WorldWideScience

Sample records for aureus surgical site

  1. Use of mupirocin-chlorhexidine treatment to prevent Staphylococcus aureus surgical-site infections.

    Science.gov (United States)

    Bertrand, X; Slekovec, C; Talon, D

    2010-05-01

    Evaluation of: Bode LGM, Kluytmans JAJW, Wertheim HFL et al.: Preventing surgical-site infections in nasal carriers of Staphylococcus aureus. N. Engl. J. Med. 362, 9-17 (2010). Staphylococcus aureus is the main pathogen responsible for surgical-site infections and nasal carriage is a major risk factor for subsequent infection with this bacteria. Mupirocin is considered to be the topical antibacterial agent of choice for eradication of nasal S. aureus. The paper by Bode et al. provides strong evidence that the combination of a rapid identification of a S. aureus nasal carrier, mupirocin nasal ointment and chlorhexidine gluconate soap, significantly reduces the rate of S. aureus surgical-site infection by nearly 60%. In conclusion, mupirocin nasal ointment use in S. aureus carriers before surgery has numerous advantages with few side effects. PMID:20441543

  2. The Current State of Screening and Decolonization for the Prevention of Staphylococcus aureus Surgical Site Infection After Total Hip and Knee Arthroplasty.

    Science.gov (United States)

    Weiser, Mitchell C; Moucha, Calin S

    2015-09-01

    The most common pathogens in surgical site infections after total hip and knee arthroplasty are methicillin-sensitive Staphylococcus aureus (MSSA), methicillin-resistant S. aureus (MRSA), and coagulase-negative staphylococci. Patients colonized with MSSA or MRSA have an increased risk for a staphylococcal infection at the site of a total hip or knee arthroplasty. Most colonized individuals who develop a staphylococcal infection at the site of a total hip or total knee arthroplasty have molecularly identical S. aureus isolates in their nares and wounds. Screening and nasal decolonization of S. aureus can potentially reduce the rates of staphylococcal surgical site infection after total hip and total knee arthroplasty.

  3. Molecular characterization of Staphylococcus aureus from patients with surgical site infections at Mulago Hospital in Kampala, Uganda.

    Directory of Open Access Journals (Sweden)

    Jeremiah Seni

    Full Text Available BACKGROUND: The prevalence of Methicillin resistant Staphylococcus aureus (MRSA is progressively increasing globally with significant regional variation. Understanding the Staphylococcus aureus lineages is crucial in controlling nosocomial infections. Recent studies on S. aureus in Uganda have revealed an escalating burden of MRSA. However, the S. aureus genotypes circulating among patients are not known. Here, we report S. aureus lineages circulating in patients with surgical site infections (SSI at Mulago National hospital, Kampala, Uganda. METHODS: A cross-sectional study involving 314 patients with SSI at Mulago National Hospital was conducted from September 2011 to April 2012. Pus swabs from the patients' SSI were processed using standard microbiological procedures. Methicillin sensitive Staphylococcus aureus (MSSA and MRSA were identified using phenotypic tests and confirmed by PCR-detection of the nuc and mecA genes, respectively. SCCmec genotypes were determined among MRSA isolates using multiplex PCR. Furthermore, to determine lineages, spa sequence based-genotyping was performed on all S. aureus isolates. RESULTS: Of the 314 patients with SSI, S. aureus accounted for 20.4% (64/314, of which 37.5% (24/64 were MRSA. The predominant SCCmec types were type V (33.3%, 8/24 and type I (16.7%, 4/24. The predominant spa lineages were t645 (17.2%, 11/64 and t4353 (15.6%, 10/64, and these were found to be clonally circulating in all the surgical wards. On the other hand, lineages t064, t355, and t4609 were confined to the obstetrics and gynecology wards. A new spa type (t10277 was identified from MSSA isolate. On multivariate logistic regression analysis, cancer and inducible clindamycin resistance remained as independent predictors of MRSA-SSI. CONCLUSION: SCCmec types I and V are the most prevalent MRSA mecA types from the patients' SSI. The predominant spa lineages (t645 and t4353 are clonally circulating in all the surgical wards, calling for

  4. Correlation of mupirocin resistance with biofilm production in methicillin-resistant Staphylococcus aureus from surgical site infections in a tertiary centre, Egypt.

    Science.gov (United States)

    Barakat, Ghada I; Nabil, Yasmin M

    2016-03-01

    The aim of this study was to detect mupirocin-resistant isolates from pus/wound swabs taken postoperatively in a tertiary centre in Egypt and to determine their ability to form biofilm in order to establish its correlation with mupirocin resistance. This was a prospective study including 513pus/wound swabs from patients suffering from postoperative surgical site infections over the period July 2013-January 2015. Samples were cultured and isolates were identified by coagulase activity, DNase test, mannitol fermentation by mannitol salt agar followed by API Staph 32. Oxacillin agar screen test, agar dilution test for mupirocin, and mupA gene detection by PCR were performed for all methicillin-resistant Staphylococcus aureus (MRSA) isolates. Biofilm detection was carried out by the microtitre plate and Congo red agar methods. Of the 161 S. aureus isolates identified, 73 (45.3%) were MRSA, among which 82.2% were mupirocin-susceptible and 17.8% were mupirocin-resistant. Among the resistant isolates, 38.5% showed low-level resistance and 61.5% were high-level mupirocin-resistant. The mupA gene was detected in 75.0% of high-level mupirocin-resistant strains and in none of the low-level mupirocin-resistant strains. Among the mupirocin-susceptible isolates, 95.0% were biofilm-producers and 5.0% did not produce biofilm. All mupirocin-resistant isolates produced biofilm. Moreover, 15.3% of high-level mupirocin-resistant strains were negative for the mupA gene but showed evidence of biofilm formation. In conclusion, biofilm formation may be suggested to play a role in mupirocin resistance besides the presence of a genetic element encoding abnormal isoleucyl-tRNA synthetase, however further studies are needed to confirm these findings. PMID:27436387

  5. A Systematic Review of Risk Factors Associated with Surgical Site Infections among Surgical Patients

    OpenAIRE

    Korol, Ellen; Johnston, Karissa; Waser, Nathalie; Sifakis, Frangiscos; Jafri, Hasan S.; Lo, Mathew; Moe H. Kyaw

    2013-01-01

    Importance Surgical site infection (SSI) complicates 2-5% of surgeries in the United States. Severity of SSI ranges from superficial skin infection to life-threatening conditions such as severe sepsis, and SSIs are responsible for increased morbidity, mortality, and economic burden associated with surgery. Staphylococcus aureus (S. aureus) is a commonly-isolated organism for SSI, and methicillin-resistant S. aureus SSI incidence is increasing globally. Objective The objective of this systemat...

  6. Methicillin-resistant Staphylococcus aureus infection in vascular surgical patients.

    Science.gov (United States)

    Murphy, G. J.; Pararajasingam, R.; Nasim, A.; Dennis, M. J.; Sayers, R. D.

    2001-01-01

    BACKGROUND: Methicillin-resistant Staphylococcus aureus (MRSA) infection is emerging as a major problem in vascular surgical practice. The aim of this study was to review the management of patients with MRSA infection complicating vascular surgical operations. METHODS: Data were obtained from the vascular audit, case notes, intensive therapy unit (ITU) notes, high dependency unit (HDU) notes and microbiological records of patients who underwent either arterial reconstruction (n = 464) or limb amputation (n = 110) between April 1994 and October 1998. RESULTS: Forty-nine vascular surgical patients developed clinical MRSA infection (9%). Clinical MRSA infection in patients who had undergone aorto-iliac reconstruction (n = 18) was associated with a 56% mortality (n = 10) and the most common infections were bacteraemia (55%) and pneumonia (50%). MRSA infection occurred in 17 patients who had undergone infra-inguinal bypass and was associated with a 29% mortality (n = 5). The most common site of MRSA infection was the groin wound (76%) leading to anastomotic dehiscence and death in one patient (11%) and necessitating wound debridement in 4 patients (22%). MRSA infection of the groin wound in the presence of a prosthetic graft (n = 3) led to anastomotic dehiscence in 2 patients, and graft excision in 2 patients. Similar complications were not observed in the presence of an underlying autogeneous long saphenous vein graft (n = 16). MRSA infection following major lower limb amputation (n = 14) was associated with death in 5 patients (36%). Wound infection in 10 amputees (71%) led to revision of the amputation to a higher level in 2 (14%) and wound debridement in 2 (14%). CONCLUSIONS: MRSA infection has a high mortality in vascular surgical patients in general, and following aorto-iliac reconstruction in particular. Autogeneous vein may confer some protection against local complications following groin wound infection. Strategies aimed at reducing the incidence of infection

  7. Surgical site markers: potential source of infection.

    Science.gov (United States)

    Driessche, Ann Marie

    2012-01-01

    Observing licensed independent practitioners mark surgical sites with all types of marking pens is a concern related to the potential spread of infections from patient to patient. The practice of using the same marking pen to mark a surgical site has been questioned as a source of cross contamination. A literature review was done on recent studies and best practice recommendations to determine whether marking pens can act as fomites for nosocomial infections. The review indicated that surgical site markers, ink pens, and aging permanent marking pens can be a source for cross-infection with methicillin-resistant Staphylococcus aureus, other bacteria, fungus, or virus. The type of marking pens used and the act of using the same marking pen from patient to patient could contribute to nosocomial infections. The literature reviewed recommends a single time use of a surgical marking pen. Interventions to prevent cross contamination and postoperative surgical site infections are a major concern in the care of the orthopaedic patient.

  8. Undernutriton and surgical site infection

    OpenAIRE

    Weimann, Arved

    2007-01-01

    There is strong evidence for the impact of nutritional status and nutritional intervention on surgical morbidity with special regard to surgical site infectious complications. Aiming on the decrease of length of hospital stay in surgery, the identification of nutritional risk patients and candidates for preoperative nutritional support has to be realized in an outpatient setting. This has to be established by improvement of health care networking. Whenever possible, nutritional support should...

  9. Preventing surgical site infection. Where now?

    LENUS (Irish Health Repository)

    Humphreys, H

    2009-12-01

    Surgical site infection (SSI) is increasingly recognised as a measure of the quality of patient care by surgeons, infection control practitioners, health planners and the public. There is increasing pressure to compare SSI rates between surgeons, institutions and countries. For this to be meaningful, data must be standardised and must include post-discharge surveillance (PDS) as many superficial SSIs do not present to the original institution. Further work is required to determine the best method of conducting PDS. In 2008 two important documents on SSI were published from the Society for Healthcare Epidemiology of America\\/The Infectious Disease Society of America and the National Institute for Health and Clincal Excellence, UK. Both emphasise key aspects during the preoperative, operative and postoperative phases of patient care. In addition to effective interventions known to be important for some time, e.g. not shaving the surgical site until the day of the procedure, there is increasing emphasis on physiological parameters, e.g. blood glucose concentrations, oxygen tensions and body temperature. Laparoscopic procedures are increasingly associated with reduced SSI rates, and the screening and decontamination of meticillin-resistant Staphylococcus aureus carriers is effective for certain surgical procedures but has to be balanced by cost and the risk of mupirocin resistance. Finally, there is a need to convert theory into practice by the rigorous application of SSI healthcare bundles. Recent studies suggest that, with a multidisciplinary approach, simple measures can be effective in reducing SSI rates.

  10. Fighting surgical site infections in small animals

    DEFF Research Database (Denmark)

    Verwilghen, Denis; Singh, Ameet

    2015-01-01

    A diverse array of pathogen-related, patient-related, and caretaker-related issues influence risk and prevention of surgical site infections (SSIs). The entire surgical team involved in health care settings in which surgical procedures are performed play a pivotal role in the prevention of SSIs. ...

  11. Bacteriological Profile of Infected Surgical Sites in Jos, Nigeria

    Directory of Open Access Journals (Sweden)

    Agada, G. O.

    2012-01-01

    Full Text Available The often-high mortality and morbidity rates of surgical site infections are the concern of most health practitioners including administrators globally. The need to know the bacterial agents responsible and their treatability to common antibiotics was the main thrust of this study. Two hundred surgical site swabs were collected from two hospitals and investigated. The swabs were cultured and organisms identified according to standard procedures. A prevalence rate of 31.5% was obtained from the surgical sites investigated. Direct gram staining gave a greater recovery rate of incriminated organisms than cultural methods. Staphylococcus aureus was the most encountered pathogen with 13.0% prevalence rate followed by Pseudomonas aeruginosa (6.5%, Proteus mirabilis (6.0% and Klebsiella aerogenes (4.0%.The least encountered pathogens were Beta-haemolytic streptococci and Escherichia coli with prevalence rates of 1.0% each. Statistically, chi square analysis showed that there was no significant difference in the number of isolates from the two health facilities at 99% confidence limit. Susceptibility of isolates was more with the aminoglycosides than with the penicillins. This study has thus revealed that some hospitals are not doing enough to stem the tide of surgical site infections.

  12. Modifiable risk factors for surgical site infection.

    Science.gov (United States)

    Moucha, Calin S; Clyburn, Terry A; Evans, Richard P; Prokuski, Laura

    2011-01-01

    Multiple risk factors for orthopaedic surgical site infection have been identified. Some of these factors directly affect the wound-healing process, whereas others can lead to blood-borne sepsis or relative immunosuppression. Modifying a patient's medications; screening for comorbidities, such as HIV or diabetes mellitus; and advising the patient on options to diminish or eliminate adverse behaviors, such as smoking, should lower the risk for surgical site infections.

  13. MRSA – ‘Bug-Bear’ of a Surgical Practice: Reducing the Incidence of MRSA Surgical Site Infections

    OpenAIRE

    Guyot, Andrea; Layer, Graham

    2006-01-01

    Adverse publicity (the ‘superbug') has demonstrated that the problem of MRSA (methicillin-resistant Staphylococcus aureus) is prevalent in many of the country's most prestigious hospitals. The results of the mandatory UK Department of Health (DH) surveillance for early surgical site infections in orthopaedic surgery (SSIS) have been published recently for the period April 2004 to March 2005 when 41,242 operations were studied ( 28 October 2005). Infection rates were generally and gratifyingly...

  14. Pelvic Surgical Site Infections in Gynecologic Surgery

    Directory of Open Access Journals (Sweden)

    Mark P. Lachiewicz

    2015-01-01

    Full Text Available The development of surgical site infection (SSI remains the most common complication of gynecologic surgical procedures and results in significant patient morbidity. Gynecologic procedures pose a unique challenge in that potential pathogenic microorganisms from the skin or vagina and endocervix may migrate to operative sites and can result in vaginal cuff cellulitis, pelvic cellulitis, and pelvic abscesses. Multiple host and surgical risk factors have been identified as risks that increase infectious sequelae after pelvic surgery. This paper will review these risk factors as many are modifiable and care should be taken to address such factors in order to decrease the chance of infection. We will also review the definitions, microbiology, pathogenesis, diagnosis, and management of pelvic SSIs after gynecologic surgery.

  15. Surgical Site Infection Surveillance Following Ambulatory Surgery

    OpenAIRE

    Rhee, Chanu; Huang, Susan S.; Berríos-Torres, Sandra I.; Kaganov, Rebecca; Bruce, Christina; Lankiewicz, Julie; Platt, Richard; Yokoe, Deborah S.

    2015-01-01

    We assessed 4045 ambulatory surgery patients for surgical site infection (SSI) using claims-based triggers for medical chart review. Of 98 patients flagged by codes suggestive of SSI, 35 had confirmed SSIs. SSI rates ranged from 0 to 3.2% for common procedures. Claims may be useful for SSI surveillance following ambulatory surgery.

  16. Surgical Site Infections After Pediatric Spine Surgery.

    Science.gov (United States)

    Floccari, Lorena V; Milbrandt, Todd A

    2016-04-01

    Surgical site infection (SSI) after spinal deformity surgery is a complication in the pediatric population resulting in high morbidity and cost. Despite modern surgical techniques and preventative strategies, the incidence remains substantial, especially in the neuromuscular population. This review focuses on recent advancements in identification of risk factors, prevention, diagnosis, and treatment strategies for acute and delayed pediatric spine infections. It reviews recent literature, including the best practice guidelines for infection prevention in high-risk patients. Targets of additional research are highlighted to assess efficacy of current practices to further reduce risk of SSI in pediatric patients with spinal deformity. PMID:26772947

  17. A systematic review of risk factors associated with surgical site infections among surgical patients.

    Directory of Open Access Journals (Sweden)

    Ellen Korol

    Full Text Available IMPORTANCE: Surgical site infection (SSI complicates 2-5% of surgeries in the United States. Severity of SSI ranges from superficial skin infection to life-threatening conditions such as severe sepsis, and SSIs are responsible for increased morbidity, mortality, and economic burden associated with surgery. Staphylococcus aureus (S. aureus is a commonly-isolated organism for SSI, and methicillin-resistant S. aureus SSI incidence is increasing globally. OBJECTIVE: The objective of this systematic review was to characterize risk factors for SSI within observational studies describing incidence of SSI in a real-world setting. EVIDENCE REVIEW: An initial search identified 328 titles published in 2002-2012; 57 were identified as relevant for data extraction. Extracted information included study design and methodology, reported cumulative incidence and post-surgical time until onset of SSI, and odds ratios and associated variability for all factors considered in univariate and/or multivariable analyses. FINDINGS: Median SSI incidence was 3.7%, ranging from 0.1% to 50.4%. Incidence of overall SSI and S. aureus SSI were both highest in tumor-related and transplant surgeries. Median time until SSI onset was 17.0 days, with longer time-to-onset for orthopedic and transplant surgeries. Risk factors consistently identified as associated with SSI included co-morbidities, advanced age, risk indices, patient frailty, and surgery complexity. Thirteen studies considered diabetes as a risk factor in multivariable analysis; 85% found a significant association with SSI, with odds ratios ranging from 1.5-24.3. Longer surgeries were associated with increased SSI risk, with a median odds ratio of 2.3 across 11 studies reporting significant results. CONCLUSIONS AND RELEVANCE: In a broad review of published literature, risk factors for SSI were characterized as describing reduced fitness, patient frailty, surgery duration, and complexity. Recognition of risk factors

  18. Characterization of colonizing Staphylococcus aureus isolated from surgical wards' patients in a Nigerian university hospital.

    Directory of Open Access Journals (Sweden)

    Deboye O Kolawole

    Full Text Available In contrast to developed countries, only limited data on the prevalence, resistance and clonal structure of Staphylococcus aureus are available for African countries. Since S. aureus carriage is a risk factor for postoperative wound infection, patients who had been hospitalized in surgical wards in a Nigerian University Teaching Hospital were screened for S. aureus carriage. All S. aureus isolates were genotyped (spa, agr and assigned to multilocus sequence types (MLST. Species affiliation, methicillin-resistance, and the possession of pyrogenic toxin superantigens (PTSAg, exfoliative toxins (ETs and Panton-Valentine Leukocidin (PVL were analyzed. Of 192 patients screened, the S. aureus carrier rate was 31.8 % (n = 61. Of these isolates, 7 (11.5% were methicillin-resistant (MRSA. The isolates comprised 24 spa types. The most frequent spa types were t064, t084, t311, and t1931, while the most prevalent MLST clonal complexes were CC5 and CC15. The most frequent PTSAg genes detected were seg/sei (41.0% followed by seb (29.5%, sea (19.7%, seh (14.7% and sec (11.5. The difference between the possession of classical and newly described PTSAg genes was not significant (63.9% versus 59.0% respectively; P = 0.602. PVL encoding genes were found in 39.3% isolates. All MRSA isolates were PVL negative, SCCmec types I and VI in MLST CC 5 and CC 30, respectively. Typing of the accessory gene regulator (agr showed the following distribution: agr group 1 (n = 20, group II (n = 17, group III (n = 14 and group IV (n = 10. Compared to European data, enterotoxin gene seb and PVL-encoding genes were more prevalent in Nigerian methicillin-susceptible S. aureus isolates, which may therefore act as potential reservoir for PVL and PTSAg genes.

  19. Surgical Site Infections Following Spine Surgery: Eliminating the Controversies in the Diagnosis

    OpenAIRE

    Jad eChahoud; Zeina eKanafani; Kanj, Souha S

    2014-01-01

    Surgical site infection (SSI) following spine surgery is a dreaded complication with significant morbidity and economic burden. SSIs following spine surgery can be superficial, characterized by obvious wound drainage or deep-seated with a healed wound. Staphylococcus aureus remains the principal causal agent. There are certain pre-operative risk factors that increase the risk of SSI, mainly diabetes, smoking, steroids, and peri-operative transfusions. Additionally, intra-operative risk factor...

  20. Evolving issues in the prevention of surgical site infections.

    LENUS (Irish Health Repository)

    Quinn, A

    2009-06-01

    Surgical site infection is one of the more common causes of post-operative morbidity. Such infections contribute to prolonged recovery, delayed discharge and increasing costs to both patients and the health service. In the current climate increased emphasis is being placed on minimising the risks of acquiring or transmitting these nosocomial infections. This article reviews the current literature obtained from a Pubmed database search in relation to three specific aspects of surgical site infection: compliance with prophylactic antibiotics, post-discharge surveillance and novel methods for preventing surgical site infections. These topics represent areas where many institutions will find room for improvement in the prevention of surgical site infections. Tight adherence to prophylactic antibiotic guidelines, close followup of surgical wounds during and after hospital discharge, and attention to oxygenation status and the body temperature of patients may all prove to be useful adjuncts in significantly decreasing surgical site infections.

  1. Pathogenic mechanisms in the development of surgical site infections

    OpenAIRE

    Jovanović Zorica; Ilić Milena; Janković Slobodan

    2007-01-01

    Introduction. Surgical site infections represent a major problem in modern medicine. Bacterial survival and growth in surgical wounds depends on the effectiveness of the host defense mechanisms and on the ability of bacteria to resist these defensive mechanisms. Surgical site contamination causes cellular injury and triggers the inflammatory response. Host response to infection. An acute inflammatory response occurs within seconds to minutes of injury or invasion; it is non-specific and self-...

  2. SURGICAL SITE INFECTIONS: A STUDY OF INCIDENCE, RISK FACTORS & ANTIMICROBIAL SENSITIVITY AT RIMS, KADAPA, A. P.

    Directory of Open Access Journals (Sweden)

    Giridhar

    2015-08-01

    Full Text Available S urgical site infection is the most common complication following surgical procedures. The aim of the study is to determine the incidence, associated risk factors and antimicrobial sensitivity pattern at RIMS, KADAPA. MATERIALS AND METHODS: This is a prospective study carried at surgical wards of RIMS KADAPA from Jan. 2015 to June 2015. All the patients were followed for 30 days for development of surgical site infection. Infected cases were identified u sing CDC, criteria. All the data are expressed in percentage. RESULTS : The overall prevalence of surgical site infection is 19%. The incidence was more common in age group above 40 years. The risk factors associated with SSI are long stay in hospital (14% , abdominal surgeries, long duration of surgery, and diabetes. The most common organism isolated is Staphylococcus aureus (30%. CONCLUSION: Surgical site infection is most common following surgery. Significant determinants are long stay in the ward, abdomi nal surgeries, emergency surgeries and diabetes. Effective infection control measures and good regular surveillance will improve the SSI rate to an acceptable level.

  3. Nasal Carriage of Staphylococcus Aureus and Cross-Contamination in a Surgical Intensive Care Unit: Efficacy of Mupirocin Ointment

    NARCIS (Netherlands)

    D. Talon; C. Rouget; V. Cailleaux; P. Bailly; M. Thouverez; F. Barale; Y. Michel-Briand

    1995-01-01

    textabstractA six month prospective study was carried out in a surgical intensive care unit (SICU) of a university hospital to assess the incidence and routes of exogenous colonization by Staphylococcus aureus. A total of 157 patients were included in the study. One thousand one hundred and eleven s

  4. Surgical Site Infections (SSIs) For 5 Operative Procedures, 2013

    Data.gov (United States)

    U.S. Department of Health & Human Services — This table shows the surgical site infections (SSIs) reported by hospitals for the 5 operative procedures without risk adjusted comparisons (Heart transplant,...

  5. Surgical site infection prevention: the operating room environment.

    Science.gov (United States)

    Clyburn, Terry A; Evans, Richard P; Moucha, Calin S; Prokuski, Laura

    2011-01-01

    Surgical site infections can complicate orthopaedic procedures and contribute to morbidity, mortality, and health care costs. Extensive literature has been published on this topic; however, the quality of data using standards of evidence-based medicine is variable with a lack of well-controlled studies. A review of the literature concerning measures to prevent surgical site infections in the operating room environment may be helpful in preventing such infections.

  6. Surgical site infection prevention and control: an emerging paradigm.

    Science.gov (United States)

    Evans, Richard P; Clyburn, Terry A; Moucha, Calin S; Prokuski, Laura

    2011-01-01

    Examining the current state of infection in orthopaedic surgery provides tools and techniques to reduce the risks of nosocomial infections and prevent and treat infections from drug-resistant organisms. It is important for surgeons to recognize modifiable surgical risk factors and be aware of the importance of preoperative patient screening in reducing surgical site infections. The latest evidence-based data from scientific exhibits, instructional course lectures, and the Orthopaedic Knowledge Online continuing medical education module gathered during the past 5 years by the American Academy of Orthopaedic Surgeons Patient Safety Committee are useful in understanding and controlling the increasing and vital problem of surgical site infection.

  7. Current Approaches for the Prevention of Surgical Site Infections

    Directory of Open Access Journals (Sweden)

    Sander Florman

    2007-01-01

    Full Text Available Surgical site infections (SSIs are the most common type of nosocomial infection among surgical patients and are commonly caused by the patients’ own microbial flora. The prevalence of SSI is a major concern because of the associated increase in the incidence of morbidity and mortality, length of hospitalization and cost of care for postoperative patients. Key factors that determine whether patients are at risk for developing SSI include the inherent potential contamination of the surgical site, the duration of the operation and the individual patient susceptibility. Preventive preoperative measures that can reduce the risk of SSIs include administration of antimicrobial prophylaxis, proper utilization of skin antiseptic agents for both the patient and the surgical team, proper patient preoperative hair removal and the policy of canceling elective procedures when remote skin, urinary or pulmonary infections occur. This paper will review the efficacy and safety of available antiseptic agents, as well as discuss patient-specific prevention strategies.

  8. Improved Surgical Site Infection (SSI) rate through accurately assessed surgical wounds

    OpenAIRE

    John, Honeymol; Nimeri, Abdelrahman; Ellahham, Samer

    2015-01-01

    Sheikh Khalifa Medical City's (SKMC) Surgery Institute was identified as a high outlier in Surgical Site Infections (SSI) based on the American College of Surgeons National Surgical Quality Improvement Program (ACS NSQIP) - Semi-Annual Report (SAR) in January 2012. The aim of this project was to improve SSI rates through accurate wound classification. We identified SSI rate reduction as a performance improvement and safety priority at SKMC, a tertiary referral center. We used the American Col...

  9. Evaluation of two surveillance methods for surgical site infection

    Directory of Open Access Journals (Sweden)

    M. Haji Abdolbaghi

    2006-08-01

    Full Text Available Background: Surgical wound infection surveillance is an important facet of hospital infection control processes. There are several surveillance methods for surgical site infections. The objective of this study is to evaluate the accuracy of two different surgical site infection surveillance methods. Methods: In this prospective cross sectional study 3020 undergoing surgey in general surgical wards of Imam Khomeini hospital were included. Surveillance methods consisted of review of medical records for postoperative fever and review of nursing daily note for prescription of antibiotics postoperatively and during patient’s discharge. Review of patient’s history and daily records and interview with patient’s surgeon and the head-nurse of the ward considered as a gold standard for surveillance. Results: The postoperative antibiotic consumption especially when considering its duration is a proper method for surgical wound infection surveillance. Accomplishments of a prospective study with postdischarge follow up until 30 days after surgery is recommended. Conclusion: The result of this study showed that postoperative antibiotic surveillance method specially with consideration of the antibiotic usage duration is a proper method for surgical site infection surveillance in general surgery wards. Accomplishments of a prospective study with post discharge follow up until 30 days after surgery is recommended.

  10. IMPORTANCE OF SOUTHAMPTON WOUND GRADING SYSTEM IN SURGICAL SITE INFECTION

    Directory of Open Access Journals (Sweden)

    Shaleen

    2014-05-01

    Full Text Available : Post-operative wound infection is defined as surgical site infection from 0-30 days after surgery, or infection to surgical site till one year in cases of implants like mesh, vascular grafts and prosthesis. This study was done to find out incidence of post-operative wound infection in surgical patients in rural setup. This study of post-operative wound infection was carried out from August 2008 to August 2010. The study is of 3275 patients who underwent surgery in the A.V.B.R.H. Significant association was observed between the nature of surgery and Southampton Wound Grading System. It concluded that severity rate of post-operative wound infection was increased from grade I to grade V which was found to be similar in clean to contaminated nature of surgery and that was found to be statistically significant at P value less than 0.001.

  11. Surgical site infections : how high are the costs?

    NARCIS (Netherlands)

    Broex, E. C. J.; van Asselt, A. D. I.; Bruggeman, C. A.; van Tiel, F. H.

    2009-01-01

    There is an increased interest in prevention of nosocomial. infections and in the potential, savings in healthcare costs. The aim of this review of recent studies on surgical site infections (SSIs) was to compare methods of cost research and magnitudes of costs due to SSI. The studies reviewed diffe

  12. Risk control of surgical site infection after cardiothoracic surgery

    NARCIS (Netherlands)

    P. Segers; A.P. de Jong; J.J. Kloek; L. Spanjaard; B.A.J.M. de Mol

    2006-01-01

    The purpose of this prospective study was to investigate whether a risk control programme based on risk assessment, new treatment modalities and the presence of a surveillance programme reduces the incidence of surgical, site infections (SSI). Between January 2001 and December 2003, 167 patients wer

  13. Operating theatre quality and prevention of surgical site infections.

    Science.gov (United States)

    Spagnolo, A M; Ottria, G; Amicizia, D; Perdelli, F; Cristina, M L

    2013-09-01

    Surgical site infections (SSI) account for 14% to 17% of all hospital-acquired infections and 38% of nosocomial infections in surgical patients. SSI remain a substantial cause of morbidity and death, possibly because of the larger numbers of elderly surgical patients or those with a variety of chronic and immunocompromising conditions, and emergence of antibiotic-resistant microorganisms. Factors causing surgical site infection are multifarious. Several studies have identified the main patient-related (endogenous risk factors) and procedure-related (external risk factors) factors that influence the risk of SSI. The rate of surgical wound infections is strongly influenced by operating theatre quality, too. A safe and salubrious operating theatre is an environment in which all sources of pollution and any micro-environmental alterations are kept strictly under control. This can be achieved only through careful planning, maintenance and periodic checks, as well as proper ongoing training for staff Many international scientific societies have produced guidelines regarding the environmental features of operating theatres (positive pressure, exchanges of filtered air per hour, air-conditioning systems with HEPA filters, etc.) and issued recommendations on healthcare-associated infection, including SSI, concerning surveillance methods, intervention to actively prevent SSI and approaches to monitoring the implementation of such strategies. Therefore, the prevention of SSI requires a multidisciplinary approach and the commitment of all concerned, including that of those who are responsible for the design, layout and functioning of operating theatres.

  14. The efficacy of normal saline irrigation to prevent surgical site infection

    International Nuclear Information System (INIS)

    The efficacy of normal saline irrigation to prevent surgical site Infection The aim of the study was to evaluate the efficacy of normal saline irrigations to prevent surgical site infection (SSI). Study Design: A comparative study. Place and Duration of Study: The study was conducted at surgery and gynecology Dept CMH Chunian from 1st Jan 2012 to 1st Nov 2012. Patients and Methods: Two hundred clean surgical and gynecological cases were included in the study. Hundred cases which were randomly selected had their wound washed with warm normal saline for 60 sec and then mopped dry with clean swabs. Subcuticular Stitches were applied to all the 200 cases. The surgical wounds were examined on 3rd post operative day and then finally on 15th post operative day. Patients with wound infection developed pain at the operation site and fever on third post operative day. Wounds were examined for swelling, redness, discharge and stitch abscess. Routine investigations were done as per protocol. Wound swabs were taken for culture and sensitivity. Results: The study was carried out on 200 clean cases (general and gynecological). They were 130 females and 70 males. The 100 cases whose wounds were washed with normal saline only 1 patient developed wound infection while in the other group who did not had saline irrigations 8 patients out of 100 developed wound infection. The commonest infective organisms were staphylococcus aureus and the other organisms were streptococcus pyogenes, proteus, Klaebsiella, E coli and pseudomonas. No MRSA was detected. Conclusion: In our study washing the wound with warm normal saline for 60 seconds resulted in the wound being infection free. Wound infection is associated with delayed wound healing, prolonged hospital stay and increased economic pressure on the patient and on the state. (author)

  15. Molecular epidemiology of Staphylococcus aureus isolates at different sites in the milk producing dairy farms.

    Science.gov (United States)

    Souza, Viviane; Nader Filho, Antonio; de Castro Melo, Poliana; Ferraudo, Guilherme Moraes; Antônio Sérgio, Ferraudo; de Oliveira Conde, Sandra; Fogaça Junior, Flavio Augusto

    2012-10-01

    The epidemiological relationships between isolated Staphylococcus aureus strains in milk samples of dairy cows, reagent to California Mastitis Test, individual and group milk was demonstrated in different sites of the production fluxogram, in 12 milk-producing farms in the Gameleira region, municipality of Sacramento MG Brazil, so that localization and transmission modes may be identified. Two hundred and forty-four strains out of 446 samples collected at several sites were isolated and bio-chemically characterized as coagulase-positive staphylococcus. Specific chromosome DNA fragment of the species Staphylococcus aureus was amplified to 106 strains and 103 underwent (PFGE). Samples' collection sites with the highest isolation frequency of Staphylococcus aureus strains comprised papillary ostia (31.1%), CMT-reagent cow milk (21.7%), mechanical milking machines' insufflators (21,7%), milk in milk pails (6.6%) and the milk in community bulk tanks (5.6%). Genetic heterogeneity existed among the isolated 103 Staphylococcus aureus strains, since 32 different pulse-types were identified. Pulse-type 1 had the highest similarity among the isolated strains within the different sites of the milk-production fluxogram. Highest occurrence of pulsetype 1 isolates of Staphylococcus aureus strains was reported in samples collected from the papillary ostia (10.6%), followed by milk samples from CMT-reagent dairy cows (5.8%) and mechanical milking machine insufflators (3.8%). The above shows the relevance of these sites in the agents' transmission mechanism within the context of the farms investigated. PMID:24031997

  16. Surgical site infection and pattern of antibiotic use in a tertiary care hospital in Peshawar

    International Nuclear Information System (INIS)

    Surgical site infection (SSI) is most common complication following surgical procedures. The objective of the study was to collect information on SSI regarding the most frequent pathogen in cases operated in casualty of Lady Read ing Hospital (LRH) Peshawar, and sensitivity of the isolated pathogens to different antibiotics used. Methods: The study was carried out at surgical 'B' unit (SBU) LRH from Jan 1, 2009 till Dec 31, 2009. A total of 100 patients who developed SSI after being operated for peritonitis following traumatic gut perforations, perforated appendix and enteric perforation. The patients included presented to casualty, operated in casualty OT and were shifted to the SBU, LRH. Children and patients operated on the elective list were excluded. Data was collected on specially designed proforma. Demographic details, details of SSI, culture/sensitivity reports and antibiotic used for prophylaxis and after C/S report were recorded. Results: Out of a total of 100, 72 had superficial, 20 had organ/space and 8 had deep SSI. Organisms were isolated in 77 cases (77%). E. coli being most common pathogen (46%), followed by Pseudomonas (23%), mixed growth of Staph. Aureus or MRSA (13%), MRSA (5%) and Staph aureus (4%) in descending order. No growth was reported in 23% of cases. Conclusion: E.coli was the most common organism involved in SSI in SBU LRH. The incidence of infection with MRSA in our unit is high. Combination of antibiotics like pipreacillin/Tazobactam, Cefoperazone/Sulbactam, were most effective against the isolated organisms, except MRSA where Linezolid, vancomycin and Tiecoplanin were effective. (author)

  17. Surgical site infection in patients submitted to heart transplantation

    Science.gov (United States)

    Rodrigues, Jussara Aparecida Souza do Nascimento; Ferretti-Rebustini, Renata Eloah de Lucena; Poveda, Vanessa de Brito

    2016-01-01

    Abstract Objectives: to analyze the occurrence and predisposing factors for surgical site infection in patients submitted to heart transplantation, evaluating the relationship between cases of infections and the variables related to the patient and the surgical procedure. Method: retrospective cohort study, with review of the medical records of patients older than 18 years submitted to heart transplantation. The correlation between variables was evaluated by using Fisher's exact test and Mann-Whitney-Wilcoxon test. Results: the sample consisted of 86 patients, predominantly men, with severe systemic disease, submitted to extensive preoperative hospitalizations. Signs of surgical site infection were observed in 9.3% of transplanted patients, with five (62.5%) superficial incisional, two (25%) deep and one (12.5%) case of organ/space infection. There was no statistically significant association between the variables related to the patient and the surgery. Conclusion: there was no association between the studied variables and the cases of surgical site infection, possibly due to the small number of cases of infection observed in the sample investigated. PMID:27579924

  18. STUDY ON SURGICAL SITE INFECTIONS CAUSED BY ESBL PRODUCING GRAM NEGATIVE BACTERIA

    Directory of Open Access Journals (Sweden)

    Rambabu

    2015-09-01

    Full Text Available Surgical site infections have been a major problem, because of the emergence of drug resistant bacteria, in particular B - lactamase producing bacteria. Extended spectrum beta lactamase producing gram negative organisms pose a great challenge in treatment o f SSI present study is aimed at determining multiple drug resistance in gram negative bacteria & to find out ESBL producers, in correlation with treatment outcome. A total of 120 wound infected cases were studied. Staphylococcus aureus was predominant bact erium - 20.Among gram negative bacteria, Pseudomonas species is predominant (14 followed by Escherichia coli (13 , Klebsiella species (12 , Proteus (9 Citrobacter (4 Providencia (2 & Acinetobacter species (2 . Out of 56 gramnegative bacteria isolated, 20 were i dentified as ESBL producers, which was statistically significant. Delay in wound healing correlated with infection by ESBL producers, which alarms the need of abstinence from antibiotic abuse

  19. Evaluation of adherence to measures for the prevention of surgical site infections by the surgical team

    Directory of Open Access Journals (Sweden)

    Adriana Cristina de Oliveira

    2015-10-01

    Full Text Available AbstractOBJECTIVEEvaluate pre- and intraoperative practices adopted by medical and nursing teams for the prevention of surgical infections.METHODA prospective study carried out in the period of April to May 2013, in a surgical center of a university hospital in Belo Horizonte, Minas Gerais.RESULTS18 surgeries were followed and 214 surgical gloves were analyzed, of which 23 (10.7% had postoperative glove perforation detected, with 52.2% being perceived by users. Hair removal was performed on 27.7% of patients in the operating room, with the use of blades in 80% of the cases. Antibiotic prophylaxis was administered to 81.8% of patients up to 60 minutes prior to surgical incision. An average of nine professionals were present during surgery and the surgery room door remained open in 94.4% of the procedures.CONCLUSIONPartial adhesion to the recommended measures was identified, reaffirming a need for greater attention to these critical steps/actions in order to prevent surgical site infection.

  20. Diabetes Associated with Increased Surgical Site Infections in Spinal Arthrodesis

    OpenAIRE

    Chen, Sam; Anderson, Matt V.; Cheng, Wayne K.; Wongworawat, Montri D.

    2009-01-01

    Diabetes mellitus (DM) is a major risk factor for surgical site infection (SSI). Spinal surgeries are also associated with an increased risk of SSI. To confirm previous reports we evaluated the association of DM with spine infection in 195 patients who underwent elective posterior instrumented lumbar arthrodesis over a 5-year period: 30 with DM and 165 without. Other known risk factors for SSI in spinal surgery were examined: age, gender, tobacco use, body mass index, American Society of Anes...

  1. Molecular diagnosis of Raoultella planticola infection of a surgical site.

    Science.gov (United States)

    Wolcott, R; Dowd, S

    2010-08-01

    Raoultella planticola has been rarely diagnosed in clinical specimens. A case of a polymicrobial surgical site infection primarily caused by R. planticola in a 66-year-old Caucasian male with a fractured left tibia after an open reduction internal fixation of his left ankle is described and confirms this organism to be an opportunistic human pathogen. This pathogen was diagnosed with rapid clinical molecular pathogen diagnostic methods, which allowed an appropriate therapy to be implemented, thereby improving prognosis.

  2. Surgical site infections in Italian Hospitals: a prospective multicenter study

    OpenAIRE

    Ippolito Giuseppe; Martini Lorena; Nicastri Emanuele; Drapeau Cecilia MJ; Petrosillo Nicola; Moro Maria

    2008-01-01

    Abstract Background Surgical site infections (SSI) remain a major clinical problem in terms of morbidity, mortality, and hospital costs. Nearly 60% of SSI diagnosis occur in the postdischarge period. However, literature provides little information on risk factors associated to in-hospital and postdischarge SSI occurrence. A national prospective multicenter study was conducted with the aim of assessing the incidence of both in-hospital and postdisharge SSI, and the associated risk factors. Met...

  3. Surgical site infection in a university hospital in northeast Brazil

    OpenAIRE

    Aldo Cunha Medeiros; Tertuliano Aires-Neto; George Dantas de Azevedo; Maria José Pereira Vilar; Laíza Araújo Mohana Pinheiro; José Brandão-Neto

    2005-01-01

    We examined prevention of surgical site infection (SSI) in a tertiary teaching hospital in northeast Brazil, from January 1994 to December 2003. The survey included 5,742 patients subjected to thoracic, urologic, vascular and general surgery. The criteria for diagnosing SSI were those of the Centers for Disease Control, USA, and the variables of the National Nosocomial Infection Surveillance risk index were used. Data analysis revealed that anesthetic risk scores, wound class and duration of ...

  4. Pathogenic mechanisms in the development of surgical site infections

    Directory of Open Access Journals (Sweden)

    Jovanović Zorica

    2007-01-01

    Full Text Available Introduction. Surgical site infections represent a major problem in modern medicine. Bacterial survival and growth in surgical wounds depends on the effectiveness of the host defense mechanisms and on the ability of bacteria to resist these defensive mechanisms. Surgical site contamination causes cellular injury and triggers the inflammatory response. Host response to infection. An acute inflammatory response occurs within seconds to minutes of injury or invasion; it is non-specific and self-limiting. Mast cell degranulation, activation of three plasma systems and release of subcellular components from damaged cells occur as a consequence of cellular injury. Inflammation is mediated by a variety of soluble factors, including the complement system, the clotting system and the kinin system. The cell-derived mediators include histamine and serotonin, platelet activating factor, arachidonic acid metabolites (prostaglandins, leukotrienes, lipoxins, nitric oxide, and cytokines (regulators of host responses to infection, inflammation and immune responses. The main role of an inflammatory reaction is to recruit various cells and plasma components to the surgical site. Neutrophils are the first immune cells recruited at the site infection. Intracellular killing of microbes by neutrophils is accomplished through several mechanisms, including lysosomal enzymes and oxygen-dependent mechanisms. Later, local and blood-borne macrophages also migrate to the surgical site, initiate phagocytosis, and present antigens to T-lymphocytes in a recognizable form. Sepsis is a common systemic complication of infection. Septic shock is associated with severe infection and release of inflammatory mediators into the systemic circulation. The lipopolysaccharide from gram-negative bacteria contributes significantly to the pathogenesis of septic shock. The most common clinical manifestations of sepsis include fever or hypothermia, tachycardia, tachypnea, altered blood pressure

  5. [Penal liability from retained foreign body inside the surgical site].

    Science.gov (United States)

    Angiò, L G; Ventura Spagnolo, E; Pirrone, G; Cardia, G

    2011-03-01

    The Authors focus on the liability of the surgery team members in the case they inadvertently forget behind in the patient's body a foreign object, which causes injuries and/or death. The Authors underline that, according to the current case law regarding medical malpractice, both the main surgeon and their assistant/subordinate are liable for engaging in a markedly imprudent and/or negligent conduct, such as not double-checking scrupulously the surgical site before its closure in order to highlight forgotten foreign bodies. As well, the Authors underline that either the circulator nurse or the theatre nurse can be considered punishable by law when that medical error occurs, even if they are responsible for the count of the instruments used in the course of the surgery. Conversely, the main surgeon and his or her assistant are always directly responsible, due to the fact that the nurses' count procedure represents merely an additional control measure, without substituting at all the check the surgeons must obligatory conduct on the surgical site. Finally, the Authors point out that, as the count procedure is performed by the members of a surgical team, where a hierarchy-based relationship rules, the main surgeon is the liable for any preventable and avoidable adverse event provoked by the nursing staff as a consequence of the objective responsibility due to culpa in eligendo and culpa in vigilando.

  6. SURGICAL SITE INFECTION IN ABDOMINAL SURGERIES: A CLINICAL STUDY

    Directory of Open Access Journals (Sweden)

    Amit

    2014-09-01

    Full Text Available Purpose: A prospective study of incisional surgical site infection in abdominal surgeries was conducted to find out incidence, common predisposing factors and microbiological profile. METHODS: 375 patients who underwent abdominal surgeries were studied in a span of 1 year. They were divided into two groups – group 1 – 316 cases who did not develop Surgical Site Infection (SSI, the 2nd group – 59 cases that developed SSI. These patients were studied by interviewing and examination according to a set proforma. The results were statistically analyzed by comparing averages using Chi square chart for finding significance of difference where applicable. RESULT: The overall SSI incidence was 15.7 % (59/375. In elective surgeries, the SSI rate was 5.7% and in emergency surgeries, it was 28.6%. It was found that SSI increased with increasing age linearly. Other significant factors involved were increasing class of wound (dirty > clean wound class, increased preoperative stay, presence of remote site infection, increased duration of surgery and use of drains. E. coli was found to be the most common organism causing SSI in abdominal operations. CONCLUSION: SSI can be reduced by decreasing the preoperative hospital stay, appropriate antibiotic administration policies, preoperative control of remote site infections, adequate preoperative patient preparation, reducing the duration of surgery to minimum, judicious use of drains and intraoperative maintenance of asepsis and following operation theatre discipline properly.

  7. A retrospective study of risk factors for poor outcomes in methicillin-resistant staphylococcus aureus (MRSA infection in surgical patients

    Directory of Open Access Journals (Sweden)

    Middleton Scott D

    2011-05-01

    Full Text Available Abstract Background Since its isolation, Methicillin-resistant Staphlococcus aureus (MRSA has become a major cause of hospital acquired infection (HAI, adverse patient outcome and overall resource utilisation. It is endemic in Scotland and widespread in Western hospitals. MRSA has been the subject of widespread media interest- a manifestation of concerns about sterile surgical techniques and hospital cleanliness. This study aimed to investigate patient outcome of MRSA infections over the last decade at a major orthopaedic trauma centre. The objective was to establish the association of variables, such as patient age and inpatient residence, against patient outcome, in order to quantify significant relationships; facilitating the evaluation of management strategies with an aim to improving patient outcomes and targeting high-risk procedures. Methods This is a retrospective study of the rates and outcomes of MRSA infection in orthopaedic trauma at the Royal Infirmary of Edinburgh. Data was collated using SPSS 14.0 for Windows(R. Shapiro-Wilkes testing was performed to investigate the normality of continuous data sets (e.g: age. Data was analysed using both Chi-Squared and Fisher's exact tests (in cases of expected values under 5 Results This study found significant associations between adverse patient outcome (persistent deep infection, osteomyelitis, the necessity for revision surgery, amputation and mortality and the following patient variables: Length of inpatient stay, immuno-compromise, pre-admission residence in an institutional setting (such as a residential nursing home and the number of antibiotics used in patient care. Despite 63% of all infections sampled resulting from proximal femoral fractures, no association between patient outcome and site of infection or diagnosis was found. Somewhat surprisingly, the relationship between age and outcome of infection was not proved to be significant, contradicting previous studies suggesting a

  8. The effect of antibiotic irrigation of surgical Incisions in prevention of Surgical Site Infection

    Directory of Open Access Journals (Sweden)

    Mirsharifi S R

    2008-05-01

    Full Text Available Background: surgical site infection is one of the most common post operative complications alongside with sepsis, cardiovascular, pulmonary and thromboembolic complications. The development of surgical site infection is related to three factors: the degree of microbial contamination of the wound during surgery, the duration of the procedure, and host factors such as diabetes, malnutrition, obesity, immune suppression, and a number of other underlying disease states. The purpose of this study was to evaluate the effects of topical cephazolin in controlling infection of the site of surgery after non-laparoscopic cholecystecomy.Methods: One hundred and two of patients referred to the outpatient clinic of Imam Khomeini Hospital from fall 2005 to fall 2006 non- laparoscopic cholecystectomy enrolled in a randomized clinical trial. All patients underwent the same procedure of anesthesia and surgery and they were randomly assigned into two groups of cases with irrigation of the site of surgery with 1g of topical Cephazolin prior to the termination of the operation- and controls. Cephazolin is a first generation cephalosporin which binds penicillin binding protein and is a potent cell wall synthesis inhibitor. The patients were followed up for six weeks for symptoms and signs of infection including discharge of the wound; and presence of pain, warmness, swelling and erythema of the wound.Results: There were no significant differences between two study groups regarding mean age, duration of operation, and sex. There was no significant difference in the incidence of infection of the site of surgery (11.8% in both groups with p=0.99 between two groups.Conclusion: Analyzing the collected data confirms that prophylactic use of topical cephazolin was unable to decrease the risk of infection of the site of surgery in patients undergoing non- laparascopic cheolecystectomy.

  9. Molecular epidemiology of Staphylococcus aureus isolates at different sites in the milk producing dairy farms

    Directory of Open Access Journals (Sweden)

    Viviane Souza

    2012-12-01

    Full Text Available The epidemiological relationships between isolated Staphylococcus aureus strains in milk samples of dairy cows, reagent to California Mastitis Test, individual and group milk was demonstrated in different sites of the production fluxogram, in 12 milk-producing farms in the Gameleira region, municipality of Sacramento MG Brazil, so that localization and transmission modes may be identified. Two hundred and forty-four strains out of 446 samples collected at several sites were isolated and bio-chemically characterized as coagulase-positive staphylococcus. Specific chromosome DNA fragment of the species Staphylococcus aureus was amplified to 106 strains and 103 underwent (PFGE. Samples' collection sites with the highest isolation frequency of Staphylococcus aureus strains comprised papillary ostia (31.1%, CMT-reagent cow milk (21.7%, mechanical milking machines' insufflators (21,7%, milk in milk pails (6.6% and the milk in community bulk tanks (5.6%. Genetic heterogeneity existed among the isolated 103 Staphylococcus aureus strains, since 32 different pulse-types were identified. Pulse-type 1 had the highest similarity among the isolated strains within the different sites of the milk-production fluxogram. Highest occurrence of pulsetype 1 isolates of Staphylococcus aureus strains was reported in samples collected from the papillary ostia (10.6%, followed by milk samples from CMT-reagent dairy cows (5.8% and mechanical milking machine insufflators (3.8%. The above shows the relevance of these sites in the agents' transmission mechanism within the context of the farms investigated.

  10. Site of impaction of ureteric calculi requiring surgical intervention.

    Science.gov (United States)

    El-Barky, Ehab; Ali, Yusuf; Sahsah, Mohammed; Terra, Ali A; Kehinde, Elijah O

    2014-02-01

    Textbooks describe three narrowest anatomic sites in the ureter as the most likely places for ureteral calculi to lodge, these are: the pelvi-ureteric junction (PUJ), the point where the ureters cross over the iliac vessels and the ureterovesical junction (UVJ). The purpose of this study is to determine whether calculi causing ureteric obstruction and requiring surgical treatment are found mostly at these three narrowest anatomic points of the ureter. Three hundred consecutive patients with impacted ureteric calculi who required surgical intervention were studied. The location of the impacted calculus on the day of surgical intervention was categorized according to nine predetermined levels outlined in a designed diagram based on findings on non-contrast CT of kidneys, ureters and bladder. Two peaks in stone distribution in the ureters were encountered; the first was above the ischial spine in the proximal part of the lower third ureter (84 patients, 28%), while the second was at the level between L3 and L4 lumbar vertebrae (66 patients, 22%). Overall, the location of impacted calculi was as follows, 53, 34, 10 and 3% in the lower third ureter, upper third ureter, PUJ and mid ureter, respectively. This study demonstrates two peaks of calculi distribution in the ureter where ureteric calculi become impacted: the upper ureter below the PUJ and a second in the lower ureter, more proximal than the UVJ. There was an absence of the peak in stone location over the iliac vessels, that is, the mid ureter.

  11. A single copy integration vector that integrates at an engineered site on the Staphylococcus aureus chromosome

    Directory of Open Access Journals (Sweden)

    Lei Mei G

    2012-01-01

    Full Text Available Abstract Background Single-copy integration vectors based upon the site-specific recombination systems of bacteriophage are invaluable tools in the study of bacterial pathogenesis. The utility of such vectors is often limited, however, by the fact that integration often results in the inactivation of bacterial genes or has undesirable effects on gene transcription. The aim of this study is to develop an integration vector that does not have a detectable effect on gene transcription upon integration. Findings We have developed a single-copy integration system that enables the cloning vector to integrate at a specific engineered site, within an untranscribed intergenic region, in the chromosome of Staphylococcus aureus. This system is based on the lysogenic phage L54a site-specific recombination system in which the L54a phage (attP and chromosome (attB attachment sites, which share an 18-bp identical core sequence, were modified with identical mutations. The integration vector, pLL102, was constructed to contain the modified L54a attP site (attP2 that was altered at 5 nucleotide positions within the core sequence. In the recipient strain, the similarly modified attB site (attB2 was inserted in an intergenic region devoid of detectable transcription read-through. Integration of the vector, which is unable to replicate in S. aureus extrachromosomally, was achieved by providing the L54a integrase gene in a plasmid in the recipient. We showed that pLL102 integrated specifically at the engineered site rather than at the native L54a attB site and that integration did not have a significant effect on transcription of genes immediately upstream or downstream of the integration site. Conclusions In this work, we describe an E. coli-S. aureus shuttle vector that can be used to introduce any cloned gene into the S. aureus chromosome at a select site without affecting gene expression. The vector should be useful for genetic manipulation of S. aureus and for

  12. SURGICAL RISK INDEX AND SURGICAL SITE INFECTION IN POSTPARTUM WOMEN SUBMITTED TO CESAREAN SECTION

    Directory of Open Access Journals (Sweden)

    Luana Machado Chianca

    2015-07-01

    Full Text Available Backgound and Objectives: Considering the use of active surveillance assists in infection identification and the need for studies that use Surgical Risk Index (SRI for assessment of Surgical Site Infection (SSI in cesareans, this study aims to determine the incidence of SSI and analyze the applicability of SRI in the prediction of SSI in women in the postpartum period after being submitted to a cesarean section at a university hospital between April 2012 and March of 2013. Methods: Prospective cohort study. Information notifying SSI by active surveillance was collected daily from the medical records. After hospital discharge, the mothers were contacted through telephone calls to identify infection criteria within 30 days after the cesarean. Descriptive and comparative analyses were performed. The chi-square test was used to compare groups. Results: 737 cesareans were performed. Telephone contact was achieved with 507 (68.8% women up to 30 days postpartum, with loss of follow-up of 230 cases (31.2%. The medical consultation in the post-partum period occurred with 188 (37.08% women, with whom telephone contact was obtained, on average, 17.28 days (SD=8.39 after delivery. It was verified that 21 patients met the criteria for SSI, with a 4.14% rate. A total of 12 cases (57.1% were classified as superficial SSI, 5 (23.8% as deep and 4 (19.1% as infection of organs and cavities. The SRI and its risk variables were not associated with SSI in patients submitted to cesarean sections. Conclusion: The SRI and the risk variables included in this index were not associated to SSI in patients submitted to cesarean sections. KEYWORDS: Cesarean Section; Surgical Wound Infection; Epidemiological Surveillance; Infection Control; Risk Index; Disease Notification.

  13. SURGICAL SITE INFECTION FOLLOWING LOWER SEGMENT CAESAREAN SECTION IN A TERTIARY CARE HOSPITAL

    Directory of Open Access Journals (Sweden)

    Nishi Roshini

    2016-03-01

    Full Text Available AIM OF THE STUDY To identify infection rates and risk factors associated with Surgical Site Infection (SSI following Caesarean Section. DESIGN OF THE STUDY Case control study. PLACE OF STUDY Academic Tertiary Care Obstetrics and Gynaecology Centre with 60 Beds. PATIENTS All women who delivered by caesarean section in Govt. Medical College, Thrissur, during 1st June 2010 to 30th September 2011. METHODS Wound infections were identified during hospital stay using the criteria of the Centres for Disease Control and Prevention, National Nosocomial Infections Surveillance System. A case control study of 50 patients with wound infection after Lower Segment Caesarean Section (LSCS was undertaken between 1st June 2010 and 30th September 2011. The control group comprised of 50 patients selected randomly from among those who had LSCS during the study period with no wound infection. The CDC definition describes three levels of SSI (Superficial incisional, Deep incisional and Organ or Space infection. Comparisons for categorical variables were performed using the X2 or Fisher exact test. Continuous variables were compared using the 2-tailed Student ‘t’ test and p 0.05 was considered significant. RESULTS The overall wound infection rate in the study was 3.5%, (50 among 1410 Lower Transverse CS. Obesity, Hypertension and Poorly Controlled Diabetes are associated with significant risk for development of SSI. The commonest presentation of SSI in LSCS was fever 40 (80% followed by local pain and induration 25 (50%. SSI was detected on 6±3 days. Average duration of hospital stay among SSI was 22.78±10.2 days. Staphylococcus aureus was the commonest pathogen for SSI in our series. The increase in the presence of (Methicillin Resistant Staphylococcus Aureus MRSA (20.83% might alter the pattern of prophylactic antibiotic given preoperatively in the near future. CONCLUSIONS Increased incidence of drug resistant organisms needs proper attention and strategies for

  14. Surgical Site Infections Following Spine Surgery: Eliminating the Controversies in the Diagnosis

    Directory of Open Access Journals (Sweden)

    Jad eChahoud

    2014-03-01

    Full Text Available Surgical site infection (SSI following spine surgery is a dreaded complication with significant morbidity and economic burden. SSIs following spine surgery can be superficial, characterized by obvious wound drainage, or deep-seated with a healed wound. Staphylococcus aureus remains the principal causal agent. There are certain pre-operative risk factors that increase the risk of SSI, mainly diabetes, smoking, steroids, and peri-operative transfusions. Additionally, intra-operative risk factors include surgical invasiveness, type of fusion, implant use, and traditional instead of minimally invasive approach. A high level of suspicion is crucial to attaining an early definitive diagnosis and initiating appropriate management. The most common presenting symptom is back pain, usually manifesting 2 to 4 weeks and up to 3 months after a spinal procedure. Scheduling a follow-up visit between weeks 2 to 4 after surgery is therefore necessary for early detection. Inflammatory markers are important diagnostic tools, and comparing pre-operative with post-operative levels should be done when suspecting SSIs following spine surgery. Particularly, Serum Amyloid A (SAA is a novel inflammatory marker that can expedite the diagnosis of SSIs. Magnetic resonance imaging remains the diagnostic modality of choice when suspecting a SSI following spine surgery. While 18F-fluorodeoxyglucose-positron emission tomography is not widely used, it may be useful in challenging cases. Despite their low yield, blood cultures should be collected before initiating antibiotic therapy. Samples from wound drainage should be sent for Gram stain and cultures. When there is a high clinical suspicion of SSI and in the absence of superficial wound drainage, CT guided aspiration of paraspinal collections is warranted. Unless the patient is hemodynamically compromised, antibiotics should be deferred until proper specimens for culture are secured.

  15. Surgical site infections following spine surgery: eliminating the controversies in the diagnosis.

    Science.gov (United States)

    Chahoud, Jad; Kanafani, Zeina; Kanj, Souha S

    2014-01-01

    Surgical site infection (SSI) following spine surgery is a dreaded complication with significant morbidity and economic burden. SSIs following spine surgery can be superficial, characterized by obvious wound drainage or deep-seated with a healed wound. Staphylococcus aureus remains the principal causal agent. There are certain pre-operative risk factors that increase the risk of SSI, mainly diabetes, smoking, steroids, and peri-operative transfusions. Additionally, intra-operative risk factors include surgical invasiveness, type of fusion, implant use, and traditional instead of minimally invasive approach. A high level of suspicion is crucial to attaining an early definitive diagnosis and initiating appropriate management. The most common presenting symptom is back pain, usually manifesting 2-4 weeks and up to 3 months after a spinal procedure. Scheduling a follow-up visit between weeks 2 and 4 after surgery is therefore necessary for early detection. Inflammatory markers are important diagnostic tools, and comparing pre-operative with post-operative levels should be done when suspecting SSIs following spine surgery. Particularly, serum amyloid A is a novel inflammatory marker that can expedite the diagnosis of SSIs. Magnetic resonance imaging remains the diagnostic modality of choice when suspecting a SSI following spine surgery. While 18F-fluorodeoxyglucose-positron emission tomography is not widely used, it may be useful in challenging cases. Despite their low yield, blood cultures should be collected before initiating antibiotic therapy. Samples from wound drainage should be sent for Gram stain and cultures. When there is a high clinical suspicion of SSI and in the absence of superficial wound drainage, computed tomography-guided aspiration of paraspinal collections is warranted. Unless the patient is hemodynamically compromised, antibiotics should be deferred until proper specimens for culture are secured. PMID:25705620

  16. Establishment of Multi-Site Infection Model in Zebrafish Larvae for Studying Staphylococcus aureus Infectious Disease

    Institute of Scientific and Technical Information of China (English)

    Ya-juan Li; Bing Hu

    2012-01-01

    Zebrafish (Danio rerio) is an ideal model for studying the mechanism of infectious disease and the interaction between host and pathogen.As a teleost,zebrafish has developed a complete immune system which is similar to mammals.Moreover,the easy acquirement of large amounts of transparent embryos makes it a good candidate for gene manipulation and drug screening.In a zebrafish infection model,all of the site,timing,and dose of the bacteria microinjection into the embryo are important factors that determine the bacterial infection of host.Here,we established a multi-site infection model in zebrafish larvae of 36 hours post-fertilization (hpf) by microinjecting wild-type or GFP-expressing Staphylococcus aereus (S.aureus) with gradient burdens into different embryo sites including the pericardial cavity (PC),eye,the fourth hindbrain ventricle (4V),yolk circulation valley (YCV),caudal vein (CV),yolk body (YB),and Duct of Cuvier (DC) to resemble human infectious disease.With the combination of GFP-expressing S.aureus and transgenic zebrafish Tg (corola:eGFP; lyz:Dsred) and Tg (lyz:Dsred) lines whose macrophages or neutrophils are fluorescent labeled,we observed the dynamic process of bacterial infection by in vivo multicolored confocal fluorescence imaging.Analyses of zebrafish embryo survival,bacterial proliferation and myeloid cells phagocytosis show that the site- and dose-dependent differences exist in infection of different bacterial entry routes.This work provides a consideration for the future study of pathogenesis and host resistance through selection of multi-site infection model.More interaction mechanisms between pathogenic bacteria virulence factors and the immune responses of zebrafish could be determined through zebrafish multi-site infection model.

  17. Surgical Site Infections Following Pediatric Ambulatory Surgery: An Epidemiologic Analysis.

    Science.gov (United States)

    Rinke, Michael L; Jan, Dominique; Nassim, Janelle; Choi, Jaeun; Choi, Steven J

    2016-08-01

    OBJECTIVE To identify surgical site infection (SSI) rates following pediatric ambulatory surgery, SSI outcomes and risk factors, and sensitivity and specificity of SSI administrative billing codes. DESIGN Retrospective chart review of pediatric ambulatory surgeries with International Classification of Disease, Ninth Revision (ICD-9) codes for SSI, and a systematic random sampling of 5% of surgeries without SSI ICD-9 codes, all adjudicated for SSI on the basis of an ambulatory-adapted National Healthcare Safety Network definition. SETTING Urban pediatric tertiary care center April 1, 2009-March 31, 2014. METHODS SSI rates and sensitivity and specificity of ICD-9 codes were estimated using sampling design, and risk factors were analyzed in case-rest of cohort, and case-control, designs. RESULTS In 15,448 pediatric ambulatory surgeries, 34 patients had ICD-9 codes for SSI and 25 met the adapted National Healthcare Safety Network criteria. One additional SSI was identified with systematic random sampling. The SSI rate following pediatric ambulatory surgery was 2.9 per 1,000 surgeries (95% CI, 1.2-6.9). Otolaryngology surgeries demonstrated significantly lower SSI rates compared with endocrine (P=.001), integumentary (P=.001), male genital (Psurgeries. Almost half of patients with an SSI were admitted, 88% received antibiotics, and 15% returned to the operating room. No risk factors were associated with SSI. The sensitivity of ICD-9 codes for SSI following ambulatory surgery was 55.31% (95% CI, 12.69%-91.33%) and specificity was 99.94% (99.89%-99.97%). CONCLUSIONS SSI following pediatric ambulatory surgery occurs at an appreciable rate and conveys morbidity on children. Infect Control Hosp Epidemiol 2016;37:931-938.

  18. Surgical Site Infections Following Pediatric Ambulatory Surgery: An Epidemiologic Analysis.

    Science.gov (United States)

    Rinke, Michael L; Jan, Dominique; Nassim, Janelle; Choi, Jaeun; Choi, Steven J

    2016-08-01

    OBJECTIVE To identify surgical site infection (SSI) rates following pediatric ambulatory surgery, SSI outcomes and risk factors, and sensitivity and specificity of SSI administrative billing codes. DESIGN Retrospective chart review of pediatric ambulatory surgeries with International Classification of Disease, Ninth Revision (ICD-9) codes for SSI, and a systematic random sampling of 5% of surgeries without SSI ICD-9 codes, all adjudicated for SSI on the basis of an ambulatory-adapted National Healthcare Safety Network definition. SETTING Urban pediatric tertiary care center April 1, 2009-March 31, 2014. METHODS SSI rates and sensitivity and specificity of ICD-9 codes were estimated using sampling design, and risk factors were analyzed in case-rest of cohort, and case-control, designs. RESULTS In 15,448 pediatric ambulatory surgeries, 34 patients had ICD-9 codes for SSI and 25 met the adapted National Healthcare Safety Network criteria. One additional SSI was identified with systematic random sampling. The SSI rate following pediatric ambulatory surgery was 2.9 per 1,000 surgeries (95% CI, 1.2-6.9). Otolaryngology surgeries demonstrated significantly lower SSI rates compared with endocrine (P=.001), integumentary (P=.001), male genital (PSSI were admitted, 88% received antibiotics, and 15% returned to the operating room. No risk factors were associated with SSI. The sensitivity of ICD-9 codes for SSI following ambulatory surgery was 55.31% (95% CI, 12.69%-91.33%) and specificity was 99.94% (99.89%-99.97%). CONCLUSIONS SSI following pediatric ambulatory surgery occurs at an appreciable rate and conveys morbidity on children. Infect Control Hosp Epidemiol 2016;37:931-938. PMID:27121727

  19. Predictors of surgical site infections among patients undergoing major surgery at Bugando Medical Centre in Northwestern Tanzania

    Directory of Open Access Journals (Sweden)

    Imirzalioglu Can

    2011-08-01

    Full Text Available Abstract Background Surgical site infection (SSI continues to be a major source of morbidity and mortality in developing countries despite recent advances in aseptic techniques. There is no baseline information regarding SSI in our setting therefore it was necessary to conduct this study to establish the prevalence, pattern and predictors of surgical site infection at Bugando Medical Centre Mwanza (BMC, Tanzania. Methods This was a cross-sectional prospective study involving all patients who underwent major surgery in surgical wards between July 2009 and March 2010. After informed written consent for the study and HIV testing, all patients who met inclusion criteria were consecutively enrolled into the study. Pre-operative, intra-operative and post operative data were collected using standardized data collection form. Wound specimens were collected and processed as per standard operative procedures; and susceptibility testing was done using disc diffusion technique. Data were analyzed using SPSS software version 15 and STATA. Results Surgical site infection (SSI was detected in 65 (26.0% patients, of whom 56 (86.2% and 9 (13.8% had superficial and deep SSI respectively. Among 65 patients with clinical SSI, 56(86.2% had positive aerobic culture. Staphylococcus aureus was the predominant organism 16/56 (28.6%; of which 3/16 (18.8% were MRSA. This was followed by Escherichia coli 14/56 (25% and Klebsiella pneumoniae 10/56 (17.9%. Among the Escherichia coli and Klebsiella pneumoniae isolates 9(64.3% and 8(80% were ESBL producers respectively. A total of 37/250 (14.8% patients were HIV positive with a mean CD4 count of 296 cells/ml. Using multivariate logistic regression analysis, presence of pre-morbid illness (OR = 6.1, use of drain (OR = 15.3, use of iodine alone in skin preparation (OR = 17.6, duration of operation ≥ 3 hours (OR = 3.2 and cigarette smoking (OR = 9.6 significantly predicted surgical site infection (SSI Conclusion SSI is common

  20. Changes in Surgical Site Infections after Living Donor Liver Transplantation

    Science.gov (United States)

    Yamamoto, Masaki; Takakura, Shunji; Iinuma, Yoshitsugu; Hotta, Go; Matsumura, Yasufumi; Matsushima, Aki; Nagao, Miki; Ogawa, Kohei; Fujimoto, Yasuhiro; Mori, Akira; Ogura, Yasuhiro; Kaido, Toshimi; Uemoto, Shinji; Ichiyama, Satoshi

    2015-01-01

    Surgical site infections (SSIs) are a major threat for liver transplant recipients. We prospectively studied SSIs after living donor liver transplantation (LDLT) at Kyoto University Hospital from April 2001 to March 2002 (1st period) and from January 2011 to June 2012 (2nd period). We investigated the epidemiology of SSIs after LDLT and determined the differences between the two periods. A total of 129 adult recipients (66 during the 1st period and 63 during the 2nd period) and 72 pediatric recipients (39 and 33) were included in this study. The SSI rates for each period were 30.3% (1st period) and 41.3% (2nd period) among the adult recipients and 25.6% and 30.3% among the pediatric recipients. The overall rates of 30-day mortality among adult transplant recipients with SSIs were 10.0% (1st period) and 3.9% (2nd period). No pediatric recipient died from SSIs after LDLT in either period. The incidence of Enterococcus faecium increased from 5.0% to 26.9% in the adults and from 10.0% to 40.0% in the pediatric patients. Extended-spectrum β-lactamase-producing Enterobacteriaceae were emerging important isolates during the 2nd period. For this period, a univariate analysis showed that ABO incompatibility (P = 0.02), total operation duration (P = 0.01), graft-to-recipient body weight ratio (GRWR [P = 0.04]), and Roux-en-Y biliary reconstruction (P<0.01) in the adults and age (P = 0.01) and NHSN risk index (P = 0.02) in the children were associated with SSI development. In a multivariate analysis, lower GRWR (P = 0.02) and Roux-en-Y biliary reconstruction (P<0.01) in the adults and older age (P = 0.01) in the children were independent risk factors for SSIs during the 2nd period. In conclusion, SSIs caused by antibiotic resistant bacteria may become a major concern. Lower GRWR and Roux-en-Y biliary reconstruction among adult LDLT recipients and older age among pediatric LDLT recipients increased the risk of developing SSIs after LDLT. PMID:26322891

  1. Changes in Surgical Site Infections after Living Donor Liver Transplantation.

    Directory of Open Access Journals (Sweden)

    Masaki Yamamoto

    Full Text Available Surgical site infections (SSIs are a major threat for liver transplant recipients. We prospectively studied SSIs after living donor liver transplantation (LDLT at Kyoto University Hospital from April 2001 to March 2002 (1st period and from January 2011 to June 2012 (2nd period. We investigated the epidemiology of SSIs after LDLT and determined the differences between the two periods. A total of 129 adult recipients (66 during the 1st period and 63 during the 2nd period and 72 pediatric recipients (39 and 33 were included in this study. The SSI rates for each period were 30.3% (1st period and 41.3% (2nd period among the adult recipients and 25.6% and 30.3% among the pediatric recipients. The overall rates of 30-day mortality among adult transplant recipients with SSIs were 10.0% (1st period and 3.9% (2nd period. No pediatric recipient died from SSIs after LDLT in either period. The incidence of Enterococcus faecium increased from 5.0% to 26.9% in the adults and from 10.0% to 40.0% in the pediatric patients. Extended-spectrum β-lactamase-producing Enterobacteriaceae were emerging important isolates during the 2nd period. For this period, a univariate analysis showed that ABO incompatibility (P = 0.02, total operation duration (P = 0.01, graft-to-recipient body weight ratio (GRWR [P = 0.04], and Roux-en-Y biliary reconstruction (P<0.01 in the adults and age (P = 0.01 and NHSN risk index (P = 0.02 in the children were associated with SSI development. In a multivariate analysis, lower GRWR (P = 0.02 and Roux-en-Y biliary reconstruction (P<0.01 in the adults and older age (P = 0.01 in the children were independent risk factors for SSIs during the 2nd period. In conclusion, SSIs caused by antibiotic resistant bacteria may become a major concern. Lower GRWR and Roux-en-Y biliary reconstruction among adult LDLT recipients and older age among pediatric LDLT recipients increased the risk of developing SSIs after LDLT.

