3 %/25.6 %), white line disease (4.7 %/42.3 %), double soles (2.6 %/33.3 %), interdigital hyperplasia (3.1 %/33.3 %), sole ulcers (0.4 %/6.4 %), toe infections caused by faulty claw-trimming (3.9 %/39.7 %) and by injury (0.1 %/2.6 %), deep lacerations (0.4 %/6.4 %), and interdigital phlegmona (0.1 %/1.3 %). Lameness and foot lesions were shown to represent important health problems of dairy cows under the conditions of the typical grass-based production system in Switzerland. Digital dermatitis has developed to the most relevant foot disease with a high impact on welfare of Swiss dairy cows within the past 10 years.