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Sample records for aureus surgical site

  1. Staphylococcus aureus and surgical site infections: benefits of screening and decolonization before surgery.

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    Humphreys, H; Becker, K; Dohmen, P M; Petrosillo, N; Spencer, M; van Rijen, M; Wechsler-Fördös, A; Pujol, M; Dubouix, A; Garau, J

    2016-11-01

    Surgical site infections (SSIs) are among the most common healthcare-associated infections, and contribute significantly to patient morbidity and healthcare costs. Staphylococcus aureus is the most common microbial cause. The epidemiology of S. aureus is changing with the dissemination of newer clones and the emergence of mupirocin resistance. The prevention and control of SSIs is multi-modal, and this article reviews the evidence on the value of screening for nasal carriage of S. aureus and subsequent decolonization of positive patients pre-operatively. Pre-operative screening, using culture- or molecular-based methods, and subsequent decolonization of patients who are positive for meticillin-susceptible S. aureus and meticillin-resistant S. aureus (MRSA) reduces SSIs and hospital stay. This applies especially to major clean surgery, such as cardiothoracic and orthopaedic, involving the insertion of implanted devices. However, it requires a multi-disciplinary approach coupled with patient education. Universal decolonization pre-operatively without screening for S. aureus may compromise the capacity to monitor for the emergence of new clones of S. aureus, contribute to mupirocin resistance, and prevent the adjustment of surgical prophylaxis for MRSA (i.e. replacement of a beta-lactam agent with a glycopeptide or alternative).

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

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    Weiser, Mitchell C; Moucha, Calin S

    2015-09-01

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

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

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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

  4. Preoperative screening/decolonization for Staphylococcus aureus to prevent orthopedic surgical site infection: prospective cohort study with 2-year follow-up.

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    Rao, Nalini; Cannella, Barbara A; Crossett, Lawrence S; Yates, Adolph J; McGough, Richard L; Hamilton, Cindy W

    2011-12-01

    We quantified surgical site infections (SSIs) after preoperative screening/selective decolonization before elective total joint arthroplasty (TJA) with 2-year follow-up and 2 controls. Concurrent controls (n = 2284) were patients of surgeons not participating in screening/decolonization. Preintervention controls (n = 741) were patients of participating surgeons who underwent TJA the previous year. Staphylococcus aureus nasal carriers (321/1285 [25%]) used intranasal mupirocin and chlorhexidine baths as outpatients. Staphylococcal SSIs occurred in no intervention patients (0/321) and 19 concurrent controls. If all SSIs occurred in carriers and 25% of controls were carriers, staphylococcal SSI rate would have been 3.3% in controls (19/571; P = .001). Overall SSI rate decreased from 2.7% (20/741) in preintervention controls to 1.2% (17/1440) in intervention patients (P = .009). Preoperative screening/selective decolonization was associated with fewer SSIs after elective TJA.

  5. Preoperative Prevalence of Staphylococcus Aureus in Cardiothoracic and Neurological Surgical Patients

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    Ritu eKapoor

    2014-11-01

    Full Text Available Methicillin-resistant Staphylococcus aureus (MRSA is a global cause of both hospital and community-acquired infection. This retrospective, observational study determined the prevalence of MRSA carriers in cardiothoracic and neurological surgical patients presenting to an outpatient preoperative assessment center in Columbus, OH. MRSA may cause aggressive skin and soft-tissue infection with potentially fatal complications, and cardiothoracic and neurological surgical patients are at high risk for surgical-site infection. Results indicated that 4.25% of the sample carried MRSA and 25.25% carried methicillin-sensitive Staphylococcus aureus.

  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. Modifiable risk factors for surgical site infection.

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

    2011-01-01

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

  9. Toxic shock syndrome in two CAPD patients with Staphylococcus aureus exit-site infection.

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    Altiparmak, Mehmet R; Demirel, Hande; Mert, Ali; Serdengecti, Kamil; Ataman, Rezzan

    2003-01-01

    Toxic shock syndrome (TSS) is an illness defined by the occurrence of fever, rash, hypotension, multiple organ system dysfunction, and desquamation. Nonmenstrual TSS is often associated with surgical or nonsurgical cutaneous infections, which are rarely purulent or inflamed (Reingold AL, et al. Nonmenstrual toxic shock syndrome: a review of 130 cases. Ann Intern Med 1982; 96:871-4). Toxic shock syndrome associated with peritoneal exit-site infection but without peritonitis is extremely unusual (Sherbotie JR, et al. Toxic shock syndrome with Staphylococcus aureus exit-site infection in a patient on peritoneal dialysis. Am J Kidney Dis 1990; 15:80-3). We describe 2 patients that met the Centers for Disease Control case definition of TSS secondary to a peritoneal dialysis catheter exit-site infection with signs of mild inflammation and growth of Staphylococcus aureus, but with no evidence of peritonitis.

  10. 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.

  11. Untreatable Surgical Site Infection: Consider Pyoderma Gangrenosum

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    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 ...

  12. Local antimicrobial administration for prophylaxis of surgical site infections.

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    Huiras, Paul; Logan, Jill K; Papadopoulos, Stella; Whitney, Dana

    2012-11-01

    Despite a lack of consensus guidelines, local antibiotic administration for prophylaxis of surgical site infections is used during many surgical procedures. The rationale behind this practice is to provide high antibiotic concentrations at the site of surgery while minimizing systemic exposure and adverse effects. Local antibiotic administration for surgical site prophylaxis has inherent limitations in that antibiotics are applied after the incision is made, rather than the current standard for surgical site prophylaxis that recommends providing adequate antibiotic concentrations at the site before the incision. The efficacy and safety of local application of antibiotics for surgical site prophylaxis have been assessed in different types of surgery with a variety of antibiotic agents and methods of application. We identified 22 prospective, randomized, controlled trials that evaluated local application of antibiotics for surgical site prophylaxis. These trials were subsequently divided and analyzed based on the type of surgical procedure: dermatologic, orthopedic, abdominal, colorectal, and cardiothoracic. Methods of local application analyzed included irrigations, powders, ointments, pastes, beads, sponges, and fleeces. Overall, there is a significant lack of level I evidence supporting this practice for any of the surgical genres evaluated. In addition, the literature spans several decades, and changes in surgical procedures, systemic antibiotic prophylaxis, and microbial flora make conclusions difficult to determine. Based on available data, the efficacy of local antibiotic administration for the prophylaxis of surgical site infections remains uncertain, and recommendations supporting this practice for surgical site prophylaxis cannot be made.

  13. 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.

  14. 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.

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

    NARCIS (Netherlands)

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

    1995-01-01

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

  16. Elderly diabetic patient with surgical site mucormycosis extending to bowel

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    Atul K Patel

    2010-01-01

    Full Text Available Mucormycosis is rare in clinical practice. Most infections are acquired by inhalation; other portals of entry are traumatic implantation and ingestion in immunocompromised host. Mucormycosis is life threatening infection in immunocompromised host with variable moratlity ranging from 15 -81% depending upon site of infection. General treatment principles include early diagnosis, correction of underlying immunosuppression and metabolic disturbances, adequate surgical debridement along with amphotericin therapy. We describe surgical site mucormycosis extended to involve large bowel in elderly diabetic patient.

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

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

    2011-01-01

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

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

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

    2011-01-01

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

  19. 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.

  20. Scalp flora in Indian patients undergoing craniotomy for brain tumors - Implications for pre-surgical site preparation and surgical site infection

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    Aliasgar V Moiyadi

    2012-01-01

    Full Text Available Introduction: Causation of surgical site infection (SSI following craniotomy is multifactorial. Most preventive strategies (including site preparation and antibiotic prophylaxis revolve around reducing preoperative contamination of the local site. There is little evidence, however, linking site contamination with postoperative infections. This is important given the preference for performing non-shaved cranial surgery. We undertook a prospective study to document the scalp flora in neurosurgical patients in an Indian setting and to assess possible association with SSI. Materials and Methods: A prospective study recruited 45 patients undergoing non-shaved clean craniotomies for various brain tumors. Standard perioperative procedures and antibiotic policy were employed. Prior to and immediately following the pre-surgical scrubbing, we collected swabs and evaluated their growth qualitatively. SSI was documented adhering to CDC guidelines. The association of swab-positivity with various parameters (including SSI was evaluated. Results: Pre-scrub positivity was seen in 18 of 44 patients, three of them developed subsequent SSI. Most were known skin contaminants. Five patients had swab positivity after scrubbing, though none of these developed any SSI. Four of these five had pre-scrub positivity. In three the same organisms persisted (two being Staphylococcus aureus, and one had different growth post-scrub, whereas one patient developed new growth (contaminant mycelial fungus in the post-scrub swab. We did not find any association between swab positivity and SSI. Swab positivity was also not related to hair-length or hygiene. Conclusion: Scalp flora in Indian patients is similar to that described. Pre-surgical preparation does not always eliminate this contamination (especially staphylococcus. However, this does not necessarily translate into increased SSI. Moreover, the results also provide objective evidence to support the performance of non

  1. 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.

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

    NARCIS (Netherlands)

    M.C. Vos (Margreet); A. Ott (Alewijn); A. Voss (Andreas); J.A.J.W. Kluytmans (Jan); C.M.J.E. Vandenbroucke-Grauls (Christina); M.H.M. Meester (Marlene); P.H.J. van Keulen (Peter); H.A. Verbrugh (Henri); H.F.L. Wertheim (Heiman)

    2004-01-01

    textabstractBACKGROUND: 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

  3. 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.

  4. 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

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

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

    2013-09-01

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

  6. 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

  7. 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.

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

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    Wolcott, R; Dowd, S

    2010-08-01

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

  9. Successful surgical treatment for methicillin-resistant Staphylococcus aureus endocarditis on the ventricular rerouting patch after a Rastelli operation.

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    Shiokawa, Yuichi; Nakashima, Atsuhiro; Tanoue, Yoshihisa; Tominaga, Ryuji

    2011-07-01

    We report a very rare case of successful surgical treatment for methicillin-resistant Staphylococcus aureus endocarditis on the Dacron patch utilized for ventricular rerouting in a Rastelli operation. Vegetations were found on the right side of the patch associated with a large laceration. The patient underwent removal of the patch followed by reventricular rerouting and replacement of the right ventricle to pulmonary artery conduit. The postoperative course was uneventful. To the best of our knowledge, this is the first reported case of postoperative infective endocarditis on this location.

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

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

    2011-03-01

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

  11. Laparoscopic surgery compared with open surgery decreases surgical site infection in obese patients

    DEFF Research Database (Denmark)

    Shabanzadeh, Daniel M; Sørensen, Lars T

    2012-01-01

    : To compare surgical site infections rate in obese patients after laparoscopic surgery with open general abdominal surgery.......: To compare surgical site infections rate in obese patients after laparoscopic surgery with open general abdominal surgery....

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

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    Amit

    2014-09-01

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

  13. [Cause and prevention of surgical site infection and hypertrophic scars].

    Science.gov (United States)

    Ogawa, Rei

    2012-03-01

    Surgical site infection (SSI) occurs at the site of surgery within 1 month of an operation or within 1 year of an operation if a foreign body is implanted as part of the surgery. Most SSIs (about 70%) are superficial infections involving the skin and subcutaneous tissues only. The remaining infections are more serious and can involve tissues under the skin, organs, or implanted material. Hypertrophic scars( HSs) occur frequently on particular sites, including the anterior chest wall. The anterior chest wall is frequently subjected to skin stretching caused by the natural daily movements of the body. Most cases of SSIs and HSs can be prevented by (1) suture technique modification to prevent high stretching tension and ischemia, and (2) appropriate wound care after surgery. It would be useful to avoid subjecting wounded skin to sustained mechanical force, thereby permitting the wound to rest and heal normally.

  14. 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.

  15. 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

  16. 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.

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

    Science.gov (United States)

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

    2014-02-01

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

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

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    Middleton Scott D

    2011-05-01

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

  19. Factors predicting surgical site infection after posterior lumbar surgery

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    Wang, Tao; Wang, Hui; Yang, Da-Long; Jiang, Li-Qiang; Zhang, Li-Jun; Ding, Wen-Yuan

    2017-01-01

    Abstract This is a retrospective study. The purpose of this study is to explore incidence and risk factors for surgical site infection (SSI) after posterior lumbar surgery. SSI is a common complication after posterior lumbar surgery, bringing mental and physical pain and prolonging hospital stay. However, predisposing factors, as reported less, remain controversial. Patients who underwent posterior lumbar surgery at 3 centers between 2006 and 2016 were included. The possible factors include 3 aspects: demographic variables-age, sex, body mass index (BMI), waist-to-hip radio (WHR), hypertension, diabetes, heart disease, smoking, drinking, steroidal injection, surgical time between June and September, preoperative shower; blood test variables-white blood cell (WBC), neutrophil, red blood cell (RBC), hemoglobin (Hb), total protein (TP), albumin, albumin/globulin (A/G), C-reactive protein (CRP), procalcitonin (PCT), erythrocyte sedimentation rate (ESR) and surgical related variables-operation time, blood loss, operative level, instrumentation, incision length. Factors related with SSI were also performed by multivariate analysis. The prevalence of SSI was 3.00% (267 cases of 8879) had a postoperative wound infection. There were significant difference in WHR (0.92 vs 0.83), WBC (4.31 vs 6.69), TP (58.7 vs 65.2), albumin (36.9 vs 43.2), CRP (2.01 vs 0.57), PCT (0.097 vs 0.067), operation time (217.9 vs 195.7), blood loss (997.1 vs 915.3) and operative level (3.05 vs 2.45) and incision length (24.1 vs 20.0) between SSI group and non-SSI group. >60 years old, female, BMI 30.0, diabetes, male smoking, preoperative steroidal injection, surgical time between June and September, no preoperative shower, instrumentation surgery were risk factors for SSI after posterior lumbar surgery. Many factors, >60 years old, female, BMI, WHR, diabetes, male smoking, preoperative steroidal injection, surgical time between June and September, preoperative shower, WBC, TP, albumin, CRP, PCT

  20. Improving prediction of surgical site infection risk with multilevel modeling.

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    Lauren Saunders

    Full Text Available BACKGROUND: Surgical site infection (SSI surveillance is a key factor in the elaboration of strategies to reduce SSI occurrence and in providing surgeons with appropriate data feedback (risk indicators, clinical prediction rule. AIM: To improve the predictive performance of an individual-based SSI risk model by considering a multilevel hierarchical structure. PATIENTS AND METHODS: Data were collected anonymously by the French SSI active surveillance system in 2011. An SSI diagnosis was made by the surgical teams and infection control practitioners following standardized criteria. A random 20% sample comprising 151 hospitals, 502 wards and 62280 patients was used. Three-level (patient, ward, hospital hierarchical logistic regression models were initially performed. Parameters were estimated using the simulation-based Markov Chain Monte Carlo procedure. RESULTS: A total of 623 SSI were diagnosed (1%. The hospital level was discarded from the analysis as it did not contribute to variability of SSI occurrence (p  = 0.32. Established individual risk factors (patient history, surgical procedure and hospitalization characteristics were identified. A significant heterogeneity in SSI occurrence between wards was found (median odds ratio [MOR] 3.59, 95% credibility interval [CI] 3.03 to 4.33 after adjusting for patient-level variables. The effects of the follow-up duration varied between wards (p<10-9, with an increased heterogeneity when follow-up was <15 days (MOR 6.92, 95% CI 5.31 to 9.07]. The final two-level model significantly improved the discriminative accuracy compared to the single level reference model (p<10-9, with an area under the ROC curve of 0.84. CONCLUSION: This study sheds new light on the respective contribution of patient-, ward- and hospital-levels to SSI occurrence and demonstrates the significant impact of the ward level over and above risk factors present at patient level (i.e., independently from patient case-mix.

  1. 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.

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

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    Nishi Roshini

    2016-03-01

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

  3. Outcomes of surgical site infections in orthopedic trauma surgeries in a tertiary care centre in India

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    N Rajkumari

    2014-01-01

    Full Text Available Background: Surgical site infections (SSIs still cause significant morbidity and mortality despite advances in trauma care. We have studied in this paper the rate of SSIs, their outcomes in patients undergoing interventions for trauma and SSI trends in developing countries. Materials and Methods: A 16-month study (May, 2011- August, 2012 was carried out. Patients undergoing interventions for orthopedic trauma were followed and assessed for SSIs and their outcomes and antimicrobial sensitivity patterns of the micro-organisms isolated were noted and correlated. Results: A total of 40 (4.4% confirmed cases of SSIs were identified among 852 patients of orthopedic trauma. Based on the new CDC criteria, after ruling out cellulitis, only 24 (2.6% were found to have SSIs. A total of 12.5% of the SSIs were detected during follow-up. Acinetobacter baumannii was the predominant organism as also Staphylococcus aureus. Outcomes observed included changes in antibiotic regime, revision surgery, readmission to hospital and deaths. Conclusion: SSI is prevalent in orthopaedic trauma patients and an active surveillance program will help in early management and prevention.

  4. 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.

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

    OpenAIRE

    Adriana Cristina de Oliveira; Camila Sarmento Gama

    2015-01-01

    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 ...