  2. Clinicopathological Parameters Associated with Surgical Site Infections in Patients who Underwent Pancreatic Resection

    OpenAIRE

    Nanashima, Atsushi; Abo, Takafumi; Arai, Junichi; Oyama, Shousaburo; Mochinaga, Koji; Matsumoto, Hirofumi; Takagi, Katsunori; Kunizaki, Masaki; To, Kazuo; Takeshita, Hiroaki; HIDAKA, SHIGEKAZU; Nagayasu, Takeshi

    2014-01-01

    Background/Aims: To clarify parameters associated with postoperative surgical site infection (SSI) after pancreatectomy, we examined clinicopathological and surgical records in 186 patients who underwent pancreatectomy at a single academic institute. Methodology: Patient demographics, liver functional parameters, histological findings, surgical records and post-hepatectomy outcomes during hospitalization were compared between the non-SSI and SSI group, in which SSIs included superficial and d...

  3. Risk Factors of Surgical Site Infection at Muhimbili National Hospital, Dar es Salaam, Tanzania

    OpenAIRE

    Akoko, L.O.; Mwanga, A.H.; Fredrick, F.; Mbembati, N.M.

    2012-01-01

    Surgical site infection (SSI) is a common source of morbidity among operated patients. At Muhimbili National Hospital (MNH), studies indicate that the rate of SSI has been increasing over the past thirty years. The aim of this study was to determine the prevalence and factors associated with SSI among patients undergoing surgery at MNH. This was a hospital-based cross-sectional study. One hundred and eighteen patients who underwent surgical procedures in the surgical wards were recruited. Dem...

  4. Identification of potential surgical site infections leveraging an enterprise clinical information warehouse.

    Science.gov (United States)

    Santangelo, Jennifer; Erdal, Selnur; Wellington, Linda; Mekhjian, Hagop; Kamal, Jyoti

    2008-11-06

    At The Ohio State University Medical Center (OSUMC), infection control practitioners (ICPs) need an accurate list of patients undergoing defined operative procedures to track surgical site infections. Using data from the OSUMC Information Warehouse (IW), we have created an automated report detailing required data. This report also displays associated surgical and pathology text or dictated reports providing additional information to the ICPs.

  5. Evaluation of the surveillance of surgical site infections within the Dutch PREZIES network

    NARCIS (Netherlands)

    Manniën, Judith

    2008-01-01

    Surgical site infections (SSI) are the most-common healthcare-associated infections among surgical patients and have severe adverse consequences. Surveillance is the ongoing systematic collection, analysis, interpretation, and feedback of data, and has been accepted worldwide as a primary step towar

  6. Surgical site infection after osteotomy of the adult spine: does type of osteotomy matter?

    NARCIS (Netherlands)

    Pull ter Gunne, A.F.; Laarhoven, C.J.H.M. van; Cohen, D.B.

    2010-01-01

    BACKGROUND CONTEXT: Surgical site infection after spinal surgery is frequently seen. It occurs between 0.7% and 12% of patients, leading to higher morbidity, mortality, and health-care costs. Osteotomy procedures are known to have increased blood losses and surgical times when compared with other sp

  7. Surgical Site Infection and Validity of Staged Surgical Procedure in Emergent/Urgent Surgery for Ulcerative Colitis

    OpenAIRE

    Uchino, Motoi; Ikeuchi, Hiroki; Matsuoka, Hiroki; Takahashi, Yoshiko; Tomita, Naohiro; Takesue, Yoshio

    2013-01-01

    Although restorative proctocolectomy is recognized as a standard procedure for ulcerative colitis, infectious complications after surgery cannot be disregarded. The aim of this study was to define predictors of surgical site infection (SSI) in urgent/emergent surgery for ulcerative colitis. We performed prospective SSI surveillance for 90 consecutive patients. Possible risk factors were analyzed by logistic regression analyses. Incidences of incisional SSI (i-SSI) and organ/space SSI were 31....

  8. Improving surveillance system and surgical site infection rates through a network: A pilot study from Thailand

    OpenAIRE

    Kasatpibal, Nongyao

    2009-01-01

    Nongyao Kasatpibal1, Mette Nørgaard2, Silom Jamulitrat3, For The Surgical Site Infection Study Group1Faculty of Nursing, Chiang Mai University, Chiang Mai, Thailand; 2Department of Clinical Epidemiology, Aarhus University hospital, Aalborg and Aarhus, Denmark; 3Department of Community Medicine, Faculty of Medicine, Prince of Songkla University, Songkhla, ThailandBackground: Surveillance of surgical site infections (SSI) provides data upon which interventions to improve patient safe...

  9. Methicillin-resistant Staphylococcus aureus multiple sites surveillance: a systemic review of the literature

    Directory of Open Access Journals (Sweden)

    Chipolombwe J

    2016-02-01

    Full Text Available John Chipolombwe,1 Mili Estee Török,2 Nontombi Mbelle,3 Peter Nyasulu,4,51Department of Internal Medicine, Mzuzu Central Hospital, Ministry of Health, Mzuzu, Malawi; 2Department of Medicine, University of Cambridge, Cambridge, UK; 3Department of Medical Microbiology, University of Pretoria, Pretoria, South Africa; 4School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, 5Department of Public Health, School of Health Sciences, Monash University, Johannesburg, South Africa Purpose: The objective of this study was to evaluate the optimal number of sampling sites for detection of methicillin-resistant Staphylococcus aureus (MRSA colonization. Methods: We performed a Medline search from January 1966 to February 2014 for articles that reported the prevalence of MRSA at different body sites. Studies were characterized by study design, country and period of the study, number of patients and/or isolates of MRSA, specimen type, sites of MRSA isolation, study population sampled, diagnostic testing method, and percentage of the MRSA isolates at each site in relation to the total number of sites. Results: We reviewed 3,211 abstracts and 177 manuscripts, of which 17 met the criteria for analysis (n=52,642 patients. MRSA colonization prevalence varied from 8% to 99% at different body sites. The nasal cavity as a single site had MRSA detection sensitivity of 68% (34%–91%.The throat and nares gave the highest detection rates as single sites. A combination of two swabs improved MRSA detection rates with the best combination being groin/throat (89.6%; 62.5%–100%. A combination of three swab sites improved MRSA detection rate to 94.2% (81%–100% with the best combination being groin/nose/throat. Certain combinations were associated with low detection rates. MRSA detection rates also varied with different culture methods. Conclusion: A combination of three swabs from different body sites resulted in the highest detection rate for

  10. Mupirocin prophylaxis against nosocomial Staphylococcus aureus infections in nonsurgical patients: a randomized study.

    NARCIS (Netherlands)

    Wertheim, H.F.; Vos, A.M.C.; Ott, A.; Voss, A.; Kluytmans, J.A.J.W.; Broucke-Grauls, C.M. van den; Meester, M.; Keulen, P.H. van; Verbrugh, H.A.

    2004-01-01

    BACKGROUND: Staphylococcus aureus nasal carriage is a major risk factor for nosocomial S. aureus infection. Studies show that intranasal mupirocin can prevent nosocomial surgical site infections. No data are available on the efficacy of mupirocin in nonsurgical patients. OBJECTIVE: To assess the eff

  11. Intraoperative technique as a factor in the prevention of surgical site infection.

    LENUS (Irish Health Repository)

    McHugh, S M

    2011-02-28

    Approximately five percent of patients who undergo surgery develop surgical site infections (SSIs) which are associated with an extra seven days as an inpatient and with increased postoperative mortality. The competence and technique of the surgeon is considered important in preventing SSI. We have reviewed the evidence on different aspects of surgical technique and its role in preventing SSI. The most recent guidelines from the National Institute for Health and Clinical Excellence in the UK recommend avoiding diathermy for skin incision even though this reduces incision time and blood loss, both associated with lower infection rates. Studies comparing different closure techniques, i.e. continuous versus interrupted sutures, have not found a statistically significant difference in the SSI rate, but using continuous sutures is quicker. For contaminated wounds, the surgical site should be left open for four days to allow for treatment of local infection before subsequent healing by primary intention. Surgical drains should be placed through separate incisions, closed suction drains are preferable to open drains, and all drains should be removed as soon as possible. There are relatively few large studies on the impact of surgical techniques on SSI rates. Larger multicentre prospective studies are required to define what aspects of surgical technique impact on SSI, to better inform surgical practice and support education programmes for surgical trainees.

  12. Intraoperative technique as a factor in the prevention of surgical site infection.

    LENUS (Irish Health Repository)

    McHugh, S M

    2012-02-01

    Approximately five percent of patients who undergo surgery develop surgical site infections (SSIs) which are associated with an extra seven days as an inpatient and with increased postoperative mortality. The competence and technique of the surgeon is considered important in preventing SSI. We have reviewed the evidence on different aspects of surgical technique and its role in preventing SSI. The most recent guidelines from the National Institute for Health and Clinical Excellence in the UK recommend avoiding diathermy for skin incision even though this reduces incision time and blood loss, both associated with lower infection rates. Studies comparing different closure techniques, i.e. continuous versus interrupted sutures, have not found a statistically significant difference in the SSI rate, but using continuous sutures is quicker. For contaminated wounds, the surgical site should be left open for four days to allow for treatment of local infection before subsequent healing by primary intention. Surgical drains should be placed through separate incisions, closed suction drains are preferable to open drains, and all drains should be removed as soon as possible. There are relatively few large studies on the impact of surgical techniques on SSI rates. Larger multicentre prospective studies are required to define what aspects of surgical technique impact on SSI, to better inform surgical practice and support education programmes for surgical trainees.

  13. Cyanoacrylate Skin Microsealant for Preventing Surgical Site Infection after Vascular Surgery : A Discontinued Randomized Clinical Trial

    NARCIS (Netherlands)

    Vierhout, Bastiaan P.; Ott, Alewijn; Reijnen, Michel M. P. J.; Oskam, Jacques; Ott, Alewijn; van den Dungen, Jan J. A. M.; Zeebregts, Clark J.

    2014-01-01

    Background: Surgical site infections (SSI) after vascular surgery are related to substantial morbidity. Restriction of bacterial access to the site of surgery with a cyanoacrylate sealant is a new concept. We performed a randomized clinical trial to assess the effect of the sealing of skin with a cy

  14. The role of topical antibiotics used as prophylaxis in surgical site infection prevention.

    LENUS (Irish Health Repository)

    McHugh, S M

    2012-02-01

    Compared with systemic antibiotic therapy, the topical or local delivery of an antibiotic has many potential advantages. However, local antibiotics at the surgical site have received very limited approval in any of the surgical prophylaxis consensus guidelines that we are aware of. A review of the literature was carried out through searches of peer-reviewed publications in PubMed in the English language over a 30 year period between January 1980 and May 2010. Both retrospective and prospective studies were included, as well as meta-analyses. With regard to defining \\'topical\\' or \\'local\\' antibiotic application, the application of an antibiotic solution to the surgical site intraoperatively or immediately post-operatively was included. A number of surgical procedures have been shown to significantly benefit from perioperative topical prophylaxis, e.g. joint arthroplasty, cataract surgery and, possibly, breast augmentation. In obese patients undergoing abdominal surgery, topical surgical prophylaxis is also proven to be beneficial. The selective use of topical antibiotics as surgical prophylaxis is justified for specific procedures, such as joint arthroplasty, cataract surgery and, possibly, breast augmentation. In selective cases, such as obese patients undergoing abdominal surgery, topical surgical prophylaxis is also proven to be beneficial. Apart from these specific indications, the evidence for use of topical antibiotics in surgery is lacking in conclusive randomized controlled trials.

  15. The role of topical antibiotics used as prophylaxis in surgical site infection prevention.

    LENUS (Irish Health Repository)

    McHugh, S M

    2011-04-01

    Compared with systemic antibiotic therapy, the topical or local delivery of an antibiotic has many potential advantages. However, local antibiotics at the surgical site have received very limited approval in any of the surgical prophylaxis consensus guidelines that we are aware of. A review of the literature was carried out through searches of peer-reviewed publications in PubMed in the English language over a 30 year period between January 1980 and May 2010. Both retrospective and prospective studies were included, as well as meta-analyses. With regard to defining \\'topical\\' or \\'local\\' antibiotic application, the application of an antibiotic solution to the surgical site intraoperatively or immediately post-operatively was included. A number of surgical procedures have been shown to significantly benefit from perioperative topical prophylaxis, e.g. joint arthroplasty, cataract surgery and, possibly, breast augmentation. In obese patients undergoing abdominal surgery, topical surgical prophylaxis is also proven to be beneficial. The selective use of topical antibiotics as surgical prophylaxis is justified for specific procedures, such as joint arthroplasty, cataract surgery and, possibly, breast augmentation. In selective cases, such as obese patients undergoing abdominal surgery, topical surgical prophylaxis is also proven to be beneficial. Apart from these specific indications, the evidence for use of topical antibiotics in surgery is lacking in conclusive randomized controlled trials.

  16. Preoperative skin preparation with 2% chlorhexidine as a factor in the prevention of surgical site infection

    OpenAIRE

    Evelyn Solano Castro

    2014-01-01

    The results of secondary research that refers to preoperative skin preparation with antiseptic chlorhexidine 2% are presented. Surgical Site Infections are one of the most common complications in surgical procedures are associated with significant morbidity and mortality in the user and are the third -associated infection more frequent in the health care . Steps of clinical practice based on evidence were applied, considering in the first instance a question in PICO format, then a search for ...

  17. Trends in surgical site infections in general surgery at a tertiary hospital

    Directory of Open Access Journals (Sweden)

    B. Ravinder Reddy

    2012-01-01

    Full Text Available Surgical site infections (SSI are a preventable cause of hospital acquired infections, which increase morbidity and mortality. This is a retrospective analysis of SSIs in patients undergoing general surgical and gastroenterological operations. The observed incidence was 3.63%. The commonest procedures resulting in SSI were those who underwent laparotomy for bowel resections. The commonest organisms isolated were Enterococcus and Klebsiella species. SSIs can be further reduced by strict adherence to SSI prevention guide-lines.

  18. Prevention and control of surgical site infections: review of the Basel Cohort Study

    OpenAIRE

    Junker, Till; Mujagic, Edin; Hoffmann, Henry; Rosenthal, Rachel; Misteli, Heidi; Zwahlen, Marcel; Oertli, Daniel; Tschudin-Sutter, Sarah; Widmer, Andreas F; Marti, Walter R; Weber, Walter P

    2012-01-01

    INTRODUCTION: Surgical site infections (SSI) are the most common hospital-acquired infections among surgical patients, with significant impact on patient morbidity and health care costs. The Basel SSI Cohort Study was performed to evaluate risk factors and validate current preventive measures for SSI. The objective of the present article was to review the main results of this study and its implications for clinical practice and future research. SUMMARY OF METHODS OF THE BASEL SSI COHORT STUDY...

  19. Comparison of postoperative surgical site infection after preoperative marking done with non-sterile stationary grade markers versus sterile surgical markers

    International Nuclear Information System (INIS)

    Objectives: To compare the frequencies of post- operative surgical site infection after preoperative marking done with non-sterile stationary. grade markers versus sterile surgical markers in the same patient. Design: Randomized control trial. Place and Duration of Study: The department of Plastic surgery, Mayo hospital, Lahore from August 2013 to August 2014. Methods: This study was conducted after taking approval from the departmental ethical committee. Forty consecutive patients were included. A sterile surgical marker was used to mark one incision site while an alcohol based stationary grade marker was used to mark another incision site on the same patient. A standard preoperative, intraoperative and postoperative protocol was followed. Cultures were performed on swabs taken from the incision sites and surgical site infection was assessed for 30 days. Results: The study included 40 patients; 17 males and 23 females. The mean age of subjects was 25.32 ± 19.69 years with the minimum age being 2 years and the maximum being 63 years. No growth was seen in cultures taken from all the incision sites after skin preparation in the non sterile stationary grade marker group as well as the sterile surgical grade marker group. Also no surgical site infection appeared during the 30 day postoperative observation period in the non sterile stationary grade marker group as well as the sterile surgical grade marker group. (author)

  20. Effect of high perioperative oxygen fraction on surgical site infection and pulmonary complications after abdominal surgery

    DEFF Research Database (Denmark)

    Meyhoff, Christian S; Wetterslev, Jørn; Jorgensen, Lars N;

    2009-01-01

    the frequency of surgical site infection without increasing the frequency of pulmonary complications in patients undergoing abdominal surgery. DESIGN, SETTING, AND PATIENTS: The PROXI trial, a patient- and observer-blinded randomized clinical trial conducted in 14 Danish hospitals between October 2006...... and October 2008 among 1400 patients undergoing acute or elective laparotomy. INTERVENTIONS: Patients were randomly assigned to receive either 80% or 30% oxygen during and for 2 hours after surgery. MAIN OUTCOME MEASURES: Surgical site infection within 14 days, defined according to the Centers for Disease...... Control and Prevention. Secondary outcomes included atelectasis, pneumonia, respiratory failure, and mortality. RESULTS: Surgical site infection occurred in 131 of 685 patients (19.1%) assigned to receive 80% oxygen vs 141 of 701 (20.1%) assigned to receive 30% oxygen (odds ratio [OR], 0.94; 95...

  1. Snoring Sounds Predict Obstruction Sites and Surgical Response in Patients with Obstructive Sleep Apnea Hypopnea Syndrome.

    Science.gov (United States)

    Lee, Li-Ang; Lo, Yu-Lun; Yu, Jen-Fang; Lee, Gui-She; Ni, Yung-Lun; Chen, Ning-Hung; Fang, Tuan-Jen; Huang, Chung-Guei; Cheng, Wen-Nuan; Li, Hsueh-Yu

    2016-01-01

    Snoring sounds generated by different vibrators of the upper airway may be useful indicators of obstruction sites in patients with obstructive sleep apnea hypopnea syndrome (OSAHS). This study aimed to investigate associations between snoring sounds, obstruction sites, and surgical responses (≥50% reduction in the apnea-hypopnea index [AHI] and Hz; odds ratio [OR], 1.25, 95% confidence interval [CI] 1.05-1.49) and body mass index (OR, 1.48, 95% CI 1.02-2.15) after logistic regression analysis. Tonsil obstruction was significantly, inversely correlated with mean snoring sound intensity (301-850 Hz; OR, 0.84, 95% CI 0.74-0.96). Moreover, baseline tonsil obstruction detected by either DISE or mean snoring sound intensity (301-850 Hz), and AHI could significantly predict the surgical response. Our findings suggest that snoring sound detection may be helpful in determining obstruction sites and predict surgical responses. PMID:27471038

  2. A Methodological Systematic Review on Surgical Site Infections Following Spinal Surgery: Part 1: Risk Factors

    NARCIS (Netherlands)

    Pull ter Gunne, A.F.; Hosman, A.J.F.; Cohen, D.B.; Schuetz, M.; Habil, D.; Laarhoven, C.J. van; Middendorp, J.J. van

    2012-01-01

    STUDY DESIGN.: A methodological systematic review. OBJECTIVE.: To critically appraise the validity of risk factors for surgical site infection (SSI) after spinal surgery. SUMMARY OF BACKGROUND DATA.: SSIs lead to higher morbidity, mortality, and increased health care costs. Understanding which facto

  3. The presentation, incidence, etiology, and treatment of surgical site infections after spinal surgery.

    NARCIS (Netherlands)

    Pull ter Gunne, A.F.; Mohamed, A.S.; Skolasky, R.L.; Laarhoven, C.J.H.M. van; Cohen, D.B.

    2010-01-01

    STUDY DESIGN: Descriptive, retrospective cohort analysis. OBJECTIVE: To evaluate the presentation, etiology, and treatment of surgical site infections (SSI) after spinal surgery. SUMMARY OF BACKGROUND DATA: SSI after spine surgery is frequently seen. Small case control studies have been published re

  4. Effect of optimized antibiotic prophylaxis on the incidence of surgical site infection.

    NARCIS (Netherlands)

    Mannien, J.; Kasteren, M.E.E. van; Nagelkerke, N.J.; Gyssens, I.C.J.; Kullberg, B.J.; Wille, J.C.; Boer, A.S. de

    2006-01-01

    Objective. To compare the rate of surgical site infection (SSI) before and after an intervention period in which an optimized policy for antibiotic prophylaxis was implemented. To demonstrate that a more prudent, restrictive policy would not have a detrimental effect on patient outcomes.Design. Befo

  5. A Methodological Systematic Review on Surgical Site Infections Following Spinal Surgery: Part 2: Prophylactic Treatments

    NARCIS (Netherlands)

    Middendorp, J.J. van; Pull ter Gunne, A.F.; Schuetz, M.; Habil, D.; Cohen, D.B.; Hosman, A.J.F.; Laarhoven, C.J. van

    2012-01-01

    STUDY DESIGN.: A methodological systematic review. OBJECTIVE.: To critically appraise the validity of preventive effects attributed to prophylactic treatments for surgical site infection (SSI) after spinal surgery. SUMMARY OF BACKGROUND DATA.: As a result of a rapidly increasing number of spinal pro

  6. Alcohol Drinking does not Affect Postoperative Surgical Site Infection or Anastomotic Leakage

    DEFF Research Database (Denmark)

    Shabanzadeh, Daniel Mønsted; Sørensen, Lars Tue

    2014-01-01

    Alcohol abuse appears to increase postoperative complications, but clinical trials have reported conflicting results. The objective of this systematic review and meta-analysis is to clarify how alcohol drinking affects postoperative surgical site infection and anastomotic leakage and to determine...... the impact of perioperative alcohol intervention....

  7. Incidence of surgical site infection following adult spinal deformity surgery: an analysis of patient risk.

    NARCIS (Netherlands)

    Pull ter Gunne, A.F.; Laarhoven, C.J.H.M. van; Cohen, D.B.

    2010-01-01

    Surgical site infection (SSI) following spinal surgery is a frequent complication and results in higher morbidity, mortality and healthcare costs. Patients undergoing surgery for spinal deformity (scoliosis/kyphosis) have longer surgeries, involving more spinal levels and larger blood losses than ty

  8. The surveillance of surgical site infection after primary total knee replacement from 1993 to 2013

    OpenAIRE

    Ng, FY; Chiu, KY; Yan, CH; Chan, PK

    2014-01-01

    INTRODUCTION: Surgical site infection (SSI) is still the most common complication after primary total knee replacement. The surveillance of SSI after total joint replacement helps to audit the infection rate, identifies risk factors, provides trend of bacteriology. This study aims at reporting the 20-year SSI after primary total knee ...

  9. Structure of S. aureus HPPK and the discovery of a new substrate site inhibitor.

    Directory of Open Access Journals (Sweden)

    Sandeep Chhabra

    Full Text Available The first structural and biophysical data on the folate biosynthesis pathway enzyme and drug target, 6-hydroxymethyl-7,8-dihydropterin pyrophosphokinase (SaHPPK, from the pathogen Staphylococcus aureus is presented. HPPK is the second essential enzyme in the pathway catalysing the pyrophosphoryl transfer from cofactor (ATP to the substrate (6-hydroxymethyl-7,8-dihydropterin, HMDP. In-silico screening identified 8-mercaptoguanine which was shown to bind with an equilibrium dissociation constant, K(d, of ∼13 µM as measured by isothermal titration calorimetry (ITC and surface plasmon resonance (SPR. An IC(50 of ∼41 µM was determined by means of a luminescent kinase assay. In contrast to the biological substrate, the inhibitor has no requirement for magnesium or the ATP cofactor for competitive binding to the substrate site. The 1.65 Å resolution crystal structure of the inhibited complex showed that it binds in the pterin site and shares many of the key intermolecular interactions of the substrate. Chemical shift and (15N heteronuclear NMR measurements reveal that the fast motion of the pterin-binding loop (L2 is partially dampened in the SaHPPK/HMDP/α,β-methylene adenosine 5'-triphosphate (AMPCPP ternary complex, but the ATP loop (L3 remains mobile on the µs-ms timescale. In contrast, for the SaHPPK/8-mercaptoguanine/AMPCPP ternary complex, the loop L2 becomes rigid on the fast timescale and the L3 loop also becomes more ordered--an observation that correlates with the large entropic penalty associated with inhibitor binding as revealed by ITC. NMR data, including (15N-(1H residual dipolar coupling measurements, indicate that the sulfur atom in the inhibitor is important for stabilizing and restricting important motions of the L2 and L3 catalytic loops in the inhibited ternary complex. This work describes a comprehensive analysis of a new HPPK inhibitor, and may provide a foundation for the development of novel antimicrobials targeting

  10. Microbial colonisation of orthopaedic tourniquets: A potential risk for surgical site infection

    Directory of Open Access Journals (Sweden)

    S K Sahu

    2015-01-01

    Full Text Available Pneumatic tourniquets have been used in orthopaedic surgery to get avascular fields. Sixteen such tourniquets were analysed for microbial colonisation. Samples were taken from two inner and two outer areas of each tourniquet and cultured on sheep blood agar. Eight of these were wiped with Savlon and the rest with Sterillium solution. Post-treatment samples from the same sites were again cultured. After incubation, colonies from each site were identified and counted. It was observed that the tourniquets were colonised with coagulase-negative staphylococci, Staphylococcus aureus, Bacillus, diphtheroids, Pseudomonas, Acinetobacter, enterococci, enterobacteria, and Candida. On treating with Savlon and Sterillium, there was 92.18% and 95.70% reduction in the colony count, respectively.

  11. Clinical application of real-time PCR to screening critically ill and emergency-care surgical patients for methicillin-resistant Staphylococcus aureus: a quantitative analytical study.

    Science.gov (United States)

    Herdman, M Trent; Wyncoll, Duncan; Halligan, Eugene; Cliff, Penelope R; French, Gary; Edgeworth, Jonathan D

    2009-12-01

    The clinical utility of real-time PCR screening assays for methicillin (methicillin)-resistant Staphylococcus aureus (MRSA) colonization is constrained by the predictive values of their results: as MRSA prevalence falls, the assay's positive predictive value (PPV) drops, and a rising proportion of positive PCR assays will not be confirmed by culture. We provide a quantitative analysis of universal PCR screening of critical care and emergency surgical patients using the BD GeneOhm MRSA PCR system, involving 3,294 assays over six months. A total of 248 PCR assays (7.7%) were positive; however, 88 failed to be confirmed by culture, giving a PPV of 65%. Multivariate analysis was performed to compare PCR-positive culture-positive (P+C+) and PCR-positive culture-negative (P+C-) assays. P+C- results were positively associated with a history of methicillin-sensitive Staphylococcus aureus infection or colonization (odds ratio [OR], 3.15; 95% confidence interval [CI], 1.32 to 7.54) and high PCR thresholds of signal intensity, indicative of a low concentration of target DNA (OR, 1.19 per cycle; 95% CI, 1.11 to 1.26). P+C- results were negatively associated with a history of MRSA infection or colonization (OR, 0.19; 95% CI, 0.09 to 0.42) and male sex (OR, 0.40; 95% CI, 0.20 to 0.81). P+C+ patients were significantly more likely to have subsequent positive MRSA culture assays and microbiological evidence of clinical MRSA infection. The risk of subsequent MRSA infection in P+C- patients was not significantly different from that in case-matched PCR-negative controls. We conclude that, given the low PPV and poor correlation between a PCR-positive assay and the clinical outcome, it would be prudent to await culture confirmation before altering infection control measures on the basis of a positive PCR result.

  12. Monetary implications of Surgical Site Infections Health Services: an Integrative Review

    Directory of Open Access Journals (Sweden)

    Suellen Rodrigues de Oliveira Maier

    2015-11-01

    Full Text Available Background and Objective: In order to meet the costs related to the Surgical Site Infection (SSI and that they were linked, this research guided the scientific literature was developed with the following objective: to perform an integrative review of literature related to expenses and costs of surgical site infections, or surgical wound, to health systems. Methods: We selected 11 scientific articles available in electronic databases of the Medical Literature Analysis and Retrieval System Online (MEDLINE, and Latin American Literature on Health Sciences (LILACS, through the portal of the Virtual Health Library (VHL. It is also one of the research methods used in Evidence Based Practice (EBP. Results: It was observed that SAIs are costly to health services, publications in very differ and used methods not specifically describe how the results of the costs were obtained. Conclusion: Thus, other studies adopt an effective and standardized assessment for the collection and calculation of costs are needed to ensure greater reliability of the information obtained. KEYWORDS: Surgical wound infection.Costs and Cost Analysis. Health service.

  13. Impact of postdischarge surveillance on surgical site infection rates for several surgical procedures: results from the nosocomial surveillance network in The Netherlands.

    OpenAIRE

    Manniën, Judith; Wille, Jan C; Snoeren, Ruud L M M; Hof, Susan van den

    2006-01-01

    OBJECTIVE: To compare the number of surgical site infections (SSIs) registered after hospital discharge with respect to various surgical procedures and to identify the procedures for which postdischarge surveillance (PDS) is most important. DESIGN: Prospective SSI surveillance with voluntary PDS. Recommended methods for PDS in the Dutch national nosocomial surveillance network are addition of a special registration card to the outpatient medical record, on which the surgeon notes clinical sym...

  14. Suction Drain Tip Culture after Spine Surgery: Can It Predict a Surgical Site Infection?

    OpenAIRE

    Ahn, Jae-Sung; Lee, Ho-Jin; Park, Eugene; Park, Il-Young; Lee, Jae Won

    2015-01-01

    Study Design Retrospective clinical study. Purpose To assess the diagnostic value of suction drain tip culture in patients undergoing primary posterior spine surgery. Overview of Literature To date, the diagnostic value of suction drain tip culture for predicting surgical site infection (SSI) has not been firmly established in orthopedic or spinal surgery. Methods In total, 133 patients who underwent primary posterior spine surgery from January 2013 to April 2015 were included in this retrosp...

  15. Incidence of surgical site infection following adult spinal deformity surgery: an analysis of patient risk

    OpenAIRE

    Pull ter Gunne, Albert F.; Laarhoven, C.J.H.M. van; Cohen, David B.

    2010-01-01

    Surgical site infection (SSI) following spinal surgery is a frequent complication and results in higher morbidity, mortality and healthcare costs. Patients undergoing surgery for spinal deformity (scoliosis/kyphosis) have longer surgeries, involving more spinal levels and larger blood losses than typical spinal procedures. Previous research has identified risk factors for SSI in spinal surgery, but few studies have looked at adult deformity surgeries. We retrospectively performed a large case...

  16. New technique for treating abdominal surgical site infection using CT woundgraphy and NPWT: A case report

    OpenAIRE

    Eisaku Ito; Masashi Yoshida; Keigo Nakashima; Norihiko Suzuki; Tomonori Imakita; Nobuhiro Tsutsui; Hironori Ohdaira; Masaki Kitajima; Yutaka Suzuki

    2016-01-01

    Introduction: Negative pressure wound therapy (NPWT) for abdominal surgical site infection (SSI) is becoming increasingly common, although enterocutaneous fistula (ECF) has been reported as a complication. To avoid ECF, we used computed tomography (CT) woundgraphy to evaluate the relationship between the wound and the intestine, and then safely treated the abdominal SSI with NPWT. Case presentation: Following a laparoscopic intersphincteric resection for low rectal neuroendocrine tumor and...

  17. Agreement among Health Care Professionals in Diagnosing Case Vignette-Based Surgical Site Infections

    OpenAIRE

    Didier Lepelletier; Philippe Ravaud; Gabriel Baron; Jean-Christophe Lucet

    2012-01-01

    OBJECTIVE: To assess agreement in diagnosing surgical site infection (SSI) among healthcare professionals involved in SSI surveillance. METHODS: Case-vignette study done in 2009 in 140 healthcare professionals from seven specialties (20 in each specialty, Anesthesiologists, Surgeons, Public health specialists, Infection control physicians, Infection control nurses, Infectious diseases specialists, Microbiologists) in 29 University and 36 non-University hospitals in France. We developed 40 cas...

  18. The preventive surgical site infection bundle in patients with colorectal perforation

    OpenAIRE

    Yamamoto, Takehito; MORIMOTO, TAKESHI; Kita, Ryosuke; Masui, Hideyuki; Kinoshita, Hiromitsu; Sakamoto, Yusuke; Okada, Kazuyuki; Komori, Junji; Miki, Akira; Kondo, Masato; Uryuhara, Kenji; Kobayashi, Hiroyuki; Hashida, Hiroki; Kaihara, Satoshi; Hosotani, Ryo

    2015-01-01

    Background Incisional surgical site infection (SSI) is one of the most frequent complications that occur after colorectal surgery. Surgery for colorectal perforation carries an especially high risk of incisional SSI because fecal ascites contaminates the incision intraoperatively, and in patients who underwent stoma creation, the incision is located near the infective origin and is subject to infection postoperatively. Although effectiveness of the preventive SSI bundle of elective colorectal...

  19. Improving surveillance system and surgical site infection rates through a network: A pilot study from Thailand

    OpenAIRE

    Kasatpibal, Nongyao; Nørgaard, Mette; Jamulitrat, Silom

    2009-01-01

    Background: Surveillance of surgical site infections (SSI) provides data upon which interventions to improve patient safety can be based. In Thailand, however, SSI surveillance has not yet been standardized. Objectives: To develop a standardized SSI surveillance system and to monitor SSI rates after introduction of such a system. Methods: We conducted a prospective study among 17,752 patients who underwent surgery in ten hospitals in Thailand from April 2004 to May 2005. The SSI rates were co...

  20. Analysis of Surgical Site Infection after Musculoskeletal Tumor Surgery: Risk Assessment Using a New Scoring System

    OpenAIRE

    Satoshi Nagano; Masahiro Yokouchi; Takao Setoguchi; Hiromi Sasaki; Hirofumi Shimada; Ichiro Kawamura; Yasuhiro Ishidou; Junichi Kamizono; Takuya Yamamoto; Hideki Kawamura; Setsuro Komiya

    2014-01-01

    Surgical site infection (SSI) has not been extensively studied in musculoskeletal tumors (MST) owing to the rarity of the disease. We analyzed incidence and risk factors of SSI in MST. SSI incidence was evaluated in consecutive 457 MST cases (benign, 310 cases and malignant, 147 cases) treated at our institution. A detailed analysis of the clinical background of the patients, pre- and postoperative hematological data, and other factors that might be associated with SSI incidence was performed...

  1. The impact of surgical site occurrences and the role of closed incision negative pressure therapy.

    Science.gov (United States)

    Willy, Christian; Engelhardt, Michael; Stichling, Marcus; Grauhan, Onnen

    2016-09-01

    Surgical site occurrences are observed in up to 60% of inpatient surgical procedures in industrialised countries. The most relevant postoperative complication is surgical site infection (SSI) because of its impact on patient outcomes and enormous treatment costs. Literature reviews ('SSI', 'deep sternal wound infections' (DSWI), 'closed incision negative pressure wound therapy' (ciNPT) were performed by electronically searching MEDLINE (PubMed) and subsequently using a 'snowball' method of continued searches of the references in the identified publications. Search criteria included publications in all languages, various study types and publication in a peer-reviewed journal. The SSI literature search identified 1325, the DSWI search 590 and the ciNPT search 103 publications that fulfilled the search criteria. Patient-related SSI risk factors (diabetes mellitus, obesity, smoking, hypertension, female gender) and operation-related SSI risk factors (re-exploration, emergency operations, prolonged ventilation, prolonged operation duration) exist. We found that patient- and operation-related SSI risk factors were often different for each speciality and/or operative procedure. Based on the evidence, we found that high-risk incisions (sternotomy and incisions in extremities after high-energy open trauma) are principally recommended for ciNPT use. In 'lower'-risk incisions, the addition of patient-related or operation-related risk factors justifies the application of ciNPT. PMID:27547962

  2. ‘This wound has spoilt everything’: emotional capital and the experience of surgical site infections

    Science.gov (United States)

    Brown, Brian; Tanner, Judith; Padley, Wendy

    2014-01-01

    In this article we explore the experience of suffering from a surgical site infection, a common complication of surgery affecting around 5 per cent of surgical patients, via an interview study of 17 patients in the Midlands in the UK. Despite their prevalence, the experience of surgical site infections has received little attention so far. In spite of the impairment resulting from these iatrogenic problems, participants expressed considerable stoicism and we interpret this via the notion of emotional capital. This idea derives from the work of Pierre Bourdieu, Helga Nowotny and Diane Reay and helps us conceptualise the emotional resources accumulated and expended in managing illness and in gaining the most from healthcare services. Participants were frequently at pains not to blame healthcare personnel or hospitals, often discounting the infection's severity, and attributing it to chance, to ‘germs’ or to their own failure to buy and apply wound care products. The participants' stoicism was thus partly afforded by their refusal to blame healthcare institutions or personnel. Where anger was described, this was either defused or expressed on behalf of another person. Emotional capital is associated with deflecting the possibility of complaint and sustaining a deferential and grateful position in relation to the healthcare system. PMID:25470322

  3. 'This wound has spoilt everything': emotional capital and the experience of surgical site infections.

    Science.gov (United States)

    Brown, Brian; Tanner, Judith; Padley, Wendy

    2014-11-01

    In this article we explore the experience of suffering from a surgical site infection, a common complication of surgery affecting around 5 per cent of surgical patients, via an interview study of 17 patients in the Midlands in the UK. Despite their prevalence, the experience of surgical site infections has received little attention so far. In spite of the impairment resulting from these iatrogenic problems, participants expressed considerable stoicism and we interpret this via the notion of emotional capital. This idea derives from the work of Pierre Bourdieu, Helga Nowotny and Diane Reay and helps us conceptualise the emotional resources accumulated and expended in managing illness and in gaining the most from healthcare services. Participants were frequently at pains not to blame healthcare personnel or hospitals, often discounting the infection's severity, and attributing it to chance, to 'germs' or to their own failure to buy and apply wound care products. The participants' stoicism was thus partly afforded by their refusal to blame healthcare institutions or personnel. Where anger was described, this was either defused or expressed on behalf of another person. Emotional capital is associated with deflecting the possibility of complaint and sustaining a deferential and grateful position in relation to the healthcare system.

  4. 'This wound has spoilt everything': emotional capital and the experience of surgical site infections.

    Science.gov (United States)

    Brown, Brian; Tanner, Judith; Padley, Wendy

    2014-11-01

    In this article we explore the experience of suffering from a surgical site infection, a common complication of surgery affecting around 5 per cent of surgical patients, via an interview study of 17 patients in the Midlands in the UK. Despite their prevalence, the experience of surgical site infections has received little attention so far. In spite of the impairment resulting from these iatrogenic problems, participants expressed considerable stoicism and we interpret this via the notion of emotional capital. This idea derives from the work of Pierre Bourdieu, Helga Nowotny and Diane Reay and helps us conceptualise the emotional resources accumulated and expended in managing illness and in gaining the most from healthcare services. Participants were frequently at pains not to blame healthcare personnel or hospitals, often discounting the infection's severity, and attributing it to chance, to 'germs' or to their own failure to buy and apply wound care products. The participants' stoicism was thus partly afforded by their refusal to blame healthcare institutions or personnel. Where anger was described, this was either defused or expressed on behalf of another person. Emotional capital is associated with deflecting the possibility of complaint and sustaining a deferential and grateful position in relation to the healthcare system. PMID:25470322

  5. Evidence-based guidelines for chlorhexidine gluconate in preoperative skin preparation to reduce surgical site infection in patients undergoing general surgery

    OpenAIRE

    Lai, Shuk-tin; 黎淑鈿

    2013-01-01

    Surgical site infection not only brings morbidity and mortality to patients, but it also bring substantial financial burden to the hospital and the healthcare system. To minimize the clinical consequences of surgical site infection, it is crucial that all appropriate measures for reduction of surgical site infection should be implemented. Since patient’s skin is a potential source of pathogens, normal skin flora is a common cause of surgical site infections. Preoperative skin disinfection of ...

  6. Improving surgical site infection prevention practices through a multifaceted educational intervention.

    LENUS (Irish Health Repository)

    Owens, P

    2015-03-01

    As part of the National Clinical Programme on healthcare-associated infection prevention, a Royal College of Surgeons in Ireland (RCSI) and Royal College of Physicians of Ireland (RCPI) working group developed a quality improvement tool for prevention of surgical site infection (SS). We aimed to validate the effectiveness of an educational campaign, which utilises this quality improvement tool to prevent SSI in a tertiary hospital. Prior to the SSI educational campaign, surgical patients were prospectively audited and details of antibiotic administration recorded. Prophylactic antibiotic administration recommendations were delivered via poster and educational presentations. Post-intervention, the audit was repeated. 50 patients were audited pre-intervention, 45 post-intervention. Post-intervention, prophylaxis within 60 minutes prior to incision increased from 54% to 68% (p = 0.266). Appropriate postoperative prescribing improved from 71% to 92% (p = 0.075). A multifaceted educational program may be effective in changing SSI prevention practices.

  7. Surgical-site infections and postoperative complications: agreement between the Danish Gynecological Cancer Database and a randomized clinical trial

    DEFF Research Database (Denmark)

    Antonsen, Sofie L; Meyhoff, Christian Sylvest; Lundvall, Lene;

    2011-01-01

    between November 2006 and October 2008 and data from the DGCD. METHODS: Outcomes within 30 days from the trial and the database were compared and levels of agreements were calculated with kappa-statistics. MAIN OUTCOME MEASURES: Primary outcome was surgical-site infection. Other outcomes included re-operation......, urinary tract infection, pneumonia and sepsis. RESULTS: Surgical-site infection was found in 21 of 222 patients (9.5%) in the PROXI trial versus 6 of 222 patients (2.7%) in the DGCD (p organ-space surgical-site infections were...... registered in the PROXI trial, but not in the DGCD. Agreements between secondary outcomes were very varying (kappa-value 0.77 for re-operation, 0.37 for urinary tract infections, 0.19 for sepsis and 0.18 for pneumonia). CONCLUSIONS: The randomized trial reported significantly more surgical-site infections...

  8. Influence of pulsed-xenon ultraviolet light-based environmental disinfection on surgical site infections.

    Science.gov (United States)

    Catalanotti, Angela; Abbe, Dudley; Simmons, Sarah; Stibich, Mark

    2016-06-01

    This study evaluates the influence of nightly pulsed-xenon ultraviolet light disinfection and dedicated housekeeping staff on surgical site infection (SSI) rates. SSIs in class I procedures were reduced by 46% (P = .0496), with a potential cost savings of $478,055. SSIs in class II procedures increased by 22.9%, but this was not significant (P = .6973). Based on these results, it appears that the intervention reduces SSI rates in clean (class I), but not clean-contaminated (class II) procedures. PMID:26856467

  9. Effect of Intra-Abdominal Absorbable Sutures on Surgical Site Infection

    OpenAIRE

    Harish Chauhan; Upendra Patel

    2012-01-01

    Purpose: To establish whether the rates of surgical site infection (SSI) in gastrointestinal surgery are affected by the type of intra-abdominal suturing: sutureless, absorbable material (polyglactin: Vicryl), and silk. Methods: We conducted SSI surveillance prospectively in our hospitla. Results: The overall SSI rate was 14.4% (13/90). The SSI rates in the sutureless, Vicryl, and silk groups were 4.8, 14.8, and 16.4%, respectively, without significant differ-ences among the groups....

  10. Interventional studies for preventing surgical site infections in sub-Saharan Africa – A systematic review

    Science.gov (United States)

    Aiken, Alexander M.; Karuri, David M.; Wanyoro, Anthony K.; Macleod, Jana

    2012-01-01

    Background There is a great need for safe surgical services in sub-Saharan Africa, but a major difficulty of performing surgery in this region is the high risk of post-operative surgical site infection (SSI). Methods We aimed to systematically review which interventions had been tested in sub-Saharan Africa to reduce the risk of SSI and to synthesize their findings. We searched Medline, Embase and Global Health databases for studies published between 1995 and 2010 without language restrictions and extracted data from full-text articles. Findings We identified 24 relevant articles originating from nine countries in sub-Saharan Africa. The methodological quality of these publications was diverse, with inconsistency in definitions used for SSI, period and method of post-operative follow-up and classification of wound contamination. Although it was difficult to synthesise information between studies, there was consistent evidence that use of single-dose pre-operative antibiotic prophylaxis could reduce, sometimes dramatically, the risk of SSI. Several studies indicated that alcohol-based handrubs could provide a low-cost alternative to traditional surgical hand-washing methods. Other studies investigated the use of drains and variants of surgical technique. There were no African studies found relating to several other promising SSI prevention strategies, including use of checklists and SSI surveillance. Conclusions There is extremely limited research from sub-Saharan Africa on interventions to curb the occurrence of SSI. Although some of the existing studies are weak, several high-quality studies have been published in recent years. Standard methodological approaches to this subject are needed. PMID:22510442

  11. Risk factors for surgical site infection after instrumented fixation in spine trauma.

    Science.gov (United States)

    Cooper, Kevin; Glenn, Chad A; Martin, Michael; Stoner, Julie; Li, Ji; Puckett, Timothy

    2016-01-01

    Surgical site infection (SSI) represents a significant complication after instrumented fixation in spine trauma. Institutional practice changes have emphasized early fracture correction, shortened intraoperative times, early ambulation, and prompt nutritional supplementation. This retrospective study evaluates the senior author's experience of instrumented spinal trauma SSI occurring at a single Level I trauma center over two equal and contiguous time periods, 2005-2007 (before nutritional supplementation was added to the institutional protocol) and 2008-2010 (after nutritional supplementation was added). This study assessed whether SSI varied depending on the primary surgical site and/or by the chosen approach. Lastly, the incidence of SSI among demographic and other clinical variables was evaluated. In total, 358 patients underwent an index procedure for spinal trauma correction. Fourteen patients developed a SSI requiring reoperation for an incidence of 4.0%. In assessing nutritional supplementation, the probability of infection tended to be lower in the supplemented group (3.7%) than the pre-supplement group (4.3%), but this did not reach significance. The difference in approach for the cervical spine was statistically significant (p=0.045) with rates of infection via posterior approach at 8.1% and no infections via anterior approach. Presence of comorbidities (p=0.03) and time to surgery >3days (p=0.006) were predictors of developing SSI. Benefit is shown from early surgical correction of spinal trauma patients in the reduction of postoperative SSI. Nutritional supplementation may provide a small reduction in infections in the spine trauma population. PMID:26498090

  12. Chronic swelling from entrapment of acrylic resin in a surgical extraction site

    Directory of Open Access Journals (Sweden)

    Weiting Ho

    2010-01-01

    Full Text Available When acrylic resin is inadvertently embedded in oral tissue, it can result in a pronounced chronic inflammatory response. This report describes a case in which temporary crown and bridge resin was forced into a surgical extraction site after the two adjacent teeth were prepared for a bridge immediately following extraction of a maxillary premolar. The patient experienced swelling at the extraction site over a ten month period despite treatment with antibiotics and anti-inflammatory drugs. After detection and removal of the foreign body, the symptoms resolved. The episode contributed to periodontal bone loss around an adjacent tooth. While morbidity of this nature is rare, this case reinforces the need to investigate persistent signs of inflammation and account for dental materials that are lost during the course of treatment.

  13. Rapid diagnostic testing of methicillin-resistant Staphylococcus aureus carriage at different anatomical sites : costs and benefits of less extensive screening regimens

    NARCIS (Netherlands)

    Wassenberg, M. W. M.; Kluytmans, J. A. J. W.; Bosboom, R. W.; Buiting, A. G. M.; van Elzakker, E. P. M.; Melchers, W. J. G.; Thijsen, S. F. T.; Troelstra, A.; Vandenbroucke-Grauls, C. M. J. E.; Visser, C. E.; Voss, A.; Wolffs, P. F. G.; Wulf, M. W. H.; van Zwet, A. A.; de Wit, G. A.; Bonten, M. J. M.

    2011-01-01

    Multiple body site screening and pre-emptive isolation of patients at risk for methicillin-resistant Staphylococcus aureus (MRSA) carriage are considered essential for control of nosocomial spread. The relative importance of extranasal screening when using rapid diagnostic testing (RDT) is unknown.

  14. Development of a Surgical Site Infection (SSI) Surveillance System, Calculation of SSI Rates and Specification of Important Factors Affecting SSI in a Digestive Organ Surgical Department

    OpenAIRE

    Kimura, Koji; Sawa, Akihiro; Akagi, Shinji; Kihira, Kenji

    2007-01-01

    We have developed an original system to conduct surgical site infection (SSI) surveillance. This system accumulates SSI surveillance information based on the National N osocomial Infections Surveillance (NNIS) System and the Japanese Nosocomial Infections Surveillance (JNIS) System. The features of this system are as follows: easy input of data, high generality, data accuracy, SSI rate by operative procedure and risk index category (RIC) can be promptly calculated and compared with the curren...

  15. The role of other stakeholders than the surgeon in relation to surgical site infections following total joint replacement.

    Science.gov (United States)

    Stuyts, Bart; Van den Eeden, Elke; Fennema, Peter

    2015-12-01

    In contemporary orthopaedics, surgical site infections (SSIs) can have significant negative consequences for both patients and the healthcare system overall. To date, most efforts at combating the risk of SSIs have focused on the role of the surgeon, yet recent data suggest that a more expansive approach is warranted. The current review offers an overview of the most-relevant factors associated with SSIs in orthopaedic surgery, and the crucial role that the full surgical staff can play in addressing them.

  16. Post liposuction Mycobacterium abscessus surgical site infection in a returned medical tourist complicated by a paradoxical reaction during treatment

    OpenAIRE

    Hui, Siong H.; Lisa Noonan; Ruchir Chavada

    2015-01-01

    Rapidly growing mycobacterial skin and soft tissue infections are known to complicate cosmetic surgical procedures. Treatment consists of more surgery and prolonged antibiotic therapy guided by drug susceptibility testing. Paradoxical reactions occurring during antibiotic therapy can further complicate treatment of non-tuberculous mycobacterial infections. We report a case of post liposuction Mycobacterium abscessus surgical site infection in a returned medical tourist and occurrence of parad...

  17. Post liposuction Mycobacterium abscessus surgical site infection in a returned medical tourist complicated by a paradoxical reaction during treatment

    Directory of Open Access Journals (Sweden)

    Siong H. Hui

    2015-12-01

    Full Text Available Rapidly growing mycobacterial skin and soft tissue infections are known to complicate cosmetic surgical procedures. Treatment consists of more surgery and prolonged antibiotic therapy guided by drug susceptibility testing. Paradoxical reactions occurring during antibiotic therapy can further complicate treatment of non-tuberculous mycobacterial infections. We report a case of post liposuction Mycobacterium abscessus surgical site infection in a returned medical tourist and occurrence of paradox during treatment.

  18. Obesity and the Risk for Surgical Site Infection in Abdominal Surgery.

    Science.gov (United States)

    Winfield, Robert D; Reese, Stacey; Bochicchio, Kelly; Mazuski, John E; Bochicchio, Grant V

    2016-04-01

    Obesity is a risk factor for surgical site infection (SSI) after abdominal procedures; however, data characterizing the risk of SSI in obese patients during abdominal procedures are lacking. We hypothesized that obesity is an independent risk factor for SSI across wound classes. We analyzed American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP) data for 2011. We calculated body mass index (BMI), classifying patients according to National Institute of Health (NIH) BMI groups. We excluded records in which height/weight was not recorded and patients with BMI less than 18.5. We examined patients undergoing open abdominal procedures, performing univariate and multivariate analyses to assess the relative contribution of obesity to SSI. Study criteria were met by 89,148 patients. Obese and morbidly obese patients had significantly greater SSI rates in clean and clean-contaminated cases but not contaminated or dirty/infected cases. Logistic regression confirmed obesity and morbid obesity as being independently associated with the overall SSI development, specifically in clean [Obesity odds ratio (OR) = 1.757, morbid obesity OR = 2.544, P obesity OR = 1.239, morbid obesity OR = 1.287, P Obesity is associated with increased risk of SSI overall, specifically in clean and clean-contaminated abdominal procedures; this is independent of diabetes mellitus. Novel techniques are needed to reduce SSI in this high-risk patient population.

  19. Surgical Site Infection by Corynebacterium macginleyi in a Patient with Neurofibromatosis Type 1

    Directory of Open Access Journals (Sweden)

    Bruno Cacopardo

    2013-01-01

    Full Text Available Corynebacterium (C. macginleyi is a gram positive, lipophilic rod, usually considered a colonizer of skin and mucosal surfaces. Several reports have associated C. macginleyi with ocular infections, such as conjunctivitis and endophthalmitis. However, even if rare, extraocular infections from C. macginleyi may occur, especially among immunocompromised patients and patients with indwelling medical devices. We report herein the first case of surgical site infection by C. macginleyi after orthopaedic surgery for the correction of kyphoscoliosis in a patient with neurofibromatosis type 1. Our patient developed a nodular granulomatous lesion of about two centimetres along the surgical scar, at the level of C4-C5, with purulent discharge and formation of a fistulous tract. Cervical magnetic resonance imaging showed the presence of a two-centimetre fluid pocket in the subcutaneous tissue. Several swabs were collected from the borders of the lesion as well as from the exudate, with isolation of C. macginleyi. The isolate was susceptible to beta-lactams, cotrimoxazole, linezolid, and glycopeptides but resistant to quinolones, third-generation cephalosporins, and erythromycin. Two 30-day courses of antibiotic therapy with amoxicillin/clavulanate (1 g three times/day and cotrimoxazole (800/160 mg twice a day were administered, obtaining a complete healing of the lesion.

  20. Surgical site infections in women and their association with clinical conditions

    Directory of Open Access Journals (Sweden)

    Maria Zélia de Araújo Madeira

    2014-07-01

    Full Text Available Introduction Surgical site infections (SSIs can affect body tissues, cavities, or organs manipulated in surgery and constitute 14% to 16% of all infections. This study aimed to determine the incidence of SSIs in women following their discharge from a gynecology outpatient clinic, to survey different types of SSIs among women, and to verify the association of SSIs with comorbidities and clinical conditions. Methods Data were collected via analytical observation with a cross-sectional design, and the study was conducted in 1,026 women who underwent gynecological surgery in a teaching hospital in the municipality of Teresina, in the northeast Brazilian State of Piauí, from June 2011 to March 2013. Results The incidence of SSIs after discharge was 5.8% among the women in the outpatient clinic. The most prevalent surgery among the patients was hysterectomy, while the most prevalent type of SSI was superficial incisional. Comorbidities in women with SSIs included cancer, diabetes mellitus, and hypertension. Conclusions Surveillance of SSIs during the post-discharge period is critical for infection prevention and control. It is worth reflecting on the planning of surgical procedures for patients who have risk factors for the development of SSIs.

  1. Post-caesarean section surgical site infections at a Tanzanian tertiary hospital: a prospective observational study.

    Science.gov (United States)

    De Nardo, P; Gentilotti, E; Nguhuni, B; Vairo, F; Chaula, Z; Nicastri, E; Nassoro, M M; Bevilacqua, N; Ismail, A; Savoldi, A; Zumla, A; Ippolito, G

    2016-08-01

    Few data are available on the determinants and characteristics of post-caesarean section (CS) surgical site infections (SSIs) in resource-limited settings. We conducted a prospective observational cohort study to evaluate the rates, determinants, and microbiological characteristics of post-CS SSI at the Dodoma Regional Referral Hospital (DRRH) Gynaecology and Obstetrics Department in Tanzania. Spanning a three-month period, all pregnant women who underwent CS were enrolled and followed up for 30 days. SSI following CS occurred in 224 (48%) women. Only 10 (2.1%) women received pre-incision antibiotic prophylaxis. Urgent intervention is needed to prevent and control infections and contain the rising rate of post-CS SSI at the DRRH. PMID:27125664

  2. Surgical site infections following colorectal cancer surgery: a randomized prospective trial comparing common and advanced antimicrobial dressing containing ionic silver

    Directory of Open Access Journals (Sweden)

    Biffi Roberto

    2012-05-01

    Full Text Available Abstract Background An antimicrobial dressing containing ionic silver was found effective in reducing surgical-site infection in a preliminary study of colorectal cancer elective surgery. We decided to test this finding in a randomized, double-blind trial. Methods Adults undergoing elective colorectal cancer surgery at two university-affiliated hospitals were randomly assigned to have the surgical incision dressed with Aquacel® Ag Hydrofiber dressing or a common dressing. To blind the patient and the nursing and medical staff to the nature of the dressing used, scrub nurses covered Aquacel® Ag Hydrofiber with a common wound dressing in the experimental arm, whereas a double common dressing was applied to patients of control group. The primary end-point of the study was the occurrence of any surgical-site infection within 30 days of surgery. Results A total of 112 patients (58 in the experimental arm and 54 in the control group qualified for primary end-point analysis. The characteristics of the patient population and their surgical procedures were similar. The overall rate of surgical-site infection was lower in the experimental group (11.1% center 1, 17.5% center 2; overall 15.5% than in controls (14.3% center 1, 24.2% center 2, overall 20.4%, but the observed difference was not statistically significant (P = 0.451, even with respect to surgical-site infection grade 1 (superficial versus grades 2 and 3, or grade 1 and 2 versus grade 3. Conclusions This randomized trial did not confirm a statistically significant superiority of Aquacel® Ag Hydrofiber dressing in reducing surgical-site infection after elective colorectal cancer surgery. Trial registration Clinicaltrials.gov: NCT00981110

  3. Agreement among health care professionals in diagnosing case Vignette-based surgical site infections.

    Directory of Open Access Journals (Sweden)

    Didier Lepelletier

    Full Text Available OBJECTIVE: To assess agreement in diagnosing surgical site infection (SSI among healthcare professionals involved in SSI surveillance. METHODS: Case-vignette study done in 2009 in 140 healthcare professionals from seven specialties (20 in each specialty, Anesthesiologists, Surgeons, Public health specialists, Infection control physicians, Infection control nurses, Infectious diseases specialists, Microbiologists in 29 University and 36 non-University hospitals in France. We developed 40 case-vignettes based on cardiac and gastrointestinal surgery patients with suspected SSI. Each participant scored six randomly assigned case-vignettes before and after reading the SSI definition on an online secure relational database. The intraclass correlation coefficient (ICC was used to assess agreement regarding SSI diagnosis on a seven-point Likert scale and the kappa coefficient to assess agreement for superficial or deep SSI on a three-point scale. RESULTS: Based on a consensus, SSI was present in 21 of 40 vignettes (52.5%. Intraspecialty agreement for SSI diagnosis ranged across specialties from 0.15 (95% confidence interval, 0.00-0.59 (anesthesiologists and infection control nurses to 0.73 (0.32-0.90 (infectious diseases specialists. Reading the SSI definition improved agreement in the specialties with poor initial agreement. Intraspecialty agreement for superficial or deep SSI ranged from 0.10 (-0.19-0.38 to 0.54 (0.25-0.83 (surgeons and increased after reading the SSI definition only among the infection control nurses from 0.10 (-0.19-0.38 to 0.41 (-0.09-0.72. Interspecialty agreement for SSI diagnosis was 0.36 (0.22-0.54 and increased to 0.47 (0.31-0.64 after reading the SSI definition. CONCLUSION: Among healthcare professionals evaluating case-vignettes for possible surgical site infection, there was large disagreement in diagnosis that varied both between and within specialties.

  4. Phenotypes and Virulence among Staphylococcus aureus USA100, USA200, USA300, USA400, and USA600 Clonal Lineages

    OpenAIRE

    King, Jessica M.; Kulhankova, Katarina; Stach, Christopher S.; Vu, Bao G.; Salgado-Pabón, Wilmara

    2016-01-01

    ABSTRACT Staphylococcus aureus diseases affect ~500,000 individuals per year in the United States. Worldwide, the USA100, USA200, USA400, and USA600 lineages cause many of the life-threatening S. aureus infections, such as bacteremia, infective endocarditis, pneumonia, toxic shock syndrome, and surgical site infections. However, the virulence mechanisms associated with these clonal lineages, in particular the USA100 and USA600 isolates, have been severely understudied. We investigated the vir...

  5. A single copy integration vector that integrates at an engineered site on the Staphylococcus aureus chromosome

    OpenAIRE

    Lei Mei G; Cue David; Alba Jimena; Junecko Jennifer; Graham Justin W; Lee Chia Y

    2012-01-01

    Abstract Background Single-copy integration vectors based upon the site-specific recombination systems of bacteriophage are invaluable tools in the study of bacterial pathogenesis. The utility of such vectors is often limited, however, by the fact that integration often results in the inactivation of bacterial genes or has undesirable effects on gene transcription. The aim of this study is to develop an integration vector that does not have a detectable effect on gene transcription upon integ...

  6. 63例肝胆手术部位感染相关因素分析%63 cases of liver surgical site infection related factors analysis

    Institute of Scientific and Technical Information of China (English)

    吴晓春; 成燕; 候章梅; 杨薇

    2015-01-01

    目的:对肝胆手术部位感染相关影响因素进行探讨。方法回顾性分析1187例肝胆手术患者的临床资料,采用SPSS12.0软件对数据进行统计分析。结果1187例肝胆手术患者发生手术部位感染63例,感染率5.31%,其中切口浅部组织51例,切口深部组织8例,器官腔隙4例,分别占80.95%、12.70%和6.35%。分离出革兰阴性菌15株,占55.56%,革兰阳性菌12株,占44.44%,其中革兰阴性菌以大肠埃希菌、革兰阳性菌以金黄色葡萄球菌检出最多,分别占25.93%和14.81%,未分离出真菌;年龄、有无合并糖尿病、引流时间、术后并发症、手术时间和开腹手术等为手术部位感染的独立危险因素(P <0.05)。结论肝胆外科患者手术部位感染与多种因素有关,应加强患者术前术后病情评估,同时提高手术操作水平,从而降低手术部位感染率。%Objective To liver surgical site infection related influencing factors were discussed.Methods Retrospective analysis the clinical data of A total of 1 187 patients with liver and gallbladder surgery,using SPSS12.0 software for statistical analysis of data.Results A total of 1 187 cases of liver and gallbladder surgery patients and 63 cases of surgical site infection occurred,the in-fection rate of 5.31%,including incision shallow tissue 51 cases,8 incision deep tissue,organ lacuna in 4 cases,accounted for 80.95%,12.70% and 6.35% respectively.Isolated pathogenic bacteria distribution and composition ratios were as follow,15 strains of gram-negative bacteria(55.56%),12 gram positive bacteria strains(44.44%),including gram-negative bacteria in e.coli, gram-positive bacterium with staphylococcus aureus detection most(25.93% and 14.81% respectively),not isolated fungus;Age, presence of diabetes mellitus,drainage time,postoperative complications,operation time and open operation for independent risk fac-tors for surgical

  7. Factors Associated With Surgical Site Infection Following Gastric Surgery in Japan.

    Science.gov (United States)

    Morikane, Keita; Honda, Hitoshi; Suzuki, Satowa

    2016-10-01

    BACKGROUND Surgical site infection (SSI) following gastric surgery has not been well documented. OBJECTIVE To describe and assess factors associated with SSI following gastric surgery in Japan using a Japanese national database for healthcare-associated infections. DESIGN A retrospective nationwide surveillance-based study. SETTING Japanese healthcare facilities. METHODS Data on gastric surgeries performed between 2012 and 2014 were extracted from the Japan Nosocomial Infections Surveillance. Gastric surgery was divided into 3 types of procedures: total gastrectomy (GAST-T), distal gastrectomy (GAST-D), and other types of gastric surgery (GAST-O). The incidence of and factors associated with SSI following gastric surgery were assessed by the 3 types of procedures. RESULTS The cumulative incidence of SSI following gastric surgery was 8.8% (3,156/36,052). The incidence of SSI following GAST-T (12.4%) was significantly higher than that following GAST-D (7.01%) or GAST-O (7.84%). Besides the 4 conventional risk factors for predicting SSI, additional risk factors were identified. Male sex was significantly associated with SSI following all types of gastric surgery, but the effect of the association was substantially different (adjusted odds ratio, 1.52, 1.47, and 1.28 for GAST-T, GAST-D, and GAST-O, respectively). The effect of an emergency operation was similar. Age was also identified as a risk factor, but the most suitable modification of age as a variable differed. CONCLUSIONS The incidence and factors associated with SSI following 3 types of gastric surgery differed. To accurately compare hospital performance in SSI prevention following gastric surgery, dividing surgical procedures in the surveillance system into 3 types should be considered. Infect Control Hosp Epidemiol 2016;1-6.

  8. Analysis of risk factors of surgical site infections in breast cancer

    Institute of Scientific and Technical Information of China (English)

    GAO Yang-xu; XU Ling; YE Jing-ming; WANG Dong-min; ZHAO Jian-xin; ZHANG Lan-bo; DUAN Xue-ning; LIU Yin-hua

    2010-01-01

    Background Adjuvant chemotherapy has become an important component of standard therapy for breast cancer. However, until now, there have been few reports on the surgical site infections (SSI) after breast cancer surgery, specially after adjuvent chemotherapy. To study the risk factors of SSI of breast cancer, we analyzed patients diagnosed with breast cancer and treated with surgery. Methods Fifty-five patients diagnosed with breast cancer and received breast conserving or modified radical operations in our hospital during January 2008 to March 2008 were selected. Factors (patients' age, body mass index (BMI), diabetes mellitus, no or administered adjuvant chemotherapy, with or without onset of myelosuppression and the degree, surgical approaches, duration of operation, postoperative drainage duration and total drainage volume) associated with SSI were retrospectively reviewed and statistically analyzed by single factor analysis. Results Five patients suffered SSI (5/55, 9.1%); nineteen receiving adjuvant chemotherapy experienced Grade III+ myelosuppression, among which 4 had SSI; only 1 out of the remaining 36 patients without adjuvant chemotherapy had SSI. The difference between the two groups was significant (P=0.043). The incidence of SSI in patients with postoperative drainage tube indwelling longer than 10 days was 5/21, whereas no SSI occurred in that less than 10 days (R=0.009). in our study, there was no significient difference in other associated factors. Conclusions Concurrent Grade III+ myelosuppression after adjuvant chemotherapy is an important risk factor of SSI in breast cancer and needs further study. No SSI was detected with indwelling time of post operative drainage less than 10 days.

  9. Prevention and treatment of surgical site infection in HIV-infected patients

    Directory of Open Access Journals (Sweden)

    Zhang Lei

    2012-05-01

    Full Text Available Abstract Background Surgical site infection (SSI are the third most frequently reported nosocomial infection, and the most common on surgical wards. HIV-infected patients may increase the possibility of developing SSI after surgery. There are few reported date on incidence and the preventive measures of SSI in HIV-infected patients. This study was to determine the incidence and the associated risk factors for SSI in HIV-infected patients. And we also explored the preventive measures. Methods A retrospective study of SSI was conducted in 242 HIV-infected patients including 17 patients who combined with hemophilia from October 2008 to September 2011 in Shanghai Public Health Clinical Center. SSI were classified according to Centers for Disease Control and Prevention (CDC criteria and identified by bedside surveillance and post-discharge follow-up. Data were analyzed using SPSS 16.0 statistical software (SPSS Inc., Chicago, IL. Results The SSI incidence rate was 47.5% (115 of 242; 38.4% incisional SSIs, 5.4% deep incisional SSIs and 3.7% organ/space SSIs. The SSI incidence rate was 37.9% in HIV-infected patients undergoing abdominal operation. Patients undergoing abdominal surgery with lower preoperative CD4 counts were more likely to develop SSIs. The incidence increased from 2.6% in clean wounds to 100% in dirty wounds. In the HIV-infected patients combined with hemophilia, the mean preoperative albumin and postoperative hemoglobin were found significantly lower than those in no-SSIs group (P Conclusions SSI is frequent in HIV-infected patients. And suitable perioperative management may decrease the SSIs incidence rate of HIV-infected patients.

  10. Abdominal surgical site infections: incidence and risk factors at an Iranian teaching hospital

    Directory of Open Access Journals (Sweden)

    Sabouri Kashani Ahmad

    2005-02-01

    Full Text Available Abstract Background Abdominal surgical site infections are among the most common complications of inpatient admissions and have serious consequences for outcomes and costs. Different risk factors may be involved, including age, sex, nutrition and immunity, prophylactic antibiotics, operation type and duration, type of shaving, and secondary infections. This study aimed to determine the risk factors affecting abdominal surgical site infections and their incidence at Imam Khomeini, a major referral teaching hospital in Iran. Methods Patients (n = 802 who had undergone abdominal surgery were studied and the relationships among variables were analyzed by Student's t and Chi-square tests. The subjects were followed for 30 days and by a 20-item questionnaire. Data were collected through pre- and post-operative examinations and telephone follow-ups. Results Of the 802 patients, 139 suffered from SSI (17.4%. In 40.8% of the cases, the wound was dirty infected. The average age for the patients was 46.7 years. The operations were elective in 75.7% of the cases and 24.7% were urgent. The average duration of the operation was 2.24 hours, the average duration of pre-operative hospital stay 4.31 days and the average length of (pre- and post-operation hospital stay 11.2 days. Three quarters of the cases were shaved 12 hours before the operation. The increased operation time, increased bed stay, electivity of the operation, septicity of the wound, type of incision, the administration of prophylactic antibiotic, type of operation, background disease, and the increased time lapse between shaving and operation all significantly associated with SSI with a p-value less than 0.001. Conclusion In view of the high rate of SSI reported here (17.4% compared with the 14% quoted in literature, this study suggests that by reducing the average operation time to less than 2 hours, the average preoperative stay to 4 days and the overall stay to less than 11 days, and

  11. Alcohol-based hand rub and surgical site infection after elective neurosurgery: An intervention

    Directory of Open Access Journals (Sweden)

    P P Saramma

    2011-01-01

    Full Text Available Background : Controlled studies on the effect of alcohol-based hand rub before and after each patient contact on surgical site infection (SSI among neurosurgical patients are scarce. Aim : To evaluate the effect of alcohol-based hand rub before and after each patient contact on SSI after elective neurosurgical procedures. Setting and Design : Department of Neurosurgery, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Trivandrum, Kerala. An intervention study using a ′before-after′ design. Material and Methods : Two 9-month study periods were compared; between these periods, an infection-control protocol incorporating an alcohol-based hand rub was implemented for a period of 3 months and continued thereafter. Consecutive patients who underwent neurosurgery between January and September 2006 (control group, before protocol and between January and September 2007 (intervention group, after protocol were included. Outcome measures included SSI rates, profile of microorganisms and patient survival. Statistical Analysis : SPSS statistics version 17.0. Results : A total of 1,899 operated cases were reviewed. The patients in the control and intervention groups were similar with regard to sex, age and type of neurosurgery. The surgical site infection rates were 22 (2.3% out of 974 in the control group and 14 (1.5% out of 925 in the intervention group (P = 0.2. Patient survival rates were 97.6% (control and 98.3% (intervention. Post hoc power calculation for an alpha value equal to 0.05, the power obtained was 24.9%, showing inadequacy of sample size to get significant results. To achieve 80% power, the sample size required is about 4,800 each for the control and intervention groups. Conclusion : Use of alcohol-based hand rub before and after each patient contact in the neurosurgical intensive care unit did not show a significant reduction in SSI in the present study. This lack of difference between the two groups may be related to

  12. A novel method of surgical site infection surveillance after cardiac surgery by active participation of stake holders.

    Science.gov (United States)

    Noman, Fatima; Mahmood, Syed Faisal; Asif, Shaheen; Rahim, Noureen; Khan, Ghufranullah; Hanif, Bashir

    2012-06-01

    We describe a comprehensive surveillance system involving infection control practitioners, surgeons, administrative staff, and patients aimed at improving the postdischarge surveillance of surgical site infections. The system was able to detect 22 infections out of 538 procedures, 95% of which were detected during the postdischarge period.

  13. Comparison of Costs of Surgical Site Infection and Endometritis after Cesarean Section Using Claims and Medical Record Data

    Science.gov (United States)

    Olsen, Margaret A.; Butler, Anne M.; Willers, Denise M.; Gross, Gilad A.; Fraser, Victoria J.

    2012-01-01

    We used administrative and clinical data from a case-control study to calculate the costs of surgical site infection and endometritis after cesarean section. Attributable costs determined by generalized least squares with the two data sources were similar, suggesting that administrative data can be used to calculate infection costs. PMID:20583923

  14. Surgical site infection after caesarean section: space for post-discharge surveillance improvements and reliable comparisons.

