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Sample records for aureus surgical site

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

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

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    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

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

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    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

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

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    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...

  5. 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...

  6. 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.

  7. 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. ...

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

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    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.

  9. Frequently Asked Questions about Surgical Site Infections

    Science.gov (United States)

    ... quirúrgico" [PDF - 217 KB] October 2008 Supplement of Infection Control and Hospital Epidemiology (Volume 29, Number S1) Guideline for the Prevention of Surgical Site Infection, 1999 Top of page Print page Get email ...

  10. 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...

  11. Pelvic Surgical Site Infections in Gynecologic Surgery

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    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.

  12. Surgical Site Infection Surveillance Following Ambulatory Surgery

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    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.

  13. Molecular characteristics of community-associated methicillin-resistant Staphylococcus aureus colonizing surgical patients in Greece.

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    Hadjihannas, Linos; Psichogiou, Mina; Empel, Joanna; Kosmidis, Chris; Goukos, Dimitrios; Bouzala, Jina; Georgopoulos, Sotirios; Malhotra-Kumar, Surbhi; Harbarth, Stephan; Daikos, George L

    2012-12-01

    Fifty-one of 925 patients screened for methicillin-resistant Staphylococcus aureus (MRSA) upon admission to a surgical unit were MRSA carriers; 15 were classified as community- and 36 as hospital-associated-MRSA. Fourteen of 22 isolates typed by molecular methods belonged to the European clone ST80-IVc, 3 of which exhibited resistance to ≥3 non-β-lactam antibiotics. PMID:23021063

  14. Surgical Site Infections After Pediatric Spine Surgery.

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    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

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

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    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

  16. Untreatable Surgical Site Infection: Consider Pyoderma Gangrenosum

    OpenAIRE

    Ilan Berlinrut, MD; Nitasha Bhatia, MD; Jonathan M. Josse, MD, MSc; David de Vinck, DO; Sanjeev Kaul, MD

    2014-01-01

    Summary: Pyoderma gangrenosum (PG) is an inflammatory disease characterized by sterile infiltration of the skin by neutrophils. We describe a case of a 63-year-old woman who developed PG following an abdominal wall reconstruction. Her initial presentation was thought to be consistent with a surgical site infection. Antibiotic therapy was initiated, and the patient was taken for multiple irrigation/lavage of her abdomen and debridement of necrotic tissue. Wound cultures remained negative, and ...

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

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    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.

  18. 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...

  19. Epidemiology of Surgical Site Infection in a Community Hospital Network.

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    Baker, Arthur W; Dicks, Kristen V; Durkin, Michael J; Weber, David J; Lewis, Sarah S; Moehring, Rebekah W; Chen, Luke F; Sexton, Daniel J; Anderson, Deverick J

    2016-05-01

    OBJECTIVE To describe the epidemiology of complex surgical site infection (SSI) following commonly performed surgical procedures in community hospitals and to characterize trends of SSI prevalence rates over time for MRSA and other common pathogens METHODS We prospectively collected SSI data at 29 community hospitals in the southeastern United States from 2008 through 2012. We determined the overall prevalence rates of SSI for commonly performed procedures during this 5-year study period. For each year of the study, we then calculated prevalence rates of SSI stratified by causative organism. We created log-binomial regression models to analyze trends of SSI prevalence over time for all pathogens combined and specifically for MRSA. RESULTS A total of 3,988 complex SSIs occurred following 532,694 procedures (prevalence rate, 0.7 infections per 100 procedures). SSIs occurred most frequently after small bowel surgery, peripheral vascular bypass surgery, and colon surgery. Staphylococcus aureus was the most common pathogen. The prevalence rate of SSI decreased from 0.76 infections per 100 procedures in 2008 to 0.69 infections per 100 procedures in 2012 (prevalence rate ratio [PRR], 0.90; 95% confidence interval [CI], 0.82-1.00). A more substantial decrease in MRSA SSI (PRR, 0.69; 95% CI, 0.54-0.89) was largely responsible for this overall trend. CONCLUSIONS The prevalence of MRSA SSI decreased from 2008 to 2012 in our network of community hospitals. This decrease in MRSA SSI prevalence led to an overall decrease in SSI prevalence over the study period. Infect Control Hosp Epidemiol 2016;37:519-526. PMID:26864617

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

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    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.

  2. Pathogenic mechanisms in the development of surgical site infections

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    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-...

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

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    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,...

  4. Antibiotic Susceptibility Pattern of Aerobic and Anaerobic Bacteria Isolated From Surgical Site Infection of Hospitalized Patients

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    Akhi, Mohammad Taghi; Ghotaslou, Reza; Beheshtirouy, Samad; Asgharzadeh, Mohammad; Pirzadeh, Tahereh; Asghari, Babak; Alizadeh, Naser; Toloue Ostadgavahi, Ali; Sorayaei Somesaraei, Vida; Memar, Mohammad Yousef

    2015-01-01

    Background: Surgical Site Infections (SSIs) are infections of incision or deep tissue at operation sites. These infections prolong hospitalization, delay wound healing, and increase the overall cost and morbidity. Objectives: This study aimed to investigate anaerobic and aerobic bacteria prevalence in surgical site infections and determinate antibiotic susceptibility pattern in these isolates. Materials and Methods: One hundred SSIs specimens were obtained by needle aspiration from purulent material in depth of infected site. These specimens were cultured and incubated in both aerobic and anaerobic condition. For detection of antibiotic susceptibility pattern in aerobic and anaerobic bacteria, we used disk diffusion, agar dilution, and E-test methods. Results: A total of 194 bacterial strains were isolated from 100 samples of surgical sites. Predominant aerobic and facultative anaerobic bacteria isolated from these specimens were the members of Enterobacteriaceae family (66, 34.03%) followed by Pseudomonas aeruginosa (26, 13.4%), Staphylococcus aureus (24, 12.37%), Acinetobacter spp. (18, 9.28%), Enterococcus spp. (16, 8.24%), coagulase negative Staphylococcus spp. (14, 7.22%) and nonhemolytic streptococci (2, 1.03%). Bacteroides fragilis (26, 13.4%), and Clostridium perfringens (2, 1.03%) were isolated as anaerobic bacteria. The most resistant bacteria among anaerobic isolates were B. fragilis. All Gram-positive isolates were susceptible to vancomycin and linezolid while most of Enterobacteriaceae showed sensitivity to imipenem. Conclusions: Most SSIs specimens were polymicrobial and predominant anaerobic isolate was B. fragilis. Isolated aerobic and anaerobic strains showed high level of resistance to antibiotics. PMID:26421133

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

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    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...

  6. Current Approaches for the Prevention of Surgical Site Infections

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    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.

  7. Evaluation of two surveillance methods for surgical site infection

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    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.

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

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    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

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

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    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.

  10. 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

  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. 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)

  13. 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)

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

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    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

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

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    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.

  16. Surgical management of Novacor drive-line exit site infections.

    Science.gov (United States)

    Pasque, Michael K; Hanselman, Tina; Shelton, Kim; Kehoe-Huck, Beth A; Hedges, Robyn; Cassivi, Stephen D; Ewald, Gregory A; Rogers, Joseph G

    2002-10-01

    Implantable left ventricular assist device (LVAD) drive-line exit site infection, an expected consequence of currently available device use, continues to be a significant limiting factor in long-term support. We theorize that the mechanism behind the establishment of the most chronic exit site infections involves a shearing torsion injury that disrupts the tissue adherence interface with the drive-line. The resulting neo-epithelialized drainage tract prevents permanent clearance of the infection with antibiotics alone. The proposed treatment strategy of established infections involves aggressive surgical excision of the involved exit site. PMID:12400795

  17. 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...

  18. 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...

  19. 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 ...

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

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    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.

  1. Pathogenic mechanisms in the development of surgical site infections

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    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

  2. Pyoderma gangrenosum in an abdominal surgical site: a case report.

    Science.gov (United States)

    Ogata, Kenichi; Takamori, Hiroshi; Ikuta, Yoshiaki; Tanaka, Hideyuki; Ozaki, Nobuyuki; Hayashi, Hiromitsu; Ogawa, Katsuhiro; Doi, Koichi

    2015-12-01

    Pyoderma gangrenosum (PG) is an uncommon, ulcerative skin disease that is often associated with systemic diseases. Herein, we report a development of PG in a surgical site after cholecystectomy that was difficult to discriminate from surgical site infection. The patient was a 74-year-old man who had previously been diagnosed with myelodysplastic syndrome (MDS). Laparoscopic cholecystectomy was planned under diagnosis of cholecystolithiasis, but we converted to open cholecystectomy. The surgical wound was partially erythematous 4 days after surgery. In spite of opening the wound, cleansing it with sterile saline, and administration of antibiotics, inflammation spread with erosion. The clinical manifestations and histopathologic features of biopsy specimen indicated that diagnosis of PG associated with MDS was most likely. Administration of glucocorticoids made a rapid response of skin inflammation. The differential diagnosis of postoperative wound healing complications that were unresponsive to conventional wound local care and antibiotic therapy should include PG, especially in patients with systemic diseases such as MDS. PMID:26943446

  3. A study on Surgical Site Infections (SSI and associated factors in a government tertiary care teaching hospital in Mysore, Karnataka

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    Naveen Kikkeri Hanumantha Setty

    2014-04-01

    Full Text Available Background: Surgical site infections (SSI are the most common nosocomial infection and frequently cause morbidity and mortality among inpatients of hospitals. The incidence varies from hospital to hospital. Several factors affect the development of SSI. Objectives: To study the incidence of and to identify the risk factors for Surgical Site Infections in the surgical wards of K.R.Hospital, Mysore. Materials and Methods: Study Period: July to August 2007 Study Subjects: One hundred and eighty patients who underwent various surgeries in the General Surgery department of K.R. Hospital Mysore. A predesigned and pretested proforma was used to collect the data. Surgical sites were examined and graded. Culture and sensitivity testing was done on infected wounds. Data was analyzed using SPSS 13 software. Results: Among 180 patients 39 (21.66% developed surgical site infections (SSI. Of 39 SSIs 20 were grade 3 and 19 were grade 4 infections. SSIs were found more commonly among the aged, males, underweight and overweight, anaemics, diabetics, hypertensives, patients with longer pre operative waiting time, with multiple blood transfusions and without antibiotic prophylaxis. Age, Sex, BMI, Diabetes mellitus, Blood transfusion and pre operative waiting had univariate statistical significance. Gender, extreme BMI, Diabetes mellitus and Blood transfusion remained independent predictors of surgical site infection in multivariate analysis. Most of the SSIs yielded multiple organisms and Staphylococcus aureus was the predominant. Resistance to tetracycline was most common. Conclusion: The incidence of SSI is high. Gender, extremes of BMI, diabetes mellitus and blood transfusion are the important risk factors for it.

  4. Surgical site infections following transcatheter apical aortic valve implantation: incidence and management

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    Baillot Richard

    2012-11-01

    Full Text Available Abstract Objective The present study was undertaken to examine the incidence and management of surgical site infection (SSI in patients submitted to transapical transcatheter aortic valve implantation (TA-TAVI. Methods From April 2007 to December 2011, 154 patients underwent TA-TAVI with an Edwards Sapien bioprosthesis (ES at the Institut Universitaire de Cardiologie et Pneumologie de Québec (IUCPQ as part of a multidisciplinary program to prospectively evaluate percutaneous aortic valve implantation. Patient demographics, perioperative variables, and postoperative complications were recorded in a prospective registry. Results Five (3.2% patients in the cohort presented with an SSI during the study period. The infections were all hospital-acquired (HAI and were considered as organ/space SSI’s based on Center for Disease Control criteria (CDC. Within the first few weeks of the initial procedure, these patients presented with an abscess or chronic draining sinus in the left thoracotomy incision and were re-operated. The infection spread to the apex of the left ventricle in all cases where pledgeted mattress sutures could be seen during debridement. Patients received multiple antibiotic regimens without success until the wound was surgically debrided and covered with viable tissue. The greater omentum was used in three patients and the pectoralis major muscle in the other two. None of the patients died or had a recurrent infection. Three of the patients were infected with Staphylococcus epidermidis, one with Staphylococcus aureus, and one with Enterobacter cloacae. Patients with surgical site infections were significantly more obese with higher BMI (31.4±3.1 vs 26.2±4.4 p=0.0099 than the other patients in the cohort. Conclusions While TA-TAVI is a minimally invasive technique, SSIs, which are associated with obesity, remain a concern. Debridement and rib resection followed by wound coverage with the greater omentum and/or the pectoralis major

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

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    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.

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

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    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

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

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    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.

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

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    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.

  9. 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

  10. 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.

  11. A STUDY OF THE BACTERIOLOGICAL PROFILE OF SURGICAL SITE INFECTIONS AND THEIR ANTIBIOGRAM

    OpenAIRE

    Bala Chandrasekhar; Radhika; Jyothi Padmaja

    2015-01-01

    Infections are encountered by all surgeons post operatively. Sometimes post - operative infections lead to death. Death from infection was so common after compound fractures, amputations and gunshot wounds. Now a day’s surgical site infections (SSI) are main ly due to hospital acquired infections and irrational use of antibiotics, so bacteriological profile of surgical site infections and their antibiogram is an essential compliment to surgical skills. OBJECTIVE: Th...

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

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    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

  13. 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

  14. Minimal inhibitory concentration of microorganisms causing surgical site infection in referral hospitals in North of Iran, 2011-2012

    Science.gov (United States)

    Alikhani, Ahmad; Babamahmoodi, Farhang; Foroutan Alizadegan, Laleh; Shojaeefar, Arman; Babamahmoodi, Abdolreza

    2015-01-01

    Background: A surgical site infection (SSI) is the most common nosocomial infection after surgery and is the third most common infection in hospitalized patients. The aim of this study was to asses minimum inhibitory concentration (MIC) of the causing agents of SSI and antimicrobial susceptibility patterns. Methods: This cross-sectional study was done in three referral hospitals in North of Iran during 2011-2012. The samples were taken one month after orthopedic, abdominal, cesarean section surgery and coronary artery bypass graft (CABG) in patients with scores compatible to SSIs criteria. The sample was sent for bacteriologic culture and MIC determination for positive cases by broth microdilution method. The data were collected and analyzed. Results: From 103 positive cases S. aureus, E.coli and coagulase negative staphylococci were the most common isolated agents as 29.12%, 23.3% and 21.3%, respectively. S. aureus was sensitive to vancomycin (70%), amikacin (70%) and teicoplanin (76.6%) and cogulase negative staphylococci was sensitive to vancomycin (68.1%) and teicoplanin (72.6%) and E.coli to amikacin (95.83%) and imipenem and meropenem (66.66%). P.aeroginosa showed no sensitivity to cefepime and was sensitive to imipenem (93.75%) and meropenem (81.25%). Conclusion: The most important point is worrisome problem of the increased MIC of S. aureus to vancomycin that causes difficult use in the treatment of staphylococcal SSIs. In spite of resistance of micro-organisms to cephalosporins, gram negative organisms had low MIC to carbapenemes especially P.aeroginosa although the rate of its MIC is increasing. PMID:26221495

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

    Directory of Open Access Journals (Sweden)

    Ippolito Giuseppe

    2008-03-01

    Full Text Available 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. Methods In 2002, a one-month, prospective national multicenter surveillance study was conducted in General and Gynecological units of 48 Italian hospitals. Case ascertainment of SSI was carried out using standardized surveillance methodology. To assess potential risk factors for SSI we used a conditional logistic regression model. We also reported the odds ratios of in-hospital and postdischarge SSI. Results SSI occurred in 241 (5.2% of 4,665 patients, of which 148 (61.4% during in-hospital, and 93 (38.6% during postdischarge period. Of 93 postdischarge SSI, sixty-two (66.7% and 31 (33.3% were detected through telephone interview and questionnaire survey, respectively. Higher SSI incidence rates were observed in colon surgery (18.9%, gastric surgery (13.6%, and appendectomy (8.6%. If considering risk factors for SSI, at multivariate analysis we found that emergency interventions, NNIS risk score, pre-operative hospital stay, and use of drains were significantly associated with SSI occurrence. Moreover, risk factors for total SSI were also associated to in-hospital SSI. Additionally, only NNIS, pre-operative hospital stay, use of drains, and antibiotic prophylaxis were associated with postdischarge SSI. Conclusion Our study provided information on risk factors for SSI in a large population in general surgery setting in Italy. Standardized postdischarge surveillance detected 38.6% of all SSI. We also compared risk factors for in-hospital and postdischarge SSI

  16. 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...

  17. 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...

  18. 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

  19. Surgical Site Infections in Genital Reconstruction Surgery for Gender Reassignment, Detroit: 1984–2008

    OpenAIRE

    Zhao, Jing J.; Marchaim, Dror; Palla, Mohan B.; Bogan, Christopher W.; Hayakawa, Kayoko; Tansek, Ryan; Moshos, Judy; Muthusamy, Arunkumar; Kotra, Harikrishna; Lephart, Paul R.; Wilson, Alan N.; Kaye, Keith S.

    2014-01-01

    Background: Gender reassignment surgery (i.e., male-to-female or female-to-male) entails a series of complex surgical procedures. We conducted a study to explore epidemiologic characteristics of patients who underwent genital reconstruction operations as components of gender reassignment and to analyze risk factors for surgical-site infections (SSIs) following these operations.

  20. 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

  1. 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

  2. Staphylococcus aureus infections in children in an Iranian referral pediatric Hospital

    OpenAIRE

    SABOUNI, F.; RANJBARI, R.; B Pourakbari; Mahmoudi, S; TEYMURI, M.; TAGHI HAGHI ASHTIANI, M.; MOVAHEDI, Z.; S Mamishi

    2013-01-01

    Summary Introduction. Staphylococcus aureus is associated with various infections ranging from skin and soft tissues such as surgical site infections and abscesses to lower respiratory tracts and bloodstream. The aim of this study was to evaluate underlying condition of patients with S. aureus infections in an Iranian referral pediatric Hospital. Material and methods. Information was extracted retrospectively from the medical records of patients who were diagnosed with S. aureus infections. D...

  3. Selection of egg attachment sites by the Indian Golden Gecko Calodactylodes aureus (Beddome, 1870 (Reptilia: Gekkonidae in Andhra Pradesh, India

    Directory of Open Access Journals (Sweden)

    R. Sreekar

    2010-10-01

    Full Text Available Some geckos lay eggs at communal egg deposition sites with as many as 300 eggs per site. Selection of egg deposition sites is important to avoid egg damage and predation. We investigated survival rates of communal egg clutches of the Indian Golden Gecko Calodactylodes aureus (Reptilia: Gekkonidae. Our results show that communal clutches have a higher survival rate in sites with water bodies and without anthropogenic activities, in comparison to sites having the opposite combination. These findings are discussed in the context of the status of this gecko.

  4. 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....

  5. 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...

  6. An In Vitro Comparison of PMMA and Calcium Sulfate as Carriers for the Local Delivery of Gallium(III) Nitrate to Staphylococcal Infected Surgical Sites.

    Science.gov (United States)

    Garcia, Rebecca A; Tennent, David J; Chang, David; Wenke, Joseph C; Sanchez, Carlos J

    2016-01-01

    Antibiotic-loaded bone cements, including poly(methyl methacrylate) (PMMA) and calcium sulfate (CaSO4), are often used for treatment of orthopaedic infections involving Staphylococcus spp., although the effectiveness of this treatment modality may be limited due to the emergence of antimicrobial resistance and/or the development of biofilms within surgical sites. Gallium(III) is an iron analog capable of inhibiting essential iron-dependent pathways, exerting broad antimicrobial activity against multiple microorganisms, including Staphylococcus spp. Herein, we evaluated PMMA and CaSO4 as carriers for delivery of gallium(III) nitrate (Ga(NO3)3) to infected surgical sites by assessing the release kinetics subsequent to incorporation and antimicrobial activity against S. aureus and S. epidermidis. PMMA and to a lesser extent CaSO4 were observed to be compatible as carriers for Ga(NO3)3, eluting concentrations with antimicrobial activity against planktonic bacteria, inhibiting bacterial growth, and preventing bacterial colonization of beads, and effective against established bacterial biofilms of S. aureus and S. epidermidis. Collectively, our in vitro results indicate that PMMA is a more suitable carrier compared to CaSO4 for delivery of Ga(NO3)3; moreover they provide evidence for the potential use of Ga(NO3)3 with PMMA as a strategy for the prevention and/or treatment for orthopaedic infections. PMID:26885514

  7. 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.

  8. 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.

  9. The Effects of Surgical Hand Scrubbing Protocols on Skin Integrity and Surgical Site Infection Rates: A Systematic Review.

    Science.gov (United States)

    Liu, Liang Qin; Mehigan, Sinead

    2016-05-01

    This systematic review aimed to critically appraise and synthesize updated evidence regarding the effect of surgical-scrub techniques on skin integrity and the incidence of surgical site infections. Databases searched include the Cumulative Index to Nursing and Allied Health Literature, MEDLINE, Embase, and Cochrane Central. Our review was limited to eight peer-reviewed, randomized controlled trials and two nonrandomized controlled trials published in English from 1990 to 2015. Comparison models included traditional hand scrubbing with chlorhexidine gluconate or povidone-iodine against alcohol-based hand rubbing, scrubbing with a brush versus without a brush, and detergent-based antiseptics alone versus antiseptics incorporating alcohol solutions. Evidence showed that hand rubbing techniques are as effective as traditional scrubbing and seem to be better tolerated. Hand rubbing appears to cause less skin damage than traditional scrub protocols, and scrub personnel tolerated brushless techniques better than scrubbing using a brush. PMID:27129749

  10. 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

  11. 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.

  12. 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.

  13. 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 ...

  14. 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...

  15. 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.