  6. Emergence of coryneforms in osteomyelitis and orthopaedic surgical site infections

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    Meher Rizvi

    2011-07-01

    Full Text Available BackgroundCoryneform species other than Corynebacterium diphtheriae are coming up as important pathogens with the potential to cause serious and life-threatening infections not only in immunocompromised but in immunocompetent individuals as well. The exact infectious potential of these bacteria and their rational antimicrobial treatment is a challenging but essential task.Method The study was conducted in the Department of Microbiology and the Department of Orthopaedics, JNMCH, AMU, Aligarh between August 2007 and May 2009. Pus samples were collected from patients of osteomyelitis and other bone infections including orthopaedic surgical site infections. The Corynebacterium species isolated in the study was identified using standard microbiological techniques and antimicrobial sensitivity testing was done by Kirby bauer disc diffusion method.ResultsA total of 312 Corynebacterium species were isolated. The majority of the coryneforms were isolated from the immunocompetent patients 270 (86.54%. C.jeikium was the most common coryneform isolated. Nearly half of the patients 153 (49.04% had acute infection caused by Corynebacterium species after orthopaedic surgery, a quarter 66 (21.15% had chronic infection and 72 (23.08% patients had device-related infection. Coryneforms exhibited maximum resistance to aminoglycosides (58.65% and β-lactams (penicillin group- 57.55%. C.jeikium was found to be the most resistant amongst all the Corynebacterium species.ConclusionThe study highlights the fact that the coryneforms are no longer just opportunistic pathogens but they are also becoming important pathogens among immunocompetent individuals as well. The emergence of drug resistance amongst these isolates is of most concern. More studies should be done on identification and on antimicrobial susceptibility of these organisms for the proper treatment of patients with such infections.

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

    Science.gov (United States)

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

    2016-08-01

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

  8. 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

  9. INCIDENCE AND RISK FACTORS FOR EARLY SURGICAL SITE INFECTION IN ELECTIVE ORTHOPAEDIC IMPLANT SURGERIES: A PROSPECTIVE STUDY

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    Suneet

    2015-02-01

    Full Text Available BACKGROUND : Surgical site infections in orthopaedic implant surgery is devasting complication range from 1 - 2% to 22%. It leads to increase case cost , prolongs antibiotic use/abuse , increases morbidity and rehabilitation. METHOD : This prospective cross sectional study was conducted on 624 patients with closed fracture cases undergoing clean and elective orthopaedic implant surgeries admitted at Gandhi Medical College and Hamidia Hospital , Bhopal (Madhya Pradesh , India between ‘1st November 2013 to 31st October 2014’. RESULTS : The surgical site infection was diagnosed in 43 (6.89% pati ents within 30 days after surgery. Klebsiella was most common infective organism islolated in 39.53% cases. On data analysis SSI was significantly associated with increasing age , duration of hospital stay more than 7 days , duration of surgery more than 120 minutes , pre - operative Hb less than 12 gm% , diabetes mellitus , use of intra - operative negative suction and tourniquet. CONCLUSION : Incidence of SSI in implants surgeries are quite high , proper measure are needed to control it. In this study gram negative organism has emerged as major threat in contrast to staphylococcus aureus.

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

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    Chipolombwe J

    2016-02-01

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

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

    Science.gov (United States)

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

    2008-11-06

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

  12. 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

  13. A comparative assessment of surgeons' tracking methods for surgical site infections

    NARCIS (Netherlands)

    G.H. van Ramshorst (Gabrielle); M.C. Vos (Margreet); D. den Hartog (Dennis); W.C.J. Hop (Wim); J. Jeekel (Hans); S.E.R. Hovius (Steven); J.F. Lange (Johan)

    2013-01-01

    textabstractBackground: The incidence of surgical site infections (SSI) is considered increasingly to be an indicator of quality of care. We conducted a study in which daily inspection of the surgical incision was performed by an independent, trained team to monitor the incidence of SSI using U.S. C

  14. Occurrence of nosocomial methicillin-resistant Staphylococcus aureus as a marker for transmission in a surgical intensive care unit in China

    NARCIS (Netherlands)

    Chen, Yong; Zhao, Wei; Liu, Hui; Song, Qing; Wang, Yan; Zhao, Jingya; Zheng, Dongyu; Han, Xuelin; Hu, Xiaohua; Grundmann, Hajo; Han, Li

    2014-01-01

    In 2008, an intensive care unit (ICU) in a large Chinese hospital was moved from a 6-bed old ward to a 20-bed new ward. After the move, the prevalence of methicillin-resistant Staphylococcus aureus (MRSA) in patients and environmental sites decreased significantly, but the number of ICU-acquired cas

  15. Incidence and Etiology of Surgical Site Infections among Emergency Postoperative Patients in Mbarara Regional Referral Hospital, South Western Uganda

    Directory of Open Access Journals (Sweden)

    Abubaker Lubega

    2017-01-01

    Full Text Available Background. This prospective hospital based study was conducted to determine the incidence, risk factors, and causative agents of surgical site infection their susceptibility to among 114 emergency postoperative patients at the Mbarara Regional Referral Hospital between September 2014 and January 2015. Methods. Consented patients were consecutively enrolled and their preoperative, intraoperative, and postoperative data were collected. Follow-ups were done in the surgical outpatient clinics. Wound specimens were collected and processed as per Sops; susceptibility testing was done using the Kirby-Bauer disc diffusion technique. Data was analyzed using STATA 11.0. Results. Overall SSI incidence was 16.4%: 5.9% superficial and 47.1% deep and organ space SSIs each. Klebsiella pneumoniae was the most predominant organism (50% followed by Staphylococcus aureus (27.8%. E. coli and P. aeruginosa both accounted for 11.1%. Wound class (p=0.009, anaemia (p=0.024, low serum albumin (p=0.046, and property of suture material used (p=0.006 were significantly associated with SSIs. All organisms had 100% resistance to ampicillin, tetracycline, septrin, and erythromycin. Ciprofloxacin and ceftriaxone are highly sensitive to all organisms. Conclusion. The incidence of SSI in this hospital is very high. Klebsiella pneumoniae is the predominant cause. Ciprofloxacin are very potent antibiotics against organisms that cause SSI.

  16. Incidence and Etiology of Surgical Site Infections among Emergency Postoperative Patients in Mbarara Regional Referral Hospital, South Western Uganda

    Science.gov (United States)

    Joel, Bazira; Justina Lucy, Najjuka

    2017-01-01

    Background. This prospective hospital based study was conducted to determine the incidence, risk factors, and causative agents of surgical site infection their susceptibility to among 114 emergency postoperative patients at the Mbarara Regional Referral Hospital between September 2014 and January 2015. Methods. Consented patients were consecutively enrolled and their preoperative, intraoperative, and postoperative data were collected. Follow-ups were done in the surgical outpatient clinics. Wound specimens were collected and processed as per Sops; susceptibility testing was done using the Kirby-Bauer disc diffusion technique. Data was analyzed using STATA 11.0. Results. Overall SSI incidence was 16.4%: 5.9% superficial and 47.1% deep and organ space SSIs each. Klebsiella pneumoniae was the most predominant organism (50%) followed by Staphylococcus aureus (27.8%). E. coli and P. aeruginosa both accounted for 11.1%. Wound class (p = 0.009), anaemia (p = 0.024), low serum albumin (p = 0.046), and property of suture material used (p = 0.006) were significantly associated with SSIs. All organisms had 100% resistance to ampicillin, tetracycline, septrin, and erythromycin. Ciprofloxacin and ceftriaxone are highly sensitive to all organisms. Conclusion. The incidence of SSI in this hospital is very high. Klebsiella pneumoniae is the predominant cause. Ciprofloxacin are very potent antibiotics against organisms that cause SSI. PMID:28168215

  17. Do antibiotics reduce the frequency of surgical site infections after impacted mandibular third molar surgery?

    Science.gov (United States)

    Susarla, Srinivas M; Sharaf, Basel; Dodson, Thomas B

    2011-11-01

    Surgical removal of impacted third molars remains the most common procedure performed by oral and maxillofacial surgeons. Given the abundance of host bacteria within the operative sites, surgical site infections are among the most common complications of third molar removal, with an estimated frequency of 1% to 30%. In this setting, significant controversy has surrounded the use of prophylactic antibiotics in the surgical management of impacted third molars. This article provides a comprehensive review of the available data on antibiotic prophylaxis in impacted third molar surgery and offers specific recommendations on antibiotic use.

  18. 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.

  19. 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.

  20. Impact of the difference in surgical site on the physique in gastrointestinal tract cancer patients.

    Science.gov (United States)

    Hara, Tsuyoshi; Kubo, Akira; Kogure, Eisuke; Ishii, Takaya

    2016-01-01

    [Purpose] The purpose of the present study was to observe physical function, physique (only BMI), and nutrition status (evaluated by serum albumin levels) from before surgery to after discharge among perioperative patients with gastrointestinal tract cancer and to examine the effect of difference in surgical site (i.e., stomach, colon, and rectum) in these patients. [Subjects and Methods] The study subjects were 70 patients who underwent surgical treatment for gastrointestinal tract cancer [36 males and 34 females, aged 59.3 ± 11.4 years (mean ± SD)]. The subjects were classified into three levels according to surgical site (stomach, colon, and rectum). We evaluated patients' physical function, physique, and nutrition status in the three points: before surgery, after surgery, and after discharge. The 6-minute walk distance was measured for physical function. Body mass index was measured for physique. The serum albumin level was measured for nutrition status. [Results] Significant declines in 6-minute walk distance, body mass index, and serum albumin were observed after surgery among the study subjects. In addition, a significant decline in body mass index was observed after discharge compared with before surgery. Regarding body mass index, a significant interaction between surgical site and evaluation times was observed for ANOVA. [Conclusion] These results suggest that BMI after discharge is significantly less than that before surgery and that body mass index changes from before surgery to after surgery are efficacy the difference of surgical site in patients who undergo surgical treatment for gastrointestinal tract cancer.

  1. 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

  2. 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.

  3. 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.

  4. 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.

  5. Laparoscope use and surgical site infections in digestive surgery

    OpenAIRE

    Romy, S.

    2009-01-01

    Rapport de synthèse : But: comparer les taux d'infections du site chirurgical (ISC) en fonction de la voie d'abord, ouverte ou laparoscopique, pour 3 procédures : l'appendicectomie, la cholécystectomie et la colectomie. Evaluer l'effet de la laparoscopie sur l'ISC pour ces trois interventions. Contexte : la laparoscopie est associée à de nombreux avantages par rapport à la chirurgie ouverte. Parmi ceux-ci, des taux inférieurs d'ISC ont été rapportés lors de laparoscopie. Ceci a été décr...

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

    Directory of Open Access Journals (Sweden)

    Sandeep Chhabra

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

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

    NARCIS (Netherlands)

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

    2010-01-01

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

  8. 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....

  9. Supplemental Perioperative Oxygen to Reduce Surgical Site Infection After High Energy Fracture Surgery

    Science.gov (United States)

    2015-10-01

    1 AWARD NUMBER: W81XWH-12-1-0588 TITLE: Supplemental Perioperative Oxygen to Reduce Surgical Site Infection After High Energy Fracture Surgery...Operations and Reports (0704-0188), 1215 Jefferson Davis Highway, Suite 1204, Arlington, VA 22202-4302. Respondents should be aware that notwithstanding...Site Infection After High Energy Fracture Surgery 5a. CONTRACT NUMBER W81XWH-12-1-0588 5b. GRANT NUMBER OR110123 5c. PROGRAM ELEMENT NUMBER 6

  10. Statewide collaboration to evaluate the effects of blood loss and transfusion on surgical site infection after hysterectomy.

    Science.gov (United States)

    Young, Heather; Berumen, Crystal; Knepper, Bryan; Miller, Amber; Silverman, Morgan; Gilmartin, Heather; Wodrich, Elizabeth; Alexander, Sandy; Price, Connie S

    2012-01-01

    We used mandatory public reporting as an impetus to perform a statewide study to define risk factors for surgical site infection. Among women who underwent abdominal hysterectomy, blood transfusion was a significant risk factor for surgical site infection in patients who experienced blood loss of less than 500 mL.

  11. Microbial colonisation of orthopaedic tourniquets: a potential risk for surgical site infection.

    Science.gov (United States)

    Sahu, S K; Tudu, B; Mall, P K

    2015-02-01

    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.

  12. 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.

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

    Science.gov (United States)

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

    2016-01-01

    Snoring sounds generated by different vibrators of the upper airway may be useful indicators of obstruction sites in patients with obstructive sleep apnea hypopnea syndrome (OSAHS). This study aimed to investigate associations between snoring sounds, obstruction sites, and surgical responses (≥50% reduction in the apnea-hypopnea index [AHI] and DISE), and relocation pharyngoplasty. All patients received follow-up polysomnography after 6 months. Fifteen (42%) patients with at least two complete obstruction sites defined by DISE were significantly, positively associated with maximal snoring sound intensity (40–300 Hz; odds ratio [OR], 1.25, 95% confidence interval [CI] 1.05–1.49) and body mass index (OR, 1.48, 95% CI 1.02–2.15) after logistic regression analysis. Tonsil obstruction was significantly, inversely correlated with mean snoring sound intensity (301–850 Hz; OR, 0.84, 95% CI 0.74–0.96). Moreover, baseline tonsil obstruction detected by either DISE or mean snoring sound intensity (301–850 Hz), and AHI could significantly predict the surgical response. Our findings suggest that snoring sound detection may be helpful in determining obstruction sites and predict surgical responses. PMID:27471038

  14. 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.

  15. ANTIMICROBIOLOGICAL PROFILE AND EPIDEMIOLOGY OF ORGANISM ISOLATED FROM SURGICAL SITE INFECTION

    Directory of Open Access Journals (Sweden)

    Ravindra Kumar

    2016-05-01

    Full Text Available BACKGROUND Infection that occurs in the wound created by a surgical procedure is generally called as surgical site infection. (1 Surgical site infection is a frequent complication of surgery and its incidence varies from 0.5 to 15% depending upon the type of surgery and status of the patient. MATERIAL AND METHODS This study was conducted over a period of 16 months and sample was collected from various surgical departments of Konaseema Institute of Medical Science, Amalapuram. Standard operating procedures for sample collection, transport, culture and susceptibility testing for isolated organisms were followed to ensure procedural quality. Swab samples were plated on nutrient agar, blood agar, and MacConkey agar medium. RESULT Staphylococcus was the most common organism isolated. But Gram-negative organism was more common organism resistant to commonly used antibiotic. CONCLUSION Idea about the antimicrobial sensitivity pattern is essential for selection of drugs. Every institution should have an antimicrobial use policy as per the resistance pattern of organism. So a longterm and large scale study is required to have the idea and detail of resistance pattern.

  16. 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.

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

    Science.gov (United States)

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

    2009-12-01

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

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

    Science.gov (United States)

    Brown, Brian; Tanner, Judith; Padley, Wendy

    2014-01-01

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

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

    Science.gov (United States)

    Brown, Brian; Tanner, Judith; Padley, Wendy

    2014-11-01

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

  20. Preoperative hair removal and surgical site infections: network meta-analysis of randomized controlled trials.

    Science.gov (United States)

    Lefebvre, A; Saliou, P; Lucet, J C; Mimoz, O; Keita-Perse, O; Grandbastien, B; Bruyère, F; Boisrenoult, P; Lepelletier, D; Aho-Glélé, L S

    2015-10-01

    Preoperative hair removal has been used to prevent surgical site infections (SSIs) or to prevent hair from interfering with the incision site. We aimed to update the meta-analysis of published randomized controlled trials about hair removal for the prevention of SSIs, and conduct network meta-analyses to combine direct and indirect evidence and to compare chemical depilation with clipping. The PubMed, ScienceDirect and Cochrane databases were searched for randomized controlled trials analysing different hair removal techniques and no hair removal in similar groups. Paired and network meta-analyses were conducted. Two readers independently assessed the study limitations for each selected article according to the Grading of Recommendations Assessment, Development and Evaluation (GRADE) method. Nineteen studies met the inclusion criteria. No study compared clipping with chemical depilation. Network meta-analyses with shaving as the reference showed significantly fewer SSIs with clipping, chemical depilation, or no depilation [relative risk 0.55, 95% confidence interval 0.38-0.79; 0.60, 0.36-0.97; and 0.56, 0.34-0.96, respectively]. No significant difference was observed between the absence of depilation and chemical depilation or clipping (1.05, 0.55-2.00; 0.97, 0.51-1.82, respectively] or between chemical depilation and clipping (1.09, 0.59-2.01). This meta-analysis of 19 randomized controlled trials confirmed the absence of any benefit of depilation to prevent surgical site infection, and the higher risk of surgical site infection when shaving is used for depilation. Chemical depilation and clipping were compared for the first time. The risk of SSI seems to be similar with both methods.

  1. 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.

  2. Surgical site wound infection in relation to antibiotic prophylaxis given before skin incision and after cord clamping during cesarean delivery.