    Science.gov (United States)

    Ferraro, Federica; Piselli, Pierluca; Pittalis, Silvia; Ruscitti, Luca E; Cimaglia, Claudia; Ippolito, Giuseppe; Puro, Vincenzo

    2016-04-01

    Surgical site infections (SSI) after caesarean section (CS) represent a substantial health system concern. Surveying SSI has been associated with a reduction in SSI incidence. We report the findings of three (2008, 2011 and 2013) regional active SSI surveillances after CS in community hospital of the Latium region determining the incidence of SSI. Each CS was surveyed for SSI occurrence by trained staff up to 30 post-operative days, and association of SSI with relevant characteristics was assessed using binomial logistic regression. A total of 3,685 CS were included in the study. A complete 30 day post-operation follow-up was achieved in over 94% of procedures. Overall 145 SSI were observed (3.9% cumulative incidence) of which 131 (90.3%) were superficial and 14 (9.7%) complex (deep or organ/space) SSI; overall 129 SSI (of which 89.9% superficial) were diagnosed post-discharge. Only higher NNIS score was significantly associated with SSI occurrence in the regression analysis. Our work provides the first regional data on CS-associated SSI incidence, highlighting the need for a post-discharge surveillance which should assure 30 days post-operation to not miss data on complex SSI, as well as being less labour intensive.

  15. Drainage Systems Effect on Surgical Site Infection in Children with Perforated Appendicitis

    Directory of Open Access Journals (Sweden)

    Seref Kilic

    2014-12-01

    Full Text Available Aim: Effect of replacing open drainage system to closed drainage system on surgical site infection (SSI in children operated for perforated appendicitis was evaluated. Material and Method: Hospital files and computer records of perforated appendicitis cases operated in 2004-2010 were evaluated retrospectively. Open drainage systems were used for 70 in cases (group I and closed systems were used in the others (group II. Results: Eleven of SSI cases had superficial infection and 3 had the organ/space infection. SSI rate was 15.7% for group I and 7.5% for the group II. The antibiotic treatment length was 7.5 ± 3.4 days for group I and 6.4 ± 2.2 days for group II and the difference between groups was not statistically significant. Hospitalization length for group I was 8.2 ± 3.1 days and 6.8 ± 1.9 days for group II and the difference was statistically significant. Discussion: SSI is an important problem increasing morbidity and treatment costs through increasing hospitalization and antibiotic treatment length. Open drainage system used in operation in patients with perforated appendicitis leads an increased frequency of SSI when compared to the closed drainage system. Thus, closed drainage systems should be preferred in when drainage is necessary in operations for perforated appendicitis in children.

  16. Review of Subcutaneous Wound Drainage in Reducing Surgical Site Infections after Laparotomy

    Directory of Open Access Journals (Sweden)

    B. Manzoor

    2015-01-01

    Full Text Available Purpose. Surgical site infections (SSIs remain a significant problem after laparotomies. The aim of this review was to assess the evidence on the efficacy of subcutaneous wound drainage in reducing SSI. Methods. MEDLINE database was searched. Studies were identified and screened according to criteria to determine their eligibility for meta-analysis. Meta-analysis was performed using the Mantel-Haenszel method and a fixed effects model. Results. Eleven studies were included with two thousand eight hundred and sixty-four patients. One thousand four hundred and fifty patients were in the control group and one thousand four hundred and fourteen patients were in the drain group. Wound drainage in all patients shows no statistically significant benefit in reducing SSI incidence. Use of drainage in high risk patients, contaminated wound types, and obese patients appears beneficial. Conclusion. Using subcutaneous wound drainage after laparotomy in all patients is unnecessary as it does not reduce SSI risk. Similarly, there seems to be no benefit in using it in clean and clean contaminated wounds. However, there may be benefit in using drains in patients who are at high risk, including patients who are obese and/or have contaminated wound types. A well designed trial is needed which examines these factors.

  17. Delayed Propionibacterium acnes surgical site infections occur only in the presence of an implant.

    Science.gov (United States)

    Shiono, Yuta; Ishii, Ken; Nagai, Shigenori; Kakinuma, Hiroaki; Sasaki, Aya; Funao, Haruki; Kuramoto, Tetsuya; Yoshioka, Kenji; Ishihama, Hiroko; Isogai, Norihiro; Takeshima, Kenichiro; Tsuji, Takashi; Okada, Yasunori; Koyasu, Shigeo; Nakamura, Masaya; Toyama, Yoshiaki; Aizawa, Mamoru; Matsumoto, Morio

    2016-01-01

    Whether Propionibacterium acnes (P. acnes) causes surgical-site infections (SSI) after orthopedic surgery is controversial. We previously reported that we frequently find P. acnes in intraoperative specimens, yet none of the patients have clinically apparent infections. Here, we tracked P. acnes for 6 months in a mouse osteomyelitis model. We inoculated P. acnes with an implant into the mouse femur in the implant group; the control group was treated with the bacteria but no implant. We then observed over a 6-month period using optical imaging system. During the first 2 weeks, bacterial signals were detected in the femur in the both groups. The bacterial signal completely disappeared in the control group within 28 days. Interestingly, in the implant group, bacterial signals were still present 6 months after inoculation. Histological and scanning electron-microscope analyses confirmed that P. acnes was absent from the control group 6 months after inoculation, but in the implant group, the bacteria had survived in a biofilm around the implant. PCR analysis also identified P. acnes in the purulent effusion from the infected femurs in the implant group. To our knowledge, this is the first report showing that P. acnes causes SSI only in the presence of an implant. PMID:27615686

  18. Analysis of Surgical Site Infection after Musculoskeletal Tumor Surgery: Risk Assessment Using a New Scoring System

    Directory of Open Access Journals (Sweden)

    Satoshi Nagano

    2014-01-01

    Full Text Available Surgical site infection (SSI has not been extensively studied in musculoskeletal tumors (MST owing to the rarity of the disease. We analyzed incidence and risk factors of SSI in MST. SSI incidence was evaluated in consecutive 457 MST cases (benign, 310 cases and malignant, 147 cases treated at our institution. A detailed analysis of the clinical background of the patients, pre- and postoperative hematological data, and other factors that might be associated with SSI incidence was performed for malignant MST cases. SSI occurred in 0.32% and 12.2% of benign and malignant MST cases, respectively. The duration of the surgery (P=0.0002 and intraoperative blood loss (P=0.0005 was significantly more in the SSI group than in the non-SSI group. We established the musculoskeletal oncological surgery invasiveness (MOSI index by combining 4 risk factors (blood loss, operation duration, preoperative chemotherapy, and the use of artificial materials. The MOSI index (0–4 points score significantly correlated with the risk of SSI, as demonstrated by an SSI incidence of 38.5% in the group with a high score (3-4 points. The MOSI index score and laboratory data at 1 week after surgery could facilitate risk evaluation and prompt diagnosis of SSI.

  19. Does chlorhexidine and povidone-iodine preoperative antisepsis reduce surgical site infection in cranial neurosurgery?

    Science.gov (United States)

    Davies, B M; Patel, H C

    2016-07-01

    Introduction Surgical site infection (SSI) is a significant cause of postoperative morbidity and mortality. Effective preoperative antisepsis is a recognised prophylactic, with commonly used agents including chlorhexidine (CHG) and povidone-iodine (PVI). However, there is emerging evidence to suggest an additional benefit when they are used in combination. Methods We analysed data from our prospective SSI database on patients undergoing clean cranial neurosurgery between October 2011 and April 2014. We compared the case-mix adjusted odds of developing a SSI in patients undergoing skin preparation with CGH or PVI alone or in combination. Results SSIs were detected in 2.6% of 1146 cases. Antisepsis with PVI alone was performed in 654 (57%) procedures, while 276 (24%) had CHG alone and 216 (19%) CHG and PVI together. SSIs were associated with longer operating time (pSSI (adjusted odds ratio [AOR] 0.12, 95% confidence interval [CI] 0.02-0.63) than either agent alone. There was no difference in SSI rates between CHG and PVI alone (AOR 0.60, 95% CI 0.24-1.5). Conclusions Combination skin preparation with CHG and PVI significantly reduced SSI rates compared to CHG or PVI alone. A prospective, randomized study validating these findings is now warranted. PMID:27055411

  20. Implementation of a bundle of care to reduce surgical site infections in patients undergoing vascular surgery.

    Directory of Open Access Journals (Sweden)

    Jasper van der Slegt

    Full Text Available BACKGROUND: Surgical site infections (SSI's are associated with severe morbidity, mortality and increased health care costs in vascular surgery. OBJECTIVE: To implement a bundle of care in vascular surgery and measure the effects on the overall and deep-SSI's rates. DESIGN: Prospective, quasi-experimental, cohort study. METHODS: A prospective surveillance for SSI's after vascular surgery was performed in the Amphia hospital in Breda, from 2009 through 2011. A bundle developed by the Dutch hospital patient safety program (DHPSP was introduced in 2009. The elements of the bundle were (1 perioperative normothermia, (2 hair removal before surgery, (3 the use of perioperative antibiotic prophylaxis and (4 discipline in the operating room. Bundle compliance was measured every 3 months in a random sample of surgical procedures and this was used for feedback. RESULTS: Bundle compliance improved significantly from an average of 10% in 2009 to 60% in 2011. In total, 720 vascular procedures were performed during the study period and 75 (10.4% SSI were observed. Deep SSI occurred in 25 (3.5% patients. Patients with SSI's (28,5±29.3 vs 10.8±11.3, p<0.001 and deep-SSI's (48.3±39.4 vs 11.4±11.8, p<0.001 had a significantly longer length of hospital stay after surgery than patients without an infection. A significantly higher mortality was observed in patients who developed a deep SSI (Adjusted OR: 2.96, 95% confidence interval 1.32-6.63. Multivariate analysis showed a significant and independent decrease of the SSI-rate over time that paralleled the introduction of the bundle. The SSI-rate was 51% lower in 2011 compared to 2009. CONCLUSION: The implementation of the bundle was associated with improved compliance over time and a 51% reduction of the SSI-rate in vascular procedures. The bundle did not require expensive or potentially harmful interventions and is therefore an important tool to improve patient safety and reduce SSI's in patients undergoing

  1. Surgical site infection and clinical microbiology in orthopaedics surgeries in a rural hospital

    Institute of Scientific and Technical Information of China (English)

    Pradeep K. Singh; Sandeep Shrivastva; Rajesh Dulani; Abhishek Yadav

    2011-01-01

    @@ Infection and Clinical Microbiology in Orthopaedics Surgeries in Wound infections resulting from contamination during major orthopaedics surgery continues to be a vital issue.In this study, specimens of pus,draining fluids or suspected pus from the wounds of surgical patients who had been undergone major orthopaedics surgical procedure were cultured.

  2. Program Strengths and Opportunities for Improvement Identified by Residents During ACGME Site Visits in 5 Surgical Specialties.

    Science.gov (United States)

    Caniano, Donna A; Hamstra, Stanley J

    2016-05-01

    Background There is limited information about how residents in surgical specialties view program strengths and opportunities for improvement (OFIs). Objective This study aggregated surgical residents' perspectives on program strengths and OFIs to determine whether there was agreement in perspectives among residents in 5 surgical specialties. Methods Resident consensus lists of program strengths and areas for improvement were aggregated from site visits reports during 2012 and 2013 for obstetrics and gynecology, orthopaedic surgery, otolaryngology, plastic surgery, and surgery programs. Four trained individuals coded each strength or OFI in 1 of 3 categories: (1) factors common to all specialties; (2) program or institutional resources; and (3) factors unique to surgical specialties. Themes were classified as most frequent when listed by residents in more than 20% of the programs and less frequent when listed by residents in less than 20% of the programs. Results This study included a total of 359 programs, representing 27% to 49% of the Accreditation Council for Graduate Medical Education accredited programs in the 5 specialties. The most frequent strengths were progressive autonomy, collegiality, program leadership, and operative volume. Improving research and didactics, increasing faculty teaching and attendance at educational sessions, and increasing the number of nurse practitioners and physician assistants were common OFIs. Conclusions Factors identified as important by surgical residents related to their learning environment, their educational program, and program and institutional support. Across programs in the study, similar attributes were listed as both program strengths and OFIs. PMID:27168889

  3. Attributable Costs of Surgical Site Infection and Endometritis After Low Transverse Cesarean Section

    Science.gov (United States)

    Olsen, Margaret A.; Butler, Anne M.; Willers, Denise M.; Gross, Gilad A.; Hamilton, Barton H.; Fraser, Victoria J.

    2012-01-01

    BACKGROUND Accurate data on costs attributable to hospital-acquired infections are needed in order to determine their economic impact and the cost-benefit of potential preventive strategies. OBJECTIVE Determine the attributable costs of surgical site infection (SSI) and endometritis (EMM) after cesarean section using two different methods. DESIGN Retrospective cohort. SETTING Barnes-Jewish Hospital, a 1250-bed academic tertiary care hospital. PATIENTS 1,605 women who underwent low transverse cesarean section from 7/1999 – 6/2001. METHODS Attributable costs of SSI and EMM were determined by generalized least squares (GLS) and propensity score matched-pairs using administrative claims data to define underlying comorbidities and procedures. For the matched-pairs analyses, uninfected control patients were matched to patients with SSI or with EMM based on their propensity to develop infection, and the median difference in costs calculated. RESULTS The attributable total hospital cost of SSI calculated by GLS was $3,529 and by propensity score matched-pairs was $2,852. The attributable total hospital cost of EMM calculated by GLS was $3,956 and by propensity score matched-pairs was $3,842. The majority of excess costs were associated with room and board and pharmacy costs. CONCLUSIONS The costs of SSI and EMM were lower than SSI costs reported after more extensive operations. The attributable costs of EMM calculated using the two methods were very similar, while the costs of SSI calculated using propensity score matched-pairs were lower than the costs calculated by GLS. The difference in costs determined by the two methods needs to be considered by investigators performing cost analyses of hospital-acquired infections. PMID:20102279

  4. Prevalence of modifiable surgical site infection risk factors in hip and knee joint arthroplasty patients at an urban academic hospital.

    Science.gov (United States)

    Pruzansky, Jason S; Bronson, Michael J; Grelsamer, Ronald P; Strauss, Elton; Moucha, Calin S

    2014-02-01

    Surgical site infections after hip and knee arthroplasty can be devastating if they lead to periprosthetic joint infection. We examined the prevalence of the modifiable risk factors for surgical site infection described by the American Academy of Orthopaedic Surgery Patient Safety Committee. Our study of 300 cases revealed that only 20% of all cases and 7% of revision cases for infection had no modifiable risk factors. The most common risk factors were obesity (46%), anemia (29%), malnutrition (26%), and diabetes (20%). Cases with obesity or diabetes were associated with all histories of remote orthopedic infection, 89% of urinary tract infections, and 72% of anemia cases. The high prevalence of several modifiable risk factors demonstrates that there are multiple opportunities for perioperative optimization of such comorbidities.

  5. 207-nm UV light - a promising tool for safe low-cost reduction of surgical site infections. I: in vitro studies.

    Directory of Open Access Journals (Sweden)

    Manuela Buonanno

    Full Text Available BACKGROUND: 0.5% to 10% of clean surgeries result in surgical-site infections, and attempts to reduce this rate have had limited success. Germicidal UV lamps, with a broad wavelength spectrum from 200 to 400 nm are an effective bactericidal option against drug-resistant and drug-sensitive bacteria, but represent a health hazard to patient and staff. By contrast, because of its limited penetration, ~200 nm far-UVC light is predicted to be effective in killing bacteria, but without the human health hazards to skin and eyes associated with conventional germicidal UV exposure. AIMS: The aim of this work was to test the biophysically-based hypothesis that ~200 nm UV light is significantly cytotoxic to bacteria, but minimally cytotoxic or mutagenic to human cells either isolated or within tissues. METHODS: A Kr-Br excimer lamp was used, which produces 207-nm UV light, with a filter to remove higher-wavelength components. Comparisons were made with results from a conventional broad spectrum 254-nm UV germicidal lamp. First, cell inactivation vs. UV fluence data were generated for methicillin-resistant S. aureus (MRSA bacteria and also for normal human fibroblasts. Second, yields of the main UV-associated pre-mutagenic DNA lesions (cyclobutane pyrimidine dimers and 6-4 photoproducts were measured, for both UV radiations incident on 3-D human skin tissue. RESULTS: We found that 207-nm UV light kills MRSA efficiently but, unlike conventional germicidal UV lamps, produces little cell killing in human cells. In a 3-D human skin model, 207-nm UV light produced almost no pre-mutagenic UV-associated DNA lesions, in contrast to significant yields induced by a conventional germicidal UV lamp. CONCLUSIONS: As predicted based on biophysical considerations, 207-nm light kills bacteria efficiently but does not appear to be significantly cytotoxic or mutagenic to human cells. Used appropriately, 207-nm light may have the potential for safely and inexpensively

  6. 手术部位感染与手术区域皮肤准备及消毒的研究进展%Research progress of the infection of surgical site and the preparation and disinfec-tion of surgical site skin

    Institute of Scientific and Technical Information of China (English)

    马建中

    2015-01-01

    Surgical site infection was the focus of hospital infection control. The preparation and disinfection of surgical site skin was the key point of surgical site infection.%手术部位感染是医院感染控制的重点,手术区皮肤准备及消毒是控制手术部位感染的关键.

  7. Negative Pressure Wound Therapy on Surgical Site Infections in Women Undergoing Elective Caesarean Sections: A Pilot RCT

    OpenAIRE

    Wendy Chaboyer; Vinah Anderson; Joan Webster; Anne Sneddon; Lukman Thalib; Gillespie, Brigid M

    2014-01-01

    Obese women undergoing caesarean section (CS) are at increased risk of surgical site infection (SSI). Negative Pressure Wound Therapy (NPWT) is growing in use as a prophylactic approach to prevent wound complications such as SSI, yet there is little evidence of its benefits. This pilot randomized controlled trial (RCT) assessed the effect of NPWT on SSI and other wound complications in obese women undergoing elective caesarean sections (CS) and also the feasibility of conducting a defi...

  8. Convergent evolution in peptidoglycan cut sites of phage endolysins protecting mice from methicillin-resistant Staphylococcus aureus septicemia

    Science.gov (United States)

    Staphylococcus S. aureus is a Gram-positive pathogen relevant for both human and animal health. It is one of the most common causes of nosocomial infections and associated with a wide range of life-threatening human diseases. As the major causative agent of bovine mastitis, it also has significant ...

  9. Inflammatory markers as predictors of surgical site infection after elective colorectal cancer surgery.

    Science.gov (United States)

    Ortega-Deballon, Pablo; Lagoutte, Nicolas; Facy, Olivier

    2014-08-01

    We raise some doubts regarding the methods, results and conclusions obtained by Takakura et al. in their article published in the August's issue of the journal about the use of inflammatory markers as early predictors of surgical infection after colorectal cancer surgery. PMID:24824798

  10. Fibrinogen binding sites P336 and Y338 of clumping factor A are crucial for Staphylococcus aureus virulence.

    Directory of Open Access Journals (Sweden)

    Elisabet Josefsson

    Full Text Available We have earlier shown that clumping factor A (ClfA, a fibrinogen binding surface protein of Staphylococcus aureus, is an important virulence factor in septic arthritis. When two amino acids in the ClfA molecule, P(336 and Y(338, were changed to serine and alanine, respectively, the fibrinogen binding property was lost. ClfAP(336Y(338 mutants have been constructed in two virulent S. aureus strains Newman and LS-1. The aim of this study was to analyze if these two amino acids which are vital for the fibrinogen binding of ClfA are of importance for the ability of S. aureus to generate disease. Septic arthritis or sepsis were induced in mice by intravenous inoculation of bacteria. The clfAP(336Y(338 mutant induced significantly less arthritis than the wild type strain, both with respect to severity and frequency. The mutant infected mice developed also a much milder systemic inflammation, measured as lower mortality, weight loss, bacterial growth in kidneys and lower IL-6 levels. The data were verified with a second mutant where clfAP(336 and Y(338 were changed to alanine and serine respectively. When sepsis was induced by a larger bacterial inoculum, the clfAP(336Y(338 mutants induced significantly less septic death. Importantly, immunization with the recombinant A domain of ClfAP(336SY(338A mutant but not with recombinant ClfA, protected against septic death. Our data strongly suggest that the fibrinogen binding activity of ClfA is crucial for the ability of S. aureus to provoke disease manifestations, and that the vaccine potential of recombinant ClfA is improved by removing its ability to bind fibrinogen.

  11. Standard abdominal wound edge protection with surgical dressings vs coverage with a sterile circular polyethylene drape for prevention of surgical site infections (BaFO: study protocol for a randomized controlled trial

    Directory of Open Access Journals (Sweden)

    Mihaljevic André L

    2012-05-01

    Full Text Available Abstract Background Postoperative surgical site infections cause substantial morbidity, prolonged hospitalization, costs and even mortality and remain one of the most frequent surgical complications. Approximately 14% to 30% of all patients undergoing elective open abdominal surgery are affected and methods to reduce surgical site infection rates warrant further investigation and evaluation in randomized controlled trials. Methods/design To investigate whether the application of a circular plastic wound protector reduces the rate of surgical site infections in general and visceral surgical patients that undergo midline or transverse laparotomy by 50%. BaFO is a randomized, controlled, patient-blinded and observer-blinded multicenter clinical trial with two parallel surgical groups. The primary outcome measure will be the rate of surgical site infections within 45 days postoperative assessed according to the definition of the Center for Disease Control. Statistical analysis of the primary endpoint will be based on the intention-to-treat population. The global level of significance is set at 5% (2 sided and sample size (n = 258 per group is determined to assure a power of 80% with a planned interim analysis for the primary endpoint after the inclusion of 340 patients. Discussion The BaFO trial will explore if the rate of surgical site infections can be reduced by a single, simple, inexpensive intervention in patients undergoing open elective abdominal surgery. Its pragmatic design guarantees high external validity and clinical relevance. Trial registration http://www.clinicaltrials.gov NCT01181206. Date of registration: 11 August 2010; date of first patient randomized: 8 September 2010

  12. Postoperative Staphylococcus aureus infections in Medicare beneficiaries.

    Directory of Open Access Journals (Sweden)

    Moaven Razavi

    Full Text Available Staphylococcus aureus (S. aureus infections are important because of their increasing frequency, resistance to antibiotics, and high associated rates of disabilities and deaths. We examined the incidence and correlates of S. aureus infections following 219,958 major surgical procedures in a 5% random sample of fee-for-service Medicare beneficiaries from 2004-2007. Of these surgical patients, 0.3% had S. aureus infections during the hospitalizations when index surgical procedures were performed; and 1.7% and 2.3%, respectively, were hospitalized with infections within 60 days or 180 days following admissions for index surgeries. S. aureus infections occurred within 180 days in 1.9% of patients following coronary artery bypass graft surgery, 2.3% following hip surgery, and 5.9% following gastric or esophageal surgery. Of patients first hospitalized with any major infection reported during the first 180 days after index surgery, 15% of infections were due to S. aureus, 18% to other documented organisms, and no specific organism was reported on claim forms in 67%. Patient-level predictors of S. aureus infections included transfer from skilled nursing facilities or chronic hospitals and comorbid conditions (e.g., diabetes, congestive heart failure, chronic obstructive pulmonary disease, and chronic renal disease. In a logarithmic regression, elective index admissions with S. aureus infection stayed 130% longer than comparable patients without that infection. Within 180 days of the index surgery, 23.9% of patients with S. aureus infection and 10.6% of patients without this infection had died. In a multivariate logistic regression of death within 180 days of admission for the index surgery with adjustment for demographics, co-morbidities, and other risks, S. aureus was associated with a 42% excess risk of death. Due to incomplete documentation of organisms in Medicare claims, these statistics may underestimate the magnitude of S. aureus infection

  13. A Journey to Zero: Reduction of Post-Operative Cesarean Surgical Site Infections over a Five-Year Period

    Science.gov (United States)

    Hickson, Evelyn; Harris, Jeanette

    2015-01-01

    Abstract Background: Surgical site infections (SSI) are a substantial concern for cesarean deliveries in which a surgical site complication is most unwelcome for a mother with a new infant. Steps taken pre- and post-operatively to reduce the number of complications may be of substantial benefit clinically, economically, and psychologically. Methods: A risk-based approach to incision management was developed and implemented for all cesarean deliveries at our institution. A number of incremental interventions for low-risk and high-risk patients including pre-operative skin preparations, standardized pre- and post-operative protocols, post-operative nanocrystalline silver anti-microbial barrier dressings, and incisional negative pressure wound therapy (NPWT) were implemented sequentially over a 5-y period. A systematic clinical chart review of 4,942 patients spanning all cesarean deliveries between 2007–2012 was performed to determine what effects the interventions had on the rate of SSI for cesarean deliveries. Results: The percentage of SSI was reduced from 2.13% (2007) to 0.10% (2012) (p<0.0001). There were no substantial changes in the patient population risk factors over this time. As a result of the changes in incision management practice, a total of 92 cesarean post-operative SSIs were avoided: A total cost saving of nearly $5,000,000. Conclusion: Applying a clinical algorithm for assessing the risk of surgical site complication and making recommendations on pre-operative and post-operative incision management can result in a substantial and sustainable reduction in cesarean SSI. PMID:25826622

  14. 73. Surgical site infection after CABG: Root cause analysis and quality measures recommendation SSI quality improvement project

    Directory of Open Access Journals (Sweden)

    A. Arifi

    2016-07-01

    Full Text Available Surgical site infection (SSI, is a preventable and devastating complication with significant morbidity after cardiac surgery. The reported SSI rate at our center, ranging from 3.4% to 11.2% (2007–2013. This rate is considered to be above the standardized rate recommended by the NHSN. Quality improvement project team to address the issue of SSI, (SCIP, where formed by the medical administration late 2014. The aim of the study was to identify SSI risk factors at our cardiac surgical unit, using evidence based practices while taking a local approach to problem solving. We performed Root Cause Analysis (RCA, and we applied other quality improvement tools to identify the area for potential improvement. Data include a Process Map of the pre-operative, intra-operative and post-operative factors that might contribute to SSI risk. We prospectively used the RCA form to investigate all the stages of the patient process map (pre, intra op, and post operatively. The data included the Patient related factors, the sterilization and the hygiene practice in the operating room, and the operating room traffic, and the compliance to the bundle of care. Figure represent the “Fishbone” diagram of the possible causes of SSI after cardiac surgery in our unit. Demographic features of patients with SSI were as follows: mean age-65 years; female 83%; time to infection (mean 101 days; range 1–36 days;. The root cause analysis identified a significant weakness in the compliance to the bundle of care to prevent SSI. Furthermore, the patient flow, the operating theatre cleaning and traffic was also identified as a contributing factor to SSI. Surgical site infection after cardiac surgery is a preventable complication. The application of the evidence based practice and structured way of thinking in problem solving, will help identify the potential risk factors. Focusing on solving the right patient process and visually represents the problem will help identifying the

  15. Pattern of Bacterial Pathogens and Their Susceptibility Isolated from Surgical Site Infections at Selected Referral Hospitals, Addis Ababa, Ethiopia

    Directory of Open Access Journals (Sweden)

    Walelign Dessie

    2016-01-01

    Full Text Available Background. The emergence of multidrug resistant bacterial pathogens in hospitals is becoming a challenge for surgeons to treat hospital acquired infections. Objective. To determine bacterial pathogens and drug susceptibility isolated from surgical site infections at St. Paul Specialized Hospital Millennium Medical College and Yekatit 12 Referral Hospital Medical College, Addis Ababa, Ethiopia. Methods. A cross-sectional study was conducted between October 2013 and March 2014 on 107 surgical site infected patients. Wound specimens were collected using sterile cotton swab and processed as per standard operative procedures in appropriate culture media; and susceptibility testing was done using Kirby-Bauer disc diffusion technique. The data were analyzed by using SPSS version 20. Result. From a total of 107 swabs collected, 90 (84.1% were culture positive and 104 organisms were isolated. E. coli (24 (23.1% was the most common organism isolated followed by multidrug resistant Acinetobacter species (23 (22.1%. More than 58 (75% of the Gram negative isolates showed multiple antibiotic resistance (resistance ≥ 5 drugs. Pan-antibiotic resistance was noted among 8 (34.8% Acinetobacter species and 3 (12.5% E. coli. This calls for abstinence from antibiotic abuse. Conclusion. Gram negative bacteria were the most important isolates accounting for 76 (73.1%. Ampicillin, amoxicillin, penicillin, cephazoline, and tetracycline showed resistance while gentamicin and ciprofloxacin were relatively effective antimicrobials.

  16. Patient perspectives on post-discharge surgical site infections: towards a patient-centered mobile health solution.

    Directory of Open Access Journals (Sweden)

    Patrick C Sanger

    Full Text Available Post-discharge surgical site infections (SSI are a major source of morbidity, expense and anxiety for patients. However, patient perceptions about barriers experienced while seeking care for post-discharge SSI have not been assessed in depth. We explored patient experience of SSI and openness to a mobile health (mHealth wound monitoring "app" as a novel solution to address this problem.Mixed method design with semi-structured interviews and surveys. Participants were patients who had post-discharge surgical wound complications after undergoing operations with high risk of SSI, including open colorectal or ventral hernia repair surgery. The study was conducted at two affiliated teaching hospitals, including an academic medical center and a level 1 trauma center.From interviews with 13 patients, we identified 3 major challenges that impact patients' ability to manage post-discharge surgical wound complications, including required knowledge for wound monitoring from discharge teaching, self-efficacy for wound monitoring at home, and accessible communication with their providers about wound concerns. Patients found an mHealth wound monitoring application highly acceptable and articulated its potential to provide more frequent, thorough, and convenient follow-up that could reduce post-discharge anxiety compared to the current practice. Major concerns with mHealth wound monitoring were lack of timely response from providers and inaccessibility due to either lack of an appropriate device or usability challenges.Our findings reveal gaps and frustrations with post-discharge care after surgery which could negatively impact clinical outcomes and quality of life. To address these issues, we are developing mPOWEr, a patient-centered mHealth wound monitoring application for patients and providers to collaboratively bridge the care transition between hospital and home.

  17. Role of Pre-Operative Blood Transfusion and Subcutaneous Fat Thickness as Risk Factors for Surgical Site Infection after Posterior Thoracic Spine Stabilization

    OpenAIRE

    Osterhoff, Georg; Burla, Laurin; Werner, Clément M. L.; Jentzsch, Thorsten; Wanner, Guido A; Simmen, Hans-Peter; Sprengel, Kai

    2015-01-01

    BACKGROUND Surgical site infections (SSIs) increase morbidity and mortality rates and generate additional cost for the healthcare system. Pre-operative blood transfusion and the subcutaneous fat thickness (SFT) have been described as risk factors for SSI in other surgical areas. The purpose of this study was to assess the impact of pre-operative blood transfusion and the SFT on the occurrence of SSI in posterior thoracic spine surgery. METHODS In total, 244 patients (median age 55 y; 97 fe...

  18. [Long-term survival after surgical resection of a cancer of unknown primary site-a case report].

    Science.gov (United States)

    Tsukao, Yukiko; Moon, Jeong Ho; Kobayashi, Kenji; Hyuga, Satoshi; Chono, Teruhiro; Watanabe, Risa; Matsumoto, Takashi; Takemoto, Hiroyoshi; Takachi, Ko; Nishioka, Kiyonori; Aoki, Taro; Uemura, Yoshio

    2013-11-01

    We report a case of long-term survival after combination chemotherapy and surgical resection of a cancer of unknown primary site[ CUPs]. A septuagenarian female was identified as having high blood levels of carcinoembryonic antigen (CEA) during follow-up monitoring of asthma. Endoscopy and imaging studies including computed tomography (CT) and positron emission tomography (PET)-CT revealed a malignant lymph node adjacent to the abdominal aorta; however, no other lesion was detected. Therefore, we performed CT-guided biopsy and diagnosed the lesion to be a lymph node metastasis of poorly differentiated adenocarcinoma. As we considered this as a systemic disease, the patient received 2 courses of combination chemotherapy with 5-fluorouracil( 5-FU)/cisplatin( CDDP) and achieved a partial response (PR). Later, the patient received S-1 therapy as second-line chemotherapy and S-1/irinotecan( CPT-11) as third-line chemotherapy in an outpatient clinic. However, the tumor continued to grow, and therefore, we decided to perform surgical resection. Histopathological examination of the resected specimen yielded a diagnosis of metastatic adenocarcinoma of the lymph node. The patient has been well without any signs of recurrence for more than 9 years since surgery. As CUPs is generally associated with poor prognosis, this case raises the possibility that combination therapy might improve convalescence.

  19. Organizational requirements of the SaeR binding sites for a functional P1 promoter of the sae operon in Staphylococcus aureus.

    Science.gov (United States)

    Cho, Hoonsik; Jeong, Do-Won; Li, Chunling; Bae, Taeok

    2012-06-01

    In Staphylococcus aureus, the SaeRS two-component system controls the expression of multiple virulence factors. Of the two promoters in the sae operon, P1 is autoinduced and has two binding sites for the response regulator SaeR. In this study, we examined the organizational requirements of the SaeR binding sites in P1 for transcription activation. Mutational studies showed that both binding sites are essential for binding to phosphorylated SaeR (P-SaeR) and transcription activation. When the 21-bp distance between the centers of the two SaeR binding sites was altered to 26 bp, 31 bp, 36 bp, or 41 bp, only the 31-bp mutant retained approximately 40% of the original promoter activity. When the -1-bp spacing (i.e.,1-bp overlap) between the primary SaeR binding site and the -35 promoter region was altered, all mutant P1 promoters failed to initiate transcription; however, when the first nucleotide of the -35 region was changed from A to T, the mutants with 0-bp or 22-bp spacing showed detectable promoter activity. Although P-SaeR was essential for the binding of RNA polymerase to P1, it was not essential for the binding of the enzyme to the alpha-hemolysin promoter. When the nonoptimal spacing between promoter elements in P1 or the coagulase promoter was altered to the optimal spacing of 17 bp, both promoters failed to initiate transcription. These results suggest that SaeR binding sites are under rather strict organizational restrictions and provide clues for understanding the molecular mechanism of sae-mediated transcription activation.

  20. Intraoperative PaO2 is not related to the development of surgical site infections after major cardiac surgery

    Directory of Open Access Journals (Sweden)

    Fierro Inma

    2011-01-01

    Full Text Available Abstract Background The perioperative use of high inspired oxygen fraction (FIO2 for preventing surgical site infections (SSIs has demonstrated a reduction in their incidence in some types of surgery however there exist some discrepancies in this respect. The aim of this study was to analyze the relationship between PaO2 values and SSIs in cardiac patients. Methods We designed a prospective study in which 1,024 patients undergoing cardiac surgery were analyzed. Results SSIs were observed in 5.3% of patients. There was not significant difference in mortality at 30 days between patients with and without SSIs. In the uni and multivariate analysis no differences in function of the inspired oxygen fraction administrated were observed. Conclusions We observed that the PaO2 in adult cardiac surgery patients was not related to SSI rate.

  1. Developing algorithms for healthcare insurers to systematically monitor surgical site infection rates

    Directory of Open Access Journals (Sweden)

    Livingston James M

    2007-06-01

    Full Text Available Abstract Background Claims data provide rapid indicators of SSIs for coronary artery bypass surgery and have been shown to successfully rank hospitals by SSI rates. We now operationalize this method for use by payers without transfer of protected health information, or any insurer data, to external analytic centers. Results We performed a descriptive study testing the operationalization of software for payers to routinely assess surgical infection rates among hospitals where enrollees receive cardiac procedures. We developed five SAS programs and a user manual for direct use by health plans and payers. The manual and programs were refined following provision to two national insurers who applied the programs to claims databases, following instructions on data preparation, data validation, analysis, and verification and interpretation of program output. A final set of programs and user manual successfully guided health plan programmer analysts to apply SSI algorithms to claims databases. Validation steps identified common problems such as incomplete preparation of data, missing data, insufficient sample size, and other issues that might result in program failure. Several user prompts enabled health plans to select time windows, strata such as insurance type, and the threshold number of procedures performed by a hospital before inclusion in regression models assessing relative SSI rates among hospitals. No health plan data was transferred to outside entities. Programs, on default settings, provided descriptive tables of SSI indicators stratified by hospital, insurer type, SSI indicator (inpatient, outpatient, antibiotic, and six-month period. Regression models provided rankings of hospital SSI indicator rates by quartiles, adjusted for comorbidities. Programs are publicly available without charge. Conclusion We describe a free, user-friendly software package that enables payers to routinely assess and identify hospitals with potentially high SSI

  2. Receptor binding sites for substance P in surgical specimens obtained from patients with ulcerative colitis and Crohn disease

    Energy Technology Data Exchange (ETDEWEB)

    Mantyh, C.R.; Gates, T.S.; Zimmerman, R.P.; Welton, M.L.; Passaro, E.P. Jr.; Vigna, S.R.; Maggio, J.E.; Kruger, L.; Mantyh, P.W.

    1988-05-01

    Several lines of evidence indicate that tachykinin neuropeptides (substance P (SP), substance K (SK), and neuromedin K (NK)) play a role in regulating the inflammatory and immune responses. To test this hypothesis in a human inflammatory disease, quantitative receptor autoradiography was used to examine possible abnormalities in tachykinin binding sites in surgical specimens from patients with inflammatory bowel disease. In all cases, specimens were processed for quantitative receptor autoradiography by using /sup 125/I-labeled Bolton-Hunter conjugates of NK, SK, and SP. In colon tissue obtained from ulcerative colitis and Crohn disease patients, very high concentrations of SP receptor binding sites are expressed by arterioles and venules located in the submucosa, muscalairs mucosa, external circular muscle, external longitudinal muscle, and serosa, in contrast to control patients. These results demonstrate that receptor binding sites for SP, but not SK or NK, are ectopically expressed in high concentrations by cells involved in mediating inflammatory and immune responses. These data suggest that SP may be involved in the pathophysiology of inflammatory bowel disease and might provide some insight into the interaction between the nervous system and the regulation of inflammation and the immune response in human inflammatory disease.

  3. Effects of surgical side and site on mood and behavior outcome in children with pharmacoresistant epilepsy

    Directory of Open Access Journals (Sweden)

    Elizabeth N Andresen

    2014-02-01

    Full Text Available Children with epilepsy have a high rate of mood and behavior problems yet few studies consider the emotional and behavioral impact of surgery. No study to date has been sufficiently powered to investigate effects of both side (left/right and site (temporal/frontal of surgery. One hundred patients (aged 6-16 and their families completed measures of depression, anxiety and behavioral function as part of neuropsychological evaluations before and after surgery for pharmacoresistant epilepsy. Among children who had left-sided surgeries (frontal=16; temporal=38, there were significant interactions between time (pre to postoperative neuropsychological assessment and resection site (frontal/temporal on Anhedonia, Social Anxiety, and Withdrawn/Depressed scales. Patients with frontal lobe epilepsy (FLE endorsed greater presurgical anhedonia and social anxiety than patients with temporal lobe epilepsy (TLE, with scores normalizing following surgery. While scores on the Withdrawn/Depressed scale were similar between groups before surgery, the FLE group showed greater symptom improvement after surgery. In children who underwent right-sided surgeries (FLE=20; TLE=26 main effects of time (patients in both groups improved and resection site (caregivers of FLE patients endorsed greater symptoms than those with TLE were observed primarily on behavior scales. Individual data revealed that a greater proportion of children with left FLE demonstrated clinically significant improvements in Anhedonia, Social Anxiety, and Aggressive Behavior than children with TLE. This is the first study to demonstrate differential effects of both side and site of surgery in children with epilepsy at group and individual levels. Results suggest that children with FLE have greater emotional and behavioral dysfunction before surgery, but show marked improvement after surgery. Overall, most children had good emotional and behavioral outcomes, with most scores remaining stable or improving.

  4. Negative Pressure Wound Therapy on Surgical Site Infections in Women Undergoing Elective Caesarean Sections: A Pilot RCT

    Directory of Open Access Journals (Sweden)

    Wendy Chaboyer

    2014-09-01

    Full Text Available Obese women undergoing caesarean section (CS are at increased risk of surgical site infection (SSI. Negative Pressure Wound Therapy (NPWT is growing in use as a prophylactic approach to prevent wound complications such as SSI, yet there is little evidence of its benefits. This pilot randomized controlled trial (RCT assessed the effect of NPWT on SSI and other wound complications in obese women undergoing elective caesarean sections (CS and also the feasibility of conducting a definitive trial. Ninety-two obese women undergoing elective CS were randomized in theatre via a central web based system using a parallel 1:1 process to two groups i.e., 46 women received the intervention (NPWT PICO™ dressing and 46 women received standard care (Comfeel Plus® dressing. All women received the intended dressing following wound closure. The relative risk of SSI in the intervention group was 0.81 (95% CI 0.38–1.68; for the number of complications excluding SSI it was 0.98 (95% CI 0.34–2.79. A sample size of 784 (392 per group would be required to find a statistically significant difference in SSI between the two groups with 90% power. These results demonstrate that a larger definitive trial is feasible and that careful planning and site selection is critical to the success of the overall study.

  5. The role of pre-operative and post-operative glucose control in surgical-site infections and mortality.

    Directory of Open Access Journals (Sweden)

    Christie Y Jeon

    Full Text Available BACKGROUND AND OBJECTIVE: The impact of glucose control on surgical-site infection (SSI and death remains unclear. We examined how pre- and post-operative glucose levels and their variability are associated with the risk of SSI or in-hospital death. METHODS: This retrospective cohort study employed data on 13,800 hospitalized patients who underwent a surgical procedure at a large referral hospital in New York between 2006 and 2008. Over 20 different sources of electronic data were used to analyze how thirty-day risk of SSI and in-hospital death varies by glucose levels and variability. Maximum pre- and post-operative glucose levels were determined for 72 hours before and after the operation and glucose variability was defined as the coefficient of variation of the glucose measurements. We employed logistic regression to model the risk of SSI or death against glucose variables and the following potential confounders: age, sex, body mass index, duration of operation, diabetes status, procedure classification, physical status, emergency status, and blood transfusion. RESULTS: While association of pre- and post-operative hyperglycemia with SSI were apparent in the crude analysis, multivariate results showed that SSI risk did not vary significantly with glucose levels. On the other hand, in-hospital deaths were associated with pre-operative hypoglycemia (OR = 5.09, 95% CI (1.80, 14.4 and glucose variability (OR = 1.14, 95% CI (1.03, 1.27 for 10% increase in coefficient of variation. CONCLUSION: In-hospital deaths occurred more often among those with pre-operative hypoglycemia and higher glucose variability. These findings warrant further investigation to determine whether stabilization of glucose and prevention of hypoglycemia could reduce post-operative deaths.

  6. Clinical relevance of surgical site infection as defined by the criteria of the Centers for Disease Control and Prevention.

    Science.gov (United States)

    Henriksen, N A; Meyhoff, C S; Wetterslev, J; Wille-Jørgensen, P; Rasmussen, L S; Jorgensen, L N

    2010-07-01

    Surgical site infection (SSI) is a common complication after abdominal surgery and the Centers for Disease Control and Prevention (CDC) criteria are commonly used for diagnosis and surveillance. The aim of this study was to evaluate whether SSI diagnosed according to CDC is clinically relevant (CRSSI) and whether there is agreement between evaluations according to the CDC criteria, the ASEPSIS score (Additional treatment, presence of Serous discharge, Erythema, Purulent exudate, Separation of the deep tissues, Isolation of bacteria and duration of Stay) and CRSSI. We included 54 patients diagnosed with SSI and a matched control group (N=46) without SSI according to the CDC criteria after laparotomy. Two blinded experienced surgeons evaluated the hospital records and determined whether patients had CRSSI, based on the following criteria: antibiotic treatment, surgical intervention, prolonged hospital stay or referral to an intensive care unit for SSI. The rate of CRSSI was 38 of 54 (70%) in patients with CDC-diagnosed SSI and none in patients without a CDC-diagnosed SSI. Sixty-one percent of the CDC-diagnosed SSIs were superficial, of which 48% were considered clinically relevant. There was substantial agreement between the CDC criteria and CRSSI [kappa=0.69; 95% confidence interval (CI): 0.55-0.83] and fair agreement between the ASEPSIS score and the CDC criteria (kappa=0.23; 95% CI: 0-0.49) and between the ASEPSIS score and CRSSI (kappa=0.39; 95% CI: 0.17-0.61). The CDC criteria represent a suitable standard definition for monitoring and identifying SSI, even if some cases of less clinically significant superficial SSI are included.

  7. Judicious use of prophylactic antimicrobials to reduce abdominal surgical site infections in periparturient cows: part 1 - a risk factor review.

    Science.gov (United States)

    Dumas, S E; French, H M; Lavergne, S N; Ramirez, C R; Brown, L J; Bromfield, C R; Garrett, E F; French, D D; Aldridge, B M

    2016-06-25

    Surgical site infections (SSI) are an uncommon, but significant, consequence of surgical interventions. There are very few studies investigating SSI risk in veterinary medicine, and even fewer in cattle, despite the fact that major surgeries are commonly conducted on livestock. Furthermore, the suboptimal conditions under which such surgeries are frequently performed on livestock could be considered an important risk factor for the development of SSIs. With increasing public concern over the contribution of veterinary-prescribed antimicrobials to the emergence of antimicrobial-resistant bacteria in people, there is widespread scrutiny and criticism of antimicrobial use in livestock production medicine systems. While the causal link between antimicrobial resistance in livestock and people is heavily debated, it is clear that the prevalence of antimicrobial resistance, in any population, is closely correlated with the antimicrobial 'consumption' within that population. As the veterinary profession explores ways of addressing the emergence and selection of antimicrobial-resistant bacteria in food-producing animals, there is a need for veterinarians and producers to carefully consider all areas of antimicrobial use, and employ an evidence-based approach in designing appropriate clinical protocols. This paper aims to review current knowledge regarding the risk factors related to abdominal SSI in periparturient cows, and to encourage practitioners to judiciously evaluate both their standard operating procedures and their use of antimicrobials in these situations. In a second paper, to be published in a subsequent issue of Veterinary Record, these principles will be used to provide specific evidence-based recommendations for antimicrobial use in bovine abdominal surgery. PMID:27339926

  8. Impact of an Automated Surveillance to Detect Surgical-Site Infections in Patients Undergoing Total Hip and Knee Arthroplasty in Brazil.

    Science.gov (United States)

    Perdiz, Luciana B; Yokoe, Deborah S; Furtado, Guilherme H; Medeiros, Eduardo A S

    2016-08-01

    In this retrospective study, we compared automated surveillance with conventional surveillance to detect surgical site infection after primary total hip or knee arthroplasty. Automated surveillance demonstrated better efficacy than routine surveillance in SSI diagnosis, sensitivity, and predictive negative value in hip and knee arthroplasty. Infect Control Hosp Epidemiol 2016;37:991-993. PMID:27072598

  9. Prophylactic Effect of Vancomycin on Infection after Cranioplasty in Methicillin-Resistant Staphylococcus Aureus Carriers with Traumatic Brain Injury

    OpenAIRE

    Bang, Jin Hyuk; Cho, Keun-Tae; Park, Seong Yeon

    2015-01-01

    Objective Methicillin-resistant Staphylococcus aureus (MRSA) and methicillin-resistant coagulase negative staphylococci (MRCNS) are major causes of neurosurgical infection. Nasal colonization of MRSA is the most important risk factor and MRSA screening can be a screening method to identify MRSA and MRCNS colonization. We retrospectively evaluated prophylactic effect of vancomycin on MRSA or MRCNS surgical site infection (SSI) after cranioplasty following decompressive craniectomy (DC) after t...

  10. Improving Public Reporting and Data Validation for Complex Surgical Site Infections After Coronary Artery Bypass Graft Surgery and Hip Arthroplasty

    Science.gov (United States)

    Calderwood, Michael S.; Kleinman, Ken; Murphy, Michael V.; Platt, Richard; Huang, Susan S.

    2014-01-01

    Background  Deep and organ/space surgical site infections (D/OS SSI) cause significant morbidity, mortality, and costs. Rates are publicly reported and increasingly used as quality metrics affecting hospital payment. Lack of standardized surveillance methods threaten the accuracy of reported data and decrease confidence in comparisons based upon these data. Methods  We analyzed data from national validation studies that used Medicare claims to trigger chart review for SSI confirmation after coronary artery bypass graft surgery (CABG) and hip arthroplasty. We evaluated code performance (sensitivity and positive predictive value) to select diagnosis codes that best identified D/OS SSI. Codes were analyzed individually and in combination. Results  Analysis included 143 patients with D/OS SSI after CABG and 175 patients with D/OS SSI after hip arthroplasty. For CABG, 9 International Classification of Diseases, 9th Revision (ICD-9) diagnosis codes identified 92% of D/OS SSI, with 1 D/OS SSI identified for every 4 cases with a diagnosis code. For hip arthroplasty, 6 ICD-9 diagnosis codes identified 99% of D/OS SSI, with 1 D/OS SSI identified for every 2 cases with a diagnosis code. Conclusions  This standardized and efficient approach for identifying D/OS SSI can be used by hospitals to improve case detection and public reporting. This method can also be used to identify potential D/OS SSI cases for review during hospital audits for data validation. PMID:25734174

  11. Mapping the Distribution of Invasive Staphylococcus aureus across Europe

    OpenAIRE

    Grundmann, Hajo; Aanensen, David M.; van den Wijngaard, Cees C.; Brian G Spratt; Harmsen, Dag; Friedrich, Alexander W.; ,

    2010-01-01

    Editors' Summary Background The bacterium Staphylococcus aureus lives on the skin and in the nose of about a third of healthy people. Although S. aureus usually coexists peacefully with its human carriers, it is also an important disease-causing organism or pathogen. If it enters the body through a cut or during a surgical procedure, S. aureus can cause minor infections such as pimples and boils or more serious, life-threatening infections such as blood poisoning and pneumonia. Minor S. aureu...

  12. Effect of Mupirocin on Nasal Carriage of Staphylococcus Aureus

    NARCIS (Netherlands)

    M. Bulanda; M. Gruszka; B. Heczko

    1989-01-01

    textabstractMupirocin eliminates nasal carriage of staphylococcal aureus among medical and surgical personnel for periode varying from several weeks upto one year. In persons recolonized after therapy densites of S. aureus population in nares were much lower than in the same persons before therapy.

  13. Agreement among healthcare professionals in ten European countries in diagnosing case-vignettes of surgical-site infections.

    Directory of Open Access Journals (Sweden)

    Gabriel Birgand

    Full Text Available OBJECTIVE: Although surgical-site infection (SSI rates are advocated as a major evaluation criterion, the reproducibility of SSI diagnosis is unknown. We assessed agreement in diagnosing SSI among specialists involved in SSI surveillance in Europe. METHODS: Twelve case-vignettes based on suspected SSI were submitted to 100 infection-control physicians (ICPs and 86 surgeons in 10 European countries. Each participant scored eight randomly-assigned case-vignettes on a secure online relational database. The intra-class correlation coefficient (ICC was used to assess agreement for SSI diagnosis on a 7-point Likert scale and the kappa coefficient to assess agreement for SSI depth on a three-point scale. RESULTS: Intra-specialty agreement for SSI diagnosis ranged across countries and specialties from 0.00 (95%CI, 0.00-0.35 to 0.65 (0.45-0.82. Inter-specialty agreement varied from 0.04 (0.00-0.62 in to 0.55 (0.37-0.74 in Germany. For all countries pooled, intra-specialty agreement was poor for surgeons (0.24, 0.14-0.42 and good for ICPs (0.41, 0.28-0.61. Reading SSI definitions improved agreement among ICPs (0.57 but not surgeons (0.09. Intra-specialty agreement for SSI depth ranged across countries and specialties from 0.05 (0.00-0.10 to 0.50 (0.45-0.55 and was not improved by reading SSI definition. CONCLUSION: Among ICPs and surgeons evaluating case-vignettes of suspected SSI, considerable disagreement occurred regarding the diagnosis, with variations across specialties and countries.

  14. Infecção de sítio cirúrgico: estudo prospectivo de 2.149 pacientes operados Surgical site infections: prospective study of 2.149 surgical patients

    Directory of Open Access Journals (Sweden)

    Francisco Ney Lemos

    1999-04-01

    Full Text Available A atual caracterização de infecção do sítio cirúrgico em incisional superficial, incisional profunda e órgão cavidade, em substituição à tradicional definição de "infecção de ferida operatória", associada a estratificação dos pacientes em grupos de risco de infecção cirúrgica de acordo com a metodologia NNISS (National Nosocomial Infection Surveillance System, permitiram a obtenção de taxas de infecção mais fidedignas e estudos comparativos entre instituições diferentes. Baseado nessa metodologia, o presente trabalho analisa prospectivamente 2.149 pacientes operados no Serviço de Cirurgia do Hospital Geral César Cals (HGCC-CE, estratificados pelo IRIC (Índice de Risco de Infecção Cirúrgica e comprova diferenças estatisticamente significativas nas taxas de infecção de sítio cirúrgico para os grupos de IRIC 0, 1,2 e 3, respectivamente de 3,2%, 7,4%, 16,6% e 20,9%. As infecções de maior gravidade ocorrem em pacientes com IRIC 3 e a vigilância pós-alta é importante, na medida em que muitas infecções somente serão diagnosticadas após a alta hospitalar.Patients undergoing surgery are at risk of surgical site infection-SSI. According to data from the National Nosocomial Infection Surveillance System-NNISS, in the United States surgical infections are the second most common type of nosocomial infection. The aim of this study is to assess surgical-site infection rates for patients operated in a general hospital in Northeasteen Brazil, break them down according to the Surgical Infection Risk Index-SIRI, and then classify such infections according to their gravity. A prospective evaluation was conducted of 2,149 surgical patients between January 1996 and January 1998, at the Cesar Cals General Hospital, using the methodology of the NNISS, adapted to our hospital. Definition standards were those recommended by Center for Disease Control-CDC- 1992. Statistical analysis was based on Qui-square test of Pearson. Of

  15. Abortion - surgical

    Science.gov (United States)

    Suction curettage; Surgical abortion; Elective abortion - surgical; Therapeutic abortion - surgical ... Surgical abortion involves dilating the opening to the uterus (cervix) and placing a small suction tube into the uterus. ...

  16. Sensitivity and specificity of serum procalcitonin level compared to leucocyte count for diagnosis of surgical site infection on patients undergoing major surgery

    OpenAIRE

    Muhammad Sayuti; Supomo; Umi Sholekah Intansari

    2016-01-01

    Surgical site infection (SSI) is one of the most serious complications on sugical procedure. However, its diagnosis is still based on the clinical and laboratory examination that take more time and less sensitive and specific. Therefore, early diagnosis that is more accurate and precise is needed. Some biomarker such as serum procalcitonin (PCT) is promoted for diagnosis SSI. The aim of the study was to evaluate the sensitivity and specificity of serum PCT compared with leucocy...

  17. Lymphopenia and Elevated Blood C-Reactive Protein Levels at Four Days Postoperatively Are Useful Markers for Early Detection of Surgical Site Infection Following Posterior Lumbar Instrumentation Surgery

    OpenAIRE

    Iwata, Eiichiro; Shigematsu, Hideki; Koizumi, Munehisa; Nakajima, Hiroshi; Okuda, Akinori; Morimoto, Yasuhiko; Masuda, Keisuke; Tanaka, Yasuhito

    2016-01-01

    Study Design Case-control study. Purpose To identify the characteristics of candidate indexes for early detection of surgical site infection (SSI). Overview of Literature SSI is a serious complication of spinal instrumentation surgery. Early diagnosis and treatment are crucial for the welfare of the patient postoperation. Methods We retrospectively reviewed laboratory data of patients who underwent posterior lumbar instrumentation surgery for degenerative spine disease. The sensitivity and sp...

  18. Perioperative oxygen fraction - effect on surgical site infection and pulmonary complications after abdominal surgery: a randomized clinical trial. Rationale and design of the PROXI-Trial

    DEFF Research Database (Denmark)

    Meyhoff, Christian Sylvest; Wetterslev, Jørn; Jorgensen, Lars N;

    2008-01-01

    A high perioperative inspiratory oxygen fraction may reduce the risk of surgical site infections, as bacterial eradication by neutrophils depends on wound oxygen tension. Two trials have shown that a high perioperative inspiratory oxygen fraction (FiO(2) = 0.80) significantly reduced risk...... complications, such as atelectasis, pneumonia and respiratory failure. The aim of our trial is to assess the potential benefits and harms of a high perioperative oxygen fraction in patients undergoing abdominal surgery....

  19. Surgical site infection in high-energy peri-articular tibia fractures with intra-wound vancomycin powder: a retrospective pilot study

    OpenAIRE

    Singh, Keerat; Bauer, Jennifer M.; LaChaud, Gregory Y.; Bible, Jesse E.; Mir, Hassan R.

    2015-01-01

    Background Surgical site infections (SSI) continue to be a significant source of morbidity despite the introduction of perioperative intravenous antibiotics. Our objective was to assess the efficacy of local vancomycin powder on lowering deep SSI rates in high-energy tibial plateau and pilon fractures. Materials and methods A retrospective review of all tibial plateau and pilon fractures treated in 2012 at our level I trauma center identified 222 patients. Of these, 107 patients sustained hig...

  20. Investigation of clustering events of surgical site infections in patients undergoing coronary artery bypass grafting%冠状动脉搭桥术患者手术部位感染聚集性调查研究

    Institute of Scientific and Technical Information of China (English)

    程丽峰; 阿依古丽; 朱敏; 卢辉; 魏育涛

    2015-01-01

    OBJECTIVE To investigate the high risk factors for clustering events of surgical site infections in wards of cardiothoracic surgery department so as to provide guidance for prevention and control of nosocomial infections . METHODS The epidemiological survey was conducted for the patients with suspected surgical site infections who were treated in the cardiothoracic surgery department from Jul to Aug ,2012 ,the high risk factors were analyzed , and the comprehensive interventions were taken to avoid the spread of nosocomial infections .RESULTS The surgical site infections occurred in 4 of 8 patients who underwent the coronary artery bypass grafting in the cardiothoracic surgery department ,with the infection rate of 50 .00% .All the 4 cases were complicated with se‐vere underlying diseases ,and 3 cases were complicated with diabetic mellitus ;the surgical procedures were com‐plex ,the operation duration was long ,and the symptoms of surgical incision infections were the same ,all the ca‐ses had the redness ,swelling ,heat ,and bloody discharge ,accompanied by incision dehiscence ,and the culture of wound secretions showed that there was no growth of bacteria .The hand hygiene of the health care workers and the cleaning of object surfaces were unqualified ,the environmental hygiene surveillance indicated that the Staphy‐lococcus aureus have been isolated , the outbreak of the surgical site infections could not completely excluded , which was defined as the clustering events of surgical site infections ,and the 4 patients were cured and discharged successively after the active treatment .CONCLUSION It is an effective way to intensify the consciousness of control of the nosocomial infections and take targeted prevention measures so as to control the clustering events of nosoco‐mial infections .%目的:调查医院心胸外科病房手术部位感染聚集性事件发生的高危因素,为预防与控制医院感染提供参考依据。方法对2012年7

  1. Development of the Biopen: a handheld device for surgical printing of adipose stem cells at a chondral wound site.

    Science.gov (United States)

    O'Connell, Cathal D; Di Bella, Claudia; Thompson, Fletcher; Augustine, Cheryl; Beirne, Stephen; Cornock, Rhys; Richards, Christopher J; Chung, Johnson; Gambhir, Sanjeev; Yue, Zhilian; Bourke, Justin; Zhang, Binbin; Taylor, Adam; Quigley, Anita; Kapsa, Robert; Choong, Peter; Wallace, Gordon G

    2016-03-01

    We present a new approach which aims to translate freeform biofabrication into the surgical field, while staying true to the practical constraints of the operating theatre. Herein we describe the development of a handheld biofabrication tool, dubbed the 'biopen', which enables the deposition of living cells and biomaterials in a manual, direct-write fashion. A gelatin-methacrylamide/hyaluronic acid-methacrylate (GelMa/HAMa) hydrogel was printed and UV crosslinked during the deposition process to generate surgically sculpted 3D structures. Custom titanium nozzles were fabricated to allow printing of multiple ink formulations in a collinear (side-by-side) geometry. Independently applied extrusion pressure for both chambers allows for geometric control of the printed structure and for the creation of compositional gradients. In vitro experiments demonstrated that human adipose stem cells maintain high viability (>97%) one week after biopen printing in GelMa/HAMa hydrogels. The biopen described in this study paves the way for the use of 3D bioprinting during the surgical process. The ability to directly control the deposition of regenerative scaffolds with or without the presence of live cells during the surgical process presents an exciting advance not only in the fields of cartilage and bone regeneration but also in other fields where tissue regeneration and replacement are critical. PMID:27004561

  2. Linezolid resistant Staphylococcus aureus

    Directory of Open Access Journals (Sweden)

    Pavani Gandham

    2014-08-01

    Full Text Available Linezolid is the only antibiotic available as an oral formulation for resistant staphylococcal infections. It is effective in skin and soft tissue infections, nosocomial pneumonias including VAP, infective endocarditis and MRSA meningitis. It is also effective in the eradication of both nasal and throat colonization of MRSA. Its high bioavailability and post antibiotic effect, ease of switching to oral therapy during its use and the fact that it can be used in patients of all ages, also in patients with liver disease and poor kidney function and its increased effectiveness over glycopeptides makes this drug a precious drug in the treatment of resistant staphylococcal infections. Linezolid resistance in staphylococcus is defined as a linezolid MIC of and #8805;8 mg/L. Reported Linezolid resistance in India and elsewhere is 2-20%. There is clonal dissemination of Linezolid Resistant Staphylococcus aureus (LRSA within or across health care settings which demands continuous surveillance to determine the emergent risk of resistance strains and to establish guidelines for appropriate use. Clinical laboratories should confirm any LRSA preferably by a second method, prior to using linezolid for serious infections. Effective surveillance, more judicious use of this antibiotic, avoiding linezolid usage for empiric therapy in hospital acquired staphylococcus infections, optimization of the pharmacological parameters of the antibiotics in specific clinical situation, decreasing bacterial load by timely surgical debridement or drainage of collections, use of combination therapies would prevent the emergence of resistance to linezolid in staphylococcus aureus. [Int J Res Med Sci 2014; 2(4.000: 1253-1256

  3. Staphylococcus aureus and Pregnancy

    Science.gov (United States)

    Staphylococcus aureus and Pregnancy In every pregnancy, a woman starts out with a 3-5% chance of ... risk. This sheet talks about whether exposure to staphylococcus aureus may increase the risk for birth defects ...

  4. 胸部手术部位感染的危险因素分析%Risk factors for surgical site infections after thoracotomy

    Institute of Scientific and Technical Information of China (English)

    王璐; 冯光强; 储勤军

    2013-01-01

    目的 分析剖胸术后引起手术部位感染的主要危险因素,为临床控制剖胸术后手术部位感染提供参考.方法 回顾性分析2006年10月-2012年10月行剖胸术的1124例患者资料,术后手术部位发生感染66例患者为感染组,随机抽取该时间段接受剖胸术但未发生感染66例患者作为非感染组,通过对比两组患者的资料,分析引起感染的原因,涉及的因素包括:性别、年龄、体重指数、住院时间、手术时间、慢性基础疾病等.结果 1124例患者剖胸术后手术部位感染患者66例,感染率为5.87%,其中表浅切口、深部切口感染率分别占65.32%和32.18%,器官腔隙感染占2.50%;通过logistic回归分析显示,手术时间、引流管个数及引流管留置时间与术后手术感染成正性相关,差异有统计学意义(P<0.05).结论 剖胸术后手术部位感染可能与手术时间的长短、引流管个数、引流管留置时间长短有关,临床在抗感染的过程中对此应特别注意.%OBJECTIVE To analyze the risk factors for the surgical site infections induced by thoracotomy so as to provide references for the control of surgical site infections after thoracotomy.METHODS The clinical data of 1124 cases of patients who underwent the thoracotomy from Oct 2006 to Oct 2012 were retrospectively analyzed,totally 66 patients with postoperative surgical site infections were set as the infections group,while 66 patients without infections who underwent the thoracotomy during the same period were chosen as the non-infection group,then the clinical data of the two groups of patients were observed to analyze the causes of infections,including the gender,age,body mass index,hospitalization duration,operation duration,and underlying chronic diseases.RESULTS Of 1124 cases of patients undergoing thoracotomy,the surgical site infections occurred in 66 cases with the incidence rate of 5.87% ; the patients with superficial incision infections

  5. Central venous catheter-related bloodstream infection caused by Staphylococcus aureus: microbiology and risk factors

    Directory of Open Access Journals (Sweden)

    Geraldo Sadoyma

    2006-04-01

    Full Text Available Although central vascular catheters (CVC are indispensable in modern medicine, they are an important risk factor for primary bacteremias. We examined the incidence and risk factors associated with catheter-related bloodstream infection (CR-BSI caused by Staphylococcus aureus in surgical patients. A prospective study was carried out in the Hospital das Clínicas da Universidade Federal de Uberlândia (HC-UFU from September 2000 to December 2002. The skin insertion site, catheter tip, and blood were microbiologically analyzed. Demographics and risk factors were recorded for each patient, and cultures were identified phenotypically. Staphylococcus aureus was the most frequent pathogen, with an incidence rate of 4.9 episodes of CR-BSIs per 1,000 catheter/days. Based on logistic regression, the independent risk factors were: colonization on the insertion site =200 colony forming units (CFU/20 cm² (p=0.03; odds ratio (OR =6.89 and catheter tip (p=0.01; OR=7.95. The CR-BSI rate was high; it was mainly associated with S. aureus, and skin colonization at the insertion site and on the catheter tip were important risk factors for CR-BSI.

  6. Can the surgical checklist reduce the risk of wrong site surgery in orthopaedics? - can the checklist help? Supporting evidence from analysis of a national patient incident reporting system

    Directory of Open Access Journals (Sweden)

    Cleary Kevin

    2011-04-01

    Full Text Available Abstract Background Surgical procedures are now very common, with estimates ranging from 4% of the general population having an operation per annum in economically-developing countries; this rising to 8% in economically-developed countries. Whilst these surgical procedures typically result in considerable improvements to health outcomes, it is increasingly appreciated that surgery is a high risk industry. Tools developed in the aviation industry are beginning to be used to minimise the risk of errors in surgery. One such tool is the World Health Organization's (WHO surgery checklist. The National Patient Safety Agency (NPSA manages the largest database of patient safety incidents (PSIs in the world, already having received over three million reports of episodes of care that could or did result in iatrogenic harm. The aim of this study was to estimate how many incidents of wrong site surgery in orthopaedics that have been reported to the NPSA could have been prevented by the WHO surgical checklist. Methods The National Reporting and Learning Service (NRLS database was searched between 1st January 2008- 31st December 2008 to identify all incidents classified as wrong site surgery in orthopaedics. These incidents were broken down into the different types of wrong site surgery. A Likert-scale from 1-5 was used to assess the preventability of these cases if the checklist was used. Results 133/316 (42% incidents satisfied the inclusion criteria. A large proportion of cases, 183/316 were misclassified. Furthermore, there were fewer cases of actual harm [9% (12/133] versus 'near-misses' [121/133 (91%]. Subsequent analysis revealed a smaller proportion of 'near-misses' being prevented by the checklist than the proportion of incidents that resulted in actual harm; 18/121 [14.9% (95% CI 8.5 - 21.2%] versus 10/12 [83.3% (95%CI 62.2 - 104.4%] respectively. Summatively, the checklist could have been prevented 28/133 [21.1% (95%CI 14.1 - 28.0%] patient safety

  7. Vigilancia de las infecciones de herida quirúrgica. Experiencia de 18 meses en el Instituto Nacional de Cancerología Surgical site infection surveillance at the National Cancer Institute in Mexico. An 18 months experience

    Directory of Open Access Journals (Sweden)

    Diana Vilar-Compte

    1999-01-01

    Full Text Available OBJETIVO. Conocer la frecuencia de infecciones quirúrgicas con un programa prospectivo de vigilancia de cirugías y seguimiento postegreso, en el Instituto Nacional de Cancerología, que es un hospital de tercer nivel de la Ciudad de México. MATERIAL Y MÉTODOS. Durante 18 meses se captaron y se vigilaron todas las cirugías efectuadas en el hospital. Se calcularon las razones (por 100 cirugías de infecciones de herida quirúrgica (IHQX por servicio y por el grado de contaminación bacteriana. Se utilizaron las definiciones de IHQX del Centro para la Prevención y el Control de las Enfermedades de Estados Unidos de América (1992. RESULTADOS. Se vigilaron 3 372 cirugías. Trescientos trece casos se infectaron: 140 (44.7% fueron incisionales superficiales; 137 (43.7%, incisionales profundas, y 36 (11.5%, de órganos y espacios. La frecuencia de IHQX fue de 9.28%; para las cirugías limpias, limpias-contaminadas, contaminadas y sucias fue de 7.35, 10.5, 17.3 y 21.5%, respectivamente. La frecuencia de infecciones por servicio fue: gastroenterología, 14.13%; tumores de mama, 11.08%; piel y partes blandas, 10.98%; ginecología, 9.06%; urología, 7.38%; cabeza y cuello, 7.13%, y neumología, 1.81%. La IHQX ocurrió en promedio a los 11.6±6.23 días; 85 casos (27.16% se diagnosticaron mientras el paciente estaba hospitalizado, y 228 (72.84%, después del egreso del paciente. Se obtuvo algún cultivo en 134 (42.8% casos. Los gérmenes más comunes fueron: E. coli, 38 (22.5%; estafilococo coagulasa negativo, 23 (13.6%; Pseudomonas sp., 22 (13%; S. aureus, 16 (9.4%, y enterococos,13 (7.7%. CONCLUSIONES. La vigilancia prospectiva de las cirugías con un seguimiento por 30 días aumentó hasta en 400% la posibilidad de detectar una IHQX. La frecuencia de IHQX en las cirugías limpias y limpias-contaminadas se encuentra por arriba de lo informado.OBJECTIVES. To calculate the surgical site infection (SSI rates with a surgical prospective surveillance

  8. Staphylococcus aureus toxins.

    Science.gov (United States)

    Otto, Michael

    2014-02-01

    Staphylococcus aureus is a dangerous pathogen that causes a variety of severe diseases. The virulence of S. aureus is defined by a large repertoire of virulence factors, among which secreted toxins play a preeminent role. Many S. aureus toxins damage biological membranes, leading to cell death. In particular, S. aureus produces potent hemolysins and leukotoxins. Among the latter, some were recently identified to lyse neutrophils after ingestion, representing an especially powerful weapon against bacterial elimination by innate host defense. Furthermore, S. aureus secretes many factors that inhibit the complement cascade or prevent recognition by host defenses. Several further toxins add to this multi-faceted program of S. aureus to evade elimination in the host. This review will give an overview over S. aureus toxins focusing on recent advances in our understanding of how leukotoxins work in receptor-mediated or receptor-independent fashions.

  9. A porcine model of haematogenous brain infectionwith staphylococcus aureus

    DEFF Research Database (Denmark)

    Astrup, Lærke Boye; Agerholm, Jørgen Steen; Nielsen, Ole Lerberg;

    2012-01-01

    A PORCINE MODEL OF HAEMATOGENOUS BRAIN INFECTION WITH STAPHYLOCOCCUS AUREUS Astrup Lærke1, Agerholm Jørgen1, Nielsen Ole1, Jensen Henrik1, Leifsson Páll1, Iburg Tine2. 1: Faculty of Health and Medical Sciences, University of Copenhagen, Denmark boye@life.ku.dk 2: National Veterinary Institute......, Uppsala, Sweden Introduction Staphylococcus aureus (S.aureus) is a common cause of sepsis and brain abscesses in man and a frequent cause of porcine pyaemia. Here we present a porcine model of haematogenous S. aureus-induced brain infection. Materials and Methods Four pigs had two intravenous catheters...... inserted surgically, one in a. carotis communis and one in v. jugularis externa. All pigs received 106 CFU/kg body weight S. aureus through the arterial catheter. Bacteria were either suspended in isotonic saline infused at constant flow for 60 minutes (two pigs) or given as a bolus injection of autologoue...