  16. 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)

  17. A STUDY OF THE BACTERIOLOGICAL PROFILE OF SURGICAL SITE INFECTIONS AND THEIR ANTIBIOGRAM

    Directory of Open Access Journals (Sweden)

    Bala Chandrasekhar

    2015-08-01

    Full Text Available Infections are encountered by all surgeons post operatively. Sometimes post - operative infections lead to death. Death from infection was so common after compound fractures, amputations and gunshot wounds. Now a day’s surgical site infections (SSI are main ly due to hospital acquired infections and irrational use of antibiotics, so bacteriological profile of surgical site infections and their antibiogram is an essential compliment to surgical skills. OBJECTIVE: The objective of the present study is to isolat e the aerobic bacteria which are associated with the post - operative surgical site infections and to determine the frequency, with which various pathogens are causing surgical site infections and their antibiogram. MATERIALS AND METHODS: Swabs were collecte d from the local wound site of 100 clinically diagnosed cases of surgical site infections in the wards of surgery, orthopedics, gynecology and obstetrics, Andhra Medical College, Visakhapatnam, Andhra Pradesh. They were processed and different bacteria wer e isolated by using standard bacteriological procedures and biochemical reactions. Antibiotic susceptibility testing was performed by Kirby Bauer disc diffusion test. RESULTS: Coagulase positive staphylococci emerged as a commonest organism with an inciden ce of 32% followed by Pseudomonas, Escherichia coli. Methicillin was found to be the most effective antibiotic against various Staphylo co ccal strains, followed by Clindamycin. All the staphylococcal strains iso l ated were resistant to Penicillin and Erythro mycin. Amikacin was found to be effective against Pseudomonas with sensitivity of 37.5%. All strains were resistant to Norfloxacin. Several isolates were found to be multi - drug resistant, and it was observed more in Gram negative bacterial isolates.

  18. Persistence of a bioluminescent Staphylococcus aureus strain on and around degradable and non-degradable surgical meshes in a murine model.

    Science.gov (United States)

    Daghighi, Seyedmojtaba; Sjollema, Jelmer; Jaspers, Valery; de Boer, Leonie; Zaat, Sebastian A J; Dijkstra, Rene J B; van Dam, Gooitzen M; van der Mei, Henny C; Busscher, Henk J

    2012-11-01

    Biomaterials are increasingly used for the restoration of human function, but can become infected as a result of peri- or early post-operative bacterial contamination, although biomaterial-associated infections (BAIs) can also initiate at any time from hematogenous spreading of bacteria from an infection elsewhere in the body. Infecting bacteria in BAIs not only seek shelter in their own protective biofilm matrix, but also hide in surrounding tissue. This study compares staphylococcal persistence on and around a degradable and non-degradable surgical mesh through the use of longitudinal bioluminescence imaging in a murine model, including histological evaluation of surrounding tissue after sacrifice. Surgical meshes were first contaminated with bioluminescent Staphylococcus aureus Xen29 and subsequently subcutaneously implanted in mice. Bioluminescent staphylococci persisted on and around non-degradable meshes during the 28-day course of the study, whereas bioluminescence returned to control levels and bacteria disappeared from surrounding tissues once a degradable mesh had fully dissolved. Thus the application of degradable biomaterials yields major advantages with respect to the prevention of BAIs, as dissolution of the implant not only is associated with elimination of the protective biofilm mode of growth of the infecting organisms, but also allows the immune system to clear the surrounding tissue from infecting organisms. PMID:22824527

  19. 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

    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...

  20. 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....

  1. 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

  2. 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

  3. 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

  4. 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

  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. 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 ...

  7. Lymphoscintigraphy Defines New Lymphatic Pathways from Cutaneous Melanoma Site: Clinical Implications and Surgical Management

    International Nuclear Information System (INIS)

    Sentinel lymph node biopsy is commonly applied as staging procedure of regional lymph nodes in patients with cutaneous melanoma. Dynamic lymphoscintigraphy defines the lymphatic pathways from a primary melanoma site and allows to identify the node receiving lymphatic drainage from the primary tumor, which is the sentinel lymph node. In rare cases, lymphoscintigraphy shows sites of lymphatic drainage in nonclassical basins never described in the past when lymphatic drainage was considered only according to the anatomical proximity of the tumor primary site. These peculiar sentinel nodes, so-called “uncommon/interval” nodes, must be surgically removed because they may contain micrometastatic disease and may be the only site of nodal involvement

  8. 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.

  9. Derivation and Validation of the Surgical Site Infections Risk Model Using Health Administrative Data.

    Science.gov (United States)

    van Walraven, Carl; Jackson, Timothy D; Daneman, Nick

    2016-04-01

    OBJECTIVE Surgical site infections (SSIs) are common hospital-acquired infections. Tracking SSIs is important to monitor their incidence, and this process requires primary data collection. In this study, we derived and validated a method using health administrative data to predict the probability that a person who had surgery would develop an SSI within 30 days. METHODS All patients enrolled in the National Surgical Quality Improvement Program (NSQIP) from 2 sites were linked to population-based administrative datasets in Ontario, Canada. We derived a multivariate model, stratified by surgical specialty, to determine the independent association of SSI status with patient and hospitalization covariates as well as physician claim codes. This SSI risk model was validated in 2 cohorts. RESULTS The derivation cohort included 5,359 patients with a 30-day SSI incidence of 6.0% (n=118). The SSI risk model predicted the probability that a person had an SSI based on 7 covariates: index hospitalization diagnostic score; physician claims score; emergency visit diagnostic score; operation duration; surgical service; and potential SSI codes. More than 90% of patients had predicted SSI risks lower than 10%. In the derivation group, model discrimination and calibration was excellent (C statistic, 0.912; Hosmer-Lemeshow [H-L] statistic, P=.47). In the 2 validation groups, performance decreased slightly (C statistics, 0.853 and 0.812; H-L statistics, 26.4 [P=.0009] and 8.0 [P=.42]), but low-risk patients were accurately identified. CONCLUSION Health administrative data can effectively identify postoperative patients with a very low risk of surgical site infection within 30 days of their procedure. Records of higher-risk patients can be reviewed to confirm SSI status. Infect. Control Hosp. Epidemiol. 2016;37(4):455-465. PMID:26785686

  10. 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.

  11. 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...

  12. 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...

  13. 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...

  14. 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...

  15. 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...

  16. 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...

  17. 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...

  18. 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...

  19. Health and Economic Impact of Surgical Site Infections Diagnosed after Hospital Discharge

    OpenAIRE

    Perencevich, Eli N.; Sands, Kenneth E.; Cosgrove, Sara E.; Guadagnoli, Edward; Meara, Ellen; Platt, Richard

    2003-01-01

    Although surgical site infections (SSIs) are known to cause substantial illness and costs during the index hospitalization, little information exists about the impact of infections diagnosed after discharge, which constitute the majority of SSIs. In this study, using patient questionnaire and administrative databases, we assessed the clinical outcomes and resource utilization in the 8-week postoperative period associated with SSIs recognized after discharge. SSI recognized after discharge was...

  20. Risk of surgical site infection in paediatric herniotomies without any prophylactic antibiotics: A preliminary experience

    Directory of Open Access Journals (Sweden)

    Dhananjay Vaze

    2014-01-01

    Full Text Available Background: Different studies underline the use of pre-operative antibiotic prophylaxis in clean surgeries like herniotomy and inguinal orchiopexy. But, the meta-analyses do not recommend nor discard the use of prophylactic pre-operative antibiotics. The scarcity of controlled clinical trials in paediatric population further vitiates the matter. This study assessed the difference in the rate of early post-operative wound infection cases in children who received single dose of pre-operative antibiotics and children who did not receive antibiotics after inguinal herniotomy and orchiopexy. Materials and Methods: This randomised prospective study was conducted in Paediatric Surgery department of PGIMER Chandigarh. Out of 251 patients, 112 patients were randomised to the case group and 139 were ascribed to the control group. The patients in control group were given a standard regimen of single dose of intravenous antibiotic at the time of induction followed by 3-4 days of oral antibiotic. Case group patients underwent the surgical procedure in similar manner with no antibiotic either at the time of induction or post-operatively. Results: The incidence of surgical site infection in case group was 3.73 % and that in control group was 2.22%. The observed difference in the incidence of surgical site infection was statistically insignificant (P value = 0.7027. The overall infection rate in case and control group was 2.89%. Conclusions: Our preliminary experience suggests that there is no statistically significant difference in the proportion of early post-operative wound infection between the patients who received single dose of pre-operative antibiotics and the patients who received no antibiotics after inguinal herniotomy and orchiopexy. The risk of surgical site infection in paediatric heriotomies does not increase even if the child′s weight is less than his/her expected weight for age.

  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. Normothermia to Prevent Surgical Site Infections After Gastrointestinal Surgery: Holy Grail or False Idol?

    Science.gov (United States)

    Lehtinen, Simon J.; Onicescu, Georgiana; Kuhn, Kathy M.; Cole, David J.; Esnaola, Nestor F.

    2012-01-01

    Objective To analyze the association between perioperative normothermia (temperature ≥36°C) and surgical site infections (SSIs) after gastrointestinal (GI) surgery. Summary of Background Data Although active warming during colorectal surgery reduces SSIs, there is limited evidence that perioperative normothermia is associated with lower rates of SSI. Nonetheless, hospitals participating in the Surgical Care Improvement Project must report normothermia rates during major surgery. Methods We conducted a nested, matched, case-control study; cases consisted of GI surgery patients enrolled in our National Surgical Quality Improvement Program database between March 2006 and March 2009 who developed SSIs. Patient/surgery risk factors for SSI were obtained from the National Surgical Quality Improvement Program database. Perioperative temperature/antibiotic/glucose data were obtained from medical records. Cases/controls were compared using univariate/random effects/logistic regression models. Independent risk factors for SSIs were identified using multivariate/random effects/logistic regression models. Results A total of 146 cases and 323 matched controls were identified; 82% of patients underwent noncolorectal surgery. Cases were more likely to have final intraoperative normothermia compared with controls (87.6% vs. 77.8%, P = 0.015); rates of immediate postoperative normothermia were similar (70.6% vs. 65.3%, respectively, P = 0.19). Emergent surgery/higher wound class were associated with higher rates of intraoperative normothermia. Independent risk factors for SSI were diabetes, surgical complexity, small bowel surgery, and nonlaparoscopic surgery. There was no independent association between perioperative normothermia and SSI (adjusted odds ratio, 1.05; 95% confidence interval, 0.48–2.33; P = 0.90). Conclusions Pay-for-reporting measures focusing on perioperative normothermia may be of limited value in preventing SSI after GI surgery. Studies to define the benefit

  3. Towards optical fibre based Raman spectroscopy for the detection of surgical site infection

    Science.gov (United States)

    Thompson, Alex J.; Koziej, Lukasz; Williams, Huw D.; Elson, Daniel S.; Yang, Guang-Zhong

    2016-03-01

    Surgical site infections (SSIs) are common post-surgical complications that remain significant clinical problems, as they are associated with substantial mortality and morbidity. As such, there is significant interest in the development of minimally invasive techniques that permit early detection of SSIs. To this end, we are applying a compact, clinically deployable Raman spectrometer coupled to an optical fibre probe to the study of bacteria, with the long term goal of using Raman spectroscopy to detect infection in vivo. Our system comprises a 785 nm laser diode for excitation and a commercial (Ocean Optics, Inc.) Raman spectrometer for detection. Here we discuss the design, optimisation and validation of this system, and describe our first experiences interrogating bacterial cells (Escherichia coli) in vitro.

  4. 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.

  5. Predictive factors of post-discharge surgical site infections among patients from a teaching hospital

    Directory of Open Access Journals (Sweden)

    Adriana Estela Biasotti Gomes

    2014-05-01

    Full Text Available Introduction Surgical site infections (SSIs often manifest after patients are discharged and are missed by hospital-based surveillance. Methods We conducted a case-reference study nested in a prospective cohort of patients from six surgical specialties in a teaching hospital. The factors related to SSI were compared for cases identified during the hospital stay and after discharge. Results Among 3,427 patients, 222 (6.4% acquired an SSI. In 138 of these patients, the onset of the SSI occurred after discharge. Neurological surgery and the use of steroids were independently associated with a greater likelihood of SSI diagnosis during the hospital stay. Conclusions Our results support the idea of a specialty-based strategy for post-discharge SSI surveillance.

  6. Comparison of primary and delayed primary closure in dirty abdominal wounds in terms of frequency of surgical site infection

    International Nuclear Information System (INIS)

    Objective: Objective of this study was to compare primary and delayed primary wound closure for dirty abdominal wounds in terms of frequency of surgical site infection. Study Design: Randomized Controlled Trial. Place and Duration of Study: Combined Military Hospital, Multan. From 16 Sep 2010 to 15 Mar 2011. Patients and Methods: A total of 110 patients were randomly divided into two groups of 55 patients each using random numbers table. Abdominal wounds of one group were closed primarily and of other group were subjected to delayed primary wound closure. The wounds were then checked for surgical site infection for seven post operative days. Results: A higher frequency of surgical site infection was observed in primary closure group (27.3%) as compared to delayed primary closure group (9.1%) which was statistically significant (p=0.013). Conclusion: Delayed primary closure is superior to primary closure in dirty abdominal wounds in terms of frequency of surgical site infection. (author)

  7. 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....

  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. A Novel Prevention Bundle to Reduce Surgical Site Infections in Pediatric Spinal Fusion Patients.

    Science.gov (United States)

    Gould, Jane M; Hennessey, Patricia; Kiernan, Andrea; Safier, Shannon; Herman, Martin

    2016-05-01

    BACKGROUND The Surgical Care Improvement Project bundle emphasizes operative infection prevention practices. Despite implementing the Surgical Care Improvement Project bundle in 2008, spinal fusion surgical site infections (SF-SSI) continued to be prevalent for this low-volume, high-risk surgery. OBJECTIVE To design a combined pre-, peri-, and postoperative bundle (PPPB) that would lead to sustained reductions in SF-SSI rates. DESIGN Quality improvement project, before-after trial with cost-effectiveness analysis. SETTING Children's hospital. PATIENTS All spinal fusion patients, 2008-2015. INTERVENTION A multidisciplinary team developed the PPPB composed of Surgical Care Improvement Project elements plus improved wound care practices, nursing standard of care, dedicated nursing unit, dermatology assessment tool and consultation, nursing education tool using "teach back" technique, and a "Back Home" kit. SF-SSI rates were compared before (2008-2010) and after (2011-February 2015) implementation of PPPB. PPPB compliance was monitored. RESULTS A total of 224 SF surgeries were performed from 2008 to February 2015. Pre-PPPB analysis revealed median time to SF-SSI of 28 days, secondary to skin and bowel flora. Mean 3-year pre-PPPB SF-SSI rate per 100 SF surgeries was 8.2 (8/98) (2008: 13.3 [4/30], 2009: 2.7 [1/37], 2010: 9.7 [3/31]). Mean SF-SSI rate after PPPB was 2.4 (3/126) (January 2011-February 2015); there was a 71% reduction in mean SSI rate (P=.0695). No SF-SSI occurred in neuromuscular patients (P=.008) after PPPB. Compliance with PPPB elements has been 100%. CONCLUSIONS PPPB led to sustained improvement in SF-SSI rates over 50 months. The PPPB could be reproduced for other surgeries. Infect Control Hosp Epidemiol 2016;37:527-534. PMID:26818613

  10. 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

  11. 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.

  12. Surgical site infection following hernia repair in the day care setting of a developing country: a retrospective review

    International Nuclear Information System (INIS)

    Objective: To determine the incidence proportion of surgical site infection following hernia repair in a daycare setting at a tertiary care hospital of a low-income country. Methods: The retrospective audit was done at the Aga Khan University Hospital, Karachi, from June 1, 2008 to May 30, 2009. Patients with age >15 years who underwent Lichenstein's open mesh repair in daycare were included. Surgical Site Infection was labelled if the records revealed any of the following: opening of the wound by the primary surgeon; pain, tenderness and raised temperature of skin; purulent discharge from the wound; if the surgeon had documented it as a surgical site infection. SPSS 16 was used for data analysis. Results: After reviewing the retrieved files, 104 patients were found eligible. Of them, 102 (98%) were males. Overall wound-related complications were found in 13 (12.5%), whereas surgical site infection was found in 8 (7.7%) patients. The mean age of those with infections was 38.7+-18 year, while that of those with no surgical site infection was 47.8+-18 years. Smoking was found significantly associated with surgical site infection with 5.8 times higher incidence as compared to the non-smokers (OR with 95% CI: 5.6 (1.2, 25.3)). Conclusions: The incidence of surgical site infection after hernia repair with mesh in a daycare setting at a tertiary care hospital of a low-income country was higher than internationally reported incidence. Smoking was found to be a significant risk factor. (author)

  13. 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...

  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. 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.

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

    Directory of Open Access Journals (Sweden)

    Evelyn Solano Castro

    2014-04-01

    Full Text Available 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 information in databases recommended in the Course of Clinical Nursing Practice Evidence-Based, taught by the program for Collaborative Research in Evidence-Based Nursing of Costa Rica ( CIEBE -CR . The PubMed database and Cochrane LIBRARY was consulted, National Center for Biotechnology Information ( NCBI, Google Scholar, CINAHL (cummulative Index of Nursing and Allied Health Literature. SCIELO (Scientific Electronic Library on line www.Scielo.org . 22 documents were recovered, but only three were selected because had methodological rigor. For the critical analysis Critical Reading Sheets 2.0 ( FLC software was used. Was concluded that 2% chlorhexidine, is the best choice for preoperative skin preparation antiseptic, however, it is necessary to conduct further studies in order to determine which is the correct way in strength, frequency, technical and adverse effects in the pediatric population.

  18. 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.

  19. 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 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. PMID:27097626

  20. 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

  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. 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...

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

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    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.

  4. 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.

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

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    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

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

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    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

  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; Høgdall, Claus Kim

    2011-01-01

    : Evaluation study. SETTING: Danish Gynecological Cancer Database (DGCD) and the Danish multicenter trial on perioperative oxygen and surgical-site infections (PROXI). SAMPLE: Paired data from 222 patients who participated in the PROXI trial taking place at Copenhagen University Hospital, Rigshospitalet...

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

    OpenAIRE

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

    2010-01-01

    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.

  9. Post-discharge surveillance to identify colorectal surgical site infection rates and related costs.

    Science.gov (United States)

    Tanner, J; Khan, D; Aplin, C; Ball, J; Thomas, M; Bankart, J

    2009-07-01

    A growing number of surveillance studies have highlighted concerns with relying only on data from inpatients. Without post-discharge surveillance (PDS) data, the rate and burden of surgical site infections (SSIs) are underestimated. PDS data for colorectal surgery in the UK remains to be published. This is an important specialty to study since it is considered to have the highest SSI rate and is among the most expensive to treat. This study of colorectal SSI used a 30 day surveillance programme with telephone interviews and home visits. Each additional healthcare resource used by patients with SSI was documented and costed. Of the 105 patients who met the inclusion criteria and completed the 30 day follow-up, 29 (27%) developed SSI, of which 12 were diagnosed after discharge. The mean number of days to presentation of SSI was 13. Multivariable logistic analysis identified body mass index as the only significant risk factor. The additional cost of treating each infected patient was pound sterling 10,523, although 15% of these additional costs were met by primary care. The 5 month surveillance programme cost pound sterling 5,200 to run. An analysis of the surveillance nurse's workload showed that the nurse could be replaced by a healthcare assistant. PDS to detect SSI after colorectal surgery is necessary to provide complete data with accurate additional costs. PMID:19446918

  10. 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.

  11. 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

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

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    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.

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

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    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.

  14. 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

  15. Surgical Site Infection After Skin Excisions in Children: Is Field Sterility Sufficient?

    Science.gov (United States)

    Nuzzi, Laura C; Greene, Arin K; Meara, John G; Taghinia, Amir; Labow, Brian I

    2016-03-01

    Skin excisions are common procedures in children. They may be performed in the clinic using field sterility or the operating room with strict sterile technique. We compared the effect of these locations and the use of antibiotics on the incidence of surgical site infection (SSI) after skin excisions. Patients ages 0-18 years presenting to our department for the excision of lesions from 2006 to 2010 with complete medical records were included in our study. Records were reviewed for demographic characteristics, presentation, perioperative conditions, and postoperative SSI and other wound complications. Analyses were performed to estimate the costs associated with sterility technique and perioperative antibiotic use. We identified 700 patients with a mean age of 9.1 years. Of 872 lesions excised, 0.3% resulted in SSI and 1.8% had other wound complications. The incidence of SSI did not vary according to sterility technique, antibiotic usage, surgeon, age, or lesion size, type, or location. The equipment costs to excise a lesion in the operating room were 200% greater than in the clinic. The incidence of SSI after excision of benign lesions in children did not differ between those performed using clinic field sterility and those using the standard aseptic sterile technique in the operating room. A considerable cost savings could be realized by adopting field sterility for simple excisions performed in the operating room and avoiding routine perioperative antibiotics in pediatric skin excisions. PMID:25727412

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

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    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

  17. 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.