    Science.gov (United States)

    Shrestha, B; Marhatha, R; Giri, A; Jaisi, S; Maskey, U

    2014-12-01

    Surgical site infection is one of the most common complications following Lower Segment Cesarean Section, which accounts for prolonged hospital stay thereby increasing expense. Prophylactic antibiotics in cesarean section reduces surgical site infection significantly. The best protection is provided when tissue level of antibiotics are adequate before incision, without prejudice to neonatal infectious morbidity. The objective of this study was to compare the incidence of surgical site wound infection with prophylactic antibiotics given before skin incision and after cord clamping following delivery of baby. This was a prospective, hospital based study, in which hundred cases of cesarean deliveries who received antibiotics prophylaxis one hour before the skin incision were compared with another 100 cases where antibiotic was given after cord clamping following delivery of the baby. Surgical site infection occurred in 3% of women who received antibiotics prophylaxis before skin incision as compared to 6% in whom antibiotic was given after cord clamping. It was statistically not significant (p = 0.465).

  3. 5-millimeter Trocar-site Hernias After Laparoscopy Requiring Surgical Repair.

    Science.gov (United States)

    Pereira, Nigel; Hutchinson, Anne P; Irani, Mohamad; Chung, Eric R; Lekovich, Jovana P; Chung, Pak H; Zarnegar, Rasa; Rosenwaks, Zev

    2016-01-01

    Trocar-site hernias are rare complications of laparoscopic surgery. Although trocar-site hernias occur more often at >10-mm sites, hernias can still develop at 5-mm sites after laparoscopy and can lead to serious complications. The primary objective of this review is to summarize the current medical literature pertaining to the clinical presentation and predisposing risk factors of trocar-site hernias at 5-mm sites after laparoscopy. A total of 295 publications were identified, 17 (5.76%) of which met the inclusion criteria. Twenty-seven patients with trocar-site hernias were identified after laparoscopic cases. The median age (interquartile range) for all adult patients with trocar-site hernias was 63 years (interquartile range, 39.5-66.5 years). Eight of the 18 patients (44.4%) undergoing gynecologic laparoscopy were parous although details of parity were not reported in most publications. Simple manual reduction or laparoscopic reduction with fascial closure (21 patients [84%]) was used more often compared with exploratory laparotomy (4 patients [16%], p manipulation can extend 5-mm fascial incisions, thereby increasing the risk of trocar-site hernias. Parous women older than 60 years may have unrecognized fascial defects, which confer a higher risk of trocar-site hernias after laparoscopic surgery, even in the absence of incision manipulation or prolonged surgical duration. Such patients may benefit from closure of 5-mm fascial incisions although prospective data are required to validate the overall generalizability of this management strategy.

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

    NARCIS (Netherlands)

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

    2011-01-01

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

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

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    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.

  6. PROPHYLAXIS OF SURGICAL SITE INFECTION WITH VANCOMYCIN IN 513 PATIENTS THAT UNDERWENT TO LUMBAR FUSION

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    Nicolas Scheverin

    2015-09-01

    Full Text Available Objective:To assess the prophylactic effects of local vancomycin on an infection of the surgical site in patients undergoing lumbar instrumented fusion.Methods:Retrospective study from January 2011 to June 2014 in patients with symptomatic and refractory lumbar spine stenosis and listhesis who underwent instrumented pedicle screw spinal fusion. Two groups of patient were analyzed, one using vancomycin on the surgical site, vancomycin group (VG and the control group (CG without topical vancomycin. The routine prophylactic procedures were performed in both groups: aseptic scrub technique, skin preparation, preoperative intravenous antibiotic therapy. The VG received a dose of 1g of vancomycin mixed with the bone graft every three spinal levels fused and the group consisted of 232 patients.Results:513 patients were analyzed, 232 in the VG and 281 in the CG. There was no statistical difference between the groups when the sex, mean surgery length, and mean bleeding volume were considered. The rate of infection for VG was reduced from 4.98% to 1.29% when compared with CG.Conclusion:The use of vancomycin added to the bone graft in posterior spinal fusion is associated with significantly lower rates of infection.

  7. Incidence and Etiology of Surgical Site Infections in Appendectomies: A 3-Year Prospective Study

    Science.gov (United States)

    Garcell, Humberto Guanche; Arias, Ariadna Villanueva; Sandoval, Cristobal A. Pancorbo; García, Elias Guilarte; Gamboa, Moraima E. Valle; Sado, Adam Bode; Serrano, Ramón N. Alfonso

    2017-01-01

    Objectives Surgical site infections (SSIs) constitute a threat, especially in complicated appendicitis, and are commonly due to gram-negative organisms. We sought to describe the incidence of SSIs in appendectomies performed during a three-year period (January 2013 to December 2015) in a community hospital in Qatar, and compare this with external benchmarks. Methods We conducted a longitudinal study at The Cuban Hospital, Qatar. We used the standardized surveillance criteria to define SSI developed by the Centers for Disease Control. Information about age, sex, smoking habits, diabetes mellitus status, body mass index, and the result of bacteriologic studies were collected. Results Of a total 603 patients, 22 (3.6%) cases of SSI were reported, with an infection rate of 13.6%, 4.5%, and 1.0% in 2013, 2014, and 2015, respectively. SSIs were observed more frequently in patients with contaminated/dirty wounds (6.6%). About 65% of isolates from the surgical site were multidrug-resistant organisms (Escherichia coli and Klebsiella spp.). Conclusions This study describes the incidence of SSI in appendectomy, which could be used as a benchmark for the facility improvement program. The high frequency of multidrug-resistant organisms in SSIs requires additional studies focused on evaluating the effectiveness of the current preventive practices with a particular reference to antimicrobial prophylaxis. PMID:28042400

  8. Reducing the risk of surgical site infection using a multidisciplinary approach: an integrative review

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    Gillespie BM

    2015-10-01

    Full Text Available Brigid M Gillespie,1 Evelyn Kang,1 Shelley Roberts,1 Frances Lin,1,2 Nicola Morley,3 Tracey Finigan,3 Allison Homer,3 Wendy Chaboyer1 1National Health and Medical Research Council Research Centre for Clinical Excellence in Nursing Interventions (NCREN and Centre for Healthcare Practice Innovation (HPI, Menzies Health Institute, 2School of Nursing and Midwifery, Griffith University, 3Surgical and Procedural Services, Gold Coast University Hospital, Gold Coast, QLD, Australia Purpose: To identify and describe the strategies and processes used by multidisciplinary teams of health care professionals to reduce surgical site infections (SSIs.Materials and methods: An integrative review of the research literature was undertaken. Searches were conducted in April 2015. Following review of the included studies, data were abstracted using summary tables and the methodological quality of each study assessed using the Standards for Quality Improvement Reporting Excellence guidelines by two reviewers. Discrepancies were dealt with through consensus. Inductive content analysis was used to identify and describe the strategies/processes used by multidisciplinary health care teams to prevent SSI.Results and discussion: In total, 13 studies met the inclusion criteria. Of these, 12 studies used quantitative methods, while a single study used qualitative interviews. The majority of the studies were conducted in North America. All quantitative studies evaluated multifaceted quality-improvement interventions aimed at preventing SSI in patients undergoing surgery. Across the 13 studies reviewed, the following multidisciplinary team-based approaches were enacted: using a bundled approach, sharing responsibility, and, adhering to best practice. The majority of studies described team collaborations that were circumscribed by role. None of the reviewed studies used strategies that included the input of allied health professionals or patient participation in SSI prevention

  9. Reduction of surgical site infections after implementation of a bundle of care.

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    Rogier M P H Crolla

    Full Text Available BACKGROUND: Surgical Site Infections (SSI are relatively frequent complications after colorectal surgery and are associated with substantial morbidity and mortality. OBJECTIVE: Implementing a bundle of care and measuring the effects on the SSI rate. DESIGN: Prospective quasi experimental cohort study. METHODS: A prospective surveillance for SSI after colorectal surgery was performed in the Amphia Hospital, Breda, from January 1, 2008 until January 1, 2012. As part of a National patient safety initiative, a bundle of care consisting of 4 elements covering the surgical process was introduced in 2009. The elements of the bundle were perioperative antibiotic prophylaxis, hair removal before surgery, perioperative normothermia and discipline in the operating room. Bundle compliance was measured every 3 months in a random sample of surgical procedures. RESULTS: Bundle compliance improved significantly from an average of 10% in 2009 to 60% in 2011. 1537 colorectal procedures were performed during the study period and 300 SSI (19.5% occurred. SSI were associated with a prolonged length of stay (mean additional length of stay 18 days and a significantly higher 6 months mortality (Adjusted OR: 2.71, 95% confidence interval 1.76-4.18. Logistic regression showed a significant decrease of the SSI rate that paralleled the introduction of the bundle. The adjusted Odds ratio of the SSI rate was 36% lower in 2011 compared to 2008. CONCLUSION: The implementation of the bundle was associated with improved compliance over time and a 36% reduction of the SSI rate after adjustment for confounders. This makes the bundle an important tool to improve patient safety.

  10. Impact of target site distribution for Type I restriction enzymes on the evolution of methicillin-resistant Staphylococcus aureus (MRSA) populations.

    Science.gov (United States)

    Roberts, Gareth A; Houston, Patrick J; White, John H; Chen, Kai; Stephanou, Augoustinos S; Cooper, Laurie P; Dryden, David T F; Lindsay, Jodi A

    2013-08-01

    A limited number of Methicillin-resistant Staphylococcus aureus (MRSA) clones are responsible for MRSA infections worldwide, and those of different lineages carry unique Type I restriction-modification (RM) variants. We have identified the specific DNA sequence targets for the dominant MRSA lineages CC1, CC5, CC8 and ST239. We experimentally demonstrate that this RM system is sufficient to block horizontal gene transfer between clinically important MRSA, confirming the bioinformatic evidence that each lineage is evolving independently. Target sites are distributed randomly in S. aureus genomes, except in a set of large conjugative plasmids encoding resistance genes that show evidence of spreading between two successful MRSA lineages. This analysis of the identification and distribution of target sites explains evolutionary patterns in a pathogenic bacterium. We show that a lack of specific target sites enables plasmids to evade the Type I RM system thereby contributing to the evolution of increasingly resistant community and hospital MRSA.

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

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    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.

  12. 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

    CONTEXT: Use of 80% oxygen during surgery has been suggested to reduce the risk of surgical wound infections, but this effect has not been consistently identified. The effect of 80% oxygen on pulmonary complications has not been well defined. OBJECTIVE: To assess whether use of 80% oxygen reduces...... 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......% confidence interval [CI], 0.72-1.22; P = .64). Atelectasis occurred in 54 of 685 patients (7.9%) assigned to receive 80% oxygen vs 50 of 701 (7.1%) assigned to receive 30% oxygen (OR, 1.11; 95% CI, 0.75-1.66; P = .60), pneumonia in 41 (6.0%) vs 44 (6.3%) (OR, 0.95; 95% CI, 0.61-1.48; P = .82), respiratory...

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

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    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.

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

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    Bruno Cacopardo

    2013-01-01

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

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

    Science.gov (United States)

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

    2016-04-01

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

  16. Post Liposuction Mycobacterium Abscessus Surgical Site Infection in a Returned Medical tourist Complicated by a Paradoxical Reaction During Treatment.

    Science.gov (United States)

    Hui, Siong H; Noonan, Lisa; Chavada, Ruchir

    2015-12-22

    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.

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

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    Siong H. Hui

    2015-12-01

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

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

    Science.gov (United States)

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

    2015-12-01

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

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

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    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

  20. Role of recipient-site preparation techniques and post-operative wound dressing in the surgical management of vitiligo

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    Nour Al-Hadidi

    2015-01-01

    Full Text Available Vitiligo is an acquired skin disorder characterized by the destruction of melanocytes resulting in achromic macules and patches involving the affected skin. Multiple methods of treatments have emerged to manage vitiligo, including medical and surgical techniques. Among the surgical techniques described in the management of vitiligo are minipunch grafting, split-thickness skin grafting, hair follicle transplantation, suction blister grafting, and cultured and non-cultured autologous melanocyte transplantation. However, prior to grafting optimal recipient-site preparation is needed for graft survival and successful repigmentation outcomes. Similarly, post-operative care of the recipient site is vital to yielding a viable graft irrespective of the transplantation technique employed. This article reviews the multiple methods employed to prepare the recipient site in vitiligo surgeries and the post-surgical conditions which optimize graft viability. A pubmed search was conducted utilizing the key words listed below.

  1. 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.

  2. 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.

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

    Science.gov (United States)

    Morikane, Keita; Honda, Hitoshi; Suzuki, Satowa

    2016-10-01

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

  4. 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

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

    Science.gov (United States)

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

    2012-06-01

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

  6. Postoperative recovery after mandibular third molar surgery: a criteria for selection of type of surgical site closure.

    Science.gov (United States)

    Damodar, Neeliahgari Durga Akhila; Nandakumar, Hanumanthaiah; Srinath, Narashimha Murthy

    2013-01-01

    This study sought to evaluate postoperative recovery after mandibular third molar surgery, with and without the use of sutures. This study utilized 50 healthy subjects (19 females and 31 males, 18-40 years of age) with bilateral impacted third molars. Two impacted teeth were removed from each patient (60 min maximum operating time). For each patient, the surgical site on one side of the mouth was closed for primary healing by using nonresorbable sutures, while the surgical site on the other side of the mouth was left open for secondary healing. Postoperative recovery was assessed by determining pain (using a visual analog scale) and swelling (by measuring anatomical landmarks pre- and postoperatively on Days 2, 5, and 7) Any incidence of socket infection and hemorrhage were considered to be complications. Both statistical analysis and clinical observation showed that the surgical sites with nonresorbable sutures showed greater swelling and a higher intensity of pain than the surgical sites without sutures; however, there were no statistical or clinical differences in pain and swelling postsurgery at Day 7. The results suggest secondary closure (that is, without sutures) after third molar surgery will produce less postoperative discomfort than primary closure (with nonresorbable sutures).

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

    DEFF Research Database (Denmark)

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

    2011-01-01

    : 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. 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.

  9. Incisional Surgical Site Infection after Elective Open Surgery for Colorectal Cancer

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    Kosuke Ishikawa

    2014-01-01

    Full Text Available Background. The purpose of this study was to clarify the incidence and risk factors for incisional surgical site infections (SSI in patients undergoing elective open surgery for colorectal cancer. Methods. We conducted prospective surveillance of incisional SSI after elective colorectal resections performed by a single surgeon for a 1-year period. Variables associated with infection, as identified in the literature, were collected and statistically analyzed for their association with incisional SSI development. Results. A total of 224 patients were identified for evaluation. The mean patient age was 67 years, and 120 (55% were male. Thirty-three (14.7% patients were diagnosed with incisional SSI. Multivariate analysis suggested that incisional SSI was independently associated with TNM stages III and IV (odds ratio [OR], 2.4 and intraoperative hypotension (OR, 3.4. Conclusions. The incidence of incisional SSI in our cohort was well within values generally reported in the literature. Our data suggest the importance of the maintenance of intraoperative normotension to reduce the development of incisional SSI.

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

    Science.gov (United States)

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

    2016-04-01

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

  11. 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

  12. Incidence of surgical site infection following caesarean section: a systematic review and meta-analysis protocol

    Science.gov (United States)

    Greene, Richard A; Corcoran, Paul; O'Neill, Sinéad M

    2017-01-01

    Introduction Caesarean section (CS) rates have increased globally during the past three decades. Surgical site infection (SSI) following CS is a common cause of morbidity with reported rates of 3–15%. SSI represents a substantial burden to the health system including increased length of hospitalisation and costs of postdischarge care. The definition of SSI varies with the postoperative follow-up period among different health systems, resulting in differences in the reporting of SSI incidence. We propose to conduct the first systematic review and meta-analysis to determine the pooled estimate for the overall incidence of SSI following CS. Methods and analysis We will perform a comprehensive search to identify all potentially relevant published studies on the incidence of SSI following CS reported from 1992 in the English language. Electronic databases including PubMed, CINAHL, EMBASE and Scopus will be searched using a detailed search strategy. Following study selection, full-text paper retrieval, data extraction and synthesis, we will appraise study quality and risk of bias and assess heterogeneity. Incidence data will be combined where feasible in a meta-analysis using Stata software and fixed-effects or random-effects models as appropriate. This systematic review will be reported according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Ethics and dissemination Ethical approval is not required as this review will use published data. The review will evaluate the overall incidence of SSI following CS and will provide the first quantitative estimate of the magnitude of SSI. It will serve as a benchmark for future studies, identify research gaps and remaining challenges, and emphasise the need for appropriate prevention and control measures for SSI post-CS. A manuscript reporting the results of the systematic review and meta-analysis will be submitted to a peer-reviewed journal and presented at scientific conferences

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

    Science.gov (United States)

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

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

    Science.gov (United States)

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

    2014-02-01

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

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

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    Elisabet Josefsson

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

  16. Active site binding modes of inhibitors of Staphylococcus aureus mevalonate diphosphate decarboxylase from docking and molecular dynamics simulations.