  10. Risk factors for surgical site infection in 630 patients with breast cancer%630例乳腺癌术后手术部位感染的相关因素分析

    Institute of Scientific and Technical Information of China (English)

    林冰心; 许春森

    2014-01-01

    目的 探讨乳腺癌术后手术部位感染(SSI)的影响因素,为制定SSI的控制措施提供依据.方法 回顾性分析630例乳腺癌患者的临床资料,观察乳腺癌术后SSI发生率,并对其常见的临床、病理相关危险因素进行单因素和多因素Logistic回归分析.结果 乳腺癌术后SSI发生率为3.65%(23/630),金黄色葡萄球菌是SSI的主要病原菌(14/20).单因素分析显示:化疗相关粒细胞减少症、糖尿病、引流管留置时间为乳腺癌术后SSI危险因素(P<0.05).多因素Logistic回归分析显示:化疗相关粒细胞减少症、引流管留置时间是乳腺癌术后SSI的独立危险因素(P<0.05).结论 化疗相关粒细胞减少症、引流管留置时间是乳腺癌术后SSI发生的主要因素,必须采取相对应的综合性措施才能有效地降低乳腺癌术后SSI发生率.%Objective To investigate the risk factors associated with surgical site infection (SSI) in patients with breast cancer,and provide the basis for preventing SSI.Methods Case-control study was used to investigate the clinical data of 630 patients of breast cancer retrospectively by single factor and multiple factors regressive analysis.Results The incidence rate of SSI was 3.65% (23/630),the main pathogenic bacteria was staphylococcus aureus (14/20),single factor regressive analysis showed that granulocytopenia associated with chemotherapy,diabetes mellitus,time of drainage were the risk factors of SSI (P < 0.05).Multiple factors regressive analysis showed that granulocytopenia associated with chemotherapy,time of drainage were the independent risk factors of SSI (P < 0.05).Conclusion Granulocytopenia associated with chemotherapy,time of drainage are the independent risk factors of SSI and comprehensive preventive measures should be taken to control the incidence rate of SSI.

  11. 手术部位感染的危险因素分析及干预措施%Risk factors for surgical site infections and intervention measures

    Institute of Scientific and Technical Information of China (English)

    蔡珺; 刘秀俊

    2012-01-01

    目的 探讨手术部位感染在手术中的危险因素,为控制手术室医院感染提供依据.方法 对手术室引起手术部位感染的相关因素进行分析,针对原因提出建立手术室医院感染监控机制,加强组织管理与培训,重视医护人员手与患者术前皮肤消毒,加强手术室的无菌操作及环境管理等措施.结果 医院2009-2011年无1例手术感染发生,未发生医院感染暴发事件,Ⅰ类切口的感染率控制为0.结论 做好手术室医院感染监控是预防手术部位感染的重要手段,加强围手术期患者的管理是控制感染的关键.%OBJECTIVE To investigate the risk factors for surgical site infections during surgery so as to provide the basis for the control of infections in operating rooms. METHODS The related factors for surgical site infections in operating rooms were analyzed, the surveillance system far nosocomial infections in operating rooms was established, the organization management and the training was strengthened, emphasis was put on the skin disinfection before the operation, the aseptic operation and environmental management in the operating rooms were intensified. RESULTS There was not any case with nosocomial infections that occurred in operating rooms during 2009 — 2011, the incidence of type 1 incision infections was 0. CONCLUSION To attach great importance to the surveillance of nosocomial infections is important for the prevention of surgical site infections! to strengthen the management during perioperative period is crucial to the control of the infections.

  12. 外科手术部位感染的相关因素分析%Relative factors analysis of surgical site infection

    Institute of Scientific and Technical Information of China (English)

    王西玲; 王宇; 余玲; 邓琪; 边杰芳

    2012-01-01

    目的 探讨外科手术部位感染(SSI)的有关因素和预防措施.方法 选取2009年1月~2011年10月我院普通外科手术患者562例,依据细菌学检查的要求,观察患者切口感染情况及切口感染发生率,通过Logistic逐步回归分析方法 分析感染的有关因素.结果 共监测手术患者562例,发生手术部位感染40例,感染率为7.12%,其中,细菌培养确诊28例,分泌物涂片确诊12例.不同年龄、体重、糖尿病情况、切口种类、切口长度、手术时间的患者术后切口感染率差异显著(χ2值为3.68、4.22、5.79、4.27、3.74、5.08,P < 0.05 ).Logistic逐步回归分析显示,年龄、肥胖、糖尿病、Ⅱ、Ⅲ类切口和手术时间为切口感染的危险因素(OR=9.6、10.3、9.7、9.8、10.4,P < 0.05).结论 应强化对手术部位感染病原菌的监测,及时采取相应的措施,从而降低感染的发生率.%Objective To explore the relevant factors and prevention measures of surgical site infection (SSI). Methods 562 cases of general surgical patients in our hospital from January 2009 to October 2011 were selected, in accordance with the requirements of the bacteriological examination, the wound infection and the incidence of incisional infection of patients were observed, the relevant factors of infection were analyzed by the Logistic stepwise regression analysis. Results 562 cases of surgical patients were monitored, there were 40 cases of surgical site infection, the infection rate was 7.12%, among whom 28 cases were confirmed by bacterial culture, 12 cases were confirmed by secretions smear. The postoperative wound infection rates of patients with different age, weight, diabetes, incision types, incision length, surgery time were significantly different (x2=3.68, 4.22, 5.79, 4.27, 3.74, 5.08, P < 0.05). Logistic stepwise regression analysis showed that age, obesity, diabetes, II, Ⅲ class incision and operative time were the risk factors of wound infection (OR = 9

  13. Receptor binding sites for substance P, but not substance K or neuromedin K, are expressed in high concentrations by arterioles, venules, and lymph nodules in surgical specimens obtained from patients with ulcerative colitis and Crohn disease.

    OpenAIRE

    Mantyh, C R; Gates, T S; Zimmerman, R P; Welton, M L; Passaro, E P; Vigna, S R; Maggio, J E; Kruger, L.; Mantyh, P W

    1988-01-01

    Several lines of evidence indicate that tachykinin neuropeptides [substance P (SP), substance K (SK), and neuromedin K (NK)] play a role in regulating the inflammatory and immune responses. To test this hypothesis in a human inflammatory disease, quantitative receptor autoradiography was used to examine possible abnormalities in tachykinin binding sites in surgical specimens from patients with inflammatory bowel disease. Surgical specimens of colon were obtained from patients with ulcerative ...

  14. Rapid tests for the detection of the Mycobacterium abscessus subsp. bolletii strain responsible for an epidemic of surgical-site infections in Brazil

    Directory of Open Access Journals (Sweden)

    Cristianne Kayoko Matsumoto

    2012-12-01

    Full Text Available A single strain of Mycobacterium abscessus subsp. bolletii, characterised by a particular rpoB sequevar and two highly related pulsed field gel electrophoresis patterns has been responsible for a nationwide outbreak of surgical infections in Brazil since 2004. In this study, we developed molecular tests based on polymerase chain reaction restriction-enzyme analysis (PRA and sequencing for the rapid identification of this strain. Sequences of 15 DNA regions conserved in mycobacteria were retrieved from GenBank or sequenced and analysed in silico. Single nucleotide polymorphisms specific to the epidemic strain and located in enzyme recognition sites were detected in rpoB, the 3' region of the 16S rDNA and gyrB. The three tests that were developed, i.e., PRA-rpoB, PRA-16S and gyrB sequence analysis, showed 100%, 100% and 92.31% sensitivity and 93.06%, 90.28% and 100% specificity, respectively, for the discrimination of the surgical strain from other M. abscessus subsp. bolletii isolates, including 116 isolates from 95 patients, one environmental isolate and two type strains. The results of the three tests were stable, as shown by results obtained for different isolates from the same patient. In conclusion, due to the clinical and epidemiological importance of this strain, these tests could be implemented in reference laboratories for the rapid preliminary diagnosis and epidemiological surveillance of this epidemic strain.

  15. Percutaneous coronary intervention without on site surgical back-up; two-years registry of a large Dutch community hospital

    NARCIS (Netherlands)

    Peels, J. O. J.; Hautvast, R. W. M.; de Swart, J. B. R. M.; Huybregts, M. A. J. M.; Umans, V. A. W. M.; Arnold, A. E. R.; Jessurun, G. A. J.; Zijlstra, F.

    2009-01-01

    Aims: To assess safety and efficacy of off-site percutaneous coronary intervention (PCI) in The Dutch invasive cardiovascular system. Methods and results: Descriptive single centre registry of elective and emergency PCI. Setting is a Dutch community hospital, 40 km north of Amsterdam, with an adhere

  16. Minimum Alveolar Concentration Needed to Block Adrenergic Response of Sevoflurane with Nitrous Oxide Varies Depending on the Stimulation Sites in Adult Surgical Patients

    Directory of Open Access Journals (Sweden)

    Tetsu Kimura

    2015-02-01

    Full Text Available Background We examined whether minimum alveolar anesthetic concentration needed to block adrenergic response (MAC-BAR of sevoflurane with nitrous oxide (N2O varies depending on body surface sites to which noxious stimuli are applied. Methods Seventy-seven ASA I adult patients, aged 18-50 years old, were anesthetized with sevoflurane and 66% N2O in O2, and their tracheas were intubated. The anesthesia was maintained with 66% N2O in O2 plus sevoflurane at predetermined end-tidal concentrations (0.8, 1.1, 1.4, 1.7, 2.0, 2.3, or 2.6%, n = 11 in each concentration for at least 15 minutes. Heart rate (HR and non-invasive blood pressure (BP was recorded at 1-minute interval automatically. As a noxious stimulus, electrical tetanic stimulation with a 15 sec burst of 50 Hz, 0.25 msec square-wave, 55 mA electric current was applied at three different sites; forehead, abdomen, or thigh. A positive cardiovascular response was defined as an increase of either mean BP or HR by more than 15% from the pre-stimulation value. Logistic regression analysis was used to determine MAC-BAR. Results MAC-BAR of sevoflurane with 66% N2O obtained by stimulating forehead, abdomen, and thigh were 2.01% (95% CI: 1.70-2.57%, 1.71% (1.13-2.74%, and 1.31% (0.77-1.66%, respectively. MAC-BAR on the forehead was significantly higher than that on the thigh. Conclusion MAC-BAR of sevoflurane with 66% N2O varied depending on the body surface sites to which noxious stimuli were applied. These findings support our clinical impression that sensitivities to pain vary among body surface sites, and that anesthetic requirement to stabilize hemodynamic variables vary among surgical sites.

  17. Staphylococcus aureus and the ecology of the nasal microbiome

    DEFF Research Database (Denmark)

    Liu, Cindy M; Price, Lance B; Hungate, Bruce A;

    2015-01-01

    The human microbiome can play a key role in host susceptibility to pathogens, including in the nasal cavity, a site favored by Staphylococcus aureus. However, what determines our resident nasal microbiota-the host or the environment-and can interactions among nasal bacteria determine S. aureus...

  18. Cochlear implants in children: surgical site infections and prevention and treatment of acute otitis media and meningitis.

    Science.gov (United States)

    Rubin, Lorry G; Papsin, Blake

    2010-08-01

    therapy is inappropriate for children with implants with acute otitis media. If feasible, tympanocentesis should be performed for acute otitis media, and the material should be sent for culture, but performance of this procedure should not result in an undue delay in initiating antimicrobial therapy. For patients with suspected meningitis, cerebrospinal fluid as well as middle-ear fluid, if present, should be sent for culture. Empiric antimicrobial therapy for meningitis occurring within 2 months of implantation should include an agent with broad activity against Gram-negative bacilli (eg, meropenem) plus vancomycin. For meningitis occurring 2 months or longer after implantation, standard empiric antimicrobial therapy for meningitis (eg, ceftriaxone plus vancomycin) is indicated. For patients with meningitis, urgent evaluation by an otolaryngologist is indicated for consideration of imaging and surgical exploration.

  19. 2013~2014年清洁手术抗菌药物使用率与切口感染率相关性分析%Correlation analysis of the utilization rate of antibacterials and surgical site infection rates in clean surgical incision from 2013 to 2014

    Institute of Scientific and Technical Information of China (English)

    曹栋; 孙福生; 范春

    2015-01-01

    ObjectiveTo study the correlation between the utilization rate of antibacterials and surgical site infection rates in clean surgical incision.Methods All the clean surgical incisions in our hospital from January in 2013 to December in 2014 were enrolled in this study. The utilization rate of antibacterials and surgical site infection rates were retrospectively investigated according to each month. On the condition that the utilization rate of antibacterials and surgical site infection rates were independent variable and dependent variable alternately, with Pearson Correlation Analysis and scatter diagram, we studied the relationship of the utilization rate of antibacterials and surgical site infection rates in clean surgical incision. Results Before logarithmic transformation of the utilization rate of antibacterials and surgical site infection rates, Pearson coeffi cient of correlation was 0.196,P=0.36>0.05.After logarithmic transformation of the utilization rate of antibacterials and surgical site infection rates, Pearson coeffi cient of correlation was 0.069, P=0.75>0.05. The results showed that there was no correlation between the utilization rate of antibacterials and surgical site infection rates, wether logarithmic transformation or not. The scatter diagram of the utilization rate of antibacterials and surgical site infection rates also demonstrated the same results. Conclusion To decrease the utilization rate of antibacterials in clean surgical incision not lead to increase of surgical site infection rates.%目的:探讨清洁手术抗菌药物使用率与切口感染率之间的相关性。方法对本院2013年1月至2014年12月清洁手术进行回顾性调查,按月份分别统计抗菌药物使用率和切口感染率。以抗菌药物使用率与切口感染率互为自变量与因变量,进行Pearson相关性分析和散点图评价。结果抗菌药物使用率与切口感染率对数转换前Pearson相关性分析,相关系数r=0.196, P

  20. Contamination of environmental surfaces by methicillin-resistant Staphylococcus aureus (MRSA) in rooms of inpatients with MRSA-positive body sites.

    Science.gov (United States)

    Kurashige, E Jessica Ohashi; Oie, Shigeharu; Furukawa, H

    2016-01-01

    Methicillin-resistant Staphylococcus aureus (MRSA) can contaminate environmental surfaces that are frequently touched by the hands of patients with MRSA colonization/infection. There have been many studies in which the presence or absence of MRSA contamination was determined but no studies in which MRSA contamination levels were also evaluated in detail. We evaluated MRSA contamination of environmental surfaces (overbed tables, bed side rails, and curtains) in the rooms of inpatients from whom MRSA was isolated via clinical specimens. We examined the curtains within 7-14 days after they had been newly hung. The environmental surfaces were wiped using gauze (molded gauze for wiping of surface bacteria; 100% cotton, 4cm×8cm) moistened with sterile physiological saline. The MRSA contamination rate and mean counts (range) were 25.0% (6/24 samples) and 30.6 (0-255)colony-forming units (cfu)/100cm(2), respectively, for the overbed tables and 31.6% (6/19 samples) and 159.5 (0-1620)cfu/100cm(2), respectively, for the bed side rails. No MRSA was detected in 24 curtain samples. The rate of MRSA contamination of environmental surfaces was high for the overbed tables and bed side rails but low for the curtains. Therefore, at least until the 14th day of use, frequent disinfection of curtains may be not necessary.

  1. Randomized Controlled Trial Evaluating Dialkylcarbamoyl Chloride Impregnated Dressings for the Prevention of Surgical Site Infections in Adult Women Undergoing Cesarean Section

    Science.gov (United States)

    Bizoń, Magdalena; Cendrowski, Krzysztof; Sawicki, Włodzimierz

    2016-01-01

    Abstract Background: Surgical site infections (SSI) occur in 1.8%–9.2% of women undergoing cesarean section (CS) and lead to greater morbidity rates and increased treatment costs. The aim of the study was to evaluate the efficacy and cost-effectiveness of dialkylcarbamoyl chloride (DACC) impregnated dressings to prevent SSI in women subject to CS. Methods: Randomized, controlled trial was conducted at the Mazovian Bródno Hospital, a tertiary care center performing approximately 1300 deliveries per year, between June 2014 and April 2015. Patients were randomly allocated to receive either DACC impregnated dressing or standard surgical dressing (SSD) following skin closure. In order to analyze cost-effectiveness of the selected dressings in the group of patients who developed SSI, the costs of ambulatory visits, additional hospitalization, nursing care, and systemic antibiotic therapy were assessed. Independent risk factors for SSI were determined by multivariable logistic regression. Results: Five hundred and forty-three women undergoing elective or emergency CS were enrolled. The SSI rates in the DACC and SSD groups were 1.8% and 5.2%, respectively (p = 0.04). The total cost of SSI prophylaxis and treatment was greater in the control group as compared with the study group (5775 EUR vs. 1065 EUR, respectively). Independent risk factors for SSI included higher pre-pregnancy body mass index (adjusted odds ratio [aOR] = 1.08; [95% confidence interval [CI]: 1.0–1.2]; p SSD application (aOR = 2.94; [95% CI: 1.1–9.3]; p < 0.05). Conclusion: The study confirmed the efficacy and cost-effectiveness of DACC impregnated dressings in SSI prevention among women undergoing CS. PMID:26891115

  2. Staphylococcus aureus vaccines: Deviating from the carol.

    Science.gov (United States)

    Missiakas, Dominique; Schneewind, Olaf

    2016-08-22

    Staphylococcus aureus, a commensal of the human nasopharynx and skin, also causes invasive disease, most frequently skin and soft tissue infections. Invasive disease caused by drug-resistant strains, designated MRSA (methicillin-resistant S. aureus), is associated with failure of antibiotic therapy and elevated mortality. Here we review polysaccharide-conjugate and subunit vaccines that were designed to prevent S. aureus infection in patients at risk of bacteremia or surgical wound infection but failed to reach their clinical endpoints. We also discuss vaccines with ongoing trials for combinations of polysaccharide-conjugates and subunits. S. aureus colonization and invasive disease are not associated with the development of protective immune responses, which is attributable to a large spectrum of immune evasion factors. Two evasive strategies, assembly of protective fibrin shields via coagulases and protein A-mediated B cell superantigen activity, are discussed as possible vaccine targets. Although correlates for protective immunity are not yet known, opsonophagocytic killing of staphylococci by phagocytic cells offers opportunities to establish such criteria. PMID:27526714

  3. Carriage of Staphylococcus aureus in the elderly

    NARCIS (Netherlands)

    R. M. Parnaby; G. O'Dwyer; H. A. Monsey; M. S. Shafi

    1996-01-01

    textabstractThe point prevalence and incidence of Staphylococcus aureus (methicillin-sensitive and -resistant) carriage by inpatients on acute elderly care wards was estimated. The relationship to body site and to previous admissions to hospital or other institutions was determined. Fifty-five patie

  4. Evaluating the cost of adult voluntary medical male circumcision in a mixed (surgical and PrePex site compared to a hypothetical PrePex-only site in South Africa

    Directory of Open Access Journals (Sweden)

    Hae-Young Kim

    2015-12-01

    Full Text Available Background: Several circumcision devices have been evaluated for a safe and simplified male circumcision among adults. The PrePex device was prequalified for voluntary male medical circumcision (VMMC in May 2013 by the World Health Organization and is expected to simplify the procedure safely while reducing cost. South Africa is scaling up VMMC. Objective: To evaluate the overall unit cost of VMMC at a mixed site vs. a hypothetical PrePex-only site in South Africa. Design: We evaluated the overall unit cost of VMMC at a mixed site where PrePex VMMC procedure was added to routine forceps-guided scalpel-based VMMC in Soweto, South Africa. We abstracted costs and then modeled these costs for a hypothetical PrePex-only site, at which 9,600 PrePex circumcisions per year could be done. We examined cost drivers and modeled costs, varying the price of the PrePex device. The healthcare system perspective was used. Results: In both sites, the main contributors of cost were personnel and consumables. If 10% of all VMMC were by PrePex at the mixed site, the overall costs of the surgical method and PrePex were similar – US$59.62 and $59.53, respectively. At the hypothetical PrePex-only site, the unit cost was US$51.10 with PrePex circumcisions having markedly lower personnel and biohazardous waste management costs. In sensitivity analysis with the cost of PrePex kit reduced to US$10 and $2, the cost of VMMC was further reduced. Conclusions: Adding PrePex to an existing site did not necessarily reduce the overall costs of VMMC. However, starting a new PrePex-only site is feasible and may significantly reduce the overall cost by lowering both personnel and capital costs, thus being cost-effective in the long term. Achieving a lower cost for PrePex will be an important contributor to the scale-up of VMMC.

  5. Risk factors for surgical site infections and other complications in elective surgery in patients with rheumatoid arthritis with special attention for anti-tumor necrosis factor: a large retrospective study.

    NARCIS (Netherlands)

    Broeder, A. den; Creemers, M.C.W.; Fransen, J.; Jong, Eefje de; Rooij, D.J.R.A.M. de; Wymenga, A.B.; Waal Malefijt, M.C. de; Hoogen, F.H.J. van den

    2007-01-01

    OBJECTIVE: To identify risk factors for surgical site infection (SSI) in patients with rheumatoid arthritis (RA) with special attention for anti-tumor necrosis factor (anti-TNF) treatment. METHODS: All patients with RA who had undergone elective orthopedic surgery since introduction of anti-TNF were

  6. 某院妇科手术部位感染目标性监测及干预%Targeted monitor and intervention strategies on surgical site infection following gynecological surgical procedure

    Institute of Scientific and Technical Information of China (English)

    张亚军; 孙庆芬; 顾彩霞; 李曼

    2013-01-01

    Objective To realize surgical site infection (SSI) following gynecological surgical procedure, analyze the possible risk factors, and explore effective measures on reducing the incidence of SSI. Methods From January 1 to December 31 ,2011 , patients receiving abdominal hysterectomy, vaginal hysterectomy, and laparoscopic hysterectomy in two gynecological departments of a hospital were monitored, SSI rates before intervention(from January 1 to June 30,2011 , control group) and after intervention (from July 1 to December 31 ,2011 , intervention group) were analyzed and compared. Results A total of 1 120 patients were in control group, including 648 cases of abdominal hysterectomy, SSI rate was 4. 94%; 212 vaginal hysterectomy, SSI rate was 9. 43%; 260 laparoscopic hysterectomy, there was no SSI; the average SSI rate in two departments was 4. 64% (52/1 120), SSI rate between two departments was not significantly different(5. 38% vs 4. 00%, x2 = 1. 206, P>0. 05), the average SSI rate in intervention group was significantly lower than control group (1. 57%[20/1 272] vs 4. 64% ,x2 = 19. 23,P<0. 001). Conclusion Through targeted monitor, risk factors are analyzed, intervention measures are performed,and SSI can be reduced.%目的 了解某院妇科手术部位感染(SSI)现状,分析可能的危险因素,探讨降低SSI发病率的有效措施.方法 2011年1月1日-12月31日,对该院两个妇科病区行剖腹子宫切除术、阴式子宫切除术、腹腔镜下子宫切除术的所有患者进行监测,定期汇总分析,比较采取干预措施前(2011年1月1日-6月30日监测的病例,设为对照组)和干预措施落实后(2011年7月1日-12月31日监测的病例,设为干预组)的SSI率.结果 对照组共1 120例患者,其中剖腹子宫切除术648例,SSI率为4.94%;阴式子宫切除术212例,SSI率为9.43%;腹腔镜下子宫切除术260例,未发生SSI.干预前妇科病区平均SSI率为4.64%(52/1 120),两个妇科病区平均SSI率( 5.38% vs 4

  7. Surgical infections: a microbiological study

    Directory of Open Access Journals (Sweden)

    Santosh Saini

    2004-04-01

    Full Text Available Surgical infections are mostly polymicrobial, involving both aerobes and anaerobes. One hundred seventeen cases comprised of abscesses (n=51, secondary peritonitis (n=25, necrotizing fascitis (n=22 and wounds with devitalized tissues (n=19 were studied. The number of microorganisms isolated per lesion was highest in secondary peritonitis (2.32. The aerobe/ anaerobe ratio was 0.81 in secondary peritonitis and 1.8 in necrotizing fascitis. Most secondary peritonitis (80%, necrotizing fascitis (75% and wounds with devitalized tissues (66.7% were polymicrobial. Common microorganisms isolated in our study were E. coli, Staphylococcus aureus, Klebsiella spp., Pseudomonas aeruginosa, Bacteroides fragilis and Peptostreptococcus spp. The most effective antibiotics for S. aureus were clindamycin (79.1% and cefuroxime (70.8%. For Gram-negatives (Klebsiella spp., E. coli and Proteus spp., the most effective antibiotics were cefotaxime, ceftizoxime, amikacin and ciprofloxacin. Pseudomonas aeruginosa was maximally sensitive to amikacin (35.2% and ciprofloxacin (35.2%. The greatest degree of multidrug resistance to all the drugs was found in P. aeruginosa (52.9%, followed by Klebsiella spp. (33.3%, Proteus spp. (33.3%, E. coli (22.2%, and S. aureus (12.5%. All the anaerobes that we isolated were 100% sensitive to metronidazole and chloramphenicol, followed by clindamycin (95% to 100%. Apart from antibiotic therapy, non-antimicrobial methods, such as hyperbaric oxygen therapy and debridement also play an important role in the treatment of surgical infections.

  8. Bacterial migration through punctured surgical gloves under real surgical conditions

    OpenAIRE

    Heidecke Claus-Dieter; Assadian Ojan; Stanislawski Natalie; Goerdt Anna-Maria; Hübner Nils-Olaf; Kramer Axel; Partecke Lars

    2010-01-01

    Abstract Background The aim of this study was to confirm recent results from a previous study focussing on the development of a method to measure the bacterial translocation through puncture holes in surgical gloves under real surgical conditions. Methods An established method was applied to detect bacterial migration from the operating site through the punctured glove. Biogel™ double-gloving surgical gloves were used during visceral surgeries over a 6-month period. A modified Gaschen-bag met...

  9. 手术部位感染控制护理中持续质量改进的应用探讨%Application of Continuous Quality Improvement in Surgical Site Infection Control

    Institute of Scientific and Technical Information of China (English)

    陈明珍

    2015-01-01

    Objective To study the clinical significance of continuous quality improvement in nursing care of surgical site infection control. Methods From July 2013 to November 2014, 100 cases of surgical site infection in high-risk patients were treated as the object of study, patients were randomly divided into experimental group and control group, 50 cases in each group. The two groups of patients take different nursing mode, the incidence of infection in patients with surgical site. Results The incidence of surgical site infection in the experimental group was significantly less than that of the control group, P<0.05. Conclusion It is important to strengthen the quality improvement of nursing care for surgical site infection control.%目的:探讨手术部位感染控制护理中持续质量改进的临床意义。方法选取我院自2013年7月~2014年11月收治的100例手术部位感染高危患者作为研究对象,将患者随机分为实验组和对照组,每组患者50例。两组患者均采取不同的护理模式,比较患者手术部位感染的发生率。结果实验组患者的手术部位感染的发生率少于对照组患者, P <0.05。结论加强对手术部位感染控制护理的持续质量改进具有重要的临床意义。

  10. Effect of on-site intervention on targeted monitoring of surgical site infections%现场干预在外科手术部位感染目标性监测中的作用

    Institute of Scientific and Technical Information of China (English)

    李金娜; 王宁宁; 刘芳菲; 段艳霞; 赵丽燕; 白小龙; 秦变妮

    2012-01-01

    OBJECTIVE To explore the risk factors of surgical site infections (SSI) and provide basis for reducing the SSI. METHODS A prospective study and interventional methods were performed on surgical site in patients undergoing six surgeries in the hospital. Both single and multiple regression logistic analysis were executed with SPSS on the 10 factors including , on-site intervention in the risk factors. RESULTS Among 519 patients undergoing surgeries, the incidence rate of SSI was 1. 9%; the insulation measure and the surgical drainage had the most significant correlation with the SSI (P<0. 01) ;after the on-site intervention, the incidence rates of the SSI caused by colorectal surgery and gallbladder bile duct surgery decreased to 7. 1% and 6. 3% , respectively, the simple cholecystectomy decreased to 1. 6%; the utilization rale of the prophylactic antibiotics of the patients undergoing thyroidectomy or high ligation of the great saphenous vein decreased from 100. 0% to below 30. 0%. CONCLUSION The intraoperative low temperature,drainage,hospital stay are the high-risk factors for SSI, and the on-site intervention in the target monitoring is an powerful way to control the high-risk factors.%目的 探讨现场干预对外科手术部位感染(SSI)目标性监测的作用,降低SSI发生率.方法 采用干预性研究方法,对6种手术患者的手术部位感染及相关因素进行了目标性监测,对危险因素进行现场干预.结果 共监测手术患者519例,SSI发生率为1.9%;手术部位感染与年龄、保温措施、ASA评分、住院天数、是否引流有关(P<0.05);其中保温措施、外科引流与手术部位感染有显著关系(P<0.01);经过现场干预,直肠、结肠手术及胆囊、胆管手术的手术部位感染率分别下降至7.1%及6.3%,单纯胆囊切除术下降至1.6%;甲状腺切除术及大隐静脉高位结扎术患者预防性抗菌药物使用率从100.0%降至<30.0%.结论 术中低体温、

  11. Evaluation of routinely reported surgical site infections against microbiological culture results: a tool to identify patient groups where diagnosis and treatment may be improved

    Directory of Open Access Journals (Sweden)

    Kievit Job

    2009-11-01

    Full Text Available Abstract Background Surgeons may improve their decision making by assessing the extent to which their initial clinical diagnosis of a surgical site infection (SSI was supported by culture results. Aim of the present study was to evaluate routinely reported SSI by surgeons against microbiological culture results, to identify patient groups with lower agreement where decision making may be improved. Methods 701 admissions with SSI were reported by surgeons in a university medical centre in the period 1997-2005, which were retrospectively checked for microbiological culture results. Reporting a SSI was conditional on treatment being given (e.g. antibiotics and was classified by severity. To identify specific patient groups, patients were classified according to the surgery group of the first operation during admission (e.g. trauma. Results Of all reported SSI, 523 (74.6% had a positive culture result, 102 (14.6% a negative culture result and 76 (10.8% were classified as unknown culture result (due to no culture taken. Given a known culture result, reported SSI with positive culture results less often concerned trauma patients (16% versus 26%, X2 = 4.99 p = 0.03 and less severe SSI (49% versus 85%, X2 = 10.11 p Conclusion Routine reporting of SSI was mostly supported by culture results. However, this support was less often found in trauma patients and less severe SSI, thereby giving surgeons feedback that diagnosis and treatment may be improved in these cases.

  12. The Effect of Preoperative Subcutaneous Fat Thickness on Surgical Site Infection Risk in Patients Undergoing Colorectal Surgery: Results of a Multisite, Prospective Cohort Study.

    Science.gov (United States)

    Nakagawa, Hiromi; Ohno, Kaori; Ikeda, Shunya; Muto, Masaki

    2016-08-01

    Surgical site infection (SSI) is one of the most frequent postoperative complications among patients undergoing elective colorectal surgery. A multisite, prospective cohort study was conducted to investigate whether the thickness of subcutaneous fat (TSF) influences the occurrence of SSI in patients undergoing colorectal surgery. Participants included patients scheduled to receive colorectal laparotomy for colorectal cancer and who were under the care of a wound ostomy continence nurse at 17 participating general hospitals in Japan. Patients were not eligible to participate if they had undergone emergency surgery, reoperation, or laparoscopic surgery. Demographic, wound, and surgical data and American Society of Anesthesiologists (ASA) scale scores were collected and assessed, along with nutritional status, TSF, body mass index, and risk factors for SSI (ie, length of surgery and wound classification). The incidence of SSI and nutritional conditions was assessed weekly for 30 days after surgery. Of the 155 participants (mean age 68.9 ± 10.8 years, 53 [34.2%] of whom were women), 90 (58.1%) underwent rectal surgery, and the remaining 65 underwent colon surgery. Seventy-two (72, 46.5%) of the 155 patients underwent colostomy surgery; 24 (15.5%) developed a SSI. The mean onset of SSI was 7.3 ± 2.9 days after surgery and commonly observed in the stoma group when the ASA score was 3 or higher (P = 0.02). Patients who developed SSI resumed oral dietary intake later than those without SSI (7.4 days versus 4.6 days, P = 0.02). Multivariate analysis indicated TSF >15 mm (P = 0.01), Alb level <3.5 g/dL at postoperative days 14 (P = 0.03) and 21 (P = 0.02), and total protein level <6.8 g/dL at postoperative day 7 (P = 0.02) were statistically significantly correlated with SSI occurrence. These results suggest preoperative TSF and preoperative and postoperative serum albumin levels are independent risk factors for SSI in patients undergoing colorectal surgery, confirming

  13. Surgical Assisting

    Science.gov (United States)

    ... specific training over and above a degree in science, nursing, physician assisting, or another health profession. Prerequisites . Recommended eligibility requirements for admission into a surgical assisting program are: Bachelor of Science degree (or higher) Associate degree in an allied ...

  14. 非局麻乳房清洁切口手术部位感染多中心调查%Multicenter survey of surgical site infection following clean incision breast surgery under non-local anesthesia

    Institute of Scientific and Technical Information of China (English)

    曾邦伟; 战榕; 徐秀莉; 吴小燕; 聂渝莉

    2015-01-01

    目的:了解非局麻乳房清洁切口手术部位感染(SSI)发病率,评估感染相关危险因素。方法回顾性调查福建省22所医院共3327例非局麻乳房清洁切口手术病例,分析其 SSI 情况及相关危险因素。结果3327例患者,恶性肿瘤者1502例(45.19%),平均手术时间(101.18±8.04)min;共发生 SSI 24例,发病率为0.72%;253例(7.60%)术前预防性使用抗菌药物,62.66%在术前0.5~2 h 内使用抗菌药物。主要感染病原菌为金黄色葡萄球菌。对 SSI 相关危险因素进行单因素和 logistic 回归分析,结果显示恶性肿瘤、糖尿病、使用免疫抑制剂是 SSI 的危险因素(均 P <0.05)。结论非局麻乳房清洁切口 SSI 控制情况较好;同时,临床术前应主动评估患者 SSI 危险因素,采取综合防控措施降低感染风险。%Objective To investigate the incidence of surgical site infection(SSI)following clean incision breast surgery under non-local anesthesia,and evaluate risk factors for SSI.Methods Clinical data of 3 327 patients who underwent clean incision breast surgery under non-local anesthesia in 22 hospitals in Fujian Province were surveyed retrospectively,SSI and risk factors were analyzed.Results Among 3 327 patients,1 502(45.19%)were with malignant tumors,the average dura-tion of surgery were (101.18 ±8.04)minutes;a total of 24 cases of SSI occurred,incidence of SSI was 0.72%;253 (7.60%)patients received pre-operative antimicrobial prophylaxis,62.66% used antimicrobial agents within 0.5-2 hours before surgery.The main pathogenic bacteria was Staphylococcus aureus .Univariate and logistic regression analysis re-vealed that malignant tumor,diabetes mellitus,and use of immunosuppressants were all risk factors for SSI (all P <0.05). Conclusion SSI following clean incision breast surgery under non-local anesthesia is well controlled,risk factors for SSI should be evaluated before

  15. Effects observation of medical care integration in management of surgical sites mark%医护一体化模式在手术部位标识管理中的应用效果

    Institute of Scientific and Technical Information of China (English)

    张军花; 钟奕

    2016-01-01

    Objective To explore the application of “doctor-nurse integrating” management model in management of surgical sites mark. Methods A “doctor-nurse integrating” management team for surgical site mark was established. Then, the current situation of surgical sites mark was investigated before operation in Operating Room. In addition, the execution of surgical sites mark was compared and the failure rate of surgical sites mark were counted before and after the implementation of “doctor-nurse integrating” management mode. Results After the implementation of “doctor-nurse integrating” management mode, the pass-rate of surgical sites marks in medical staff was significantly better than before with a significant difference (P <0. 05). Conclusions “Doctor-nurse integrating” management mode can make medical staff give full play to subjective initiative, prevent the medical incidents, ensure the safety of patients, and improve medical care quality.%目的:探讨“医护一体化”管理模式在手术部位标识管理中的应用。方法成立“医护一体化”手术部位标识管理小组,调查各手术科室术前手术部位标识的现状,比较实施“医护一体化”管理模式前后手术部位标识的执行情况,同时对实施前后手术部位标识不合格率进行统计。结果医护一体化管理后医护人员落实手术部位标识合格率显著优于管理前,差异具有统计学意义(P <0.05)。结论医护一体化管理模式可充分发挥医护人员的主观能动性,防范医疗事故的发生,确保患者生命安全,提高医护质量。

  16. In Vivo Assessment of Phage and Linezolid Based Implant Coatings for Treatment of Methicillin Resistant S. aureus (MRSA) Mediated Orthopaedic Device Related Infections

    Science.gov (United States)

    Kaur, Sandeep; Harjai, Kusum; Chhibber, Sanjay

    2016-01-01

    Staphylococcus comprises up to two-thirds of all pathogens in orthopaedic implant infections with two species respectively Staphylococcus aureus and Staphylococcus epidermidis, being the predominate etiological agents isolated. Further, with the emergence of methicillin-resistant S. aureus (MRSA), treatment of S. aureus implant infections has become more difficult, thus representing a devastating complication. Use of local delivery system consisting of S.aureus specific phage along with linezolid (incorporated in biopolymer) allowing gradual release of the two agents at the implant site represents a new, still unexplored treatment option (against orthopaedic implant infections) that has been studied in an animal model of prosthetic joint infection. Naked wire, hydroxypropyl methylcellulose (HPMC) coated wire and phage and /or linezolid coated K-wire were surgically implanted into the intra-medullary canal of mouse femur bone of respective groups followed by inoculation of S.aureus ATCC 43300(MRSA). Mice implanted with K-wire coated with both the agents i.e phage as well as linezolid (dual coated wires) showed maximum reduction in bacterial adherence, associated inflammation of the joint as well as faster resumption of locomotion and motor function of the limb. Also, all the coating treatments showed no emergence of resistant mutants. Use of dual coated implants incorporating lytic phage (capable of self-multiplication) as well as linezolid presents an attractive and aggressive early approach in preventing as well as treating implant associated infections caused by methicillin resistant S. aureus strains as assessed in a murine model of experimental joint infection. PMID:27333300

  17. Risk factors for surgical site infection in orthopaedic surgery%骨科手术部位感染危险因素

    Institute of Scientific and Technical Information of China (English)

    彭美玲; 刘惕; 周健; 江淑芳; 戴玉芳; 冯诚怿

    2014-01-01

    目的:探讨骨科手术部位感染(SSI)的危险因素,以针对危险因素提出干预措施。方法采用目标性监测方法,对2012年1月—2013年12月某院骨科1082例手术患者进行监测,由医院感染管理专职人员通过查阅病历资料、现场查看切口及出院后电话随访等方式了解SSI 情况。结果共监测骨科手术患者1082例,发生SSI 8例,SSI率为0.74%。单因素分析结果显示,SSI与年龄、合并糖尿病、急诊手术、切口个数、切口类型、手术时间、植入物7项因素有关(均P<0.05);logistic回归分析结果显示,年龄、合并糖尿病、急诊手术、切口个数、切口类型、手术时间是SSI的独立危险因素(均P<0.05)。结论 SSI的发生是多种因素作用的结果,必须采取综合性预防措施才能有效降低SSI的发生率。%Objective To explore risk factors for surgical site infection(SSI)in orthopaedic surgery,and propose the intervention measures. Methods 1 082 patients who received orthopaedic surgery in a hospital from January 2012 to December 2013 were monitored,SSI were surveyed by healthcare-associated infection control professionals based on medical records reviewing,on-site examination of surgical incision and post-discharged following up call. Results Of 1 082 patients,8(0.74% )developed SSI. Univariate analysis revealed that SSI were related to patients’age, associated diabetes mellitus,emergency operation,incision numbers,types of incisions,duration of operation,and implant (P<0.05);Logistic regression analysis revealed that independent risk factors for SSI were age,diabetes mellitus,emer-gency operation,incision numbers,incision types,and duration of operation (P<0.05). Conclusion Multiple factors contribute to SSI in orthopaedic surgery. It is necessary to take comprehensive prevention measures to reduce the in-cidence of SSI.

  18. Improving Surveillance for Surgical Site Infections Following Total Hip and Knee Arthroplasty Using Diagnosis and Procedure Codes in a Provincial Surveillance Network.

    Science.gov (United States)

    Rusk, Alysha; Bush, Kathryn; Brandt, Marlene; Smith, Christopher; Howatt, Andrea; Chow, Blanda; Henderson, Elizabeth

    2016-06-01

    OBJECTIVE To evaluate hospital administrative data to identify potential surgical site infections (SSIs) following primary elective total hip or knee arthroplasty. DESIGN Retrospective cohort study. SETTING All acute care facilities in Alberta, Canada. METHODS Diagnosis and procedure codes for 6 months following total hip or knee arthroplasty were used to identify potential SSI cases. Medical charts of patients with potential SSIs were reviewed by an infection control professional at the acute care facility where the patient was identified with a diagnosis or procedure code. For SSI decision, infection control professionals used the National Healthcare Safety Network SSI definition. The performance of traditional surveillance methods and administrative data-triggered medical chart review was assessed. RESULTS Of the 162 patients identified by diagnosis or procedure code, 46 (28%) were confirmed as an SSI by an infection control professional. More SSIs were identified following total hip vs total knee arthroplasty (42% vs16%). Of 46 confirmed SSI cases, 20 (43%) were identified at an acute care facility different than their procedure facility. Administrative data-triggered medical chart review with infection control professional confirmation resulted in a 1.1- to 1.7-fold increase in SSI rate compared with traditional surveillance. SSIs identified by administrative data resulted in sensitivity of 90% and specificity of 99%. CONCLUSION Medical chart review for cases identified through administrative data is an efficient supplemental SSI surveillance strategy. It improves case-finding by increasing SSI identification and making identification consistent across facilities, and in a provincial surveillance network it identifies SSIs presenting at nonprocedure facilities. Infect Control Hosp Epidemiol 2016;37:699-703. PMID:27018968

  19. Cosmetic outcome and surgical site infection rates of antibacterial absorbable (Polyglactin 910) suture compared to Chinese silk suture in breast cancer surgery: a randomized pilot research

    Institute of Scientific and Technical Information of China (English)

    ZHANG Zhong-tao; Jessica Shen; Martin Weisberg; ZHANG Hong-wei; FANG Xue-dong; WANG Li-ming; LI Xiao-xi; LI Ya-fen; SUN Xiao-wei; Judith Carver; Dorella Simpkins

    2011-01-01

    Background The primary objective of this multicenter post-market study was to compare the cosmetic outcome of triclosan-coated VICRYL* Plus sutures with Chinese silk sutures for skin closure of modified radical mastectomy. A secondary objective was to assess the incidence of surgical site infection (SSI).Methods Patients undergoing modified radical mastectomy were randomly assigned to coated VICRYL* Plus antibacterial (Polyglactin 910) suture or Chinese silk suture. Cosmetic outcomes were evaluated postoperatively at days 12 (±2) and 30 (±5), and the evidence of SSI was assessed at days 3, 5, 7, 12 (±2), 30 (±5), and 90 (±7). Cosmetic outcomes were independently assessed via visual analogue scale (VAS) score evaluations of blinded incision photographs (primary endpoint) and surgeon-assessed modified Hollander Scale (mHCS) scores (secondary endpoint).SSI assessments used both CDC criteria and ASEPSIS scores.Results Six Chinese hospitals randomized 101 women undergoing modified radical mastectomy to closure with coated VICRYL* Plus suture (n=51) or Chinese silk suture (n=50). Mean VAS cosmetic outcome scores for antibacterial suture (67.2) were better than for Chinese silk (45.4) at day 30 (P<0.0001)). Mean mHCS cosmetic outcome total scores, were also higher for antibacterial suture (5.7) than for Chinese silk (5.0) at day 30 (P=0.002).Conclusions Patients using coated VICRYL* Plus suture had significantly better cosmetic outcomes than those with Chinese silk sutures. Patients using coated VICRYL* Plus suture had a lower SSI incidence compared to the Chinese silk sutures, although the difference did not reach statistical significance. (ClinicalTrials.gov NCT 00768222)

  20. Staphylococcus aureus Transcriptome Architecture

    DEFF Research Database (Denmark)

    Mäder, Ulrike; Nicolas, Pierre; Depke, Maren;

    2016-01-01

    Staphylococcus aureus is a major pathogen that colonizes about 20% of the human population. Intriguingly, this Gram-positive bacterium can survive and thrive under a wide range of different conditions, both inside and outside the human body. Here, we investigated the transcriptional adaptation of S....... aureus HG001, a derivative of strain NCTC 8325, across experimental conditions ranging from optimal growth in vitro to intracellular growth in host cells. These data establish an extensive repertoire of transcription units and non-coding RNAs, a classification of 1412 promoters according...... to their dependence on the RNA polymerase sigma factors SigA or SigB, and allow identification of new potential targets for several known transcription factors. In particular, this study revealed a relatively low abundance of antisense RNAs in S. aureus, where they overlap only 6% of the coding genes, and only 19...

  1. Close association between oropharyngeal and rhinopharyngeal colonization with Staphylococcus aureus - clues to new insight of MRSA colonization of the oropharynx

    DEFF Research Database (Denmark)

    Petersen, I S; Larsen, P L; Brandelev, B L;

    2013-01-01

    This study provides data on prevalence of Staphylococcus aureus in oropharynx, rhinopharynx and vestibulum nasi. Specimens were taken from these three pharyngeal sites in 346 patients and analysed for S. aureus. Abnormal pharyngeal findings and patient histories were recorded. S. aureus was found...

  2. Antimicrobial susceptibility pattern of bacterial isolates from surgical wound infections in Tertiary Care Hospital in Allahabad, India

    Directory of Open Access Journals (Sweden)

    A K Kapoor

    2012-01-01

    Full Text Available The aim of present study to analyze the occurrence and in-vitro antimicrobial susceptibility of bacterial pathogens isolated from surgical wound infections. Specimens from a total of 129 patients undergoing either emergency or elective surgery were collected from infected sites or stitch lines and inoculated onto appropriate media. The bacterial cultures were identified utilizing standard microbiological and biochemical methods. Isolates were tested for susceptibility to antimicrobials using the Kirby Bauer disk diffusion method. Statistical analysis was performed using the chi-square test. Of 129 patients investigated (62 emergency and 67 elective surgery cases, bacterial isolates were isolated with almost equal frequency both from emergency and elective surgery cases. Of 108 (83.72% culture positive samples, 62 (57.41% were Gram negative, 39 (36.11% Gram positive, and 7 (6.48% showed multiple organisms. Of total 115 bacteria isolated (101 single and 7 double organisms culture positive, 33 (28.69% were Escherichia coli and were also the commonest; followed by Staphylococcus aureus, 30 (26.09% cases. S. aureus and Streptococcus spp. showed maximum susceptibility (100% to linezolid and vancomycin. Maximum susceptibility of E. coli was observed to ciprofloxacin (75.7%, followed by gentamicin (54.5%; of Klebsiella spp. to ceftriaxone and gentamicin (66.6% each, of Proteus spp. to gentamicin (70% followed by ciprofloxacin (60%, and of Pseudomonas aeruginosa to piperacillin (100% and tobramycin (71.4%. E. coli and S. aureus were the most common and Salmonella spp. and Acinetobacter spp. were the least common organism causing surgical site infections. The definitive therapy included ciprofloxacin and gentamicin for E. coli; linezolid and vancomycin for S. aureus and Streptococcus spp; ceftriaxone and ciprofloxacin for Klebsiella spp., Citrobacter spp., acinetobacter spp and Salmonella spp.

  3. Risk Factors and Nursing Strategies of Surgical Site Wound Infection%外科手术部位切口感染的危险因素及护理对策

    Institute of Scientific and Technical Information of China (English)

    刘俊芝

    2015-01-01

    目的研究并探讨外科手术部位切口感染的危险因素及护理方法的临床应用,并分析其应用价值。方法选取我院收治的200例外科手术部位切口感染患者作为研究对象,对所有引起患者切口感染的危险因素进行分析和探讨,并总结出对外科手术患者的护理措施。结果由统计结果可得,手术时间过长、患者年龄太大、肥胖、患者伴有糖尿病等因素为引起外科手术部位切口感染的危险因素。结论引起患者发生手术切口感染的因素较多,需要加强对患者的护理,保证手术的安全性。%Objective To investigate the risk factors of surgical site wound infection and its clinical application, and to analyze its application value. Methods In our hospital 200 cases of surgical incision infection patients as the research object, of al were analyzed and discussed by the risk factors of patients with infection of incision, and summed up the nursing measures of surgical patients. Results From the statistical results, the operation time is too long, the patient's age is too large, obesity, patients with diabetes and other factors to cause surgical site wound infection risk factors. Conclusion There are many factors that cause patients to have surgical wound infection, and need to strengthen the nursing of patients, and ensure the safety of the operation.

  4. Systematic review and meta-analysis of sutures coated with triclosan for the prevention of surgical site infection after elective colorectal surgery according to the PRISMA statement

    Science.gov (United States)

    Sandini, Marta; Mattavelli, Ilaria; Nespoli, Luca; Uggeri, Fabio; Gianotti, Luca

    2016-01-01

    Abstract Background: Several randomized clinical trials (RCTs) conducted to evaluate the effect of triclosan-coated suture on surgical site infection (SSI) yield to controversial results. The primary purpose of this systematic review and meta-analysis was to analyze the available RCTs, comparing the effect of triclosan-coated suture with uncoated suture on the incidence of SSI after elective colorectal operations. As secondary endpoint of the analysis, we considered length of hospital stay after surgery. Methods: We performed a systematic literature review through Medline, Embase, Pubmed, Scopus, Ovid, ISI Web of Science, and the Cochrane Controlled Trials Register searching for RCTs published from 1990 to 2015. To conduct these meta-analyses, we followed the guidelines and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement. Study inclusion criteria were as follows: parallel-group RCTs in adult populations reporting the closure of the abdominal wall after elective colorectal operation with triclosan-coated suture or noncoated suture, and reporting the outcomes considered in the meta-analysis. Results: Six trials including 2168 patients (1102 treated and 1066 controls) provided data on SSIs. The overall rate was 11.7% (129/1102) in the triclosan group and 13.4% (143/1066) in the control group (odds ratio 0.81, 95% confidence interval [CI] 0.58–1.13, P = 0.220). Heterogeneity among studies was moderate (I2 = 44.9%). No evidence of publication bias was detectable. Five RCTs (1783 patients; 914 treated and 689 controls) described hospital length of stay with no significant effect (mean difference: −0.02, 95% CI −0.11 to −0.07, P = 0.668). The I2 test for heterogeneity was 0% (P = 0.836). Moderator analyses showed no significant differences were detected in analyses comparing the suture materials (polydioxanone vs polyglactin). In open-label trials, the odds ratio for SSI risk was 0.62 (95% CI 0.20–1.93, P = 0

  5. 乡镇级医院手术部位感染影响因素研究%Factors for surgical site infections in township hospitals

    Institute of Scientific and Technical Information of China (English)

    赵伟平; 郑海燕; 赵丽; 邱静; 朱万行; 程元荣; 邹长春; 侯海峰

    2012-01-01

    OBJECTIVE To investigate the factors and preventive measures for surgical site infections (SSI) in township hospitals. METHODS Retrospective investigation of the incidence of SSI was performed in patients receiving surgeries who were enrolled from 15 hospitals in Tai'an from Mar. 2008 to -Jan. 2011. the factors for SSI were analyzed through case-control study. RESULTS A total of 3105 patients receiving surgeries were investigated, and SSI occurred in 107 patients, with the rate of 3. 45%. The infection rate of intestinal surgery was 18. 75%, and the infection rate of prostate surgery was 12. 56%, Multiple logistic regression analysis demonstrated that the incision type, length of hospital stay, duration of the surgery, operation characteristics, diabetes, and body mass index (BMI) were the factors that influenced SSI. CONCLUSION SSI in township hospitals is serious, the incision type, length of hospital stay, duration of die surgery, operation characteristics, diabetes, and BMI are the factors associated with SSI.%目的 研究乡镇级医院普外科手术患者手术部位感染(SSI)的影响因素及预防措施.方法 对山东省泰安市岱岳区15所乡镇医院2008年3月-2011年1月收治的外科手术患者SSI发生情况进行回顾性调查,通过病例对照研究分析SSI的影响因素.结果 共调查3105例外科术后患者,发生SSI 107例,手术部位感染率为3.45%、肠道手术感染率为18.75%和前列腺手术感染率为12.56%的SSI最为严重,多因素条件logistic回归分析筛选的影响因素有切口类型、住院时间、手术持续时间、手术性质、糖尿病、体质指数.结论 乡镇级医院SSI较严重,切口类型、住院时间、手术持续时间、手术性质、糖尿病、体质指数等多种因素与SSI发生有关.

  6. Haematogenous Staphylococcus aureus meningitis. A 10-year nationwide study of 96 consecutive cases

    DEFF Research Database (Denmark)

    Pedersen, Michael; Benfield, Thomas L; Skinhoej, Peter;

    2006-01-01

    BACKGROUND: Haematogenous Staphylococcus aureus meningitis is rare but associated with high mortality. Knowledge about the disease is still limited. The objective of this study was to evaluate demographic and clinical prognostic features of bacteraemic S. aureus meningitis. METHODS: Nationwide...... surveillance in Denmark from 1991 to 2000 with clinical and bacteriological data. Risks of death were estimated by Cox proportional hazards regression analysis. RESULTS: Among 12480 cases of S. aureus bacteraemia/sepsis, we identified 96 cases of non-surgical bacteraemic S. aureus meningitis (0.8%). Incidence...... > or = 4) (HR, 2.14; CI, 1.09 to 4.19) remained independent predictors of mortality. CONCLUSION: The incidence, but not mortality of bacteraemic S. aureus meningitis decreased during the study period. Co morbidity and critical illness were independent predictors of a poor outcome....

  7. 手术室优质护理对手术部位感染影响的分析%Impact of high-quality nursing on surgical site infections in operating rooms

    Institute of Scientific and Technical Information of China (English)

    张彩霞; 郑建萍; 杨东; 张敏丽; 姚霞

    2014-01-01

    OBJECTIVE To explore the impact of high-quality nursing on surgical site infections in operating rooms . METHODS In Apr 2012 ,the high-quality nursing was carried out to strengthen the organization and nursing man-agement ,improve nursing quality ,and enhance the environment of the operating rooms as well as the management of surgery ,then the monitoring indicators of control of the surgical site infections in Apr-Sep 2011 and Apr-Sep 2012 were analyzed ,and the quality of control of the surgical site infections was compared between before and after the conduct of high-quality nursing .RESULTS Before the conduct of high-quality nursing ,the surgical site infec-tions occurred in 60 of 6 386 patients who underwent the surgery ,with the infection rate of 0 .94% ;after the con-duct of high-quality nursing ,the surgical site infections occurred in 53 of 7 561 patients who underwent the surger-y ,with the infection rate of 0 .70% .The qualified rates of the surgical hand disinfection ,common hand washing , surveillance of air ,surveillance of object surfaces ,and environmental health were respectively 93 .33% ,86 .67% , 97 .22% ,88 .89% ,and 82 .86% before the conduct of high-quality nursing and were respectively 100 .00% ,and 96 .67% ,100 .00% ,94 .44% ,and 97 .77% after the conduct of high-quality nursing .CONCLUSION The conduct of high-quality nursing can promote the control of surgical site infections in the operating rooms .%目的:探讨手术室开展优质护理对手术部位感染的影响。方法2012年4月手术室开展以加强组织、护理管理,提高护理质量,加强手术室环境及手术管理为重点内容的优质护理服务;对2011年4-9月及2012年4-9月手术部位感染管理的各项监测进行分析,比较开展优质护理服务前后手术部位感染控制的质量。结果开展优质护理活动前,外科手术患者6386例,发生手术部位感染60例,感染率0.94%;开展优质护理

  8. Surgical attire and the operating room: role in infection prevention.

    Science.gov (United States)

    Salassa, Tiare E; Swiontkowski, Marc F

    2014-09-01

    ➤ Although there is some evidence that scrubs, masks, and head coverings reduce bacterial counts in the operating room, there is no evidence that these measures reduce the prevalence of surgical site infection.➤ The use of gloves and impervious surgical gowns in the operating room reduces the prevalence of surgical site infection.➤ Operating-room ventilation plays an unclear role in the prevention of surgical site infection.➤ Exposure of fluids and surgical instruments to the operating-room environment can lead to contamination. Room traffic increases levels of bacteria in the operating room, although the role of this contamination in surgical site infection is unclear.

  9. Surgical attire and the operating room: role in infection prevention.

    Science.gov (United States)

    Salassa, Tiare E; Swiontkowski, Marc F

    2014-09-01

    ➤ Although there is some evidence that scrubs, masks, and head coverings reduce bacterial counts in the operating room, there is no evidence that these measures reduce the prevalence of surgical site infection.➤ The use of gloves and impervious surgical gowns in the operating room reduces the prevalence of surgical site infection.➤ Operating-room ventilation plays an unclear role in the prevention of surgical site infection.➤ Exposure of fluids and surgical instruments to the operating-room environment can lead to contamination. Room traffic increases levels of bacteria in the operating room, although the role of this contamination in surgical site infection is unclear. PMID:25187588

  10. Risk factors for Staphylococcus aureus nasal colonization in Danish middle-aged and elderly twins

    DEFF Research Database (Denmark)

    Andersen, P S; Larsen, Lisbeth Aagaard; Fowler, V G;

    2013-01-01

    Staphylococcus aureus is a human commensal bacterium found in the nasal cavity and other body sites. Identifying risk factors for S. aureus nasal carriage is of interest, as nasal carriage is a risk factor for subsequent invasive infection. We recently investigated the influence of host genetics ......, male gender, psoriasis, and atopic diseases. Also, present living on a farm is clearly associated with S. aureus colonization, while smoking had a borderline statistically significant protective effect....

  11. Differential Expression and Roles of Staphylococcus aureus Virulence Determinants during Colonization and Disease

    OpenAIRE

    Jenkins, Amy; Diep, Binh An; Mai, Thuy T.; Vo, Nhung H.; Warrener, Paul; Suzich, Joann; Stover, C. Kendall; Sellman, Bret R.

    2015-01-01

    ABSTRACT Staphylococcus aureus is a Gram-positive, commensal bacterium known to asymptomatically colonize the human skin, nares, and gastrointestinal tract. Colonized individuals are at increased risk for developing S. aureus infections, which range from mild skin and soft tissue infections to more severe diseases, such as endocarditis, bacteremia, sepsis, and osteomyelitis. Different virulence factors are required for S. aureus to infect different body sites. In this study, virulence gene ex...

  12. 剖宫产手术部位感染临床特点分析%Clinical characteristics of surgical site infections after cesarean section

    Institute of Scientific and Technical Information of China (English)

    金丽君

    2012-01-01

    目的 探讨剖宫产手术部位感染(SSI)临床特点及预防措施.方法 回顾性分析剖宫产2450例产妇的临床资料;观察病原菌分布、SSI发生情况及相关因素、临床结果.结果 2450例剖宫产产妇合并SSI共80例,占3.26%;检出病原菌52株,革兰阴性杆菌40株,革兰阳性球菌12株,SSI组年龄大、检查和治疗次数多、体质量指数高、术前身体状况分级低、试产时间长、瘢痕子宫比例高、手术时间长,是SSI的危险因素,SSI经过治疗均痊愈,住院时间(7.12±2.56)d,长于非SSI组的(5.22±2.13)d,差异有统计学意义(P<0.05).结论 剖宫产术发生SSI发生率较高,虽然愈合良好,但延长住院时间,应采用合理方法预防SSI,做好产前检查保健工作、提高手术水平、合理使用抗菌药物.%OBJECTIVE To explore the clinical characteristics of surgical site infection (SSI) after cesarean section and preventive measures. METHODS The clinical data of 2450 cases receiving cesarean section were retrospectively analyzed; the incidence of SSIt distribution of the pathogens, related factors of SSI, and clinical outcomes were analyzed. RESULTS Totally 80 of 2450 cesarean section cases were complicated with SSI, accounting for 3. 26%; 52 trains of pathogens were detected, including 40 strains of gram-negative bacilli and 12 strains of gram-positive coccit the aduanced age, frequent examination and treatment, high body mass index, low ASA before surgery, long trial laboring time, high proportion of uterine scar, and long operation time were the risk factors for SSI. SSI patients were healed after treatment. Hospital stay was (7. 12±2. 56) days in SSI group, longer than that in non-SSI group(5. 22±2.13)days, with statistically significant difference (P<0. 05). CONCLUSION Cesarean section is with high incidence of SSI. Although the healing is good, it prolongs hospitalization time. We should adopt reasonable method to prevent SSI, make well

  13. Antimicrobial Analysis of an Antiseptic Made from Ethanol Crude Extracts of P. granatum and E. uniflora in Wistar Rats against Staphylococcus aureus and Staphylococcus epidermidis

    Directory of Open Access Journals (Sweden)

    Thaís Honório Lins Bernardo

    2015-01-01

    Full Text Available Introduction. Surgical site infection remains a challenge for hospital infection control, especially when it relates to skin antisepsis in the surgical site. Objective. To analyze the antimicrobial activity in vivo of an antiseptic from ethanol crude extracts of P. granatum and E. uniflora against Gram-positive and Gram-negative bacteria. Methods. Agar drilling and minimal inhibitory tests were conducted for in vitro evaluation. In the in vivo bioassay were used Wistar rats and Staphylococcus aureus (ATCC 25923 and Staphylococcus epidermidis (ATCC 14990. Statistical analysis was performed through variance analysis and Scott-Knott cluster test at 5% probability and significance level. Results. In the in vitro, ethanolic extracts of Punica granatum and Eugenia uniflora and their combination showed the best antimicrobial potential against S. epidermidis and S. aureus. In the in vivo bioassay against S. epidermidis, there was no statistically significant difference between the tested product and the patterns used after five minutes of applying the product. Conclusion. The results indicate that the originated product is an antiseptic alternative source against S. epidermidis compared to chlorhexidine gluconate. It is suggested that further researches are to be conducted in different concentrations of the test product, evaluating its effectiveness and operational costs.

  14. Potential risk factors for surgical site infection after isolated coronary artery bypass grafting in a Bahrain Cardiac Centre: A retrospective, case-controlled study

    Directory of Open Access Journals (Sweden)

    Ahmed Abdulaziz Abuzaid

    2015-01-01

    Conclusions: Patients with comorbidities of impaired renal function and/or impaired left ventricular systolic function are at high risk of developing SSI. There appears to be a relationship between SSIs in CABG patients and impaired renal or LV function (low ejection fraction. CABG with BIMA grafting could be performed safely even in diabetics. Future studies should consider further scrutiny of these and other factors in relation to SSIs in a larger surgical population.

  15. ANTIBACTERIAL ACTIVITY OF THREE PLANT EXTRACTS USED IN NIGERIA FOLKLORIC MEDICINE AGAINST HOSPITAL ISOLATES OF METHICILLIN-RESISTANT STAPHYLOCOCCUS AUREUS (MRSA AND METHICILLIN-SENSITIVE STAPHYLOCOCCUS AUREUS (MSSA

    Directory of Open Access Journals (Sweden)

    Daniyan SY

    2011-03-01

    Full Text Available Staphylococcus aureus is a species of bacterium commonly found on the skin and/or in the noses of healthy people. Although it is usually harmless at these sites, it may occasionally get into the body (eg through breaks in the skin such as abrasions, cuts, wounds, surgical incisions or indwelling catheters and cause infections. These infections may be mild (eg pimples or boils or serious (eg infection of the bloodstream, bones or joints. It is one of the important bacteria as a potential pathogen specifically for nosocomial infections. Interest in plants with antimicrobial properties has revived as a result of current problems associated with the use of antibiotics.Hexane, ethylacetate, methanol and water extracts from 3 different plant species, Jatropha curcas, Piliostigma thonningii and Hyptis suaveolens used in Nigeria as popular medicine for the treatment of several ailments of microbial and non-microbial origin were evaluated for potential antimicrobial activity against methicillin-resistant Staphylococcus aureus (MRSA and methicillin-sensitive Staphylococcus aureus (MSSA using agar dilution method. Results revealed that there were no significant differences in the % susceptibility to MRSA and MSSA between the standard drugs and the different plant extracts using different extracting solvents (P>0.05. All the extracts of the 3 plants were effective on MRSA except water extract of Jatropha curcas and Piliostigma thonningii. Hexane extract from P. thonningii was inhibitory to 100% of both MRSA and MSSA isolates followed by ethyl acetate extract of J. curcas 61% of MSSA, ethyl acetate extract of P. thonningii on 38% of MRSA, methanol extract of J. curcas on 33% of both MSSA and MRSA and the least activity was with water extract of H. suaveolens on 17% of both MSSA and MRSA; no activity was observed with water extract of J. curcas. Hexane extract of P.thonningii was the only extract found in this study to inhibit the growth of both MRSA and MSSA

  16. Antibiotic surgical prophylaxis increases nasal carriage of antibiotic-resistant staphylococci.

    Science.gov (United States)

    McMurray, Claire L; Hardy, Katherine J; Verlander, Neville Q; Hawkey, Peter M

    2015-12-01

    Staphylococci are a significant cause of hospital-acquired infection. Nasal carriage of Staphylococcus aureus is an important risk factor for infection in surgical patients and coagulase-negative staphylococci (CNS) are a major cause of prosthetic joint infections. The impact that antibiotic surgical prophylaxis has on the nasal carriage of staphylococci has not been studied. Daily nasal swabs were taken from 63 patients who received antibiotic surgical prophylaxis and 16 patients who received no antibiotics. Total aerobic bacterial count, S. aureus and CNS were enumerated by culture from nasal swabs. Representative isolates were typed by staphylococcal interspersed repeat units (SIRU) typing and PFGE, and MICs to nine antibiotics were determined. After antibiotic administration, there was a reduction in S. aureus counts (median - 2.3 log(10)c.f.u. ml(- 1)) in 64.0 % of S. aureus carriers, compared with only a 0.89 log(10)c.f.u. ml(- 1) reduction in 75.0 % of S. aureus carriers who did not receive antibiotics. A greater increase in the nasal carriage rate of meticillin-resistant CNS was observed after antibiotic surgical prophylaxis compared with hospitalization alone, with increases of 16.4 and 4.6 %, respectively. Antibiotic-resistant S. epidermidis carriage rate increased by 16.6 % after antibiotic administration compared with 7.5 % with hospitalization alone. Antibiotic surgical prophylaxis impacts the nasal carriage of both S. aureus and CNS.

  17. SURGICAL NUTRITION

    Directory of Open Access Journals (Sweden)

    Danny Kurniawan Darianto

    2015-07-01

    Full Text Available A patient undergoing surgery faces great physiologic and psychologic stress. so nutritional demands are greatly increased during this period and deficiencies can easily develop. If these deficiencies are allowed to develop and are not in screening, serious malnutrition and clinical problem can occur. Therefore careful attention must be given to a patient's nutritional status in preparation of surgery, as well as to the individual nutritional needs. If these needs are met, complications are less likely developing. Natural resources provide for rapid recovery. Proper nutrition can speed healing in surgical patients with major trauma, severe malnutition, burns, and other severe illnesses. New techniques for tube feeding, intravenous nutrition for patients with serious weight loss due to gastrointestinal disorders, and use of supplements can hasten wound healing and shorten recovery times.

  18. 手术室优质护理对手术部位感染影响的分析%Analysis of the Impact of the Operating Room Nursing Quality on Surgical Site Infection

    Institute of Scientific and Technical Information of China (English)

    刘素琼

    2015-01-01

    Objective:Analyze the influence of the operating room nursing quality to surgical site infection.Methods:Since March 2012,our hospital began the implementation of formal quality of nursing, and improved the quality of nursing by the behavior of strengthening supervision,optimizing the environment of the operating room and standard operation,such as behavior.Make the results of the manageG ment of surgical site monitoring to our hospital in March 2012 to August 2013 as the research object,analyze the operating room nursing quality to the influence of surgical site infection.Result:Before impleG menting high quality nursing,the hospital surgery patients with surgical site infection rate was 1.36%;With a high quality nursing after implementation,surgery surgical site infection control within 0.63%. Before implement high quality nursing,surgical hand disinfection percent of pass is 92.1%;Ordinary washing percent of pass is 88.4%;Air disinfection qualified rate 93.3%;An object's surface monitoring percent of pass is 90.6%;Environmental health percent of pass is 95.2%.After the implementation of high quality nursing,surgical hand disinfection percent of pass is 100%;Ordinary washing,percent of pass is 98.7%;Air disinfection qualified rate 100%;An object's surface monitoring percent of pass is 96.4%;Environmental health percent of pass is 98.8%.Conclusion:The implementation of the operating room nursing quality can ef ectively reduce the surgical site infections,and create favorable conditions for surgical site infection control work,it is suitable for clinical application.%目的::分析手术室优质护理对手术部位感染的影响.方法:我院自2012年3月起,正式实施优质护理,通过加强监管力度、改善护理行为、优化手术室环境、规范手术操作等行为,提高护理质量.将我院2012年3月~2013年8月,手术部位管理的监测结果作为研究对象,分析总结手术室优质护理对手术部位感染的影

  19. Staphylococcus aureus in the community: colonization versus infection.

    Directory of Open Access Journals (Sweden)

    Maureen Miller

    Full Text Available BACKGROUND: Antibiotic-resistant Staphylococcus aureus infections have increased dramatically in the community, yet S. aureus nasal colonization has remained stable. The objectives of this study were to determine if S. aureus colonization is a useful proxy measure to study disease transmission and infection in community settings, and to identify potential community reservoirs. METHODOLOGY/PRINCIPAL FINDINGS: Randomly selected households in Northern Manhattan, completed a structured social network questionnaire and provided nasal swabs that were typed by pulsed field gel electrophoresis to identify S. aureus colonizing strains. The main outcome measures were: 1 colonization with S. aureus; and 2 recent serious skin infection. Risk factor analyses were conducted at both the individual and the household levels; logistic regression models identified independent risks for household colonization and infection. RESULTS: 321 surveyed households contained 914 members. The S. aureus prevalence was 25% and MRSA was 0.4%. More than 40% of households were colonized. Recent antibiotic use was the only significant correlate for household colonization (p = .002. Seventy-eight (24% households reported serious skin infection. In contrast with colonization, five of the six risk factors that increased the risk of skin infection in the household at the univariate level remained independently significant in multivariable analysis: international travel, sports participation, surgery, antibiotic use and towel sharing. S. aureus colonization was not significantly associated with serious skin infection in any analysis. Among multiperson households with more than one person colonized, 50% carried the same strain. CONCLUSIONS/SIGNIFICANCE: The lack of association between S. aureus nasal colonization and serious skin infection underscores the need to explore alternative venues or body sites that may be crucial to transmission. Moreover, the magnitude of colonization and

  20. 护理干预对预防消化道手术切口感染的效果研究%Research in effect of nursing intervention on prevention of surgical site infection after gastrointestinal operation

    Institute of Scientific and Technical Information of China (English)

    林卫红; 陈云志; 曾其强; 钱黄静; 张启瑜

    2009-01-01

    Objecltive To intensify the coordination and nursing in the operation room in order to prevent surgical site infection after gastrointestinal operation. Methods 337 medical history of patients received gastrointestinal operation and third rate healing from 1999 to 2006 were collected. A series of intensified measures were applied to surgical site infection from 2003 gradually, including invocation of new surgical handwashing method, modified skin disinfection manner, adoption of degreasing with ethanol first before disinfection with iodophor, placement of incision protector and clean bag for incision protection after entering abdomen, changing to use new gastrointestinal anastomofic thimerosal,standardization of operation order and clean manage-ment in operation room. The incidence rate of surgical site infection after gastrointestinal operation of patients from 1999 to 2002 and from 2003 to 2006 underwent χ2 test. Results The incidence rate of surgical site in-fection after gastrointestinal operation greatly decreased after adoption of intensified nursing intervention, Signifi-cant difference existed in rate of patients with third rate healing between the year 1999 to 2002 and 2003 to 2006. Conclusions Modified nursing intervention for surgical incision after gastrointestinal operation can de-crease incision infection rate evidently.%目的 加强改进手术室的配合和护理,预防消化道手术后切口感染. 方法 收集1999-2006年所有消化道手术及术后切口丙级愈合病历资料337份.2003年始对消化道手术切口感染预防逐步采用系列的强化措施,包括启用新的外科洗手方法;改进皮肤消毒方式,采用先用乙醇给患者皮肤脱脂后再以碘伏消毒的方式;进腹后放置切口保护器和洁净袋保护切口;改用新的消化道吻合口消毒液;规范手术顺序的安排,手术间的清洁管理.对1999-2002年和2003-2006年2个时期病例的消化道手术术后切口感染的发生率进行χ2

  1. Receptor Binding Sites for Substance P, but not Substance K or Neuromedin K, are Expressed in High Concentrations by Arterioles, Venules, and Lymph Nodules in Surgical Specimens Obtained from Patients with Ulcerative Colitis and Crohn Disease

    Science.gov (United States)

    Mantyh, Christopher R.; Gates, Troy S.; Zimmerman, Robert P.; Welton, Mark L.; Passaro, Edward P.; Vigna, Steven R.; Maggio, John E.; Kruger, Lawrence; Mantyh, Patrick W.