  18. 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

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

    Science.gov (United States)

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

    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 covering ileostomy, a 59-year-old woman underwent stoma closure. Six days after surgery, we diagnosed SSI. We suspected ECF, because the wound was deep and the pus resembled enteric fluid. However, CT woundgraphy showed that the wound was separated from the abdominal cavity and the intestine by the abdominal rectus muscle. Accordingly, we performed NPWT. SSI was cured and the wound was well granulated. Twenty-three days after surgery, the patient was discharged. Eventually, the wound was completely epithelialized. Discussion Although successful NPWT has been reported for open abdominal wounds, ECF is a common complication. ECF can be prevented by separating the wound from the intestine by the omentum or muscle fascia, protecting the intestinal serosa during surgery, and applying low vacuum pressure. The relationships among the wound, the fascia, and the intestine must be evaluated before abdominal SSI treatment. One good method is CT woundgraphy, which evaluates wound extent and depth, closure of muscle fascia, and the relationship between the wound and the intestine. Conclusion We report a case of CT woundgraphy before NPWT for abdominal SSI. CT woundgraphy is a good candidate for evaluating wound condition. PMID:27002290

  20. Effectiveness of a care bundle to reduce surgical site infections in patients having open colorectal surgery.

    Science.gov (United States)

    Tanner, J; Kiernan, M; Hilliam, R; Davey, S; Collins, E; Wood, T; Ball, J; Leaper, D

    2016-04-01

    Introduction In 2010 a care bundle was introduced by the Department of Health (DH) to reduce surgical site infections (SSIs) in England. To date, use of the care bundle has not been evaluated despite incorporating interventions with resource implications. The aim of this study was to evaluate the DH SSI care bundle in open colorectal surgery. Methods A prospective cohort design was used at two teaching hospitals in England. The baseline group consisted of 127 consecutive patients having colorectal surgery during a 6-month period while the intervention group comprised 166 patients in the subsequent 6 months. SSI and care bundle compliance data were collected using dedicated surveillance staff. Results Just under a quarter (24%) of the patients in the baseline group developed a SSI compared with just over a quarter (28%) in the care bundle group (p>0.05). However, compliance rates with individual interventions, both before and after the implementation of the bundle, were similar. Interestingly, in only 19% of cases was there compliance with the total care bundle. The single intervention that showed an associated reduction in SSI was preoperative warming (p=0.032). Conclusions The DH care bundle did not reduce SSIs after open colorectal surgery. Despite this, it is not possible to state that the bundle is ineffective as compliance rates before and after bundle implementation were similar. All studies evaluating the effectiveness of care bundles must include data for compliance with interventions both before and after implementation of the care bundle; poor compliance may be one of the reasons for the lower than expected reduction of SSIs. PMID:26924481

  1. An intraoperative irrigation regimen to reduce the surgical site infection rate following adolescent idiopathic scoliosis surgery.

    Science.gov (United States)

    Herwijnen, B van; Evans, N R; Dare, C J; Davies, E M

    2016-05-01

    Introduction The aim of this study was to compare the efficacy of a gentamicin antibiotic intraoperative irrigation regimen (regimen A) with a povidone-iodine intraoperative irrigation regimen (regimen B) and to evaluate the ability of adjunctive local vancomycin powder (regimen C) to reduce the surgical site infection (SSI) rate following idiopathic scoliosis correction. Methods This was a retrospective, single centre, two-surgeon cohort study of paediatric scoliosis procedures involving 118 patients under the age of 18 years who underwent correction for idiopathic scoliosis over a period of 42 months. Patients' baseline characteristics, pseudarthrosis and rates of SSI were compared. Results Baseline characteristics were comparable in all three groups, with the exception of sex distribution. Over a quarter (27%) of patients with regimen B were male compared with 13% and 6% for regimens A and C respectively. Patients were mostly followed up for a minimum of 12 months. The SSI rate for both superficial and deep infections was higher with regimen A (26.7%) than with regimens B and C (7.0% and 6.3% respectively). The SSI rates for regimens B and C were comparable. No patients developed complications related to vancomycin toxicity, metalwork failure or pseudarthrosis. Conclusions Wound irrigation with a povidone-iodine solution reduces SSIs following adolescent idiopathic scoliosis surgery. The direct application of vancomycin powder to the wound is safe but does not reduce the SSI rate further in low risk patients. Additional studies are needed to elucidate whether it is effective at higher doses and in high risk patient groups. PMID:27087324

  2. Surgical site infection prevention in a local hospital setting - A cost-effectiveness analysis of a multi-modal intervention to prevent surgical site infection after hemi arthroplasty in hip fracture patients

    OpenAIRE

    Karlsen, Vebjørn Enger

    2015-01-01

    Background: Surgical site infections (SSI) are associated with incremental hospital costs, cause diverse clinical consequences and are detrimental to quality of life. The aim of this study was to identify risk factors of SSI, identify clinical consequences and estimate the costeffectiveness of a multi-modal intervention strategy to prevent SSI in a local hospital setting. The strategy included use of antibiotic cement, antibiotic prophylaxis and minimum two surgeons for hemi arthroplasty trea...

  3. Comparative Effectiveness of Skin Antiseptic Agents in Reducing Surgical Site Infections: A Report from the Washington State Surgical Care and Outcomes Assessment Program

    Science.gov (United States)

    Hakkarainen, Timo W; Dellinger, E Patchen; Evans, Heather L; Farjah, Farhood; Farrokhi, Ellen; Steele, Scott R; Thirlby, Richard; Flum, David R

    2015-01-01

    Background Surgical site infections (SSI) are an important source of morbidity and mortality. Chlorhexidine in isopropyl alcohol is effective in preventing central venous-catheter associated infections, but its effectiveness in reducing SSI in clean-contaminated procedures is uncertain. Surgical studies to date have had contradictory results. We aimed to further evaluate the relationship of commonly used antiseptic agents and SSI, and to determine if isopropyl alcohol had a unique effect. Study Design We performed a prospective cohort analysis to evaluate the relationship of commonly used skin antiseptic agents and SSI for patients undergoing mostly clean-contaminated surgery from January 2011 through June 2012. Multivariate regression modeling predicted expected rates of SSI. Risk adjusted event rates (RAERs) of SSI were compared across groups using proportionality testing. Results Among 7,669 patients the rate of SSI was 4.6%. The RAERs were 0.85 (p=0.28) for chlorhexidine (CHG), 1.10 (p=0.06) for chlorhexidine in isopropyl alcohol (CHG+IPA), 0.98 (p=0.96) for povidone-iodine (PVI) and 0.93 (p=0.51) for iodine-povacrylex in isopropyl alcohol (IPC+IPA). The RAERs were 0.91 (p=0.39) for the non-IPA group and 1.10 (p=0.07) for the IPA group. Among elective colorectal patients the RAERs were 0.90 (p=0.48) for CHG, 1.04 (p=0.67) for CHG+IPA, 1.04 (p=0.85) for PVI and 1.00 (p=0.99) for IPC+IPA. Conclusions For clean-contaminated surgical cases, this large-scale state cohort study does not demonstrate superiority of any commonly-used skin antiseptic agent in reducing the risk of SSI, nor does it find any unique effect of isopropyl alcohol. These results do not support the use of more expensive skin preparation agents. PMID:24364925

  4. Pattern of pathogens and their sensitivity isolated from superficial surgical site infections in a tertiary care hospital

    International Nuclear Information System (INIS)

    Infection is an important cause of morbidity and mortality in surgical patients. Rapidly emerging nosocomial pathogens and the problem of multi-drug resistance necessitates periodic review of isolation patterns and sensitivity in surgical practice. Surgical site infections (SSI) are defined as an infections that occurs at the incision site within thirty days after surgery. Objectives of the study were to determine the pattern of pathogens involved and their antibiotic sensitivity isolated from superficial surgical site infections in a teaching hospital. This observational study was conducted for 1 year from January 2008 to December 2008 in all 4 surgical units of Liaquat University Hospital Hyderabad which caters to patients from low socioeconomic status. Pus culture and sensitivity reports were collected prospectively from hospitalised patients who developed postoperative wound infection. The patients who developed fecal/biliary/urinary fistula or operated for malignancies, and with negative cultures were excluded from the study. Analysis was carried out using SPSS 10. During the study period 112 pus culture and sensitivity reports were analyzed. E. coli 68 (60.7%) was the most common organism isolated followed by Klebsiella 23 (20.5%). The least frequent organism was staph. Epidermidis 1 (0.9%). All isolates were sensitive to penicillin derivatives and carbapenem. Quinolones, Aminoglycosides and Monobactum were also showing some promise in our study. However, Cephalosporins were ineffective against most of the important isolates in our study. E. coli and klebsiella were the most important isolates form SSI in our study, and penicillin derivatives and carbapenem were showing 100% antibiotic sensitivity to all of the isolates. (author)

  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. 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

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

    DEFF Research Database (Denmark)

    Henriksen, N A; Meyhoff, C S; Wetterslev, J;

    2010-01-01

    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...... 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...

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

    DEFF Research Database (Denmark)

    Henriksen, N A; Meyhoff, C S; Wetterslev, J;

    2010-01-01

    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...... 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...

  11. Pseudoangiomatous stromal hyperplasia (PASH) tumour at the surgical scar site in a patient of carcinoma breast.

    Science.gov (United States)

    Abrari, Andleeb

    2011-01-01

    A patient on follow-up post surgery for carcinoma breast, presented with a nodule under the surgical scar. The sinister eventuality of recurrent carcinoma was clinically considered first. The lesion was biopsied and the histopathology was diagnostic of pseudoangiomatous stromal hyperplasia tumour. The nodule was excised and the patient's clinical denouement has been uneventful in the 4 months which have elapsed after this event. PMID:22688488

  12. The level of microbial contamination and frequency of surgical site infections at the Department of Orthopedic and Traumatologic Surgery of the Clinical Hospital Center in Kragujevac

    OpenAIRE

    Grujović Zoran; Ilić Milena D.; Miličić Biljana

    2005-01-01

    Introduction. The level of microbial contamination is an important risk factor for surgical site infections. The aim of this study was to investigate the frequency of surgical site infections in regard to the level of microbial contamination at the Department of Orthopedic and Traumatologic Surgery of the Clinical Hospital Center in Kragujevac. Material and methods. This study included 474 patients who underwent surgery in the period from January 1, 2002 to December 31, 2002 at the Department...

  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. Comparison of laparoscopic and open appendectomy in terms of operative time, hospital stay and frequency of surgical site infection

    International Nuclear Information System (INIS)

    To compare laparoscopic and conventional open appendectomy in terms of operative time, hospital stay and frequency of surgical site infection (SSI). Patient and Methods: A total of 417 patients underwent appendectomy during this period. 137 patients underwent laparoscopic appendectomy (group A) while 280 patient had open appendectomy (group B). The samples include all patients who were operated open between the time span of june 2010 to september 2011. A chi square-test was performed to compare the data for statistical significance. Result: Mean operative time for group A was 79.21+-23.42 minitues where as in group B, the mean operative time was 41.49+-20.86 minitues. Group A patients had a shorter hospital 1 stay (3.6+-1 day) but in group B it was (5.2+-3 days). Seven patients (5.1 %) developed surgical site infection (SSI) in group A and 34 patients (12.14 %)developed postoperative SSI in group B. Conclusion: Laparoscopic appendectomy is superior to open appendectomy because of shorter hospital stay and laser-operative SSI, but requires longer operative time. (author)

  15. 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...

  16. 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.

  17. 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

  18. 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.

  19. 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.

  20. 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...

  1. 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...

  2. 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.

  3. 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.

  4. 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.

  5. 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

  6. Collagen binding to Staphylococcus aureus

    International Nuclear Information System (INIS)

    Staphylococcus aureus can bind soluble collagen in a specific, saturable manner. We have previously shown that some variability exists in the degree of collagen binding between different strains of heat-killed, formaldehyde-fixed S. aureus which are commercially available as immunologic reagents. The present study demonstrates that live S. aureus of the Cowan 1 strain binds amounts of collagen per organism equivalent to those demonstrated previously in heat-killed, formaldehyde-fixed bacteria but has an affinity over 100 times greater, with Kd values of 9.7 X 10(-11) M and 4.3 X 10(-8) M for live and heat-killed organisms, respectively. Studies were also carried out with S. aureus killed by ionizing radiation, since this method of killing the organism seemed less likely to alter the binding moieties on the surface than did heat killing. Bacteria killed by exposure to gamma radiation bound collagen in a manner essentially indistinguishable from that of live organisms. Binding of collagen to irradiated cells of the Cowan 1 strain was rapid, with equilibrium reached by 30 min at 22 degrees C, and was fully reversible. The binding was not inhibited by fibronectin, fibrinogen, C1q, or immunoglobulin G, suggesting a binding site for collagen distinct from those for these proteins. Collagen binding was virtually eliminated in trypsin-treated organisms, indicating that the binding site has a protein component. Of four strains examined, Cowan 1 and S. aureus ATCC 25923 showed saturable, specific binding, while strains Woods and S4 showed a complete lack of binding. These results suggest that some strains of S. aureus contain high-affinity binding sites for collagen. While the number of binding sites per bacterium varied sixfold in the two collagen-binding strains, the apparent affinity was similar

  7. 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

  8. ROLE OF INCISION SITE IN REDUCING SURGICALLY INDUCE D ASTIGMATISM IN MANUAL SMALL INCISION CATARACT SURGE RY

    Directory of Open Access Journals (Sweden)

    Sathish

    2013-04-01

    Full Text Available INTRODUCTION: Phacoemulsification and foldable IOLs allow modern day surgeon to aim at minimal induction of any astigmatic error as well a s correct any pre-operative refractive errors thus making patients’ life, spectacle free i.e. una ided emmetropia. But its high price and maintenance with a long learning curve for the surg eon make it unsuitable for the Indian camp scenario. Manual SICS in comparison needs a larger incision f or both nucleus removal and a rigid IOL insertion, but still provides for a sutureless and c onvenient alternative to phaco. Manual SICS does induce some amount of astigmatism by altering corneal curvatures (i.e., by coupling effect, while phaco surgery with 3 mm incision is astigmatic ally neutral. Manifold of studies have been done to compare Surgically Induced Astigmatism of ma nual SICS to phaco surgery but not much has been done to compare various techniques in manua l SICS itself. In this study an attempt has been made to analyze t he role of incision site depending on the pre operative keratometry readings in reducing su rgically induced astigmatism in manual small incision cataract surgery.

  9. A PROSPECTIVE STUDY TO ASSESS RISK FACTORS FOR SURGICAL SITE INFECTI ONS IN A TERTIARY CARE CENTER

    Directory of Open Access Journals (Sweden)

    Ashwin

    2015-03-01

    Full Text Available CONTEXT: Surgical site infections (SSI remain a significant problem following an operation and the second most frequently reported nosocomial infections. Aim: The current study was undertaken to identify various risk factors for SSI. MATERIAL AND METHODS: The prospective study was carried out on 50 abdominal surgeries of class III and class IV contamination. Details various functional parameters, laboratory inve stigation and surgery of patient were evaluated and analyzed with occurrence of wound infection . RESULTS AND CONCLUSIONS: The infection rate was 36.0% in our study population. The SSI rate was 19.04 % in contaminated ones and 48.2% in dirty surgeries. Male patients were affected more (21% than the female patients (18.88%. The SSI rate increased with increasing age and it also increased in patients with low hemoglobin. The SSI rate was higher in emergency surgeries as compared to the elective surgeries. Th e infection rate was significantly higher as the order and the duration of the surgery increased.

  10. Abortion - surgical

    Science.gov (United States)

    Suction curettage; Surgical abortion; Elective abortion - surgical; Therapeutic abortion - surgical ... problem. Your pregnancy is harmful to your health (therapeutic abortion). The pregnancy resulted after a traumatic event such ...

  11. 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. ...

  12. 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

  13. 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

  14. 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 ...

  15. 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...

  16. 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...

  17. 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...

  18. Triclosan-coated sutures reduce surgical site infection after open vein harvesting in coronary artery bypass grafting patients: a randomized controlled trial †

    OpenAIRE

    Thimour-Bergström, Linda; Roman-Emanuel, Christine; Scherstén, Henrik; Friberg, Örjan; Gudbjartsson, Tomas; Jeppsson, Anders

    2013-01-01

    OBJECTIVES The incidence of surgical site infection (SSI) after open vein harvesting in coronary artery bypass grafting (CABG) patients ranges in different studies between 2 and 20%. Triclosan is an antibacterial substance that reduces the growth of bacteria by inhibiting fatty acid synthesis. We hypothesized that wound closure with triclosan-coated sutures would reduce SSI after open vein harvesting. METHODS An investigator-initiated prospective randomized double-blind single-centre study wa...

  19. Staphylococcus aureus toxins

    OpenAIRE

    Otto, Michael

    2013-01-01

    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 agai...

  20. Evidence-Based Update to the U.S. Centers for Disease Control and Prevention and Healthcare Infection Control Practices Advisory Committee Guideline for the Prevention of Surgical Site Infection: Developmental Process.

    Science.gov (United States)

    Berríos-Torres, Sandra I

    2016-04-01

    Recommendations in the "Guideline for Prevention of Surgical Site Infection, 1999" were based on experts' selective interpretation of the scientific evidence. Effective 2009, the U.S. Centers for Disease Control and Prevention (CDC) and its Healthcare Infection Control Practices Advisory Committee (HICPAC) updated their guideline development process. This is a narrative summary of the updated process focusing on key changes and challenges specific to the Guideline for Prevention of Surgical Site Infection. The guideline development process now incorporates evidence-based methodology and provides explicit links between the evidence and the recommendations using the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) method. There is also participation by professional surgical societies, an updated guideline structure (core and procedure-specific sections), additional planned related manuscripts (introductions to the guideline and research opportunities), and new proposed venues for publication. The new CDC and HICPAC "Guideline for the Prevention of Surgical Site Infection" represents a substantial advancement from recommendations for infection control practices based on expert opinion to evidence-based practices. The new structure is meant to facilitate future updates, in particular, those addressing specialty or procedure-specific surgical site infection prevention questions. Increased presence by the surgical community through the professional surgical societies' engagement in the guideline development process, lead authorship of related manuscripts, and proposed publication in the surgical literature not only increase adherence by the surgical community, but also promote an ongoing collaboration with public health and other partners in a multidisciplinary approach to SSI prevention. PMID:26891203

  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. 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...

  3. 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

  4. 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

  5. Surgical Site Infection after Orthopedic Surgery Performed in Dong Guan Hospital of Traditional Chinese Medicine: A Descriptive Study of the Burden of Surgical Site Infection and its Risk factors with A Focus on Antimicrobial Prophylaxis and Traditional Chinese Medicine in Spinal Surgery

    OpenAIRE

    Wang, Jiancong

    2015-01-01

    Background: Surgical site infection (SSI) is a serious complication after orthopedic surgery, and it is associated with high morbidity rates, high healthcare costs and in some cases poor patients outcomes. Aims: The purpose of this study was to identify the burden of SSI among orthopedic surgery and its associated risk factors of SSI among the people underwent spinal surgery in a selected hospital in China. Methods: From June 26 to November 30 in 2014, we performed a prospective surveillance...

  6. 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.

  7. 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

  8. 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 ...

  9. 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.

  10. The Development of Statistical Models for Predicting Surgical Site Infections in Japan: Toward a Statistical Model-Based Standardized Infection Ratio.

    Science.gov (United States)

    Fukuda, Haruhisa; Kuroki, Manabu

    2016-03-01

    OBJECTIVE To develop and internally validate a surgical site infection (SSI) prediction model for Japan. DESIGN Retrospective observational cohort study. METHODS We analyzed surveillance data submitted to the Japan Nosocomial Infections Surveillance system for patients who had undergone target surgical procedures from January 1, 2010, through December 31, 2012. Logistic regression analyses were used to develop statistical models for predicting SSIs. An SSI prediction model was constructed for each of the procedure categories by statistically selecting the appropriate risk factors from among the collected surveillance data and determining their optimal categorization. Standard bootstrapping techniques were applied to assess potential overfitting. The C-index was used to compare the predictive performances of the new statistical models with those of models based on conventional risk index variables. RESULTS The study sample comprised 349,987 cases from 428 participant hospitals throughout Japan, and the overall SSI incidence was 7.0%. The C-indices of the new statistical models were significantly higher than those of the conventional risk index models in 21 (67.7%) of the 31 procedure categories (PSSI prediction models were shown to generally have higher accuracy than conventional risk index models. These new models may have applications in assessing hospital performance and identifying high-risk patients in specific procedure categories. Infect. Control Hosp. Epidemiol. 2016;37(3):260-271. PMID:26694760

  11. 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

  12. 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

  13. 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

  14. Resident and Faculty Perceptions of Program Strengths and Opportunities for Improvement: Comparison of Site Visit Reports and ACGME Resident Survey Data in 5 Surgical Specialties.

    Science.gov (United States)

    Caniano, Donna A; Yamazaki, Kenji; Yaghmour, Nicholas; Philibert, Ingrid; Hamstra, Stanley J

    2016-05-01

    Background Resident and faculty views of program strengths and opportunities for improvement (OFIs) offer insight into how stakeholders assess key elements of the learning environment. Objective This study sought (1) to assess the degree to which residents and faculty in 359 programs in 5 surgical specialties (obstetrics and gynecology, orthopaedic surgery, otolaryngology, plastic surgery, and surgery) were aligned or divergent in their respective views of program strengths and OFIs; and (2) to evaluate whether responses to selected questions on the Accreditation Council for Graduate Medical Education (ACGME) Resident Survey correlated with strengths or OFIs identified by the residents during the site visit. Methods Faculty and resident lists of program strengths and OFIs in site visit reports for 2012 and 2013 were aggregated, analyzed, and compared to responses on the Resident Survey. Results While there was considerable alignment in resident and faculty perceptions of program strengths and OFIs, some attributes were more important to one or the other group. Collegiality was valued highly by both stakeholder groups. Responses to 2 questions on the ACGME Resident Survey were associated with resident-identified OFIs in site visit reports pertaining to aspects of the didactic program and responsiveness to resident suggestions for improvement. Conclusions The findings offer program leadership additional insight into how 2 key stakeholder groups view elements of the learning environment as program strengths or OFIs and may serve as useful focal areas for ongoing improvement activities. PMID:27168915

  15. 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.

  16. 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

  17. Surgical Exposure

    OpenAIRE

    Hendra Chandra

    2015-01-01

    Surgical exposure is a surgical method to expose mucous or bone which prevent delayed or unerupted permanent crown teeth, in order to provide normal eruption and to prevent malocclusion. Surgical exposure is usually carried out on maxillary caninces as they have higher incidence of delayed eruption. Nevertheless, this procedure can also be performed on other teeth. For patient management, this procedure need cooperation betweent oral surgeon and orthodontist.

  18. 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...... on S. aureus carriage in Danish middle-aged and elderly twins, which indicated no significant heritability that could account for the observed S. aureus carriage. In the present study, we performed a questionnaire-based study of S. aureus colonization on the same cohort of 2,196 Danish middle......-aged and elderly twins to identify specific risk factors for S. aureus nasal colonization, including analyzing the paired twins (n = 478) that were discordant for S. aureus colonization. We found associations between risk factors and S. aureus nasal colonization among middle-aged and elderly twins, including age...