    Science.gov (United States)

    Addo, James K; Skaff, D Andrew; Miziorko, Henry M

    2016-01-01

    Bacterial mevalonate diphosphate decarboxylase (MDD) is an attractive therapeutic target for antibacterial drug development. In this work, we discuss a combined docking and molecular dynamics strategy toward inhibitor binding to bacterial MDD. The docking parameters utilized in this study were first validated with observations for the inhibitors 6-fluoromevalonate diphosphate (FMVAPP) and diphosphoglycolylproline (DPGP) using existing structures for the Staphylococcus epidermidis enzyme. The validated docking protocol was then used to predict structures of the inhibitors bound to Staphylococcus aureus MDD using the unliganded crystal structure of Staphylococcus aureus MDD. We also investigated a possible interactions improvement by combining this docking method with molecular dynamics simulations. Thus, the predicted docking structures were analyzed in a molecular dynamics trajectory to generate dynamic models and reinforce the predicted binding modes. FMVAPP is predicted to make more extensive contacts with S. aureus MDD, forming stable hydrogen bonds with Arg144, Arg193, Lys21, Ser107, and Tyr18, as well as making stable hydrophobic interactions with Tyr18, Trp19, and Met196. The differences in predicted binding are supported by experimentally determined Ki values of 0.23 ± 0.02 and 34 ± 8 μM, for FMVAPP and DPGP, respectively. The structural information coupled with the kinetic characterization obtained from this study should be useful in defining the requirements for inhibition as well as in guiding the selection of active compounds for inhibitor optimization.

  17. Strain Specific Phage Treatment for Staphylococcus aureus Infection Is Influenced by Host Immunity and Site of Infection.

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    Nathan B Pincus

    Full Text Available The response to multi-drug resistant bacterial infections must be a global priority. While mounting resistance threatens to create what the World Health Organization has termed a "post-antibiotic era", the recent discovery that antibiotic use may adversely impact the microbiome adds further urgency to the need for new developmental approaches for anti-pathogen treatments. Methicillin-resistant Staphylococcus aureus (MRSA, in particular, has declared itself a serious threat within the United States and abroad. A potential solution to the problem of antibiotic resistance may not entail looking to the future for completely novel treatments, but instead looking into our history of bacteriophage therapy. This study aimed to test the efficacy, safety, and commercial viability of the use of phages to treat Staphylococcus aureus infections using the commercially available phage SATA-8505. We found that SATA-8505 effectively controls S. aureus growth and reduces bacterial viability both in vitro and in a skin infection mouse model. However, this killing effect was not observed when phage was cultured in the presence of human whole blood. SATA-8505 did not induce inflammatory responses in peripheral blood mononuclear cultures. However, phage did induce IFN gamma production in primary human keratinocyte cultures and induced inflammatory responses in our mouse models, particularly in a mouse model of chronic granulomatous disease. Our findings support the potential efficacy of phage therapy, although regulatory and market factors may limit its wider investigation and use.

  18. Transversus Abdominis Plane Block for Surgical Anaesthesia at Multiple Sites-Not Ideal

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    Vasanth RaoKadam

    2015-06-01

    Full Text Available Ultrasound (US guided Transversus abdominis plane (TAP block is commonly used for postoperative analgesia and there are case reports of its use for providing surgical anaesthesia in emergency procedures. We report its use as a regional anaesthetic technique in inguinal hernia and epigastric hernia repair in an elective setting and discuss issues during the intra and postoperative period.

  19. Strategies for handling missing clinical data for automated surgical site infection detection from the electronic health record.

    Science.gov (United States)

    Hu, Zhen; Melton, Genevieve B; Arsoniadis, Elliot G; Wang, Yan; Kwaan, Mary R; Simon, Gyorgy J

    2017-03-16

    Proper handling of missing data is important for many secondary uses of electronic health record (EHR) data. Data imputation methods can be used to handle missing data, but their use for analyzing EHR data is limited and specific efficacy for postoperative complication detection is unclear. Several data imputation methods were used to develop data models for automated detection of three types (i.e., superficial, deep, and organ space) of surgical site infection (SSI) and overall SSI using American College of Surgeons National Surgical Quality Improvement Project (NSQIP) Registry 30-day SSI occurrence data as a reference standard. Overall, models with missing data imputation almost always outperformed reference models without imputation that included only cases with complete data for detection of SSI overall achieving very good average area under the curve values. Missing data imputation appears to be an effective means for improving postoperative SSI detection using EHR clinical data.

  20. 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

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    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

  1. Reducing the risk of surgical site infection using a multidisciplinary approach: an integrative review

    OpenAIRE

    Gillespie BM; Kang E.; Roberts S; Lin F; Morley N; Finigan T; Homer A; Chaboyer W

    2015-01-01

    Brigid M Gillespie,1 Evelyn Kang,1 Shelley Roberts,1 Frances Lin,1,2 Nicola Morley,3 Tracey Finigan,3 Allison Homer,3 Wendy Chaboyer1 1National Health and Medical Research Council Research Centre for Clinical Excellence in Nursing Interventions (NCREN) and Centre for Healthcare Practice Innovation (HPI), Menzies Health Institute, 2School of Nursing and Midwifery, Griffith University, 3Surgical and Procedural Services, Gold Coast University Hospital, Gold Coast, QLD, Australia Purpose: To iden...

  2. Site-Specific Mutation of Staphylococcus aureus VraS Reveals a Crucial Role for the VraR-VraS Sensor in the Emergence of Glycopeptide Resistance▿

    Science.gov (United States)

    Galbusera, Elena; Renzoni, Adriana; Andrey, Diego O.; Monod, Antoinette; Barras, Christine; Tortora, Paolo; Polissi, Alessandra; Kelley, William L.

    2011-01-01

    An initial response of Staphylococcus aureus to encounter with cell wall-active antibiotics occurs by transmembrane signaling systems that orchestrate changes in gene expression to promote survival. Histidine kinase two-component sensor-response regulators such as VraRS contribute to this response. In this study, we examined VraS membrane sensor phosphotransfer signal transduction and explored the genetic consequences of disrupting signaling by engineering a site-specific vraS chromosomal mutation. We have used in vitro autophosphorylation assay with purified VraS[64-347] lacking its transmembrane anchor region and tested site-specific kinase domain histidine mutants. We identified VraS H156 as the probable site of autophosphorylation and show phosphotransfer in vitro using purified VraR. Genetic studies show that the vraS(H156A) mutation in three strain backgrounds (ISP794, Newman, and COL) fails to generate detectable first-step reduced susceptibility teicoplanin mutants and severely reduces first-step vancomycin mutants. The emergence of low-level glycopeptide resistance in strain ISP794, derived from strain 8325 (ΔrsbU), did not require a functional σB, but rsbU restoration could enhance the emergence frequency supporting a role for this alternative sigma factor in promoting glycopeptide resistance. Transcriptional analysis of vraS(H156A) strains revealed a pronounced reduction but not complete abrogation of the vraRS operon after exposure to cell wall-active antibiotics, suggesting that additional factors independent of VraS-driven phosphotransfer, or σB, exist for this promoter. Collectively, our results reveal important details of the VraRS signaling system and predict that pharmacologic blockade of the VraS sensor kinase will have profound effects on blocking emergence of cell wall-active antibiotic resistance in S. aureus. PMID:21173175

  3. Postoperative Staphylococcus aureus infections in Medicare beneficiaries.

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    Moaven Razavi

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

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

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    A. Arifi

    2016-07-01

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

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

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    Walelign Dessie

    2016-01-01

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

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

    OpenAIRE

    Sahu, S. K.; B Tudu; P K Mall

    2015-01-01

    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 t...

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

    Science.gov (United States)

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

    2012-06-01

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

  8. Capturing orthopaedic surgical site infection data and assessing dental recommendations with respect to total joint arthroplasty.

    Science.gov (United States)

    Florschutz, Anthony V; Parsley, Brian S; Shapiro, Irving M

    2015-04-01

    Greater documentation of patient history and clinical course is crucial for identifying factors that can influence surgical outcomes. The Centers for Medicare and Medicaid Services have already begun public reporting of hospital data on readmission, complication, and infection rates and will soon launch a website to make physician-specific outcomes data public. The orthopaedic community has the opportunity to lead the way in ensuring that adequate and accurate data is collected to facilitate appropriate comparisons that are based on patients' true risk of complications and the complexity of treatment. Several studies have reported a link between oral pathogens and periprosthetic infection, although it remains unclear whether organisms unique to dental tissues are also present in osteoarthritic joints and tissues affected by periprosthetic joint infection. The American Academy of Orthopaedic Surgeons and the American Dental Association are aware of these concerns and have created guidelines for antibiotic prophylaxis in patients who have undergone total hip or knee arthroplasty and require high-risk dental procedures. Because these guidelines have received considerable criticism, recommendations that are based on scientific and case-controlled clinical studies and provide effective guidance on this important subject are needed.

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

    Science.gov (United States)

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

    2013-11-01

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

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

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    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.

  11. A Quality Improvement Approach to Reducing the Caesarean section Surgical Site Infection Rate in a Regional Hospital

    LENUS (Irish Health Repository)

    O’ Hanlon, M

    2016-09-01

    Surgical site infection (SSI) rates are used extensively by hospitals as a basis for quality improvement. A 30-day post-discharge SSI programme for Caesarean section operations has been implemented in Our Lady of Lourdes Hospital since 2011. It has been shown that skin antisepsis and antibiotic prophylaxis are key factors in the prevention of SSI. Using quality improvement methodology, an infection prevention bundle was introduced to address these two factors. Skin antisepsis was changed from povidone-iodine to chlorhexidine-alcohol. Compliance with choice of antibiotic prophylaxis increased from 89.6% in 2014 to 98.5% in 2015. Compliance with timing also improved. The SSI rate of 7.5% was the lowest recorded to date, with the majority of SSIs (64%) diagnosed after hospital discharge. The level of variation was also reduced. However, the continued presence of variation and possibility of lower infection rates from the literature imply that further improvements are required.

  12. 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

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

    Science.gov (United States)

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

    2014-09-30

    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.

  14. 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.

  15. Reducing surgical site infection incidence through a network: results from the French ISO-RAISIN surveillance system.

    Science.gov (United States)

    Astagneau, P; L'Hériteau, F; Daniel, F; Parneix, P; Venier, A-G; Malavaud, S; Jarno, P; Lejeune, B; Savey, A; Metzger, M-H; Bernet, C; Fabry, J; Rabaud, C; Tronel, H; Thiolet, J-M; Coignard, B

    2009-06-01

    Surgical-site infections (SSIs) are a key target for nosocomial infection control programmes. We evaluated the impact of an eight-year national SSI surveillance system named ISO-RAISIN (infection du site opératoire - Réseau Alerte Investigation Surveillance des Infections). Consecutive patients undergoing surgery were enrolled during a three-month period each year and surveyed for 30 days following surgery. A standardised form was completed for each patient including SSI diagnosis according to standard criteria, and several risk factors such as wound class, American Society of Anesthesiologists (ASA) score, operation duration, elective/emergency surgery, and type of surgery. From 1999 to 2006, 14,845 SSIs were identified in 964,128 patients (overall crude incidence: 1.54%) operated on in 838 participating hospitals. The crude overall SSI incidence decreased from 2.04% to 1.26% (P<0.001; relative reduction: -38%) and the National Nosocomial Infections Surveillance system (NNIS)-0 adjusted SSI incidence from 1.10% to 0.74% (P<0.001; relative reduction: -33%). The most significant SSI incidence reduction was observed for hernia repair and caesarean section, and to a lesser extent, cholecystectomy, hip prosthesis arthroplasty, and mastectomy. Active surveillance striving for a benchmark throughout a network is an effective strategy to reduce SSI incidence.

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

    Science.gov (United States)

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

    2010-07-01

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

  17. 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.

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

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    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.

  19. 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.

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

    Science.gov (United States)

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

    2014-01-01

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

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

    DEFF Research Database (Denmark)

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

    2008-01-01

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

  2. [Use of plastic adhesive drapes during surgery may increase the risk of surgical site infections. A survey of a Cochrane review].

    Science.gov (United States)

    Qvist, Niels; Kolmos, Hans Jørn J

    2009-10-05

    In theory, the products act as a barrier, which hinders the spreading of bacteria from the deeper skin layers and hair follicles to the incision. On the other hand, the use of plastic adhesive drapes may promote bacterial overgrowth due to a >greenhouse effectplastic adhesive drapes reduces the surgical site infection rate and some evidence that they increase infection rates in clean operations. Consequently, their use should be abandoned. Further studies are warranted to determine the effect of other adhesive products currently used.

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

    Institute of Scientific and Technical Information of China (English)

    程丽峰; 阿依古丽; 朱敏; 卢辉; 魏育涛

    2015-01-01

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

  4. Effect of surgical drill guide and irrigans temperature on thermal bone changes during drilling implant sites - thermographic analysis on bovine ribs

    Directory of Open Access Journals (Sweden)

    Marković Aleksa

    2016-01-01

    Full Text Available Background/Aim. During drilling implant sites, mechanical energy is converted into thermal one resulting in transient rise in temperature of surrounding bone. The temperature of 47°C exeeding one minute impairs osseointegration, compromises mechanical properties of the local bone and could cause early implant failure. This in vitro study aimed to assess the effect of surgical drill guide and temperature of irrigans on thermal changes of the local bone during drilling implant sites, and to test the influence of irrigans temperature on the temperature of surgical drill guide. Methods. A total of 48 specimens obtained from bovine ribs were randomly allocated to four experimental conditions according to the 2 x 2 factorial design: drill guide (with or without and saline (at 25°C or 5°C. Real-time infrared thermography was used as a method for temperature measurement. The primary outcome was bone temperature change during drilling implant sites measured at 3 osteotomy depths, whereas the second one was change in the temperature of the drill guide. Data were analyzed by Brunner and Langer nonparametric analysis and Wilcoxon test. Results. The effect of drill guide on the changes of bone temperature was significant at the entrance of osteotomy, whereas the effect of saline temperature was significant at all osteotomy levels (p 0.05. Guided surgery and irrigation with saline at 25°C were associated with the highest bone temperature increase. Increase in drill guide temperature was significantly higher when saline at 25°C was used (p < 0.001. Conclusion. Guided implant site preparation generates higher temperature of the local bone than conventional drilling, not exceeding the threshold for thermal bone necrosis. Although saline at room temperature provides sufficient heat control during drilling, cooled saline is more effective regardless the use of surgical drill guide.

  5. 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. ...

  6. Linezolid resistant Staphylococcus aureus

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    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

  7. 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 having a ... This sheet talks about whether exposure to staphylococcus aureus may increase the risk for birth defects over ...

  8. 术前备皮对手术野感染的影响%Influence of hair removal on surgical site infection

    Institute of Scientific and Technical Information of China (English)

    刘畅; 王聪敏; 赵志力

    2011-01-01

    @@ 手术野感染(surgical site infection,SSI)是外科手术的并发症之一,易发生于切口或器官(组织),通常会采取术前清洁皮肤及剃除手术野毛发的准备方式预防SSl.上世纪20年代开始将备皮作为一种常规,一般于手术前一日进行.

  9. 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

  10. 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

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

    Directory of Open Access Journals (Sweden)

    Geraldo Sadoyma

    2006-04-01

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

  12. Staphylococcus aureus toxins.

    Science.gov (United States)

    Otto, Michael

    2014-02-01

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

  13. Characterization of the staphylococcal cassette chromosome mec insertion site in 108 isolates lacking the mecA gene and identified as methicillin-resistant Staphylococcus aureus by the Xpert MRSA assay.

    Science.gov (United States)

    Stojanov, M; Blanc, D S

    2014-11-01

    During a 3-year period, 848 patients were detected as carriers of methicillin-resistant Staphylococcus aureus (MRSA) by the Xpert MRSA assay (Cepheid). Among them, 108 patients (12.7 %) were colonized with strains showing methicillin-susceptible phenotypes and absence of the mecA gene, despite being positive with the rapid polymerase chain reaction (PCR) assay. DNA sequences of the staphylococcal cassette chromosome mec (SCCmec) insertion site of these "false-positive" strains was determined by direct sequencing of the genomic DNA. More than half (53.7 %) of the strains had DNA sequences unrelated to either SCC or SCCmec and one-third had DNA sequences related to non-mec SCC. Only 10.2 % of the strains carried sequences related to SCCmec, suggesting that a sequence containing the mecA gene was lost from an SCCmec. These findings differ from the general idea that all methicillin-susceptible S. aureus having positive Xpert MRSA assay results are essentially MRSA that lost the mecA gene.

  14. Preserving the socket dimensions with bone grafting in single sites: an esthetic surgical approach when planning delayed implant placement.

    Science.gov (United States)

    Irinakis, Tassos; Tabesh, Moe

    2007-01-01

    Recent advancements in barrier membranes, bone grafting substitutes, and surgical techniques have led to a predictable arsenal of treatment methods for clinicians who practice implant dentistry. The contemporary clinician is supplied with proven knowledge, substantiated materials, and instrument inventory that allows implant placement in cases that used to be reserved for the specialist in the past because of their complexity. Nowadays, postextraction alveolar ridge maintenance can be a predictable procedure and can certainly aid the clinician in preventing ridge collapse, thereby allowing for implant placement in a position that satisfies esthetics and function. Extraction socket maintenance for future implant therapy does not rule out immediate implant placement but rather provides an additional option when treatment planning implant patients. This article will focus on the concept of extraction socket preservation using regenerative materials. It will describe a technique suggested by the authors to resist bone resorption and soft tissue shrinkage following tooth extraction.

  15. Surgical Assisting

    Science.gov (United States)

    ... Insert and remove Foley urinary bladder catheter Place pneumatic tourniquet Confirm procedure with surgeon Drape patient within ... Technology and Surgical Assisting (NBSTSA) offers the CertifiedSurgical First Assistant (CSFA) credential, and the National Surgical Assistant ...