    1988-05-01

    Several lines of evidence indicate that tachykinin neuropeptides [substance P (SP), substance K (SK), and neuromedin K (NK)] play a role in regulating the inflammatory and immune responses. To test this hypothesis in a human inflammatory disease, quantitative receptor autoradiography was used to examine possible abnormalities in tachykinin binding sites in surgical specimens from patients with inflammatory bowel disease. Surgical specimens of colon were obtained from patients with ulcerative colitis (n = 4) and Crohn disease (n = 4). Normal tissue was obtained from uninvolved areas of extensive resections for carcinoma (n = 6). In all cases, specimens were obtained artifacts and were processed for quantitative receptor autoradiography by using 125I-labeled Bolton--Hunter conjugates of NK, SK, and SP. In the normal colon a low concentration of SP receptor binding sites is expressed by submucosal arterioles and venules and a moderate concentration is expressed by the external circular muscle, whereas SK receptor binding sites are expressed in low concentrations by the external circular and longitudinal muscle. In contrast, specific NK binding sites were not observed in any area of the human colon. In colon tissue obtained from ulcerative colitis and Crohn disease patients, however, very high concentrations of SP receptor binding sites are expressed by arterioles and venules located in the submucosa, muscularis mucosa, external circular muscle, external longitudinal muscle, and serosa. In addition, very high concentrations of SP receptor binding sites are expressed within the germinal center of lymph nodules, whereas the concentrations of SP and SK binding sites expressed by the external muscle layers are not altered significantly. These results demonstrate that receptor binding sites for SP, but not SK or NK, are ectopically expressed in high concentrations (1000-2000 times normal) by cells involved in mediating inflammatory and immune responses. These data suggest

  2. Risk factors of surgical site infection after incarcerated inguinal hernia repair%腹股沟嵌顿疝术后手术部位感染因素分析

    Institute of Scientific and Technical Information of China (English)

    杨林华; 陈涛; 王坚

    2012-01-01

    目的 探讨引起腹股沟嵌顿疝手术部位感染的危险因素.方法 回顾性分析上海交通大学医学院附属仁济医院普外科2005年1月至2010年12月经手术治疗的301例腹股沟嵌顿疝病人的临床资料及随访结果,其中伴有绞窄坏死者予以剔除.结果 术后近期(3个月内)全部随访,术后发生伤口血肿1例(0.3%),伤口积液8例(2.7%),伤口感染4例(1.3%),无深部补片感染,术后近期浅表切口手术部位感染与糖尿病(P=0.015)、嵌顿时间(P=0.005)、伤口积液(P=0.000)相关.远期随访病例226例,随访率75.1%,随访期6~72个月,平均随访时间34.2个月,3例复发,无伤口感染或深部补片感染.结论 腹股沟嵌顿疝术后近期切口手术部位感染的危险因素为合并糖尿病、嵌顿时间>24h及切口积液;腹股沟嵌顿疝行无张力修补术是安全可行的.%Objective To investigate risk factors of surgical site infection after incarcerated inguinal hernia repair. Methods The clinical data and follow-up of 301 cases of incarcerated inguinal hernia repair performed from January 2005 to December 2010 in Renji Hospital, Shanghai Jiao Tong University were analyzed retrospectively. Cases of intestinal necrosis were excluded. Results All cases had shortterm followup (3 month). There were 13 cases of postoperative complication including 1 case of localized hematoma (0.3%), 8 cases of seroma (2.7% ) and 4 cases of superficial surgical site infection (1.3%). Diabetes (P=0.015), incarcerated time (P=0.005)and seroma (P =0.000) were related to superficial surgical site infection in shortterm follow-up and no mesh infection was found. Among 226 cases (75.1%) of long-term follow-up (6-72 months), neither surgical site infection nor mesh infection was found, except for 3 cases of hernia recurrences. Conclusion Surgical site infection rate in short-term is related to diabetes, incarcerated time (>24 hours) and seroma. Tension-free hernia repair is safe and

  3. Infarct size in primary angioplasty without on-site cardiac surgical backup versus transferal to a tertiary center: a single photon emission computed tomography study

    Energy Technology Data Exchange (ETDEWEB)

    Knaapen, Paul; Rossum, Albert C. van [VU University Medical Center, Department of Cardiology, Amsterdam (Netherlands); Mulder, Maarten de; Peels, Hans O.; Cornel, Jan H.; Umans, Victor A.W.M. [Medical Center Alkmaar, Department of Cardiology, Alkmaar (Netherlands); Zant, Friso M. van der [Medical Center Alkmaar, Department of Nuclear Medicine, Alkmaar (Netherlands); Twisk, Jos W.R. [VU University Medical Center, Department of Clinical Epidemiology and Biostatistics, Amsterdam (Netherlands)

    2009-02-15

    Primary percutaneous coronary intervention (PCI) performed in large community hospitals without cardiac surgery back-up facilities (off-site) reduces door-to-balloon time compared with emergency transferal to tertiary interventional centers (on-site). The present study was performed to explore whether off-site PCI for acute myocardial infarction results in reduced infarct size. One hundred twenty-eight patients with acute ST-segment elevation myocardial infarction were randomly assigned to undergo primary PCI at the off-site center (n = 68) or to transferal to an on-site center (n = 60). Three days after PCI, {sup 99m}Tc-sestamibi SPECT was performed to estimate infarct size. Off-site PCI significantly reduced door-to-balloon time compared with on-site PCI (94 {+-} 54 versus 125 {+-} 59 min, respectively, p < 0.01), although symptoms-to-treatment time was only insignificantly reduced (257 {+-} 211 versus 286 {+-} 146 min, respectively, p = 0.39). Infarct size was comparable between treatment centers (16 {+-} 15 versus 14 {+-} 12%, respectively p = 0.35). Multivariate analysis revealed that TIMI 0/1 flow grade at initial coronary angiography (OR 3.125, 95% CI 1.17-8.33, p = 0.023), anterior wall localization of the myocardial infarction (OR 3.44, 95% CI 1.38-8.55, p < 0.01), and development of pathological Q-waves (OR 5.07, 95% CI 2.10-12.25, p < 0.01) were independent predictors of an infarct size > 12%. Off-site PCI reduces door-to-balloon time compared with transferal to a remote on-site interventional center but does not reduce infarct size. Instead, pre-PCI TIMI 0/1 flow, anterior wall infarct localization, and development of Q-waves are more important predictors of infarct size. (orig.)

  4. Staphylococcus aureus aortitis and retroperitoneal fibrosis: A case report and literature review

    Directory of Open Access Journals (Sweden)

    Marta Yague

    2016-01-01

    Full Text Available An infected aortic aneurysm is a process with high mortality rate. Survival is dependent on an early diagnosis and surgical management. This case report details a rare presentation of aortitis with persistent methicillin-sensitive Staphylococcus aureus (MSSA bacteremia, which initially presented as retroperitoneal fibrosis and was ultimately fatal.

  5. Staphylococcus aureus aortitis and retroperitoneal fibrosis: A case report and literature review.

    Science.gov (United States)

    Yague, Marta; Temprano, Ignacio; Losa, Juan; De Benito, Luis; De La Cruz, Raul; Cheyne, Natalie; Henriquez, Cesar

    2016-01-01

    An infected aortic aneurysm is a process with high mortality rate. Survival is dependent on an early diagnosis and surgical management. This case report details a rare presentation of aortitis with persistent methicillin-sensitive Staphylococcus aureus (MSSA) bacteremia, which initially presented as retroperitoneal fibrosis and was ultimately fatal. PMID:27516965

  6. Tolerance of Salmonella Enteritidis and Staphylococcus aureus to surface cleaning and household bleach

    NARCIS (Netherlands)

    Kusumaningrum, H.D.; Paltinaite, R.; Koomen, A.J.; Hazeleger, W.C.; Rombouts, F.M.; Beumer, R.R.

    2003-01-01

    Effective cleaning and sanitizing of food preparation sites is important because pathogens are readily spread to food contact surfaces after preparation of contaminated raw products. Tolerance of Salmonella Enteritidis and Staphylococcus aureus to surface cleaning by wiping with regular, microfiber,

  7. Staphylococcus aureus triggered reactive arthritis.

    OpenAIRE

    Siam, A R; M. Hammoudeh

    1995-01-01

    OBJECTIVES--To report two patients who developed reactive arthritis in association with Staphylococcus aureus infection. METHODS--A review of the case notes of two patients. RESULTS--Two adult female patients have developed sterile arthritis in association with Staph aureus infection. The first patient has had two episodes of arthritis; the first followed olecranon bursitis, the second followed infection of a central venous catheter used for dialysis. The second patient developed sterile arth...

  8. Prevalence of nasal carriage and diversity of Staphylococcus aureus among inpatients and hospital staff at Korle Bu Teaching Hospital, Ghana

    DEFF Research Database (Denmark)

    Egyir, Beverly; Guardabassi, Luca; Nielsen, Søren Saxmose;

    2013-01-01

    There is a paucity of data on Staphylococcus aureus epidemiology in Africa. Prevalence of nasal carriage and genetic diversity of S. aureus were determined among hospital staff (HS) and inpatients (IP) at the largest hospital in Ghana. In total, 632 nasal swabs were obtained from 452 IP and 180 HS...... and ST72–SCCmec V). Altogether, these data indicate a high diversity of S. aureus, low levels of MRSA carriage, and a higher chance of nasal carriage of multidrug-resistant S. aureus among IP compared with HS in this hospital....... in the Child Health Department (CHD) and Surgical Department (SD). S. aureus carriage prevalences were 13.9% in IP and 23.3% in HS. The chance of being a carrier was higher in HS (P = 0.005) and IP staying ≤7 days in hospital (P = 0.007). Resistance to penicillin (93%), tetracycline (28%) and fusidic acid (12...

  9. Incidence of early symptomatic port-site hernia: a case series from a department where laparoscopy is the preferred surgical approach.

    LENUS (Irish Health Repository)

    Moran, D C

    2012-12-01

    Potential benefits of laparoscopic surgery include decreased post-operative pain, improved cosmesis and a shorter hospital stay. However as the volume and complexity of laparoscopic procedures increase, there appears to be a simultaneous increase in complications relating to laparoscopic access. Development of a port-site hernia is one such complication.

  10. Staphylococcus aureus biofilms: recent developments in biofilm dispersal.

    Science.gov (United States)

    Lister, Jessica L; Horswill, Alexander R

    2014-01-01

    Staphylococcus aureus is a major cause of nosocomial and community-acquired infections and represents a significant burden on the healthcare system. S. aureus attachment to medical implants and host tissue, and the establishment of a mature biofilm, play an important role in the persistence of chronic infections. The formation of a biofilm, and encasement of cells in a polymer-based matrix, decreases the susceptibility to antimicrobials and immune defenses, making these infections difficult to eradicate. During infection, dispersal of cells from the biofilm can result in spread to secondary sites and worsening of the infection. In this review, we discuss the current understanding of the pathways behind biofilm dispersal in S. aureus, with a focus on enzymatic and newly described broad-spectrum dispersal mechanisms. Additionally, we explore potential applications of dispersal in the treatment of biofilm-mediated infections.

  11. 肝胆手术后的手术部位感染相关因素研究%Study on related factors of surgical sites infection after hepatobiliary surgery

    Institute of Scientific and Technical Information of China (English)

    何培生; 袁云峰; 苟剑林; 何天时

    2011-01-01

    目的 针对肝胆手术后手术部位感染相关因素进行研究,为控制感染提供依据.方法 提取2008年5月-2011年3月肝胆手术患者临床资料,对手术部位感染的相关情况进行回顾性分析;对术前情况、手术方式、手术时间、术中出血量、术后并发症进行单因素分析,并利用logistic进行多因素回归分析.结果 肝胆手术患者共312例,手术部位感染37例,感染率11.86%;其中住院期间发生感染25例,占67.57%;出院后发生感染12例,占32.43%;发生部位浅部切口24例,深部切H9例,脏器腔隙4例;logistic回归分析表明,术后出现切口感染、手术时间、及术后引流管留置时间是主要影响因素.结论 肝胆手术部位感染存在多种因素,采取综合性防治措施,是预防和降低发生手术部位感染的主要措施.%OBJECTIVE To study the related factors of surgical site infection after hepatobiliary surgery, to provide basis for the infection control. METHODS The clinical data of patients received hepatobiliary surgery from May 2008 to Mar 2011 were collected, Vital part of the infection of the relevant information was retrospectively analyzed.. The preoperative situation, operation mode, operation time, the amount of bleeding, and postoperative complications were performed the univariate analysis. And use of the logistic regression analysis was also employed. RESULTS Of 312 cases of patients received hepatobiliary surgery, 37 cases occurred surgical sites infection with the infection rate of 11. 86%, among which 25 cases occurred during the hospital stay, accounting for 67. 57%, 12 cases occurred after discharge from the hospital, accounting for 32. 43%,24 cases were shallow incision, 9 cases were deep, 4 cases were organ compartment) the logistic regression analysis indicated that the postoperative complications, operation duration and postoperative drainage were the independent trigger factors. CONCLUSION There are many

  12. Phenotypes and Virulence among Staphylococcus aureus USA100, USA200, USA300, USA400, and USA600 Clonal Lineages.

    Science.gov (United States)

    King, Jessica M; Kulhankova, Katarina; Stach, Christopher S; Vu, Bao G; Salgado-Pabón, Wilmara

    2016-01-01

    Staphylococcus aureus diseases affect ~500,000 individuals per year in the United States. Worldwide, the USA100, USA200, USA400, and USA600 lineages cause many of the life-threatening S. aureus infections, such as bacteremia, infective endocarditis, pneumonia, toxic shock syndrome, and surgical site infections. However, the virulence mechanisms associated with these clonal lineages, in particular the USA100 and USA600 isolates, have been severely understudied. We investigated the virulence of these strains, in addition to strains in the USA200, USA300, and USA400 types, in well-established in vitro assays and in vivo in the rabbit model of infective endocarditis and sepsis. We show in the infective endocarditis and sepsis model that strains in the USA100 and USA600 lineages cause high lethality and are proficient in causing native valve infective endocarditis. Strains with high cytolytic activity or producing toxic shock syndrome toxin 1 (TSST-1) or staphylococcal enterotoxin C (SEC) caused lethal sepsis, even with low cytolytic activity. Strains in the USA100, USA200, USA400, and USA600 lineages consistently contained genes that encode for the enterotoxin gene cluster proteins, SEC, or TSST-1 and were proficient at causing infective endocarditis, while the USA300 strains lacked these toxins and were deficient in promoting vegetation growth. The USA100, USA200, and USA400 strains in our collection formed strong biofilms in vitro, whereas the USA200 and USA600 strains exhibited increased blood survival. Hence, infective endocarditis and lethal sepsis are multifactorial and not intrinsic to any one individual clonal group, further highlighting the importance of expanding our knowledge of S. aureus pathogenesis to clonal lineages causative of invasive disease. IMPORTANCE S. aureus is the leading cause of infective endocarditis in the developed world, affecting ~40,000 individuals each year in the United States, and the second leading cause of bacteremia (D. R

  13. Staphylococcus aureus Bacteraemia

    Directory of Open Access Journals (Sweden)

    James Price

    2010-01-01

    Full Text Available Staphylococcus aureus bacteraemia (SAB is commonly complicated by metastatic infection or relapse after treatment. Objectives. The study aim was to determine the role of bacterial, host, and management factors in development of complicated SAB. Methods. A prospectively-conducted observational study gathered data on predisposition, management and outcome of 100 consecutive SAB cases. Antibiotic susceptibilities and genetic lineage of bacterial isolates were determined. Further clinical and microbiological data were gathered on two retrospective series from 1999–2000 (n=57 and 2004 (n=116. Results. In the prospective cases, 27% met our definition of complicated disease. Expressed as RR and 95% CI, complicated disease was associated with diabetes (1.58, 1.00–2.48, injecting-drug use (5.48, 0.88–33.49, community-onset of symptoms (1.4, 1.02–1.92, and symptom duration ≥48 hours prior to starting effective antibiotic therapy (2.10, 1.22–3.61. Uncomplicated disease was associated with the presence of a central line (0.69, 0.55–0.88 and prompt removal of a primary focus (0.71, 0.57–0.90. Neither methicillin resistance nor genetic lineage was associated with complicated disease, but methicillin resistance was associated with higher mortality. Conclusions. This study demonstrates that clinical rather than microbial factors are the major determinants of SAB outcome and underscores the importance of early treatment.

  14. Electronic surgical record management.

    Science.gov (United States)

    Rockman, Justin

    2010-01-01

    This paper explores the challenges surgical practices face in coordinating surgeries and how the electronic surgical record management (ESRM) approach to surgical coordination can solve these problems and improve efficiency. Surgical practices continue to experience costly inefficiencies when managing surgical coordination. Application software like practice management and electronic health record systems have enabled practices to "go digital" for their administrative, financial, and clinical data. However, surgical coordination is still a manual and labor-intensive process. Surgical practices need to create a central and secure record of their surgeries. When surgical data are inputted once only and stored in a central repository, the data are transformed into active information that can be outputted to any form, letter, calendar, or report. ESRM is a new approach to surgical coordination. It enables surgical practices to automate and streamline their processes, reduce costs, and ensure that patients receive the best possible care. PMID:20480775

  15. Assessment of adhesion, invasion and cytotoxicity potential of oral Staphylococcus aureus strains.

    Science.gov (United States)

    Merghni, Abderrahmen; Ben Nejma, Mouna; Helali, Imen; Hentati, Hajer; Bongiovanni, Antonino; Lafont, Frank; Aouni, Mahjoub; Mastouri, Maha

    2015-09-01

    The oral cavity is regarded as a relevant site for Staphylococcus aureus colonization. However, characterization of virulence mechanisms of oral S. aureus remains to be uncovered. In this study, twenty one S. aureus strains isolated from the oral cavity of Tunisian patients were screened for adherence, invasion and cytotoxicity against HeLa cells. In addition, the presence of adhesins (icaA, icaD, can, fnbA and fnbB) and α-hemolysin (hla) genes in each strain was achieved by polymerase chain reaction (PCR). Our finding revealed that oral S. aureus strains were able to adhere and invade epithelial cells, with variable degrees (P toxin was found in 52.4% of the isolates. All these virulence factors give to S. aureus the right qualities to become a redoubtable pathogen associated to oral infections.

  16. Surgical innovation as sui generis surgical research.

    Science.gov (United States)

    Lotz, Mianna

    2013-12-01

    Successful innovative 'leaps' in surgical technique have the potential to contribute exponentially to surgical advancement, and thereby to improved health outcomes for patients. Such innovative leaps often occur relatively spontaneously, without substantial forethought, planning, or preparation. This feature of surgical innovation raises special challenges for ensuring sufficient evaluation and regulatory oversight of new interventions that have not been the subject of controlled investigatory exploration and review. It is this feature in particular that makes early-stage surgical innovation especially resistant to classification as 'research', with all of the attendant methodological and ethical obligations--of planning, regulation, monitoring, reporting, and publication--associated with such a classification. This paper proposes conceptual and ethical grounds for a restricted definition according to which innovation in surgical technique is classified as a form of sui generis surgical 'research', where the explicit goal of adopting such a definition is to bring about needed improvements in knowledge transfer and thereby benefit current and future patients.

  17. Bacterial migration through punctured surgical gloves under real surgical conditions

    Directory of Open Access Journals (Sweden)

    Heidecke Claus-Dieter

    2010-07-01

    Full Text Available Abstract Background The aim of this study was to confirm recent results from a previous study focussing on the development of a method to measure the bacterial translocation through puncture holes in surgical gloves under real surgical conditions. Methods An established method was applied to detect bacterial migration from the operating site through the punctured glove. Biogel™ double-gloving surgical gloves were used during visceral surgeries over a 6-month period. A modified Gaschen-bag method was used to retrieve organisms from the inner glove, and thus-obtained bacteria were compared with micro-organisms detected by an intra-operative swab. Results In 20 consecutive procedures, 194 gloves (98 outer gloves, 96 inner gloves were examined. The rate of micro-perforations of the outer surgical glove was 10% with a median wearing time of 100 minutes (range: 20-175 minutes. Perforations occurred in 81% on the non-dominant hand, with the index finger most frequently (25% punctured. In six cases, bacterial migration could be demonstrated microbiologically. In 5% (5/98 of outer gloves and in 1% (1/96 of the inner gloves, bacterial migration through micro-perforations was observed. For gloves with detected micro-perforations (n = 10 outer layers, the calculated migration was 50% (n = 5. The minimum wearing time was 62 minutes, with a calculated median wearing time of 71 minutes. Conclusions This study confirms previous results that bacterial migration through unnoticed micro-perforations in surgical gloves does occur under real practical surgical conditions. Undetected perforation of surgical gloves occurs frequently. Bacterial migration from the patient through micro-perforations on the hand of surgeons was confirmed, limiting the protective barrier function of gloves if worn over longer periods.

  18. Neutrophil-generated oxidative stress and protein damage in Staphylococcus aureus.

    Science.gov (United States)

    Beavers, William N; Skaar, Eric P

    2016-08-01

    Staphylococcus aureus is a ubiquitous, versatile and dangerous pathogen. It colonizes over 30% of the human population, and is one of the leading causes of death by an infectious agent. During S. aureus colonization and invasion, leukocytes are recruited to the site of infection. To combat S. aureus, leukocytes generate an arsenal of reactive species including superoxide, hydrogen peroxide, nitric oxide and hypohalous acids that modify and inactivate cellular macromolecules, resulting in growth defects or death. When S. aureus colonization cannot be cleared by the immune system, antibiotic treatment is necessary and can be effective. Yet, this organism quickly gains resistance to each new antibiotic it encounters. Therefore, it is in the interest of human health to acquire a deeper understanding of how S. aureus evades killing by the immune system. Advances in this field will have implications for the design of future S. aureus treatments that complement and assist the host immune response. In that regard, this review focuses on how S. aureus avoids host-generated oxidative stress, and discusses the mechanisms used by S. aureus to survive oxidative damage including antioxidants, direct repair of damaged proteins, sensing oxidant stress and transcriptional changes. This review will elucidate areas for studies to identify and validate future antimicrobial targets.

  19. Neutrophil-generated oxidative stress and protein damage in Staphylococcus aureus.

    Science.gov (United States)

    Beavers, William N; Skaar, Eric P

    2016-08-01

    Staphylococcus aureus is a ubiquitous, versatile and dangerous pathogen. It colonizes over 30% of the human population, and is one of the leading causes of death by an infectious agent. During S. aureus colonization and invasion, leukocytes are recruited to the site of infection. To combat S. aureus, leukocytes generate an arsenal of reactive species including superoxide, hydrogen peroxide, nitric oxide and hypohalous acids that modify and inactivate cellular macromolecules, resulting in growth defects or death. When S. aureus colonization cannot be cleared by the immune system, antibiotic treatment is necessary and can be effective. Yet, this organism quickly gains resistance to each new antibiotic it encounters. Therefore, it is in the interest of human health to acquire a deeper understanding of how S. aureus evades killing by the immune system. Advances in this field will have implications for the design of future S. aureus treatments that complement and assist the host immune response. In that regard, this review focuses on how S. aureus avoids host-generated oxidative stress, and discusses the mechanisms used by S. aureus to survive oxidative damage including antioxidants, direct repair of damaged proteins, sensing oxidant stress and transcriptional changes. This review will elucidate areas for studies to identify and validate future antimicrobial targets. PMID:27354296

  20. Risk and prognosis of Staphylococcus aureus bacteremia among individuals with and without end-stage renal disease

    DEFF Research Database (Denmark)

    Nielsen, Lise H; Jensen-Fangel, Søren; Benfield, Thomas;

    2015-01-01

    BACKGROUND: Staphylococcus aureus is a leading cause of bloodstream infections among hemodialysis patients and of exit-site infections among peritoneal dialysis patients. However, the risk and prognosis of Staphylococcus aureus bacteremia among end-stage renal disease patients have not been delin...

  1. Mild Staphylococcus aureus skin infection improves the course of subsequent endogenous S. aureus bacteremia in mice

    NARCIS (Netherlands)

    S. van den Berg (Sanne); C.P. de Vogel (Corné); A.F. van Belkum (Alex); I.A.J.M. Bakker-Woudenberg (Irma)

    2015-01-01

    textabstractStaphylococcus aureus carriers with S. aureus bacteremia may have a reduced mortality risk compared to non-carriers. A role for the immune system is suggested. Here, we study in mice the effect of mild S. aureus skin infection prior to endogenous or exogenous S. aureus bacteremia, and ev

  2. Effects of Fermented Sumach on the Formation of Slime Layer of Staphylococcus aureus

    Directory of Open Access Journals (Sweden)

    Sahra Kırmusaoğlu

    2012-03-01

    Full Text Available Objective: Staphylococcus aureus (S. aureus is one of the most commonly isolated bacterial pathogens in hospitals, and the most frequent cause of nosocomial infections. Nosocomial staphylococcal foreign-body infections related to biofilm formation are a serious threat, demanding new therapeutic and preventive strategies. Implantation of intravenous catheters and surgical implantation of prosthetic implants carry a risk of infection. In order to prevent all these effects of biofilms, a study was designed to observe the possible antibacterial effect of sumach (Rhus coriaria on the biofilm formation of S. aureus. Material and Methods: The influence of varying concentrations of sumach on the formation of biofilms by 13 strains of Staphylococcus aureus was tested by a microelisa assay. Results: The significant differences between varying concentrations of sumach (0.1, 0.2, 0.5 and 1.0 µl/ml were observed in four methicillin resistant Staphylococcus aureus (MRSA and nine methicillin sensitive Staphylococcus aureus (MSSA (p<0.05. In bacteria, a dose-related decrease in the formation of slime, which is a major virulence factor of staphylococcal infections, was observed. Conclusion: In our study, using 0.1, 0.2, 0.5 and 1.0 µl/ml of sumach, thirteen strains lost, 17%, 22%, 28% and 48% respectively of their capacity to produce biofilms. Sumach, which is a herbal product, can decrease the formation of biofilm, which is a major virulence factor in staphylococcal infections.

  3. Host-adaptive evolution of Staphylococcus aureus

    OpenAIRE

    Lowder, Bethan Victoria

    2011-01-01

    Staphylococcus aureus is a notorious human pathogen associated with severe nosocomial and community-acquired infections. In addition, S. aureus is a major cause of animal diseases including skeletal infections of poultry and bovine and ovine mastitis, which are a large economic burden on the broiler chicken and dairy farming industries. The population structure of S. aureus associated with humans has been well studied. However, despite the prevalence of S. aureus infections in ...

  4. [Protein toxins of Staphylococcus aureus].

    Science.gov (United States)

    Shamsutdinov, A F; Tiurin, Iu A

    2014-01-01

    Main scientific-research studies regarding protein bacterial toxins of the most widespread bacteria that belong to Staphylococcus spp. genus and in particular the most pathogenic species for humans--Staphylococcus aureus, are analyzed. Structural and biological properties of protein toxins that have received the name of staphylococcus pyrogenic toxins (PTSAg) are presented. Data regarding genetic regulation of secretion and synthesis of these toxins and 3 main regulatory genetic systems (agr--accessory gene regulator, xpr--extracellular protein regulator, sar--staphylococcal accessory regulator) that coordinate synthesis of the most important protein toxins and enzymes for virulence of S. aureus, are presented.

  5. Gold nanoprobe functionalized with specific fusion protein selection from phage display and its application in rapid, selective and sensitive colorimetric biosensing of Staphylococcus aureus.

    Science.gov (United States)

    Liu, Pei; Han, Lei; Wang, Fei; Petrenko, Valery A; Liu, Aihua

    2016-08-15

    Staphylococcus aureus (S. aureus) is one of the most ubiquitous pathogens in public healthcare worldwide. It holds great insterest in establishing robust analytical method for S. aureus. Herein, we report a S. aureus-specific recognition element, isolated from phage monoclone GQTTLTTS, which was selected from f8/8 landscape phage library against S. aureus in a high-throughput way. By functionalizing cysteamine (CS)-stabilized gold nanoparticles (CS-AuNPs) with S. aureus-specific pVIII fusion protein (fusion-pVIII), a bifunctional nanoprobe (CS-AuNPs@fusion-pVIII) for S. aureus was developed. In this strategy, the CS-AuNPs@fusion-pVIII could be induced to aggregate quickly in the presence of target S. aureus, resulting in a rapid colorimetric response of gold nanoparticles. More importantly, the as-designed probe exhibited excellent selectivity over other bacteria. Thus, the CS-AuNPs@fusion-pVIII could be used as the indicator of target S. aureus. This assay can detect as low as 19CFUmL(-1)S. aureus within 30min. Further, this approach can be applicable to detect S. aureus in real water samples. Due to its sensitivity, specificity and rapidness, this proposed method is promising for on-site testing of S. aureus without using any costly instruments.

  6. Gold nanoprobe functionalized with specific fusion protein selection from phage display and its application in rapid, selective and sensitive colorimetric biosensing of Staphylococcus aureus.

    Science.gov (United States)

    Liu, Pei; Han, Lei; Wang, Fei; Petrenko, Valery A; Liu, Aihua

    2016-08-15

    Staphylococcus aureus (S. aureus) is one of the most ubiquitous pathogens in public healthcare worldwide. It holds great insterest in establishing robust analytical method for S. aureus. Herein, we report a S. aureus-specific recognition element, isolated from phage monoclone GQTTLTTS, which was selected from f8/8 landscape phage library against S. aureus in a high-throughput way. By functionalizing cysteamine (CS)-stabilized gold nanoparticles (CS-AuNPs) with S. aureus-specific pVIII fusion protein (fusion-pVIII), a bifunctional nanoprobe (CS-AuNPs@fusion-pVIII) for S. aureus was developed. In this strategy, the CS-AuNPs@fusion-pVIII could be induced to aggregate quickly in the presence of target S. aureus, resulting in a rapid colorimetric response of gold nanoparticles. More importantly, the as-designed probe exhibited excellent selectivity over other bacteria. Thus, the CS-AuNPs@fusion-pVIII could be used as the indicator of target S. aureus. This assay can detect as low as 19CFUmL(-1)S. aureus within 30min. Further, this approach can be applicable to detect S. aureus in real water samples. Due to its sensitivity, specificity and rapidness, this proposed method is promising for on-site testing of S. aureus without using any costly instruments. PMID:27085951

  7. Prevention of Healthcare Associated Staphylococcus aureus Infections

    NARCIS (Netherlands)

    L.G.M. Bode (Lonneke)

    2014-01-01

    markdownabstract__Abstract__ S. aureus colonizes the skin and mucosae of a proportion of the human population. Carriers of S. aureus are at increased risk of developing infections with this pathogen. The aim of this thesis was to add to the prevention of healthcare associated S. aureus infections.

  8. Abortion - surgical - aftercare

    Science.gov (United States)

    ... this page: //medlineplus.gov/ency/patientinstructions/000658.htm Abortion - surgical - aftercare To use the sharing features on ... please enable JavaScript. You have had a surgical abortion. This is a procedure that ends pregnancy by ...

  9. Optimizing surgical f

    Directory of Open Access Journals (Sweden)

    Sabry Mohamed Amin

    2016-07-01

    Conclusions: In our study both dexmedetomidine and esmolol were effective in reducing MABP, and lowering the heart rate providing dry surgical field and ensured good surgical condition during cochlear implant surgery in pediatric patients.

  10. Urogynecologic Surgical Mesh Implants

    Science.gov (United States)

    ... be used for urogynecologic procedures, including repair of pelvic organ prolapse (POP) and stress urinary incontinence (SUI). It is ... associated with surgical mesh for transvaginal repair of pelvic organ prolapse 513(e) Proposed Order for Reclassification of Surgical ...

  11. The application of evidence-based measures to reduce surgical site infections during orthopedic surgery - report of a single-center experience in Sweden

    Directory of Open Access Journals (Sweden)

    Andersson Annette Erichsen

    2012-06-01

    Full Text Available Abstract Background Current knowledge suggests that, by applying evidence-based measures relating to the correct use of prophylactic antibiotics, perioperative normothermia, urinary tract catheterization and hand hygiene, important contributions can be made to reducing the risk of postoperative infections and device-related infections. The aim of this study was to explore and describe the application of intraoperative evidence-based measures, designed to reduce the risk of infection. In addition, we aimed to investigate whether the type of surgery, i.e. total joint arthroplasty compared with tibia and femur/hip fracture surgery, affected the use of protective measures. Method Data on the clinical application of evidence-based measures were collected structurally on site during 69 consecutively included operations involving fracture surgery (n = 35 and total joint arthroplasties (n = 34 using a pre-tested observation form. For observations in relation to hand disinfection, a modified version of the World Health Organization hand hygiene observation method was used. Results In all, only 29 patients (49% of 59 received prophylaxis within the recommended time span. The differences in the timing of prophylactic antibiotics between total joint arthroplasty and fracture surgery were significant, i.e. a more accurate timing was implemented in patients undergoing total joint arthroplasty (p = 0.02. Eighteen (53% of the patients undergoing total joint arthroplasty were actively treated with a forced-air warming system. The corresponding number for fracture surgery was 12 (34% (p = 0.04. Observations of 254 opportunities for hand hygiene revealed an overall adherence rate of 10.3% to hand disinfection guidelines. Conclusions The results showed that the utilization of evidence-based measures to reduce infections in clinical practice is not sufficient and there are unjustifiable differences in care depending on the type of surgery. The poor

  12. [SURGICAL HAND WASHING: HANDSCRUBBING OR HANDRUBBING].

    Science.gov (United States)

    Santacatalina Mas, Roser; Peix Sagues, Ma Teresa; Miranda Salmerón, Josep; Claramunt Jofre, Marta; López López, Alba; Salas Marco, Elena

    2016-02-01

    The importance of protocols for preoperative antisepsis of the hands is given by the risk of transferring bacteria from the hands of the surgical team to the patient during surgery and it is relationship with infection of surgical wound site (SSI). Careful surgical scrub reduces the number of bacteria on the skin, but does not eliminate them completely, remaining transient microorganisms on hands after the surgical scrub. There fore if micropuncture in surgical gloves occurs, the correct preoperative preparation of hands and double gloving will be essential to reduce the risk of bacterial transmission to patients. The protocols for surgical hand antisepsis are two: Surgical scrub with antiseptic soap (hand scrubbing). Surgical scrub by rubbing alcohol (handrubbing). The hand antisepsis by rubbing with an alcohol solution has proved to be significantly more effective compared to soap solutions. We must also see that in surgical hand antisepsis with soap, you must rinse them with water. And often hospitals' taps and keys are contaminated by Pseudomonas spp., including P. aeuinosa. PMID:27101645

  13. Stress Responses in Staphylococcus aureus

    DEFF Research Database (Denmark)

    Frees, Dorte; Ingmer, Hanne

    2016-01-01

    Staphylococcus aures are prominent members of the normal flora of humans and animals, but are also a major cause of mild and severe infections. To persist and disseminate in the human host, and to survive in environmental settings, such as hospitals, S. aureus have developed a plethora of cellular...

  14. Identification of single nucleotide polymorphisms associated with hyperproduction of alpha-toxin in Staphylococcus aureus.

    Directory of Open Access Journals (Sweden)

    Xudong Liang

    Full Text Available The virulence factor α-toxin (hla is needed by Staphylococcus aureus in order to cause infections in both animals and humans. Although the complicated regulation of hla expression has been well studied in human S. aureus isolates, the mechanisms of of hla regulation in bovine S. aureus isolates remain undefined. In this study, we found that many bovine S. aureus isolates, including the RF122 strain, generate dramatic amounts of α-toxin in vitro compared with human clinical S. aureus isolates, including MRSA WCUH29 and MRSA USA300. To elucidate potential regulatory mechanisms, we analyzed the hla promoter regions and identified predominant single nucleotide polymorphisms (SNPs at positions -376, -483, and -484 from the start codon in α-toxin hyper-producing isolates. Using site-directed mutagenesis and hla promoter-gfp-luxABCDE dual reporter approaches, we demonstrated that the SNPs contribute to the differential control of hla expression among bovine and human S. aureus isolates. Using a DNA affinity assay, gel-shift assays and a null mutant, we identified and revealed that an hla positive regulator, SarZ, contributes to the involvement of the SNPs in mediating hla expression. In addition, we found that the bovine S. aureus isolate RF122 exhibits higher transcription levels of hla positive regulators, including agrA, saeR, arlR and sarZ, but a lower expression level of hla repressor rot compared to the human S. aureus isolate WCUH29. Our results indicate α-toxin hyperproduction in bovine S. aureus is a multifactorial process, influenced at both the genomic and transcriptional levels. Moreover, the identification of predominant SNPs in the hla promoter region may provide a novel method for genotyping the S. aureus isolates.

  15. Nasal Carriage as a Source of agr-Defective Staphylococcus aureus Bacteremia

    OpenAIRE

    Smyth, Davida S.; Kafer, Jared M.; Wasserman, Gregory A.; Velickovic, Lili; Mathema, Barun; Robert S Holzman; Knipe, Tiffany A.; Becker, Karsten; von Eiff, Christof; Peters, Georg; Chen, Liang; Kreiswirth, Barry N.; Novick, Richard P.; Shopsin, Bo

    2012-01-01

    Inactivating mutations in the Staphylococcus aureus virulence regulator agr are associated with worse outcomes in bacteremic patients. However, whether agr dysfunction is primarily a cause or a consequence of early bacteremia is unknown. Analysis of 158 paired S. aureus clones from blood and nasal carriage sites in individual patients revealed that recovery of an agr-defective mutant from blood was usually predicted by the agr functionality of carriage isolates. Many agr-positive blood isolat...

  16. The effectiveness of surgical face masks in the operating room : a systematic review / Nontsokolo Sylvia Makeleni.

    OpenAIRE

    Makeleni, Nontsokolo Sylvia

    2012-01-01

    Surgical face masks have been designed to protect health care professionals from the splashes of the patients’ blood or body fluids and also to minimise the transmission of oro- and nasopharyngeal bacteria from the surgical team to the patient’s wounds, thereby decreasing the likelihood of postoperative surgical site infections during a surgical procedure. However, there are several ways in which surgical face masks could potentially contribute to contamination of the wound during a surgical ...

  17. Staphylococcus aureus and hand eczema severity

    DEFF Research Database (Denmark)

    Haslund, P; Bangsgaard, N; Jarløv, J O;

    2009-01-01

    BACKGROUND: The role of bacterial infections in hand eczema (HE) remains to be assessed. OBJECTIVES: To determine the prevalence of Staphylococcus aureus in patients with HE compared with controls, and to relate presence of S. aureus, subtypes and toxin production to severity of HE. METHODS......: Bacterial swabs were taken at three different visits from the hand and nose in 50 patients with HE and 50 controls. Staphylococcus aureus was subtyped by spa typing and assigned to clonal complexes (CCs), and isolates were tested for exotoxin-producing S. aureus strains. The Hand Eczema Severity Index...... was used for severity assessment. RESULTS: Staphylococcus aureus was found on the hands in 24 patients with HE and four controls (P aureus was found to be related to increased severity of the eczema (P aureus types on the hands...

  18. Human Staphylococcus aureus lineages among Zoological Park residents in Greece

    Directory of Open Access Journals (Sweden)

    E. Drougka

    2015-10-01

    Full Text Available Staphylococcus aureus is a part of the microbiota flora in many animal species. The clonal spread of S. aureus among animals and personnel in a Zoological Park was investigated. Samples were collected from colonized and infected sites among 32 mammals, 11 birds and eight humans. The genes mecA, mecC, lukF/lukS-PV (encoding Panton-Valentine leukocidin, PVL and tst (toxic shock syndrome toxin-1 were investigated by PCR. Clones were defined by Multilocus Sequence Typing (MLST, spa type and Pulsed-Field Gel Electrophoresis (PFGE. Seven S. aureus isolates were recovered from four animals and one from an employee. All were mecA, mecC and tst–negative, whereas, one carried the PVL genes and was isolated from an infected Squirrel monkey. Clonal analysis revealed the occurrence of seven STs, eight PFGE and five spa types including ones of human origin. Even though a variety of genotypes were identified among S. aureus strains colonizing zoo park residents, our results indicate that colonization with human lineages has indeed occurred.

  19. Risk factors of early surgical site infection after total hip arthroplasty%人工全髋关节置换术后早期手术部位感染的危险因素分析

    Institute of Scientific and Technical Information of China (English)

    谢章家; 庞安琪; 谢壮

    2011-01-01

    目的 探讨人工全髋关节置换术(THA)后早期手术部位感染的危险因素.方法 回顾分析2000年1月至2010年10月本组所行153例单侧THA的患者,其中男46例,女107例,年龄29~79岁,平均(61.0±8.9)岁.回顾性分析多项临床因素与手术部位感染的相关性.连续变量包括:年龄、手术时间、手术出血量、术前白蛋白血清浓度、伤口引流管停留时间;分类变量包括:性别、有无长期使用激素病史、是否合并糖尿病、有无前次手术史、是否使用骨水泥、预防性抗生素使用方案.153例患者按照是否发生手术部位感染分成两组,对连续变量采用t检验、分类变量采用X2检验进行比较.结果 153例患者中8例出现手术部位感染,发生率为5.23%.单因素分析发现术前白蛋白血清浓度因素差异有统计学意义(t=2.752,P35 g/L比较差异有统计学意义(X2= 7.23,P<0.05).有无长期口服激素、有无前次手术比较差异有统计学意义(其X2值分别为3.93与12.38,P<0.05).年龄、性别、手术时间、术中出血量、抗生素使用时间、引流管停留时间、是否合并糖尿病、是否使用骨水泥等因素对手术部位感染发生无影响,均无统计学差异.结论 THA术前低蛋白血症、前次手术史、长期口服激素史是手术部位感染的高危因素.%Objective To analyse risk factors of infection at surgical site after total hip arthroplasty ( THA ). Methods From January, 2000 to October, 2010, 153 patients. including 46 men and 107 women. received THA in our hospital. The average age was ( 61. 0 ±8. 9 ) years ( range , 29 to 79 years ). Eleven clinical factors were analyzed retrospectively to determine their association with surgical site infection. Five continous variables were analyzed by t test while six categorical variables were analyzed by X2 test. Results The incidence of surgical site infection in this series was 5. 23% ( 8/153 ). Single factor analysis indicated

  20. 子宫下段横切口剖宫产术后切口感染的危险因素探讨%The study of risk factors of surgical site infection of low transverse cesarean section

    Institute of Scientific and Technical Information of China (English)

    梁冬莲

    2012-01-01

    Objective: To explore risk factors of surgical site infection (SSI) of low transverse cesarean section. Methods: The data of 3 765 cases with low transverse cesarean section were retrospective analysed, 150 cases with SSI and other 420 control cases were compared, and risk factors were analysed using mono-factor and multi-factor methods. Results: Analysis results showed that SSI was associated with chorioamnionitis, times of vaginal examination, development of subcutaneous hematoma after operation and high body mass index(BMI) at admission hospital(P 0.05),其他三者则是SSI发生的独立危险因素(P<0.05~P<0.01).结论:术后出现皮下血肿、入院时体重指数较高、孕期多次阴道检查会增加子宫下段横切口剖宫产术后SSI发生的风险.应注意对这些高危患者加强术后监测管理,防止SSI的发生.

  1. 结肠直肠手术部位感染的手术技术因素及其预防%The effect of maneuvering factors on the occurrence of surgical site infection and its prevention

    Institute of Scientific and Technical Information of China (English)

    冯宇; 王强

    2006-01-01

    手术部位感染(surgical site infection,SSI)是外科手术的并发症之一,不仅影响病人的预后,甚至导致死亡。美国CDC国家医院感染监视系统资料显示SSI是第3位常见的院内感染.占住院病人院内感染的14%~16%,其中结肠直肠外科手术的SSI发生概率较高,为8.6%~9.7%。美国医院感染控制委员会颁布的SSI预防指南指出.除外术中环境因素、无菌材料、无菌术等,手术技术和操作对SSI的防治具重要意义口。SSI其诊断标准已达成共识,包括切口浅部感染、切口深部感染、器官或腔隙感染等。现就结肠直肠外科SSI相关手术技术及其预防作一概述和分析。

  2. High-dose daptomycin and fosfomycin treatment of a patient with endocarditis caused by daptomycin-nonsusceptible Staphylococcus aureus: Case report

    Directory of Open Access Journals (Sweden)

    Hsiao Chen-Yuan

    2011-05-01

    Full Text Available Abstract Background Emergence of daptomycin-nonsusceptible (DNS Staphylococcus aureus is a dreadful problem in the treatment of endocarditis. Few current therapeutic agents are effective for treating infections caused by DNS S. aureus. Case presentation We describe the emergence of DNS S. aureus. in a patient with implantable cardioverter-defibrillator (ICD device -related endocarditis who was priorily treated with daptomycin. Metastatic dissemination as osteomyelitis further complicated the management of endocarditis. The dilemma was successfully managed by surgical removal of the ICD device and combination antimicrobial therapy with high-dose daptomycin and fosfomycin. Conclusions Surgical removal of intracardiac devices remains an important adjunctive measure in the treatment of endocarditis. Our case suggests that combination therapy is more favorable than single-agent therapy for infections caused by DNS S. aureus.

  3. Effect of sodium fusidate and ofloxacin on Staphylococcus aureus colonization and infection in patients on continuous ambulatory peritoneal dialysis.

    Science.gov (United States)

    Sesso, R; Parisio, K; Dalboni, A; Rabelo, T; Barbosa, D; Cendoroglo, M; Pignatari, A; Draibe, S; Ajzen, H

    1994-06-01

    The effectiveness of sodium fusidate and ofloxacin to eliminate nasal and catheter exit-site Staphylococcus aureus colonization and to prevent infections was compared in 31 patients on continuous ambulatory peritoneal dialysis (CAPD). In a prospective randomized study, 9 patients were treated with topical 2% sodium fusidate ointment applied in the anterior nares and in the pericatheter skin twice daily for 5 days; 9 subjects received oral ofloxacin 200 mg taken every 48 hours for 5 days and 13 subjects were in the control group. Treatment courses were repeated at one-month intervals. Mean duration of follow-up was 7.8 months (242 patients-month). Follow-up samples from the nares and the catheter exit-site were obtained every month from all participants to determine the presence of S. aureus. Development of S. aureus exit-site infection and peritonitis were assessed. During the study, S. aureus was recovered from 45%, 59% and 52% of the samples from the nares and/or exit-site in the sodium fusidate, ofloxacin and control groups, respectively (p = 0.13). S. aureus grew less frequently (p 0.50). The corresponding figures for exit-site eradication were 43%, 33% and 11%, respectively (p = 0.34). Twenty-four S. aureus-associated infection episodes (12 of exit-site and 12 of peritonitis) were diagnosed in 16 of the 31 patients.(ABSTRACT TRUNCATED AT 250 WORDS) PMID:8076441

  4. Intracellular persisting Staphylococcus aureus is the major pathogen in recurrent tonsillitis.

    Directory of Open Access Journals (Sweden)

    Andreas E Zautner

    Full Text Available BACKGROUND: The two major indications for tonsillectomy are recurrent tonsillitis (RT and peritonsillar abscess (PTA. Unlike PTAs, which are primarily treated surgically, RT is often cured by tonsillectomy only after a series of failed drug therapy attempts. Although the bacteriological background of RT has been studied, the reason for the lack of success of conservative therapeutic approaches is not well understood. METHODS: In a prospective study, tonsil specimens from 130 RT patients and 124 PTA patients were examined for the presence of extra- and intracellular bacteria using antibiotic protection assays. Staphylococcus aureus isolates from RT patients were characterized by pulsed-field gel electrophoresis (PFGE, spa-typing and MSCRAMM-gene-PCR. Their ability for biofilm formation was tested and their cell invasiveness was confirmed by a flow cytometric invasion assay (FACS, fluorescent in situ hybridization (FISH and immunohistochemistry. FINDINGS: S. aureus was the predominant species (57.7% in RT patients, whereas Streptococcus pyogenes was most prevalent (20.2% in PTA patients. Three different assays (FACS, FISH, antibiotic protection assay showed that nearly all RT-associated S. aureus strains were located inside tonsillar cells. Correspondingly, the results of the MSCRAMM-gene-PCRs confirmed that 87% of these S. aureus isolates were invasive strains and not mere colonizers. Based upon PFGE analyses of genomic DNA and on spa-gene typing the vast majority of the S. aureus isolates belonged to different clonal lineages. CONCLUSIONS: Our results demonstrate that intracellular residing S. aureus is the most common cause of RT and indicate that S. aureus uses this location to survive the effects of antibiotics and the host immune response. A German translation of the Abstract is provided as supplementary material (Abstract S1.

  5. Manual of Surgical Instruments

    Directory of Open Access Journals (Sweden)

    Olga Lidia Sánchez Sarría

    2014-10-01

    Full Text Available Surgical instruments are the group of tools used in surgical procedures. They are very expensive and sophisticated. Consequently, a standardized and meticulous care is essential; they should go through the decontamination, cleaning and sterilization process. These instruments are designed in order to provide surgeons with tools that help them to perform a basic surgical procedure; there are multiple variations and the design depends on their function. This paper aims at showing all surgical instruments that can be used in an operating room during surgery and are not generally included in the medical literature.

  6. Risk factors of surgical site infection in post-thoracotomy incision%剖胸术后手术部位感染的危险因素调查分析

    Institute of Scientific and Technical Information of China (English)

    秦颖; 谢金兰; 孙俊; 石纯娟; 钱巧珍

    2011-01-01

    OBJECTIVE To study on the direct risk factors of surgical site infection in post-thoracotomy incision.METHODS The clinic medical records collected from Jan 2006 to Dec 2008 in cardiothoracic surgery were retrospectively investigated, check in and verify the cases. RESULTS There were 91 cases with infected surgical site infection among 1755 thoracotomy cases. The infection rate was 5.2%. Among these, rate of superficial incision was 62. 64% while that of deep incision was 30. 77% and rate of organ compartment was 6.59%.Multiple-variation logistic regression analysis indicated that the major factors were emergency admission (P=0.02), duration of operation(P=0.00), number of drainage(P=0. 044), duration of drainage(P=0. 018),kinds of antibiotic used(P<0.005). CONCLUSION In order to prevent and control SSI, we should strengthen the sterile operation, shorten the duration of operation, use antibiotic prophylaxis rationally and remove the drains as soon as possible.%目的 调查分析剖胸术后手术部位感染的危险因素.方法 回顾性调查2006年1月1日-2008年12月31日某三甲医院心胸外科出院病历.对手术部位感染病例进行登记核实.结果 手术部位感染91例,感染发生率为5.19%,表浅切口感染占62.64%,深部切口感染占30.77%,器官腔隙感染占6.59%;多因素logistic回归分析急诊人院(P=0.02)、手术持续时间(P=0.00)、术后引流管留置个数(P=0.044)、术后引流管留置时间(P=0.018)、术后预防用药种类(P=0.012)是手术部位感染的主要危险因素(P<0.05),与手术部位感染呈正相关.结论 加强无菌技术操作、缩短手术时间、术后尽早拔除引流管,合理预防性使用抗菌药物,可有效预防和控制手术部位感染.

  7. Immunomodulation and Disease Tolerance to Staphylococcus aureus

    OpenAIRE

    Zhigang Li; Peres, Adam G.; Andreea C. Damian; Joaquín Madrenas

    2015-01-01

    The Gram-positive bacterium Staphylococcus aureus is one of the most frequent pathogens that causes severe morbidity and mortality throughout the world. S. aureus can infect skin and soft tissues or become invasive leading to diseases such as pneumonia, endocarditis, sepsis or toxic shock syndrome. In contrast, S. aureus is also a common commensal microbe and is often part of the human nasal microbiome without causing any apparent disease. In this review, we explore the immunomodulation and d...

  8. A systematic review and meta-analysis including GRADE qualification of the risk of surgical site infections after prophylactic negative pressure wound therapy compared with conventional dressings in clean and contaminated surgery

    Science.gov (United States)

    De Vries, Fleur E.E.; Wallert, Elon D.; Solomkin, Joseph S.; Allegranzi, Benedetta; Egger, Matthias; Dellinger, E. Patchen; Boermeester, Marja A.

    2016-01-01

    Abstract Objective: Systematically review and Grading of Recommendations Assessment, Development, and Evaluation (GRADE) studies on prophylactic negative pressure wound therapy (pNPWT) to prevent surgical site infections (SSIs). Introduction: pNPWT has been suggested as a new method to prevent wound complications, specifically SSIs, by its application on closed incisional wounds. Methods: This review was conducted as part of the development of the Global Guidelines for prevention of SSIs commissioned by World Health Organization in Geneva. PubMed, Embase, CENTRAL, CINAHL, and the World Health Organization database between January 1, 1990 and October 7, 2015 were searched. Inclusion criteria were randomized controlled trials and observational studies comparing pNPWT with conventional wound dressings and reporting on the incidence of SSI. Meta-analyses were performed with a random effect model. GRADE Pro software was used to qualify the evidence. Results: Nineteen articles describing 21 studies (6 randomized controlled trials and 15 observational) were included in the review. Summary estimate showed a significant benefit of pNPWT over conventional wound dressings in reducing SSIs in both randomized controlled trials and observational studies, odds ratio of 0.56 (95% confidence interval, 0.32–0.96; P = 0.04) and odds ratio of 0.30 (95% confidence interval, 0.22–0.42; P contaminated procedures and in different types of surgery, however results were no longer significant for orthopaedic/trauma surgery. The level of evidence as qualified with GRADE was however low. Conclusions: Low-quality evidence indicates that prophylactic NPWT significantly reduces the risk of SSIs. PMID:27603360

  9. 不同皮肤准备方法术后切口感染的研究及预防%Prospective study on the effect of different methods of preoperative skin prepara-tion on surgical site infection and the implications for infection prevention

    Institute of Scientific and Technical Information of China (English)

    刘德秀; 王正芸; 李家瑜

    2014-01-01

    析差异有统计学意义(P <0.01),A 因素(剃毛与否)单因素分析差异无统计学意义(P >0.05);B 与 C、A 与 C 之间存在交互作用(P <0.01),A 与 B 之间无交互作用(P >0.05);A、B、C 之间存在二级交互作用(P <0.01)。结论手术前皮肤准备对于术后切口感染预防具有重要意义。在进行术前备皮时,应优先考虑皮肤清洁,大量肥皂水或消毒水冲洗,彻底杀灭皮肤表面暂居致病菌;同时缩短备皮准备时间,减少细菌在皮肤表面的繁殖,预防切口感染;在保证术野清洁的前提下,尽量减少皮肤损伤,可以考虑剪毛或使用脱毛剂脱毛等方式,无须剃毛。%Objective To examine the correlation betwee different methods of preoperative skin preparation and post-operative surgical site infections and propose scientific,effective,and convenient measures for infection control.Methods The factorial design in this study considered three possible factors of post-operative surgical site infections,including factor A (shaving), factor B (way of cleaning),factor C (timing of skin preparation).There were 8 combinations in the design.The incidence of infection was analyzed for the total patients and each specificied group based on factors A,B,C.Results A total of 1 802 inpa-tients were included in this investigation.Infection was identified in 146 (8.1%)patients,including 80 (8.2%)of the 978 pa-tients undergoing type I operation,66 (8.0%)of the 824 patients receiving type II operation (P >0.05).Microbiological pathogens were identified for 65 patients.The top three pathogens were Staphylococcus aureus (22.5% ),Pseudomonas aeruginosa (15.3%)and Escherichia coli (13.9%).The surgical site infections were mainly seen in gastrointestinal tract surgery (42, 10.3%), followed by orthopedic operation (37, 10.1%).The incidence of surgical site infections was significantly different between groups (χ2 = 24.540,P

  10. Immunomodulation and Disease Tolerance to Staphylococcus aureus

    Directory of Open Access Journals (Sweden)

    Zhigang Li

    2015-11-01

    Full Text Available The Gram-positive bacterium Staphylococcus aureus is one of the most frequent pathogens that causes severe morbidity and mortality throughout the world. S. aureus can infect skin and soft tissues or become invasive leading to diseases such as pneumonia, endocarditis, sepsis or toxic shock syndrome. In contrast, S. aureus is also a common commensal microbe and is often part of the human nasal microbiome without causing any apparent disease. In this review, we explore the immunomodulation and disease tolerance mechanisms that promote commensalism to S. aureus.

  11. Mastite com lesões sistêmicas por Staphylococus aureus subesp. aureus em coelhos Mastitis with systemic lesions due to Staphylococus aureus subesp. aureus in rabbits

    OpenAIRE

    Sandra Davi Traverso; Leonardo da Cunha; Joaquim César Teixeira Fernandes; Alexandre Paulino Loretti; Adriana Rhoden; Elsio Wunder Jr.; David Driemeier

    2003-01-01

    Em uma criação composta por 1800 coelhos, 33% das matrizes apresentaram mastite e lesões cutâneas crostosas e purulentas. Estes animais apresentavam-se entre 10 a- 12 meses de idade e em segunda parição. Quinze coelhos afetados foram sacrificados e necropsiados. Na necropsia, além das lesões cutâneas haviam microabscessos em diversos órgãos. Das amostras coletadas isolou-se Staphylococcus aureus subesp. aureus. S. aureus subesp. aureus também foi isolado de "swab" nasal coletado do tratador e...

  12. Methicillin-Resistant Staphylococcus aureus (MRSA) Treatment

    Science.gov (United States)

    ... Laboratory of Bacteriology Network on Antimicrobial Resistance in Staphylococcus aureus (NARSA) Antibacterial Resistance Leadership Group (ARLG) NIAID Antimicrobial Resistance Funding Information ...

  13. Methicillin-Resistant Staphylococcus aureus (MRSA) Diagnosis

    Science.gov (United States)

    ... Laboratory of Bacteriology Network on Antimicrobial Resistance in Staphylococcus aureus (NARSA) Antibacterial Resistance Leadership Group (ARLG) NIAID Antimicrobial Resistance Funding Information ...

  14. Mild Staphylococcus aureus Skin Infection Improves the Course of Subsequent Endogenous S. aureus Bacteremia in Mice.

    Directory of Open Access Journals (Sweden)

    Sanne van den Berg

    Full Text Available Staphylococcus aureus carriers with S. aureus bacteremia may have a reduced mortality risk compared to non-carriers. A role for the immune system is suggested. Here, we study in mice the effect of mild S. aureus skin infection prior to endogenous or exogenous S. aureus bacteremia, and evaluate protection in relation to anti-staphylococcal antibody levels. Skin infections once or twice by a clinical S. aureus isolate (isolate P or S. aureus strain 8325-4 were induced in mice free of S. aureus and anti-staphylococcal antibodies. Five weeks later, immunoglobulin G (IgG levels in blood against 25 S. aureus antigens were determined, and LD50 or LD100 bacteremia caused by S. aureus isolate P was induced. S. aureus skin infections led to elevated levels of anti-staphylococcal IgG in blood. One skin infection improved the course of subsequent severe endogenous bacteremia only. A second skin infection further improved animal survival rate, which was associated with increased pre-bacteremia IgG levels against Efb, IsaA, LukD, LukE, Nuc, PrsA and WTA. In conclusion, S. aureus isolate P skin infection in mice reduces the severity of subsequent endogenous S. aureus bacteremia only. Although cellular immune effects cannot be rules out, anti-staphylococcal IgG against specified antigens may contribute to this effect.

  15. Surgical ethics and the challenge of surgical innovation.

    Science.gov (United States)

    Angelos, Peter

    2014-12-01

    Surgical ethics as a specific discipline is relatively new to many. Surgical ethics focuses on the ethical issues that are particularly important to the care of surgical patients. Informed consent for surgical procedures, the level of responsibility that surgeons feel for their patients' outcomes, and the management of surgical innovation are specific issues that are important in surgical ethics and are different from other areas of medicine. The future of surgical progress is dependent on surgical innovation, yet the nature of surgical innovation raises specific concerns that challenge the professionalism of surgeons. These concerns will be considered in the following pages.

  16. Characterisation of Staphylococcus aureus bacteraemia at Tygerberg hospital

    NARCIS (Netherlands)

    Orth, H.; Dreyer, Z.S.; Makgotlho, E.; Oosthuysen, W.; Sinha, B.; Wasserman, E.

    2013-01-01

    To elucidate the local epidemiology of Staphylococcus aureus bacteraemia, we characterised blood culture isolates using molecular methods and prospectively collected clinical data to determine the occurrence of community-acquired, methicillinresistant S. aureus (MRSA). Consecutive S. aureus blood cu

  17. Glycerol monolaurate and dodecylglycerol effects on Staphylococcus aureus and toxic shock syndrome toxin-1 in vitro and in vivo.

    Directory of Open Access Journals (Sweden)

    Ying-Chi Lin

    Full Text Available Glycerol monolaurate (GML, a 12 carbon fatty acid monoester, inhibits Staphylococcus aureus growth and exotoxin production, but is degraded by S. aureus lipase. Therefore, dodecylglycerol (DDG, a 12 carbon fatty acid monoether, was compared in vitro and in vivo to GML for its effects on S. aureus growth, exotoxin production, and stability.Antimicrobial effects of GML and DDG (0 to 500 microg/ml on 54 clinical isolates of S. aureus, including pulsed-field gel electrophoresis (PFGE types USA200, USA300, and USA400, were determined in vitro. A rabbit Wiffle ball infection model assessed GML and DDG (1 mg/ml instilled into the Wiffle ball every other day effects on S. aureus (MN8 growth (inoculum 3x10(8 CFU/ml, toxic shock syndrome toxin-1 (TSST-1 production, tumor necrosis factor-alpha (TNF-alpha concentrations and mortality over 7 days. DDG (50 and 100 microg/ml inhibited S. aureus growth in vitro more effectively than GML (p<0.01 and was stable to lipase degradation. Unlike GML, DDG inhibition of TSST-1 was dependent on S. aureus growth. GML-treated (4 of 5; 80% and DDG-treated rabbits (2 of 5; 40% survived after 7 days. Control rabbits (5 of 5; 100% succumbed by day 4. GML suppressed TNF-alpha at the infection site on day 7; however, DDG did not (<10 ng/ml versus 80 ng/ml, respectively.These data suggest that DDG was stable to S. aureus lipase and inhibited S. aureus growth at lower concentrations than GML in vitro. However, in vivo GML was more effective than DDG by reducing mortality, and suppressing TNF-alpha, S. aureus growth and exotoxin production, which may reduce toxic shock syndrome. GML is proposed as a more effective anti-staphylococcal topical anti-infective candidate than DDG, despite its potential degradation by S. aureus lipase.

  18. Recognizing surgical patterns

    NARCIS (Netherlands)

    Bouarfa, L.

    2012-01-01

    In the Netherlands, each year over 1700 patients die from preventable surgical errors. Numerous initiatives to improve surgical practice have had some impact, but problems persist. Despite the introduction of checklists and protocols, patient safety in surgery remains a continuing challenge. This is

  19. Surgical medical record

    DEFF Research Database (Denmark)

    Bulow, S.

    2008-01-01

    A medical record is presented on the basis of selected linguistic pearls collected over the years from surgical case records Udgivelsesdato: 2008/12/15......A medical record is presented on the basis of selected linguistic pearls collected over the years from surgical case records Udgivelsesdato: 2008/12/15...

  20. Evaluation of Two New Chromogenic Media, CHROMagar MRSA and S. aureus ID, for Identifying Staphylococcus aureus and Screening Methicillin-Resistant S. aureus

    OpenAIRE

    Hedin, Göran; Fang, Hong

    2005-01-01

    Thirty-nine methicillin-resistant Staphylococcus aureus (MRSA) isolates with diverse genetic backgrounds and two reference strains were correctly identified as S. aureus on CHROMagar MRSA and S. aureus ID media. Growth inhibition on CHROMagar MRSA was noted. A combination of cefoxitin disk and S. aureus ID was found suitable for rapid MRSA screening.

  1. 开腹胆道探查术后手术部位感染危险因素的Logistic分析%Risk factors of surgical site infection in patients with choledochotomy:a Logistic analysis

    Institute of Scientific and Technical Information of China (English)

    何彦安; 丁辉; 蔡铭; 曾勇; 杨传松

    2014-01-01

    Objective: To explore the risk factors of surgical site infection in patients with choledochotomy. Methods:The clinic data of 184 patients with choledochotomy from January 2009 to July 2012 were retrospectively analyzed. All patients were divided into SSI group (29 patients) and non-SSI group (155 patients). Risk factors influencing the incidence of SSI were determined by analyzing of 17 relevant factors with one-way analysis of variance (ANOVA) and Logistic multivariate regression analysis. Results: The result of univariate analysis revealed that cholangitis, location of stone, diabetes, duration of jaundice, surgical procedures and bile bacteria culture were correlated with SSI (X2=23.395, 19.089, 3.935, 25.422, 12.483, 20.4921, P<0.05). The result of multivariate analysis revealed that cholangitis, location of stone, duration of jaundice and bile bacteria culture were the independant risk factors of SSI (Wald=7.235, 7.386, 1.818, 13.999, P<0.05). Conclusion:Cholangitis, location of stone, duration of jaundice and bile bacteria culture are main risk factors of SSI in patients with choledochotomy.%目的:分析胆管结石患者开腹胆道术后手术部位感染(SSI)的危险因素。方法:回顾性分析2009年1月至2012年7月我院184例行开腹胆道手术患者的临床资料,根据是否发生SSI分为SSI组(29例)和无SSI组(155例)。对可能与SSI发现有关的17个因素进行单因素分析及Logistic回归多因素分析,从而判定影响手术部位感染发生的危险因素。结果:单因素分析结果显示,合并胆管炎、结石部位、糖尿病、黄疸持续天数、手术方式、胆汁细菌培养情况与胆道术后SSI的发生相关(字2=23.395、19.089、3.935、25.422、12.483、20.4921, P<0.05)。多因素分析结果显示合并胆管炎、结石部位、术前黄疸天数、胆汁细菌培养情况是SSI发生的独立危险因素(Wald=7.235、7.386、1.818、13.999, P<0.05)。结论

  2. Community-acquired methicillin-resistant Staphylococcus aureus pyomyositis with myelitis: A rare occurrence with diverse presentation

    Directory of Open Access Journals (Sweden)

    Kulkarni Girish

    2009-12-01

    Full Text Available Staphylococcus aureus is the most common bacterial pathogen implicated in pyomyositis. There are increasing reports of community-acquired methicillin-resistant Staphylococcus aureus (CA-MRSA infections. The present case report brings out the diverse clinical manifestations of MRSA infection in the form of paraspinal pyomyositis, myelitis, spinal osteomyelitis, and pneumonia. Molecular typing of the organism confirmed the diagnosis. Patient was successfully treated with vancomycin and surgical drainage. Consideration of the possibility of methicillin-resistance and appropriate antibiotic selection is vital in the treatment of serious community-acquired staphylococcal infections.

  3. Immunogenicity of toxins during Staphylococcus aureus infection

    NARCIS (Netherlands)

    N.J. Verkaik (Nelianne); O. Dauwalder (Olivier); K. Antri (Kenza); I. Boubekri (Ilhem); C.P. de Vogel (Corné); C. Badiou (Cédric); M. Bes (Michèle); F. Vandenesch (François); M. Tazir (Mohammed); H. Hooijkaas (Herbert); H.A. Verbrugh (Henri); A.F. van Belkum (Alex); J. Etienne (Jerome); G. Lina (Gérard); N. Ramdani-Bouguessa (Nadjia); W.J.B. van Wamel (Willem)

    2010-01-01

    textabstractAB - BACKGROUND: Toxins are important Staphylococcus aureus virulence factors, but little is known about their immunogenicity during infection. Here, additional insight is generated. METHODS: Serum samples from 206 S. aureus-infected patients and 201 hospital-admitted control subjects we

  4. The cell surface proteome of Staphylococcus aureus

    NARCIS (Netherlands)

    Dreisbach, Annette; van Dijl, Jan Maarten; Buist, Girbe

    2011-01-01

    The Gram-positive bacterium Staphylococcus aureus is a wide spread opportunistic pathogen that can cause a range of life-threatening diseases. To obtain a better understanding of the global mechanisms for pathogenesis and to identify novel targets for therapeutic interventions, the S. aureus proteom

  5. Population structure of Staphylococcus aureus in China

    NARCIS (Netherlands)

    Yan, Xiaomei

    2015-01-01

    The present PhD research was aimed at analysing the population structure of Staphylococcus aureus in China. Between 2000 and 2005 we found that patients from a single Chinese hospital showed increasing trends in antimicrobial resistance. Among methicillin-resistant S. aureus (MRSA), resistance again

  6. Lactobacillus reuteri protects epidermal keratinocytes from Staphylococcus aureus-induced cell death by competitive exclusion.

    Science.gov (United States)

    Prince, Tessa; McBain, Andrew J; O'Neill, Catherine A

    2012-08-01

    Recent studies have suggested that the topical application of probiotic bacteria can improve skin health or combat disease. We have utilized a primary human keratinocyte culture model to investigate whether probiotic bacteria can inhibit Staphylococcus aureus infection. Evaluation of the candidate probiotics Lactobacillus reuteri ATCC 55730, Lactobacillus rhamnosus AC413, and Lactobacillus salivarius UCC118 demonstrated that both L. reuteri and L. rhamnosus, but not L. salivarius, reduced S. aureus-induced keratinocyte cell death in both undifferentiated and differentiated keratinocytes. Keratinocyte survival was significantly higher if the probiotic was applied prior to (P 0.05). The protective effect of L. reuteri was not dependent on the elaboration of inhibitory substances such as lactic acid. L. reuteri inhibited adherence of S. aureus to keratinocytes by competitive exclusion (P = 0.026). L. salivarius UCC118, however, did not inhibit S. aureus from adhering to keratinocytes (P > 0.05) and did not protect keratinocyte viability. S. aureus utilizes the α5β1 integrin to adhere to keratinocytes, and blocking of this integrin resulted in a protective effect similar to that observed with probiotics (P = 0.03). This suggests that the protective mechanism for L. reuteri-mediated protection of keratinocytes was by competitive exclusion of the pathogen from its binding sites on the cells. Our results suggest that use of a topical probiotic prophylactically could inhibit the colonization of skin by S. aureus and thus aid in the prevention of infection. PMID:22582077

  7. Population Genomics of Reduced Vancomycin Susceptibility in Staphylococcus aureus.

    Science.gov (United States)

    Rishishwar, Lavanya; Kraft, Colleen S; Jordan, I King

    2016-01-01

    The increased prevalence of vancomycin-intermediate Staphylococcus aureus (VISA) is an emerging health care threat. Genome-based comparative methods hold great promise to uncover the genetic basis of the VISA phenotype, which remains obscure. S. aureus isolates were collected from a single individual that presented with recurrent staphylococcal bacteremia at three time points, and the isolates showed successively reduced levels of vancomycin susceptibility. A population genomic approach was taken to compare patient S. aureus isolates with decreasing vancomycin susceptibility across the three time points. To do this, patient isolates were sequenced to high coverage (~500×), and sequence reads were used to model site-specific allelic variation within and between isolate populations. Population genetic methods were then applied to evaluate the overall levels of variation across the three time points and to identify individual variants that show anomalous levels of allelic change between populations. A successive reduction in the overall levels of population genomic variation was observed across the three time points, consistent with a population bottleneck resulting from antibiotic treatment. Despite this overall reduction in variation, a number of individual mutations were swept to high frequency in the VISA population. These mutations were implicated as potentially involved in the VISA phenotype and interrogated with respect to their functional roles. This approach allowed us to identify a number of mutations previously implicated in VISA along with allelic changes within a novel class of genes, encoding LPXTG motif-containing cell-wall-anchoring proteins, which shed light on a novel mechanistic aspect of vancomycin resistance. IMPORTANCE The emergence and spread of antibiotic resistance among bacterial pathogens are two of the gravest threats to public health facing the world today. We report the development and application of a novel population genomic

  8. Multiscale Surgical Telerobots

    Energy Technology Data Exchange (ETDEWEB)

    Miles, R R; Seward, K P; Benett, W J; Tendick, F; Bentley, L; Stephan, P L

    2002-01-23

    A project was undertaken to improve robotic surgical tools for telerobotic minimally invasive surgery. The major objectives were to reduce the size of the tools to permit new surgical procedures in confined spaces such as the heart and to improve control of surgical tools by locating positional sensors and actuators at the end effector rather than external to the patient as is currently the state of the technology. A new compact end-effector with wrist-like flexibility was designed. Positional sensors based on MEMS microfabrication techniques were designed.