  19. 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.

  20. Surgical site infections in liver transplant recipients in the model for end-stage liver disease era: an analysis of the epidemiology, risk factors, and outcomes.

    Science.gov (United States)

    Freire, Maristela Pinheiro; Soares Oshiro, Isabel C V; Bonazzi, Patricia Rodrigues; Guimarães, Thais; Ramos Figueira, Estela Regina; Bacchella, Telésforo; Costa, Silvia Figueiredo; Carneiro D'Albuquerque, Luiz Augusto; Abdala, Edson

    2013-09-01

    In recipients of liver transplantation (LT), surgical site infection (SSIs) are among the most common types of infection occurring in the first 60 days after LT. In 2007, the Model for End-Stage Liver Disease (MELD) scoring system was adopted as the basis for prioritizing organ allocation. Patients with higher MELD scores are at higher risk for developing SSIs as well as other health care-associated infections. However, there have been no studies comparing the incidence of SSIs in the pre-MELD era with the incidence in the period since its adoption. Therefore, the objectives of this study were to evaluate the incidence, etiology, epidemiology, and outcomes of post-LT SSIs in those 2 periods and to identify risk factors for SSIs. We evaluated all patients who underwent LT over a 10-year period (2002-2011). SSI cases were identified through active surveillance. The primary outcome measure was an SSI during the first 60 days after LT. Risk factors were analyzed via logistic regression, and 60-day survival rates were evaluated via Cox regression. We evaluated 543 patients who underwent LT 597 times. The SSI rates in the 2002-2006 and 2007-2011 periods were 30% and 24%, respectively (P = 0.21). We identified the following risk factors for SSIs: retransplantation, the transfusion of more than 2 U of blood during LT, dialysis, cold ischemia for >400 minutes, and a cytomegalovirus infection. The overall 60-day survival rate was 79%. Risk factors for 60-day mortality were retransplantation, dialysis, and a longer surgical time. The use of the MELD score modified the incidence and epidemiology of SSIs only during the first year after its adoption. Risks for SSIs were related more to intraoperative conditions and intercurrences after LT than to a patient's status before LT. PMID:23744748

  1. 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

  2. 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...... 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...... antisense RNAs not co-transcribed with other genes were found. Promoter analysis and comparison with Bacillus subtilis links the small number of antisense RNAs to a less profound impact of alternative sigma factors in S. aureus. Furthermore, we revealed that Rho-dependent transcription termination...

  3. 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

  4. 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

  5. Staphylococcus aureus CC398

    DEFF Research Database (Denmark)

    Price, Lance B.; Stegger, Marc; Hasman, Henrik;

    2012-01-01

    Since its discovery in the early 2000s, methicillin-resistant Staphylococcus aureus (MRSA) clonal complex 398 (CC398) has become a rapidly emerging cause of human infections, most often associated with livestock exposure. We applied whole-genome sequence typing to characterize a diverse collection...... of CC398 isolates (n = 89), including MRSA and methicillin-susceptible S. aureus (MSSA) from animals and humans spanning 19 countries and four continents. We identified 4,238 single nucleotide polymorphisms (SNPs) among the 89 core genomes. Minimal homoplasy (consistency index = 0.9591) was detected...

  6. 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.

  7. 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 ...

  8. 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。

  9. 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.

  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. 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...

  12. 21 CFR 878.4370 - Surgical drape and drape accessories.

    Science.gov (United States)

    2010-04-01

    ... (CONTINUED) MEDICAL DEVICES GENERAL AND PLASTIC SURGERY DEVICES Surgical Devices § 878.4370 Surgical drape... site of surgical incision from microbial and other contamination. The device includes a plastic...

  13. 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 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 current recommendations to maximize the preoperative nutritional status of patients in order to prevent major complications. The results also confirm obesity/TSF should be assessed

  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. Sensitive and rapid detection of staphylococcus aureus in milk via cell binding domain of lysin.

    Science.gov (United States)

    Yu, Junping; Zhang, Yun; Zhang, Yun; Li, Heng; Yang, Hang; Wei, Hongping

    2016-03-15

    Staphylococcus aureus (S. aureus) is an important food-borne pathogen in dairy products contaminated through raw ingredients or improper food handling. Rapid detection of S. aureus with high sensitivity is of significance for food quality and safety. In this study, a new method was developed for detecting S. aureus in milk by coupling immunomagnetic separation with enzyme linked cell wall binding domain (CBD) of lysin plyV12, which can bind to S. aureus with high affinity. There are millions of binding sites present on the cell surface of S. aureus for the CBD attachment, which greatly improves the detection sensitivity. The method has the overall testing time of only 1.5h with the detection limit of 4 × 10(3)CFU/mL in spiked milk. Because it is simple, rapid and sensitive, this method could be used for the detection of S. aureus in various food samples. PMID:26433070

  16. 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.

  17. 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)

  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. Delayed wound healing and postoperative surgical site infections in patients with rheumatoid arthritis treated with or without biological disease-modifying antirheumatic drugs.

    Science.gov (United States)

    Tada, Masahiro; Inui, Kentaro; Sugioka, Yuko; Mamoto, Kenji; Okano, Tadashi; Kinoshita, Takuya; Hidaka, Noriaki; Koike, Tatsuya

    2016-06-01

    Biological disease-modifying antirheumatic drugs (bDMARDs) have become more popular for treating rheumatoid arthritis (RA). Whether or not bDMARDs increase the postoperative risk of surgical site infection (SSI) has remained controversial. We aimed to clarify the effects of bDMARDs on the outcomes of elective orthopedic surgery. We used multivariate logistic regression analysis to analyze risk factors for SSI and delayed wound healing among 227 patients with RA (mean age, 65.0 years; disease duration, 16.9 years) after 332 elective orthopedic surgeries. We also attempted to evaluate the effects of individual medications on infection. Rates of bDMARD and conventional synthetic DMARD (csDMARD) administration were 30.4 and 91.0 %, respectively. Risk factors for SSI were advanced age (odds ratio [OR], 1.11; P = 0.045), prolonged surgery (OR, 1.02; P = 0.03), and preoperative white blood cell count >10,000/μL (OR, 3.66; P = 0.003). Those for delayed wound healing were advanced age (OR, 1.16; P = 0.001), prolonged surgery (OR, 1.02; P = 0.007), preoperative white blood cell count >10,000/μL (OR, 4.56; P = 0.02), and foot surgery (OR, 6.60; P = 0.001). Risk factors for SSI and medications did not significantly differ. No DMARDs were risk factors for any outcome examined. Biological DMARDs were not risk factors for postoperative SSI. Foot surgery was a risk factor for delayed wound healing. PMID:27129711

  20. Frequency of methicillin-resistant Staphylococcus aureus nasal colonization among patients suffering from methicillin resistant Staphylococcus aureus bacteraemia

    Science.gov (United States)

    Aslam, Nadia; Izhar, Mateen; Mehdi, Naima

    2013-01-01

    Objective: To determine rate of nasal colonization in Patients suffering from bacteraemia caused by methicillin resistant Staphylococcus aureus. Methods: This descriptive cross sectional study was carried out in a tertiary ca re, University Teaching Hospital (Shaikh Zayed Hospital, Lahore) from October 2010 to August 2011. Nasal swabs were taken from patients suffering from MRSA bacteraemia and were plated on mannitol salt agar plates to isolate Staphylococcus aureus (S. aureus) which were then tested for oxacillin susceptibility. Results: Nasal colonization was present in 52.5% of patients suffering from MRSA bacteraemia. Conclusion: Nasal colonization rates with MRSA were high among patients suffering from MRSA bacteraemia especially in those undergoing dialysis or surgical procedures. Therefore, screening and nasal decolonization should be practiced in hospitals. PMID:24550968

  1. 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....

  2. Surgical adhesives

    Directory of Open Access Journals (Sweden)

    I. A. THOMAZINI-SANTOS

    2001-12-01

    Full Text Available The authors have performed a literature review of surgical adhesives, such as cyanoacrylate, collagen gelatin, and fibrin glue. They have included different types of commercial and non-commercial fibrin sealants and have reported on the different components in these adhesives, such as fibrinogen, cryoprecipitate, bovine thrombin, and thrombin-like fraction of snake venom.

  3. 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...

  4. 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.

  5. Efficiency of Local Antiseptic Alkosol (Ethanol, Isopropanol-30g and Ortophenilphenol) and Povidone Iodide on the Incidence Of Surgical Site Infection After Inguinal Hernioplasty

    Science.gov (United States)

    Djozic, Harun; Pandza, Haris; Hasukic, Sefik; Custovic, Samir; Pandza, Berina; Krupalija, Amina; Beciragic, Edin

    2016-01-01

    Background: The risk of wound infection after elective inguinal hernia repair depends on several factors. One of the most important factors is the preoperative skin preparation. The use of antisepsis is performed to reduce the risk of surgical site infections (SSIs) and to remove causing organisms. This work compares two different agent forms for preoperative skin preparation to prevent SSIs. Objectives: The objective of the study is comparing the effects of two different agents used for preoperative skin preparation and prevention of SSIs. Material and methods: 100 adult patients were divided and randomized into two groups, each containing 50 patients. Both groups included patients that are scheduled for elective Lichtenstein inguinal hernia repair. The first group includes patients whose skin preparations were done with povidone iodine (PI) only. The second group included patients that are treated with two antiseptics; Alkosol (96% ethanol, isopropanol-30g and ortophenilphenol-0.1g) and povidone iodide. Alkosol is applied before the induction of anesthesia. The povidone iodide is applied after Alkosol has evaporated. The presence of bacterial growth in the wound was determined 24 and 48 hours after operation. Swabs were used to take samples, which were then cultivated to check for bacterial growth. The presence of infection was also determined by the following criteria: pain or tenderness, induration, erythema, local warmth of the wound etc. Results: The surgeon or clinician declared that after 24 hours the wound was infected in 20 patients in the control group and in 22 patients after 48 hours. In the Alkosol (96% ethanol, isopropanol-30g and ortophenilphenol-0.1g) and povidone iodide group infection was declared in only 3 patients after 24 hours. Discussion: Compared to the use of providone only, the use of Alkosol (96% ethanol, isopropanol-30g and ortophenilphenol-0.1g) and povidone iodide has many advantages and was associated with lower rates of SSIs

  6. Stress-Induced Hyperglycemia as a Risk Factor for Surgical-Site Infection in Non-diabetic Orthopaedic Trauma Patients Admitted to the Intensive Care Unit

    Science.gov (United States)

    Richards, Justin E; Kauffmann, Rondi M; Obremskey, William T; May, Addison K

    2012-01-01

    Objectives To evaluate the association between stress-induced hyperglycemia and infectious complications in non-diabetic orthopaedic trauma patients admitted to the Intensive Care Unit (ICU). Design Retrospective review. Setting Academic Level-1 Trauma Center. Patients One hundred and eighty-seven consecutive trauma patients with isolated orthopaedic injuries. Intervention Blood glucose values during initial hospitalization were evaluated. The admission blood glucose (BG) and Hyperglycemic Index (HGI) were determined for each patient. Main Outcome Measures Perioperative infectious complications: pneumonia, urinary tract infection (UTI), surgical-site infection (SSI), sepsis. Results An average of 21.5 BG values was obtained for each patient. Mean ICU and hospital length of stay was 4.0±4.9 and 10.0±8.1 days, respectively. Infections were recorded in 43/187 patients (23.0%) and SSI’s specifically documented in 16 patients (8.6%). Open fractures were not associated with SSI (8/83, 9.6% vs. 8/104, 7.7%). There was no difference in admission BG or HGI and infection. However, there was a significant difference in HGI when considering SSI alone (2.1±1.7 vs. 1.2±1.1). Patients with an SSI received a greater amount of blood transfusions (14.9±12.1 vs. 4.9±7.6). No patient was diagnosed with a separate infection (i.e. pneumonia, UTI, bacteremia) prior to SSI. There was no significant difference in Injury Severity Score among patients with an SSI (11.1±4.0 vs. 9.6±3.0). Multivariable regression testing with HGI as a continuous variable demonstrated a significant relationship (OR: 1.8, 95% CI: 1.3–2.5) with SSI after adjusting for blood transfusions (OR: 1.1, 95% CI: 1.1–1.2). Conclusions Stress-induced hyperglycemia demonstrated a significant independent association with SSI’s in non-diabetic orthopaedic trauma patients who were admitted to the ICU. PMID:22588532

  7. 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.

  8. 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

  9. 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

  10. 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.

  11. The dynamics of Staphylococcus aureus intramammary infection in nine Danish dairy herds

    DEFF Research Database (Denmark)

    Larsen, H. D.; Sloth, K. H.; Elsberg, C.;

    2000-01-01

    The aim of the present study was to examine the diversity of Staphylococcus aureus isolates from bovine intramammary infections (IMI) in nine dairy herds, and compare these with isolates from other sites on the cows by phage- and ribotyping. Whether colonisation of milkers with S. aureus could...... be a source of infection for bovine IMI was investigated. In addition, 100 epidemiologically unrelated S. aureus isolates from asymptomatic human carriers were also phage- and ribotyped to compare the human and bovine reservoir of S. aureus in Denmark. A total of 625 S. aureus isolates from bovine IMI, bovine......, there was a close correspondence between ribo- and phage types of S. aureus isolated from bovine intramammmary infections and skin lesions. Isolates from milking personnel, however, were not identical to any of the predominant intramammary strains. Furthermore, several of the isolates from milking personnel showed...

  12. 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

  13. 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

  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. 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....../67) of all catheter periods--84% of these were due to coagulase-negative staphylococci. CONCLUSIONS: Dialysis catheter-related S. aureus septicaemia was highly unlikely if the patient had not been carrying S. aureus in the nose or at the insertion site during the time the catheter was in place. The best...... predictor of dialysis catheter-related S. aureus septicaemia was a positive S. aureus culture from the insertion site. Positive catheter blood cultures unrelated to any clinical signs of septicaemia occurred in one-third of all catheter periods, and 84% of these were due to coagulase-negative staphylococci....

  16. 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...

  17. Staphylococcus aureus and sore nipples.

    OpenAIRE

    Livingstone, V. H.; Willis, C. E.; Berkowitz, J

    1996-01-01

    OBJECTIVE: To correlate clinical symptoms and signs of sore nipples with the presence of Staphylococcus aureus and to determine the probability of mothers having S aureus-infected nipples when these local symptoms and signs are found. DESIGN: Two cohorts of consecutive patients were enrolled regardless of presenting complaint. A questionnaire was administered to determine the presence and severity of sore nipples. Objective findings on breast examination were documented. A nipple swab was tak...

  18. 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,

  19. Surgical site infection incidence after a clean-contaminated surgery in Yasuj Shahid Beheshti hospital, Iran Incidencia de infección de herida por cirugía limpia contaminada en el hospital Yasuj Shahid Beheshti, Irán Incidência de infecção de ferida depois de cirurgia limpa-contaminada em hospital Yasuj Shahid Beheshti, Irã

    Directory of Open Access Journals (Sweden)

    Mohebbi Nobandegani Zinat

    2011-11-01

    Full Text Available Objective. To determine the incidence rate of infection after a clean-contaminated surgery and its relationship with some risk factors. Methodology. Cross sectional study, in a convenience sample of 300 patients who underwent surgery classified as clean-contaminated in a hospital of Yasuj, Iran. Samples were taken directly from the wound at the first dressing change to all the patients. They were studied to determine bacteria growth. Results. The rate of infection after a clean-contaminated surgery was 53%. The most common gram positive microorganism was Staphylococcus aureus (22%, and among gram negative: Escherichia coli (26%, Klebsiella sp (26% and Pseudomonas sp (25%. Significant correlation between the type of surgery and surgical site infection was found, it was not seen with the variables sex and surgical procedure. Conclusion. This study shows important problems regarding patient’s safety. Protocols should be reviewed to control infections.Objetivo. Determinar la tasa de incidencia por infección de herida por cirugía limpia-contaminada y su relación con algunos factores de riesgo. Metodología. Estudio de corte transversal en una muestra por conveniencia de 300 pacientes sometidos a cirugía clasificada como limpia-contaminada. A todos los pacientes les tomaron una muestra para cultivo directamente de la herida en el primer cambio del apósito, la cual se estudió para determinar el crecimiento de bacterias. Resultados. La tasa de infección en heridas quirúrgicas limpias-contaminadas fue del 53%. El microorganismo gram positivo más frecuente fue Staphylococcus aureus (22%, y dentro de los gram negatives fueron: Escherichia coli (26%, Klebsiella sp (26% y Pseudomonas sp (25%. Se encontró asociación significativa entre el tipo de cirugía y la infección de la herida quirúrgica, lo que no se observó con las variables sexo y el procedimiento quirúrgico. Conclusión. Este estudio muestra problemas importantes en el aseguramiento

  20. 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...

  1. 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

  2. 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

  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

    International Nuclear Information System (INIS)

    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, 99mTc-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 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. 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 <5 min after removal to minimize influences associated with degradation 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

  5. 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

  6. 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.)

  7. 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

  8. Prospective Analysis Methicillin-resistant Staphylococcus aureus and its Risk Factors

    Science.gov (United States)

    Abdallah, Soad A; Al-Asfoor, Khulood K; Salama, Mona F; Al-Awadi, Bashayer M

    2013-01-01

    Background: Since the early nineties, a new methicillin-resistant Staphylococcus aureus (MRSA) has existed in a form correlating with community health personnel. Community-acquired MRSA (CA-MRSA) could be differentiated from healthcare-associated MRSA (HA-MRSA) microbiologically, epidemiologically, and molecularly. Aims: To determine the prevalence, risk factors of MRSA infections in community and hospital. Settings: The incidence and risk factors for CA-MRSA and HA-MRSA among patients of medical, surgical, and pediatrics wards and ICU at a Kuwaiti teaching hospital between 1 March 2011 and 30 November 2011 were studied. Materials and Methods: Cultures for MRSA were taken from nasal (nostril), groin, axilla, wound, sputum, or throat, and the inguinal area in all enrolled patients upon admission. All preserved isolates were examined for their susceptibility to different types of antibiotics. Results and Conclusion: A total of 71 MRSA patients admitted to different hospital wards were examined. Among these patients, 52 (73.2%) were carriers of MRSA before they were admitted to the hospital. Nineteen patients (26.8%) were found to have acquired MRSA during their stay in the hospital. Twenty-nine patients (40.8%) were given mupirocin local skin antibiotic. Binomial and the t-test (paired) were used to compare the prevalence of CA-MRSA and HA-MRSA; significant correlation (P < 0.05) between the type of MRSA and different wards, sites, and lengths of hospital stay was found. The level of serum albumin that is routinely measured at hospital admission is a predictor to MRSA infection. This study suggests that S. aureus and MRSA should become a national priority for disease control to avoid outbreaks. PMID:23599613

  9. 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 ...

  10. 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

  11. Sternal and costochondral infections with gentamicin and methicillin resistant Staphylococcus aureus following thoracic surgery.

    Science.gov (United States)

    Cafferkey, M T; Luke, D A; Keane, C T

    1983-01-01

    Six patients in a thoracic unit developed sternal osteomyelitis and costochondritis following median sternotomy. Five of the patients were operated on in another hospital. Gentamicin and methicillin resistant Staphylococcus aureus was isolated in pure culture in each case. The S. aureus isolate from 2 patients was of the same phage type suggesting cross-infection. Antibiotic prophylaxis administered in the perioperative period was ineffective. One patient, treated with amikacin (to which all of the strains were sensitive in vitro) and cefuroxime, died from overwhelming infection in spite of débridement and resuturing of the wound. The remaining 5 patients were cured with vancomycin therapy usually coupled with surgical intervention. PMID:6557667

  12. 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.

  13. 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.

  14. 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

  15. Genome Sequence of the Clinical Isolate Staphylococcus aureus subsp. aureus Strain UAMS-1

    OpenAIRE

    Sassi, Mohamed; Sharma, Deepak; Brinsmade, Shaun ,; Felden, Brice; Augagneur, Yoann

    2015-01-01

    We report here the draft genome sequence of Staphylococcus aureus subsp. aureus strain UAMS-1. UAMS-1 is a virulent oxacillin-susceptible clinical isolate. Its genome is composed of 2,763,963 bp and will be useful for further gene expression analysis using RNA sequencing (RNA-seq) technology. S taphylococcus aureus is an opportunistic human bacterial pathogen responsible for nosocomial and community-associated infections. S. aureus subsp. aureus strain UAMS-1 was originally isolated from the ...

  16. 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.

  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......, their negative interactions depend on thresholds of absolute abundance. These findings demonstrate that nasal microbiota is not fixed by host genetics and opens the possibility that nasal microbiota may be manipulated to prevent or eliminate S. aureus colonization....

  18. Surgeon`s adherence to guidelines for surgical antimicrobial prophylaxis-a review

    OpenAIRE

    Ru Shing Ng; Chee Ping Chong

    2012-01-01

    AbstractSurgical site infections are the most common nosocomial infection among surgical patients. Patients who experience surgical site infections are associated with prolonged hospital stay, rehospitalisation, increased morbidity and mortality, and costs. Consequently, surgical antimicrobial prophylaxis (SAP), which is a very brief course of antibiotic given just before the surgery, has been introduced to prevent the occurrence of surgical site infections. The efficacy of SAP depends on sev...

  19. Surgeons' adherence to guidelines for surgical antimicrobial prophylaxis – a review

    OpenAIRE

    Ng, Ru Shing; Chong, Chee Ping

    2012-01-01

    Surgical site infections are the most common nosocomial infection among surgical patients. Patients who experience surgical site infections are associated with prolonged hospital stay, rehospitalisation, increased morbidity and mortality, and costs. Consequently, surgical antimicrobial prophylaxis (SAP), which is a very brief course of antibiotic given just before the surgery, has been introduced to prevent the occurrence of surgical site infections. The efficacy of SAP depends on several fac...

  20. 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.

  1. [Cirrhosis and surgical risk].