  16. Total hip replacement in an ipsilateral above-the-knee amputation: surgical technique, rehabilitation, and review of the literature.

    Science.gov (United States)

    Malagelada, Francesc; Coll Rivas, Moisès; Jiménez Obach, Albert; Auleda, Jaume; Guirao, Lluis; Pleguezuelos, Eulogio

    2013-03-01

    In this article, we present a case report of a 62-year-old patient who previously underwent an above-the-knee amputation for vascular disease and we performed a total hip replacement on him because of hip osteoarthritis. As the only postoperative complication, the patient developed a methicillin-resistant Staphylococcus aureus surgical site infection, which was successfully treated. The surgical technique and the postoperative rehabilitation program are described in detail in an attempt to detect and face the challenges that patients with major lower limb amputations may present. The literature is reviewed and all known cases of hip replacements in amputees are presented.

  17. 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.

  18. The OneTogether collaborative approach to reduce the risk of surgical site infection: identifying the challenges to assuring best practice

    Science.gov (United States)

    Topley, Katherine; Stott, Dawn; Neachell, Jonathan; Gallagher, Rose

    2015-01-01

    Background: Surgical site infections (SSI) account for 16% of healthcare associated infections, and are associated with considerable morbidity, mortality and increased costs of care. Ensuring evidence-based practice to prevent SSI is incorporated across the patient’s surgical journey is complex. OneTogether is a quality improvement collaborative of infection prevention and operating department specialists, formed to support the spread and adoption of best practice to prevent SSI. This paper describes the findings of an expert workshop on infection prevention in operating departments. Methods: A total of 84 delegates from 75 hospitals attended the workshop, comprising 46 (55%) theatre nurses/operating department practitioners; 16 (19%) infection control practitioners and 22 (26%) other healthcare practitioners. Discussion focused on evidence, policy implementation and barriers to best practice. Responses were synthesised into a narrative review. Results: Delegates reported significant problems in translating evidence-based guidance into everyday practice, lack of local polices and poor compliance. Major barriers were lack of leadership, poorly defined responsibilities, and lack of knowledge/training. Conclusions: This workshop has provided important insights into major challenges in assuring compliance with best practice in relation to the prevention of SSI. The OneTogether partnership aims to support healthcare practitioners to improve the outcomes of patients undergoing surgery by reducing the risk of SSI.

  19. Sperm recovery and IVF after testicular sperm extraction (TESE: effect of male diagnosis and use of off-site surgical centers on sperm recovery and IVF.

    Directory of Open Access Journals (Sweden)

    Kenan Omurtag

    Full Text Available OBJECTIVE: Determine whether testicular sperm extractions and pregnancy outcomes are influenced by male and female infertility diagnoses, location of surgical center and time to cryopreservation. PATIENTS: One hundred and thirty men undergoing testicular sperm extraction and 76 couples undergoing 123 in vitro fertilization cycles with testicular sperm. OUTCOME MEASURES: Successful sperm recovery defined as 1-2 sperm/0.5 mL by diagnosis including obstructive azoospermia (n = 60, non-obstructive azoospermia (n = 39, cancer (n = 14, paralysis (n = 7 and other (n = 10. Obstructive azoospermia was analyzed as congenital absence of the vas deferens (n = 22, vasectomy or failed vasectomy reversal (n = 37 and "other"(n = 1. Sperm recovery was also evaluated by surgical site including infertility clinic (n = 54, hospital operating room (n = 67 and physician's office (n = 11. Treatment cycles were evaluated for number of oocytes, fertilization, embryo quality, implantation rate and clinical/ongoing pregnancies as related to male diagnosis, female diagnosis, and use of fresh or cryopreserved testicular sperm. RESULTS: Testicular sperm recovery from azoospermic males with all diagnoses was high (70 to 100% except non-obstructive azoospermia (31% and was not influenced by distance from surgical center to laboratory. Following in vitro fertilization, rate of fertilization was significantly lower with non-obstructive azoospermia (43%, p = <0.0001 compared to other male diagnoses (66%, p = <0.0001, 59% p = 0.015. No differences were noted in clinical pregnancy rate by male diagnosis; however, the delivery rate per cycle was significantly higher with obstructive azoospermia (38% p = 0.0371 compared to diagnoses of cancer, paralysis or other (16.7%. Women diagnosed with diminished ovarian reserve had a reduced clinical pregnancy rate (7.4% p = 0.007 compared to those with other diagnoses (44

  20. 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.

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

    Science.gov (United States)

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

    2016-01-01

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

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

    Science.gov (United States)

    Rubin, Lorry G; Papsin, Blake

    2010-08-01

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

  3. 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...

  4. 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

  5. whole-genome sequence of livestock-associated st398 methicillin-resistant staphylococcus aureus Isolated from Humans in Canada.

    Science.gov (United States)

    Golding, George R; Bryden, Louis; Levett, Paul N; McDonald, Ryan R; Wong, Alice; Graham, Morag R; Tyler, Shaun; Van Domselaar, Gary; Mabon, Philip; Kent, Heather; Butaye, Patrick; Smith, Tara C; Kadlec, Kristina; Schwarz, Stefan; Weese, Scott J; Mulvey, Michael R

    2012-12-01

    Despite reports of high colonization rates of ST398 livestock-associated methicillin-resistant Staphylococcus aureus (LA-MRSA) among pigs and pig farmers, the incidence of LA-MRSA infection in the general population in Canada appears to be rare in comparison to that in some European countries. In this study, the complete genome sequence of a Canadian representative LA-MRSA isolate (08BA02176) from a human postoperative surgical site infection was acquired and compared to the sequenced genome of an LA-MRSA isolate (S0385) from Europe to identify genetic traits that may explain differences in the success of these particular strains in some locales.

  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. 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

    OpenAIRE

    2012-01-01

    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 (compa...

  8. Changes in the Staphylococcus aureus Transcriptome during Early Adaptation to the Lung

    OpenAIRE

    Chaffin, Donald O.; Destry Taylor; Skerrett, Shawn J.; Craig E Rubens

    2012-01-01

    Staphylococcus aureus is a common inhabitant of the human nasopharynx. It is also a cause of life-threatening illness, producing a potent array of virulence factors that enable survival in normally sterile sites. The transformation of S. aureus from commensal to pathogen is poorly understood. We analyzed S. aureus gene expression during adaptation to the lung using a mouse model of S. aureus pneumonia. Bacteria were isolated by bronchoalveolar lavage after residence in vivo for up to 6 hours....

  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. [Assessing the effect of subcuticular buried sutures with subcutaneous closed suction drain to prevent surgical site infection in patients undergoing total cystectomy with urinary diversion using intestine].

    Science.gov (United States)

    Kanamaru, Sojun; Tsuchihashi, Kazunari; Makino, Yuki; Shimizu, Yosuke; Ito, Noriyuki

    2014-11-01

    We assessed the effect of subcuticular buried sutures with subcutaneous closed suction drain to prevent surgical site infection (SSI) in patients undergoing total cystectomy with urinary diversion using the intestine. We reviewed the clinical charts of 43 consecutive patients who underwent total cystectomy with urinary diversion using the intestine from February 2006 to March 2011 at Nishi-Kobe Medical Center. All patients received intravenous prophylactic antibiotics before and throughout surgery as well as for three days after surgery. Skin closure was performed with interrupted vertical mattress sutures with 2-0 nylon on the first 22 patients (mattress group), and with interrupted subcuticular buried sutures with 4-0 absorbable monofilament with subcutaneous closed suction drain on the remaining 21 patients (subcuticular buried suture with subcutaneous drain; SBD group). SSI occurred in 7 (31.8%) patients in the mattress group, but did not affect any patient in the SBD group. We compared risk factors for SSI between the groups, and found that the method of skin closure was significant risk factor for SSI (P = 0.005). We concluded that interrupted subcuticular buried sutures with 4-0 absorbable monofilament with subcutaneous suction drain is effective for prevention of SSI in total cystectomy with urinary diversion using the intestine.

  11. Surgical infections: a microbiological study

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    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.

  12. 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)

  13. Closed-suction drain placement at laparotomy in isolated solid organ injury is not associated with decreased risk of deep surgical site infection.

    Science.gov (United States)

    Mohseni, Shahin; Talving, Peep; Kobayashi, Leslie; Kim, Dennis; Inaba, Kenji; Lam, Lydia; Chan, Linda S; Coimbra, Raul; Demetriades, Demetrios

    2012-10-01

    The purpose of this study was to investigate the role of intra-abdominal closed-suction drainage after emergent trauma laparotomy for isolated solid organ injuries (iSOI) and to determine its association with deep surgical site infections (DSSI). All patients subjected to trauma laparotomy between January 2006 and December 2008 for an iSOI at two Level I urban trauma centers were identified. Patients with isolated hepatic, splenic, or renal injuries were included. Study variables extracted included demographics, clinical characteristics, intra-abdominal injuries, drain placement, DSSI, septic events, intensive care unit and hospital length of stay, and in-hospital mortality. Diagnosis of DSSI was based on abdominal computed tomography scan demonstrating an intra-abdominal collection combined with fever and elevated white blood cell count. For the analysis, patients were stratified based on injury severity. To identify an independent association between closed-suction drain placement and DSSI, stepwise logistic regression analysis was performed. Overall, 142 patients met the inclusion criteria with 80 per cent (n=114) having severe iSOI. In 47 per cent (n=53) of the patients with a severe injury, an intra-abdominal drain was placed. A drain was placed more often in patients with a blunt trauma with more severe injury defined by Injury Severity Score and abdominal Abbreviated Injury Scale Score and those who underwent splenectomy (Pdrain placement (odds ratio, 2.8; 95% confidence interval, 1.0 to 8.2; P=0.046). Subgroup analysis demonstrated those who sustained severe hepatic injury receiving a drain had a significantly increase risk of DSSI (P=0.02). There was no statistical difference in the rate of DSSI based on the presence or absence of an intra-abdominal drain after severe splenic injury (17 vs 18%, P=0.88). The use of intra-abdominal closed-suction drains after iSOI is not associated with decreased risk of DSSI.

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

    Directory of Open Access Journals (Sweden)

    Sandeep Kaur

    Full Text Available 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.

  15. Risk factors for surgical site infection following nonshunt pediatric neurosurgery: a review of 9296 procedures from a national database and comparison with a single-center experience.

    Science.gov (United States)

    Sherrod, Brandon A; Arynchyna, Anastasia A; Johnston, James M; Rozzelle, Curtis J; Blount, Jeffrey P; Oakes, W Jerry; Rocque, Brandon G

    2017-02-10

    OBJECTIVE Surgical site infection (SSI) following CSF shunt operations has been well studied, yet risk factors for nonshunt pediatric neurosurgery are less well understood. The purpose of this study was to determine SSI rates and risk factors following nonshunt pediatric neurosurgery using a nationwide patient cohort and an institutional data set specifically for better understanding SSI. METHODS The authors reviewed the American College of Surgeons National Surgical Quality Improvement Program-Pediatric (ACS NSQIP-P) database for the years 2012-2014, including all neurosurgical procedures performed on pediatric patients except CSF shunts and hematoma evacuations. SSI included deep (intracranial abscesses, meningitis, osteomyelitis, and ventriculitis) and superficial wound infections. The authors performed univariate analyses of SSI association with procedure, demographic, comorbidity, operative, and hospital variables, with subsequent multivariate logistic regression analysis to determine independent risk factors for SSI within 30 days of the index procedure. A similar analysis was performed using a detailed institutional infection database from Children's of Alabama (COA). RESULTS A total of 9296 nonshunt procedures were identified in NSQIP-P with an overall 30-day SSI rate of 2.7%. The 30-day SSI rate in the COA institutional database was similar (3.3% of 1103 procedures, p = 0.325). Postoperative time to SSI in NSQIP-P and COA was 14.6 ± 6.8 days and 14.8 ± 7.3 days, respectively (mean ± SD). Myelomeningocele (4.3% in NSQIP-P, 6.3% in COA), spine (3.5%, 4.9%), and epilepsy (3.4%, 3.1%) procedure categories had the highest SSI rates by procedure category in both NSQIP-P and COA. Independent SSI risk factors in NSQIP-P included postoperative pneumonia (OR 4.761, 95% CI 1.269-17.857, p = 0.021), immune disease/immunosuppressant use (OR 3.671, 95% CI 1.371-9.827, p = 0.010), cerebral palsy (OR 2.835, 95% CI 1.463-5.494, p = 0.002), emergency operation (OR 1

  16. 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...

  17. 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

  18. 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

    ribo- and phage patterns identical to S. aureus isolates from human carriers. The findings of the present study underline the importance of strict milking hygiene and improvement of current mastitis therapy. The results support the hypothesis that some S. aureus mastitis strains are more contagious......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...

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

    Directory of Open Access Journals (Sweden)

    A K Kapoor

    2012-01-01

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

  20. Staphylococcus aureus bacteremia.

    Science.gov (United States)

    Jensen, Allan Garlik

    2003-11-01

    Staphylococcus aureus bacteremia (SAB) is still associated with a high mortality, and knowledge on risk factors and the clinical and the therapeutic aspects of SAB is still limited. This thesis focuses on the clinical aspects of SAB and its metastatic infections. In a study of all patients with bacteremia in Copenhagen County October 1992 through April 1993 (study I) we emphasized previous findings, that S. aureus is one of the most frequent pathogens in bacteremia, and in a case control study also in Copenhagen County 1994-95 (study II) we demonstrated, that not only an inserted central venous catheter and nasal S. aureus carriage but also hyponatremia and anemia are important risk factors for hospital-acquired SAB (study II). Studies on the treatment of SAB have pointed out, that the eradication of a primary is important, but there are only limited clinical studies dealing with antibiotic treatment. By logistic regression analysis, we were able to demonstrate that focus eradication is essential, but also that treatment with dicloxacillin 1 g x 4 or 2 g x 3 are superior to 1 g x 3 (studie III), indicating that the time for serum concentration above the Minimal Inhibitory Concentration (MIC) for the bacteria plays a role in the outcome of SAB treatment. S. aureus osteomyelitis secondary to SAB is frequently observed. No other countries, however, have a centralized registration, which make it possible to evaluate a large number of these patients. Since 1960, The Staphylococcal Laboratory, Statens Serum Institut in Copenhagen, has registrated selected clinical informations from nearly all patients with positive blood cultures of S. aureus. Based on this registration, we were able to show an increased number of S. aureus osteomyelitis among older patients and a decreased number of S. aureus osteomyelitis of femur and tibia among younger infants in the period 1980-90 (study IV). By reviewing the records of a large number of patients with vertebral S. aureus

  1. Impact of integrated hand management on incidence of surgical site infections%手卫生整合管理对手术切口感染率的影响

    Institute of Scientific and Technical Information of China (English)

    郭月琼; 许琍文; 熊欢

    2012-01-01

    OBJECTIVE To explore the integrated hand management on the incidence of surgical site infections. METHODS Integrated hand management mainly including the surgical hand-disinfectants in the operating room, none-contacting gloves wearing, and double gloves wearing were performed since Jan 2009, the change of the incidence of surgical site infections before and after the implementation was retrospectively analyzed. RESULTS The qualified rates of hand cleaning and disinfection and the compliance of the operation staff have been significantly improved after the implementation of integrated hand management, and the incidence of surgical site infections significantly decreased from 0. 87% during 2007-2007 to 0. 18% during 2009-2010, the difference was statistically significant (χ2 = 12. 463,P<0. 01). CONCLUSION Integrated hand management is helpful in improving the quality of disinfection and isolation and reducing exogenous contacting infections, resulting in minimizing the surgical site infections.%目的 了解针对手术人员实施手卫生整合管理后,对手术切口感染发生率的影响.方法 自2009年1月起对手术医护人员实施以手术间内实行手消毒剂干洗手法、外科手消毒揉搓、无触式戴无菌手套方法及戴双层手套等为主要措施的规范化手卫生整合管理,并回顾性分析实施前后手术切口感染发生率的变化情况.结果 通过对参加手术人员手卫生进行整合管理方法后,手术人员的手卫生清洁消毒合格率和洗手依从性得到提高,手术切口感染发生率由2007-2008年的0.87%降至2009-2010年的0.18%,差异有统计学意义(x2=12.463,P<0.01).结论 规范的手卫生整合管理措施有利于提高消毒隔离质量,减少外源性接触感染,对降低手术切口感染率具有重要意义.