  9. 胸部手术后手术部位感染的危险因素调查%Survey on Risk Factors of Surgical Site Infection in Post-thoracotomy Surgery

    Institute of Scientific and Technical Information of China (English)

    刘维维; 华莎

    2013-01-01

    Objective To analyze the risk factors of surgical site infection (SSI) in post - thoracotomy incision. Methods A total of 1,964 patients' medical records of cardiothoracic surgery were analyzed and the patients with SSI in post - thoracotomy incision were registered and verified. The 1:1 ratio method was applied to select the uninfected patients in the same period, and then the related factors of SSI were surveyed and analyzed. Results There were 89 patients with SSI among 1,964 thoracotomy cases, with the infection rate of 4.53 % . Multiple - variation Logistic regression analysis indicated that the risk factors for SSI were emergency admission (P = 0.019), duration of operation (P = 0.000), the number of postoperative drainage tubes (P = 0.043 ) , duration of postoperative drainage tube (P = 0.021), and various kinds of postoperative preventive medication (P = 0.014). Conclusions SSI can be effectively prevented by strengthening the sterile operation, shortening the duration of operation, removing the drainage tubes as soon as possible and using antibiotics rationally.%目的 分析剖胸术后手术部位感染(SSI)的危险因素.方法 分析心胸外科出院病历1 964例,对剖胸术后SSI患者病例进行登记核实.对SSI患者与同期住院未感染者按1:1配比法进行SSI相关因素的调查分析.结果 在1964例出院病历中,发生SSI患者病历89例,感染发生率为4.53%.通过多因素Logistic回归分析结果显示,急诊入院(P=0.019)、手术时间(P=0.000)、术后引流管留置个数(P=0.043)、术后引流管留置时间(P =0.021)、术后预防用药种类(P=0.014)是SSI发生的危险因素.结论 通过加强无菌技术操作、缩短手术时间、术后尽早拔除引流管以及合理使用抗生素能有效预防SSI的发生.

  10. Ambulatory Surgical Measures - State

    Data.gov (United States)

    U.S. Department of Health & Human Services — The Ambulatory Surgical Center Quality Reporting (ASCQR) Program seeks to make care safer and more efficient through quality reporting. ASCs eligible for this...

  11. Ambulatory Surgical Measures - National

    Data.gov (United States)

    U.S. Department of Health & Human Services — The Ambulatory Surgical Center Quality Reporting (ASCQR) Program seeks to make care safer and more efficient through quality reporting. ASCs eligible for this...

  12. Ambulatory Surgical Measures - Facility

    Data.gov (United States)

    U.S. Department of Health & Human Services — The Ambulatory Surgical Center Quality Reporting (ASCQR) Program seeks to make care safer and more efficient through quality reporting. ASCs eligible for this...

  13. Surgical Critical Care Initiative

    Data.gov (United States)

    Federal Laboratory Consortium — The Surgical Critical Care Initiative (SC2i) is a USU research program established in October 2013 to develop, translate, and validate biology-driven critical care....

  14. Multicenter survey on risk factors for surgical site infection following limb fracture surgery%四肢骨折手术部位感染危险因素多中心调查

    Institute of Scientific and Technical Information of China (English)

    芦永华; 黄新玲; 何文英; 先疆燕

    2016-01-01

    目的:探讨四肢骨折术后手术部位感染(SSI)的相关危险因素,为制定合理的预防控制措施提供依据。方法收集2014年1月1日—6月30日16所医院1453例接受四肢骨折手术患者的临床资料,进行单因素及多因素 logistic 回归分析。结果1453例四肢骨折手术患者,发生 SSI 12例,SSI 发生率为0.83%。单因素分析结果显示,术前7 d 是否存在其他部位感染、损伤至手术的时间、手术时机、手术持续时间、开放性骨折、切口类型及麻醉类型是四肢骨折 SSI 的危险因素(均 P <0.05)。多因素 logistic 回归分析结果显示,切口类型、麻醉类型、开放性骨折、损伤至手术的时间及手术持续时间是四肢骨折术后 SSI 的独立危险因素,其 OR 及95% CI 分别为12.47(2.78~15.88)、11.55(2.84~17.02)、10.79(2.72~11.13)、2.35(2.12~6.81)、3.07(1.88~4.13)。结论四肢骨折术后 SSI 是多因素综合作用所致,识别危险因素,加强重点环节管理,是预防和控制手术部位感染的关键。%Objective To evaluate the risk factors for surgical site infection(SSI)following limb fracture surgery, and provide basis for making prevention and control measures.Methods Clinical data of 1 453 patients undergoing limb fracture surgery in 16 hospitals between January 1,2014 and June 30,2014 were collected,risk factors for SSI were analyzed by univariate and multivariate logistic regression analysis.Results Among 1 453 patients undergoing limb fracture surgery,12 developed SSI(0.83%).Univariate analysis showed that risk factors for SSI following limb fracture surgery were infection at the other sites 7 days before operation,time from injury to operation,opera-tion opportunity, duration of operation,open fracture, wound type, and anesthesia type ( all P < 0.05 ). Multivariate logistic regression analysis showed that independent risk

  15. 2010年北京地区全髋关节置换术手术部位感染目标性监测分析%Targeted monitoring of surgical site infections after total hip arthroplasty in Beijing in 2010

    Institute of Scientific and Technical Information of China (English)

    钟群杰; 林剑浩; 武迎宏

    2012-01-01

    目的 通过分析2010年北京地区全髋关节置换术手术部位感染目标性监测数据,探讨全髋关节置换术手术部位感染率及危险因素,并间接评价手术部位感染导致的经济损失.方法 该研究数据来自北京医院感染监控管理系统,2010年1-12月对北京地区的39所医院的714例全髋关节置换术进行前瞻性研究,采用SPSS 12.0软件对与手术部位感染相关的危险因素进行单因素以及多因素logistic回归分析,并且采用MannWhitney检验比较感染组与未感染组住院日的差异.结果 714例初次全髋关节置换术患者术后SSI发生率为2.24%;多因素logistic回归分析显示,手术医院级别、手术后进入ICU、糖尿病以及手术前住院日是全髋关节置换术手术部位感染发生的危险因素;感染组(中位数31.0 d)与未感染组(中位数16.9 d)的住院日比较,差异有统计学意义(P<0.05).结论 北京地区全髋关节置换术手术部位感染发生率与欧美国家的类似;手术部位感染所造成的经济损失将越来越受到重视,对SSI进行目标性监测有助于降低医疗体制所承受的巨大经济损失;全髋关节置换术手术部位感染的发生是多因素的综合,必须采取综合性的预防措施才能有效降低其发生率.%OBJECTIVE To explore the surgical site infection rate and the risk factors and estimate the economic loss due to surgical site infections indirectly by analyzing data from targeted monitoring of surgical site infections after total hip arthroplasty in 2010. METHODS A total of 714 patients who underwent total hip replacements from 39 hospitals in Beijing were monitored prospectively by Beijing Nosocomial Infection Surveillance System from Jan 2010 to Dec 2010. Univariate and multivariate logistic analysis of all related risk factors for surgical site infections were analyzed with statistical software SPSS 12. 0. At the same time, the total hospital stay between

  16. 泌尿外科后腹腔镜手术后切口感染分析%Clinical Analysis of Surgical Site Infection of Retroperitoneal Laparoscopy in Urinary Surgery

    Institute of Scientific and Technical Information of China (English)

    卓晖; 徐何; 李强; 熊黎强

    2016-01-01

    目的:分析泌尿外科后腹腔镜手术后术区感染的原因,以期优化围手术期的流程(术前准备、术中操作、术后管理等),提高手术操作技巧,降低术后感染率。方法:对2013年1月至2015年1月行后腹腔镜手术患者的临床资料进行回顾性分析。第1组:2013年1月至2013年12月,共38例,后腹膜腔术后感染行二次手术清除感染灶者6例(肾囊肿2例,肾上腺瘤2例,无功能肾1例,肾癌1例);第2组:2014年1月至2015年1月,共47例,后腹膜腔感染行二次手术清除感染灶者3例(肾癌1例,肾囊肿1例,肾上腺瘤1例)。寻找第1组手术患者感染的相关因素。对第2组手术患者进行改进,包括优化围手术期的流程,治疗患者术前尿路感染,控制血糖,强化手术操作技能训练,缩短手术时间,减少术中、术后出血,避免或减少一次性植入性材料(止血胶、血管夹)的使用,剔除可控的潜在感染因素。比较2组患者术后发生感染的差异。结果:第1组术后感染率为15畅7%,第2组术后感染率为6畅38%,2组比较有显著性差异( P<0畅05)。结论:对泌尿外科后腹腔镜手术后术区感染患者进行根因性分析,找到引起感染的可能因素,并针对性地规范围手术期流程,加强质量控制,减少易感因素,从而降低术后感染发生率。%Objective:To analyse the reasons of surgical site infection of retroperitoneal laparoscopy;to optimize the perioperative process ( preoperative preparation, operation, postoperative management );to improve the operative skill;toreduce operation infection rates.Methods:The clinical data of patients with retroperitoneal laparoscopy were retrospectively analysed. Finded infection related factors of the previous group,than optimized operation process,treated urinary tract infection and glycemic control,strengthened operation skills training

  17. Rapid Detection of Methicillin-Resistant Staphylococcus aureus Directly from Sterile or Nonsterile Clinical Samples by a New Molecular Assay

    OpenAIRE

    Francois, Patrice; Pittet, Didier; Bento, Manuela; Pepey, Béatrice; Vaudaux, Pierre; Lew, Daniel; Schrenzel, Jacques

    2003-01-01

    A rapid procedure was developed for detection and identification of methicillin-resistant Staphylococcus aureus (MRSA) directly from sterile sites or mixed flora samples (e.g., nose or inguinal swabs). After a rapid conditioning of samples, the method consists of two main steps: (i) immunomagnetic enrichment in S. aureus and (ii) amplification-detection profile on DNA extracts using multiplex quantitative PCR (5′-exonuclease qPCR, TaqMan). The triplex qPCR assay measures simultaneously the fo...

  18. Immunization routes in cattle impact the levels and neutralizing capacity of antibodies induced against S. aureus immune evasion proteins

    OpenAIRE

    Boerhout, Eveline; Vrieling, Manouk; Benedictus, Lindert; Daemen, Ineke; Ravesloot, Lars; Rutten, Victor; Nuijten, Piet; Van Strijp, Jos; Koets, Ad; Eisenberg, Susanne

    2015-01-01

    Vaccines against S. aureus bovine mastitis are scarce and show limited protection only. All currently available vaccines are applied via the parenteral (usually intramuscular) route. It is unknown, however, whether this route is the most suitable to specifically increase intramammary immunity to combat S. aureus at the site of infection. Hence, in the present study, immunization via mucosal (intranasal; IN), intramuscular (triangle of the neck; IM), intramammary (IMM) and subcutaneous (suspen...

  19. Comparative structural and functional analysis of staphylococcus aureus glucokinase with other bacterial glucokinases

    Directory of Open Access Journals (Sweden)

    P S Kumar

    2014-01-01

    Full Text Available Glucokinase is classified in bacteria based upon having ATP binding site and ′repressor/open reading frames of unknown function/sugar kinases′ motif, the sequence of glucokinase gene (JN645812 of Staphylococcus aureus ATCC12600 showed presence of ATP binding site and ′repressor/open reading frames of unknown function/sugar kinases′ motif. We have earlier observed glucokinase of S. aureus has higher affinity towards the substrate compared to other bacterial glucokinase and under anaerobic condition with increased glucose concentration S. aureus exhibited higher rate of biofilm formation. To establish this, 3D structure of glucokinase was built using homology modeling method, the PROCHECK and ProSA-Web analysis indicated this built glucokinase structure was close to the crystal structure. This structure was superimposed with different bacterial glucokinase structures and from the root-mean-square deviation values, it is concluded that S. aureus glucokinase exhibited very close homology with Enterococcus faecalis and Clostridium difficle while with other bacteria it showed high degree of variations both in domain and nondomain regions. Glucose docking results indicated -12.3697 kcal/mol for S. aureus glucokinase compared with other bacterial glucokinase suggesting higher affinity of glucose which correlates with enzyme kinetics and higher rate of biofilm formation.

  20. Genomic Analysis of Companion Rabbit Staphylococcus aureus.

    Science.gov (United States)

    Holmes, Mark A; Harrison, Ewan M; Fisher, Elizabeth A; Graham, Elizabeth M; Parkhill, Julian; Foster, Geoffrey; Paterson, Gavin K

    2016-01-01

    In addition to being an important human pathogen, Staphylococcus aureus is able to cause a variety of infections in numerous other host species. While the S. aureus strains causing infection in several of these hosts have been well characterised, this is not the case for companion rabbits (Oryctolagus cuniculus), where little data are available on S. aureus strains from this host. To address this deficiency we have performed antimicrobial susceptibility testing and genome sequencing on a collection of S. aureus isolates from companion rabbits. The findings show a diverse S. aureus population is able to cause infection in this host, and while antimicrobial resistance was uncommon, the isolates possess a range of known and putative virulence factors consistent with a diverse clinical presentation in companion rabbits including severe abscesses. We additionally show that companion rabbit isolates carry polymorphisms within dltB as described as underlying host-adaption of S. aureus to farmed rabbits. The availability of S. aureus genome sequences from companion rabbits provides an important aid to understanding the pathogenesis of disease in this host and in the clinical management and surveillance of these infections. PMID:26963381

  1. 21 CFR 866.3700 - Staphylococcus aureus serological reagents.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Staphylococcus aureus serological reagents. 866... Staphylococcus aureus serological reagents. (a) Identification. Staphylococcus aureus serological reagents are... epidemiological information on these diseases. Certain strains of Staphylococcus aureus produce an...

  2. Exfoliative Toxins of Staphylococcus aureus

    Directory of Open Access Journals (Sweden)

    Michal Bukowski

    2010-05-01

    Full Text Available Staphylococcus aureus is an important pathogen of humans and livestock. It causes a diverse array of diseases, ranging from relatively harmless localized skin infections to life-threatening systemic conditions. Among multiple virulence factors, staphylococci secrete several exotoxins directly associated with particular disease symptoms. These include toxic shock syndrome toxin 1 (TSST-1, enterotoxins, and exfoliative toxins (ETs. The latter are particularly interesting as the sole agents responsible for staphylococcal scalded skin syndrome (SSSS, a disease predominantly affecting infants and characterized by the loss of superficial skin layers, dehydration, and secondary infections. The molecular basis of the clinical symptoms of SSSS is well understood. ETs are serine proteases with high substrate specificity, which selectively recognize and hydrolyze desmosomal proteins in the skin. The fascinating road leading to the discovery of ETs as the agents responsible for SSSS and the characterization of the molecular mechanism of their action, including recent advances in the field, are reviewed in this article.

  3. [Staphylococcus aureus and antibiotic resistance].

    Science.gov (United States)

    Sancak, Banu

    2011-07-01

    After the report of first case of methicillin-resistant Staphylococcus aureus (MRSA) in 1961, MRSA become a major problem worldwide. Over the last decade MRSA strains have emerged as serious pathogens in nosocomial and community settings. Glycopeptides (vancomycin and teicoplanin) are still the current mainstay of therapy for infections caused by MRSA. In the last decade dramatic changes have occurred in the epidemiology of MRSA infections. The isolates with reduced susceptibility and in vitro resistance to vancomycin have emerged. Recently, therapeutic alternatives such as quinupristin/dalfopristin, linezolid, tigecycline and daptomycin have been introduced into clinical practice for treating MRSA infections. Nevertheless, these drugs are only approved for certain indication and resistance has already been reported. In this review, the new information on novel drugs for treating MRSA infections and the resistance mechanisms of these drugs were discussed. PMID:21935792

  4. The Heme Sensor System of Staphylococcus aureus

    OpenAIRE

    Stauff, Devin L; Skaar, Eric P.

    2009-01-01

    The important human pathogen Staphylococcus aureus is able to satisfy its nutrient iron requirement by acquiring heme from host hemoglobin in the context of infection. However, heme acquisition exposes S. aureus to heme toxicity. In order to detect the presence of toxic levels of exogenous heme, S. aureus is able to sense heme through the heme sensing system (HssRS) two-component system. Upon sensing heme, HssRS directly regulates the expression of the heme-regulated ABC transporter HrtAB, wh...

  5. Laboratory Maintenance of Methicillin-Resistant Staphylococcus aureus (MRSA)

    OpenAIRE

    Nicholas P Vitko; Richardson, Anthony R.

    2013-01-01

    Staphylococcus aureus is an important bacterial pathogen in the hospital and community settings, especially Staphylococcus aureus clones that exhibit methicillin-resistance (MRSA). Many strains of S. aureus are utilized in the laboratory, underscoring the genetic differences inherent in clinical isolates. S. aureus grows quickly at 37°C with aeration in rich media (e.g. BHI) and exhibits a preference for glycolytic carbon sources. Furthermore, S. aureus has a gold pigmentation, exhibits β-hem...

  6. The single-species metagenome: subtyping Staphylococcus aureus core genome sequences from shotgun metagenomic data

    Science.gov (United States)

    Li, Ben; Petit III, Robert A.; Qin, Zhaohui S.; Darrow, Lyndsey

    2016-01-01

    In this study we developed a genome-based method for detecting Staphylococcus aureus subtypes from metagenome shotgun sequence data. We used a binomial mixture model and the coverage counts at >100,000 known S. aureus SNP (single nucleotide polymorphism) sites derived from prior comparative genomic analysis to estimate the proportion of 40 subtypes in metagenome samples. We were able to obtain >87% sensitivity and >94% specificity at 0.025X coverage for S. aureus. We found that 321 and 149 metagenome samples from the Human Microbiome Project and metaSUB analysis of the New York City subway, respectively, contained S. aureus at genome coverage >0.025. In both projects, CC8 and CC30 were the most common S. aureus clonal complexes encountered. We found evidence that the subtype composition at different body sites of the same individual were more similar than random sampling and more limited evidence that certain body sites were enriched for particular subtypes. One surprising finding was the apparent high frequency of CC398, a lineage often associated with livestock, in samples from the tongue dorsum. Epidemiologic analysis of the HMP subject population suggested that high BMI (body mass index) and health insurance are possibly associated with S. aureus carriage but there was limited power to identify factors linked to carriage of even the most common subtype. In the NYC subway data, we found a small signal of geographic distance affecting subtype clustering but other unknown factors influence taxonomic distribution of the species around the city. PMID:27781166

  7. Mastite com lesões sistêmicas por Staphylococus aureus subesp. aureus em coelhos

    OpenAIRE

    Traverso Sandra Davi; Cunha Leonardo da; Fernandes Joaquim César Teixeira; Loretti Alexandre Paulino; Rhoden Adriana; Wunder Jr. Elsio; Driemeier David

    2003-01-01

    Em uma criação composta por 1800 coelhos, 33% das matrizes apresentaram mastite e lesões cutâneas crostosas e purulentas. Estes animais apresentavam-se entre 10 a- 12 meses de idade e em segunda parição. Quinze coelhos afetados foram sacrificados e necropsiados. Na necropsia, além das lesões cutâneas haviam microabscessos em diversos órgãos. Das amostras coletadas isolou-se Staphylococcus aureus subesp. aureus. S. aureus subesp. aureus também foi isolado de "swab" nasal coletado do tratador e...

  8. Correlation between hypothermia during perioperative period of intestinal surgery and surgical site infections%肠道手术围术期低体温与手术部位感染关系研究

    Institute of Scientific and Technical Information of China (English)

    郑彩娟

    2013-01-01

    目的 探讨结肠及直肠手术患者围手术期低体温与手术部位感染(SSI)之间的关系,以降低SSI发生率.方法 选取2010年10月-2012年5月收治的190例结肠及直肠手术患者为研究对象,随机分为研究组和对照组各95例,研究组患者在常规护理基础上加以保温措施,对照组仅进行常规护理,比较两组低体温和SSI的发生率,总结两者的关系.结果 研究组患者低体温发生率为0,SSI发生率7.37%,对照组患者低体温发生率为98.95%,SSI发生率18.95%,研究组低体温和SSI发生率明显低于对照组,差异有统计学意义(P<0.05),体温越高SSI发生率越低,切口恢复与体温高低成正比.结论 结肠及直肠手术患者SSI发生率与低体温有关,围手术期施以保温措施干预,可以减少低体温的发生,降低SSI的发生率.%OBJECTIVE To explore the relationship between the perioperative hypothermia in the colon and rectal surgery patients and the surgical site infections (SSI) so as to reduce the incidence of SSI.METHODS A total of 190 patients,who underwent colon and rectal surgery in the hospital from Oct 2010 to May 2012,were selected as the study objects and were randomly divided into the study group and the control group with 95 cases in each.The patients in the study group were treated with the insulation measures on the basis of routine care,while the patients in the control group were only given the routine nursing,then the incidence of hypothermia or the SSI was compared between the two groups,and the relationship between the two was observed.RESULTS The incidence of hypothermia was 0% in the study group,significantly lower than 98.95% of the control group; the incidence of SSI was 7.37% in the study group,significantly lower than 18.95% of the control group,the difference in the incidence of hypothermia or SSI between the study group and the control group was statistically significant.The higher the body temperature,the lower

  9. Univariate and multivariate factor logistic regression analysis on surgical site infection after hepatic surgery%肝胆手术患者手术部位感染相关因素logistic回归分析

    Institute of Scientific and Technical Information of China (English)

    郝金霞; 王春红; 王洪刚

    2015-01-01

    目的:研究肝胆手术患者手术部位感染(SSI)的影响因素,为预防SSI的临床措施提供参考。方法选取2012年1月-2014年1月医院212例接受肝胆手术治疗患者的临床资料,回顾性分析其 SSI发生率,并使用SPSS19.0统计软件对SSI进行单因素及多因素 logistic模型分析。结果212例肝胆手术患者SSI发生率为11.79%;单因素分析显示,住院时间、血清白蛋白、手术方式、手术持续时长、切口类型和长度、手术中出血量、术后引流管留置时间及术后并发症是SSI发生的相关因素,而 logistic回归分析结果表明,术后出现脂肪液化和切口裂开等并发症,手术持续时长及术后引流管留置时间是其独立危险因素。结论肝胆手术患者发生SSI ,应采取综合性的预防措施,避免多因素共同导致的SSI发生,才能有效降低其感染率,改善患者预后。%OBJECTIVE To study the risk factors for surgical site infections (SSI) in patients with hepatobiliary op‐erations ,so as to provide the clinical basis for preventing SSI .METHODS The completeclinical data of 212 patients who underwent the hepatobiliary surgery were retrospectively investigated ,and the related factors for hepatobili‐ary SSI were analyzed with univariate and multivariate factor logistic regression model by SPSS19 .0 .RESULTS The infection rate of SSI after hepatic surgery was 11 .79 % .Single factor analysis showed that time of hospitaliza‐tion ,serum albumin ,operation methods ,length of operation ,incision types and length ,amount of bleeding dur‐ing operations ,time of indwelling of drainage tube post‐operation and postoperative complications were related fac‐tors for SSI .Logistic regression analysis showed that complications such as fat liquefaction and disruption of wound , length of surgeries and postoperative indwelling of drainage tube were independent risk factors . CONCLUSION Comprehensive

  10. 骨科Ⅰ类切口手术部位感染流行的调查与控制%Investigation and control on the epidemic of surgical site infection follow-ing clean wound operation in orthopedics patients

    Institute of Scientific and Technical Information of China (English)

    张京利; 王力红; 马文晖; 赵霞; 赵会杰

    2014-01-01

    Objective To explore the investigation and control method for the epidemic of surgical site infection (SSI)in a hospital.Methods Data of orthopedics patients receiving clean wound orthopedics operation were ana-lyzed retrospectively,and effective measures were taken to control the epidemic of HAI.Results From June to August 2012,a total of 312 patients received clean wound orthopedics operation,7 (2.24%)SSI cases occurred.SSI rates during the same period from 2009 to 2012 were significantly different(P <0.05),and was the highest in 2012. HAI management staff reviewed patients’medical records,communicated with staff in orthopedics department,and put forward advice for SSI control;orthopedics department worked out and implemented detailed infection control measures.The subsequent surveillance showed that the prevalence of SSI in orthopedics ward decreased to 0.38%, infection outbreak was effectively controlled.Conclusion HAI management department played an important role in the finding and control of HAI outbreak.Scientific analysis on monitored data and proper measures adopted by HAI management department and clinical department can effectively control HAI outbreak.%目的:探讨某院手术部位感染(SSI)暴发流行的调查与控制方法。方法对骨科Ⅰ类切口手术患者资料进行回顾性调查分析,并采取干预措施,控制医院感染的暴发流行。结果2012年6-8月该院骨科Ⅰ类切口手术患者312例,发生 SSI 7例,SSI 发病率为2.24%。2009-2012年同期Ⅰ类切口 SSI 发病率比较,差异有统计学意义(P <0.05),其中2012年 SSI 发病率最高。通过病例调查,医院感染管理科分析感染可能原因,并与骨科沟通,提出7项整改要求;骨科制定18项 SSI 防控细则并切实执行。后续追踪结果显示,2012年9-11月,该科 SSI发病率为0.38%,回落至正常水平,此次 SSI 流行得到有效控制。结论医院感染管理部门对及时

  11. Monitoring on surgical site infection and risk factors for clean wound orthopedic surgery%骨科清洁切口手术部位感染监测及危险因素

    Institute of Scientific and Technical Information of China (English)

    王清妍; 范学辉; 韩月欣; 董智勇

    2015-01-01

    Objective To investigate the incidence and risk factors for surgical site infection (SSI)in clean wound orthopedics surgery.Methods SSI among patients receiving clean wound orthopedic surgery from April 1 to Sep-tember 30 in 2014 were monitored,risk factors for SSI were analyzed.Results A total of 665 patients were moni-tored,14 cases(2.11 %)of SSI occurred.Univariate analysis showed that types of skin,skin preparation modes, and ASA score were risk factors for SSI in clean wound orthopedic surgery (all P <0.05 ).Multivariate logistic analysis revealed that conventional skin preparation,ASA score ≥ grade Ⅱ,and duration of operation ≥90 minutes were independent risk factors for SSI in patients receiving clean wound orthopedic surgery (OR [95%CI ],3.96 [1 .07-14.70],6.45[1 .97-21 .11],and 4.08[1 .35 -12.30]respectively).Conclusion The improved method of skin preparation,grade I ASA score,and shortening duration of operation can reduce the incidence of SSI in clean wound orthopedic surgery,on the basis of improving the autoimmunization of patients,strengthening prevention and control of healthcare-associated infection can reduce the incidence of SSI in clean wound orthopedic surgery.%目的:了解骨科清洁切口手术部位感染(SSI)发病率和 SSI 危险因素。方法对某院2014年4月1日—9月30日实施骨科清洁手术的患者进行 SSI 监测,分析其危险因素。结果共监测患者665例,发生 SSI 14例,SSI发病率为2.11%。单因素分析结果显示,手术类型、皮肤准备方法、ASA 评分和手术时间均是骨科清洁切口发生 SSI的危险因素(均 P <0.05)。多因素 logistic 分析结果显示:传统备皮法、ASA 评分Ⅱ级及以上、手术时间≥90 min 是骨科清洁手术患者发生 SSI 的独立危险因素[OR 及 OR95%CI 分别为3.96(1.07-14.70)、6.45(1.97-21.11)、4.08(1.35-12.30)]。结论改良备皮法、ASA 评分 I 级及手术持

  12. 胃结肠手术部位感染相关危险因素研究%Research on risk factors of surgical site infections of gastrocolic surgery

    Institute of Scientific and Technical Information of China (English)

    谢金兰; 秦颖; 石纯娟; 钱巧珍; 杨伟霞

    2011-01-01

    OBJECTIVE To explore the risk factors of gastrocolic surgical site infection(SSI) and providing basis on preventing and controlling measures on SSI. METHODS The occurrence of SSI was monitored, both single and multiple regression logistic analysis were executed with SPSS on the 25 variables like periods in hospital before surgery, glucose level, blood plasma albumin, fever before surgery, duration of operation, operating mode, ASA rating, endoscopy applying, blood loss and etc. RESULTS Among the sample of 502 gastrocolic surgeries, the occurring rate of SSI was 6. 17%, during which 24 (77. 4%) in hospital, 7 (22. 6%) after discharged from hospital. As the multiple regression analysis indicates: abnormal level of glucose (P= 0. 002), excessive time duration of operation( P = 0. 000), endoscopy application(P = 0. 032) constitute the main risk factors of SSI.CONCLUSION Multiple factors are caused by comprehensive effects, occurring rate of gastrocolic SSI can be decreased by targeted monitoring and clinical intervention.%目的 探讨胃结肠手术部位感染(SSI)的危险因素,为SSI的预防控制措施提供依据.方法 采用目标性监测的方法,研究胃结肠手术后SSI的发生,采用SPSS 10.0软件对其相关危险因素,如术前住院日、血糖、外周血血浆白蛋白、术前发热、手术持续时间、手术方式、ASA评分、内镜使用、失血量、术后引流管放置天数、入住ICU等25个变量进行单因素和多元logistic回归分析.结果 502例胃结肠手术后SSI发生率为6.17%,其中住院期间感染24例,感染率为77.4%,出院后随访感染7例,感染率为22.6%;多元logistic回归分析显示,血糖异常(P=0.002)、手术持续时间长(P=0.000)、内镜使用(P=0.032)是SSI发生的主要危险因素.结论 胃结肠SSI是多因素综合作用引起的,开展目标性监测加强对临床干预可促使医疗质量持续改进,降低SSI发生率.

  13. Prevalence and Risk Factors of Colonization with Staphylococcus aureus in Healthy Pet Cats Kept in the City Households

    Science.gov (United States)

    Płoneczka-Janeczko, Katarzyna; Rypuła, Krzysztof

    2016-01-01

    Staphylococcus aureus, especially methicillin-resistant S. aureus (MRSA), is a significant pathogen in both human medicine and veterinary medicine. The importance of pets as reservoirs of human infections is still poorly understood. This article provides detailed information of a cross-sectional study of a S. aureus colonization in clinically healthy indoor cats. The study systematically assessed a number of different anatomical locations for the S. aureus colonization and the influence of a range of potential risk factors on the value of the final S. aureus colonization rate. The incidence rates observed for cats with at least one site positive for S. aureus or MRSA were 17.5% and 6.63%, respectively. The following risk factors were identified: one or more owners working in the healthcare industry (human or veterinary); dogs being kept with the cat under investigation; treatment of the cat under investigation with antibiotics or chemotherapeutics during the previous year. In conclusion, this study revealed a higher prevalence of MRSA than what has previously been reported in healthy pets. A combination of anatomical locations from which the samples were collected had a major influence on the final value of the S. aureus colonization rate.

  14. Dynamics of the surgical microbiota along the cardiothoracic surgery pathway

    OpenAIRE

    Romano-Bertrand, Sara; Frapier, Jean-Marc; Calvet, Brigitte; Colson, Pascal; Albat, Bernard; Parer, Sylvie; Jumas-Bilak, Estelle

    2015-01-01

    Human skin associated microbiota are increasingly described by culture-independent methods that showed an unexpected diversity with variation correlated with several pathologies. A role of microbiota disequilibrium in infection occurrence is hypothesized, particularly in surgical site infections. We study the diversities of operative site microbiota and its dynamics during surgical pathway of patients undergoing coronary-artery by-pass graft (CABG). Pre-, per-, and post-operative samples were...

  15. Staphylococcus aureus spa type t437

    DEFF Research Database (Denmark)

    Glasner, C; Pluister, G; Westh, H;

    2015-01-01

    Methicillin-resistant Staphylococcus aureus (MRSA) belonging to the multilocus sequence type clonal complex 59 (MLST CC59) is the predominant community-associated MRSA clone in Asia. This clone, which is primarily linked with the spa type t437, has so far only been reported in low numbers among...... large epidemiological studies in Europe. Nevertheless, the overall numbers identified in some Northern European reference laboratories have increased during the past decade. To determine whether the S. aureus t437 clone is present in other European countries, and to assess its genetic diversity across...... Europe, we analysed 147 S. aureus t437 isolates from 11 European countries collected over a period of 11 years using multiple locus variable number tandem repeat fingerprinting/analysis (MLVF/MLVA) and MLST. Additionally 16 S. aureus t437 isolates from healthy carriers and patients from China were...

  16. Surgical management of presbyopia

    Directory of Open Access Journals (Sweden)

    Torricelli AA

    2012-09-01

    Full Text Available André AM Torricelli, Jackson B Junior, Marcony R Santhiago, Samir J BecharaDivision of Ophthalmology, University of São Paulo Medical School, São Paulo, BrazilAbstract: Presbyopia, the gradual loss of accommodation that becomes clinically significant during the fifth decade of life, is a physiologic inevitability. Different technologies are being pursued to achieve surgical correction of this disability; however, a number of limitations have prevented widespread acceptance of surgical presbyopia correction, such as optical and visual distortion, induced corneal ectasia, haze, anisometropy with monovision, regression of effect, decline in uncorrected distance vision, and the inherent risks with invasive techniques, limiting the development of an ideal solution. The correction of the presbyopia and the restoration of accommodation are considered the final frontier of refractive surgery. The purpose of this paper is to provide an update about current procedures available for presbyopia correction, their advantages, and disadvantages.Keywords: presbyopia, surgical correction, treatment

  17. The Staphylococcus aureus “superbug”

    OpenAIRE

    FOSTER, TIMOTHY JAMES

    2004-01-01

    PUBLISHED There has been some debate about the disease-invoking potential of Staphylococcus aureus strains and whether invasive disease is associated with particularly virulent genotypes, or "superbugs." A study in this issue of the JCI describes the genotyping of a large collection of nonclinical, commensal S. aureus strains from healthy individuals in a Dutch population. Extensive study of their genetic relatedness by amplified restriction fragment typing and comparison with strains that...

  18. Transmissible mupirocin resistance in Staphylococcus aureus.

    OpenAIRE

    Rahman, M.; Noble, W. C.; Cookson, B

    1989-01-01

    The spread of two strains of Staphylococcus aureus with high level resistance to mupirocin is described. The resistance proved to be easily transferred to other S. aureus strains by filter mating experiments and on the skin of mice. No plasmid band corresponding to the resistance could be demonstrated by agarose gel electrophoresis or by caesium chloride gradient centrifugation but cleavage of 'chromosomal' DNA from resistant recipients showed bright bands of DNA absent from sensitive controls.

  19. Anxiety in veterinary surgical students

    DEFF Research Database (Denmark)

    Langebæk, Rikke; Eika, Berit; Jensen, Asger Lundorff;

    2012-01-01

    The surgical educational environment is potentially stressful and this can negatively affect students' learning. The aim of this study was to investigate whether veterinary students' level of anxiety is higher in a surgical course than in a non-surgical course and if pre-surgical training...... in a Surgical Skills Lab (SSL) has an anxiety reducing effect. Investigations were carried out as a comparative study and a parallel group study. Potential participants were fourth-year veterinary students who attended a surgical course (Basic Surgical Skills) and a non-surgical course (Clinical Examination...... Skills); both courses were offered in multiple classes (with a total of 171 students in 2009 and 156 students in 2010). All classes in 2009 participated in the SSL stage of the Basic Surgical Skills course before performing live-animal surgery, and one class (28 students) in 2010 did not. Two validated...

  20. Low Fluid Shear Culture of Staphylococcus Aureus Represses hfq Expression and Induces an Attachment-Independent Biofilm Phenotype

    Science.gov (United States)

    Ott, C. Mark; Castro, S. L.; Nickerson, C. A.; Nelman-Gonzalez, M.

    2011-01-01

    Background: The opportunistic pathogen, Staphylococcus aureus, experiences fluctuations in fluid shear during infection and colonization of a human host. Colonization frequently occurs at mucus membrane sites such as in the gastrointestinal tract where the bacterium may experience low levels of fluid shear. The response of S. aureus to low fluid shear remains unclear. Methods: S. aureus was cultured to stationary phase using Rotating-Wall Vessel (RWV) bioreactors which produce a physiologically relevant low fluid shear environment. The bacterial aggregates that developed in the RWV were evaluated by electron microscopy as well as for antibiotic resistance and other virulence-associated stressors. Genetic expression profiles for the low-shear cultured S. aureus were determined by microarray analysis and quantitative real-time PCR. Results: Planktonic S. aureus cultures in the low-shear environment formed aggregates completely encased in high amounts of extracellular polymeric substances. In addition, these aggregates demonstrated increased antibiotic resistance indicating attachment-independent biofilm formation. Carotenoid production in the low-shear cultured S. aureus was significantly decreased, and these cultures displayed an increased susceptibility to oxidative stress and killing by whole blood. The hfq gene, associated with low-shear growth in Gram negative organisms, was also found to be down-regulated in S. aureus. Conclusions: Collectively, this data suggests that S. aureus decreases virulence characteristics in favor of a biofilm-dwelling colonization phenotype in response to a low fluid shear environment. Furthermore, the identification of an Hfq response to low-shear culture in S. aureus, in addition to the previously reported responses in Gram negative organisms, strongly suggests an evolutionarily conserved response to mechanical stimuli among structurally diverse prokaryotes.

  1. Staphylococcus aureus-induced G2/M phase transition delay in host epithelial cells increases bacterial infective efficiency.

    Science.gov (United States)

    Alekseeva, Ludmila; Rault, Lucie; Almeida, Sintia; Legembre, Patrick; Edmond, Valérie; Azevedo, Vasco; Miyoshi, Anderson; Even, Sergine; Taieb, Frédéric; Arlot-Bonnemains, Yannick; Le Loir, Yves; Berkova, Nadia

    2013-01-01

    Staphylococcus aureus is a highly versatile, opportunistic pathogen and the etiological agent of a wide range of infections in humans and warm-blooded animals. The epithelial surface is its principal site of colonization and infection. In this work, we investigated the cytopathic effect of S. aureus strains from human and animal origins and their ability to affect the host cell cycle in human HeLa and bovine MAC-T epithelial cell lines. S. aureus invasion slowed down cell proliferation and induced a cytopathic effect, resulting in the enlargement of host cells. A dramatic decrease in the number of mitotic cells was observed in the infected cultures. Flow cytometry analysis revealed an S. aureus-induced delay in the G2/M phase transition in synchronous HeLa cells. This delay required the presence of live S. aureus since the addition of the heat-killed bacteria did not alter the cell cycle. The results of Western blot experiments showed that the G2/M transition delay was associated with the accumulation of inactive cyclin-dependent kinase Cdk1, a key inducer of mitosis entry, and with the accumulation of unphosphorylated histone H3, which was correlated with a reduction of the mitotic cell number. Analysis of S. aureus proliferation in asynchronous, G1- and G2-phase-enriched HeLa cells showed that the G2 phase was preferential for bacterial infective efficiency, suggesting that the G2 phase delay may be used by S. aureus for propagation within the host. Taken together, our results divulge the potential of S. aureus in the subversion of key cellular processes such as cell cycle progression, and shed light on the biological significance of S. aureus-induced host cell cycle alteration.

  2. Staphylococcus aureus-induced G2/M phase transition delay in host epithelial cells increases bacterial infective efficiency.

    Directory of Open Access Journals (Sweden)

    Ludmila Alekseeva

    Full Text Available Staphylococcus aureus is a highly versatile, opportunistic pathogen and the etiological agent of a wide range of infections in humans and warm-blooded animals. The epithelial surface is its principal site of colonization and infection. In this work, we investigated the cytopathic effect of S. aureus strains from human and animal origins and their ability to affect the host cell cycle in human HeLa and bovine MAC-T epithelial cell lines. S. aureus invasion slowed down cell proliferation and induced a cytopathic effect, resulting in the enlargement of host cells. A dramatic decrease in the number of mitotic cells was observed in the infected cultures. Flow cytometry analysis revealed an S. aureus-induced delay in the G2/M phase transition in synchronous HeLa cells. This delay required the presence of live S. aureus since the addition of the heat-killed bacteria did not alter the cell cycle. The results of Western blot experiments showed that the G2/M transition delay was associated with the accumulation of inactive cyclin-dependent kinase Cdk1, a key inducer of mitosis entry, and with the accumulation of unphosphorylated histone H3, which was correlated with a reduction of the mitotic cell number. Analysis of S. aureus proliferation in asynchronous, G1- and G2-phase-enriched HeLa cells showed that the G2 phase was preferential for bacterial infective efficiency, suggesting that the G2 phase delay may be used by S. aureus for propagation within the host. Taken together, our results divulge the potential of S. aureus in the subversion of key cellular processes such as cell cycle progression, and shed light on the biological significance of S. aureus-induced host cell cycle alteration.

  3. Surgical management of diabetic foot and role of UT (University of Texas) classification

    International Nuclear Information System (INIS)

    To evaluate the role of University of Texas Classification in the management of Diabetic foot. Design: Descriptive study Place and Duration of Study: Surgical unit II Combined Military Hospital Rawalpindi (2003 to 2008) and Department of Surgery Combined Military Hospital Peshawar (July 2008 to Jan 2010). Patients and Method: A total of 300 patients who reported to Surgical Department with a foot ulcer or infection and diagnosed to have Diabetes Mellitus were studied. Patients of both gender and age >12 years were included. Patients of end stage renal disease, compromised immunity or on steroid therapy were excluded. Detailed history and clinical examination were recorded. Routine investigations including complete blood examination, urine routine examination, renal function tests, x-ray foot, chest x-ray, ECG and pus for culture and sensitivity were recorded. Lesions were classified according to University of Texas classification and treated accordingly. Results: Majority of the patients were of 50 to 70 years age group. Male to female ratio was 4:1. Big toe was the commonest site followed by fore foot and heel. Patients were classified according to UT classification. Patients were managed with antibiotics, dressings, incision and drainage, debridement, vacuum assisted closure (VAC) with or without skin grafting and amputations of different types. Staphylococcus aureus was the commonest isolate. Conclusion: Our study has shown that UT classification is an effective system of assessing the severity of Diabetic foot at the time of presentation and planning its management. Amputation rates, time of healing and morbidity increases with increasing stage and grade. (author)

  4. Eradication of Staphylococcus aureus Catheter-Related Biofilm Infections Using ML:8 and Citrox.

    Science.gov (United States)

    Hogan, S; Zapotoczna, M; Stevens, N T; Humphreys, H; O'Gara, J P; O'Neill, E

    2016-10-01

    Staphylococci are a leading cause of catheter-related infections (CRIs) due to biofilm formation. CRIs are typically managed by either device removal or systemic antibiotics, often in combination with catheter lock solutions (CLSs). CLSs provide high concentrations of the antimicrobial agent at the site of infection. However, the most effective CLSs against staphylococcal biofilm-associated infections have yet to be determined. The purpose of this study was to evaluate the efficacy and suitability of two newly described antimicrobial agents, ML:8 and Citrox, as CLSs against Staphylococcus aureus biofilms. ML:8 (1% [vol/vol]) and Citrox (1% [vol/vol]), containing caprylic acid and flavonoids, respectively, were used to treat S. aureus biofilms grown in vitro using newly described static and flow biofilm assays. Both agents reduced biofilm viability >97% after 24 h of treatment. Using a rat model of CRI, ML:8 was shown to inactivate early-stage S. aureus biofilms in vivo, while Citrox inactivated established, mature in vivo biofilms. Cytotoxicity and hemolytic activity of ML:8 and Citrox were equivalent to those of other commercially available CLSs. Neither ML:8 nor Citrox induced a cytokine response in human whole blood, and exposure of S. aureus to either agent for 90 days was not associated with any increase in resistance. Taken together, these data reveal the therapeutic potential of these agents for the treatment of S. aureus catheter-related biofilm infections. PMID:27458213

  5. Surgical infections with Mycoplasma

    DEFF Research Database (Denmark)

    Levi-Mazloum, Niels Donald; Prag, Jørgen Brorson; Jensen, J S;

    1997-01-01

    Mycoplasma hominis and Ureaplasma urealyticum are common inhabitants of the human genital tract. Evidence for an aetiological role in pyelonephritis, pelvic inflammatory disease, post-abortion and post-partum fever has been presented. There are sporadic reports of Mycoplasma causing serious extra...... extragenital infection such as septicemia, septic arthritis, neonatal meningitis and encephalitis. We review 38 cases of surgical infections with Mycoplasma....

  6. Surgical wound care

    Science.gov (United States)

    ... F for more than 4 hours Alternate Names Surgical incision care; Open wound care Images Proper hand washing References Lynn PB. Cleaning a wound and applying a dry, sterile dressing. In: Lynn PB. Taylor’s Handbook of Nursing Skills . Philadelphia, PA: Lippincott Williams and Wilkins, Wolters ...

  7. Ancient Egyptian surgical heritage.

    Science.gov (United States)

    Saber, Aly

    2010-12-01

    Egyptian medicine influenced the medicine of neighboring cultures, including the culture of ancient Greece. From Greece, its influence spread onward, thereby affecting Western civilization significantly. The oldest extant Egyptian medical texts are six papyri: The Edwin Smith Surgical Papyrus and the Ebers Medical Papyrus are famous. PMID:21208098

  8. Purification of Staphylococcus aureus beta-lactamases by using sequential cation-exchange and affinity chromatography.

    OpenAIRE

    Kernodle, D S; Zygmunt, D J; McGraw, P A; Chipley, J R

    1990-01-01

    Boronic acids are active-site inhibitors of serine beta-lactamases, and a phenylboronic acid-agarose affinity column has been used to purify beta-lactamase from crude cell extracts of several bacterial species. We applied phenylboronic acid-agarose chromatography to the purification of Staphylococcus aureus beta-lactamase. Two factors interfered with the success of the previously described single-step chromatographic protocol. First, staphylococcal beta-lactamase exhibited non-active-site-med...

  9. Carotenoid Formation by Staphylococcus aureus

    Science.gov (United States)

    Hammond, Ray K.; White, David C.

    1970-01-01

    The carotenoid pigments of Staphylococcus aureus U-71 were identified as phytoene; ζ-carotene; δ-carotene; phytofluenol; a phytofluenol-like carotenoid, rubixanthin; and three rubixanthin-like carotenoids after extraction, saponification, chromatographic separation, and determination of their absorption spectra. There was no evidence of carotenoid esters or glycoside ethers in the extract before saponification. During the aerobic growth cycle the total carotenoids increased from 45 to 1,000 nmoles per g (dry weight), with the greatest increases in the polar, hydroxylated carotenoids. During the anaerobic growth cycle, the total carotenoids increased from 20 nmoles per g (dry weight) to 80 nmoles per g (dry weight), and only traces of the polar carotenoids were formed. Light had no effect on carotenoid synthesis. About 0.14% of the mevalonate-2-14C added to the culture was incorporated into the carotenoids during each bacterial doubling. The total carotenoids did not lose radioactivity when grown in the absence of 14C for 2.5 bacterial doublings. The total carotenoids did not lose radioactivity when grown in the absence of 14C for 2.5 bacterial doublings. The incorporation and turnover of 14C indicated the carotenes were sequentially desaturated and hydroxylated to form the polar carotenoids. PMID:5423369

  10. Complete Genome Sequence of the Quality Control Strain Staphylococcus aureus subsp. aureus ATCC 25923.

    Science.gov (United States)

    Treangen, Todd J; Maybank, Rosslyn A; Enke, Sana; Friss, Mary Beth; Diviak, Lynn F; Karaolis, David K R; Koren, Sergey; Ondov, Brian; Phillippy, Adam M; Bergman, Nicholas H; Rosovitz, M J

    2014-01-01

    Staphylococcus aureus subsp. aureus ATCC 25923 is commonly used as a control strain for susceptibility testing to antibiotics and as a quality control strain for commercial products. We present the completed genome sequence for the strain, consisting of the chromosome and a 27.5-kb plasmid. PMID:25377701

  11. Complete Genome Sequence of the Quality Control Strain Staphylococcus aureus subsp. aureus ATCC 25923

    OpenAIRE

    Todd J. Treangen; Maybank, Rosslyn A.; Enke, Sana; Friss, Mary Beth; Diviak, Lynn F.; Karaolis, David K. R.; Koren, Sergey; Ondov, Brian; Phillippy, Adam M.; Bergman, Nicholas H.; Rosovitz, M. J.

    2014-01-01

    Staphylococcus aureus subsp. aureus ATCC 25923 is commonly used as a control strain for susceptibility testing to antibiotics and as a quality control strain for commercial products. We present the completed genome sequence for the strain, consisting of the chromosome and a 27.5-kb plasmid.

  12. Treatment of the positive surgical margin following radical prostatectomy

    Institute of Scientific and Technical Information of China (English)

    2008-01-01

    Objective With increased incidence of prostate cancer and an increased number of patients undergoing radical prostatectomy in China,it will be necessary to elaborate the diagnosis,clinical significance and treatment of patients whose tumors have positive surgical margins following radical prostatectomy.Data sources Positive surgical margin,prostate cancer and radical prostatectomy were used as subject words and the medical literature in recent decades was searched using the PubMed database and the results are summarized.Study selection Using positive surgical margin,prostate cancer and radical prostatectomy as subject words the PubMed medical database produced 275 papers of pertinent literature.By further screening 28 papers were selected and they represent relatively large-scale clinical randomized and controlled clinical trials.Results A pertinent literature of 275 papers was identified and 28 papers on large clinical studies were obtained.Analysis of results indicated that the positive rate of surgical margin after radical prostatectomy is 20%-40%,and although most patients with positive surgical margins are stable for a considerable period,the data available now suggested that the presence of a positive surgical margin will have an impact on the patient's prognosis.The risk factors of positive surgical margin include preoperative prostate specific antigen level,Gleason's score and pelvic lymph node metastasis.The most common site with positive surgical margin is in apical areas of the prostate;therefore surgical technique is also a factor resulting in positive surgical margins.From data available now it appears that as long as the surgical technique is skilled,different surgical modes do not affect the rate of surgical margin.Adjuvant radiotherapy is mainly used to treat patients with positive surgical margin after radical prostatectomy,but combination with androgen deprivation therapy may increase the curative effect.Conclusion The current data indicated that

  13. Potassium Uptake Modulates Staphylococcus aureus Metabolism.

    Science.gov (United States)

    Gries, Casey M; Sadykov, Marat R; Bulock, Logan L; Chaudhari, Sujata S; Thomas, Vinai C; Bose, Jeffrey L; Bayles, Kenneth W

    2016-01-01

    As a leading cause of community-associated and nosocomial infections, Staphylococcus aureus requires sophisticated mechanisms that function to maintain cellular homeostasis in response to its exposure to changing environmental conditions. The adaptation to stress and maintenance of homeostasis depend largely on membrane activity, including supporting electrochemical gradients and synthesis of ATP. This is largely achieved through potassium (K(+)) transport, which plays an essential role in maintaining chemiosmotic homeostasis, affects antimicrobial resistance, and contributes to fitness in vivo. Here, we report that S. aureus Ktr-mediated K(+) uptake is necessary for maintaining cytoplasmic pH and the establishment of a proton motive force. Metabolite analyses revealed that K(+) deficiency affects both metabolic and energy states of S. aureus by impairing oxidative phosphorylation and directing carbon flux toward substrate-level phosphorylation. Taken together, these results underline the importance of K(+) uptake in maintaining essential components of S. aureus metabolism. IMPORTANCE Previous studies describing mechanisms for K(+) uptake in S. aureus revealed that the Ktr-mediated K(+) transport system was required for normal growth under alkaline conditions but not under neutral or acidic conditions. This work focuses on the effect of K(+) uptake on S. aureus metabolism, including intracellular pH and carbon flux, and is the first to utilize a pH-dependent green fluorescent protein (GFP) to measure S. aureus cytoplasmic pH. These studies highlight the role of K(+) uptake in supporting proton efflux under alkaline conditions and uncover a critical role for K(+) uptake in establishing efficient carbon utilization. PMID:27340697

  14. Baerere af Staphylococcus aureus som kilde til hospitalsinfektioner. Epidemiologiske og profylaktiske aspekter

    DEFF Research Database (Denmark)

    Kolmos, H J

    1999-01-01

    20% of the normal population are nasal carriers of Staphylococcus aureus (Sa), and the carrier rate is even higher in insulin dependent diabetics, intravenous drug addicts, patients on haemo- and peritoneal dialysis, and HIV infected patients. Nasal Sa carriers have an increased risk of Sa...... infections following invasive therapy. Mupirocin, a novel topical antibiotic, is highly effective against nasal Sa. A number of studies indicate that it may reduce the incidence of Sa infections in dialysis patients, however experience with other categories of patients is sparse. Surgical wound infection...

  15. Effect of composite temperature-keeping measures for reducing surgical site infections in elderly patients%复合保温对降低老年患者手术部位感染的效果分析

    Institute of Scientific and Technical Information of China (English)

    周学颖; 赵峰; 王萃; 周乐

    2016-01-01

    目的 探讨老年腹部手术患者术中低体温与手术部位感染(SSI)的相关性,分析术中低体温发生的原因,研究复合保温措施对降低老年腹部手术患者术中低体温发生率、降低SSI发生率的干预效果,为临床应用提供依据.方法 选取医院2014年5-10月择期行腹部外科手术的老年患者240例为研究对象,采用随机分组,将研究对象分为观察组和对照组,每组120例,对照组患者术中采用常规保温措施,观察组患者术中采用复合保温措施;记录两组患者麻醉前、麻醉后30、60、120、180 min、手术结束时的体温,观察并记录两组患者SSI发生率;应用SPSS 19.0统计软件对所收集的数据进行整理分析.结果 对照组患者在麻醉后60、120、180 min、手术结束时体温均低于观察组患者,两组比较差异有统计学意义(P<0.05);对照组患者SSI感染率18.33%、手术结束时低体温发生率100.00%,观察组患者SSI感染率5.83%、手术结束时低体温发生率为0,两组比较差异有统计学意义(P<0.05).结论 老年腹部手术患者SSI的发生与术中低体温具有相关性,复合保温措施可有效降低术中低体温的发生率,进而降低患者SSI发生率,具有临床应用价值.%OBJECTIVE To explore the correlation between hypothermia and surgical site infections (SSI) during abdominal surgery for elderly patients ,analyze the causes of intraoperative hypothermia ,and investigate the inter-ventional effect of composite temperature-keeping measures on reducing the incidences of hypothermia and SSI in abdominal surgery for elderly patients ,so as to provide evidence for their clinical application .METHODS Totally 240 elderly patients who underwent elective abdominal surgery in the hospital during May to Oct .,2014 were se-lected as subjects ,and were randomized into observation group and control group ,120 patients in each group .Pa-tients in the control group received routine temperature

  16. Paired study of surgical site infections after the coronary artery bypass grafting surgery%冠状动脉旁路移植术后手术部位感染的配对研究

    Institute of Scientific and Technical Information of China (English)

    孟黎辉; 李夏明; 李京明; 施颖; 束冬兰; 武迎宏

    2013-01-01

    OBJECTIVE To assess the prophylactic use of antibiotics of the patients with surgical site infections (SSI) and the patients without the infections after the coronary artery bypass grafting(CABG) surgery and analyze some of the clinical indicators so as to guide the reasonable use of antibiotics.METHODS The prospective and targeted monitoring was carried out for the CABG surgeries which were undertaken in 9 hospitals of Beijing during 2008-2010; totally 62 cases of patients with SSI were selected as the SSI group,and 124 cases of patients without SSI were set as the control group.The clinical indicators such as the perioperative antibiotic prophylaxis,postoperative hemogram,and temperature were compared between the two groups.RESULTS The utilization rate of antibiotics was 100.0% in both the SSI group and the control group; the utilization rate of combined antibiotic prophylaxis was 81.42%% in the SSI group,79.29% in the control group; the duration of antibiotic prophylaxis was (11.18±1.12)d in the SSI group,(10.95 ± 0.98)d in the control group,the difference between the two groups was not statistically significant; the absolute value of WBC 24-48 h after the surgery was (18.2±0.48) in the SSI group,(17.9±0.92) in the control group; the body temperature 72 hours after the surgery was (37.8± 0.86) ℃ in the SSI group,(38.0±0.24)℃ in the control group,the difference between the two groups was not statistically significant.CONCLUSION The long term or combined use of antibiotics is not reliable for the prevention of SSI,and the elevated early WBC counts or the body temperature can not indicate the SSI significantly,which can not be one-sided used as the absolute indicators for the prevention of SSI,and it should be comprehensively diagnosed by combining other indicators.%目的 分析冠状动脉旁路移植术(CABG)后手术部位感染(SSI)患者和非感染患者的抗菌药物预防使用情况和部分临床指标,为合理使用

  17. Effect of antimicrobial-impregnated incise drape on preventing surgical site infection following neurosurgical operation%抗菌手术薄膜在预防神经外科手术部位感染效果研究

    Institute of Scientific and Technical Information of China (English)

    胡玲; 卢昌懿; 杨翠凤; 刘佳; 郭金友

    2015-01-01

    Objective To investigate the effect of antimicrobial-impregnated incise drape on preventing surgical site in-fection(SSI)following neurosurgical operation.Methods Patients undergoing neurosurgical operation from January to De-cember 2012 were divided into two groups:antimicrobial-impregnated incise drape group(group A)and general incise drape group(group B).The occurrence of SSI and risk factors for SSI were analyzed.Results Percentage of drape lifting at the wound edge in group A was lower than group B(38.3%[98/256]vs 96.88% [248/256],χ2 =200.57,P <0.01).Among 512 patients,SSI rate was 3.32%(n=17),SSI rate in group A was lower than group B(1.56%[4/256]vs 5.08%[13/256],χ2 = 7.93,P <0.05 ).Multivariate analysis revealed that body mass index ≥24,perioperative hypothermia,smok-ing,perioperative length of hospital stay ≥5 days,and lack of drape use were independent risk factors for SSI following neurosurgical operation.Conclusion Whether antimicrobial-impregnated incise drape is used in neurosurgical operation is one of the independent risk factors for SSI following neurosurgical operation,it can effectively reduce the drape lifting rate and incidence of SSI,and is recommended to be used in neurosurgical operation.%目的:了解抗菌手术薄膜对降低神经外科患者手术部位感染(SSI)的效果。方法将2012年1—12月某院神经外科病变手术患者分为使用抗菌手术薄膜组(A 组)和普通手术薄膜组(B 组),比较两组患者术后SSI 发生率,并进行危险因素分析。结果A 组患者术中手术切口薄膜起边率为38.3%(98/256),低于 B 组的96.88%(248/256),两组患者薄膜起边率比较,差异有统计学意义(χ2=200.57,P <0.01)。512例患者,发生 SSI 17例,发生率为3.32%,A 组患者 SSI 发生率为1.56%(4/256),低于 B 组的5.08%(13/256)(χ2=7.93,P <0.05)。神经外科 SSI 高危因素多因素分析

  18. [Surgical procedures for bone neoplasms in children].

    Science.gov (United States)

    Woźniak, W

    1991-01-01

    The treatment of 40 patients with bone tumors have been presented. The primary tumors were located in the following sites: femur (14), tibia (8), fibula (4), humerus (4), scapula (1), clavicle (2), pelvis (5), hand (1). Investigated group were: osteosarcoma (18), Ewing's sarcoma (14), chondrosarcoma (2), fibrosarcoma (1), synovial sarcoma (1), chondroblastoma (4). In the most frequent malignant bone tumors, osteosarcoma and Ewing's sarcoma, unified management was adapted. The treatment was initiated with multidrug chemotherapy and followed by surgery or radiotherapy (Ewing's sarcoma) of the primary site. Surgery was performed in 30 cases: 19 mutilating operations because of the broad local invasion, 11 conservative surgical procedures (limb -- salvage operations). Satisfactory oncological and functional effect can be achieved after limb-salvage surgical procedures in the cases of localized, especially semimalignant bone tumors. PMID:1369876

  19. Hepatic surgical anatomy.

    Science.gov (United States)

    Skandalakis, John E; Skandalakis, Lee J; Skandalakis, Panajiotis N; Mirilas, Petros

    2004-04-01

    The liver, the largest organ in the body, has been misunderstood at nearly all levels of organization, and there is a tendency to ignore details that do not fit the preconception. A complete presentation of the surgical anatomy of the liver includes the study of hepatic surfaces, margins, and fissures; the various classifications of lobes and segments; and the vasculature and lymphatics. A brief overview of the intrahepatic biliary tract is also presented.

  20. Louis Pasteur surgical revolution.

    Science.gov (United States)

    Toledo-Pereyra, Luis H

    2009-01-01

    Louis Pasteur (1822-1895) is considered the most notable medical scientist of his time and perhaps one of the most distinguished of all times in the history of medicine. From Dole in France to Paris, from a student of crystals to "living ferments," and from chemistry to biology and medicine, Pasteur changed the world for the benefit of humanity. The genius of Pasteur dealt with the most pressing issues of his time, basing the germ theory on the effects that microorganisms had on fermentation and putrefaction of organic matter, which gave birth to the science of bacteriology. Many other difficult problems in medicine and biology were tackled by Pasteur, culminating in the spectacular results seen with the treatment of rabies. Surgery was no exception to the scientific conquests of Pasteur. The transformation of the surgical world arose from the antiseptic concepts of Lister that were based on the germ theory of the disease, which had been derived from the germ theory of fermentation and putrefaction discovered by Pasteur. The acceptance of these principles represented the surgical revolution brought on by the science of Pasteur, a revolution that is now accepted in our daily care of surgical patients.

  1. Genomics of Natural Populations of Staphylococcus aureus.

    Science.gov (United States)

    Fitzgerald, J Ross; Holden, Matthew T G

    2016-09-01

    Staphylococcus aureus is a major human pathogen and an important cause of livestock infections. The first S. aureus genomes to be published, 15 years ago, provided the first view of genome structure and gene content. Since then, thousands of genomes from a wide array of strains from different sources have been sequenced. Comparison of these sequences has resulted in broad insights into population structure, bacterial evolution, clone emergence and expansion, and the molecular basis of niche adaptation. Furthermore, this information is now being applied clinically in outbreak investigations to inform infection control measures and to determine appropriate treatment regimens. In this review, we summarize some of the broad insights into S. aureus biology gained from the analysis of genomes and discuss future directions and opportunities in this dynamic field of research. PMID:27482738

  2. Genomics of Natural Populations of Staphylococcus aureus.

    Science.gov (United States)

    Fitzgerald, J Ross; Holden, Matthew T G

    2016-09-01

    Staphylococcus aureus is a major human pathogen and an important cause of livestock infections. The first S. aureus genomes to be published, 15 years ago, provided the first view of genome structure and gene content. Since then, thousands of genomes from a wide array of strains from different sources have been sequenced. Comparison of these sequences has resulted in broad insights into population structure, bacterial evolution, clone emergence and expansion, and the molecular basis of niche adaptation. Furthermore, this information is now being applied clinically in outbreak investigations to inform infection control measures and to determine appropriate treatment regimens. In this review, we summarize some of the broad insights into S. aureus biology gained from the analysis of genomes and discuss future directions and opportunities in this dynamic field of research.

  3. Antimicrobial (Drug) Resistance: Methicillin-Resistant Staphylococcus aureus (MRSA)

    Science.gov (United States)

    ... Marketing Share this: Main Content Area Methicillin-Resistant Staphylococcus aureus (MRSA) During the past four decades, methicillin-resistant Staphylococcus aureus , or MRSA, has evolved from a controllable ...

  4. Evolution of methicillin-resistant Staphylococcus aureus towards increasing resistance

    DEFF Research Database (Denmark)

    Strommenger, Birgit; Bartels, Mette Damkjær; Kurt, Kevin;

    2014-01-01

    To elucidate the evolutionary history of Staphylococcus aureus clonal complex (CC) 8, which encompasses several globally distributed epidemic lineages, including hospital-associated methicillin-resistant S. aureus (MRSA) and the highly prevalent community-associated MRSA clone USA300....

  5. Propionibacterium acnes biofilm - A sanctuary for Staphylococcus aureus?

    Science.gov (United States)

    Tyner, Harmony; Patel, Robin

    2016-08-01

    The purpose of this study was to measure the effect of combined culture of Propionibacterium acnes and Staphylococcus aureus on biofilm formation under different oxygen concentrations. We measured planktonic growth and biofilm formation of P. acnes and S. aureus alone and together under aerobic and anaerobic conditions. Both P. acnes and S. aureus grew under anaerobic conditions. When grown under anaerobic conditions, P. acnes with or without S. aureus formed a denser biomass biofilm than did S. aureus alone. Viable S. aureus was recovered from a16-day old combined P. acnes and S. aureus biofilm, but not a monomicrobial S. aureus biofilm.

  6. Prevalence of infective endocarditis in patients with Staphylococcus aureus bacteraemia

    DEFF Research Database (Denmark)

    Rasmussen, Rasmus V; Høst, Ulla; Arpi, Magnus;

    2011-01-01

    Aims Staphylococcus aureus infective endocarditis (IE) is a critical medical condition associated with a high morbidity and mortality. In the present study, we prospectively evaluated the importance of screening with echocardiography in an unselected S. aureus bacteraemia (SAB) population. Methods...

  7. Comparative Efficacy of Ceftaroline with Linezolid against Staphylococcus Aureus and Methicillin Resistant Staphylococcus Aureus

    International Nuclear Information System (INIS)

    Objective:To compare the in vitro antimicrobial efficacy of ceftaroline with linezolid against Staphylococcus aureus and methicillin resistant Staphylococcus aureus. Study Design: Quasi-experimental study. Place and Duration of Study: Microbiology Department, Army Medical College, Rawalpindi, from January to December 2013. Methodology: Clinical samples from respiratory tract, blood, pus and various catheter tips routinely received in the Department of Microbiology, Army Medical College, Rawalpindi were innoculated on blood and MacConkey agar. Staphylococcus aureus was identified by colony morphology, Gram reaction, catalase test and coagulase test. Methicillin resistant Staphylococcus aureus detection was done by modified Kirby Bauer disc diffusion method using cefoxitin disc (30g) and the isolates were considered methicillin resistant if the zone of inhibition around cefoxitin disc was /sup 2/ 21 mm. Bacterial suspensions of 56 Staphylococcus aureus isolates and 50 MRSA isolates were prepared, which were standardized equal to 0.5 McFarland's turbidity standard and inoculated on Mueller-Hinton agar plates followed by application of ceftaroline and linezolid disc (Oxoid, UK), according to manufacturer's instructions. The plates were then incubated at 37 Degree C aerobically for 18 - 24 hours. Diameters of inhibition zone were measured and interpretated as per Clinical and Laboratory Standards Institute (CLSI) guidelines. Results: Out of 106 isolates all of the 56 Staphylococcus aureus (100%) were sensitive to ceftaroline and linezolid. However, out of 50 methicillin resistant Staphylococcus aureus, 48 (96%) were sensitive to ceftaroline whereas, 49 (98%) were sensitive to linezolid. Conclusion: Ceftaroline is equally effective as linezolid against Staphylococcus aureus and methicillin resistant Staphylococcus aureus. (author)

  8. Outcomes of managing the surgical site infection with local vancomycin following posterior cervical surgery%颈后路术中局部应用万古霉素对术后手术部位感染的影响

    Institute of Scientific and Technical Information of China (English)

    刘祥; 徐宏光; 赵泉来; 高智; 肖良

    2016-01-01

    目的:对比颈后路切口在术中是否局部应用万古霉素对术后切口愈合及感染的影响,探讨颈后路切口在术中局部应用万古霉素的优点。方法:前瞻性对照分析皖南医学院弋矶山医院脊柱外科2013年1月~2014年12月所选取的52个病例,分为A、B两组,其中男27人,女25人,平均年龄(52.25±11.00)岁,年龄32~68岁;术前、术后临床感染性指标变化的资料(体温、红细胞沉降率ESR、C-反应蛋白CRP、中性粒细胞比、淋巴细胞比),其中脊髓型或神经根型颈椎病42人、颈部外伤致颈椎不稳9人、椎管内肿瘤1人,所选病例都接受颈后路手术并排除颈部感染性疾病。结果:52例手术均顺利完成,无手术或围手术期死亡病例,术后随访3个月。 A、B两组术后第7天体温分别为(37.78±0.60)℃和(36.66±0.31)℃,P<0.05;ESR分别为(31.00±8.49)mm/h和(14.19±1.30)mm/h,P<0.05;CRP分别为(26.77±9.92)mg/L和(6.50±1.88)mg/L,P<0.05;中性粒细胞比分别为(80.58±4.06)%和(56.92±3.11)%,P<0.05;淋巴细胞比分别为(12.88±1.61)%和(23.08±3.77)%,P<0.05。 A、B两组间术前、术后第1天、术后第3天、术后第1个月、术后第3个月的体温、ESR、CRP、中性粒细胞比、淋巴细胞比均有统计学差异,P<0.05。 A组病例有9人在术后切口部位有轻微红肿发生并且A组病例平均住院天数比B组病例平均住院天数长5天。结论:颈后路手术切口在术中局部应用万古霉素可以有效地降低患者术后切口的感染率,减少患者的实际住院天数和医疗支出。%Objective:To observe the efficacy of managing the surgical site infection with local vancomycin following posterior cervical surgery .Methods:Retrospective analysis was performed in 52 cases undergone cervical surgery

  9. Mastite com lesões sistêmicas por Staphylococus aureus subesp. aureus em coelhos Mastitis with systemic lesions due to Staphylococus aureus subesp. aureus in rabbits

    Directory of Open Access Journals (Sweden)

    Sandra Davi Traverso

    2003-04-01

    Full Text Available Em uma criação composta por 1800 coelhos, 33% das matrizes apresentaram mastite e lesões cutâneas crostosas e purulentas. Estes animais apresentavam-se entre 10 a- 12 meses de idade e em segunda parição. Quinze coelhos afetados foram sacrificados e necropsiados. Na necropsia, além das lesões cutâneas haviam microabscessos em diversos órgãos. Das amostras coletadas isolou-se Staphylococcus aureus subesp. aureus. S. aureus subesp. aureus também foi isolado de "swab" nasal coletado do tratador encarregado de fazer o diagnóstico de gestação nas coelhas. Histologicamente, havia formação de múltiplos abscessos, presença de bactérias gram positivas em vasos sangüíneos e linfáticos, além de êmbolos bacterianos nos tecidos. Nas mamas, observou-se tecido glandular normal associado a abscessos multifocais delimitados.At a commercial rabbitry which was composed of 1800 New Zealand White rabbits, 30% of the does had presented mastitis and purulent cutaneal lesions. The age of the animals ranged from 10 to 12 months and were at the second parturition. At necropsy, microabscesses were observed in several organs. Bacteriological samples collected from affected animals resulted Staphylococcus aureus subesp. aureus.. Additionally, the same agent has been isolated from a nasal swab collected from the person responsible for the pregnancy diagnosis. Histologically, there were multiple abscesses, gram positive bacteria within blood and lymphatic vessels, and bacterial emboli scattered in the tissues. In the mammas, normal glandular tissue associated with multifocal abscesses were observed.

  10. Surgical education and the theoretical concept of communities of practice

    Directory of Open Access Journals (Sweden)

    Debra Nestel

    2014-01-01

    Full Text Available Surgical practice is largely learned in the workplace. Changes in health services and education provision have seen a shift from traditional apprenticeship-type learning to competency-based curricula with the workplace remaining the principal site for learning. Sociocultural learning theories offer valuable lenses through which to observe, design for, and analyze workplace-based learning. In this paper, we consider the theoretical concept of communities of practice in surgery. We describe notions of legitimate peripheral participation and development of professional identity. We highlight the benefits that communities of practice bring to surgical training, as well as the limitations. By understanding community of practice theory as applied to the surgical workplace and the factors that both drive and impede its development, surgical trainers may improve the learning environment, enhancing the attainment of competencies by surgical trainees.

  11. The inhibition of fluorescence resonance energy transfer between multicolor quantum dots for rapid and sensitive detection of Staphylococcus aureus

    Science.gov (United States)

    Wang, Beibei; Wang, Qi; Ma, Meihu; Cai, Zhaoxia

    2015-01-01

    In this paper, we constructed the fluorescence resonance energy transfer (FRET) system between two multi-color quantum dots (QDs) of two sizes for rapid and sensitive detection of Staphylococcus aureus. In this system, green-emitting QDs conjugated with rabbit anti-S. aureus antibodies were used as energy donors while orange-emitting QDs conjugated with goat-anti-rabbit IgG were used as energy acceptors to form FRET system. Pre-binding of Staphylococcus aureus (S. aureus) on the donor occupied the binding sites and thus blocked resonance energy transfer between two colors QDs, leading to the quenching fluorescence of the acceptor. The fluorescence of acceptor has a linear calibration graph with the concentrations of S. aureus from 52 to 2.6 × 105 CFU mL-1. The low detection limit was 10 CFU/mL. It was worth mentioning that the detection method of S. aureus had been applied to the analysis of apple juice and milk samples, which could potentially be developed into a sensor in the further study.