    Science.gov (United States)

    Paugam-Burtz, Catherine

    2011-01-01

    Major surgery in cirrhotic patient is associated with an increased risk of postoperative morbidity and mortality. This risk increases with the disease severity. Cirrhosis generates a wide variety of organ dysfunctions including hemostasis abnormalities, cardiocirculatory and renal dysfunctions. These modifications facilitate postoperative complications. Postoperative morbidity includes surgical site complications such as sepsis or haemorrhage and organ complications such as pneumonia, kidney injury, hepatic failure or ascite. Perioperative care in cirrhotic patient can probably be improved by various techniques such as perioperative nutritional support, intraoperative hemodynamic optimization and close postoperative monitoring. Optimal perioperative care of patients with endstage liver disease necessitates collaboration between anesthesiologists, hepatologists and surgeons in charge of the patient. Indeed, they should be aware of any discussion about possible liver transplantation. PMID:20980124

  2. 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...

  3. 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...

  4. 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.

  5. Diversity of Prophages in Dominant Staphylococcus aureus Clonal Lineages▿

    OpenAIRE

    Goerke, Christiane; Pantucek, Roman; Holtfreter, Silva; Schulte, Berit; Zink, Manuel; Grumann, Dorothee; Barbara M. Bröker; Doskar, Jiri; Wolz, Christiane

    2009-01-01

    Temperate bacteriophages play an important role in the pathogenicity of Staphylococcus aureus, for instance, by mediating the horizontal gene transfer of virulence factors. Here we established a classification scheme for staphylococcal prophages of the major Siphoviridae family based on integrase gene polymorphism. Seventy-one published genome sequences of staphylococcal phages were clustered into distinct integrase groups which were related to the chromosomal integration site and to the enco...

  6. Genome sequence of type strain of Staphylococcus aureus subsp. aureus

    OpenAIRE

    Kim, Bong-Soo; Yi, Hana; Chun, Jongsik; Cha, Chang-Jun

    2014-01-01

    Background Staphylococcus aureus is a pathogen that causes food poisoning and community-associated infection with antibiotic resistance. This species is an indigenous intestinal microbe found in infants and not found in adult intestine. The relatively small genome size and rapid evolution of antibiotic resistance genes in the species have been drawing an increasing attention in public health. To extend our understanding of the species and use the genome data for comparative genomic studies, w...

  7. 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 ...

  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. Surgical Ventricular Reconstruction

    Medline Plus

    Full Text Available ... is being studied currently in the largest surgical trial ever conducted by the National Institutes of Health ... Heart and Lung Blood Institute, called the STITCH Trial, the Surgical Treatment for Ischemic Heart Failure. And ...

  11. 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.

  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. Utility of telepathology as a consultation tool between an off-site surgical pathology suite and affiliated hospitals in the frozen section diagnosis of lung neoplasms

    Directory of Open Access Journals (Sweden)

    Taisia Vitkovski

    2015-01-01

    Full Text Available Background: Increasingly, as in our institution, operating rooms are located in hospitals and the pathology suite is located at a distant location because of off-site consolidation of pathology services. Telepathology is a technology which bridges the gap between pathologists and offers a means to obtain a consultation remotely. We aimed to evaluate the utility of telepathology as a means to assist the pathologist at the time of intraoperative consultation of lung nodules when a subspecialty pathologist is not available to directly review the slide. Methods: Cases of lung nodules suspicious for a neoplasm were included. Frozen sections were prepared in the usual manner. The pathologists on the intraoperative consultation service at two of our system hospitals notified the thoracic pathologist of each case after rendering a preliminary diagnosis. The consultation was performed utilizing a Nikon™ Digital Sight camera and web-based Remote Medical Technologies™ software with live video streaming directed by the host pathologist. The thoracic pathologist rendered a diagnosis without knowledge of the preliminary interpretation then discussed the interpretation with the frozen section pathologist. The interpretations were compared with the final diagnosis rendered after sign-out. Results: One hundred and three consecutive cases were included. The frozen section pathologist and a thoracic pathologist had concordant diagnoses in 93 cases (90.2%, discordant diagnoses in nine cases (8.7%, and one case in which both deferred. There was an agreement between the thoracic pathologist′s diagnosis and the final diagnosis in 98% of total cases including 8/9 (88.9% of the total discordant cases. In two cases, if the thoracic pathologist had not been consulted, the patient would have been undertreated. Conclusions: We have shown that telepathology is an excellent consultation tool in the frozen section diagnosis of lung nodules.

  14. 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

  15. 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 ...

  16. Evasion of Neutrophil Killing by Staphylococcus aureus

    Directory of Open Access Journals (Sweden)

    Will A. McGuinness

    2016-03-01

    Full Text Available Staphylococcus aureus causes many types of infections, ranging from self-resolving skin infections to severe or fatal pneumonia. Human innate immune cells, called polymorphonuclear leukocytes (PMNs or neutrophils, are essential for defense against S. aureus infections. Neutrophils are the most prominent cell type of the innate immune system and are capable of producing non-specific antimicrobial molecules that are effective at eliminating bacteria. Although significant progress has been made over the past few decades, our knowledge of S. aureus-host innate immune system interactions is incomplete. Most notably, S. aureus has the capacity to produce numerous molecules that are directed to protect the bacterium from neutrophils. Here we review in brief the role played by neutrophils in defense against S. aureus infection, and correspondingly, highlight selected S. aureus molecules that target key neutrophil functions.

  17. Staphylococcus aureus and the ecology of the nasal microbiome

    DEFF Research Database (Denmark)

    Liu, Cindy M; Price, Lance B; Hungate, Bruce A; Abraham, Alison G; Larsen, Lisbeth A; Christensen, Kaare; Stegger, Marc; Skov, Robert; Andersen, Paal Skytt

    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...... colonization? Our study of 46 monozygotic and 43 dizygotic twin pairs revealed that nasal microbiota is an environmentally derived trait, but the host's sex and genetics significantly influence nasal bacterial density. Although specific taxa, including lactic acid bacteria, can determine S. aureus colonization......, their negative interactions depend on thresholds of absolute abundance. These findings demonstrate that nasal microbiota is not fixed by host genetics and opens the possibility that nasal microbiota may be manipulated to prevent or eliminate S. aureus colonization....

  18. Structure of homoserine O-acetyltransferase from Staphylococcus aureus: the first Gram-positive ortholog structure

    OpenAIRE

    Thangavelu, Bharani; Pavlovsky, Alexander G.; Viola, Ronald

    2014-01-01

    The structure of homoserine O-acetyltransferase (HTA) from the human pathogen Staphylococcus aureus has been determined. Despite a similar overall fold and active site architecture to other α/β-hydrolases, this more compact HTA structure has a more narrow access to the active site than can confer important specificity differences.

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

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    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.

  20. Population structure of Staphylococcus aureus in China

    OpenAIRE

    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 against rifampicin doubled to 68%. Staphylococcal food poisoning (SFP) is frequent in China. Two predominant S. aureus lineages, ST6 and ST943, were identified causing outbreaks of SFP in Southern China...

  1. 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...

  2. 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...

  3. 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.

  4. 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 ...

  5. 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 ...

  6. 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.

  7. 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。

  8. 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.

  9. Staphylococcus aureus small colony variants in diabetic foot infections

    OpenAIRE

    Cervante-García, Estrella; García-Gonzalez, Rafael; Reyes-Torres, Angélica; Resendiz-Albor, Aldo Arturo; Salazar-Schettino, Paz María

    2015-01-01

    Background: Staphylococcus aureus (S. aureus) is one of the major pathogens causing chronic infections. The ability of S. aureus to acquire resistance to a diverse range of antimicrobial compounds results in limited treatment options, particularly in methicillin-resistant S. aureus (MRSA). A mechanism by which S. aureus develops reduced susceptibility to antimicrobials is through the formation of small colony variants (SCVs). Infections by SCVs of S. aureus are an upcoming problem due to diff...

  10. 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.

  11. Mastectomy -- The Surgical Procedure

    Medline Plus

    Full Text Available ... Surgical Biopsies Assessing Margins after Breast Surgery Pathology Reports Pathology Reports Contents of a Pathology Report Factors That Affect Prognosis & Treatment Factors That Affect ...

  12. 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.

  13. 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

  14. 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

  15. 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.

  16. 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

  17. Deriving DICOM surgical extensions from surgical workflows

    Science.gov (United States)

    Burgert, O.; Neumuth, T.; Gessat, M.; Jacobs, S.; Lemke, H. U.

    2007-03-01

    The generation, storage, transfer, and representation of image data in radiology are standardized by DICOM. To cover the needs of image guided surgery or computer assisted surgery in general one needs to handle patient information besides image data. A large number of objects must be defined in DICOM to address the needs of surgery. We propose an analysis process based on Surgical Workflows that helps to identify these objects together with use cases and requirements motivating for their specification. As the first result we confirmed the need for the specification of representation and transfer of geometric models. The analysis of Surgical Workflows has shown that geometric models are widely used to represent planned procedure steps, surgical tools, anatomical structures, or prosthesis in the context of surgical planning, image guided surgery, augmented reality, and simulation. By now, the models are stored and transferred in several file formats bare of contextual information. The standardization of data types including contextual information and specifications for handling of geometric models allows a broader usage of such models. This paper explains the specification process leading to Geometry Mesh Service Object Pair classes. This process can be a template for the definition of further DICOM classes.

  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. 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

  1. 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

  2. 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...

  3. 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...

  4. [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

  5. 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.

  6. Choosing the right surgical glove: an overview and update.

    Science.gov (United States)

    Tanner, Judith

    Sterile surgical gloves are routinely worn during all invasive procedures to prevent the two-way transmission of pathogens between the surgical team and the patient. This reduces the risk of surgical-site infections and blood-borne diseases. Since their introduction to the operating room over 100 years ago, surgical gloves, and the materials used to make them, have continued to evolve in line with ever-changing healthcare demands. Following recent developments in surgical glove technologies, including de-proteinized natural rubber latex and newer gloving methods such as triple gloving, it is timely that an overview and update of surgical gloves is given. By providing information on latex-associated allergies, glove materials, gloving methods and glove protection, this article will enable practitioners to choose the most appropriate surgical glove. PMID:18825848

  7. 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...

  8. Staphylococcus aureus infections in psittacine birds.

    Science.gov (United States)

    Hermans, K; Devriese, L A; De Herdt, P; Godard, C; Haesebrouck, F

    2000-10-01

    Staphylococcus aureus was isolated from internal organs of 13 different psittacine birds submitted for necropsy over a period of 6 years. The birds all had lesions consistent with septicaemia. S. aureus isolates included three different phage types. In seven of the 13 birds, concurrent infections with Chlamydophila species, Enterococcus hirae, Candida species, unidentified streptococci and coagulasenegative staphylococci were detected. One bird also had lesions of lymphoid leucosis. Few indications were found that staphylococcosis associated problems may spread epidemically. The present studies suggest that S. aureus is pathogenic for psittacine birds, although it does not seem to be a frequent cause of disease. PMID:19184832

  9. 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.

  10. 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

  11. 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...

  12. Surgical Ventricular Reconstruction

    Medline Plus

    Full Text Available SURGICAL VENTRICULAR RECONSTRUCTION MONTEFIORE-EINSTEIN HEART CENTER NEW YORK CITY, NEW YORK February 13, 2008 00:00:09 NARRATOR: Welcome to the Montefiore-Einstein Heart Center in ...

  13. Surgical Ventricular Reconstruction

    Medline Plus

    Full Text Available SURGICAL VENTRICULAR RECONSTRUCTION MONTEFIORE-EINSTEIN HEART CENTER NEW YORK CITY, NEW YORK February 13, 2008 00:00:09 NARRATOR: Welcome to the Montefiore-Einstein Heart Center in New York City. In ...

  14. 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...

  15. Surgical Ventricular Reconstruction

    Medline Plus

    Full Text Available ... Blood Institute, called the STITCH Trial, the Surgical Treatment for Ischemic Heart Failure. And that trial has ... patients that were divided essentially into three different treatment groups. All patients enrolled in the trial had ...

  16. 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....

  17. Surgical Ventricular Reconstruction

    Medline Plus

    Full Text Available ... the STITCH Trial, the Surgical Treatment for Ischemic Heart Failure. And that trial has now looked at over ... 15 III or IV New York Heart Association heart failure. And not uncommonly have anginal symptoms as well. ...

  18. Biocompatibility of surgical implants

    Science.gov (United States)

    Kaelble, D. H.

    1979-01-01

    Method of selecting biocompatible materials for surgical implants uses fracture mechanic relationships and surface energies of candidate materials in presence of blood plasma. Technique has been used to characterize 190 materials by parameters that reflect their biocompatibility.

  19. Surgical Ventricular Reconstruction

    Medline Plus

    Full Text Available ... five year old male with hypertension, Type II Diabetes and hypercholesterolemia, who presented to St. Barnabas Hospital ... Blood Institute, called the STITCH Trial, the Surgical Treatment for Ischemic Heart Failure. And that trial has ...

  20. Surgical Ventricular Reconstruction

    Medline Plus

    Full Text Available ... He has not been readmitted for any reasons related to heart failure. 00:41:57 ROBERT E. ... question, because it really deals with whether anything related to surgical ventricular reconstruction would add to the ...

  1. Postthrombotic Syndrome: Surgical Possibilities

    OpenAIRE

    Khanna, Ajay K; Shivanshu Singh

    2011-01-01

    Postthrombotic syndrome (PTS) is a late outcome of deep vein thrombosis characterized by cramping pain, swelling, hyperpigmentation, eczema, lipodermatosclerosis, and ulceration in the leg due to increased venous outflow resistance and reflux venous flow. Newer surgical and endovascular interventions have a promising result in the management of postthrombotic syndrome. Early surgical or endovascular interventions in appropriately selected patients may decrease the incidence of recurrent ulcer...

  2. The Heme Sensor System of Staphylococcus aureus

    Science.gov (United States)

    Stauff, Devin L.; Skaar, Eric P.

    2016-01-01

    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, which alleviates heme toxicity. Importantly, the inability to sense or respond to heme alters the virulence of S. aureus, highlighting the importance of heme sensing and detoxification to staphylococcal pathogenesis. Furthermore, potential orthologues of the Hss and Hrt systems are found in many species of Gram-positive bacteria, a possible indication that heme stress is a challenge faced by bacteria whose habitats include host tissues rich in heme. PMID:19494582

  3. The potential of the endolysin Lysdb from Lactobacillus delbrueckii phage for combating Staphylococcus aureus during cheese manufacture from raw milk.

    Science.gov (United States)

    Guo, Tingting; Xin, YongPing; Zhang, Chenchen; Ouyang, Xudong; Kong, Jian

    2016-04-01

    Phage endolysins have received increased attention in recent times as potential antibacterial agents and the biopreservatives in food production processes. Staphylococcus aureus is one of the most common pathogens in bacterial food poisoning outbreaks. In this study, the endolysin Lysdb, one of the two-component cell lysis cassette of Lactobacillus delbrueckii phage phiLdb, was shown to possess a muramidase domain and catalytic sites with homology to Chalaropsis-type lysozymes. Peptidoglycan hydrolytic bond specificity determination revealed that Lysdb was able to cleave the 6-O-acetylated peptidoglycans present in the cell walls of S. aureus. Turbidity reduction assays demonstrated that Lysdb could effectively lyse the S. aureus live cells under acidic and mesothermal conditions. To further evaluate the ability of Lysdb as a potential antibacterial agent against S. aureus in cheese manufacture, Lactobacillus casei BL23 was engineered to constitutively deliver active Lysdb to challenge S. aureus in lab-scale cheese making from raw milk. Compared with the raw milk, the viable counts of S. aureus were reduced by 10(5)-fold in the cheese inoculated with the engineered L. casei strain during the fermentation process, and the pathogenic bacterial numbers remained at a low level (10(4) CFU/g) after 6 weeks of ripening at 10 °C. Taken together, all results indicated that the Lysdb has the function as an effective tool for combating S. aureus during cheese manufacture from raw milk. PMID:26621799

  4. Binding of heparan sulfate to Staphylococcus aureus.

    OpenAIRE

    Liang, O D; Ascencio, F; Fransson, L A; Wadström, T

    1992-01-01

    Heparan sulfate binds to proteins present on the surface of Staphylococcus aureus cells. Binding of 125I-heparan sulfate to S. aureus was time dependent, saturable, and influenced by pH and ionic strength, and cell-bound 125I-heparan sulfate was displaced by unlabelled heparan sulfate or heparin. Other glycosaminoglycans of comparable size (chondroitin sulfate and dermatan sulfate), highly glycosylated glycoprotein (hog gastric mucin), and some anionic polysaccharides (dextran sulfate and RNA...

  5. 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...

  6. 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.

  7. Triclosan Promotes Staphylococcus aureus Nasal Colonization

    OpenAIRE

    Syed, Adnan K.; Ghosh, Sudeshna; Love, Nancy G.; Boles, Blaise R.

    2014-01-01

    ABSTRACT The biocide triclosan is used in many personal care products, including toothpastes, soaps, clothing, and medical equipment. Consequently, it is present as a contaminant in the environment and has been detected in some human fluids, including serum, urine, and milk. Staphylococcus aureus is an opportunistic pathogen that colonizes the noses and throats of approximately 30% of the population. Colonization with S. aureus is known to be a risk factor for several types of infection. Here...

  8. 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.

  9. Nursing diagnosis of delayed surgical recovery

    Directory of Open Access Journals (Sweden)

    Rosimere Ferreira Santana

    2014-09-01

    Full Text Available The purpose of this study was to identify and analyze the nursing diagnosis of delayed surgical recovery, its defining characteristics and related factors according to NANDA-I taxonomy, through an integrative review. 34 articles were selected from MEDLINE, CINAHL, LILACS, and BDENF databases. In these, the delayed surgical recovery diagnosis was identified in a study. However, it was possible to identify the defining characteristics: difficulty to move about (36.4% which requires help to complete self-care (27.3% and the evidence of interrupted healing of the surgical site (27.3%. Additionally, the related factors were: pain (34.2%, postoperative surgical site infection (31.7%, postoperative expectations (31.7%, and obesity (2.4%. Other identified related factors were: advanced age (38.9%, diabetes mellitus (22.2% and nutritional deficiency (16.7%. In conclusion, the diagnosis deals with a phenomenon of nursing surgical practice, recommended for the monitoring and standardized documentation of complications that may delay recovery and hospital discharge.

  10. 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.

  11. Successful reduction of hospital-acquired methicillin-resistant Staphylococcus aureus in a urology ward: a 10-year study

    OpenAIRE

    Tatokoro, Manabu; Kihara, Kazunori; Masuda, Hitoshi; Ito, Masaya; Yoshida, Soichiro; Kijima, Toshiki; Yokoyama, Minato; Saito, Kazutaka; Koga, Fumitaka; Kawakami, Satoru; Fujii, Yasuhisa

    2013-01-01

    Background To eradicate hospital-acquired methicillin-resistant Staphylococcus aureus (MRSA) using a stepwise infection control strategy that includes an avoidance of antimicrobial prophylaxis (AMP) based on surgical wound classification and an improvement in operative procedures in gasless single-port urologic surgery. Methods The study was conducted at an 801-bed university hospital. Since 2001, in the urology ward, we have introduced the stepwise infection control strategy. In 2007, survei...

  12. 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...... anxiety questionnaires (Spielberger's state-trait anxiety inventory and Cox and Kenardy's performance anxiety questionnaire) were used. Anxiety levels were measured before the non-surgical course (111 students from 2009) and before live-animal surgery during the surgical course (153 students from 2009 and...

  13. Staphylococcus aureus infections: transmission within households and the community.

    Science.gov (United States)

    Knox, Justin; Uhlemann, Anne-Catrin; Lowy, Franklin D

    2015-07-01

    Staphylococcus aureus, both methicillin susceptible and resistant, are now major community-based pathogens worldwide. The basis for this is multifactorial and includes the emergence of epidemic clones with enhanced virulence, antibiotic resistance, colonization potential, or transmissibility. Household reservoirs of these unique strains are crucial to their success as community-based pathogens. Staphylococci become resident in households, either as colonizers or environmental contaminants, increasing the risk for recurrent infections. Interactions of household members with others in different households or at community sites, including schools and daycare facilities, have a critical role in the ability of these strains to become endemic. Colonization density at these sites appears to have an important role in facilitating transmission. The integration of research tools, including whole-genome sequencing (WGS), mathematical modeling, and social network analysis, has provided additional insight into the transmission dynamics of these strains. Thus far, interventions designed to reduce recurrent infections among household members have had limited success, likely due to the multiplicity of potential sources for recolonization. The development of better strategies to reduce the number of household-based infections will depend on greater insight into the different factors that contribute to the success of these uniquely successful epidemic clones of S. aureus. PMID:25864883

  14. 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...

  15. 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

  16. 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...

  17. Intra-cellular Staphylococcus aureus alone causes infection in vivo

    Directory of Open Access Journals (Sweden)

    T Hamza

    2013-07-01

    Full Text Available Chronic and recurrent bone infections occur frequently but have not been explained. Staphylococcus aureus (S. aureus is often found among chronic and recurrent infections and may be responsible for such infections. One possible reason is that S. aureus can internalize and survive within host cells and by doing so, S. aureus can evade both host defense mechanisms and most conventional antibiotic treatments. In this study, we hypothesized that intra-cellular S. aureus could induce infections in vivo. Osteoblasts were infected with S. aureus and, after eliminating extra-cellular S. aureus, inoculated into an open fracture rat model. Bacterial cultures and radiographic observations at post-operative day 21 confirmed local bone infections in animals inoculated with intra-cellular S. aureus within osteoblasts alone. We present direct in vivo evidence that intra-cellular S. aureus could be sufficient to induce bone infection in animals; we found that intra-cellular S. aureus inoculation of as low as 102 colony forming units could induce severe bone infections. Our data may suggest that intra-cellular S. aureus can “hide” in host cells during symptom-free periods and, under certain conditions, they may escape and lead to infection recurrence. Intra-cellular S. aureus therefore could play an important role in the pathogenesis of S. aureus infections, especially those chronic and recurrent infections in which disease episodes may be separated by weeks, months, or even years.