  2. 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

  3. Risk factors for surgical site infection in cardiac surgery Los factores de riesgo para la infecciones del sitio quirúrgico en s a cirugía cardíaca Fatores de risco para infecção de sítio cirúrgico em cirurgia cardíaca

    Directory of Open Access Journals (Sweden)

    Quenia Cristina Gonçalves da Silva

    2012-01-01

    Full Text Available OBJECTIVE: To analyze the occurrence of surgical site infection (SSI in patients undergoing cardiac surgery in the period between July 2005, and July 2010. METHODS: A quantitative, historical cohort study that evaluated 384 patients in a public teaching hospital. The Statistical Package for the Social Sciences software was used for data analysis and for descriptive analysis, measures of association in contigency tables and logistic regression were used. RESULTS: It was found that 36 (9.4% patients developed a SSI and that mortality occurred in 14 (38.9%. Staphylococcus aureus was the prevalent microorganism (12, 27.3% In the multivariate analysis, the risk factors identified as predictors of SSI were male gender, intubation for more than 24 hours, and reintubation. CONCLUSION: The risk factors predictive of the occurence of SSI (pOBJETIVO: Analizar la ocurrencia de infección de sitio quirúrgico (ISC en pacientes sometidos a cirugía cardiaca en el período entre julio del 2005 y julio del 2010. MÉTODOS: Estudio de abordaje cuantitativo, cohorte histórica en el que se evaluó a 384 pacientes de un hospital público de enseñanza. Fue utilizado el software Statistical Package for the Social Sciences para el análisis de los datos y para el análisis descriptivo, fueron usadas medidas de asociación en tablas de contingencia y regresión logística. RESULTADOS: Se verificó que 36 (9,4% pacientes evolucionaron con ISC y que la mortalidad fue de 14 (38,9%. El Staphylococcus aureus fue el microorganismo prevalente 12 (27,3%. En el análisis multivariado, los factores de riesgo identificados como predictores de la ISC fueron género masculino, tiempo de intubación mayor de 24 horas y reintubación. CONCLUSIÓN: Los factores de riesgo predictores para la ocurrencia de ISC (pOBJETIVO: Analisar a ocorrência de infecção de sítio cirúrgico (ISC nos pacientes submetidos à cirurgia cardíaca no período ente julho de 2005 e julho de 2010. M

  4. 肥胖对结直肠癌手术部位感染的影响%Impact of obesity on surgical site infection following colorectal cancer surgery

    Institute of Scientific and Technical Information of China (English)

    黄新玲; 郑丽英; 何文英; 张焱

    2015-01-01

    目的:探讨肥胖对结直肠癌手术部位感染(SSI)的影响。方法回顾性调查2008年1月—2013年12月某院行结直肠癌根治性手术的215例患者,其中100例体重指数(BMI)≥25 kg/m2(肥胖组),115例 BMI<25 kg/m2(正常体重组),比较两组患者术中情况、术后恢复、手术并发症等指标。结果肥胖患者72例(72.00%)术中出血量>60 mL,58例(58.00%)手术持续时间>220 min,其中20例(20.00%)发生 SSI;正常体重组中仅30例(26.09%)术中出血量>60 mL,20例(17.39%)手术持续时间>220 min,8例(6.96%)发生 SSI。肥胖组患者术中出血量、SSI 发病率高于正常体重组,手术持续时间、术后住院时间长于正常体重组,各组比较,差异均有统计学意义(均 P <0.05)。结论结直肠癌患者 SSI 发病率较高,肥胖、手术持续时间长、出血量多是结直肠患者 SSI 的危险因素。%Objective To evaluated the impact of obesity on surgical site infection (SSI)following colorectal cancer surgery.Methods A total of 215 patients undergoing radical surgery for colorectal cancer in a hospital be-tween January 2008 and December 2013 were investigated retrospectively,100 patients were with body mass index (BMI)≥25 kg/m2 (obesity group)and 115 patients with BMI60 mL,58(58.00%)patients’duration of surgery was >220 min ,20 (20.00%)of whom developed postoperative SSI;in normal weight group,30(26.09%)patients had intra-operative blood loss of >60 mL,20(17.39%)patients’duration of surgery was >220 min,8(6.96%)of whom developed postoperative SSI.Intra-operative blood loss and incidence of SSI in obesity group were both signif-icantly higher than normal weight group,duration of surgery and postoperative length of hospital stay were both longer than normal weight group(both P <0.05).Conclusion Incidence of SSI in colorectal cancer patients is high. Obesity,long duration

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

    DEFF Research Database (Denmark)

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

    2013-01-01

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

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

    DEFF Research Database (Denmark)

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

    2006-01-01

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

  7. Diabetic mouse model of orthopaedic implant-related Staphylococcus aureus infection.

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    Arianna B Lovati

    Full Text Available BACKGROUND: Periprosthetic bacterial infections represent one of the most challenging orthopaedic complications that often require implant removal and surgical debridement and carry high social and economical costs. Diabetes is one of the most relevant risk factors of implant-related infection and its clinical occurrence is growing worldwide. The aim of the present study was to test a model of implant-related infection in the diabetic mouse, with a view to allow further investigation on the relative efficacy of prevention and treatment options in diabetic and non-diabetic individuals. METHODOLOGY: A cohort of diabetic NOD/ShiLtJ mice was compared with non-diabetic CD1 mice as an in vivo model of S. aureus orthopaedic infection of bone and soft tissues after femur intramedullary pin implantation. We tested control and infected groups with 1×10(3 colony-forming units of S. aureus ATCC 25923 strain injected in the implant site. At 4 weeks post-inoculation, host response to infection, microbial biofilm formation, and bone damage were assessed by traditional diagnostic parameters (bacterial culture, C-reactive protein and white blood cell count, histological analysis and imaging techniques (micro computed tomography and scanning electron microscopy. RESULTS: Unlike the controls and the CD1 mice, all the diabetic mice challenged with a single inoculum of S. aureus displayed severe osteomyelitic changes around the implant. CONCLUSIONS: Our findings demonstrate for the first time that the diabetic mouse can be successfully used in a model of orthopaedic implant-related infection. Furthermore, the same bacteria inoculum induced periprosthetic infection in all the diabetic mice but not in the controls. This animal model of implant-related infection in diabetes may be a useful tool to test in vivo treatments in diabetic and non-diabetic individuals.

  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

    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 germinal center of lymph nodules, whereas the concentrations of SP and SK binding sites expressed by the external muscle layers are not altered significantly. These results demonstrate that receptor binding sites for SP, but not SK or NK, are ectopically expressed in high concentrations (1000-2000 times normal) by cells involved in mediating inflammatory and immune responses. These data suggest 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.

  9. 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.

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

    Science.gov (United States)

    Salassa, Tiare E; Swiontkowski, Marc F

    2014-09-01

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

  11. 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

  12. 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 co...

  13. 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

  14. [Optimizing surgical hand disinfection].

    Science.gov (United States)

    Kampf, G; Kramer, A; Rotter, M; Widmer, A

    2006-08-01

    For more than 110 years hands of surgeons have been treated before a surgical procedure in order to reduce the bacterial density. The kind and duration of treatment, however, has changed significantly over time. Recent scientific evidence suggests a few changes with the aim to optimize both the efficacy and the dermal tolerance. Aim of this article is the presentation and discussion of new insights in surgical hand disinfection. A hand wash should be performed before the first disinfection of a day, ideally at least 10 min before the beginning of the disinfection as it has been shown that a 1 min hand wash significantly increases skin hydration for up to 10 min. The application time may be as short as 1.5 min depending on the type of hand rub. Hands and forearms should be kept wet with the hand rub for the recommended application time in any case. A specific rub-in procedure according to EN 12791 has been found to be suitable in order to avoid untreated skin areas. The alcohol-based hand rub should have a proven excellent dermal tolerance in order to ensure appropriate compliance. Considering these elements in clinical practice can have a significant impact to optimize the high quality of surgical hand disinfection for prevention of surgical site infections.

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

    Directory of Open Access Journals (Sweden)

    Maureen Miller

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

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

    Institute of Scientific and Technical Information of China (English)

    杨林华; 陈涛; 王坚

    2012-01-01

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

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

    Science.gov (United States)

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

    2015-12-01

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

  18. Evaluation of the bactericidal effect of five products for surgical hand disinfection according to prEN 12054 and prEN 12791.

    Science.gov (United States)

    Marchetti, M G; Kampf, G; Finzi, G; Salvatorelli, G

    2003-05-01

    Surgical hand disinfection (with an alcohol-based hand rub) and surgical handwash (with an antiseptic-based liquid soap) are accepted measures to reduce the risk for surgical site infections. The new European Standards allow a comparison of their antimicrobial efficacy. The bactericidal activity of surgical hand rubs [Sterillium and Softaman, (active ingredient=alcohols)] and handwashes [Derman plus (triclosan), Hibiscrub (chlorhexidine) and Betadine (PVP-iodine)] was tested according to the prEN 12054 suspension test using Escherichia coli, Pseudomonas aeruginosa, Staphylococcus aureus and Enterococcus hirae, and to prEN 12791 for the effect on resident skin flora in comparison with 1-propanol, 60% (v/v). All five products achieved a reduction of test bacteria within 3 min of >10(5)-fold so fulfilling prEN 12054. However, only Hibiscrub, Sterillium and Softa Man met the requirements of prEN 12791, giving a mean reduction of resident micro-organisms (immediate and sustained effect) which was not significantly lower than the reference alcohol (P>0.1; Wilcoxon matched-pairs signed-rank test). Sterillium was significantly more effective than the reference alcohol (immediate and sustained affect). Products for surgical hand disinfection may have equal antimicrobial activity in suspension tests but show large differences under practical conditions. Healthcare workers should not rely on results from suspension tests when deciding on a product for surgical hand disinfection.

  19. Líquen aureus "algesiogênico" "Algesiogenic" lichen aureus

    Directory of Open Access Journals (Sweden)

    Roberto Rheingantz da Cunha Filho

    2006-03-01

    Full Text Available Descreve-se caso de líquen aureus em paciente do sexo feminino, com 23 anos de idade que apresentava há dois anos lesão dolorosa, purpúrica, acastanhada tendendo por semelhante a cor de ferrugem e de aspecto liquenóide no antebraço. O exame anatomopatológico revelou denso infiltrado linfo-histiocitário na derme superior papilar, com extravasamento de hemácias. O líquen aureus é relativamente raro, sendo ainda mais raro o sintoma de dor.A case is described of lichen aureus in a 23 year old female with a 2-year history of painful, purpuric, rust-coloured to tan, lichenous lesion on forearm. A biopsy specimen demonstrated a dense lymphohistiocytic infiltrate in the upper dermis, with extravasation of red cells. The "algesiogenic" lichen aureus is a very rare dermatosis.

  20. Staphylococcus aureus: methicillin-susceptible S. aureus to methicillin-resistant S. aureus and vancomycin-resistant S. aureus.

    Science.gov (United States)

    Rehm, Susan J; Tice, Alan

    2010-09-15

    The evolution of methicillin-resistant and vancomycin-resistant Staphylococcus aureus has demanded serious review of antimicrobial use and development of new agents and revised approaches to prevent and overcome drug resistance. Depending on local conditions and patient risk factors, empirical therapy of suspected S. aureus infection may require coverage of drug-resistant organisms with newer agents and novel antibiotic combinations. The question of treatment with inappropriate antibiotics raises grave concerns with regard to methicillin-resistant S. aureus selection, overgrowth, and increased virulence. Several strategies to reduce the nosocomial burden of resistance are suggested, including shortened hospital stays and outpatient parenteral antimicrobial therapy of the most serious infections.

  1. 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.

  2. 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,

  3. Pathogenesis of Staphylococcus aureus abscesses.

    Science.gov (United States)

    Kobayashi, Scott D; Malachowa, Natalia; DeLeo, Frank R

    2015-06-01

    Staphylococcus aureus causes many types of human infections and syndromes-most notably skin and soft tissue infections. Abscesses are a frequent manifestation of S. aureus skin and soft tissue infections and are formed, in part, to contain the nidus of infection. Polymorphonuclear leukocytes (neutrophils) are the primary cellular host defense against S. aureus infections and a major component of S. aureus abscesses. These host cells contain and produce many antimicrobial agents that are effective at killing bacteria, but can also cause non-specific damage to host tissues and contribute to the formation of abscesses. By comparison, S. aureus produces several molecules that also contribute to the formation of abscesses. Such molecules include those that recruit neutrophils, cause host cell lysis, and are involved in the formation of the fibrin capsule surrounding the abscess. Herein, we review our current knowledge of the mechanisms and processes underlying the formation of S. aureus abscesses, including the involvement of polymorphonuclear leukocytes, and provide a brief overview of therapeutic approaches.

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

    Science.gov (United States)

    Lister, Jessica L; Horswill, Alexander R

    2014-01-01

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

  5. Botryomycosis Due to Staphylococcus Aureus-A Case Report

    Directory of Open Access Journals (Sweden)

    Manjula A.Vagarali

    2012-04-01

    Full Text Available Objectives: To study Staphylococcus aureus as the causative organism of botryomycosis. Background: the botryomycosis is a chronic purulent granulomatous lesion of the skin, subcutaneous tissue and visceral organs caused by several bacterial species. This condition clinically and histopathologically resembles with that of mycetoma and Actinomycosis. Method: A 51 year old male presented to us with swelling over medial aspect of the right foot with multiple sinuses. He gave a history of trauma 3 years back at the same site. The sample was examined directly by KOH preparation and grams stain. The culture was put up on blood, chocolate, lowenstein Jensen (LJ and sabouraud dextrose agar (SDA media. Fungal culture was negative. Result: Staphylococcus aureus was isolated in aerobic culture. Conclusion: the patient with botryomycosis caused by Staphylococcus aureus was subsequently treated with antibiotics and he recovered completely.

  6. Staphylococcus aureus Bacteraemia

    Directory of Open Access Journals (Sweden)

    James Price

    2010-01-01

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

  7. Staphylococcus aureus isolated from tonsillectomized adult patients with recurrent tonsillitis.

    Science.gov (United States)

    Katkowska, Marta; Garbacz, Katarzyna; Stromkowski, Józef

    2017-01-01

    The aim of this study was to analyze the prevalence and antibiotic resistance of Staphylococcus aureus strains from 118 tonsillectomized adults due to recurrent tonsillitis (RT). The study included strains isolated from the tonsillar surface prior to tonsillectomy, recovered from the tonsillar core at the time of surgery, and from the posterior throat 2-4 weeks after the procedure. Susceptibility of isolates to 19 antibiotics was tested in line with the Clinical and Laboratory Standards Institute recommendations. Irrespective of the stage, the most commonly isolated bacteria were gram-positive cocci, and among them S. aureus. The tonsillar core was the most common site of S. aureus isolation (30.5%), followed by the tonsillar surface (10.8%) and the posterior pharynx (5.9%). This difference turned out to be statistically significant (p aureus seems to be the most common pathogen isolated from patients tonsillectomized due to RT. Staphylococcal isolates associated with RT are present mostly within the tonsillar core and susceptible to most antibiotics. They are typically isolated from patients between 21 and 30 years of age. Tonsillectomy results in less frequent isolation of S. aureus strains.

  8. Surgical pearl: the temporary assistant.

    Science.gov (United States)

    Jacobs, Aleda A; Orengo, Ida F

    2008-04-15

    A simple maneuver is presented which simultaneously facilitates both adequate surgical site exposure and sufficient traction. A single suture with high tensile strength can be utilized to this end. This technique is especially helpful when the cutaneous surgeon is operating alone.

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

    Science.gov (United States)

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

    2015-09-01

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

  10. Evolution of surgical treatment for breast cancer

    Directory of Open Access Journals (Sweden)

    V. P. Letyagin

    2012-01-01

    Full Text Available The paper considers main surgical interventions used to treat breast cancer. It defines the role and place of conservative surgery and describes current procedures for the organ-saving treatment of cancer at this site.

  11. 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.

  12. The therapeutic effect of Chlorogenic acid against Staphylococcus aureus infection through Sortase A inhibition

    Directory of Open Access Journals (Sweden)

    Lin eWang

    2015-10-01

    Full Text Available The emergence and wide spread of multi-drug resistant Staphylococcus aureus (S. aureus requires the development of new therapeutic agents with alternative modes of action. Anti-virulence strategies are hoped to meet that need. Sortase A (SrtA has attracted great interest as a potential drug target to treat infections caused by S. aureus, as many of the surface proteins displayed by SrtA function as virulence factors by mediating bacterial adhesion to specific organ tissues, invasion of host cells, and evasion of the host-immune responses. It has been suggested that inhibitors of SrtA might be promising candidates for the treatment and/or prevention of S. aureus infections. In this study, we report that Chlorogenic acid (CHA, a natural compound that lacks significant anti–S. aureus activity, inhibit the activity of SrtA in vitro (IC50=33.86±5.55μg/ml and the binding of S. aureus to fibrinogen (Fg. Using molecular dynamics simulations and mutagenesis assays, we further demonstrate that CHA binds to the binding sites of C184 and G192 in the SrtA. In vivo studies demonstrated that CHA prevent mice from S. aureus-induced renal abscess, resulting in a significant survival advantage. These findings indicate that CHA is a promising therapeutic compound against SrtA during S. aureus infections.

  13. 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.