  12. Meticillin-resistant Staphylococcus aureus (MRSA)

    DEFF Research Database (Denmark)

    Stefani, Stefania; Chung, Doo Ryeon; Lindsay, Jodi A;

    2012-01-01

    This article reviews recent findings on the global epidemiology of healthcare-acquired/associated (HA), community-acquired/associated (CA) and livestock-associated (LA) meticillin-resistant Staphylococcus aureus (MRSA) and aims to reach a consensus regarding the harmonisation of typing methods...... health. Continuous efforts to understand the changing epidemiology of S. aureus infection in humans and animals are therefore necessary, not only for appropriate antimicrobial treatment and effective infection control but also to monitor the evolution of the species. The group made several consensus...

  13. Evaluation of genetically inactivated alpha toxin for protection in multiple mouse models of Staphylococcus aureus infection.

    Directory of Open Access Journals (Sweden)

    Rebecca A Brady

    Full Text Available Staphylococcus aureus is a major human pathogen and a leading cause of nosocomial and community-acquired infections. Development of a vaccine against this pathogen is an important goal. While S. aureus protective antigens have been identified in the literature, the majority have only been tested in a single animal model of disease. We wished to evaluate the ability of one S. aureus vaccine antigen to protect in multiple mouse models, thus assessing whether protection in one model translates to protection in other models encompassing the full breadth of infections the pathogen can cause. We chose to focus on genetically inactivated alpha toxin mutant HlaH35L. We evaluated the protection afforded by this antigen in three models of infection using the same vaccine dose, regimen, route of immunization, adjuvant, and challenge strain. When mice were immunized with HlaH35L and challenged via a skin and soft tissue infection model, HlaH35L immunization led to a less severe infection and decreased S. aureus levels at the challenge site when compared to controls. Challenge of HlaH35L-immunized mice using a systemic infection model resulted in a limited, but statistically significant decrease in bacterial colonization as compared to that observed with control mice. In contrast, in a prosthetic implant model of chronic biofilm infection, there was no significant difference in bacterial levels when compared to controls. These results demonstrate that vaccines may confer protection against one form of S. aureus disease without conferring protection against other disease presentations and thus underscore a significant challenge in S. aureus vaccine development.

  14. Community-acquired methicillin-resistant Staphylococcus aureus in Central Australia.

    Science.gov (United States)

    Stevens, Claire L; Ralph, Anna; McLeod, James E T; McDonald, Malcolm I

    2006-01-01

    To date, there has been scant information about the burden of methicillin-resistant Staphylococcus aureus infections in Central Australia. Our aims were to determine the proportion of Staphylococcus aureus infections due to methicillin-resistant strains in Central Australia, to characterise resistance to non-beta lactam antibiotics and to correlate findings with available demographic information. We retrospectively reviewed S. aureus isolates identified by the Microbiology Laboratory of the Pathology Department, Alice Springs Hospital between September 2005 and February 2006. Multi-resistance was defined as resistance to three or more non-beta lactam antibiotics. We identified the recovery site and extended antibiotic resistance profile of each isolate. Demographic data included place of residence, discharge diagnosis and ethnicity. There were 524 S. aureus isolates: 417 (79.6%) methicillin-sensitive S. aureus, 104 (19.7%) non-multi-resistant MRSA (nmrMRSA) and 3 (0.7%) multi-resistant MRSA (mrMRSA). MRSA accounted for 7/22 (32%) invasive infections and 91/474 (19.2%) cases of staphylococcal skin infections. Aboriginal people comprised 89 per cent (93/104) of patients with nmrMRSA; 57 per cent lived in remote communities, 21 per cent in suburban Alice Springs, and 18 per cent in Alice Springs Town Camps. Six per cent (6/104) of nmrMRSA were hospital-acquired. Of the nmrMRSA isolates, 57 per cent (59/104) were resistant to erythromycin and 7 per cent (7/104) to fusidic acid. All MRSA isolates were susceptible to co-trimoxazole. In conclusion, Central Australia has high rates of community-acquired nmrMRSA and low rates of multi-resistant MRSA. Erythromycin resistance in S. aureus is also common. These findings should prompt the review of antimicrobial prescribing guidelines for the region, especially for treatment of skin and soft tissue infections.

  15. Divergent responses of different endothelial cell types to infection with Candida albicans and Staphylococcus aureus.

    Directory of Open Access Journals (Sweden)

    Kati Seidl

    Full Text Available Endothelial cells are important in the pathogenesis of bloodstream infections caused by Candida albicans and Staphylococcus aureus. Numerous investigations have used human umbilical vein endothelial cells (HUVECs to study microbial-endothelial cell interactions in vitro. However, the use of HUVECs requires a constant supply of umbilical cords, and there are significant donor-to-donor variations in these endothelial cells. The use of an immortalized endothelial cell line would obviate such difficulties. One candidate in this regard is HMEC-1, an immortalized human dermal microvascular endothelial cell line. To determine if HMEC-1 cells are suitable for studying the interactions of C. albicans and S. aureus with endothelial cells in vitro, we compared the interactions of these organisms with HMEC-1 cells and HUVECs. We found that wild-type C. albicans had significantly reduced adherence to and invasion of HMEC-1 cells as compared to HUVECs. Although wild-type S. aureus adhered to and invaded HMEC-1 cells similarly to HUVECs, an agr mutant strain had significantly reduced invasion of HMEC-1 cells, but not HUVECs. Furthermore, HMEC-1 cells were less susceptible to damage induced by C. albicans, but more susceptible to damage caused by S. aureus. In addition, HMEC-1 cells secreted very little IL-8 in response to infection with either organism, whereas infection of HUVECs induced substantial IL-8 secretion. This weak IL-8 response was likely due to the anatomic site from which HMEC-1 cells were obtained because infection of primary human dermal microvascular endothelial cells with C. albicans and S. aureus also induced little increase in IL-8 production above basal levels. Thus, C. albicans and S. aureus interact with HMEC-1 cells in a substantially different manner than with HUVECs, and data obtained with one type of endothelial cell cannot necessarily be extrapolated to other types.

  16. 9 CFR 113.115 - Staphylococcus Aureus Bacterin-Toxoid.

    Science.gov (United States)

    2010-01-01

    ... 9 Animals and Animal Products 1 2010-01-01 2010-01-01 false Staphylococcus Aureus Bacterin-Toxoid... REQUIREMENTS Inactivated Bacterial Products § 113.115 Staphylococcus Aureus Bacterin-Toxoid. Staphylococcus Aureus Bacterin-Toxoid shall be prepared from toxoided broth cultures of selected toxogenic strains...

  17. A pig model of acute Staphylococcus aureus induced pyemia

    DEFF Research Database (Denmark)

    Nielsen, O. L.; Iburg, T.; Aalbæk, B.;

    2009-01-01

    Background: Sepsis caused by Staphylococcus aureus constitutes an important cause of morbidity and mortality in humans, and the incidence of this disease-entity is increasing. In this paper we describe the initial microbial dynamics and lesions in pigs experimentally infected with S. aureus....... aureus isolated from man and an extension of the timeframe aiming at inducing sepsis, severe sepsis and septic shock....

  18. Multidrug-Resistant Staphylococcus aureus in US Meat and Poultry

    OpenAIRE

    Waters, Andrew E.; Contente-Cuomo, Tania; Buchhagen, Jordan; Liu, Cindy M.; Watson, Lindsey; Pearce, Kimberly; Foster, Jeffrey T.; Bowers, Jolene; Driebe, Elizabeth M; Engelthaler, David M.; Keim, Paul S; Lance B Price

    2011-01-01

    We characterized the prevalence, antibiotic susceptibility profiles, and genotypes of Staphylococcus aureus among US meat and poultry samples (n = 136). S. aureus contaminated 47% of samples, and multidrug resistance was common among isolates (52%). S. aureus genotypes and resistance profiles differed significantly among sample types, suggesting food animal–specific contamination.

  19. The retained surgical sponge.

    Science.gov (United States)

    Kaiser, C W; Friedman, S; Spurling, K P; Slowick, T; Kaiser, H A

    1996-01-01

    OBJECTIVE. A review was performed to investigate the frequency of occurrence and outcome of patients who have retained surgical sponges. METHODS. Closed case records from the files of the Medical Professional Mutual Insurance Company (ProMutual, Boston, MA) involving a claim of retained surgical sponges were reviewed for a 7-year period. RESULTS. Retained sponges occurred in 40 patients, comprising 48% of all closed claims for retained foreign bodies. A falsely correct sponge count after an abdominal procedure was documented in 76% of these claims. Ten percent of claims involved vaginal deliveries and minor non-body cavity procedures, for which no sponge count was performed. Total indemnity payments were $2,072,319, and defense costs were $572,079. In three cases, the surgeon was deemed responsible by the court despite the nursing staff's admitting liability and evidence presented that the surgeon complied completely with the standard of care. A wide range of indemnity payments was made despite a remarkable similarity of outcome in the patients studied. CONCLUSIONS. Despite the rarity of the reporting of a retained surgical sponge, this occurrence appears to be encountered more commonly than generally is appreciated. Operating teams should ensure that sponges be counted for all vaginal and any incisional procedures at risk for retaining a sponge. In addition, the surgeon should not unquestioningly accept correct count reports, but should develop the habit of performing a brief but thorough routine postprocedure wound/body cavity exploration before wound closure. The strikingly similar outcome for most patients would argue for a standardized indemnity payment being made without the need for adversarial legal procedures. PMID:8678622

  20. Surgical Simulation and Competency.

    Science.gov (United States)

    Kim-Fine, Shunaha; Brennand, Erin A

    2016-09-01

    Simulation in surgical training is playing an increasingly important role as postgraduate medical education programs navigate an environment of increasing costs of education, increased attention on patient safety, and new duty hour restrictions. In obstetrics and gynecology, simulation has been used to teach many procedures; however, it lacks a standardized curriculum. Several different simulators exist for teaching various routes and aspects of hysterectomy. This article describes how a formal framework of increasing levels of competencies can be applied to simulation in teaching the procedure of hysterectomy. PMID:27521885

  1. Requirements on surgical hand disinfection and modified procedures

    OpenAIRE

    Kramer, A; Hübner, NO; Assadian, O

    2007-01-01

    The special importance of the surgeon's hand in the multi-barrier concept to prevent surgical site infections is based on two facts: the resident flora on the hands cannot be totally eradicated and the surgical glove is no reliable barrier for micro-organisms. The aim of the pre-surgical disinfection is therefore to eliminate the transient flora and reduce the resident flora to the greatest possible amount for the duration of the surgery. New experimental evidence has led to changes in ...

  2. Requirements on surgical hand disinfection and modified procedures

    OpenAIRE

    Assadian, Ojan; Hübner, Nils-Olaf; Kramer, Axel

    2007-01-01

    The special importance of the surgeon's hand in the multi-barrier concept to prevent surgical site infections is based on two facts: the resident flora on the hands cannot be totally eradicated and the surgical glove is no reliable barrier for micro-organisms. The aim of the pre-surgical disinfection is therefore to eliminate the transient flora and reduce the resident flora to the greatest possible amount for the duration of the surgery. New experimental evidence has led to changes in the pr...

  3. Surgical management of ureteropelvic junction obstruction in adults

    Directory of Open Access Journals (Sweden)

    Sankar Kausik

    2003-02-01

    Full Text Available Ureteropelvic junction (UPJ obstruction is a well-recognized entity that may present at any time - in fetal life, infancy, childhood, or early or late adulthood. As the most common site of obstruction in the upper urinary tract, the UPJ is an area with which urologists should be well familiar. There has been an improved understanding of the pathophysiology of primary congenital UPJ obstruction that has been reflected in the evolution of surgical options, from open surgical repair to minimally invasive surgery. Although the primary scope of this review is the surgical management of this condition, we will briefly review the pathogenesis, clinical presentation, and diagnosis of UPJ obstruction.

  4. Medicare Payment: Surgical Dressings and Topical Wound Care Products

    OpenAIRE

    Schaum, Kathleen D.

    2014-01-01

    Medicare patients' access to surgical dressings and topical wound care products is greatly influenced by the Medicare payment system that exists in each site of care. Qualified healthcare professionals should consider these payment systems, as well as the medical necessity for surgical dressings and topical wound care products. Scientists and manufacturers should also consider these payment systems, in addition to the Food and Drug Administration requirements for clearance or approval, when t...

  5. CHARACTERISATION OF AEROBIC BACTERIOLOGICAL ISOLATES FROM ORTHOPEDIC IMPLANT SITE INFECTIONS WITH SPECIAL REFERENCE TO BIOFILM FORMATION IN A TERITIARY CARE HOSPITAL

    Directory of Open Access Journals (Sweden)

    Roopa Shree

    2015-04-01

    Full Text Available INTRODUCTION: Orthopedic implant site infection is one of the major constituents of surgical site infection associated with high morbidity and mortality . Due to the use of implants for open reduction and internal fixation , which are foreign to the body , orthopedic trauma surgery is at grave risk of microbiological contamination . Often isolates causing these infections are assoc iated with biofilm formation resulting in increased antibiotic resistance . OBJECTIVES: To determine the aerobic bacteriological profile with their antibiotic susceptibility patterns from pus samples of patients with orthopedic implant site infections . To d etermine the potential of these isolates to produce biofilm . MATERIALS AND METHODS : Pus samples were collected and sent to the laboratory from patients with suspected implant infections over a period of 6 months were processed according to CLSI guidelines . Biofilm detection was done using Congo red Agar ( CRA method , tube method and Tissue culture plate method . RESULTS: Of the 46 culture positive cases out of 63 , most common isolate was Staphylococcus aureus 30 ( 65 . 21% followed by Coagulase negative Staphy lococcus 4 ( 8 . 69% , Escherichia coli 4 ( 8 . 69% , Klebsiella species 3 ( 6 . 52% , Pseudomonas species 3 ( 6 . 52% , enterococcus species 2 ( 4 . 32% . 13 . 33% of S . aureus was Methicillin resistant ( MRSA , 100% of gram negative bacilli were ESBL and AmpC producers , 27 . 27% of gram negative bacilli were resistant to Imepenem and Meropenem , 1 vancomycin resistant enterococci was isolated . 72% of the isolates were biofilm producers by Congo Red Agar method , 76% by Tube method , and 84% by tissue culture plate m ethod . CONCLUSIONS : Staphylococcus aureus ( MSSA is the most common organism causing orthopedic implant site infection . Gram negative isolates exhibit multidrug resistance patterns . Significant numbers of isolates causing implant infections are biofilm pro ducers . Antibiotic

  6. Staphylococcus aureus Entrance into the Dairy Chain: Tracking S. aureus from Dairy Cow to Cheese

    Science.gov (United States)

    Kümmel, Judith; Stessl, Beatrix; Gonano, Monika; Walcher, Georg; Bereuter, Othmar; Fricker, Martina; Grunert, Tom; Wagner, Martin; Ehling-Schulz, Monika

    2016-01-01

    Staphylococcus aureus is one of the most important contagious mastitis pathogens in dairy cattle. Due to its zoonotic potential, control of S. aureus is not only of great economic importance in the dairy industry but also a significant public health concern. The aim of this study was to decipher the potential of bovine udder associated S. aureus as reservoir for S. aureus contamination in dairy production and processing. From 18 farms, delivering their milk to an alpine dairy plant for the production of smeared semi-hard and hard cheese. one thousand hundred seventy six one thousand hundred seventy six quarter milk (QM) samples of all cows in lactation (n = 294) and representative samples form bulk tank milk (BTM) of all farms were surveyed for coagulase positive (CPS) and coagulase negative Staphylococci (CNS). Furthermore, samples from different steps of the cheese manufacturing process were tested for CPS and CNS. As revealed by chemometric-assisted FTIR spectroscopy and molecular subtyping (spa typing and multi locus sequence typing), dairy cattle represent indeed an important, yet underreported, entrance point of S. aureus into the dairy chain. Our data clearly show that certain S. aureus subtypes are present in primary production as well as in the cheese processing at the dairy plant. However, although a considerable diversity of S. aureus subtypes was observed in QM and BTM at the farms, only certain S. aureus subtypes were able to enter and persist in the cheese manufacturing at the dairy plant and could be isolated from cheese until day 14 of ripening. Farm strains belonging to the FTIR cluster B1 and B3, which show genetic characteristics (t2953, ST8, enterotoxin profile: sea/sed/sej) of the recently described S. aureus genotype B, most successfully contaminated the cheese production at the dairy plant. Thus, our study fosters the hypothesis that genotype B S. aureus represent a specific challenge in control of S. aureus in the dairy chain that requires

  7. Methicillin-resistant Staphylococcus aureus prevalence: Current susceptibility patterns in Trinidad

    Directory of Open Access Journals (Sweden)

    Land Michael

    2006-05-01

    Full Text Available Abstract Background Methicillin-resistant Staphylococcus aureus (MRSA has become one of the most widespread causes of nosocomial infections worldwide. Recently, reports have emerged that S. aureus strains recovered from community-acquired infections are also methicillin-resistant. This study was undertaken to analyze the prevalence of methicillin resistance among isolates at a regional hospital in Trinidad, and document the current resistance profile of MRSA and methicillin-sensitive Staphylococcus aureus (MSSA to the commonly used anti-staphylococcal agents. Methods Over a 6-year period we analyzed 2430 isolates of S. aureus strains recovered from various clinical sources, from hospital and community practices. Antimicrobial susceptibility testing was done according to guideline recommendations of the National Committee for Clinical Laboratory Standards. Results The prevalence of MRSA from surgical/burn wounds, urine and pus/abscess were 60.1%, 15.5% and 6.6%, respectively. The major sources of MSSA were surgical/burn wounds, pus/abscess and upper respiratory tract specimens with rates of 32.9%, 17.1% and 14.3%, respectively. The greatest prevalence of resistance of MRSA was seen for erythromycin (86.7%, and clindamycin (75.3%. Resistance rates among MSSA were highest for ampicillin (70%. Resistance rates for tetracycline were similar among both MRSA (78.7% and MSSA (73.5%. The MRSA recovery rates from nosocomial sources (20.8% was significantly higher than that of previous years (12.5% (p Conclusion The prevalence of MRSA in the hospital increased from 12.5% in 1999 to 20.8% in 2004. Most isolates were associated with infected surgical/burn wounds which may have become infected via the hands of HCPs during dressing exercises. Infection control measures aimed at the proper hand hygiene procedures may interrupt the spread of MRSA. HCPs may also be carriers of MRSA in their anterior nares. Surveillance cultures of both patients and HCPs may help

  8. Common R-plasmids in Staphylococcus aureus and Staphylococcus epidermidis during a nosocomial Staphylococcus aureus outbreak.

    OpenAIRE

    Cohen, M. L.; Wong, E. S.; Falkow, S

    1982-01-01

    During a 7-month period in 1978 to 1979, 31 patients and personnel at a Kentucky hospital were colonized or infected with a Staphylococcus aureus strain resistant to clindamycin, erythromycin, gentamicin, methicillin, penicillin, and tetracycline. S. epidermidis with similar antibiotic resistance patterns had been isolated in this hospital in the year before the S. aureus outbreak. A 32-megadalton R-plasmid, pUW3626, mediating resistance to penicillin and gentamicin, was present in these isol...

  9. Staphylococcus aureus resistente a la meticilina (SARM)

    Centers for Disease Control (CDC) Podcasts

    2007-10-22

    Datos importantes sobre las infecciones por SARM en Estados Unidos, en las escuelas y los entornos médicos. (Title: Methicillin-resistant Staphylococcus aureus (MRSA)Created: 10/2007).  Created: 10/22/2007 by National Center for Preparedness, Detection, and Control of Infectious Diseases.   Date Released: 11/9/2007.

  10. Methicillin-resistant Staphylococcus aureus transmission

    DEFF Research Database (Denmark)

    Andersen, Leif Percival; Nielsen, Xiaohui

    2015-01-01

    INTRODUCTION: Even though methicillin-resistant Staphylococcus aureus (MRSA) is a common cause of nosocomial infections, it may often be difficult to evaluate the exact route of transmission. METHODS: In this study, we describe four cases of nosocomial transmission of MRSA in a hospital with a low...

  11. Increasing resistance of Staphylococcus aureus to ciprofloxacin.

    OpenAIRE

    Daum, T E; Schaberg, D R; Terpenning, M S; Sottile, W S; Kauffman, C A

    1990-01-01

    We demonstrated the marked emergence of resistance to ciprofloxacin among Staphylococcus arueus strains isolated at the Ann Arbor Veterans Administration Medical Center. All S. aureus isolates tested from 1984 to 1985 were susceptible, whereas 55.1% of methicillin-resistant and 2.5% of methicillin-susceptible strains from 1989 had high-level resistance to ciprofloxacin.

  12. Surgical treatments for osteoarthritis.

    Science.gov (United States)

    de l'Escalopier, Nicolas; Anract, Philippe; Biau, David

    2016-06-01

    There are two main surgical treatments for osteoarthritis: conservative treatments, where the damaged cartilage is left in place, and radical treatments, where the cartilage is replaced by an artificial endoprosthesis; this latter procedure is termed joint arthroplasty. These treatments are only offered to symptomatic patients. Arthrodesis is yet another surgical intervention in cases of osteoarthritis. It will sacrifice the joint's articular function and is performed on small osteoarthritic joints, such as wrists and ankles, for instance. Osteoarthritis symptoms are usually the consequence of an imbalance between the load applied to a joint and the surface available to support that load. Therefore, conservative treatments will either tend to decrease the load exerted on the joint, such as in a tibial valgus osteotomy for instance, or to improve the articular surface supporting that load. Sometimes, both can be provided at the same time; the peri-acetabular osteotomy for hip dysplasia is an example of such a procedure. Conservative treatments are usually offered to young patients in order to delay, if not avoid, the need for a joint prosthesis. They are usually performed before osteoarthritis appears or at an early stage. Joint arthroplasties have overwhelmingly excellent functional results and today's research is directed towards providing rapid recovery, very long-term stability, and the assurance of a good functionality in extreme conditions. However, complications with joint arthroplasties can be serious with little, if any, reasonable salvage solution. Therefore, these procedures are offered to patients who have failed adequate medical treatment measures. PMID:27185463

  13. Juxtarenal Modular Aortic Stent Graft Infection Caused by Staphylococcus aureus

    Directory of Open Access Journals (Sweden)

    Róbert Novotný

    2016-01-01

    Full Text Available Introduction. We are presenting a case report of an infected modular abdominal stent graft. Case Presentation. A 67-year-old male patient three years after Cook’s modular abdominal aortic aneurysm (AAA graft implantation for juxtarenal AAA with an implantation of a stent extension into the right common iliac artery for type Ib endoleak. The patient was admitted into our center in severe condition with suspected retroperitoneal bleeding. Computed tomography angiography (CTAG confirmed retroperitoneal bleeding in the right common iliac artery. An urgent surgical revision was indicated; destructed arterial wall around the stent extension in the right common iliac artery was discovered. Due to the severe state of health of the patient, a resection of the infected stent and affected arterial wall was performed, followed by an iliac-femoral crossover bypass. The patient was transported to the intensive care unit with hepatic and renal failure, with maximal catecholamine support. Combined antibiotic treatment was started. The patient died five hours after the procedure. The cause of death was multiorgan failure caused by sepsis. Hemocultures and perioperative microbiological cultures showed the infection agent to be Staphylococcus aureus methicillin sensitive. Conclusion. Stent graft infection is a rare complication. Treatment is associated with high mortality and morbidity.

  14. Dialysis catheter-related septicaemia--focus on Staphylococcus aureus septicaemia

    DEFF Research Database (Denmark)

    Nielsen, J; Ladefoged, S D; Kolmos, H J

    1998-01-01

    BACKGROUND: Dialysis catheters are a common cause of nosocomial septicaemia in haemodialysis units usually due to staphylococci, of which Staphylococcus aureus is the most pathogenic. In this study, the epidemiology and pathogenesis of dialysis catheter-related infections were studied, and methods...... to identify patients with these infections were evaluated. METHODS: A one-year prospective study of 67 catheters in 43 haemodialysis patients was performed. Details about patients and catheters were obtained successively during the catheter period, and biochemical parameters expected to be related...... to infection were measured. After catheter insertion, all patients were screened for nasal carriage of S. aureus, and a culture was taken from the skin overlying the catheter insertion site. Once a week, cultures were taken from the insertion site and from the hub, and aerobic and anaerobic blood cultures were...

  15. Surgical scar revision: An overview

    Directory of Open Access Journals (Sweden)

    Shilpa Garg

    2014-01-01

    Full Text Available Scar formation is an inevitable consequence of wound healing from either a traumatic or a surgical intervention. The aesthetic appearance of a scar is the most important criteria to judge the surgical outcome. An understanding of the anatomy and wound healing along with experience, meticulous planning and technique can reduce complications and improve the surgical outcome. Scar revision does not erase a scar but helps to make it less noticeable and more acceptable. Both surgical and non-surgical techniques, used either alone or in combination can be used for revising a scar. In planning a scar revision surgeon should decide on when to act and the type of technique to use for scar revision to get an aesthetically pleasing outcome. This review article provides overview of methods applied for facial scar revision. This predominantly covers surgical methods.

  16. Relationship between Vancomycin-Resistant Staphylococcus aureus, Vancomycin-Intermediate S. aureus, High Vancomycin MIC, and Outcome in Serious S. aureus Infections

    OpenAIRE

    Holmes, Natasha E.; Johnson, Paul D. R.; Howden, Benjamin P.

    2012-01-01

    Vancomycin has been used successfully for over 50 years for the treatment of Staphylococcus aureus infections, particularly those involving methicillin-resistant S. aureus. It has proven remarkably reliable, but its efficacy is now being questioned with the emergence of strains of S. aureus that display heteroresistance, intermediate resistance, and, occasionally, complete vancomycin resistance. More recently, an association has been established between poor outcome and infections with strain...

  17. Surgical Safety Checklists : an Update

    OpenAIRE

    BERGS, J.; Hellings, Johan; CLEEMPUT, Irina; SIMONS, Pascale; ZUREL, Ozhan; Vertriest, Sonja; Vandijck, Dominique

    2014-01-01

    Surgical safety checklists aim to improve patient safety by prompting the attention of the surgical team towards critical steps during the operation. The checklist's items are aimed to improve compliance with proven interventions, and to facilitate multidisciplinary communication and teamwork. Based on the current literature, corroborated by systematic reviews and meta-analysis, surgical safety checklists have a positive impact on communication and reduce postoperative complications including...

  18. Necrotizing Pneumonia Caused by Panton-Valentine Leucocidin-Producing Staphylococcus aureus Originating from a Bartholin's Abscess

    Directory of Open Access Journals (Sweden)

    N. Jung

    2008-01-01

    Full Text Available Background. Panton-Valentine leukocidin (PVL-producing Staphylococcus aureus is emerging as a serious problem worldwide. There has been an increase in the incidence of necrotizing lung infections in otherwise healthy young people with a very high mortality associated with these strains. Sporadic severe infectious complications after incision of Bartholin's abcesses have been described but involvement of S. aureus is rare. Case report. We present a 23-year-old apparently healthy female patient without any typical predisposing findings who developed severe sepsis with necrotizing pneumonia and multiple abscesses following incision of a Bartholin's abscess. Methicillin-sensitive S. aureus harbouring Panton-Valentine leucocidin genes were cultured from the abscess fluid, multiple blood cultures and a postoperative wound swab. Aggressive antibiotic therapy with flucloxacillin, rifampicin and clindamycin, drainage and intensive supportive care lead finally to recovery. Conclusions. S. aureus, in particular PVL-positive strains, should be considered when a young, immunocompetent person develops a fulminant necrotizing pneumonia. Minor infections—such as Bartholin's abscess—can precede this life-threating syndrome. Bactericidal antistaphylococcal antibiotics are recommended for treatment, and surgical procedures may become necessary.

  19. Coordinated Molecular Cross-Talk between Staphylococcus aureus, Endothelial Cells and Platelets in Bloodstream Infection

    Directory of Open Access Journals (Sweden)

    Carolina D. Garciarena

    2015-12-01

    Full Text Available Staphylococcus aureus is an opportunistic pathogen often carried asymptomatically on the human body. Upon entry to the otherwise sterile environment of the cardiovascular system, S. aureus can lead to serious complications resulting in organ failure and death. The success of S. aureus as a pathogen in the bloodstream is due to its ability to express a wide array of cell wall proteins on its surface that recognise host receptors, extracellular matrix proteins and plasma proteins. Endothelial cells and platelets are important cells in the cardiovascular system and are a major target of bloodstream infection. Endothelial cells form the inner lining of a blood vessel and provide an antithrombotic barrier between the vessel wall and blood. Platelets on the other hand travel throughout the cardiovascular system and respond by aggregating around the site of injury and initiating clot formation. Activation of either of these cells leads to functional dysregulation in the cardiovascular system. In this review, we will illustrate how S. aureus establish intimate interactions with both endothelial cells and platelets leading to cardiovascular dysregulation.

  20. Revisão sistemática sobre aventais cirúrgicos no controle da contaminação/infecção do sítio cirúrgico Revisión sistemática sobre delantales quirúrgicos en el control de la contaminación/infección del local quirúrgico Systematic review of surgical gowns in the control of contamination/surgical site infection

    Directory of Open Access Journals (Sweden)

    Juliane Cristina Burgatti

    2009-03-01

    (E1, E2 obtuvieron una fuerte evidencia de recomendación, concluyendo por no diferenciar la contaminación e infección del sitio quirúrgico entre delantales e indumentaria quirúrgica de tejido y no-tejido.Surgical scrubs are made with both fabric and non-fabric material. The study aimed to observe whether there is scientific evidence, according to the systematic review, that supports the practice of wearing scrubs in surgeries, according to the material they are made of. Basic intervention studies were considered, which investigated contamination and/or infection of the surgical site with the use of either reusable or single-use surgical scrubs, using people submitted to surgeries as the study population, either in real or simulated situations, at any period, without any language limitations. The strategy of searching electronic databases was used to find studies. With this, difficulties in isolating the object of intervention from countless other factors that can interfere in the outcomes were identified in studies of this type. Two studies (E1 and E2 showed strong evidence for the recommendation. In conclusion, there is no difference in contamination and infection of the surgical site between fabric and non-fabric scrubs.

  1. Occurence of Streptococcus canis, Staphylococcus aureus and intermedius in dog breeding in Berlin and surround areas

    OpenAIRE

    Mellert, Simone

    2010-01-01

    Staphylococcus intermedius, Staphylococcus aureus and Streptococcus canis are suspected as the most important bacterial pathogens for puppies losses. In the presented study the occurrence of these bacterial species was investigated in newborn puppies, their bitches and in the environment of these animals. Fourteen bitches and their litters were included in the study. The animals were sampled at a number of sites using swabs. Further environmental samples were collected. The bitches were s...

  2. Staphylococcus aureus Shifts toward Commensalism in Response to Corynebacterium Species.

    Science.gov (United States)

    Ramsey, Matthew M; Freire, Marcelo O; Gabrilska, Rebecca A; Rumbaugh, Kendra P; Lemon, Katherine P

    2016-01-01

    Staphylococcus aureus-human interactions result in a continuum of outcomes from commensalism to pathogenesis. S. aureus is a clinically important pathogen that asymptomatically colonizes ~25% of humans as a member of the nostril and skin microbiota, where it resides with other bacteria including commensal Corynebacterium species. Commensal Corynebacterium spp. are also positively correlated with S. aureus in chronic polymicrobial diabetic foot infections, distinct from acute monomicrobial S. aureus infections. Recent work by our lab and others indicates that microbe-microbe interactions between S. aureus and human skin/nasal commensals, including Corynebacterium species, affect S. aureus behavior and fitness. Thus, we hypothesized that S. aureus interactions with Corynebacterium spp. diminish S. aureus virulence. We tested this by assaying for changes in S. aureus gene expression during in vitro mono- versus coculture with Corynebacterium striatum, a common skin and nasal commensal. We observed a broad shift in S. aureus gene transcription during in vitro growth with C. striatum, including increased transcription of genes known to exhibit increased expression during human nasal colonization and decreased transcription of virulence genes. S. aureus uses several regulatory pathways to transition between commensal and pathogenic states. One of these, the quorum signal accessory gene regulator (agr) system, was strongly inhibited in response to Corynebacterium spp. Phenotypically, S. aureus exposed to C. striatum exhibited increased adhesion to epithelial cells, reflecting a commensal state, and decreased hemolysin activity, reflecting an attenuation of virulence. Consistent with this, S. aureus displayed diminished fitness in experimental in vivo coinfection with C. striatum when compared to monoinfection. These data support a model in which S. aureus shifts from virulence toward a commensal state when exposed to commensal Corynebacterium species.

  3. Staphylococcus aureus Shifts toward Commensalism in Response to Corynebacterium Species.

    Science.gov (United States)

    Ramsey, Matthew M; Freire, Marcelo O; Gabrilska, Rebecca A; Rumbaugh, Kendra P; Lemon, Katherine P

    2016-01-01

    Staphylococcus aureus-human interactions result in a continuum of outcomes from commensalism to pathogenesis. S. aureus is a clinically important pathogen that asymptomatically colonizes ~25% of humans as a member of the nostril and skin microbiota, where it resides with other bacteria including commensal Corynebacterium species. Commensal Corynebacterium spp. are also positively correlated with S. aureus in chronic polymicrobial diabetic foot infections, distinct from acute monomicrobial S. aureus infections. Recent work by our lab and others indicates that microbe-microbe interactions between S. aureus and human skin/nasal commensals, including Corynebacterium species, affect S. aureus behavior and fitness. Thus, we hypothesized that S. aureus interactions with Corynebacterium spp. diminish S. aureus virulence. We tested this by assaying for changes in S. aureus gene expression during in vitro mono- versus coculture with Corynebacterium striatum, a common skin and nasal commensal. We observed a broad shift in S. aureus gene transcription during in vitro growth with C. striatum, including increased transcription of genes known to exhibit increased expression during human nasal colonization and decreased transcription of virulence genes. S. aureus uses several regulatory pathways to transition between commensal and pathogenic states. One of these, the quorum signal accessory gene regulator (agr) system, was strongly inhibited in response to Corynebacterium spp. Phenotypically, S. aureus exposed to C. striatum exhibited increased adhesion to epithelial cells, reflecting a commensal state, and decreased hemolysin activity, reflecting an attenuation of virulence. Consistent with this, S. aureus displayed diminished fitness in experimental in vivo coinfection with C. striatum when compared to monoinfection. These data support a model in which S. aureus shifts from virulence toward a commensal state when exposed to commensal Corynebacterium species. PMID:27582729

  4. Neuronavigation. Principles. Surgical technique.

    Science.gov (United States)

    Ivanov, Marcel; Ciurea, Alexandru Vlad

    2009-01-01

    Neuronavigation and stereotaxy are techniques designed to help neurosurgeons precisely localize different intracerebral pathological processes by using a set of preoperative images (CT, MRI, fMRI, PET, SPECT etc.). The development of computer assisted surgery was possible only after a significant technological progress, especially in the area of informatics and imagistics. The main indications of neuronavigation are represented by the targeting of small and deep intracerebral lesions and choosing the best way to treat them, in order to preserve the neurological function. Stereotaxis also allows lesioning or stimulation of basal ganglia for the treatment of movement disorders. These techniques can bring an important amount of confort both to the patient and to the neurosurgeon. Neuronavigation was introduced in Romania around 2003, in four neurosurgical centers. We present our five-years experience in neuronavigation and describe the main principles and surgical techniques. PMID:20108488

  5. Neuronavigation. Principles. Surgical technique.

    Science.gov (United States)

    Ivanov, Marcel; Ciurea, Alexandru Vlad

    2009-01-01

    Neuronavigation and stereotaxy are techniques designed to help neurosurgeons precisely localize different intracerebral pathological processes by using a set of preoperative images (CT, MRI, fMRI, PET, SPECT etc.). The development of computer assisted surgery was possible only after a significant technological progress, especially in the area of informatics and imagistics. The main indications of neuronavigation are represented by the targeting of small and deep intracerebral lesions and choosing the best way to treat them, in order to preserve the neurological function. Stereotaxis also allows lesioning or stimulation of basal ganglia for the treatment of movement disorders. These techniques can bring an important amount of confort both to the patient and to the neurosurgeon. Neuronavigation was introduced in Romania around 2003, in four neurosurgical centers. We present our five-years experience in neuronavigation and describe the main principles and surgical techniques.

  6. Comparison of cefazolin versus oxacillin for treatment of complicated bacteremia caused by methicillin-susceptible Staphylococcus aureus.

    Science.gov (United States)

    Li, Julius; Echevarria, Kelly L; Hughes, Darrel W; Cadena, Jose A; Bowling, Jason E; Lewis, James S

    2014-09-01

    Contrary to prior case reports that described occasional clinical failures with cefazolin for methicillin-susceptible Staphylococcus aureus (MSSA) infections, recent studies have demonstrated no difference in outcomes between cefazolin and antistaphylococcal penicillins for the treatment of MSSA bacteremia. While promising, these studies described low frequencies of high-inoculum infections, such as endocarditis. This retrospective study compares clinical outcomes of cefazolin versus oxacillin for complicated MSSA bacteremia at two tertiary care hospitals between January 2008 and June 2012. Fifty-nine patients treated with cefazolin and 34 patients treated with oxacillin were included. Osteoarticular (41%) and endovascular (20%) sources were the predominant sites of infection. The rates of clinical cure at the end of therapy were similar between cefazolin and oxacillin (95% versus 88%; P=0.25), but overall failure at 90 days was higher in the oxacillin arm (47% versus 24%; P=0.04). Failures were more likely to have received surgical interventions (63% versus 40%; P=0.05) and to have an osteoarticular source (57% versus 33%; P=0.04). Failures also had a longer duration of bacteremia (7 versus 3 days; P=0.0002), which was the only predictor of failure. Antibiotic selection was not predictive of failure. Rates of adverse drug events were higher in the oxacillin arm (30% versus 3%; P=0.0006), and oxacillin was more frequently discontinued due to adverse drug events (21% versus 3%; P=0.01). Cefazolin appears similar to oxacillin for the treatment of complicated MSSA bacteremia but with significantly improved safety. The higher rates of failure with oxacillin may have been confounded by other patient factors and warrant further investigation. PMID:24936596

  7. Cloning, expression and characterization of glucokinase gene involved in the glucose-6- phosphate formation in Staphylococcus aureus

    OpenAIRE

    Lakshmi, Hanumanthu Prasanna; Yeswanth, Sthanikam; Prasad, Uppu Venkateswara; Vasu, Dudipeta; Swarupa, Vimjam; Kumar, Pasupuleti Santhosh; Narasu, Mangamoori Lakshmi; Krishna Sarma, Potukuchi Venkata Gurunadha

    2013-01-01

    Glucose-6-phosphate (G-6-P) formation in Staphylococcus aureus is catalysed by glucokinase (glkA) gene under high glucose concentration leading to upregulation of various pathogenic factors; therefore the present study is aimed in the cloning and characterization of glk A gene from S. aureus ATCC12600. The glk A gene was cloned in the Sma I site of pQE 30, sequenced (Accession number: JN645812) and expressed in E. coli DH5α. The recombinant glk A expressed from the resultant glk A 1 clone was...

  8. Staphylococcus aureus shifts towards commensalism in response to Corynebacterium species

    Directory of Open Access Journals (Sweden)

    Matthew M Ramsey

    2016-08-01

    Full Text Available Staphylococcus aureus–human interactions result in a continuum of outcomes from commensalism to pathogenesis. S. aureus is a clinically important pathogen that asymptomatically colonizes ~25% of humans as a member of the nostril and skin microbiota, where it resides with other bacteria including commensal Corynebacterium species. Commensal Corynebacterium spp. are also positively correlated with S. aureus in chronic polymicrobial diabetic foot infections, distinct from acute monomicrobial S. aureus infections. Recent work by our lab and others indicates that microbe-microbe interactions between S. aureus and human skin/nasal commensals, including Corynebacterium species, affect S. aureus behavior and fitness. Thus, we hypothesized that S. aureus interactions with Corynebacterium spp. diminish S. aureus virulence. We tested this by assaying for changes in S. aureus gene expression during in vitro mono- versus coculture with Corynebacterium striatum, a common skin and nasal commensal. We observed a broad shift in S. aureus gene transcription during in vitro growth with C. striatum, including increased transcription of genes known to exhibit increased expression during human nasal colonization and decreased transcription of virulence genes. S. aureus uses several regulatory pathways to transition between commensal and pathogenic states. One of these, the quorum signal accessory gene regulator (agr system, was strongly inhibited in response to Corynebacterium spp. Phenotypically, S. aureus exposed to C. striatum exhibited increased adhesion to epithelial cells, reflecting a commensal state, and decreased hemolysin activity, reflecting an attenuation of virulence. Consistent with this, S. aureus displayed diminished fitness in experimental in vivo coinfection with C. striatum when compared to monoinfection. These data support a model in which S. aureus shifts from virulence towards a commensal state when exposed to commensal Corynebacterium species.

  9. Evolution of surgical skills training

    OpenAIRE

    Roberts, Kurt E.; Bell, Robert L.; Duffy, Andrew J

    2006-01-01

    Surgical training is changing: one hundred years of tradition is being challenged by legal and ethical concerns for patient safety, work hours restrictions, the cost of operating room time, and complications. Surgical simulation and skills training offers an opportunity to teach and practice advanced skills outside of the operating room environment before attempting them on living patients.

  10. Surgical innovations in canine gonadectomy

    NARCIS (Netherlands)

    Van Goethem, Bart

    2016-01-01

    In this thesis some recent technological developments in human surgery are evaluated for their potential use in veterinary medicine by introducing them as surgical innovations for canine gonadectomy. Barbed sutures achieve wound apposition without surgical knot tying and thus avoid knot-associated n

  11. Impact of sub-inhibitory antibiotics on fibronectin-mediated host cell adhesion and invasion by Staphylococcus aureus

    Directory of Open Access Journals (Sweden)

    Rasigade Jean

    2011-12-01

    Full Text Available Abstract Background Staphylococcus aureus is a well-armed pathogen prevalent in severe infections such as endocarditis and osteomyelitis. Fibronectin-binding proteins A and B, encoded by fnbA/B, are major pathogenesis determinants in these infections through their involvement in S. aureus adhesion to and invasion of host cells. Sub-minimum inhibitory concentrations (sub-MICs of antibiotics, frequently occurring in vivo because of impaired drug diffusion at the infection site, can alter S. aureus phenotype. We therefore investigated their impact on S. aureus fibronectin-mediated adhesiveness and invasiveness. Methods After in vitro challenge of S. aureus 8325-4 and clinical isolates with sub-MICs of major anti-staphylococcal agents, we explored fnbA/B transcription levels, bacterial adhesiveness to immobilised human fibronectin and human osteoblasts in culture, and bacterial invasion of human osteoblasts. Results Oxacillin, moxifloxacin and linezolid led to the development of a hyper-adhesive phenotype in the fibronectin adhesion assay that was consistent with an increase in fnbA/B transcription. Conversely, rifampin treatment decreased fibronectin binding in all strains tested without affecting fnbA/B transcription. Gentamicin and vancomycin had no impact on fibronectin binding or fnbA/B transcription levels. Only oxacillin-treated S. aureus displayed a significantly increased adhesion to cultured osteoblasts, but its invasiveness did not differ from that of untreated controls. Conclusion Our findings demonstrate that several antibiotics at sub-MICs modulate fibronectin binding in S. aureus in a drug-specific fashion. However, hyper- and hypo- adhesive phenotypes observed in controlled in vitro conditions were not fully confirmed in whole cell infection assays. The relevance of adhesion modulation during in vivo infections is thus still uncertain and requires further investigations.

  12. Surgical treatment of tibial avulsion fracture at the posterior ligament- to- bone insertion site%手术治疗后交叉韧带胫骨止点撕脱性骨折

    Institute of Scientific and Technical Information of China (English)

    陈红峰; 王东明; 徐明勇

    2012-01-01

    Objective To study the clinical effect of the medial knee after surgical fixation of posterior cruciate ligament surgery tibial avulsion fracture. Methods Fifteen cases of cruciate ligament tibial avulsion fractures were performed with knee down "L-shaped" incision and anatomic fracture reduction was fixed with hollow screws and anchors. Patients were followed up for 6 months. Data regarding fractures, healing and joint stability, and range were collected. The recovery of knee function was assessed by Lysholm scale for knee function. Results All patients were cured after 8 to 13 weeks with no displacement. After 6 months, 2 cases of posteriordrawer test was weakly positive. There was 1 case with mild knee flexion limitation, but no knee extension limitation was observed. Lysholmknee score was (92 ± 2. 4) points. Conclusion Knee medial approach with a line of hollow screw and anchor screw fixation of posterior cruciate ligament tibial avulsion fracture is simple, safe, effective and reliable.%目的 探讨膝关节后内侧入路手术内固定治疗手术后交叉韧带胫骨止点撕脱性骨折的临床效果.方法 对15例交叉韧带胫骨止点撕脱性骨折患者行膝后倒“L”形小切口显露,解剖复位骨折,予以中空螺钉及带线锚钉内固定.术后随访6个月,收集骨折复位、愈合及关节稳定性、活动度以及Lysholm膝关节功能评分标准评估膝关节功能恢复情况.结果 术后8~13周均骨性愈合,未见位移.术后6个月,有2例后抽屉试验弱阳性,1例轻度屈膝受限,无伸膝受限,Lysholm膝关节功能评分( 92.0±2.4)分.结论 膝后内侧入路中空螺钉及带线锚钉内固定治疗后交叉韧带胫骨止点撕脱性骨折操作简单、安全、效果可靠.

  13. Methicillin-resistant Staphylococcus aureus: the superbug.

    Science.gov (United States)

    Ippolito, Giuseppe; Leone, Sebastiano; Lauria, Francesco N; Nicastri, Emanuele; Wenzel, Richard P

    2010-10-01

    Over the last decade, methicillin-resistant Staphylococcus aureus (MRSA) strains have emerged as serious pathogens in the nosocomial and community setting. Hospitalization costs associated with MRSA infections are substantially greater than those associated with methicillin-sensitive S. aureus (MSSA) infections, and MRSA has wider economic effects that involve indirect costs to the patient and to society. In addition, there is some evidence suggesting that MRSA infections increase morbidity and the risk of mortality. Glycopeptides are the backbone antibiotics for the treatment of MRSA infections. However, several recent reports have highlighted the limitations of vancomycin, and its role in the management of serious infections is now being reconsidered. Several new antimicrobials demonstrate in vitro activity against MRSA and other Gram-positive bacteria. Data from large surveys indicate that linezolid, daptomycin, and tigecycline are almost universally active against MRSA. This review will briefly discuss the epidemiology, costs, outcome, and therapeutic options for the management of MRSA infections. PMID:20851011

  14. Curcumin Reverse Methicillin Resistance in Staphylococcus aureus

    OpenAIRE

    Su-Hyun Mun; Sung-Bae Kim; Ryong Kong; Jang-Gi Choi; Youn-Chul Kim; Dong-Won Shin; Ok-Hwa Kang; Dong-Yeul Kwon

    2014-01-01

    Curcumin, a natural polyphenolic flavonoid extracted from the rhizome of Curcuma longa L., was shown to possess superior potency to resensitize methicillin-resistant Staphylococcus aureus (MRSA) to antibiotics. Previous studies have shown the synergistic activity of curcumin with β-lactam and quinolone antibiotics. Further, to understand the anti-MRSA mechanism of curcumin, we investigated the potentiated effect of curcumin by its interaction in diverse conditions. The mechanism of anti-MRSA ...

  15. Tranexamic Acid in Anesthetic Management of Surgical Procedures.

    Science.gov (United States)

    Mayeux, Jessica; Alwon, Kathy; Collins, Shawn; Hewer, Ian

    2016-06-01

    Blood loss during surgical procedures poses a grave risk to the patient, but transfusion is costly and associated with adverse outcomes. Antifibrinolytics, however, offer an economical and effective means of decreasing blood loss associated with surgical procedures. Tranexamic acid (TXA) is an antifibrinolytic that blocks lysine-binding sites of fibrinogen and fibrin, preventing the breakdown of existing clots. This journal course reviews extensive research demonstrating that antifibrinolytics such as TXA decrease blood loss and in some studies reduce allogeneic transfusion requirements. In addition, this journal course addresses concerns that use of antifibrinolytics increases embolic events, reviews research that demonstrates TXA does not increase the incidence of vascular occlusive events, and describes methods of TXA use in cardiac and orthopedic surgical procedures, neurosurgery, and obstetrics. The Certified Registered Nurse Anesthetist should consider the possibility, on a case-by-case basis, of using TXA in surgical procedures to reduce blood loss with minimal adverse effects. PMID:27501656

  16. Characterization of inosine monophosphate dehydrogenase from Staphylococcus aureus ATCC12600 and its involvement in biofilm formation

    Directory of Open Access Journals (Sweden)

    S. Yeswanth

    2013-10-01

    Full Text Available Background: In Staphylococcus aureus purine metabolism plays a crucial role in the formation of biofilm which is a key pathogenic factor. The present study is aimed in the characterization of inosine monophosphate dehydrogenase (IMPDH from Staphylococcus aureus ATCC 12600. Methods: IMPDH gene was amplified using primers designed from IMPDH gene sequence of S. aureus reported in the database. Then polymerase chain reaction (PCR product was cloned in the Sma I site of M13mp18 and expressed in Escherichia coli JM109. The recombinant IMPDH (rIMPDH was overexpressed with 1 mM isopropyl beta-D-1- thiogalactopyranoside (IPTG; Michaelis constant (Km, maximum enzyme velocity (Vmax and catalytic constant (Kcat of expressed IMPDH were determined. Results: The enzyme kinetics of IMPDH grown under aerobic conditions showed a Km of 43.71±1.56 µM, Vmax of 0.247±0.84/µM/mg/min and Kcat of 2.74±0.015/min while in anaerobic conditions the kinetics showed Km of 42.81±3.154/ µM, Vmax of 0.378±0.036 µM/mg/min and Kcat of 4.78±0.021 /min, indicating elevated levels of IMPDH activity under anaerobic conditions. Three-folds increased activity in the presence of 1 mM adenosine triphosphate (ATP correlated with biofilm formation. The kinetics of pure rIMPDH were close to the native IMPDH of S. aureus ATCC12600 and the enzyme showed single band in sodium dodecyl sulphate polyacrylamide gel electrophoresis with a molecular weight of 53 KDa. Conclusions: Elevated activity of IMPDH was observed in S. aureus grown under anaerobic conditions and this was correlated with the biofilm formation indicating the linkage between purine metabolism and pathogenesis.

  17. Vigilância pós-alta das infecções de sítio cirúrgico em crianças e adolescentes em um hospital universitário de Belo Horizonte, Minas Gerais, Brasil Post-discharge surveillance of children and adolescents treated for surgical site infections at a university hospital in Belo Horizonte, Minas Gerais State, Brazil

    Directory of Open Access Journals (Sweden)

    Maria A. Martins

    2008-05-01

    Full Text Available As infecções hospitalares são as principais complicações na prática cirúrgica e, dentre estas, as infecções de sítio cirúrgico são as mais freqüentes. Apesar dessas infecções poderem se manifestar após a alta, no Brasil, a maioria dos serviços não faz vigilância pós-alta. Para avaliar a importância dessa vigilância e o perfil das infecções em crianças e adolescentes, acompanhou-se uma coorte de 730 pacientes cirúrgicos de um hospital universitário de Belo Horizonte, Minas Gerais, Brasil, de 1999 a 2001. Calculou-se a incidência acumulada, aplicou-se o teste t de Student na comparação de médias e o método de Kaplan-Meier na análise do tempo de ocorrência das infecções; considerou-se significativo o valor p Hospital infections are the main complications in surgical practice. Surgical site infections are the most frequent, and can manifest after hospital discharge. In Brazil, the majority of clinical services do not maintain infection surveillance after discharge. In order to evaluate the importance of such surveillance and the profile of these post-discharge infections, a cohort of 730 child and adolescent surgical patients was followed in a teaching hospital, from 1999 to 2001. The accumulated incidence was calculated. Student's t test was used to compare mean values and the Kaplan-Meier method to analyze the period until infection, using a p value of < 0.05. A total of 87 surgical site infections were diagnosed, 37% of which after discharge. The overall surgical infection rate was 11.9%; without outpatient follow-up, the rate would have been 7.5%. Post-charge infections were diagnosed after a mean of 11.3 ± 6.4 days, and in these patients the preoperative and postoperative hospital stays were significantly lower than in the group with in-hospital infections. The study indicates the importance of post-discharge surveillance in determining the real incidence of surgical site infections.

  18. Comparison of Community-Associated and Health Care-Associated Methicillin-Resistant Staphylococcus aureus in Canada: Results from CANWARD 2007

    OpenAIRE

    Nichol, Kimberly A.; McCracken, Melissa; DeCorby, Melanie R.; Thompson, Kristjan; Mulvey, Michael R; Karlowsky, James A.; Hoban, Daryl J.; Zhanel, George G

    2009-01-01

    BACKGROUND: Community-associated methicillin-resistant Staphylococcus aureus (CA-MRSA) differ from health care-associated MRSA (HA-MRSA) in their genotypic and phenotypic characteristics. The purpose of the present study was to compare the demographics, antimicrobial susceptibilities and molecular epidemiology of CA-MRSA and HA-MRSA in Canada. METHODS: In 2007, 385 MRSA isolates were collected from Canadian patients attending hospital clinics, emergency rooms, medical/ surgical wards and inte...

  19. Local recurrence, rate and sites of metastases, and time to relapse as a function of treatment regimen, size of primary and surgical history in 62 patients presenting with non-metastatic Ewing's sarcoma of the pelvic bones

    International Nuclear Information System (INIS)

    This report reviews the experience of 62 patients who presented between 1972 and 1978 with non-metastatic Ewing's sarcoma of the pelvis and were entered on IESS I. Seventeen patients (27%) developed a local recurrence, 38 patients (61%) demonstrated metastases and 21 (34%) neither. In the dose range 4000 rad to 6000 rad no dose response could be detected for local control of tumor. Forty-six patients (74%) had a biopsy or exploratory surgery only, 5 patients (8%) had an incomplete resection and 11 patients (18%) has a complete resection of their tumor. In the 46 patients having a biopsy only, 13 developed a local recurrence (28%) as compared to 2 of 11 patients undergoing a complete resection (18%). The most common sites for metastases were lung in 19 patients (31%) and bone in 23 patients (37%). No significant difference was noted in the frequency of overall metastases or metastases to any site between those patients receiving one of the three treatment regimens used in IESS I: VAC and Adriamycin (regime I), VAC alone (regimen II) and VAC plus bilateral pulmonary irradiation (regimen III). At a median follow-up of 135 weeks no significant difference in median survival could be detected in patients with pelvic primaries between regimens I, II and III. The possible reasons for the poor prognosis of pelvic primary patients are discussed together with treatment policies that might improve the survival of this group of patients

  20. Toxin-Antitoxin Systems of Staphylococcus aureus.

    Science.gov (United States)

    Schuster, Christopher F; Bertram, Ralph

    2016-05-05

    Toxin-antitoxin (TA) systems are small genetic elements found in the majority of prokaryotes. They encode toxin proteins that interfere with vital cellular functions and are counteracted by antitoxins. Dependent on the chemical nature of the antitoxins (protein or RNA) and how they control the activity of the toxin, TA systems are currently divided into six different types. Genes comprising the TA types I, II and III have been identified in Staphylococcus aureus. MazF, the toxin of the mazEF locus is a sequence-specific RNase that cleaves a number of transcripts, including those encoding pathogenicity factors. Two yefM-yoeB paralogs represent two independent, but auto-regulated TA systems that give rise to ribosome-dependent RNases. In addition, omega/epsilon/zeta constitutes a tripartite TA system that supposedly plays a role in the stabilization of resistance factors. The SprA1/SprA1AS and SprF1/SprG1 systems are post-transcriptionally regulated by RNA antitoxins and encode small membrane damaging proteins. TA systems controlled by interaction between toxin protein and antitoxin RNA have been identified in S. aureus in silico, but not yet experimentally proven. A closer inspection of possible links between TA systems and S. aureus pathophysiology will reveal, if these genetic loci may represent druggable targets. The modification of a staphylococcal TA toxin to a cyclopeptide antibiotic highlights the potential of TA systems as rather untapped sources of drug discovery.

  1. Aspartate inhibits Staphylococcus aureus biofilm formation.

    Science.gov (United States)

    Yang, Hang; Wang, Mengyue; Yu, Junping; Wei, Hongping

    2015-04-01

    Biofilm formation renders Staphylococcus aureus highly resistant to conventional antibiotics and host defenses. Four D-amino acids (D-Leu, D-Met, D-Trp and D-Tyr) have been reported to be able to inhibit biofilm formation and disassemble established S. aureus biofilms. We report here for the first time that both D- and L-isoforms of aspartate (Asp) inhibited S. aureus biofilm formation on tissue culture plates. Similar biofilm inhibition effects were also observed against other staphylococcal strains, including S. saprophyticus, S. equorum, S. chromogenes and S. haemolyticus. It was found that Asp at high concentrations (>10 mM) inhibited the growth of planktonic N315 cells, but at subinhibitory concentrations decreased the cellular metabolic activity without influencing cell growth. The decreased cellular metabolic activity might be the reason for the production of less protein and DNA in the matrix of the biofilms formed in the presence of Asp. However, varied inhibition efficacies of Asp were observed for biofilms formed by clinical staphylococcal isolates. There might be mechanisms other than decreasing the metabolic activity, e.g. the biofilm phenotypes, affecting biofilm formation in the presence of Asp.

  2. Aspartate inhibits Staphylococcus aureus biofilm formation.

    Science.gov (United States)

    Yang, Hang; Wang, Mengyue; Yu, Junping; Wei, Hongping

    2015-04-01

    Biofilm formation renders Staphylococcus aureus highly resistant to conventional antibiotics and host defenses. Four D-amino acids (D-Leu, D-Met, D-Trp and D-Tyr) have been reported to be able to inhibit biofilm formation and disassemble established S. aureus biofilms. We report here for the first time that both D- and L-isoforms of aspartate (Asp) inhibited S. aureus biofilm formation on tissue culture plates. Similar biofilm inhibition effects were also observed against other staphylococcal strains, including S. saprophyticus, S. equorum, S. chromogenes and S. haemolyticus. It was found that Asp at high concentrations (>10 mM) inhibited the growth of planktonic N315 cells, but at subinhibitory concentrations decreased the cellular metabolic activity without influencing cell growth. The decreased cellular metabolic activity might be the reason for the production of less protein and DNA in the matrix of the biofilms formed in the presence of Asp. However, varied inhibition efficacies of Asp were observed for biofilms formed by clinical staphylococcal isolates. There might be mechanisms other than decreasing the metabolic activity, e.g. the biofilm phenotypes, affecting biofilm formation in the presence of Asp. PMID:25687923

  3. Whole-Genome Sequence of Staphylococcus aureus Strain LCT-SA112

    OpenAIRE

    Wang, Junfeng; Liu, Yanhong; Wan, Daiwei; Fang, Xiangqun; Li, Tianzhi; Guo, Yinghua; Chang, De; Su, Longxiang; Wang, Yajuan; Zhao, Jiao; Liu, Changting

    2012-01-01

    Staphylococcus aureus is a facultative anaerobic Gram-positive coccal bacterium. S. aureus is the most common species of Staphylococcus to cause staphylococcal infections, which are very common in clinical medicine. Here we report the genome sequence of S. aureus strain LCT-SA112, which was isolated from S. aureus subsp. aureus CGMCC 1.230.

  4. Effect of non-surgical periodontal treatment on the subgingival microbiota of patients with chronic kidney disease

    Directory of Open Access Journals (Sweden)

    Hilana Paula Carillo Artese

    2012-08-01

    Full Text Available This study investigated the effect of non-surgical periodontal therapy on the composition of subgingival microbiota of patients with chronic kidney disease (CKD. Sixteen CKD pre-dialysis individuals (CKD and 14 individuals without clinical evidence of kidney disease (C presenting chronic periodontitis were treated by scaling and root planing. Subgingival samples were collected from each patient and analyzed for their composition by checkerboard at baseline and 3 months post-therapy. Significant differences between groups at baseline were sought by the Mann-Whitney and χ² tests. Changes over time were examined by the Wilcoxon test. At baseline, the CKD group had significantly lower counts of E. faecalis compared to the C group (p < 0.05. After treatment, the levels of a greater number of species were reduced in the C group. Higher levels of A. israelii, C. rectus, F. periodonticum, P. micra, P. nigrescens, T. forsythia, N. mucosa, and S. anginosus (p < 0.05 were found in the CKD group compared to the C group. Also, non-responsive sites in CKD individuals harbored significantly higher levels of pathogenic species (T. forsythia, P. gingivalis, T. denticola, Fusobacterium spp., D. pneumosintes, E. faecalis and S. aureus; p < 0.05 than sites that responded to therapy, as well as non-responsive sites in the C group. The periodontitis-associated subgingival microbiota of CKD and systemically healthy individuals was similar in composition. However, high levels of pathogenic species persisted in the subgingival microbiota of patients with CKD after treatment.

  5. Epidemiology of Staphylococcus aureus harboring the mecA or Panton-Valentine leukocidin genes in hospitals in Java and Bali, Indonesia.

    Science.gov (United States)

    Santosaningsih, Dewi; Santoso, Sanarto; Budayanti, Nyoman S; Kuntaman, Kuntaman; Lestari, Endang S; Farida, Helmia; Hapsari, Rebriarina; Hadi, Purnomo; Winarto, Winarto; Milheiriço, Catarina; Maquelin, Kees; Willemse-Erix, Diana; van Belkum, Alex; Severin, Juliëtte A; Verbrugh, Henri A

    2014-04-01

    Data of Staphylococcus aureus carriage in Indonesian hospitals are scarce. Therefore, the epidemiology of S. aureus among surgery patients in three academic hospitals in Indonesia was studied. In total, 366 of 1,502 (24.4%) patients carried S. aureus. The methicillin-resistant S. aureus (MRSA) carriage rate was 4.3%, whereas 1.5% of the patients carried Panton-Valentine leukocidin (PVL)-positive methicillin-sensitive S. aureus (MSSA). Semarang and Malang city (odds ratio [OR] 9.4 and OR 9.0), being male (OR 2.4), hospitalization for more than 5 days (OR 11.708), and antibiotic therapy during hospitalization (OR 2.6) were independent determinants for MRSA carriage, whereas prior hospitalization (OR 2.5) was the only one risk factor for PVL-positive MSSA carriage. Typing of MRSA strains by Raman spectroscopy showed three large clusters assigned type 21, 24, and 38, all corresponding to ST239-MRSA-SCCmec type III. In conclusion, MRSA and PVL-positive MSSA are present among patients in surgical wards in Indonesian academic hospitals.

  6. A non-coding RNA promotes bacterial persistence and decreases virulence by regulating a regulator in Staphylococcus aureus.

    Directory of Open Access Journals (Sweden)

    Cédric Romilly

    2014-03-01

    Full Text Available Staphylococcus aureus produces a high number of RNAs for which the functions are poorly understood. Several non-coding RNAs carry a C-rich sequence suggesting that they regulate mRNAs at the post-transcriptional level. We demonstrate that the Sigma B-dependent RsaA RNA represses the synthesis of the global transcriptional regulator MgrA by forming an imperfect duplex with the Shine and Dalgarno sequence and a loop-loop interaction within the coding region of the target mRNA. These two recognition sites are required for translation repression. Consequently, RsaA causes enhanced production of biofilm and a decreased synthesis of capsule formation in several strain backgrounds. These phenotypes led to a decreased protection of S. aureus against opsonophagocytic killing by polymorphonuclear leukocytes compared to the mutant strains lacking RsaA. Mice animal models showed that RsaA attenuates the severity of acute systemic infections and enhances chronic catheter infection. RsaA takes part in a regulatory network that contributes to the complex interactions of S. aureus with the host immune system to moderate invasiveness and favour chronic infections. It is the first example of a conserved small RNA in S. aureus functioning as a virulence suppressor of acute infections. Because S. aureus is essentially a human commensal, we propose that RsaA has been positively selected through evolution to support commensalism and saprophytic interactions with the host.

  7. Rapid Isolation of Staphylococcus aureus Pathogens from Infected Clinical Samples Using Magnetic Beads Coated with Fc-Mannose Binding Lectin.

    Directory of Open Access Journals (Sweden)

    A Bicart-See

    Full Text Available Here we describe how Staphylococcus aureus bacteria can be rapidly isolated from clinical samples of articular fluid and synovial tissue using magnetic beads coated with the engineered chimeric human opsonin protein, Fc-mannose-binding lectin (FcMBL. The FcMBL-beads were used to capture and magnetically remove bacteria from purified cultures of 12 S. aureus strains, and from 8 articular fluid samples and 4 synovial tissue samples collected from patients with osteoarthritis or periprosthetic infections previously documented by positive S. aureus cultures. While the capture efficiency was high (85% with purified S. aureus strains grown in vitro, direct FcMBL-bead capture from the clinical samples was initially disappointing (< 5% efficiency. Further analysis revealed that inhibition of FcMBL binding was due to coating of the bacteria by immunoglobulins and immune cells that masked FcMBL binding sites, and to the high viscosity of these complex biological samples. Importantly, capture of pathogens using the FcMBL-beads was increased to 76% efficiency by pretreating clinical specimens with hypotonic washes, hyaluronidase and a protease cocktail. Using this approach, S. aureus bacteria could be isolated from infected osteoarthritic tissues within 2 hours after sample collection. This FcMBL-enabled magnetic method for rapid capture and concentration of pathogens from clinical samples could be integrated upstream of current processes used in clinical microbiology laboratories to identify pathogens and perform antibiotic sensitivity testing when bacterial culture is not possible or before colonies can be detected.

  8. Immunization routes in cattle impact the levels and neutralizing capacity of antibodies induced against S. aureus immune evasion proteins.

    Science.gov (United States)

    Boerhout, Eveline; Vrieling, Manouk; Benedictus, Lindert; Daemen, Ineke; Ravesloot, Lars; Rutten, Victor; Nuijten, Piet; van Strijp, Jos; Koets, Ad; Eisenberg, Susanne

    2015-01-01

    Vaccines against S. aureus bovine mastitis are scarce and show limited protection only. All currently available vaccines are applied via the parenteral (usually intramuscular) route. It is unknown, however, whether this route is the most suitable to specifically increase intramammary immunity to combat S. aureus at the site of infection. Hence, in the present study, immunization via mucosal (intranasal; IN), intramuscular (triangle of the neck; IM), intramammary (IMM) and subcutaneous (suspensory ligament; SC) routes were analyzed for their effects on the quantity of the antibody responses in serum and milk as well as the neutralizing capacity of the antibodies within serum. The experimental vaccine comprised the recombinant S. aureus immune evasion proteins extracellular fibrinogen-binding protein (Efb) and the leukotoxin subunit LukM in an oil-in-water adjuvant combined with a hydrogel and alginate. The highest titer increases for both Efb and LukM specific IgG1 and IgG2 antibody levels in serum and milk were observed following SC/SC immunizations. Furthermore, the harmful effects of Efb and leukotoxin LukMF' on host-defense were neutralized by serum antibodies in a route-dependent manner. SC/SC immunization resulted in a significant increase in the neutralizing capacity of serum antibodies towards Efb and LukMF', shown by increased phagocytosis of S. aureus and increased viability of bovine leukocytes. Therefore, a SC immunization route should be considered when aiming to optimize humoral immunity against S. aureus mastitis in cattle. PMID:26411347

  9. Intravital two-photon microscopy of host-pathogen interactions in a mouse model of Staphylococcus aureus skin abscess formation.

    Science.gov (United States)

    Liese, Jan; Rooijakkers, Suzan H M; van Strijp, Jos A G; Novick, Richard P; Dustin, Michael L

    2013-06-01

    Staphylococcus (S.) aureus is a frequent cause of severe skin infections. The ability to control the infection is largely dependent on the rapid recruitment of neutrophils (PMN). To gain more insight into the dynamics of PMN migration and host-pathogen interactions in vivo, we used intravital two-photon (2-P) microscopy to visualize S. aureus skin infections in the mouse. Reporter S. aureus strains expressing fluorescent proteins were developed, which allowed for detection of the bacteria in vivo. By employing LysM-EGFP mice to visualize PMN, we observed the rapid appearance of PMN in the extravascular space of the dermis and their directed movement towards the focus of infection, which led to the delineation of an abscess within 1 day. Moreover, tracking of transferred labelled bone-marrow neutrophils showed that PMN localization to the site of infection is dependent on the presence of G-protein-coupled receptors on the PMN, whereas Interleukin-1 receptor was required on host cells other than PMN. Furthermore, the S. aureus complement inhibitor Ecb could block PMN accumulation at thesite of infection. Our results establish that 2-P microscopy is a powerful tool to investigate the orchestration of the immune cells, S. aureus location and gene expression in vivo on a single cell level.

  10. Site development interim removable dental prosthesis.

    Science.gov (United States)

    Pasquinelli, Kirk L; Sze, Alexander J; Matosian, Alex J

    2016-07-01

    Transitioning a patient with partial edentulism through hard and soft tissue grafting to an implant restoration with an interim removable dental prosthesis (IRDP) presents a challenge to the restorative dentist. The management of grafted sites requires care, and without the appropriate design, an IRDP may impede surgical outcomes and place the graft at risk for displacement or necrosis. A site development IRDP (SDIRDP) for a grafted site must fulfill restorative goals and promote the surgical objectives for site development. A technique is described for fabricating an SDIRDP that facilitates surgical procedures and maintains prosthetic goals. PMID:26831920

  11. SAMMD: Staphylococcus aureus Microarray Meta-Database

    Directory of Open Access Journals (Sweden)

    Elasri Mohamed O

    2007-10-01

    Full Text Available Abstract Background Staphylococcus aureus is an important human pathogen, causing a wide variety of diseases ranging from superficial skin infections to severe life threatening infections. S. aureus is one of the leading causes of nosocomial infections. Its ability to resist multiple antibiotics poses a growing public health problem. In order to understand the mechanism of pathogenesis of S. aureus, several global expression profiles have been developed. These transcriptional profiles included regulatory mutants of S. aureus and growth of wild type under different growth conditions. The abundance of these profiles has generated a large amount of data without a uniform annotation system to comprehensively examine them. We report the development of the Staphylococcus aureus Microarray meta-database (SAMMD which includes data from all the published transcriptional profiles. SAMMD is a web-accessible database that helps users to perform a variety of analysis against and within the existing transcriptional profiles. Description SAMMD is a relational database that uses MySQL as the back end and PHP/JavaScript/DHTML as the front end. The database is normalized and consists of five tables, which holds information about gene annotations, regulated gene lists, experimental details, references, and other details. SAMMD data is collected from the peer-reviewed published articles. Data extraction and conversion was done using perl scripts while data entry was done through phpMyAdmin tool. The database is accessible via a web interface that contains several features such as a simple search by ORF ID, gene name, gene product name, advanced search using gene lists, comparing among datasets, browsing, downloading, statistics, and help. The database is licensed under General Public License (GPL. Conclusion SAMMD is hosted and available at http://www.bioinformatics.org/sammd/. Currently there are over 9500 entries for regulated genes, from 67 microarray

  12. Solution structure of the parvulin-type PPIase domain of Staphylococcus aureus PrsA – Implications for the catalytic mechanism of parvulins

    Directory of Open Access Journals (Sweden)

    Koskela Harri

    2009-03-01

    Full Text Available Abstract Background Staphylococcus aureus is a Gram-positive pathogenic bacterium causing many kinds of infections from mild respiratory tract infections to life-threatening states as sepsis. Recent emergence of S. aureus strains resistant to numerous antibiotics has created a need for new antimicrobial agents and novel drug targets. S. aureus PrsA is a membrane associated extra-cytoplasmic lipoprotein which contains a parvulin-type peptidyl-prolyl cis-trans isomerase domain. PrsA is known to act as an essential folding factor for secreted proteins in Gram-positive bacteria and thus it is a potential target for antimicrobial drugs against S. aureus. Results We have solved a high-resolution solution structure of the parvulin-type peptidyl-prolyl cis-trans isomerase domain of S. aureus PrsA (PrsA-PPIase. The results of substrate peptide titrations pinpoint the active site and demonstrate the substrate preference of the enzyme. With detailed NMR spectroscopic investigation of the orientation and tautomeric state of the active site histidines we are able to give further insight into the structure of the catalytic site. NMR relaxation analysis gives information on the dynamic behaviour of PrsA-PPIase. Conclusion Detailed structural description of the S. aureus PrsA-PPIase lays the foundation for structure-based design of enzyme inhibitors. The structure resembles hPin1-type parvulins both structurally and regarding substrate preference. Even though a wealth of structural data is available on parvulins, the catalytic mechanism has yet to be resolved. The structure of S. aureus PrsA-PPIase and our findings on the role of the conserved active site histidines help in designing further experiments to solve the detailed catalytic mechanism.