  18. 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)

  19. 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

  20. 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

  1. 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

  2. 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

  3. 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.

  4. 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 ...

  5. Improving surgical weekend handover

    Science.gov (United States)

    Culwick, Caroline; Devine, Chris; Coombs, Catherine

    2014-01-01

    Effective handovers are vital to patient safety and continuity of care, and this is recognised by several national bodies including the GMC. The existing model at Great Western Hospital (GWH) involved three general surgical teams and a urology team placing their printed patient lists, complete with weekend jobs, in a folder for the on-call team to collect at the weekend. We recognised a need to reduce time searching for patients, jobs and reviews, and to streamline weekend ward rounds. A unified weekend list ordering all surgical patients by ward and bed number was introduced. Discrepancies in the layout of each team's weekday list necessitated the design of a new weekday list to match the weekend list to facilitate the easy transfer of information between the two lists. A colour coding system was also used to highlight specific jobs. Prior to this improvement project only 7.1% of those polled were satisfied with the existing system, after a series of interventions satisfaction increased to 85.7%. The significant increase in overall satisfaction with surgical handover following the introduction of the unified weekend list is promising. Locating patients and identifying jobs is easier and weekend ward rounds can conducted in a more logical and timely fashion. It has also helped facilitate the transition to consultant ward rounds of all surgical inpatients at the weekends with promising feedback from a recent consultants meeting. PMID:26734294

  6. 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...... extragenital infection such as septicemia, septic arthritis, neonatal meningitis and encephalitis. We review 38 cases of surgical infections with Mycoplasma....

  7. 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 ...

  8. 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....

  9. Classification of Healthcare-Associated Staphylococcus aureus Bacteremia

    DEFF Research Database (Denmark)

    Smit, Jesper; Søgaard, Mette; Schønheyder, Henrik Carl; Nielsen, Henrik; Thomsen, Reimar Wernich

    2016-01-01

    We investigated whether different definitions of healthcare-associated infection influenced the prevalence, characteristics, and mortality of patients with Staphylococcus aureus bacteremia. With different definitions, the proportion of patients classified as having healthcare-associated S. aureus...

  10. 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)

  11. Characterization of a Mouse-Adapted Staphylococcus aureus Strain

    OpenAIRE

    Holtfreter, Silva; Fiona J Radcliff; Grumann, Dorothee; Read, Hannah; Johnson, Sarah; Monecke, Stefan; Ritchie, Stephen; Clow, Fiona; Goerke, Christiane; Bröker, Barbara M.; Fraser, John D.; Wiles, Siouxsie

    2013-01-01

    More effective antibiotics and a protective vaccine are desperately needed to combat the ‘superbug’ Staphylococcus aureus. While in vivo pathogenicity studies routinely involve infection of mice with human S. aureus isolates, recent genetic studies have demonstrated that S. aureus lineages are largely host-specific. The use of such animal-adapted S. aureus strains may therefore be a promising approach for developing more clinically relevant animal infection models. We have isolated a mouse-ad...

  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. A sensitive assay for Staphylococcus aureus nucleases

    International Nuclear Information System (INIS)

    A sensitive assay for staphylococcal nuclease involving incubation of the enzyme sample with heat-denatured [3H] thymidine labelled DNA from E.coli, precipitation with trichloroacetic acid and measurement of the radioactivity of acid-soluble nucleotides released has been developed. The assay is sensitive enough to be used for comparing the levels of nucleases elaborated by different strains of S. aureus as well as for determining the extent of contamination of S. aureus in food and water samples even at levels at which the conventional spectrophotometric and toluidine blue-DNA methods are totally inadequate. (author). 26 refs., 3 figs ., 3 tabs

  14. Staphylococcus aureus bacteremia in hemodialysis patients.

    Science.gov (United States)

    Latos, D L; Stone, W J; Alford, R H

    1977-01-01

    Fifteen male hemodialysis patients developed 21 episodes of S. aureus bacteremia. Infections involving vascular access were responsible for 65% of initial bacteremias. The arteriovenous fistula was the most prevalent type of access used, and thus was responsible for the majority of these illnesses. Phage typing indicated that recurrent episodes were due to reinfection rather than relapse. Complications included endocarditis, osteomyelitis, septic embolism, and pericarditis. One patient died of infectious complications. It is recommended that hemodialysis patients developing bacteremia due to S. aureus receive at least 6 weeks of beta lactamase-resistant antimicrobial therapy. PMID:608860

  15. 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.

  16. Frequency of Mupirocin Resistant Staphylococcus aureus Strains Isolated From Nasal Carriers in Hospital Patients in Kermanshah

    Directory of Open Access Journals (Sweden)

    Parviz Mohajeri

    2012-09-01

    Full Text Available Background: Staphylococcus aureus is a major nosocomial pathogen world wide. Mupirocin plays a crucial role in strategies designed to control outbreaks of S. aureus. .Objectives: The aim of this study was to determine the frequency of mupirocin resistance in S. aureus strains isolated from nasal carriers among the hospitalized patients at Kermanshah Hospital, Iran..Patients and Methods: A total of 174 S. aureus isolates (sensitive and resistant to methicillin were collected from the nasal anterior nares of hospitalized patients. All isolates were tested for mupirocin susceptibility by a disc diffusion method. The minimum inhibitory concentration (MIC was determined by an E-test and they were also analyzed by a PCR for the presence of ileS-1 and ileS-2 genes..Results: Utilizing the disc diffusion agar method, E-test and PCR, all of the S. aureus strains tested were susceptible to mupirocin. In this study, the range of mupirocin MICs was determined to be between 0.064 and 4 μg/ml. There was a significant association between MIC observed and multi-drug resistant (MDR carriage (P value 0.04, and resistance to oxacillin (P value 0.004..Conclusions: This is a report of an initial survey of mupirocin resistance in S. aureus, in Kermanshah where the use of mupirocin is still limited. Perhaps the sensitivity of all isolates to mupirocin in this study is due to the less common usage of this antibiotic, especially in the form of nasal and site sample collections.

  17. 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... diagnosis of disease caused by this bacterium belonging to the genus Staphylococcus and...

  18. 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... Staphylococcus aureus which has been inactivated and is nontoxic. Each serial of biological product...

  19. 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....

  20. 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.

  1. Risk factors for Staphylococcus aureus and methicillin-resistant S aureus colonization among health care workers in pediatrics departments.

    Science.gov (United States)

    Gomes, Ivete Martins; Marlow, Mariel Asbury; Pinheiro, Marcos Gabriel; de Freitas, Maria de Fátima Nogueira; Fonseca, Fernanda Fernandes; Cardoso, Claudete Aparecida Araújo; Aguiar-Alves, Fábio

    2014-08-01

    Risk factors for Staphylococcus aureus and methicillin-resistant S aureus (MRSA) were evaluated for 178 health care workers from a public hospital pediatrics department in Brazil. Colonization rates were 33.1% for S aureus and 5.1% for MRSA. Risk factors for S aureus colonization differed from those for MRSA. Results suggest nurses with prolonged pediatric patient contact in inpatient units are at higher risk for MRSA colonization. PMID:25087145

  2. Surgically treated pulmonary stenosis

    DEFF Research Database (Denmark)

    Nielsen, Eva A; Hjortdal, Vibeke E

    additional four patients died after hospital discharge; therefore, the long-term mortality was 5%. The maximum follow-up period was 57 years, with a median of 33 years. In all, 16 patients (20%) required at least one re-intervention. Pulmonary valve replacement due to pulmonary regurgitation was the most...... re-intervention at the present stage. CONCLUSION: Surgical relief for pulmonary stenosis is efficient in relieving outflow obstruction; however, this efficiency is achieved at the cost of pulmonary regurgitation, leading to right ventricular dilatation and tricuspid regurgitation. When required......, pulmonary valve replacement is performed most frequently >20 years after the initial surgery. Lifelong follow-up of patients treated surgically for pulmonary stenosis is emphasised in this group of patients, who might otherwise consider themselves cured....

  3. Radiology trainer. Surgical ambulance

    International Nuclear Information System (INIS)

    The DVD-ROM contains landmarks for fast anatomical orientation, a training mode showing the most common pathological radiological findings, a practical mode for accurate diagnosis, and textbook texts for background information. Situations encountered in surgical ambulance are simulated close to reality and in a user-friendly manner. The DVD-ROM is lavishly illustrated with more than 1600 X-ray images. (orig.)

  4. Surgical management of presbyopia

    OpenAIRE

    Torricelli AA; Junior JB; Santhiago, MR; Bechara SJ

    2012-01-01

    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 widespre...

  5. Surgical management of soft tissue sarcomas

    International Nuclear Information System (INIS)

    This volume reflects the latest thinking in surgical and adjuvant forms of therapy that can be offered to the sarcoma patient. Based on their analysis of sarcoma patients, the authors stress management based on site of origin, and discuss tumors on and about the shoulder girdle, hip joint, extremity, retroperitoneum, etc. Coverage includes methods for limb preservation; techniques for regional node resection; indications and methods for arterial perfusion, cryosurgery and isotope implantation; pre- and post-operative immunotherapy chemotherapy and radiation therapy

  6. 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...

  7. 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.

  8. Staphylococcus aureus enterotoxins A- and B

    DEFF Research Database (Denmark)

    Danielsen, E Michael; Hansen, Gert H; Karlsdóttir, Edda

    2013-01-01

    Enterotoxins of Staphylococcus aureus are among the most common causes of food poisoning. Acting as superantigens they intoxicate the organism by causing a massive uncontrolled T cell activation that ultimately may lead to toxic shock and death. In contrast to our detailed knowledge regarding...

  9. 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.

  10. Staphylococcus aureus spa type t437

    DEFF Research Database (Denmark)

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

    2015-01-01

    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...

  11. Nasal carriers are more likely to acquire exogenous Staphylococcus aureus strains than non-carriers.

    Science.gov (United States)

    Ghasemzadeh-Moghaddam, H; Neela, V; van Wamel, W; Hamat, R A; Shamsudin, M Nor; Hussin, N Suhaila Che; Aziz, M N; Haspani, M S Mohammad; Johar, A; Thevarajah, S; Vos, M; van Belkum, A

    2015-11-01

    We performed a prospective observational study in a clinical setting to test the hypothesis that prior colonization by a Staphylococcus aureus strain would protect, by colonization interference or other processes, against de novo colonization and, hence, possible endo-infections by newly acquired S. aureus strains. Three hundred and six patients hospitalized for >7 days were enrolled. For every patient, four nasal swabs (days 1, 3, 5, and 7) were taken, and patients were identified as carriers when a positive nasal culture for S. aureus was obtained on day 1 of hospitalization. For all patients who acquired methicillin-resistant S. aureus (MRSA) or methicillin-susceptible S. aureus via colonization and/or infection during hospitalization, strains were collected. We note that our study may suffer from false-negative cultures, local problems with infection control and hospital hygiene, or staphylococcal carriage at alternative anatomical sites. Among all patients, 22% were prior carriers of S. aureus, including 1.9% whom carried MRSA upon admission. The overall nasal staphylococcal carriage rate among dermatology patients was significantly higher than that among neurosurgery patients (n = 25 (55.5%) vs. n = 42 (16.1%), p 0.005). This conclusion held when the carriage definition included individuals who were nasal culture positive on day 1 and day 3 of hospitalization (p 0.0001). All MRSA carriers were dermatology patients. There was significantly less S. aureus acquisition among non-carriers than among carriers during hospitalization (p 0.005). The mean number of days spent in the hospital before experiencing MRSA acquisition in nasal carriers was 5.1, which was significantly lower than the score among non-carriers (22 days, p 0.012). In conclusion, we found that nasal carriage of S. aureus predisposes to rather than protects against staphylococcal acquisition in the nose, thereby refuting our null hypothesis. PMID:26183299

  12. 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

  13. 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

  14. 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

  15. 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.

  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. 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.

  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. 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. 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. Antibacterial Surgical Silk Sutures Using a High-Performance Slow-Release Carrier Coating System.

    Science.gov (United States)

    Chen, Xiaojie; Hou, Dandan; Wang, Lu; Zhang, Qian; Zou, Jiahan; Sun, Gang

    2015-10-14

    Sutures are a vital part for surgical operation, and suture-associated surgical site infections are an important issue of postoperative care. Antibacterial sutures have been proved to reduce challenging complications caused by bacterial infections. In recent decades, triclosan-free sutures have been on their way to commercialization. Alternative antibacterial substances are becoming relevant to processing surgical suture materials. Most of the antibacterial substances are loaded directly on sutures by dipping or coating methods. The aim of this study was to optimize novel antibacterial braided silk sutures based on levofloxacin hydrochloride and poly(ε-caprolactone) by two different processing sequences, to achieve suture materials with slow-release antibacterial efficacy and ideal physical and handling properties. Silk strands were processed into sutures on a circular braiding machine, and antibacterial treatment was introduced alternatively before or after braiding by two-dipping-two-rolling method (M1 group and M2 group). The antibacterial activity and durability against Staphylococcus aureus and Escherichia coli were tested. Drug release profiles were measured in phosphate buffer with different pH values, and release kinetics model was built to analyze the sustained drug release mechanism between the interface of biomaterials and the in vitro aqueous environment. Knot-pull tensile strength, thread-to-thread friction, and bending stiffness were determined to evaluate physical and handling properties of sutures. All coated sutures showed continuous antibacterial efficacy and slow drug release features for more than 5 days. Besides, treated sutures fulfilled U.S. Pharmacopoeia required knot-pull tensile strength. The thread-to-thread friction and bending stiffness for the M1 group changed slightly when compared with those of uncoated ones. However, physical and handling characteristics of the M2 group tend to approach those of monofilament ones. The novel suture

  3. Staphylococcus aureus methicillin-resistance mechanisms

    Directory of Open Access Journals (Sweden)

    Petrović-Jeremić Ljiljana

    2008-01-01

    Full Text Available Background/Aim. In many hospitals in the world and in our country, the spread of methicillin-resistant Staphylococcus aureus (MRSA is so wide that nowdays vancomycin is recommended for empiric treatment of staphylococcal life threatening infections (sepsis, pneumonia instead of beta-lactam antibiotics. The aim of this study was to determine the production of beta-lactamases in hospital and community isolates of staphyloococus aureus, i. e. hospital associated MRSA (HA-MRSA and community associated MRSA (CA-MRSA, the presence of homogeneous and heterogeneous type of methicillin resistance, and border-line resistance in Staphylococcus aureus (BORSA. The aim of this study was also to determine if there was a statistically significant difference between mechanisms of resistance in HA-MRSA and CA-MRSA. Methods. A total 216 clinical Staphylococcus aureus isolates from the General Hospital in the town of Cuprija and 186 ambulance Staphylococcus aureus isolates from the community were examined for the presence of methicillin-resistance using disk-diffusion test with penicillin disk (10 ij, oxacillin disk (1 μg and cefoxitin disk (30 μg. Betalactamases production was detected by nitrocefin disk and betalactamase tablets. Determination of oxacillin minimum inhibitory concentracion (MIC was done by agar-dilution method. Results. The prevalence of HA-MRSA was 57.4%, and CA-MRSA was 17.7% (p < 0.05. There was a higher rate of heterogeneous type of resistance among clinical MRSA isolates (11.1% compared with ambulance ones (3.8% (p < 0.05. The rates of beta-lactamases production were similar among hospital associated isolates (97.5%, as well as in the community associated isolates (95.5% (p > 0.05. There were 4.6 % of BORSA hospital isolates and 3.3 % of BORSA ambulance isolates (p > 0.05. Conclusion. The frequency of MRSA isolates in hospital was significantly higher than in community, as well as the heterogeneous type of resistance. The frequency of BORSA

  4. 76 FR 42169 - Medicare and Medicaid Programs: Hospital Outpatient Prospective Payment; Ambulatory Surgical...

    Science.gov (United States)

    2011-07-18

    ... Hospital-Acquired Condition HAI Healthcare-Associated Infection HCAHPS Hospital Consumer Assessment of...) Healthcare Associated Infection (HAI) Measure for the CY 2014 Payment Determination: Surgical Site Infection... Determinations f. Proposed Data Submission Deadlines for the Proposed NHSN HAI Surgical Site Infection...

  5. 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 ...

  6. 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...

  7. 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.

  8. 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...

  9. 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

  10. 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

  11. 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.

  12. 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...

  13. 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.

  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. Xanthgranulomatous pyelonephritis associated with Staphylococcus aureus.

    Science.gov (United States)

    Al-Hwiesh, Abdulla K

    2007-11-01

    A 44-year old man with xanthogranulomatous pyelonephritis presented with abdominal distention, left lumber pain, fever, loss of appetite, and loss of weight. He had been known to have diabetes mellitus type II for 20 years, and he was diagnosed to have a left renal stone three months prior to this presentation. The patient's urine and the left psous abscess grew staphylococcus aureus. PMID:17951953

  16. Xanthgranulomatous pyelonephritis associated with staphylococcus aureus

    International Nuclear Information System (INIS)

    A 44-year-old man with xanthgranulomatous pyelonephritis presented with abdominal distention, left lumber pain, fever, loss of appetite and loss of weight. He had been known to have diabetes mellitus type II for 20 years and he was diagnosed to have a left renal stone three months prior to this presentation. The patient's urine and the left psous abscess grew staphylococcus aureus. (author)

  17. 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

  18. [Transsexualism: indication and surgical treatment].

    Science.gov (United States)

    Biemer, E; Kockott, G; Hartung, R

    1979-09-01

    After the diagnosis of transsexuality is well definated and recognized in most western countries, the surgical transformation of the genital area is performed. Before surgical treatment an exact psychiatric clarification is absolutely essential. The operation is the last part of a long treatment. The surgical result in the more common female transsexual is quite reasonable. The treatment of the fewer male transsexuals is not solved completely, especially the reliable techniques for penis reconstructions are not very sufficient. PMID:524996

  19. 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...

  20. 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

  1. 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.

  2. 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.

  3. Surgical education in Mexico.

    Science.gov (United States)

    Cervantes, Jorge

    2010-05-01

    Surgical education in Mexico basically follows the same model as in the United States, with a selection process resembling the matching program. There is a 4-year training period during which residents in their third year spend 4 months as the sole surgeon in a rural community. During the senior year they are entitled to an elective period in a place of their choosing. After completion of the 4 years, residents have to present a thesis and undergo an oral examination before getting a university diploma. They are then encouraged to pass the written and oral examination of the Mexican Board of Surgery before they are fully certified to enter practice in a public or private hospital. PMID:19603225

  4. Percutaneous Versus Surgical Tracheostomy

    Science.gov (United States)

    Gysin, Claudine; Dulguerov, Pavel; Guyot, Jean-Philippe; Perneger, Thomas V.; Abajo, Blanca; Chevrolet, Jean-Claude

    1999-01-01

    Objective To compare surgical (SgT) and percutaneous (PcT) tracheostomies. Background Percutaneous tracheostomy has been said to provide numerous advantages over classical SgT. Methods A prospective randomized trial with a double-blind evaluation was used to compare SgT and PcT. SgT and PcT were performed according to established techniques (n = 70). The procedure was performed at the bedside in the intensive care unit in 21 cases (30%). The outcome measures were divided into procedure-related variables, perioperative complications, and postoperative complications. The procedure-related variables (location, duration, and difficulty) were evaluated by the surgeon. The perioperative and postoperative complications were divided into serious, intermediate, and minor. Perioperative and early postoperative (14 days) complications were evaluated daily by an intensive care unit nurse blinded to the technique used. Long-term postoperative complications were evaluated 3 months after decannulation by a surgeon blinded to the surgical technique. Results There were no major complications in either group. Most variables studied were not statistically different between the PcT and SgT groups. The only variables to reach statistical significance were the size of the incision (smaller with PcT, p < 0.0001), minor perioperative complications (greater with PcT, p = 0.02), and difficult cannula changes (greater with PcT; p < 0.05). Among nonsignificant differences, difficult procedures and false passages were more frequent with PcT, whereas long-term unesthetic scars were more frequent with SgT. Conclusions Both techniques are associated with a low rate of serious or intermediate complications when performed by experienced surgeons. There were more minor perioperative complications with PcT and more minor long-term complications with SgT. PMID:10561096

  5. [Raw milk-associated Staphylococcus aureus intoxication in children].

    Science.gov (United States)

    Giezendanner, N; Meyer, B; Gort, M; Müller, P; Zweifel, C

    2009-07-01

    Four hours after the consumption of raw goat milk, three Swiss children came down with emesis and diarrhea in July 2008. First investigations showed that the milk originated from a goat suffering from clinical mastitis (Staphylococcus aureus). In the milk sample from the untreated left udder, Staphylococcus aureus counts reached 5.0 x 10(7) CFU ml(-1). By PCR, the gene for the staphylococcal enterotoxin D was found in isolated strains. The consumption of raw milk is rarely associated with Staphylococcus aureus intoxications. Due to the flora naturally present in raw milk, Staphylococcus aureus normally cannot multiply sufficiently. However, in the present case, high Staphylococcus aureus counts were already present in the milk due to the mastitis of the goat. This amount sufficed to cause a Staphylococcus aureus intoxication in the children. PMID:19565455

  6. Response of Streptococcus pyogenes to therapy with amoxicillin or amoxicillin-clavulanic acid in a mouse model of mixed infection caused by Staphylococcus aureus and Streptococcus pyogenes.

    OpenAIRE

    Boon, R J; Beale, A S

    1987-01-01

    The response of Streptococcus pyogenes to amoxicillin or amoxicillin-clavulanic acid (Augmentin; Beecham Group) therapy of a mixed streptococcal-staphylococcal infection was studied in a surgical wound in mice. A superficial wound was produced on the backs of anesthetized mice, and a suture infected with S. pyogenes, Staphylococcus aureus, or a mixed inoculum of both organisms was inserted. Oral therapy was started 4 h after infection and continued for 3 days. Both amoxicillin and amoxicillin...

  7. 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...