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

    NARCIS (Netherlands)

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

    2015-01-01

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

  16. Antibiotic prophylaxis in prevention of surgical site infections after breast cancer surgery%乳腺癌手术预防应用抗菌药物对降低手术部位感染的作用

    Institute of Scientific and Technical Information of China (English)

    贾会学; 林金兰

    2012-01-01

    OBJECTIVE To determine the effect of antibiotic prophylaxis on the incidence of surgical site infections after breast cancer surgery. METHODS We searched the Cochrane Library, Ovid MEDI.INE and EMBASE to select articles published before Dec 2011. No language restrictions were applied. Randomized controlled trials of pre and peri-operative antibiotics for patients undergoing surgery for breast cancer were included. Primary outcomes were incidence of breast wound infections. The authors examined the titles and abstracts of all studies identified by the search strategy, then assessed study quality and extracted data from those that met the inclusion criteria. RESULTS A total of eight studies were included in the review. All eight evaluated pre-operative antibiotic compared with no antibiotic or placebo, and all of them had high quality as randomized controlled trial. The results demonstrated that prophylactic antibiotics significantly reduced the incidence of surgical site infections for the patients undergoing breast cancer surgery (pooled RR= 0. 71, 95% CI:.0. 55 to 0. 92); through the Begg's test (z = 0. 12, P = 0. 90) and Egger's test (t = 0. 16. P = 0. 88), there were no obvious publication bias. CONCLUSION Prophylactic antibiotics may reduce the incidence of surgical site infections in the patients undergoing breast cancer surgery. The potential risks caused by the infections, such as the increase in the cost, drug reaction and the bacterial resistance due to the delay in wound healing or adjuvant antibiotics, must be weighed.%目的 明确预防应用抗菌药物对乳腺癌手术后手术部位感染发病率的影响.方法 通过检索Medline、Embase和Cochrane图书馆数据库,筛选2011年12月之的公开发表的文献,无语言限制;选择标准为乳腺癌患者接受围手术期抗菌药物的随机对照试验、研究结局为手术部位感染;数据收集和分析由作者审查检索的所有研究的标题和摘要,然后评估研究质

  17. [Protein toxins of Staphylococcus aureus].

    Science.gov (United States)

    Shamsutdinov, A F; Tiurin, Iu A

    2014-01-01

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

  18. Prevention of Healthcare Associated Staphylococcus aureus Infections

    NARCIS (Netherlands)

    L.G.M. Bode (Lonneke)

    2014-01-01

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

  19. 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.

  20. Micro-surgical endodontics.

    Science.gov (United States)

    Eliyas, S; Vere, J; Ali, Z; Harris, I

    2014-02-01

    Non-surgical endodontic retreatment is the treatment of choice for endodontically treated teeth with recurrent or residual disease in the majority of cases. In some cases, surgical endodontic treatment is indicated. Successful micro-surgical endodontic treatment depends on the accuracy of diagnosis, appropriate case selection, the quality of the surgical skills, and the application of the most appropriate haemostatic agents and biomaterials. This article describes the armamentarium and technical procedures involved in performing micro-surgical endodontics to a high standard.

  1. 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.

  2. Surgical innovation as sui generis surgical research.

    Science.gov (United States)

    Lotz, Mianna

    2013-12-01

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

  3. Phosphorylation controls the functioning of Staphylococcus aureus isocitrate dehydrogenase--favours biofilm formation.

    Science.gov (United States)

    Prasad, U Venkateswara; Vasu, D; Yeswanth, S; Swarupa, V; Sunitha, M M; Choudhary, A; Sarma, P V G K

    2015-01-01

    Isocitrate dehydrogenase (IDH) gene from Staphylococcus aureus ATCC12600 was cloned, sequenced and characterized (HM067707). PknB site was observed in the active site of IDH; thus, it was predicted as IDH may be regulated by phosphorylation. Therefore, in this study, PknB, alkaline phosphatase III (SAOV 2675) and IDH genes (JN695616, JN645811 and HM067707) of S. aureus ATCC12600 were over expressed from clones PV 1, UVPALP-3 and UVIDH 1. On passing the cytosloic fractions through nickel metal chelate column, pure enzymes were obtained. Phosphorylation of pure IDH by PknB resulted in the complete loss of activity and was restored upon dephosphorylation with SAOV 2675 which indicated that phosphorylation and dephosphorylation regulate IDH activity in S. aureus. Further, when S. aureus ATCC12600 was grown in BHI broth, decreased IDH activity and increased biofilm units were observed; therefore, this regulation of IDH alters redox status in this pathogen favouring biofilm formation.

  4. Dermatology case: segmental lichen aureus

    OpenAIRE

    Fernandes, I.; S. Carvalho; Machado, S.; Alves,R.; Selores, M.

    2012-01-01

    ABSTRACT The authors describe a clinical case of a six-year-old boy with history of a segmental brownish maculopapular skin eruption on his left thoracic and lumbar wall, since the last four months. Based on clinical and histological findings he was diagnosed with segmental lichen aureus.

  5. 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 wound... insertion of the surgeon's finger into the rectum during performance of a transurethral prostatectomy....

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

    Institute of Scientific and Technical Information of China (English)

    谢章家; 庞安琪; 谢壮

    2011-01-01

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

  7. 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.

  8. Evaluation of analgesic effect of two different doses of fentanyl in combination with bupivacaine for surgical site infiltration in cases of modified radical mastoidectomy: A double blind randomized study

    Science.gov (United States)

    Bhandari, Geeta; Shahi, Kedar Singh; Parmar, Nitish Kumar; Asad, Mohammad; Joshi, Hemchandra Kumar; Bhakuni, Rajni

    2013-01-01

    Background: Limited evidence supports the efficacy of peripheral route fentanyl and local anesthetic combination for postoperative analgesia. Our study was therefore designed to demonstrate the analgesic efficacy of two different doses of fentanyl in combination with bupivacaine for surgical site infiltration in patients undergoing modified radical mastoidectomy (MRM). Materials and Methods: 60 patients undergoing MRM under general anesthesia were randomly allocated into two groups, first group receiving 0.5% bupivacaine at a dose of 2 mg/kg body weight with 50 μg fentanyl and second group receiving bupivacaine 0.5% at a dose of 2 mg/kg body weight with 100 μg fentanyl as infiltration of operative field in and around the incision site, after the incision and just before completion of surgery. In postoperative period pain, nausea-vomiting and sedation was recorded at 0 hr, 2, 4, 6, 12 and 24 hrs. Results: Both the combinations of bupivacaine and fentanyl (Group I and Group II) were effective for postoperative analgesia. In both the groups the Visual Analogue Scale (VAS) score was less than 3 at each time interval. None of the patients required rescue analgesia. The comparison of VAS scores at different intervals showed that group II had lower VAS scores at all time points. Conclusions: Fentanyl and bupivacaine combinations in doses of 50 and 100 μg along with 0.5% bupivacaine at a fixed dose of 2 mg/kg body weight are effective in the management of postoperative pain. Patients who received 100 μg fentanyl (Group II) had lower VAS scores as compared to the patients who received 50 μg fentanyl (Group I) with similar side effects. PMID:25885841

  9. Menaquinone biosynthesis potentiates haem toxicity in Staphylococcus aureus.

    Science.gov (United States)

    Wakeman, Catherine A; Hammer, Neal D; Stauff, Devin L; Attia, Ahmed S; Anzaldi, Laura L; Dikalov, Sergey I; Calcutt, M Wade; Skaar, Eric P

    2012-12-01

    Staphylococcus aureus is a pathogen that infects multiple anatomical sites leading to a diverse array of diseases. Although vertebrates can restrict the growth of invading pathogens by sequestering iron within haem, S. aureus surmounts this challenge by employing high-affinity haem uptake systems. However, the presence of excess haem is highly toxic, necessitating tight regulation of haem levels. To overcome haem stress, S. aureus expresses the detoxification system HrtAB. In this work, a transposon screen was performed in the background of a haem-susceptible, HrtAB-deficient S. aureus strain to identify the substrate transported by this putative pump and the source of haem toxicity. While a recent report indicates that HrtAB exports haem itself, the haem-resistant mutants uncovered by the transposon selection enabled us to elucidate the cellular factors contributing to haem toxicity. All mutants identified in this screen inactivated the menaquinone (MK) biosynthesis pathway. Deletion of the final steps of this pathway revealed that quinone molecules localizing to the cell membrane potentiate haem-associated superoxide production and subsequent oxidative damage. These data suggest a model in which membrane-associated haem and quinone molecules form a redox cycle that continuously generates semiquinones and reduced haem, both of which react with atmospheric oxygen to produce superoxide.

  10. 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.

  11. Frequently Asked Questions about Surgical Site Infections

    Science.gov (United States)

    ... Infection FAQs about SSIs Catheter-associated Urinary Tract Infection FAQs about CAUTI Ventilator-associated Pneumonia FAQs about VAP Diseases and Organisms Acinetobacter Burkholderia cepacia Clostridium difficile Patients Clinicians FAQs about ...

  12. Injections through skin colonized with Staphylococcus aureus biofilm introduce contamination despite standard antimicrobial preparation procedures

    Science.gov (United States)

    Wang, Yi; Leng, Valery; Patel, Viraj; Phillips, K. Scott

    2017-01-01

    While surgical site preparation has been extensively studied, there is little information about resistance of skin microbiota in the biofilm form to antimicrobial decontamination, and there are no quantitative models to study how biofilm might be transferred into sterile tissue/implant materials during injections for joint spine and tendon, aspiration biopsies and dermal fillers (DF). In this work, we develop two in vitro models to simulate the process of skin preparation and DF injection using pig skin and SimSkin (silicone) materials, respectively. Using the pig skin model, we tested three of the most common skin preparation wipes (alcohol, chlorhexidine and povidone iodine) and found that during wiping they reduced the biofilm bacterial burden of S. aureus (CFU cm−2) by three logs with no statistically significant differences between wipes. Using the SimSkin model, we found that transfer of viable bacteria increased with needle diameter for 30G, 25G and 18G needles. Transfer incidence decreased as injection depth was increased from 1 mm to 3 mm. Serial puncture and linear threading injection styles had similar transfer incidence, whereas fanning significantly increased transfer incidence. The results show that contamination of DF during injection is a risk that can be reduced by modifying skin prep and injection practices. PMID:28332593

  13. Hernia Surgical Mesh Implants

    Science.gov (United States)

    ... Prosthetics Hernia Surgical Mesh Implants Hernia Surgical Mesh Implants Share Tweet Linkedin Pin it More sharing options ... majority of tissue used to produce these mesh implants are from a pig (porcine) or cow (bovine) ...

  14. Urogynecologic Surgical Mesh Implants

    Science.gov (United States)

    ... Prosthetics Urogynecologic Surgical Mesh Implants Urogynecologic Surgical Mesh Implants Share Tweet Linkedin Pin it More sharing options ... majority of tissue used to produce these mesh implants are from a pig (porcine) or cow (bovine). ...

  15. 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 ...

  16. Control of Staphylococcus aureus pathogenicity island excision.

    Science.gov (United States)

    Mir-Sanchis, Ignacio; Martínez-Rubio, Roser; Martí, Miguel; Chen, John; Lasa, Íñigo; Novick, Richard P; Tormo-Más, María Ángeles; Penadés, José R

    2012-09-01

    Staphylococcus aureus pathogenicity islands (SaPIs) are a group of related 15-17 kb mobile genetic elements that commonly carry genes for superantigen toxins and other virulence factors. The key feature of their mobility is the induction of SaPI excision and replication by certain phages and their efficient encapsidation into specific small-headed phage-like infectious particles. Previous work demonstrated that chromosomal integration depends on the SaPI-encoded recombinase, Int. However, although involved in the process, Int alone was not sufficient to mediate efficient SaPI excision from chromosomal sites, and we expected that SaPI excision would involve an Xis function, which could be encoded by a helper phage or by the SaPI, itself. Here we report that the latter is the case. In vivo recombination assays with plasmids in Escherichia coli demonstrate that SaPI-coded Xis is absolutely required for recombination between the SaPI att(L) and att(R) sites, and that both sites, as well as their flanking SaPI sequences, are required for SaPI excision. Mutational analysis reveals that Xis is essential for efficient horizontal SaPI transfer to a recipient strain. Finally, we show that the master regulator of the SaPI life cycle, Stl, blocks expression of int and xis by binding to inverted repeats present in the promoter region, thus controlling SaPI excision.

  17. 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

  18. Structure of Staphylococcus aureus cytidine monophosphate kinase in complex with cytidine 5'-monophosphate.

    Science.gov (United States)

    Dhaliwal, Balvinder; Ren, Jingshan; Lockyer, Michael; Charles, Ian; Hawkins, Alastair R; Stammers, David K

    2006-08-01

    The crystal structure of Staphylococcus aureus cytidine monophosphate kinase (CMK) in complex with cytidine 5'-monophosphate (CMP) has been determined at 2.3 angstroms resolution. The active site reveals novel features when compared with two orthologues of known structure. Compared with the Streptococcus pneumoniae CMK solution structure of the enzyme alone, S. aureus CMK adopts a more closed conformation, with the NMP-binding domain rotating by approximately 16 degrees towards the central pocket of the molecule, thereby assembling the active site. Comparing Escherichia coli and S. aureus CMK-CMP complex structures reveals differences within the active site, including a previously unreported indirect interaction of CMP with Asp33, the replacement of a serine residue involved in the binding of CDP by Ala12 in S. aureus CMK and an additional sulfate ion in the E. coli CMK active site. The detailed understanding of the stereochemistry of CMP binding to CMK will assist in the design of novel inhibitors of the enzyme. Inhibitors are required to treat the widespread hospital infection methicillin-resistant S. aureus (MRSA), currently a major public health concern.

  19. 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.

  20. Interventions for wound healing among diabetic patients infected with Staphylococcus aureus: a systematic review

    Directory of Open Access Journals (Sweden)

    Anacássia Fonseca Lima

    Full Text Available CONTEXT AND OBJECTIVE: Staphylococcus aureus is the most frequent agent isolated in diabetic foot infections and may be associated with changes to wound healing times. The aim of this study was to perform a systematic review of the literature, including studies that assessed the efficacy of any clinical or surgical intervention, as well as oral or topical therapy for diabetic ulcers infected with S. aureus. DESIGN AND SETTING: Systematic review with a search conducted in databases. METHODS: We conducted a systematic review with a comprehensive search in the Lilacs, SciELO, PubMed/Medline, Old Medline, Embase and Cochrane Library databases, for articles published from 1966 to 2010. The articles selected were limited to studies on diabetic patients with wounds infected with S. aureus for whom their healing was followed up, with the use of either antibiotics or experimental treatments. Animal studies and those that did not report the wound healing, as well as review articles, were excluded. RESULTS: Five studies that met the inclusion and exclusion criteria were analyzed. CONCLUSIONS: There are few studies reporting the healing of wounds infected with S. aureus in diabetic patients, although this is the most commonly found pathogen in this type of wound and it frequently consists of methicillin-resistant S. aureus (MRSA. There is insufficient evidence to support early use of broad-spectrum antibiotics against MRSA to promote healing of diabetic ulcers, since antibiotic resistance may develop from such treatment. This highlights the need for further studies on the subject.

  1. Surgical Lasers In Gynecology

    Science.gov (United States)

    Schellhas, Helmut F.; Barnes, Alfonso E.

    1982-12-01

    Multipurpose surgical CO2 lasers marketed in the USA have been developed to be applicable to a variety of surgical procedures in many surgical fields. They are all suited for endoscopic surgical procedures and can be fitted to all standard surgical microscopes. They all can adjust the focal length of the laser beam to the different standard focal lengths of the surgical microscope which for instance in laryngoscopy is 400 mm and in colposcopy 300 mm. One laser instrument can even change the spot size in a given focal distance which is very advantageous for some microsurgical procedures (Merrimack Laboratories 820). All multipurpose surgical CO2 laser systems provide a multi-articulated surgical arm for free-hand surgery. The surgical arms are cumbersome to use but they are adapted to the surgeons needs with ingenuity. The practicality of the multi-articulated surgical arms depends mostly on the distance of the handpiece from the surgical console which now is also overbridged by the laser tube in most surgical laser system. The spot size of the beam is variable in most handpieces by interchangeable lenses which modify the focal distance of the beam and the power density. Another common feature in all systems is a coaxial He-Ne pilot light which provides a red spot which unfortunately becomes invisible in a bleeding surgical field. Most surgical laser systems have a spacial mode of TEM 00 which is essential for incisional surgery. The continuous mode of beam delivery is used for incisional surgery and also for most endoscopic procedures.

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

    Directory of Open Access Journals (Sweden)

    Andreas E Zautner

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

  3. Fluorescent reporters for markerless genomic integration in Staphylococcus aureus

    Science.gov (United States)

    de Jong, Nienke W. M.; van der Horst, Thijs; van Strijp, Jos A. G.; Nijland, Reindert

    2017-01-01

    We present integration vectors for Staphylococcus aureus encoding the fluorescent reporters mAmetrine, CFP, sGFP, YFP, mCherry and mKate. The expression is driven either from the sarA-P1 promoter or from any other promoter of choice. The reporter can be inserted markerless in the chromosome of a wide range of S. aureus strains. The integration site chosen does not disrupt any open reading frame, provides good expression, and has no detectable effect on the strains physiology. As an intermediate construct, we present a set of replicating plasmids containing the same fluorescent reporters. Also in these reporter plasmids the sarA-P1 promoter can be replaced by any other promoter of interest for expression studies. Cassettes from the replication plasmids can be readily swapped with the integration vector. With these constructs it becomes possible to monitor reporters of separate fluorescent wavelengths simultaneously. PMID:28266573

  4. CHROMOSOMAL MAPPING IN STRAINS OF STAPHYLOCOCCUS AUREUS,

    Science.gov (United States)

    STAPHYLOCOCCUS AUREUS , CHROMOSOMES), (*CHROMOSOMES, MAPPING), NITROSO COMPOUNDS, GUANIDINES, GENETICS, MUTATIONS, DRUGS, TOLERANCES(PHYSIOLOGY), TEST METHODS, DEOXYRIBONUCLEIC ACIDS, INHIBITION, RESISTANCE(BIOLOGY).