  13. Antibody responses in patients with invasive Staphylococcus aureus infections

    OpenAIRE

    Jacobsson, G; Colque-Navarro, P.; Gustafsson, E.; Andersson, R.; Möllby, R

    2010-01-01

    Abstract Correlation between antibody response and clinical outcome in Staphylococcus aureus bacteremia has yielded conflicting results. Immunization schedules have failed in clinical trials. Is the humoral response toward S. aureus of protective nature? A prospective study was performed in patients with invasive S. aureus (ISA) infections during the period 2003?2005. The antibody levels were determined at the beginning and at the end of treatment and one month later (n?=?96, n?=?7...

  14. Staphylococcus aureus atsparumas antibiotikams ir fagotipų paplitimas

    OpenAIRE

    Kareivienė, Violeta; Pavilonis, Alvydas; Sinkutė, Gintarė; Liegiūtė, Sigutė; Gailienė, Greta

    2006-01-01

    Objective. The aim of this study was to identify the phage groups of Staphylococcus aureus strains, their prevalence, and resistance of different phage groups to antibiotics. Materials and methods. A total of 294 Staphylococcus aureus strains in Kaunas hospitals were obtained; they were phage typed and their resistance to antibiotics was determined. We used the method of routine dilution to test 17 antibiotics against the isolates. Susceptibility of Staphylococcus aureus to studied antibio...

  15. Threat of drug resistant Staphylococcus aureus to health in Nepal

    OpenAIRE

    Ansari, Shamshul; Nepal, Hari Prasad; Gautam, Rajendra; Rayamajhi, Nabin; Shrestha, Sony; Upadhyay, Goma; Acharya, Anju; Chapagain, Moti Lal

    2014-01-01

    Background Staphylococcus aureus is the most commonly isolated organism from the different clinical samples in hospital. The emergence and dissemination of methicillin resistant Staphylococcus aureus (MRSA) and growing resistance to non-beta-lactam antibiotics is making treatment of infections due to this organism increasingly difficult. Methods This study was conducted to determine the frequency of Staphylococcus aureus isolated from different clinical samples, rates of MRSA and full antibio...

  16. Daya Hambat Ekstrak Aloe Vera terhadap pertumbuhan Staphylococcus Aureus

    OpenAIRE

    Rahmat, drg.Sp,Pros

    2011-01-01

    Dari hasil penelitian , maka dapat disimpulkan bahwa ekstrak Aloe Vera dapat menghambat pertumbuhan bakteri Stafhylococcus aureus, dan kadar hambat minimal ekstrak Aloe Vera adalah pada konsentrasi 25%.

  17. Towards Safe Robotic Surgical Systems

    DEFF Research Database (Denmark)

    Sloth, Christoffer; Wisniewski, Rafael

    2015-01-01

    A proof of safety is paramount for an autonomous robotic surgical system to ensure that it does not cause trauma to patients. However, a proof of safety is rarely constructed, as surgical systems are too complex to be dealt with by most formal verification methods. In this paper, we design...... a controller for motion compensation in beating-heart surgery, and prove that it is safe, i.e., the surgical tool is kept within an allowable distance and orientation of the heart. We solve the problem by simultaneously finding a control law and a barrier function. The motion compensation system is simulated...

  18. Surgical Skills Beyond Scientific Management

    Science.gov (United States)

    Whitfield, Nicholas

    2015-01-01

    During the Great War, the French surgeon Alexis Carrel, in collaboration with the English chemist Henry Dakin, devised an antiseptic treatment for infected wounds. This paper focuses on Carrel’s attempt to standardise knowledge of infected wounds and their treatment, and looks closely at the vision of surgical skill he espoused and its difference from those associated with the doctrines of scientific management. Examining contemporary claims that the Carrel–Dakin method increased rather than diminished demands on surgical work, this paper further shows how debates about antiseptic wound treatment opened up a critical space for considering the nature of skill as a vital dynamic in surgical innovation and practice. PMID:26090737

  19. The structure of a universally employed enzyme: V8 protease from Staphylococcus aureus

    Energy Technology Data Exchange (ETDEWEB)

    Prasad, Lata; Leduc, Yvonne; Hayakawa, Koto; Delbaere, Louis T.J. (Saskatchewan)

    2008-06-27

    V8 protease, an extracellular protease of Staphylococcus aureus, is related to the pancreatic serine proteases. The enzyme cleaves peptide bonds exclusively on the carbonyl side of aspartate and glutamate residues. Unlike the pancreatic serine proteases, V8 protease possesses no disulfide bridges. This is a major evolutionary difference, as all pancreatic proteases have at least two disulfide bridges. The structure of V8 protease shows structural similarity with several other serine proteases, specifically the epidermolytic toxins A and B from S. aureus and trypsin, in which the conformation of the active site is almost identical. V8 protease is also unique in that the positively charged N-terminus is involved in determining the substrate-specificity of the enzyme.

  20. Evidence-based surgical wound care on surgical wound infection.

    Science.gov (United States)

    Reilly, Jaqueline

    2002-09-01

    Surgical wound infection is an important outcome indicator in the postoperative period. A 3-year prospective cohort epidemiological study of 2202 surgical patients from seven surgical wards across two hospitals was carried out using gold standard surveillance methodology. This involved following patients up as inpatients and postdischarge surveillance to 30 days by an independent observer. The results led to the development of a mathematical model for risk of clean, elective surgical wound infection. Risk of surgical wound infection was increased by smoking, higher body mass index, presence of malignancy, haematoma formation, increasing numbers of people in theatre, adherent dressing usage, and higher times to suture removal (P<0.05). The results show that this type of surveillance is an effective way of collecting accurate data on wound infection rates. It was noted that patient care practices affected the surgical wound infection rate and the surveillance was used to facilitate the adoption of evidence-based practice, through recommendations for clean surgery, to reduce the risk from extrinsic risk factors for wound infection. As a result of the implementation of this evidence-based practice there was a significant reduction (P<0.05) in the clean wound infection rate.

  1. VISA/VRSA (Vancomycin-Intermediate/Resistant Staphylococcus aureus) in Healthcare Settings

    Science.gov (United States)

    ... to vancomycin and other antimicrobial agents. What is Staphylococcus aureus? Staphylococcus aureus is a bacterium commonly found on the ... control personnel. Investigation and Control of Vancomycin-Resistant Staphylococcus aureus (VRSA) [PDF - 300 KB] - This document is ...

  2. Dissecting the role of ADAM10 as a mediator of Staphylococcus aureus α-toxin action.

    Science.gov (United States)

    von Hoven, Gisela; Rivas, Amable J; Neukirch, Claudia; Klein, Stefan; Hamm, Christian; Qin, Qianqian; Meyenburg, Martina; Füser, Sabine; Saftig, Paul; Hellmann, Nadja; Postina, Rolf; Husmann, Matthias

    2016-07-01

    Staphylococcus aureus is a leading cause of bacterial infections in humans, including life-threatening diseases such as pneumonia and sepsis. Its small membrane-pore-forming α-toxin is considered an important virulence factor. By destroying cell-cell contacts through cleavage of cadherins, the metalloproteinase ADAM10 (a disintegrin and metalloproteinase 10) critically contributes to α-toxin-dependent pathology of experimental S. aureus infections in mice. Moreover, ADAM10 was proposed to be a receptor for α-toxin. However, it is unclear whether the catalytic activity or specific domains of ADAM10 are involved in mediating binding and/or subsequent cytotoxicity of α-toxin. Also, it is not known how α-toxin triggers ADAM10's enzymatic activity, and whether ADAM10 is invariably required for all α-toxin action on cells. In the present study, we show that efficient cleavage of the ADAM10 substrate epithelial cadherin (E-cadherin) requires supra-cytotoxic concentrations of α-toxin, leading to significant increases in intracellular [Ca(2+)]; the fall in cellular ATP levels, typically following membrane perforation, became observable at far lower concentrations. Surprisingly, ADAM10 was dispensable for α-toxin-dependent xenophagic targeting of S. aureus, whereas a role for α-toxin attack on the plasma membrane was confirmed. The catalytic site of ADAM10, furin cleavage site, cysteine switch and intracellular domain of ADAM10 were not required for α-toxin binding and subsequent cytotoxicity. In contrast, an essential role for the disintegrin domain and the prodomain emerged. Thus, co-expression of the prodomain with prodomain-deficient ADAM10 reconstituted binding of α-toxin and susceptibility of ADAM10-deficient cells. The results of the present study may help to inform structural analyses of α-toxin-ADAM10 interactions and to design novel strategies to counteract S. aureus α-toxin action.

  3. Effectiveness of Surgical Safety Checklists in Improving Patient Safety.

    Science.gov (United States)

    Ragusa, Paul S; Bitterman, Adam; Auerbach, Brett; Healy, William A

    2016-01-01

    Wrong-site surgery is all too common. Despite more than a decade of campaigns by major organizations to prevent these events, there are still reports of such mistakes. This article reviews the recent literature on surgical safety checklists and other tools designed to prevent wrong-site surgery and improve patient safety in the operating room. Emphasis is placed on how well institutions comply with these guidelines, the perceptions and attitudes of those who are asked to implement them, and their effectiveness. The literature shows that the implementation of such protocols has improved patient safety. In general, these efforts are viewed favorably by operating room personnel. However, the role of these checklists and other tools in reducing wrong-sided surgeries has not been proven. The goal of the health care profession should be to continue to improve on the advances that have been made in implementing surgical checklists and preventing wrong-site surgery. Practitioners at the authors' institution are continuously searching for ways to improve on the current protocols to prevent wrong-site surgeries. The authors recently employed a protocol in which surgical instruments are kept in the back of the room, away from the patient, until completion of the surgical time-out. This practice helps to ensure that team members are not distracted or preoccupied with setting up equipment during the time-out. This approach also helps to mitigate the hierarchal style in the operating room. PMID:26942472

  4. Audit of antibiotic therapy in surgical neonates in a tertiary hospital in Benin City, Nigeria

    Directory of Open Access Journals (Sweden)

    Osifo Osarumwense

    2011-01-01

    Full Text Available Objective: To report the outcome of commonly used antibiotic combinations in surgical neonates in sub-Saharan African settings. Methods: A retrospective analysis that determines the outcome of commonly combined antibiotics in surgical neonates between January 2006 and December 2008 at two referral paediatric surgical centres in Benin city was carried out. Results: Ampicillin ampiclox, metronidazole, gentamicin, cefuroxime and ceftriaxone were variously combined in the management of 161 neonates with a mean age at presentation of 9.2 ± 2.6 days, mean weight 3.1 ± 1.4 kg and a male:female ratio 1.6:1. Polymicrobial postoperative wound infections and sepsis caused by Staphylococcus aureus, Escherichia coli, Neisseria meningitidis, Klebsiella pneumonia, Pseudomonas aeroginosa and anaerobes, were mainly encountered. The most common aerobes isolated from wound cultures were S. aureus and P. aeroginosa while the ones from that of blood cultures were E. coli and K. pneumonia. Overall postoperative infections recorded were: wound infection 19 (11.8%, sepsis 16 (9.9% and sepsis-related deaths 6 (3.7%. Conclusion: Combinations of gentamicin/metronidazole/cefuroxime and gentamicin/cefuroxime were adequate for gastrointestinal and extra-gastrointestinal neonatal operations, respectively, in these sub-Saharan African settings, which may be useful in similar regions.

  5. Surgical Procedures for Vestibular Dysfunction

    Science.gov (United States)

    ... Rated Nonprofit! Volunteer. Donate. Review. Surgical Procedures for Vestibular Dysfunction When is surgery necessary? When medical treatment ... organ (cochlea) is also sacrificed with this procedure. Vestibular nerve section A vestibular nerve section is a ...

  6. Aesthetic Surgical Crown Lengthening Procedure

    Directory of Open Access Journals (Sweden)

    Pablo Santos de Oliveira

    2015-01-01

    Full Text Available The aim of this case report was to describe the surgical sequence of crown lengthening to apically reposition the dentogingival complex, in addition to an esthetic restorative procedure. Many different causes can be responsible for short clinical crown. In these cases, the correct execution of a restorative or prosthetic rehabilitation requires an increasing of the crown length. According to the 2003 American Academy of Periodontology (Practice Profile Survey, crown lengthening is the most habitual surgical periodontal treatment.

  7. Aesthetic Surgical Crown Lengthening Procedure.

    Science.gov (United States)

    de Oliveira, Pablo Santos; Chiarelli, Fabio; Rodrigues, José A; Shibli, Jamil A; Zizzari, Vincenzo Luca; Piattelli, Adriano; Iezzi, Giovanna; Perrotti, Vittoria

    2015-01-01

    The aim of this case report was to describe the surgical sequence of crown lengthening to apically reposition the dentogingival complex, in addition to an esthetic restorative procedure. Many different causes can be responsible for short clinical crown. In these cases, the correct execution of a restorative or prosthetic rehabilitation requires an increasing of the crown length. According to the 2003 American Academy of Periodontology (Practice Profile Survey), crown lengthening is the most habitual surgical periodontal treatment.

  8. Surgical checklists: the human factor

    OpenAIRE

    O’Connor, Paul; Reddin, Catriona; O’Sullivan, Michael; O’Duffy, Fergal; Keogh, Ivan

    2013-01-01

    Background Surgical checklists has been shown to improve patient safety and teamwork in the operating theatre. However, despite the known benefits of the use of checklists in surgery, in some cases the practical implementation has been found to be less than universal. A questionnaire methodology was used to quantitatively evaluate the attitudes of theatre staff towards a modified version of the World Health Organisation (WHO) surgical checklist with relation to: beliefs about levels of compli...

  9. Surgical treatment for liver cancer

    Institute of Scientific and Technical Information of China (English)

    Nicole; C; Tsim; Adam; E; Frampton; Nagy; A; Habib; Long; R; Jiao

    2010-01-01

    Primary liver cancer is amongst the commonest tumors worldwide,particularly in parts of the developing world,and is increasing in incidence. Over the past three decades,surgical hepatic resection has evolved from a high risk,resource intensive procedure with limited application,to a safe and commonly performed operation with a range of indications. This article reviews the approach to surgical resection for malignancies such as hepatocellular cancer,metastatic liver de-posits and neuroendocrine tumors. Surv...

  10. Innovation in pediatric surgical education.

    Science.gov (United States)

    Clifton, Matthew S; Wulkan, Mark L

    2015-06-01

    Pediatric surgical training in the United States remained basically unchanged from the model developed by Ladd and Gross in the 1930s until recently. Standardized curriculum and novel evaluation methods are now being implemented. Pediatric Surgical education is currently undergoing a transition to competency-based evaluation and promotion. Unfortunately, there is little data on the efficacy of these changes. This presents an opportunity for further study of how we conduct training, and how we evaluate and promote our trainees.

  11. Blepharoplasty and periorbital surgical rejuvenation

    OpenAIRE

    Milind Naik

    2013-01-01

    The periorbital region forms the epicenter of facial aging changes and receives highest attention from physicians and patients. The concern about visual function, clubbed with the need for hidden incisions, makes the periocular region a highly specialized surgical area, most appropriately handled by an ophthalmic plastic surgeon. The article provides an overview of cosmetic eyelid and facial surgery in the periocular region. Common aesthetic surgical procedures as well as ocular side-effects ...

  12. Surgical treatment of primary hyperparathyroidism

    DEFF Research Database (Denmark)

    Brasso, K; Karstrup, S; Lundby, C M;

    1994-01-01

    One hundred and two patients with primary hyperparathyroidism underwent a total of 108 bilateral neck explorations with attempted identification and biopsy of all four glands. Hypercalcaemia was surgically eliminated in 97 of 102 patients (95%). Of the remaining hypercalcaemic patients one.......9%). Permanent paralysis of the recurrent nerve occurred in three patients (2.9%). Twenty-one patients developed other postoperative complications from which they all recovered without sequelae. No postoperative deaths occurred. Our results show that surgical treatment of primary hyperparathyroidism...

  13. Surgical innovations in canine gonadectomy

    OpenAIRE

    Van Goethem, Bart

    2016-01-01

    In this thesis some recent technological developments in human surgery are evaluated for their potential use in veterinary medicine by introducing them as surgical innovations for canine gonadectomy. Barbed sutures achieve wound apposition without surgical knot tying and thus avoid knot-associated negative consequences (lengthy placement, impaired wound healing around bulky knots, and the effect of unsightly knots on cosmetics). A study in 9 dogs found that celiotomy closure was easily achiev...

  14. Evolution of surgical skills training

    Institute of Scientific and Technical Information of China (English)

    Kurt E Roberts; Robert L Bell; Andrew J Duffy

    2006-01-01

    Surgical training is changing: one hundred years of tradition is being challenged by legal and ethical concerns for patient safety, work hours restrictions, the cost of operating room time, and complications. Surgical simulation and skills training offers an opportunity to teach and practice advanced skills outside of the operating room environment before attempting them on living patients.Simulation training can be as straight forward as using real instruments and video equipment to manipulate simulated "tissue" in a box trainer. More advanced,virtual reality simulators are now available and ready for widespread use. Early systems have demonstrated their effectiveness and discriminative ability. Newer systems enable the development of comprehensive curricula and full procedural simulations.The Accreditation Council of Graduate Medical Education's (ACGME) has mandated the development of novel methods of training and evaluation. Surgical organizations are calling for methods to ensure the maintenance of skills, advance surgical training, and to credential surgeons as technically competent.Simulators in their current form have been demonstrated to improve the operating room performance of surgical residents. Development of standardized training curricula remains an urgent and important agenda, particularly for minimal invasive surgery.An innovative and progressive approach, borrowing experiences from the field of aviation, can provide the foundation for the next century of surgical training,ensuring the quality of the product. As the technology develops, the way we practice will continue to evolve, to the benefit of physicians and patients.

  15. Clinical and putative periodontal pathogens’ features of different sites with probing depth reduction after non-surgical periodontal treatment of patients with aggressive periodontitis%侵袭性牙周炎在非手术治疗后不同治疗反应位点的临床和可疑致病微生物特性

    Institute of Scientific and Technical Information of China (English)

    路瑞芳; 冯向辉; 徐莉; 孟焕新

    2015-01-01

    目的:探讨侵袭性牙周炎( aggressive periodontitis ,AgP)患者接受牙周基础治疗后袋深减少不同位点的临床和龈下可疑致病微生物的特征,以期为临床治疗及预后判断提供指导。方法:20例AgP患者拍全口根尖片,完成牙周基础治疗并定期复查,每位患者每象限取同1个位点采集治疗前和治疗后6个月的龈沟液,同时记录菌斑指数、出血指数、牙周袋探诊深度和附着水平,检测龈沟液中6种牙周可疑致病微生物和6种微生物代谢产物有机酸浓度,分析治疗前后不同袋深减少位点间的临床指标、牙周可疑致病微生物检出率及代谢产物有机酸浓度的特征。结果:袋深减少>2 mm的位点在治疗前的探诊深度、附着丧失和出血指数,琥珀酸、乙酸、丙酸和丁酸浓度,齿垢密螺旋体的检出率均高于袋深减少≤2 mm的位点,差异有统计学意义(P<0.05),但是治疗后两组临床指标、有机酸浓度和牙周可疑致病微生物检出率间差异无统计学意义(P<0.05);治疗后探诊深度≥6 mm的位点仍有红色复合体微生物的感染,多数伴有角型骨吸收。结论:侵袭性牙周炎患者治疗后袋深减少与治疗前的临床指标有关,基础治疗后深袋位点仍有红色复合体微生物的感染,需要积极的进行感染控制。%Objective:To evaluate the differences of clinical parameters and putative periodontal patho-gens in sites of different probing depth ( PD) reduction after non-surgical periodontal treatment in patients with aggressive periodontitis ( AgP ) .Methods: Clinical examinations including plaque index , probing depth (PD), attachment level (AL) and bleeding index (BI), and full-mouth periapical photographs were collected from 20 patients with AgP .All the patients received non-surgical periodontal treatment , including oral hygiene instruction , supra-gingival scaling , subgingival

  16. Staphylococcus aureus: resistance pattern and risk factors

    Directory of Open Access Journals (Sweden)

    Mohammad Naghavi-Behzad

    2015-03-01

    Full Text Available Introduction: Methicillin resistant Staphylococcus aureus (MRSA has emerged as a nosocomial pathogen of major worldwide importance and is an increasingly frequent cause of community-acquired infections. In this study, different risk factors and MRSA resistance pattern were investigated. Methods: In a 24 months period, all of the patients who were confined to bed in the surgery ward were included in the study. Then they were assessed to find out as if they had MRSA infection when hospitalized and once when they were discharged. Almost 48 h after admission, when patients were discharged, social and medical histories were acquired. Acquired samples were examined. Results: During the present study of 475 patients, 108 patients (22.8% had S. aureus. About frequency of antibiotic resistance among collected S. aureus colonies, erythromycin resistance, was the most frequent antibiotic resistance, also resistance to vancomycin was 0.4% that was the least. Only hospitalization duration had statistically significant correlation with antibiotic resistance, also resistance to erythromycin had statistically significant relation with history of surgery and alcohol consumption. Of all 34 MRSA species, 22 (64.7% samples were resistant to erythromycin, 17 (50.0% resistant to cefoxitin, 5 (14.7% resistant to mupirocin, 1 (2.9% resistant to vancomycin and 1 (2.9% resistant to linezolid. Conclusion: The results of the current study show that among hospitalized patients, there is resistance against methicillin. Since based on results of the study there is resistance against oxacillin and erythromycin in most cases, administering appropriate antibiotics have an important role in minimizing the resistance burden among bacterial species.

  17. Biofouling of surgical power tools during routine use.

    Science.gov (United States)

    Deshpande, A; Smith, G W G; Smith, A J

    2015-07-01

    Surgical power tools (SPTs) are frequently used in many surgical specialties such as dentistry, orthopaedics, ophthalmology, neurology, and podiatry. They have complex designs that may restrict access to cleaning and sterilization agents and frequently become contaminated with microbial and tissue residues following use. Due to these challenges, surgical power tools can be considered the weak link in the decontamination cycle and present a potential for iatrogenic transmission of infection. We aimed to review the existing literature on the decontamination of surgical power tools and associated iatrogenic transmission of infection. A search of the medical literature was performed using Ovid online using the following databases: Ovid Medline 1950-2014, Embase 1980-2014, and EBM Reviews Full Text--Cochrane DSR, ACP Journal Club, and Dare. Despite challenges to decontamination processes, reported episodes of iatrogenic infection directly linked to SPTs appear rare. This may reflect a true picture but more likely represents incomplete reporting, failure to investigate power tools, or lack of surveillance linking surgical site infections (SSIs) to power tools. Healthcare professionals should be aware of the complexities associated with the decontamination of different SPTs, and should review manufacturers' reprocessing instructions prior to purchase. More clarity is required in the manufacturers' validation of these reprocessing instructions. This particularly applies to the emerging surgical robot systems that present extreme challenges to decontamination between uses. Investigation of cross-infection incidents or SSI surveillance should include an element of assessment of SPT decontamination to further elucidate the contribution of SPTs to skin and soft tissue infections.

  18. Resistencia antimicrobiana de cepas de Staphylococcus aureus, Costa Rica Antimicrobial resistance of Staphylococcus aureus, Costa Rica

    Directory of Open Access Journals (Sweden)

    Víctor Hugo Alvarado

    2011-12-01

    Full Text Available Objetivo: Determinar y comparar los perfiles de resistencia de cepas de S. aureus aisladas de quesos, producidos en la Zona Sur de Costa Rica y de un centro hospitalario de la misma región. Materiales y Métodos: Se analizaron 35 muestras de queso fresco, adquiridas durante los meses de setiembre y octubre del 2010 en la zona de San Vito de Coto Brus. A cada muestra se le realizaron recuentos de coliformes totales, coliformes fecales y Staphylococcus aureus. Adicionalmente se analizó presencia/ausencia de Listeria monocytogenes en 25 gramos del producto. A las cepas identificadas como S. aureus se les realizó la prueba de sensibilidad a los antibióticos mediante el sistema automatizado Vitek y la interpretación de los datos se realizó siguiendo las pautas del Clinical and Laboratory Standards Institute antimicrobial susceptibility testing 2011. Adicional a esto se recolectaron datos acerca de la sensibilidad de las cepas de S. aureus aisladas e identificadas en el Hospital de San Vito de Coto Brus en el mismo período. Resultados: El promedio obtenido para el recuento de coliformes totales fue de 9,7 X 10(6 UFC/g, para coliformes fecales de 6,7 X 10(5 y para S. aureus de 2,8 X 10(5 UFC/g, obteniéndose un 83 % de muestras positivas por esta bacteria. En cuanto a la resistencia antimicrobiana, se obtuvieron porcentajes de resistencia mayores en las cepas de origen clínico. Se encontró también que 23 de las cepas (96% provenientes de muestras clínicas, presentaban resistencia a más de un antibiótico, mientras que siete de las obtenidas a partir de queso (27% presentaban esta característica. Con respecto a los betalactamicos (ampicilina, oxacilina y penicilina se observó la existencia de una diferencia estadísticamente significativa (pObjective: determined and compared the resistance patters of S. aureus strains isolated from cheese produced in the southern zone of Costa Rica and from clinical samples isolated at the hospital center

  19. Methicillin-resistant Staphylococcus aureus laryngitis.

    Science.gov (United States)

    Liakos, Tracey; Kaye, Keith; Rubin, Adam D

    2010-09-01

    Infections due to methicillin-resistant Staphylococcus aureus (MRSA) have become more prevalent, in part because of the emergence and spread of community-acquired MRSA. This trend is particularly concerning because of the significant rates of morbidity and mortality associated with MRSA infections, and because MRSA strains are often resistant to many classes of antibiotics. Reports of infections of the head and neck, including wound infections, cellulitis, sinusitis, otitis media, and otitis externa, are well documented. However, to our knowledge, there have been no reports of bacterial laryngitis due to MRSA. We report the first published case of bacterial laryngitis caused by MRSA.

  20. Assessment of protocols for surgical-site preparation in a regional network of hospitals Evaluación de la normalización de la preparación prequirúrgica en una red regional de hospitales Avaliação da normatização da preparação pré-cirúrgica em uma rede regional de hospitais

    Directory of Open Access Journals (Sweden)

    Maria Dolores Peñalver-Mompeán

    2012-04-01

    Full Text Available Surgical-site infection is a preventable adverse event. Implementation of good practices for correct surgical-site preparation can contribute to lessen this safety problem. The objective of this study was to describe the presence and quality of protocols on surgical-site preparation in the Murcia (Spain regional network of public hospitals. The indicator "existence of protocol for surgical-site preparation" was assessed, as well as the formal quality (expected attributes and contents (compared to current evidence-based recommendations of existing documents. Seven of the nine hospitals have a protocol for surgical-site preparation. Opportunities to improve have been identified in relation to the protocols' formal quality and contents. Recommendations related to skin asepsis are incomplete and those related to hair removal contradict existing evidence. Most hospitals have protocols for surgical-site preparation; however, there is great room for improvement, in relation to their expected attributes and to the inclusion of evidence-based recommendations.La infección del sitio quirúrgico es un evento adverso prevenible mediante la implementación de buenas prácticas de preparación prequirúrgica. El objetivo del presente estudio fue describir la existencia y calidad de protocolización de la preparación prequirúrgica en la red regional de hospitales públicos de Murcia (España. Se evaluó el indicador "Existencia de protocolo/norma de preparación prequirúrgica", analizando la calidad formal (atributos y de contenido (presencia de recomendaciones basadas en evidencia de los documentos existentes. Siete (de nueve hospitales acreditaron tener protocolos de preparación prequirúrgica. Existen oportunidades de mejora en la calidad formal y de contenido. Las recomendaciones sobre asepsia son incompletas en la mayoría de los documentos, y las de eliminación del vello contrarias a la evidencia. La preparación prequirúrgica está protocolizada

  1. Surgical versus non-surgical treatment of congenital hyperinsulinism.

    Science.gov (United States)

    Mazor-Aronovitch, Kineret; Landau, Heddy; Gillis, David

    2009-03-01

    Congenital hyperinsulinism is a functional disorder of insulin secretion. In its diffuse severe form, it is traditionally treated with over 95% pancreatectomy. However, even after this procedure normoglycemia is not always achieved. Non-surgical therapy with frequent or continuous feeding, medication and close monitoring is another alternative. In this review we compare the two approaches to this condition focusing on early complications, diabetes, neurological outcome and home management issues. Early complications of pancreatectomy include mechanical, metabolic and infectious complications. Non-surgical interventions can be complicated by unwarranted effects of medications and of invasive procedures. Diabetes occurs with both approaches but much less frequently and years later with non-surgical treatment. Regarding neurodevelopmental outcome, most data come from heterogeneous groups. Nevertheless, it appears that outcome is not adversely affected by avoiding surgery. Home management is far more difficult for the non-surgical form. When the non-surgical approach is successful in achieving normoglycemia and parents are highly motivated, this mode of therapy should be considered.

  2. Staphylococcus aureus bacteriuria as a prognosticator for outcome of Staphylococcus aureus bacteremia: a case-control study

    Directory of Open Access Journals (Sweden)

    Weinstein Robert A

    2010-07-01

    Full Text Available Abstract Background When Staphylococcus aureus is isolated in urine, it is thought to usually represent hematogenous spread. Because such spread might have special clinical significance, we evaluated predictors and outcomes of S. aureus bacteriuria among patients with S. aureus bacteremia. Methods A case-control study was performed at John H. Stroger Jr. Hospital of Cook County among adult inpatients during January 2002-December 2006. Cases and controls had positive and negative urine cultures, respectively, for S. aureus, within 72 hours of positive blood culture for S. aureus. Controls were sampled randomly in a 1:4 ratio. Univariate and multivariable logistic regression analyses were done. Results Overall, 59% of patients were African-American, 12% died, 56% of infections had community-onset infections, and 58% were infected with methicillin-susceptible S. aureus (MSSA. Among 61 cases and 247 controls, predictors of S. aureus bacteriuria on multivariate analysis were urological surgery (OR = 3.4, p = 0.06 and genitourinary infection (OR = 9.2, p = 0.002. Among patients who died, there were significantly more patients with bacteriuria than among patients who survived (39% vs. 17%; p = 0.002. In multiple Cox regression analysis, death risks in bacteremic patients were bacteriuria (hazard ratio 2.9, CI 1.4-5.9, p = 0.004, bladder catheter use (2.0, 1.0-4.0, p = 0.06, and Charlson score (1.1, 1.1-1.3, p = 0.02. Neither length of stay nor methicillin-resistant Staphylococcus aureus (MRSA infection was a predictor of S. aureus bacteriuria or death. Conclusions Among patients with S. aureus bacteremia, those with S. aureus bacteriuria had 3-fold higher mortality than those without bacteriuria, even after adjustment for comorbidities. Bacteriuria may identify patients with more severe bacteremia, who are at risk of worse outcomes.

  3. Intracellular Staphylococcus aureus : live-in and let die

    NARCIS (Netherlands)

    Fraunholz, Martin; Sinha, Bhanu

    2012-01-01

    Staphylococcus aureus uses a plethora of virulence factors to accommodate a diversity of niches in its human host. Aside from the classical manifestations of S. aureus-induced diseases, the pathogen also invades and survives within mammalian host cells. The survival strategies of the pathogen are as

  4. Duplex Identification of Staphylococcus aureus by Aptamer and Gold Nanoparticles.

    Science.gov (United States)

    Chang, Tianjun; Wang, Libo; Zhao, Kexu; Ge, Yu; He, Meng; Li, Gang

    2016-06-01

    Staphylococcus aureus is the top common pathogen causing infections and food poisoning. Identification of S. aureus is crucial for the disease diagnosis and regulation of food hygiene. Herein, we report an aptamer-AuNPs based method for duplex identification of S. aureus. Using AuNPs as an indicator, SA23, an aptamer against S. aureus, can well identify its target from Escherichia coli, Listeria monocytogenes and Pseudomonas aeruginosa. Furthermore, we find citrate-coated AuNPs can strongly bind to S. aureus, but not bind to Salmonella enterica and Proteus mirabilis, which leads to different color changes in salt solution. This colorimetric response is capable of distinguishing S. aureus from S. enteritidis and P. mirabilis. Thus, using the aptasensor and AuNPs together, S. aureus can be accurately identified from the common pathogens. This duplex identification system is a promising platform for simple visual identification of S. aureus. Additionally, in the aptasensing process, bacteria are incubated with aptamers and then be removed before the aptamers adding to AuNPs, which may avoid the interactions between bacteria and AuNPs. This strategy can be potentially applied in principle to detect other cells by AuNPs-based aptasensors. PMID:27427591

  5. Duplex Identification of Staphylococcus aureus by Aptamer and Gold Nanoparticles.

    Science.gov (United States)

    Chang, Tianjun; Wang, Libo; Zhao, Kexu; Ge, Yu; He, Meng; Li, Gang

    2016-06-01

    Staphylococcus aureus is the top common pathogen causing infections and food poisoning. Identification of S. aureus is crucial for the disease diagnosis and regulation of food hygiene. Herein, we report an aptamer-AuNPs based method for duplex identification of S. aureus. Using AuNPs as an indicator, SA23, an aptamer against S. aureus, can well identify its target from Escherichia coli, Listeria monocytogenes and Pseudomonas aeruginosa. Furthermore, we find citrate-coated AuNPs can strongly bind to S. aureus, but not bind to Salmonella enterica and Proteus mirabilis, which leads to different color changes in salt solution. This colorimetric response is capable of distinguishing S. aureus from S. enteritidis and P. mirabilis. Thus, using the aptasensor and AuNPs together, S. aureus can be accurately identified from the common pathogens. This duplex identification system is a promising platform for simple visual identification of S. aureus. Additionally, in the aptasensing process, bacteria are incubated with aptamers and then be removed before the aptamers adding to AuNPs, which may avoid the interactions between bacteria and AuNPs. This strategy can be potentially applied in principle to detect other cells by AuNPs-based aptasensors.

  6. Susceptibility of methicillin-resistant Staphylococcus aureus to lysostaphin.

    OpenAIRE

    Huber, M M; Huber, T. W.

    1989-01-01

    One hundred and eleven isolates of methicillin-resistant Staphylococcus aureus recovered from patients at the Olin E. Teague Veterans Center from March 1983 to April 1987 were as susceptible to lysis by lysostaphin as methicillin-susceptible S. aureus controls were.

  7. Mechanism of resistance to some cephalosporins in Staphylococcus aureus.

    OpenAIRE

    Kono, M; Sasatsu, M; O'Hara, K; Shiomi, Y.; HAYASAKA, T.

    1983-01-01

    The mechanism of resistance to some cephalosporins in Staphylococcus aureus strains was investigated with high-pressure liquid chromatography and nuclear magnetic resonance spectrometry. Drug inactivation by penicillinase was found to be the main mechanism of resistance to cefazolin, cephaloridine, and cephalothin in S. aureus.

  8. Activity of and Resistance to Moxifloxacin in Staphylococcus aureus

    OpenAIRE

    Ince, Dilek; Zhang, Xiamei; Hooper, David C.

    2003-01-01

    Moxifloxacin has enhanced potency against Staphylococcus aureus, lower propensity to select for resistant mutants, and higher bactericidal activity against highly resistant strains than ciprofloxacin. Despite similar activity against purified S. aureus topoisomerase IV and DNA gyrase, it selects for topoisomerase IV mutants, making topoisomerase IV the preferred target in vivo.

  9. Changing Trends in Resistance Pattern of Methicillin Resistant Staphylococcus aureus

    OpenAIRE

    Kali, Arunava; Stephen, Selvaraj; Umadevi, Sivaraman; Kumar, Shailesh; Joseph, Noyal Mariya; Srirangaraj, Sreenivasan

    2013-01-01

    Background: Methicillin resistance in Staphylococcus aureus is associated with multidrug resistance, an aggressive course, increased mortality and morbidity in both community and health care facilities. Monitoring of newly emerging and prevalent Methicillin Resistant Staphylococcus aureus (MRSA) strains for their resistance patterns to conventional as well as novel drugs, are essential for infection control.

  10. Pneumonia and new methicillin-resistant Staphylococcus aureus clone.

    NARCIS (Netherlands)

    Garnier, Fabien; Tristan, Anne; François, Bruno; Etienne, Jerome; Delage-Corre, Manuella; Martin, Christian; Liassine, Nadia; Wannet, Wim; Denis, François; Ploy, Marie-Cécile

    2006-01-01

    Necrotizing pneumonia caused by Staphylococcus aureus strains carrying the Panton-Valentin leukocidin gene is a newly described disease entity. We report a new fatal case of necrotizing pneumonia. An S. aureus strain with an agr1 allele and of a new sequence type 377 was recovered, representing a ne

  11. CD36 Is Essential for Regulation of the Host Innate Response to Staphylococcus aureus α-Toxin-Mediated Dermonecrosis.

    Science.gov (United States)

    Castleman, Moriah J; Febbraio, Maria; Hall, Pamela R

    2015-09-01

    Staphylococcus aureus is the primary cause of skin and skin structure infections (SSSIs) in the United States. α-Hemolysin (Hla), a pore-forming toxin secreted by S. aureus and a major contributor to tissue necrosis, prompts recruitment of neutrophils critical for host defense against S. aureus infections. However, the failure to clear apoptotic neutrophils can result in damage to host tissues, suggesting that mechanisms of neutrophil clearance are essential to limiting Hla-mediated dermonecrosis. We hypothesized that CD36, a scavenger receptor which facilitates recognition of apoptosing cells, would play a significant role in regulating Hla-mediated inflammation and tissue injury during S. aureus SSSI. In this study, we show that CD36 on macrophages negatively regulates dermonecrosis caused by Hla-producing S. aureus. This regulation is independent of bacterial burden, as CD36 also limits dermonecrosis caused by intoxication with sterile bacterial supernatant or purified Hla. Dermonecrotic lesions of supernatant intoxicated CD36(-/-) mice are significantly larger, with increased neutrophil accumulation and IL-1β expression, compared with CD36(+/+) (wild-type) mice. Neutrophil depletion of CD36(-/-) mice prevents this phenotype, demonstrating the contribution of neutrophils to tissue injury in this model. Furthermore, administration of CD36(+/+) but not CD36(-/-) macrophages near the site of intoxication reduces dermonecrosis, IL-1β production and neutrophil accumulation to levels seen in wild-type mice. This therapeutic effect is reversed by inhibiting actin polymerization in the CD36(+/+) macrophages, supporting a mechanism of action whereby CD36-dependent macrophage phagocytosis of apoptotic neutrophils regulates Hla-mediated dermonecrosis. Taken together, these data demonstrate that CD36 is essential for controlling the host innate response to S. aureus skin infection.

  12. Bactericidal Effect of a Photoresponsive Carbon Monoxide-Releasing Nonwoven against Staphylococcus aureus Biofilms.

    Science.gov (United States)

    Klinger-Strobel, Mareike; Gläser, Steve; Makarewicz, Oliwia; Wyrwa, Ralf; Weisser, Jürgen; Pletz, Mathias W; Schiller, Alexander

    2016-07-01

    Staphylococcus aureus is a leading pathogen in skin and skin structure infections, including surgical and traumatic infections that are associated with biofilm formation. Because biofilm formation is accompanied by high phenotypic resistance of the embedded bacteria, they are almost impossible to eradicate by conventional antibiotics. Therefore, alternative therapeutic strategies are of high interest. We generated nanostructured hybrid nonwovens via the electrospinning of a photoresponsive carbon monoxide (CO)-releasing molecule [CORM-1, Mn2(CO)10] and the polymer polylactide. This nonwoven showed a CO-induced antimicrobial activity that was sufficient to reduce the biofilm-embedded bacteria by 70% after photostimulation at 405 nm. The released CO increased the concentration of reactive oxygen species (ROS) in the biofilms, suggesting that in addition to inhibiting the electron transport chain, ROS might play a role in the antimicrobial activity of CORMs on S. aureus The nonwoven showed increased cytotoxicity on eukaryotic cells after longer exposure, most probably due to the released lactic acid, that might be acceptable for local and short-time treatments. Therefore, CO-releasing nonwovens might be a promising local antimicrobial therapy against biofilm-associated skin wound infections.

  13. Committee Opinion No. 571: Solutions for surgical preparation of the vagina.

    Science.gov (United States)

    2013-09-01

    Currently, only povidone-iodine preparations are approved for vaginal surgical-site antisepsis. However, there are compelling reasons to consider chlorhexidine gluconate solutions for off-label use in surgical preparation of the vagina, especially in women with allergies to iodine. Although chlorhexidine gluconate solutions with high concentrations of alcohol are contraindicated for surgical preparation of the vagina, solutions with low concentrations of alcohol (eg, 4%) are both safe and effective for off-label use as vaginal surgical preparations and may be used as an alternative to iodine-based preparations in cases of allergy or when preferred by the surgeon. PMID:23963423

  14. Characterization of methicillin-resistant Staphylococcus aureus Sequence Type 398

    DEFF Research Database (Denmark)

    Christiansen, Mette Theilgaard

    Staphylococcus aureus is an opportunistic pathogen that colonizes the nares and skin surfaces of several animal species, including man. S. aureus can cause a wide variety of infections ranging from superficial soft tissue and skin infections to severe and deadly systemic infections. Traditionally S....... aureus and methicillin-resistant Staphylococcus aureus (MRSA) have been associated with hospitals, but during the past decades MRSA has emerged in the community and now a new branch of MRSA has been found in association with livestock (LA-MRSA). A specific lineage (multilocus sequence type 398 (ST398...... for LA-MRSA ST398 survival on porcine skin and nasal epithelium ex vivo were identified. These genes could represent targets for de-colonization, which could help prevent further spread and adaption of LA-MRSA ST398. Manuscript III describes the construction of the S. aureus VirulenceFinder database...

  15. Antimicrobial drug resistance ofStaphylococcus aureus in dairy products

    Institute of Scientific and Technical Information of China (English)

    Sasidharan S; Prema B; Yoga Latha L

    2011-01-01

    Objective:To evaluate the prevalence of multidrug resistantStaphylococcus aureus(S. aureus) in dairy products.Methods:Isolation and identification ofS. aureus were performed in3 dairy-based food products. The isolates were tested for their susceptibility to5 different common antimicrobial drugs.Results:Of50 samples examined,5 (10%) were contaminated with S. aureus. Subsequently, the5 isolates were subjected to antimicrobial resistance pattern using five antibiotic discs (methicillin, vancomycin, kanamycin, chloramphenicol and tetracycline). Sample 29 showed resistance to methicillin and vancomycin. Sample18 showed intermediate response to tetracycline. The other samples were susceptible to all the antibiotics tested.Conclusions:The results provide preliminary data on sources of food contamination which may act as vehicles for the transmission of antimicrobial-resistantStaphylococcus.Therefore, it enables us to develop preventive strategies to avoid the emergence of new strains of resistantS. aureus.

  16. Prevalence of Staphylococcus aureus introduced into intensive care units of a University Hospital

    Directory of Open Access Journals (Sweden)

    Silvana M.M. Cavalcanti

    2005-02-01

    Full Text Available Staphylococcus aureus is one of the principal human pathogens that colonize healthy individuals in the community in general, and it is responsible for severe infections in hospitalized patients. Due to an increase in the prevalence of strains of methicillin-resistant S. aureus (MRSA, combating these microorganisms has become increasingly difficult. A descriptive study was carried out on 231 patients in intensive care at the Oswaldo Cruz University Hospital (HUOC in Recife, Brazil between January and April 2003 to determine the prevalence of S. aureus and MRSA and to evaluate risk factors for colonization by these bacteria when introduced into Intensive Care Units (ICUs. Body secretions were collected from the nostrils, axillary and perineal regions, and from broken skin lesions, of all patients during the first 48 hours following admission to the ICU. Samples were inoculated into blood agar and mannitol-salt-agar culture medium and identified by Gram staining, and by coagulase, DNAse and agglutination (Slidex Staph Test® tests. Growth in Mueller-Hinton agar with 4% sodium chloride and 6mg/L oxacillin was used to identify MRSA. In addition, the latex agglutination test was performed to identify penicillin-binding protein, PBP 2A. The prevalence of S. aureus and MRSA was 87/231 (37.7% and 30/231 (12.98%, respectively. There was no association between any risk factor studied (age, sex, origin of the patient - whether hospital or community, previous hospitalization, use of current or previous antibiotic therapy, corticotherapy and/or immunotherapy, reason for hospitalization and place of hospitalization and the presence of S. aureus. However, a significant association was established between previous hospitalization and the presence of MRSA (RR:1.85; CI:1.00-3.41; p=0.041. The nostrils were the principal site of colonization by both S. aureus (80.4% and MRSA (26.4%, followed by the perineal area, with rates of 27.6% and 12.6%, respectively. If only

  17. Adhesive polypeptides of Staphylococcus aureus identified using a novel secretion library technique in Escherichia coli

    Directory of Open Access Journals (Sweden)

    Holm Liisa

    2011-05-01

    Full Text Available Abstract Background Bacterial adhesive proteins, called adhesins, are frequently the decisive factor in initiation of a bacterial infection. Characterization of such molecules is crucial for the understanding of bacterial pathogenesis, design of vaccines and development of antibacterial drugs. Because adhesins are frequently difficult to express, their characterization has often been hampered. Alternative expression methods developed for the analysis of adhesins, e.g. surface display techniques, suffer from various drawbacks and reports on high-level extracellular secretion of heterologous proteins in Gram-negative bacteria are scarce. These expression techniques are currently a field of active research. The purpose of the current study was to construct a convenient, new technique for identification of unknown bacterial adhesive polypeptides directly from the growth medium of the Escherichia coli host and to identify novel proteinaceous adhesins of the model organism Staphylococcus aureus. Results Randomly fragmented chromosomal DNA of S. aureus was cloned into a unique restriction site of our expression vector, which facilitates secretion of foreign FLAG-tagged polypeptides into the growth medium of E. coli ΔfliCΔfliD, to generate a library of 1663 clones expressing FLAG-tagged polypeptides. Sequence and bioinformatics analyses showed that in our example, the library covered approximately 32% of the S. aureus proteome. Polypeptides from the growth medium of the library clones were screened for binding to a selection of S. aureus target molecules and adhesive fragments of known staphylococcal adhesins (e.g coagulase and fibronectin-binding protein A as well as polypeptides of novel function (e.g. a universal stress protein and phosphoribosylamino-imidazole carboxylase ATPase subunit were detected. The results were further validated using purified His-tagged recombinant proteins of the corresponding fragments in enzyme-linked immunoassay and

  18. Where does a Staphylococcus aureus vaccine stand?

    Science.gov (United States)

    Fowler, V G; Proctor, R A

    2014-05-01

    In this review, we examine the current status of Staphylococcus aureus vaccine development and the prospects for future vaccines. Examination of the clinical trials to date show that murine models have not predicted success in humans for active or passive immunization. A key factor in the failure to develop a vaccine to prevent S. aureus infections comes from our relatively limited knowledge of human protective immunity. More recent reports on the elements of the human immune response to staphylococci are analysed. In addition, there is some controversy concerning the role of antibodies for protecting humans, and these data are reviewed. From a review of the current state of understanding of staphylococcal immunity, a working model is proposed. Some new work has provided some initial candidate biomarker(s) to predict outcomes of invasive infections and to predict the efficacy of antibiotic therapy in humans. We conclude by looking to the future through the perspective of lessons gleaned from the clinical vaccine trials. PMID:24476315

  19. Mapping and Surgical Ablation of Focal Epicardial Left Ventricular Tachycardia

    Directory of Open Access Journals (Sweden)

    Arif Elvan

    2011-01-01

    Full Text Available We describe a technical challenge in a 17-year-old patient with incessant epicardial focal ventricular arrhythmia and diminished LV function. Failure of ablation at the earliest activated endocardial site during ectopy suggested an epicardial origin, which was supported by specific electrocardiographic criteria. Epicardial ablation was not possible due to the localization of the origin of the ventricular tachycardia adjacent to the phrenic nerve. Minimal invasive surgical multielectrode high-density epicardial mapping was performed to localize the arrhythmia focus. Epicardial surgical RF ablation resulted in the termination of ventricular ectopy. After 2 years, the patient is still free from arrhythmias.

  20. Efektivitas Ekstrak Daun Jambu Biji Buah Putih Terhadap Pertumbuhan Staphylococcus aureus Dari Abses Dan Staphylococcus aureus (ATCC® 29213™)

    OpenAIRE

    Sinurat, Jojor

    2016-01-01

    Daun jambu biji mengandung senyawa aktif seperti tanin, triterpenoid, flavonoid, saponin yang mempunyai efek antibakteri. Mekanisme tanin sebagai antibakteri dengan mengkerutkan dinding sel dan membran sel, inaktivasi enzim, inaktivasi fungsi materi genetik bakteri. Flavonoid merusak sel bakteri, denaturasi protein, inaktivasi enzim dan menyebabkan lisis. Triterpenoid dan saponin menghambat pertumbuhan Staphylococcus aureus dengan cara merusak struktur membran sel. Staphylococcus aureus adala...

  1. Stationary surgical smoke evacuation systems.

    Science.gov (United States)

    2001-03-01

    Two types of systems are available for evacuating the surgical smoke created by electrosurgery and laser surgery: portable and stationary surgical smoke evacuation systems. While portable systems dominate the market today, stationary systems are an alternative worth considering--even though they are still in their infancy, with fewer than 90 systems installed to date. Stationary systems represent a major commitment on the part of the healthcare facility. Several system components must be installed as part of the physical plant (for instance, within the walls), making the system a permanent fixture in the surgical suite. Installation of these systems is often carried out during building construction or major renovation--although the systems can be cost-effective even if no renovations are planned. For this Evaluation, we tested three stationary systems. All three are adequate to capture surgical smoke and evacuate it from the operating room. These systems are easy to use, are quietter than their portable counterparts, and require minimal user maintenance. They represent an excellent option for most hospitals actively evacuating surgical smoke. In this article, we discuss the factors to consider when selecting from among these systems. We also offer guidance on choosing between stationary systems and portable ones. PMID:11321758

  2. Loop-Mediated Isothermal Amplification for Detection of Staphylococcus aureus in Dairy Cow Suffering from Mastitis

    Directory of Open Access Journals (Sweden)

    Zhang Tie

    2012-01-01

    Full Text Available To develop a rapid detection method of Staphylococcus aureus using loop-mediated isothermal amplification (LAMP, four specific primers were designed according to six distinct sequences of the nuc gene. In addition, the specificity and sensitivity of LAMP were verified and compared with those of PCR. Results showed that the LAMP reaction was completed within 45 min at 62.5°C, and ladder bands were appeared in LAMP products analyzed by gel electrophoresis. After adding 1x SYBR Green l, the positive reaction tube showed green color and the negative reaction tube remained orange, indicating that the LAMP has high specificity. The minimal detectable concentration of LAMP was 1×102 CFU/mL and that of PCR was 1×104 CFU/mL, indicating that the LAMP was 100 times more sensitive than the PCR. The LAMP method for detection of Staphylococcus aureus has many advantages, such as simple operation, high sensitivity, high specificity, and rapid analysis. Therefore, this method is more suitable for the rapid on-site detection of Staphylococcus aureus.

  3. 68Ga-labeled phage-display selected peptides as tracers for positron emission tomography imaging of Staphylococcus aureus biofilm-associated infections

    DEFF Research Database (Denmark)

    Nielsen, Karin M; Kyneb, Majbritt H; Alstrup, Aage K O;

    2016-01-01

    INTRODUCTION: Staphylococcus aureus is a major cause of skin and deep-sited infections, often associated with the formation of biofilms. Early diagnosis and initiated therapy is essential to prevent disease progression and to reduce complications that can be serious. Imaging techniques are helpful...... combining anatomical with functional data in order to describe and characterize site, extent and activity of the disease. The purpose of the study was to identify and (68)Ga-label peptides with affinity for S. aureus biofilm and evaluate their potential as bacteria-specific positron emission tomography (PET......) imaging agents. METHODS: Phage-displayed dodecapeptides were selected using an in vitro grown S. aureus biofilm as target. One cyclic (A8) and two linear (A9, A11) dodecapeptides were custom synthesized with 1,4,7,10-tetraazacyclododecane-N,N',N″,N‴-tetraacetic acid (DOTA) conjugated via a lysine linker...

  4. Estudo comparativo da prevalência de Staphylococcus aureus importado para as unidades de terapia intensiva de hospital universitário, Pernambuco, Brasil Comparative study on the prevalence of Staphylococcus aureus imported to intensive care units of a university hospital, Pernambuco, Brazil

    Directory of Open Access Journals (Sweden)

    Silvana Maria de Morais Cavalcanti

    2006-12-01

    carried out to determine the prevalence of methicillin-resistant and sensitive S. aureus, in 231 patients, hospitalized from January to April 2003, in the Intensive Care Units (ICU of Hospital Universitário Oswaldo Cruz, as well as possible factors associated with colonization. Secretions, from the anterior nostrils, armpits, perineum and dermatosis with continuity solutions, were collected from all patients, within the first 48 h of admission at the ICU. These samples were spread on appropriate media. The prevalence of S. aureus was 37.7% (87/231, of which 13% (30/231 methicillin-resistant and 24.8% (57/231 methicillin-sensitive. Age, gender, antibiotic therapy, corticoid therapy and cause and place of hospitalization were not associated to colonization by S. aureus or methicillin-resistance. There was a significant association between hospital of origin and S. aureus colonization, regardless of strain, as well as between previous hospitalization and the presence of methicillin-resistant S. aureus. Regardless of strain, nostrils were the most significant colonization site for methicillin-resistant (47/57=82.4% and methicillin-sensitive S. aureus (23/30=76.7%. There was a high prevalence of S aureus, (methicillin resistant or sensitive, as well as of methicillin resistance among ICU patients in this hospital. Future studies may prove the results reported here and screening routines for S. aureus should be adopted, prospectively, to evaluate risk, as well as the magnitude of the effect, on the control of hospital infections caused by these pathogens.

  5. Petrifilm rapid S. aureus Count Plate method for rapid enumeration of Staphylococcus aureus in selected foods: collaborative study.

    Science.gov (United States)

    Silbernagel, K M; Lindberg, K G

    2001-01-01

    A rehydratable dry-film plating method for Staphylococcus aureus in foods, the 3M Petrifilm Rapid S. aureus Count Plate method, was compared with AOAC Official Method 975.55 (Staphylococcus aureus in Foods). Nine foods-instant nonfat dried milk, dry seasoned vegetable coating, frozen hash browns, frozen cooked chicken patty, frozen ground raw pork, shredded cheddar cheese, fresh green beans, pasta filled with beef and cheese, and egg custard-were analyzed for S. aureus by 13 collaborating laboratories. For each food tested, the collaborators received 8 blind test samples consisting of a control sample and 3 levels of inoculated test sample, each in duplicate. The mean log counts for the methods were comparable for pasta filled with beef and cheese; frozen hash browns; cooked chicken patty; egg custard; frozen ground raw pork; and instant nonfat dried milk. The repeatability and reproducibility variances of the Petrifilm Rapid S. aureus Count Plate method were similar to those of the standard method.

  6. Mechanical performance of disposable surgical needle holders.

    Science.gov (United States)

    Francis, E H; Towler, M A; Moody, F P; McGregor, W; Himel, H N; Rodeheaver, G T; Edlich, R F

    1992-01-01

    The mechanical performance of disposable Webster surgical needle holders supplied by three different surgical instrument companies was determined by recording the forces (clamping moment) applied by the different needle holder jaws to curved surgical needles. This investigation demonstrated that there was a large variability in the mechanical performance of the disposable needle holders supplied by each surgical instrument company. In addition, the mechanical performance of the disposable needle holder of each surgical instrument company was distinctly different.

  7. Characterization of community acquired Staphylococcus aureus associated with skin and soft tissue infection in Beijing: high prevalence of PVL+ ST398.

    Directory of Open Access Journals (Sweden)

    Chunjiang Zhao

    Full Text Available Adult community-associated methicillin-resistant Staphylococcus aureus (CA-MRSA and methicillin-susceptible S. aureus (CA-MSSA skin and soft tissue infection (SSTI in China is not well described. A prospective cohort of adults with SSTI was established between January 2009 and August 2010 at 4 hospitals in Beijing. Susceptibility testing and molecular typing, including multilocus sequence typing, spa, agr typing, and toxin detection were assessed for all S. aureus isolates. Overall, 501 SSTI patients were enrolled. Cutaneous abscess (40.7% was the most common infection, followed by impetigo (6.8% and cellulitis (4.8%. S. aureus accounted for 32.7% (164/501 of SSTIs. Five isolates (5/164, 3.0% were CA-MRSA. The most dominant ST in CA-MSSA was ST398 (17.6%. The prevalence of Panton-Valentine Leukocidin (pvl gene was 41.5% (66/159 in MSSA. Female, younger patients and infections requiring incision or drainage were more commonly associated with pvl-positive S. aureus (P<0.03; sec gene was more often identified in CC5 (P<0.03; seh gene was more prevalent in CC1 (P = 0.001. Importantly, ST59 isolates showed more resistance to erythromycin, clindamycin and tetracycline, and needed more surgical intervention. In conclusion, CA-MRSA infections were rare among adult SSTI patients in Beijing. Six major MSSA clones were identified and associated with unique antimicrobial susceptibility, toxin profiles, and agr types. A high prevalence of livestock ST398 clone (17.1% of all S. aureus infections was found with no apparent association to animal contact.

  8. Studies on correlation of positive surgical margin with clinicopathological factors and prognoses in breast conserving surgery

    Energy Technology Data Exchange (ETDEWEB)

    Nishimura, Reiki; Nagao, Kazuharu; Miyayama, Haruhiko [Kumamoto City Hospital (Japan)

    1999-09-01

    Out of 484 cases with breast conserving surgery between April 1989 and March 1999, surgical procedures of 34 cases were changed to total mastectomy due to positive surgical margins. In this study we evaluated a clinical significance of surgical margin in relation to clinicopathological factors and prognoses. Ninety-nine cases (20.5%) had positive margins that were judged when cancer cells existed within 5 mm from margin. In multivariate analysis of factors for surgical margin, EIC-comedo status, ly, located site, proliferative activity, and age were significant and independent factors. Regarding local recurrence, positive margin, age, ER and proliferative activity were significant factors in multivariate analysis, especially in cases not receiving postoperative radiation therapy. Radiation therapy may be beneficial for patients with positive surgical margin. And patients with breast recurrence alone had significantly higher survival rates. Therefore, it is suggested that surgical margin may not reflect survival, although it is a significant factor for local recurrence. (author)

  9. Emotions in veterinary surgical students

    DEFF Research Database (Denmark)

    Langebæk, Rikke; Eika, Berit; Pedersen, Lene Tanggaard;

    2012-01-01

    A surgical educational environment is potentially stressful and can negatively affect students' learning. The aim of the present study was to investigate the emotions experienced by veterinary students in relation to their first encounter with live-animal surgery and to identify possible sources ...... and enhance positive emotions and engagement, thereby improving students' learning.......A surgical educational environment is potentially stressful and can negatively affect students' learning. The aim of the present study was to investigate the emotions experienced by veterinary students in relation to their first encounter with live-animal surgery and to identify possible sources...... of positive and negative emotions, respectively. During a Basic Surgical Skills course, 155 veterinary fourth-year students completed a survey. Of these, 26 students additionally participated in individual semi-structured interviews. The results of the study show that students often experienced a combination...

  10. Surgical Complications of Cochlear Implantation

    Directory of Open Access Journals (Sweden)

    Basir Hashemi

    2010-03-01

    Full Text Available Cochlear implantation is a method used for the treatment ofpatients with profound hearing loss. This procedure may theaccompanied by some major or minor complications. Weevaluated the surgical complications of cochlear implantationin Fars province (south of Iran. A total of 150 patients withcochlear implantation were enrolled in the present study. Mostof the patients were pre-lingual children and most of our deviceswere nucleus prosthesis. We had three device failuresand four major complications, including one misplaced electrode,one case of meningitis, one case of foreign body reactionto suture and one case with extensive hematoma. Thesecomplications were managed successfully by surgical interventionor re-implantation. Facial nerve damage or woundbreakdown was not seen. Minor complications including smallhematoma, edema, stitch infection and dizziness were found in15 cases, which were managed medically. In our center, therate of minor complications was comparable to other centersin the world. But the rate of major surgical complications waslower than other centers.

  11. Surgical treatment of facial paralysis.

    Science.gov (United States)

    Mehta, Ritvik P

    2009-03-01

    The management of facial paralysis is one of the most complex areas of reconstructive surgery. Given the wide variety of functional and cosmetic deficits in the facial paralysis patient, the reconstructive surgeon requires a thorough understanding of the surgical techniques available to treat this condition. This review article will focus on surgical management of facial paralysis and the treatment options available for acute facial paralysis (facial paralysis (3 weeks to 2 yr) and chronic facial paralysis (>2 yr). For acute facial paralysis, the main surgical therapies are facial nerve decompression and facial nerve repair. For facial paralysis of intermediate duration, nerve transfer procedures are appropriate. For chronic facial paralysis, treatment typically requires regional or free muscle transfer. Static techniques of facial reanimation can be used for acute, intermediate, or chronic facial paralysis as these techniques are often important adjuncts to the overall management strategy.

  12. Molecular characteristics of bap-positive Staphylococcus aureus strains from dairy cow mastitis.

    Science.gov (United States)

    Snel, Gustavo G M; Monecke, Stefan; Ehricht, Ralf; Piccinini, Renata

    2015-08-01

    The biofilm-associated protein (Bap) of Staphylococcus aureus is a high molecular weight cell-wall-anchored protein involved in biofilm formation, first described in bovine mastitis strains from Spain. So far, studies regarding Bap were mainly based on the Spanish strain V329 and its mutants, but no information on the genetic variability of bap-positive Staph. aureus strains is yet available in the literature. The present study investigated the molecular characteristics of 8 bap-positive Staph. aureus strains from subclinical bovine mastitis, isolated in 5 herds; somatic cell counts (SCC) of milk samples were also registered. Strains were characterised using MLST, SPA typing and microarray and the results were compared with V329. All isolates from this study and V329 were assigned to ST126, t605, but some molecular differences were observed. Only herd A and B strains harboured the genes for β-lactams resistance; the leukocidin D/E gene, a type I site-specific deoxyribonuclease subunit, 3rd locus gene and serin-protease A and B were carried by all strains, but not by V329, while serin-protease E was absent in V329 and in another isolate. Four isolates and V329 harboured the fibronectin-binding protein B gene. SCC showed the highest value in the milk sample affected by the only strain carrying all the virulence factors considered. Potential large variability of virulence was evidenced among V329 and all bap-positive Staph. aureus strains considered: the carriage of fnb could enhance the accumulation of biofilm, but the lack of lukD/E and splA, B or E might decrease the invasiveness of strain.

  13. Molecular characteristics of bap-positive Staphylococcus aureus strains from dairy cow mastitis.

    Science.gov (United States)

    Snel, Gustavo G M; Monecke, Stefan; Ehricht, Ralf; Piccinini, Renata

    2015-08-01

    The biofilm-associated protein (Bap) of Staphylococcus aureus is a high molecular weight cell-wall-anchored protein involved in biofilm formation, first described in bovine mastitis strains from Spain. So far, studies regarding Bap were mainly based on the Spanish strain V329 and its mutants, but no information on the genetic variability of bap-positive Staph. aureus strains is yet available in the literature. The present study investigated the molecular characteristics of 8 bap-positive Staph. aureus strains from subclinical bovine mastitis, isolated in 5 herds; somatic cell counts (SCC) of milk samples were also registered. Strains were characterised using MLST, SPA typing and microarray and the results were compared with V329. All isolates from this study and V329 were assigned to ST126, t605, but some molecular differences were observed. Only herd A and B strains harboured the genes for β-lactams resistance; the leukocidin D/E gene, a type I site-specific deoxyribonuclease subunit, 3rd locus gene and serin-protease A and B were carried by all strains, but not by V329, while serin-protease E was absent in V329 and in another isolate. Four isolates and V329 harboured the fibronectin-binding protein B gene. SCC showed the highest value in the milk sample affected by the only strain carrying all the virulence factors considered. Potential large variability of virulence was evidenced among V329 and all bap-positive Staph. aureus strains considered: the carriage of fnb could enhance the accumulation of biofilm, but the lack of lukD/E and splA, B or E might decrease the invasiveness of strain. PMID:25850658

  14. Stpahylococcus aureus biofilms on central venous haemodialysis catheters Biofilmes de Staphylococcus aureus em cateter venoso central em hemodiálise

    Directory of Open Access Journals (Sweden)

    Elisabeth Eyko Aoki

    2005-12-01

    Full Text Available Biofilm bacterial infections are common in patients undergoing treatment with haemodialysis. This study involved 16 patients (7 males, 9 females; ages from 22 to 81 with an average age of 50 who had had a total of 25 temporary haemodialysis polyurethane catheter insertions into the subclavian vein (22 dual-lumen and 3 triple-lumen. The catheters remained in place from 3 to 91 days, on an average of 47 days. The reasons for catheter removal were: bad functioning (44%, suspicion of catheter-related infection (20%, availability of permanent access (16%, accidental removal (12%, signs and symptoms of infection at the site of catheter insertion (4%, and exogenous contamination (4%. Positive tip cultures were observed on seven of the catheters (28%, showing three positive blood cultures. The Staphylococcus aureus were identified in 12% of the blood cultures and isolated from one of the hubs, and biofilms were observed on all catheter tips. The S. aureus retrieved from both blood and catheters (tips and hubs were resistant to penicillin and susceptible to azithromycin, ciprofloxacin, clindamycin, chloramphenicol, gentamicin, oxacillin, rifampin, sulfamethoxazole, tetracycline, and vancomycin. The S. aureus strains isolated from both blood and catheters (tips and hubs were considered to be identical based on antibiotic susceptibility patterns and genetic similarity assessed using an automated ribotyping system.As infecções devido a biofilmes bacterianos são comuns em pacientes sob tratamento em hemodiálise. Neste estudo, 16 pacientes (7 homens, 9 mulheres, de 22 a 81 anos, média 50 anos de idade, com um total de 25 cateteres de hemodiálise (3 de triplo-lúmen e 22 de duplo-lúmen de poliuretano inseridos em veia subclávia foram estudados. Os cateteres permaneceram no local de 3 a 91 dias (média de 47 dias. Os cateteres foram removidos devido ao: mau funcionamento (44%, suspeita de infecção relacionada ao cateter (20%, viabilidade de um acesso

  15. A STUDY ON THE POST SURGICAL WOUND INFECTIONS IN A TERTIARY CARE HOSPITAL IN KANCHIPURAM

    Directory of Open Access Journals (Sweden)

    Sivasankari

    2016-03-01

    Full Text Available BACKGROUND Surgical site infections are the infections that occur within thirty days after the operative procedure (Except in case of added implants. Surgical site infections are the 3rd most commonly reported nosocomial infections accounting for a quarter of all such infections. A wide range of organisms are known to infect wounds like gram positive cocci, gram negative bacilli, spore formers, aerobes and anaerobes. Despite the advances in operative technique and better understanding of the pathogenesis of wound infections and wound healing, surgical site infections still remain a major source of morbidity and mortality. Hence, this study was done to identify the aetiological bacterial agents and their antibiogram pattern and the risk factors associated with surgical site infections. METHODS Wounds were examined for signs and symptoms of infection in postoperative ward. All the pus swabs were processed and identified as per standard methods of identification. Antibiogram was performed as per CLSI guidelines. The isolates were screened and confirmed with double disc diffusion method using CLSI guidelines. RESULTS The rate of surgical site infections in our study was 8.3%. The rate of surgical site infections was higher (73.3% in emergency surgeries than the elective surgeries. E. coli was the commonest isolate among gram negative bacilli; 33.3% isolates of E. coli were ESBL procedures. E. coli were sensitive to cefepime and ciprofloxacin and showed maximum resistance to ampicillin and ceftazidime. All the E. coli were sensitive to imipenem.

  16. Surgical management of ectopic pregnancy.

    Science.gov (United States)

    Stock, Laura; Milad, Magdy

    2012-06-01

    Surgery remains an acceptable, and sometimes necessary, modality for the treatment of ectopic pregnancy. Laparoscopy is the preferred method of access, yet controversy remains regarding the optimal procedure and postoperative management. Generally, salpingostomy is employed with the goal of maintaining fertility, although data to support this tenet are lacking. In most cases, the decision to perform conservative versus radical surgery is on the basis of the patient's history, her desire for future fertility, and surgical findings. The procedures of salpingostomy and salpingectomy, techniques to prevent and control blood loss at the time of surgery, and surgical options for nontubal ectopic pregnancies are reviewed. PMID:22510627

  17. Blepharoplasty and periorbital surgical rejuvenation

    Directory of Open Access Journals (Sweden)

    Milind Naik

    2013-01-01

    Full Text Available The periorbital region forms the epicenter of facial aging changes and receives highest attention from physicians and patients. The concern about visual function, clubbed with the need for hidden incisions, makes the periocular region a highly specialized surgical area, most appropriately handled by an ophthalmic plastic surgeon. The article provides an overview of cosmetic eyelid and facial surgery in the periocular region. Common aesthetic surgical procedures as well as ocular side-effects of commonly performed periocular injections are discussed from the dermatologist′s point of view.

  18. The molecular changing mechanism of Ampicillin-Sulbactam resistant Staphylococcus aureus towards Methicillin resistant Staphylococcus aureus

    Directory of Open Access Journals (Sweden)

    Mieke Hemiawati Satari

    2005-12-01

    Full Text Available The aim of this study was to determine the molecular changing of S.aureus, which is resistant to Ampicillin-Sulbactam and then become resistant to Methicillin as a result of improper dosage. The study was conducted by isolating Ampicillin-Sulbactam resistant and Methicillin Resistant S.aureus (MRSA, afterwards an amplification process was performed by PCR (Polymerase Chain Reaction. to isolate the betalactamase enzyme regulator and PBP 2a genes. The result of this research showed that there were a deletion of few amino acids from the regulator gene, and a suspicion that the DNA sequence had been substituted from PBP 2 gene into PBP 2a (gen mec. This process had formed MRSA.

  19. Towards an in vivo wireless mobile robot for surgical assistance.

    Science.gov (United States)

    Hawks, Jeff A; Rentschler, Mark E; Redden, Lee; Infanger, Roger; Dumpert, Jason; Farritor, Shane; Oleynikov, Dmitry; Platt, Stephen R

    2008-01-01

    The use of miniature in vivo robots that fit entirely inside the peritoneal cavity represents a novel approach to laparoscopic surgery. Previous work has demonstrated that mobile and fixed-base in vivo robots can be used to improve visualization of the surgical field and perform surgical tasks such as collecting biopsy tissue samples. All of these robots used tethers to provide for power and data transmission. This paper describes recent work focused on developing a modular wireless mobile platform that could be used for in vivo robotic sensing and manipulation applications. One vision for these types of self-contained in vivo robotic devices is that they could be easily carried and deployed by non-medical personnel at the site of an injury. Such wireless in vivo robots are much more transportable and lower cost than current robotic surgical assistants, and could ultimately allow a surgeon to become a remote first responder irrespective of the location of the patient. PMID:18391277

  20. [Surgical treatment for pancreatic neuroendocrine neoplasmas].

    Science.gov (United States)

    Wu, Junli; Guo, Feng; Wei, Jishu; Lu, Zipeng; Chen, Jianmin; Gao, Wentao; Li, Qiang; Jiang, Kuirong; Dai, Cuncai; Miao, Yi

    2016-01-01

    Pancreatic neuroendocrine neoplasmas (PNENs) are classified into functioning & non-functioning tumors. The radical surgery is the only effective way for the cure & long-term survival. For the locoregional resectable tumors, the surgical resection is the first choice of treatment; the surgical procedures include local resection (enucleation) and standard resection. For the insulinomas and non-functioning tumors less than 2 cm, local resection (enucleation),distal pancreatectomy with spleen-preservation or segmental pancreatectomy are the commonly selected procedures. The radical resections with regional lymph nodes dissection, including pancreaticoduodenectomy, distal pancreatectomy and middle segmental pancreatectomy, should be applied for tumors more than 2 cm or malignant ones. For the locoregional advanced or unresectable functioning tumors, debulking surgery should be performed and more than 90% of the lesions including primary and metastatic tumors should be removed; for the non-functioning tumors, if complicated with biliary & digestive tract obstruction or hemorrhage, the primary tumors should be resected. The liver is the most frequent site of metastases for PNENs and three types of metastases are defined. For typeⅠmetastasis, patients are recommended for surgery if there are no contraindications; For type II metastasis, debulking surgery should be applied and at least 90% of metastatic lesions should be resected, and for patients with primary tumors removed and no extrahepatic metastases, or for patients with well-differentiated (G1/G2) tumors, liver transplantation may be indicated. For the unresectable type Ⅲ metastasis, multiple adjuvant therapies should be chosen. PMID:27045238