  8. Mastectomy -- The Surgical Procedure

    Medline Plus

    Full Text Available ... Video Mastectomy Related Video Breast Cancer 101 NEED HELP OR MORE INFORMATION? 1-877 GO KOMEN (1- ... Boards Site Map Blog ShopKomen.com How to Help Terms of Use Privacy Policy Legal and Disclosures ...

  9. 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.

  10. 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

  11. 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.

  12. 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...

  13. Vitamin D sufficiency and Staphylococcus aureus infection in children.

    Science.gov (United States)

    Wang, Jeffrey W; Hogan, Patrick G; Hunstad, David A; Fritz, Stephanie A

    2015-05-01

    Vitamin D promotes epithelial immunity by upregulating antimicrobial peptides, including LL-37, which have bactericidal activity against Staphylococcus aureus. We found that children with vitamin D deficiency or insufficiency [25-hydroxyvitamin D recurrent, rather than primary, S. aureus skin or soft tissue infection. Vitamin D sufficiency may be one of a myriad of host and environmental factors that can be directly impacted to reduce the frequency of S. aureus skin and soft tissue infection. PMID:25860535

  14. Infection control of Staphylococcus aureus : spa typing to elucidate transmission

    OpenAIRE

    Mernelius, Sara

    2015-01-01

    Staphylococcus aureus is a commensal of the human flora, primarily colonizing the anterior nares and throat, but it may also cause infections ranging from mild skin and soft tissue infections to severe diseases such as endocarditis and septicemia. S. aureus is also a major nosocomial problem increasing with the worldwide dissemination of methicillin-resistant S. aureus (MRSA). The main vector for bacterial cross-transmission in healthcare settings is the hands of healthcare workers (HCWs). No...

  15. 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...

  16. 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...

  17. Epicutaneous Model of Community-Acquired Staphylococcus aureus Skin Infections

    OpenAIRE

    Prabhakara, Ranjani; Foreman, Oded; De Pascalis, Roberto; Lee, Gloria M.; Plaut, Roger D.; Kim, Stanley Y.; Stibitz, Scott; Elkins, Karen L.; Merkel, Tod J.

    2013-01-01

    Staphylococcus aureus is one of the most common etiological agents of community-acquired skin and soft tissue infection (SSTI). Although the majority of S. aureus community-acquired SSTIs are uncomplicated and self-clearing in nature, some percentage of these cases progress into life-threatening invasive infections. Current animal models of S. aureus SSTI suffer from two drawbacks: these models are a better representation of hospital-acquired SSTI than community-acquired SSTI, and they involv...

  18. 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.

  19. 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.

  20. 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.

  1. 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...

  2. 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

  3. Training of breast surgical oncologists.

    Science.gov (United States)

    Teshome, Mediget; Kuerer, Henry M

    2016-06-01

    Breast surgical oncology is a defined sub-specialty of general surgery with focus on the surgical management of breast disease and malignancy within a multidisciplinary context. Much of the training of breast surgical oncologists in the United States exists within a fellowship training structure with oversight and approval by the Society of Surgical Oncology (SSO). Rapid continuous changes in breast oncology practice have further substantiated dedicated expertise in breast surgical oncology. Training programs are structured to develop proficiency in fellows for advanced surgical techniques and clinical decision-making as well as exposure to the multidisciplinary aspects of breast cancer management. Components of a successful program include an intense multidisciplinary curriculum, engagement in clinical research and attention to strong mentorship. National curriculum and training requirements as well as supplemental resources assist in standardizing the fellowship experience. As surgical training and the field of breast oncology continues to evolve, so do fellowship training programs to ensure high quality breast surgical oncologists equipped to deliver high quality evidence based patient care while continuing to drive future research and trainee education. PMID:27197510

  4. Combined Surgical Treatment of Gynecomastia

    Directory of Open Access Journals (Sweden)

    Yordanov Y.

    2015-05-01

    Full Text Available Surgical treatment of gynecomastia could present unique challenges for the plastic surgeon. Achieving a good balance between effectiveness of the selected approach and the satisfactory aesthetic outcome often is a difficult endeavor. Optimal surgical treatment involves a combination of liposuction and direct excision. In the present study the charts of 11 patients treated with suction-assisted liposuction and direct surgical excision were retrospectively reviewed; a special emphasis is placed on the surgical technique. The mean follow-up period of the patients was 11.6 months. No infection, hematoma, nipple-areola complex necrosis and nipple retraction was encountered in this series. The combined surgical treatment of gynecomastia has shown to be a reliable technique in both small and moderate breast enlargement including those with skin excess.

  5. 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 ...

  6. 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.

  7. Interventional neuroradiology (surgical neuroanglography)

    International Nuclear Information System (INIS)

    The applications and effectiveness of surgical neuroangiography, or interventional neuroradiology of the head, neck, spine and brain are rapidly increasing. These procedures are used in the management of a variety of vascular lesions, either preoperatively or as the primary mode of treatment. Lesions that can be approached by the endovascular route, vascular neoplasms (benign or malignant), vasculas malformations (arterial, venous, or mixed), hemangiomas, arteriovenous fistulas, vessel lacerations, and extracranial or intracranial aneurysms are discussed, as are infusion chemotherapy and angioplasties of atherosclerotic or vasospastic extracranial or intracranial vessels. The various catheters or delivery systems and embolic agents, including conventional or special microcatheters, balloon catheters of various lumens, detachable balloons of silicone and latex, open-ended guide wires, and steerable microwires, as well as various embolic agents, either particulated or liquid, and including cytotoxic agents, are described. Functional vascular anatomy of the collateral circulation is reviewed, including extracerebral to intracerebral anastomases and the supply to the transcranial nerves. The use of chemical testing with Amytal and Xylocaine and electrophysiologic monitoring for safe embolization is demonstrated

  8. Mastectomy -- The Surgical Procedure

    Medline Plus

    Full Text Available ... an Affiliate Shop Komen.com Connect Skip main navigation Shopkomen.com Find an Event Donate Now Donate ... Central FAQs Media Center Contact Us Message Boards Site Map Blog ShopKomen.com How to Help Terms ...

  9. 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.

  10. 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.

  11. 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.

  12. Intracellular proliferation of S. aureus in osteoblasts and effects of rifampicin and gentamicin on S. aureus intracellular proliferation and survival

    Directory of Open Access Journals (Sweden)

    W Mohamed

    2014-10-01

    Full Text Available Staphylococcus aureus is the most clinically relevant pathogen regarding implant-associated bone infection and its capability to invade osteoblasts is well known. The aim of this study was to investigate firstly whether S. aureus is not only able to invade but also to proliferate within osteoblasts, secondly to delineate the mechanism of invasion and thirdly to clarify whether rifampicin or gentamicin can inhibit intracellular proliferation and survival of S. aureus. The SAOS-2 osteoblast-like cell line and human primary osteoblasts were infected with S. aureus EDCC5055 and S. aureus Rosenbach 1884. Both S. aureus strains were able to invade efficiently and to proliferate within human osteoblasts. Immunofluorescence microscopy showed intracellular invasion of S. aureus and transmission electron microscopy images could demonstrate bacterial division as a sign of intracellular proliferation as well as cytosolic bacterial persistence. Cytochalasin D, the major actin depolymerisation agent, was able to significantly reduce S. aureus invasion, suggesting that invasion was enabled by promoting actin rearrangement at the cell surface. 7.5 μg/mL of rifampicin was able to inhibit bacterial survival in SAOS-2 cells with almost complete elimination of bacteria after 4 h. Gentamicin could also kill intracellular S. aureus in a dose-dependent manner, an effect that was significantly lower than that observed using rifampicin. In conclusion, S. aureus is not only able to invade but also to proliferate in osteoblasts. Invasion seems to be associated with actin rearrangement at the cell surface. Rifampicin is effective in intracellular eradication of S. aureus whereas gentamicin only poorly eliminates intracellularly replicating bacteria.

  13. 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

  14. Lysostaphin in treatment of neonatal Staphylococcus aureus infection.

    Science.gov (United States)

    Oluola, Okunola; Kong, Lingkun; Fein, Mindy; Weisman, Leonard E

    2007-06-01

    This study describes lysostaphin's effect against methicillin-sensitive Staphylococcus aureus in suckling rats. Standard techniques determined minimal inhibitory and bactericidal concentrations, pharmacokinetics, and efficacy. The numbers of surviving rats after vancomycin, oxacillin, and lysostaphin treatment were comparable and were different from that of controls (P < 0.00001). Lysostaphin appears effective in the treatment of neonatal S. aureus infection. PMID:17420212

  15. 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.

  16. 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.

  17. 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.

  18. 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.

  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. 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.

  1. 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...... 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....... The database can be applied for identification of virulence genes in S. aureus using whole genome 5 sequence data. The S. aureus VirulenceFinder will be part of the tool package generated for the Centre for Genomic Epidemiology (CGE) (www.genomicepidemiology.org)....

  2. 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

  3. 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

  4. 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

  5. Photodynamic Antimicrobial Chemotherapy (PACT) in osteomyelitis induced by Staphylococcus aureus: Microbiological and histological study.

    Science.gov (United States)

    Dos Reis, João Alves; Dos Santos, Jean Nunes; Barreto, Brunna Santos; de Assis, Patrícia Nascimento; Almeida, Paulo Fernando; Pinheiro, Antônio Luiz Barbosa

    2015-08-01

    Osteomyelitis is an inflammation either of medullar spaces or of the surface of cortical bones, which represents a bacterial infection. Photodynamic Antimicrobial Chemotherapy (PACT) is a treatment based on a cytotoxic photochemical reaction that induces a series of metabolic reactions and culminates in bacterial suppression. Such effect led to the idea that it could be used as a treatment of osteomyelitis. Following approval by the Animal Experimentation Committee of the School of Dentistry of the Federal University of Bahia, the present randomized study used eighty Wistar rats with the aim to evaluate, by microbiological and histological analysis, the effects of Photodynamic Antimicrobial Chemotherapy - PACT on tibial surgical bone defects in rats infected by Staphylococcus aureus. The animals were divided in groups: Control (non-infected); Control Osteomyelitis Induction; Saline solution; Photosensitizer; Red Laser and PACT - on this group, a diode laser (40mW; λ660nm ∅=0.04cm(2), CW, 10J/cm(2)) was used in combination with 5μg/ml of toluidine blue as the photosensitizer. On the microbiological study, immediately after treatment, the PACT group presented a bacterial reduction of 97.4% (pbone sequestration and micro-abscesses. The PACT using toluidine blue was effective in reducing the number of S. aureus enabling a better quality bone repair. PMID:26111990

  6. 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 ...

  7. [Surgical approach in Peyronie's disease].

    Science.gov (United States)

    Carmignani, G; De Rose, A F; Simonato, A; Galli, S; Corbu, C

    1997-02-01

    The goal of surgical treatment of Induratio Penis Plastica should be the achievement of the best aesthetic and functional result with the lowest side-effects. During the last two years different techniques have been proposed for the cases with conserved erectile function, such as Nesbit's technique, excision or incision of the plaque followed by implants of autologous (dermal, saphena vein) or heterologous (dura madre, gore-tex) patches. The criteria for the choice of the most appropriated surgical technique include the curvature degree, the plaque dimension and the penis length. In our experience 6 months after the surgical correction a remaining curvature was observed in 4/38 patients (10%), only 1 of whom needed a new surgical treatment. One case of erectile disfunction occurred, treated by intra-cavernous injection of PgE1. PMID:9181914

  8. 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...

  9. 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 ...

  10. 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...

  11. Intermittent exotropia: Surgical treatment strategies

    Directory of Open Access Journals (Sweden)

    Jai Aditya Kelkar

    2015-01-01

    Full Text Available Surgical management of intermittent exotropias (IXTs is ambiguous, with techniques of management varying widely between institutions. This review aims to examine available literature on the surgical management of IXT. A literature search was performed using PubMed, Web of Knowledge, LILACS, and the University of Liverpool Orthoptic Journals and Conference Transactions Database. All English-language papers published between 1958 and the present day were considered.

  12. 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...

  13. Regional anaesthesia and surgical morbidity

    DEFF Research Database (Denmark)

    Scott, N B; Kehlet, H

    1988-01-01

    This review assesses the results of studies examining the influence of regional anaesthesia on surgical morbidity. Morbidity appears to be reduced when procedures below the umbilicus are concerned, but evidence is less convincing for upper abdominal and thoracic procedures.......This review assesses the results of studies examining the influence of regional anaesthesia on surgical morbidity. Morbidity appears to be reduced when procedures below the umbilicus are concerned, but evidence is less convincing for upper abdominal and thoracic procedures....

  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. 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.

  16. 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.

  17. 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

  18. 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

  19. Multiple advanced surgical techniques to treat acquired seminal duct obstruction

    Directory of Open Access Journals (Sweden)

    Hong-Tao Jiang

    2014-12-01

    Full Text Available The aim of this study was to evaluate the outcomes of multiple advanced surgical treatments (i.e. microsurgery, laparoscopic surgery and endoscopic surgery for acquired obstructive azoospermia. We analyzed the surgical outcomes of 51 patients with suspected acquired obstructive azoospermia consecutively who enrolled at our center between January 2009 and May 2013. Modified vasoepididymostomy, laparoscopically assisted vasovasostomy and transurethral incision of the ejaculatory duct with holmium laser were chosen and performed based on the different obstruction sites. The mean postoperative follow-up time was 22 months (range: 9 months to 52 months. Semen analyses were initiated at four postoperative weeks, followed by trimonthly (months 3, 6, 9 and 12 semen analyses, until no sperm was found at 12 months or until pregnancy was achieved. Patency was defined as >10,000 sperm ml−1 of semen. The obstruction sites, postoperative patency and natural pregnancy rate were recorded. Of 51 patients, 47 underwent bilateral or unilateral surgical reconstruction; the other four patients were unable to be treated with surgical reconstruction because of pelvic vas or intratesticular tubules obstruction. The reconstruction rate was 92.2% (47/51, and the patency rate and natural pregnancy rate were 89.4% (42/47 and 38.1% (16/42, respectively. No severe complications were observed. Using multiple advanced surgical techniques, more extensive range of seminal duct obstruction was accessible and correctable; thus, a favorable patency and pregnancy rate can be achieved.

  20. 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.

  1. Risk of peritonitis during peritoneal dialysis in carriers of Staphylococcus aureus and coagulase-negative staphylococci

    Directory of Open Access Journals (Sweden)

    J. E. N. Batalha

    2006-01-01

    Full Text Available The presence of Staphylococcus aureus in the nasal cavities and pericatheter skin of peritoneal dialysis patients put them at high risk of developing peritonitis. However, it is not clear whether the presence of coagulase-negative staphylococci (CNS in the nasal passages and skin of patients is related to subsequent occurrence of peritoneal infection. The aim of the present study was to verify the relationship between endogenous sources of S. aureus and CNS and occurrence of peritonitis in patients undergoing peritoneal dialysis. Thirty-two patients on peritoneal hemodialysis were observed for 18 months. Staphylococcus species present in their nasal passage, pericatheter skin and peritoneal effluent were identified and compared based on drug susceptibility tests and dendrograms, which were drawn to better visualize the similarity among strains from extraperitoneal sites as well as their involvement in the causes of infection. Out of 288 Staphylococcus strains isolated, 155 (53.8% were detected in the nasal cavity, 122 (42.4% on the skin, and 11 (3.8% in the peritoneal effluent of patients who developed peritonitis during the study. The most frequent Staphylococcus species were CNS (78.1%, compared with S. aureus (21.9%. Among CNS, S. epidermidis was predominant (64.4%, followed by S. warneri (15.1%, S. haemolyticus (10.7%, and other species (9.8%. Seven (64% out of 11 cases of peritonitis analyzed presented similar strains. The same strain was isolated from different sites in two (66% out of three S. aureus infection cases. In the six cases of S. epidermidis peritonitis, the species that caused infection was also found in the normal flora. From these, two cases (33% presented highly similar strains and in three cases (50%, it was difficult to group strains as to similarity. Patients colonized with multidrug-resistant S. epidermidis strains were more predisposed to infection. Results demonstrated that an endogenous source of S. epidermidis could

  2. Indole and 7-benzyloxyindole attenuate the virulence of Staphylococcus aureus.

    Science.gov (United States)

    Lee, Jin-Hyung; Cho, Hyun Seob; Kim, Younghoon; Kim, Jung-Ae; Banskota, Suhrid; Cho, Moo Hwan; Lee, Jintae

    2013-05-01

    Human pathogens can readily develop drug resistance due to the long-term use of antibiotics that mostly inhibit bacterial growth. Unlike antibiotics, antivirulence compounds diminish bacterial virulence without affecting cell viability and thus, may not lead to drug resistance. Staphylococcus aureus is a major agent of nosocomial infections and produces diverse virulence factors, such as the yellow carotenoid staphyloxanthin, which promotes resistance to reactive oxygen species (ROS) and the host immune system. To identify novel antivirulence compounds, bacterial signal indole present in animal gut and diverse indole derivatives were investigated with respect to reducing staphyloxanthin production and the hemolytic activity of S. aureus. Treatment with indole or its derivative 7-benzyloxyindole (7BOI) caused S. aureus to become colorless and inhibited its hemolytic ability without affecting bacterial growth. As a result, S. aureus was more easily killed by hydrogen peroxide (H₂O₂) and by human whole blood in the presence of indole or 7BOI. In addition, 7BOI attenuated S. aureus virulence in an in vivo model of nematode Caenorhabditis elegans, which is readily infected and killed by S. aureus. Transcriptional analyses showed that both indole and 7BOI repressed the expressions of several virulence genes such as α-hemolysin gene hla, enterotoxin seb, and the protease genes splA and sspA and modulated the expressions of the important regulatory genes agrA and sarA. These findings show that indole derivatives are potential candidates for use in antivirulence strategies against persistent S. aureus infection. PMID:23318836

  3. The changing epidemiology of Staphylococcus aureus bloodstream infection

    DEFF Research Database (Denmark)

    Galbraith, J.C.; Valiquette, G.; Kennedy, K.J.;

    2013-01-01

    Clin Microbiol Infect ABSTRACT: Although the epidemiology of Staphylococcus aureus bloodstream infection (BSI) has been changing, international comparisons are lacking. We sought to determine the incidence of S. aureus BSI and assess trends over time and by region. Population-based surveillance...... episodes of S. aureus BSI were identified. The overall annual incidence rate for S. aureus BSI was 26.1 per 100 000 population, and those for methicillin-sensitive S. aureus (MSSA) and methicillin-resistant S. aureus (MRSA) were 24.2 and 1.9 per 100 000, respectively. Although the overall incidence...... of community-onset MSSA BSI (15.0 per 100 000) was relatively similar across regions, the incidence rates of hospital-onset MSSA (9.2 per 100 000), community-onset MRSA (1.0 per 100 000) and hospital-onset MRSA (0.8 per 100 000) BSI varied substantially. Whereas the overall incidence of S. aureus BSI did...

  4. Staphylococcus aureus: portadores entre manipuladores de alimentos Staphylococcus aureus: food handler carriers

    Directory of Open Access Journals (Sweden)

    Maria Stella Gonçalves Raddi

    1988-02-01

    Full Text Available Foram colhidas amostras de mãos e fossas nasais de 48 manipuladores de alimentos das principais casas comerciais da cidade de Araraquara, Estado de São Paulo (Brasil, e de 20 estudantes universitários. Dentre os indivíduos foram encontrados 44,1% e 34,8% que portavam Staphylococcus aureus em fossas nasais e mãos, respectivamente. Observou-se predomínio de fagotipos dos grupos I e III. Dos 12 portadores do microrganismo, concomitantemente em mãos e fossas nasais, 75,0% apresentaram cepas com vínculo epidemiológico. Os achados mostram o risco potencial representado pelas mãos nas intoxicações alimentares.Material was collected from the hands and nasal passages of forty-eight food handlers and twenty college students of Araraquara (S. Paulo State, Brazil and analized in order to evaluate the carrier function with regard to Staphylococcus aureus. The organism discovered in both samples of nine out of the twelve volunteers were of the same S. aureus phage types. The incidence of carriage on the hands was much greater in the handlers' group. These findings demonstrate the potential risk represented by hands in the transmission of food poisoning.

  5. Absence in Bacillus subtilis and Staphylococcus aureus of the sequence-specific deoxyribonucleic acid methylation that is conferred in Escherichia coli K-12 by the dam and dcm enzymes.

    OpenAIRE

    Dreiseikelmann, Brigitte; Wackernagel, Wilfried

    1981-01-01

    Restriction analysis of plasmid pHV14 deoxyribonucleic acid isolated from Escherichia coli K-12, Bacillus subtilis, and Staphylococcus aureus with restriction endonucleases MboI, Sau3AI, and EcoRII was used to study the methylation of those nucleotide sequences which in E. coli contain the major portions of N6-methyladenine and 5-methylcytosine. The results showed that neither B. subtilis nor S. aureus methylates deoxyribonucleic acid at the same sites and nucleotides which are recognized and...

  6. Methicillin-resistant Staphylococcus aureus transmission

    DEFF Research Database (Denmark)

    Andersen, Leif Percival; Nielsen, Xiaohui

    2015-01-01

    increase the risk of contaminating hands, arms and the front of the uniform. Hand hygiene is therefore essential, but the use of protection gowns with long sleeves is also important in order to prevent transmission of MRSA. After culture of MRSA and implementation of specific precautions to prevent......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...... transmission of MRSA, no further transmissions were observed. FUNDING: not relevant. TRIAL REGISTRATION: The data in this study are included in the routine surveillance of MRSA at Rigshospitalet and do not form part of a trial....

  7. 21 CFR 878.4040 - Surgical apparel.

    Science.gov (United States)

    2010-04-01

    ... and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES GENERAL AND PLASTIC SURGERY DEVICES Surgical Devices § 878.4040 Surgical apparel. (a... surgical procedures to protect both the surgical patient and the operating room personnel from transfer...

  8. 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

  9. Bovine Staphylococcus aureus: Subtyping, evolution, and zoonotic transfer.

    Science.gov (United States)

    Boss, R; Cosandey, A; Luini, M; Artursson, K; Bardiau, M; Breitenwieser, F; Hehenberger, E; Lam, Th; Mansfeld, M; Michel, A; Mösslacher, G; Naskova, J; Nelson, S; Podpečan, O; Raemy, A; Ryan, E; Salat, O; Zangerl, P; Steiner, A; Graber, H U

    2016-01-01

    Staphylococcus aureus is globally one of the most important pathogens causing contagious mastitis in cattle. Previous studies using ribosomal spacer (RS)-PCR, however, demonstrated in Swiss cows that Staph. aureus isolated from bovine intramammary infections are genetically heterogeneous, with Staph. aureus genotype B (GTB) and GTC being the most prominent genotypes. Furthermore, Staph. aureus GTB was found to be contagious, whereas Staph. aureus GTC and all the remaining genotypes were involved in individual cow disease. In addition to RS-PCR, other methods for subtyping Staph. aureus are known, including spa typing and multilocus sequence typing (MLST). They are based on sequencing the spa and various housekeeping genes, respectively. The aim of the present study was to compare the 3 analytic methods using 456 strains of Staph. aureus isolated from milk of bovine intramammary infections and bulk tanks obtained from 12 European countries. Furthermore, the phylogeny of animal Staph. aureus was inferred and the zoonotic transfer of Staph. aureus between cattle and humans was studied. The analyzed strains could be grouped into 6 genotypic clusters, with CLB, CLC, and CLR being the most prominent ones. Comparing the 3 subtyping methods, RS-PCR showed the highest resolution, followed by spa typing and MLST. We found associations among the methods but in many cases they were unsatisfactory except for CLB and CLC. Cluster CLB was positive for clonal complex (CC)8 in 99% of the cases and typically positive for t2953; it is the cattle-adapted form of CC8. Cluster CLC was always positive for tbl 2645 and typically positive for CC705. For CLR and the remaining subtypes, links among the 3 methods were generally poor. Bovine Staph. aureus is highly clonal and a few clones predominate. Animal Staph. aureus always evolve from human strains, such that every human strain may be the ancestor of a novel animal-adapted strain. The zoonotic transfer of IMI- and milk-associated strains

  10. Identification of the ClpX Regulon in Staphylococcus aureus

    DEFF Research Database (Denmark)

    Jelsbak, Lotte; Thomsen, Line Elnif; Ingmer, Hanne;

    Staphyloccous aureus is a major human pathogen capable of causing a wide spectrum of infections ranging from superficial wound infections to life-threatening endocarditis and toxic shock syndrome. Essential for S. aureus virulence is a large number of cell-surface-associated proteins and secreted...... we show here that almost 400 genes (15%) are influenced by the clpX deletion. Furthermore, ClpX not only regulates many virulence factors, but rather serves as a global regulator of central functions for S. aureus lifestyle and pathogenicity....

  11. 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

  12. [Surgical management of pancreatic cancer].

    Science.gov (United States)

    Kim, Song Cheol

    2008-02-01

    Pancreatic cancer is a major problematic concern among all forms of gastrointestinal malignancies because of its poor prognosis. Although significant progress has been made in the surgical treatment in terms of increased resection rate and decreased treatment-related morbidity and mortality, the true survival rate still remains below 5% today. Surgical options for pancreatic cancer are based on the its unique anatomy and physiology, catastrophic tumor biology, experience of surgeon, and status of patients. Four main options exist for the surgical treatment of pancreatic cancer. These include standard "Whipple" pancreaticoduodenectomy (PD), pylorus preserving PD (PPPD), distal pancreatectomy (left-side pancreatectomy), and total pancreatectomy according to the location of tumor. Portal vein involvement by tumor is regarded as an anatomical extension of disease, and en bloc resection of portal vein with tumor is recommended if technically feasible, which is stated in 2002 AJCC tumor staging for pancreatic cancer. In comparison of the survival rates between standard and extended resection of pancreatic head cancer, no significant survival benefit was demonstrated from the prospective reports. PPPD may be superior to standard PD in respect to nutrition and quality of life without any deleterious effect upon long term survival or tumor recurrence. New surgical treatment modalities including modified extended pancreatectomy, neoadjuvant chemotherapy, and radical antegrade modular distal pancreatectomy have been tried to improve the patients' survival. However, early diagnosis and treatment remain as key factors for the cure of pancreatic cancer irrespective of various surgical trials. PMID:18349571

  13. 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

  14. 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

  15. 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.

  16. Presence of Leishmania and Brucella Species in the Golden Jackal Canis aureus in Serbia

    OpenAIRE

    Duško Ćirović; Dimosthenis Chochlakis; Snežana Tomanović; Ratko Sukara; Aleksandra Penezić; Yannis Tselentis; Anna Psaroulaki

    2014-01-01

    The golden jackal Canis aureus occurs in south-eastern Europe, Asia, the Middle East, the Caucasus, and Africa. In Serbia, jackals neared extinction; however, during the last 30 years, the species started to spread quickly and to increase in number. Few studies in the past have revealed their potential role as carriers of zoonotic diseases. Animal samples were collected over a three-year period (01/2010–02/2013) from 12 sites all over Serbia. Of the tissue samples collected, spleen was ch...

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

    Science.gov (United States)

    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 following targets: (i) mecA gene, conferring methicillin resistance, common to both S. aureus and Staphylococcus epidermidis; (ii) femA gene from S. aureus; and (iii) femA gene from S. epidermidis. This quantitative approach allows discrimination of the origin of the measured mecA signal. qPCR data were calibrated using two reference strains (MRSA and methicillin-resistant S. epidermidis) processed in parallel to clinical samples. This 96-well format assay allowed analysis of 30 swab samples per run and detection of the presence of MRSA with exquisite sensitivity compared to optimal culture-based techniques. The complete protocol may provide results in less than 6 h (while standard procedure needs 2 to 3 days), thus allowing prompt and cost-effective implementation of contact precautions. PMID:12517857

  18. [Surgical aspects of acute aortic dissection].

    Science.gov (United States)

    Laas, J; Heinemann, M; Jurmann, M; Borst, H G

    1992-12-01

    This paper highlights some of the surgical aspects of acute aortic dissections such as: emergency diagnosis, indications for surgery, reconstructive operative techniques, malperfusion phenomena and necessity for follow-up. Aortic dissection is caused by an intimal tear, called the "entry", and subsequent splitting of the media by the stream of blood. Two lumina are thus created, which may communicate through "re-entries". As this creates severe weakness of the aortic wall, rupture and/or dilatation are the imminent dangers of acute aortic dissection. Acute aortic dissection type A, by definition involving the ascending aorta (Figures 1 and 2), is an absolute indication for emergency surgical treatment, because its natural history shows an extremely poor outcome (Figure 3). Due to impending (intrapericardial) aortic rupture, it may be necessary to limit diagnostic procedures to a minimum. Transesophageal echocardiography is the method of choice for establishing a quick, precise and reliable diagnosis (Figure 4). In stable patients, computed tomography gives additional information about aortic diameters or sites of extrapericardial perforation. Digital subtraction angiography (DSA) shows perfusion of the lumina and dependent organs. The surgical strategy in acute aortic dissection type A aims at replacement of the ascending aorta. Reconstructive techniques have to be considered, especially in aortic valve regurgitation without annuloectasia (Figures 5 and 6). In recent times, the use of GRF tissue glue has reduced the need for teflon felt. Involvement of the aortic arch should be treated aggressively up to the point of total arch replacement in deep hypothermic circulatory arrest as part of the primary procedure (Figure 7). Malperfusion phenomena of aortic branches remain risk-factors.(ABSTRACT TRUNCATED AT 250 WORDS) PMID:1483624

  19. Studies on correlation of positive surgical margin with clinicopathological factors and prognoses in breast conserving surgery

    International Nuclear Information System (INIS)

    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)

  20. 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.

  1. 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

  2. Separation of Staphylococcus aureus causing serious infections by electrophoretic techniques

    Czech Academy of Sciences Publication Activity Database

    Tesařová, Marie; Horká, Marie; Moravcová, Dana; Šťavíková, Lenka; Růžička, F.

    2014. s. 237-238. [Chemtech /14./. 22.10.2014-25.10.2014, Istambul] R&D Projects: GA MV VG20112015021 Institutional support: RVO:68081715 Keywords : Staphylococcus aureus * electrophoretic techniques Subject RIV: CB - Analytical Chemistry, Separation

  3. Improving Diagnosis and Treatment of Staphylococcus aureus Infections : Experimental Studies

    NARCIS (Netherlands)

    S. van den Berg (Sanne)

    2015-01-01

    markdownabstract__Abstract__ Staphylococcus aureus is an opportunistic pathogen that causes a variety of infections, ranging from mild skin infections like furuncles and impetigo, to severe, lifethreatening infections including endocarditis, osteomyelitis and pneumonia. Invasive infections are freq

  4. Surgical treatment of chronic osteomyelitis in children admitted from developing countries

    Directory of Open Access Journals (Sweden)

    Reiner Wirbel

    2014-01-01

    Full Text Available Background: The surgical management of chronic osteomyelitis in children is still challenging in developing countries. This study analysed the extent of the disease and the therapeutic regime. Subjects and Methods: This was a retrospective study in two primary health care hospitals from January 2009 to December 2013, 27 children (20 males and 7 females, mean age 7 years admitted from developing countries who were treated for chronic osteomyelitis. Localization, duration of the disease, extent of the osseous involvement, spectrum of germs, number of previous and required surgical procedures and duration of hospital stay are reported. Results: A total of 16 cases had haematogenous and 11 cases post-traumatic aetiology. The mean duration of the disease was 18 months. On average, three (range, 1-12 previous surgical procedures were performed. The affected bones were: Tibia in 11, femur in 8, forearm in 6 cases, spine and humerus each in 1 case. Staphylococcus aureus was the responsible germ in 75%. On average, four (range, 2-8 surgical procedures were required. Osseous stabilizations were necessary in 17, plastic soft tissue reconstructions in 8 cases. In three cases with metaphyseal/diaphyseal defect, bone transfers had to be performed (2 × fibula-pro-tibia, 1 × rib for radius. The mean hospital stay took 8 (range, 4-20 weeks. Three local recurrences occurred within 3 months, all could be cured surgically. Conclusions: The surgical treatment of chronic osteomyelitis in children requires a radical osseous debridement. The knowledge of different plastic-surgical procedures is necessary to reconstruct osseous and/or soft tissue defects.

  5. Staphylococcus aureus Peptidoglycan Tertiary Structure from Carbon-13 Spin Diffusion

    OpenAIRE

    Sharif, Shasad; Singh, Manmilan; Kim, Sung Joon; Schaefer,Jacob

    2009-01-01

    The cell-wall peptidoglycan of Staphylococcus aureus is a heterogeneous, highly cross-linked polymer of unknown tertiary structure. We have partially characterized this structure by measuring spin diffusion from 13C labels in pentaglycyl cross-linking segments to natural-abundance 13C in the surrounding intact cell walls. The measurements were performed using a version of centerband-only detection of exchange (CODEX). The cell walls were isolated from S. aureus grown in media containing [1-13...

  6. S. aureus bacteria : a new target of serum calcification activity

    OpenAIRE

    Dy, Diane Jazmin

    2009-01-01

    Staphylococcus aureus are gram- positive bacteria that cause skin and soft tissue infections. The continual incidence of infection is of great concern especially with the advent of methicillin resistant S. aureus (MRSA). Continued investigation on mechanisms our body uses to fight bacterial infection is vital. Our study suggests that the body takes advantage of a mechanism that mineralizes type-I collagen of bone and tendon to also mineralize bacteria. Serum driven bacterial mineralization ma...

  7. Comparative Pharmacodynamics of Gentamicin against Staphylococcus aureus and Pseudomonas aeruginosa†

    OpenAIRE

    Tam, Vincent H.; Kabbara, Samer; Vo, Giao; Schilling, Amy N.; Coyle, Elizabeth A.

    2006-01-01

    Aminoglycosides are often used to treat severe infections with gram-positive organisms. Previous studies have shown concentration-dependent killing by aminoglycosides of gram-negative bacteria, but limited data are available for gram-positive bacteria. We compared the in vitro pharmacodynamics of gentamicin against Staphylococcus aureus and Pseudomonas aeruginosa. Five S. aureus strains were examined (ATCC 29213 and four clinical isolates). Time-kill studies (TKS) in duplicate (baseline inocu...

  8. Role of Monocytes in Experimental Staphylococcus aureus Endocarditis

    OpenAIRE

    Veltrop, Marcel H. A. M.; Bancsi, Maurice J. L. M. F.; Bertina, Rogier M.; Thompson, Jan

    2000-01-01

    In the pathogenesis of bacterial endocarditis (BE), the clotting system plays a cardinal role in the formation and maintenance of the endocardial vegetations. The extrinsic pathway is involved in the activation of the coagulation pathway with tissue factor (TF) as the key protein. Staphylococcus aureus is a frequently isolated bacterium from patients with BE. We therefore investigated whether S. aureus can induce TF activity (TFA) on fibrin-adherent monocytes, used as an in vitro model of BE....

  9. Vancomycin Resistance Pattern of Staphylococcus Aureus among Clinical Samples

    OpenAIRE

    S Saadat; K Solhjoo; A. Kazemi; Erfanian, S. (MSc); Ashrafian, F. (MSc)

    2014-01-01

    Background and Objective: Vancomycin is used for treatment of methicillin-resistant S. Aureus (MRSA) infections; therefore, resistance to this antibiotic is increasing. We aimed to determine the antibiotic resistance pattern and frequency of vancomycin resistant S. Areas (VRSA) strains isolated from clinical samples. Material and Methods: In this cross-sectional study, 100 S. Aureus isolates collected from hospitals in Shiraz during six months, 2012, were identified by biochemical, microbiolo...

  10. AKTIVITAS ANTIBAKTERI KITOSAN TERHADAP BAKTERI S.aureus

    OpenAIRE

    Mardiyah Kurniasih; Dwi Kartika

    2009-01-01

    Chitosan is the N-deacetylated derivative of chitin. Chitosan is biodegradable, biocompatible and non-toxic. Chitosan is polycationic in acidic media and give antibacterial activity. In this paper, antibacterial activity of chitosan have been studied. Chitosan had been isolated from white shrimp. Antibacterial activity of chitosan solutions was examined against S. aureus The result showed that antimicrobial effect on S. aureus was strengthened as the choitosan concentrate decreased.

  11. Susceptibility of Staphylococcus aureus biofilms to reactive discharge gases

    OpenAIRE

    Traba, Christian; Liang, Jun F.

    2011-01-01

    Formation of bacterial biofilms at solid-liquid interfaces creates numerous problems in both industrial and biomedical sciences. In this study, the susceptibility of Staphylococcus aureus biofilms to discharge gas generated from plasma was tested. It was found that despite distinct chemical/physical properties, discharge gases from oxygen, nitrogen, and argon demonstrated very potent and almost the same anti-biofilm activity. The bacterial cells in S. aureus biofilms were killed (>99.9%) by d...

  12. Resistance to Antimicrobials Mediated by Efflux Pumps in Staphylococcus aureus

    OpenAIRE

    Isabel Couto; Leonard Amaral; José Melo-Cristino; Miguel Viveiros; Cláudia Palma; Elisabete Junqueira; Costa, Sofia S.

    2013-01-01

    Resistance mediated by efflux has been recognized in Staphylococcus aureus in the last few decades, although its clinical relevance has only been recognized recently. The existence of only a few studies on the individual and overall contribution of efflux to resistance phenotypes associated with the need of well-established methods to assess efflux activity in clinical isolates contributes greatly to the lack of solid knowledge of this mechanism in S. aureus. This study aims to provide inform...

  13. Methicillin resistance & inducible clindamycin resistance in Staphylococcus aureus

    OpenAIRE

    Soumyadeep Ghosh; Mandira Banerjee

    2016-01-01

    Background & objectives: Methicillin resistant Staphylococcus aureus (MRSA) isolates with inducible clindamycin resistance (iCR) are resistant to erythromycin and sensitive to clindamycin on routine testing and inducible clindamycin resistance can only be identified by D-test. This study was aimed to detect methicillin resistance and iCR among S. aureus isolates, effectiveness of some commonly used antibiotics and correlation between methicillin resistance and iCR. Methods: The present cro...

  14. Detection and characterization of mupirocin resistance in Staphylococcus aureus.

    OpenAIRE

    Janssen, D A; Zarins, L T; Schaberg, D R; Bradley, S. F.; Terpenning, M S; Kauffman, C A

    1993-01-01

    Fourteen mupirocin-resistant Staphylococcus aureus strains were isolated over 18 months; 12 exhibited low-level resistance, while two showed high-level resistance. Highly mupirocin-resistant strains contained a large plasmid which transferred mupirocin resistance to other S. aureus strains and to Staphylococcus epidermidis. This plasmid and pAM899-1, a self-transferable gentamicin resistance plasmid, have molecular and biologic similarities.

  15. Methicillin-Resistant Staphylococcus aureus Ocular Infection in Taiwan

    OpenAIRE

    Kang, Yu-Chuan; Hsiao, Ching-Hsi; Yeh, Lung-Kun; Ma, David H. K.; Chen, Phil Y. F.; Lin, Hsin-Chiung; Tan, Hsin-Yuan; Chen, Hung-Chi; Chen, Shin-Yi; Huang, Yhu-Chering

    2015-01-01

    Abstract Methicillin-resistant Staphylococcus aureus (MRSA) infection is an important public health issue. This observational study aimed to characterize clinical features, antibiotic susceptibility, and genotypes of ocular infections caused by MRSA based on the clinical and molecular definitions of community-associated (CA) and healthcare-associated (HA) strains. Fifty-nine patients with culture-proven S aureus ocular infection were enrolled from January 1, 2010 to December 31, 2011 at Chang...

  16. [Surgical treatment for pancreatic neuroendocrine neoplasmas].

    Science.gov (United States)

    Junli, W U; Feng, Guo; Jishu, Wei; Zipeng, L U; Jianmin, Chen; Wentao, Gao; Qiang, L I; Kuirong, Jiang; Cuncai, Dai; Yi, Miao

    2016-05-25

    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

  17. 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.

  18. Resistance to Antimicrobials Mediated by Efflux Pumps in Staphylococcus aureus

    Directory of Open Access Journals (Sweden)

    Isabel Couto

    2013-03-01

    Full Text Available Resistance mediated by efflux has been recognized in Staphylococcus aureus in the last few decades, although its clinical relevance has only been recognized recently. The existence of only a few studies on the individual and overall contribution of efflux to resistance phenotypes associated with the need of well-established methods to assess efflux activity in clinical isolates contributes greatly to the lack of solid knowledge of this mechanism in S. aureus. This study aims to provide information on approaches useful to the assessment and characterization of efflux activity, as well as contributing to our understanding of the role of efflux to phenotypes of antibiotic resistance and biocide tolerance in S. aureus clinical isolates. The results described show that efflux is an important contributor to fluoroquinolone resistance in S. aureus and suggest it as a major mechanism in the early stages of resistance development. We also show that efflux plays an important role on the reduced susceptibility to biocides in S. aureus, strengthening the importance of this long neglected resistance mechanism to the persistence and proliferation of antibiotic/biocide-resistant S. aureus in the hospital environment.

  19. Photoreactivation of ultraviolet-irradiation damage in Staphylococcus aureus

    International Nuclear Information System (INIS)

    This study reports the capacity of Staphylococcus aureus strain 7 - 8 to undergo photoenzymatic repair of UV-irradiation induced damage and compares it to the photoreactivation (PR) response of Escherichia coli strain B. Staphylococcus aureaus showed greater inhibition by UV irradiation than E. coli, consistent with its higher adenine and thymine content of DNA. Staphylococcus aureus showed an enhanced rate of photoreactivation with no lag in initiation of the PR response at low PR doses compared to E. coli. Maximum PR capacity of both cultures was about equal and occurred in cultures incubated at 23 - 250. The PR responses at 11 - 12 and 35 - 370 for S. aureus and E. coli differed although both were capable of PR at each of these temperatures. The PR response of E. coli was directly related to the dosage of PR light (J/m2); however, the photoenzymatic capacity of S. aureus was not directly responsive to continued decrease in light intensity. The capacity of S. aureus to undergo liquid holding recovery (LHR) occurred at 23 - 250 (not at 11 - 120 or 35 - 370), whereas E. coli underwent LHR at 11 - 120 and 23 - 250 but not at 35 - 370. The LHR response of S. aureus was somewhat more effective than E. coli and did not show the direct response to increased liquid-holding period as did E. coli. (author)

  20. Staphylococcus aureus – antimicrobial resistance and the immunocompromised child

    Directory of Open Access Journals (Sweden)

    McNeil JC

    2014-05-01

    Full Text Available J Chase McNeilDepartment of Pediatrics, Section of Infectious Diseases, Baylor College of Medicine, Houston, TX, USAAbstract: Children with immunocompromising conditions represent a unique group for the acquisition of antimicrobial resistant infections due to their frequent encounters with the health care system, need for empiric antimicrobials, and immune dysfunction. These infections are further complicated in that there is a relative paucity of literature on the clinical features and management of Staphylococcus aureus infections in immunocompromised children. The available literature on the clinical features, antimicrobial susceptibility, and management of S. aureus infections in immunocompromised children is reviewed. S. aureus infections in children with human immunodeficiency virus (HIV are associated with higher HIV viral loads and a greater degree of CD4 T-cell suppression. In addition, staphylococcal infections in children with HIV often exhibit a multidrug resistant phenotype. Children with cancer have a high rate of S. aureus bacteremia and associated complications. Increased tolerance to antiseptics among staphylococcal isolates from pediatric oncology patients is an emerging area of research. The incidence of S. aureus infections among pediatric solid organ transplant recipients varies considerably by the organ transplanted; in general however, staphylococci figure prominently among infections in the early posttransplant period. Staphylococcal infections are also prominent pathogens among children with a number of immunodeficiencies, notably chronic granulomatous disease. Significant gaps in knowledge exist regarding the epidemiology and management of S. aureus infection in these vulnerable children.Keywords: pediatric, HIV, cancer, transplant