  5. 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...

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

    Directory of Open Access Journals (Sweden)

    Sanne van den Berg

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

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

    DEFF Research Database (Denmark)

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

    2015-01-01

    BACKGROUND: Staphylococcus aureus is a leading cause of bloodstream infections among hemodialysis patients and of exit-site infections among peritoneal dialysis patients. However, the risk and prognosis of Staphylococcus aureus bacteremia among end-stage renal disease patients have not been...... delineated. METHODS: In this Danish nationwide, population-based cohort study patients with end-stage renal disease and matched population controls were observed from end-stage renal disease diagnosis/sampling until first episode of Staphylococcus aureus bacteremia, death, or end of study period....... Staphylococcus aureus positive blood cultures, hospitalization, comorbidity, and case fatality were obtained from nationwide microbiological, clinical, and administrative databases. Incidence rates and risk factors were assessed by regression analysis. RESULTS: The incidence rate of Staphylococcus aureus...

  8. Characterisation of Staphylococcus aureus bacteraemia at Tygerberg hospital

    NARCIS (Netherlands)

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

    2013-01-01

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

  9. Surgical management of Diabetic foot ulcers: A Tanzanian university teaching hospital experience

    Directory of Open Access Journals (Sweden)

    Kataraihya Johannes B

    2011-09-01

    Full Text Available Abstract Background Diabetic foot ulcers (DFUs pose a therapeutic challenge to surgeons, especially in developing countries where health care resources are limited and the vast majority of patients present to health facilities late with advanced foot ulcers. A prospective descriptive study was done at Bugando Medical Centre from February 2008 to January 2010 to describe our experience in the surgical management of DFUs in our local environment and compare with what is known in the literature. Findings Of the total 4238 diabetic patients seen at BMC during the period under study, 136 (3.2% patients had DFUs. Males outnumbered females by the ratio of 1.2:1. Their mean age was 54.32 years (ranged 21-72years. Thirty-eight (27.9% patients were newly diagnosed diabetic patients. The majority of patients (95.5% had type 2 diabetes mellitus. The mean duration of diabetes was 8.2 years while the duration of DFUs was 18.34 weeks. Fourteen (10.3% patients had previous history of foot ulcers and six (4.4% patients had previous amputations. The forefoot was commonly affected in 60.3% of cases. Neuropathic ulcers were the most common type of DFUs in 57.4% of cases. Wagner's stage 4 and 5 ulcers were the most prevalent at 29.4% and 23.5% respectively. The majority of patients (72.1% were treated surgically. Lower limb amputation was the most common surgical procedure performed in 56.7% of cases. The complication rate was (33.5% and surgical site infection was the most common complication (18.8%. Bacterial profile revealed polymicrobial pattern and Staphylococcus aureus was the most frequent microorganism isolated. All the microorganisms isolated showed high resistance to commonly used antibiotics except for Meropenem and imipenem, which were 100% sensitive each respectively. The mean hospital stay was 36.24 ± 12.62 days (ranged 18-128 days. Mortality rate was 13.2%. Conclusion Diabetic foot ulceration constitutes a major source of morbidity and mortality

  10. 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.

  11. Triclosan promotes Staphylococcus aureus nasal colonization.

    Science.gov (United States)

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

    2014-04-08

    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 we demonstrate that triclosan is commonly found in the nasal secretions of healthy adults and the presence of triclosan trends positively with nasal colonization by S. aureus. We demonstrate that triclosan can promote the binding of S. aureus to host proteins such as collagen, fibronectin, and keratin, as well as inanimate surfaces such as plastic and glass. Lastly, triclosan-exposed rats are more susceptible to nasal colonization with S. aureus. These data reveal a novel factor that influences the ability of S. aureus to bind surfaces and alters S. aureus nasal colonization. IMPORTANCE Triclosan has been used as a biocide for over 40 years, but the broader effects that it has on the human microbiome have not been investigated. We demonstrate that triclosan is present in nasal secretions of a large portion of a test population and its presence correlates with Staphylococcus aureus nasal colonization. Triclosan also promotes the binding of S. aureus to human proteins and increases the susceptibility of rats to nasal colonization by S. aureus. These findings are significant because S. aureus colonization is a known risk factor for the development of several types of infections. Our data demonstrate the unintended consequences of unregulated triclosan use and contribute to the growing body of research demonstrating inadvertent effects of triclosan on the environment and human health.

  12. Phosphorylation of Staphylococcus aureus Protein-Tyrosine Kinase Affects the Function of Glucokinase and Biofilm Formation

    Science.gov (United States)

    Vasu, Dudipeta; Kumar, Pasupuleti Santhosh; Prasad, Uppu Venkateswara; Swarupa, Vimjam; Yeswanth, Sthanikam; Srikanth, Lokanathan; Sunitha, Manne Mudhu; Choudhary, Abhijith; Krishna Sarma, Potukuchi Venkata Gurunadha

    2017-01-01

    Background: When Staphylococcus aureus is grown in the presence of high concentration of external glucose, this sugar is phosphorylated by glucokinase (glkA) to form glucose-6-phosphate. This product subsequently enters into anabolic phase, which favors biofilm formation. The presence of ROK (repressor protein, open reading frame, sugar kinase) motif, phosphate-1 and -2 sites, and tyrosine kinase sites in glkA of S. aureus indicates that phosphorylation must regulate the glkA activity. The aim of the present study was to identify the effect of phosphorylation on the function of S. aureus glkA and biofilm formation. Methods: Pure glkA and protein-tyrosine kinase (BYK) of S. aureus ATCC 12600 were obtained by fractionating the cytosolic fractions of glkA1 and BYK-1 expressing recombinant clones through nickel metal chelate column. The pure glkA was used as a substrate for BYK, and the phosphorylation of glkA was confirmed by treating with reagent A and resolving in SDS-PAGE, as well as staining with reagent A. The kinetic parameters of glkA and phosphorylated glkA were determined spectrophotometrically, and in silico tools were used for validation. S. aureus was grown in brain heart infusion broth, which was supplemented with glucose, and then biofilm units were calculated. Results: Fourfold elevated glkA activity was observed upon the phosphorylation by BYK. Protein-protein docking analysis revealed that glkA structure docked close to the adenosine triphosphate-binding site of BYK structure corroborating the kinetic results. Further, S. aureus grown in the presence of elevated glucose concentration exhibited an increase in the rate of biofilm formation. Conclusion: The elevated function of glkA is an essential requirement for increased biofilm units in S. aureus, a key pathogenic factor that helps its survival and the progress of infection. PMID:27695030

  13. 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.

  14. Chromones from an ascomycete,Chaetomium aureus

    Institute of Scientific and Technical Information of China (English)

    Li Mei Li; Qiang Zou; Guo You Li

    2010-01-01

    A novel chromone,named chaetoaurin (1),along with six known chromone derivatives (2-7),was isolated from the ethyl acetate extract of a solid-state fermented culture of Chaetomium aureus.Their structures were elucidated by extensive spectral analysis.All of these compounds were reported from C.aureus for the first time.

  15. Immunogenicity of toxins during Staphylococcus aureus infection

    NARCIS (Netherlands)

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

    2010-01-01

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

  16. Antimicrobial susceptibility pattern of Staphylococcus aureus isolated from clinical specimens in Northern area of Jordan

    Directory of Open Access Journals (Sweden)

    Mazhar Salim Al Zoubi

    2015-12-01

    Full Text Available Background and Objectives: The global spread of methicillin resistant Staphylococcus aureus (MRSA constitutes one of the most serious contemporary challenges to the treatment of hospital-acquired infections. We aimed to screen and assess the antibiotic susceptibility pattern of Staphylococcus aureus isolated from clinical specimens in local hospitals of Northern province in Jordan.Materials and Methods: Staphylococcus aureus was isolated and identified using standard methods from various clinical specimens of different infected body sites from 358 patients during the period from January 2005 to November 2008.Results: Our analysis showed that 31.6% of S. aureus infections were MRSA, while 31% were multidrug resistance (MDR and 42.7% were Oxacillin-resistant (ORSA. Most of these strains were isolated from wound specimens. All isolates were susceptible to vancomycin (100%. They were also susceptible to chloramphenicol, linezolid, nitrofurantoin, rifampicin and teicoplanin (>80%, but showed resistance to erythromycin and penicillin.Conclusion: Vancomycin was the most effective antimicrobial agent against S. aureus. We recommend regular surveillance of hospital associated infections and monitoring antibiotic sensitivity pattern and strict drug policy for antibiotics used within and outside the hospital environments. Keywords: Staphylococcus aureus, MRSA, MDR

  17. Staphylococcus aureus and hand eczema severity

    DEFF Research Database (Denmark)

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

    2009-01-01

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

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

    Institute of Scientific and Technical Information of China (English)

    芦永华; 黄新玲; 何文英; 先疆燕

    2016-01-01

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

  19. Methicillin-resistant Staphylococcus aureus (mrsa) in a Malaysian hospital.

    Science.gov (United States)

    Cheong, I; Tan, S C; Wong, Y H; Zainudin, B M; Rahman, M Z

    1994-03-01

    Between August 1990 to November 1991, 905 of 2583 (35.4%) isolates of Staphylococcus aureus were found to be methicillin-resistant in a general hospital in Malaysia. A detailed study of 539 of these isolates showed a high prevalence of methicillin resistant Staphylococcus aureus (MRSA) in the surgical/orthopaedic wards, paediatric wards and the special care unit. The yield of MRSA was highest from wounds/ulcers/skin swabs accounting for 64.2 per cent followed by 6.9 per cent in blood cultures. Vancomycin remains the drug of choice with no resistance detected. The resistance to ciprofloxacin was 6.7 per cent, rifampicin 4.5 per cent and fusidic acid 2.0 per cent. Most isolates were resistant to aminoglycosides. In view of the high prevalence of MRSA in this hospital, the authorities must introduce more effective measures to control its spread as a nosocomial pathogen. Otherwise it may seriously disrupt the efficient delivery of health care services in the country.

  20. Chronic ethanol feeding increases the severity of Staphylococcus aureus skin infections by altering local host defenses

    Science.gov (United States)

    Parlet, Corey P.; Kavanaugh, Jeffrey S.; Horswill, Alexander R.; Schlueter, Annette J.

    2015-01-01

    Alcoholics are at increased risk of Staphylococcus aureus skin infection and serious sequelae, such as bacteremia and death. Despite the association between alcoholism and severe S. aureus skin infection, the impact of EtOH on anti-S. aureus cutaneous immunity has not been investigated in a model of chronic EtOH exposure. To test the hypothesis that EtOH enhances the severity of S. aureus skin infection, mice were fed EtOH for ≥12 weeks via the Meadows-Cook model of alcoholism and inoculated with S. aureus following epidermal abrasion. Evidence of exacerbated staphylococcal disease in EtOH-fed mice included: skin lesions that were larger and contained more organisms, greater weight loss, and increased bacterial dissemination. Infected EtOH-fed mice demonstrated poor maintenance and induction of PMN responses in skin and draining LNs, respectively. Additionally, altered PMN dynamics in the skin of these mice corresponded with reduced production of IL-23 and IL-1β by CD11b+ myeloid cells and IL-17 production by γδ T cells, with the latter defect occurring in the draining LNs as well. In addition, IL-17 restoration attenuated S. aureus-induced dermatopathology and improved bacterial clearance defects in EtOH-fed mice. Taken together, the findings show, in a novel model system, that the EtOH-induced increase in S. aureus-related injury/illness corresponds with defects in the IL-23/IL-17 inflammatory axis and poor PMN accumulation at the site of infection and draining LNs. These findings offer new information about the impact of EtOH on cutaneous host-defense pathways and provide a potential mechanism explaining why alcoholics are predisposed to S. aureus skin infection. PMID:25605871

  1. Surgical ethics and the challenge of surgical innovation.

    Science.gov (United States)

    Angelos, Peter

    2014-12-01

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

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

    Directory of Open Access Journals (Sweden)

    Kulkarni Girish

    2009-12-01

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

  3. Frequência de infecção do sítio cirúrgico em gastrectomia Frecuencia de infección de sitio quirurgico en gastrectomía Frequence of surgical site infection in gastrectomy

    Directory of Open Access Journals (Sweden)

    Vanessa de Brito Poveda

    2005-12-01

    período de 6 a 10 días después de la cirugía y fueron aislados diferentes microorganismos en las culturas solicitadas. Se evidenció que la frecuencia de infecciones en cirugía potencialmente contaminada está de acuerdo con lo que es preconizado por la literatura. Sin embargo, respecto a la topografía, la mayoría de los casos detectados fue clasificada como infección incisional profunda y la literatura retrata que dos tercios de las infecciones son confinados a la incisión.This research aimed to identify the frequency of surgical site infection (SSI in patients submitted to potentially contaminated, elective gastrectomy, at the Gastric Surgery specialty of a school hospital, in the period from 1998 to 2002. A retrospective study was carried out by means of an information survey in medical records. Surgical site infection was detected in 17 patients (9.4% out of 181 analyzed cases, 23.5% of which were classified as superficial incisional infection; 52.9% as profound incisional infection and 23.5% as organ/space infection; 41.2% of the infection cases developed between 6 and 10 days after the surgery and different microorganisms were isolated in the requested cultures. It was evidenced that the frequency of SSI in potentially contaminated surgeries is according to literature. However, what topography is concerned, most of the detected cases were classified as profound incisional infection, while literature reports that two thirds of SSI are confined to the incision.

  4. 2010年北京地区全髋关节置换术手术部位感染目标性监测分析%Targeted monitoring of surgical site infections after total hip arthroplasty in Beijing in 2010

    Institute of Scientific and Technical Information of China (English)

    钟群杰; 林剑浩; 武迎宏

    2012-01-01

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

  5. 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...

  6. 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

  7. A type IV modification-dependent restriction enzyme SauUSI from Staphylococcus aureus subsp. aureus USA300.

    Science.gov (United States)

    Xu, Shuang-Yong; Corvaglia, Anna R; Chan, Siu-Hong; Zheng, Yu; Linder, Patrick

    2011-07-01

    A gene encoding a putative DNA helicase from Staphylococcus aureus USA300 was cloned and expressed in Escherichia coli. The protein was purified to over 90% purity by chromatography. The purified enzyme, SauUSI, predominantly cleaves modified DNA containing 5mC and 5-hydroxymethylcytosine. Cleavage of 5mC-modified plasmids indicated that the sites S5mCNGS (S = C or G) are preferentially digested. The endonuclease activity requires the presence of adenosine triphosphate (ATP) or dATP whereas the non-hydrolyzable γ-S-ATP does not support activity. SauUSI activity was inhibited by ethylenediaminetetraacetic acid. It is most active in Mg(++) buffers. No companion methylase gene was found near the SauUSI restriction gene. The absence of a cognate methylase and cleavage of modified DNA indicate that SauUSI belongs to type IV restriction endonucleases, a group that includes EcoK McrBC and Mrr. SauUSI belongs to a family of highly similar homologs found in other sequenced S. aureus, S. epidermidis and S. carnosus genomes. More distant SauUSI orthologs can be found in over 150 sequenced bacterial/archaea genomes. Finally, we demonstrated the biological function of the type IV REase in restricting 5mC-modified plasmid DNA by transformation into clinical S. aureus strain SA564, and in restricting phage λ infection when the endonuclease is expressed in E. coli.

  8. 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.

  9. 21 CFR 866.3700 - Staphylococcus aureus serological reagents.

    Science.gov (United States)

    2010-04-01

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

  10. Aminoglycoside inhibition of Staphylococcus aureus biofilm formation is nutrient dependent.

    Science.gov (United States)

    Henry-Stanley, Michelle J; Hess, Donavon J; Wells, Carol L

    2014-06-01

    Biofilms represent microbial communities, encased in a self-produced matrix or extracellular polymeric substance. Microbial biofilms are likely responsible for a large proportion of clinically significant infections and the multicellular nature of biofilm existence has been repeatedly associated with antibiotic resistance. Classical in vitro antibiotic-susceptibility testing utilizes artificial growth media and planktonic microbes, but this method may not account for the variability inherent in environments subject to biofilm growth in vivo. Experiments were designed to test the hypothesis that nutrient concentration can modulate the antibiotic susceptibility of Staphylococcus aureus biofilms. Developing S. aureus biofilms initiated on surgical sutures, and in selected experiments planktonic cultures, were incubated for 16 h in 66 % tryptic soy broth, 0.2 % glucose (1× TSBg), supplemented with bactericidal concentrations of gentamicin, streptomycin, ampicillin or vancomycin. In parallel experiments, antibiotics were added to growth medium diluted one-third (1/3× TSBg) or concentrated threefold (3× TSBg). Following incubation, viable bacteria were enumerated from planktonic cultures or suture sonicates, and biofilm biomass was assayed using spectrophotometry. Interestingly, bactericidal concentrations of gentamicin (5 µg gentamicin ml(-1)) and streptomycin (32 µg streptomycin ml(-1)) inhibited biofilm formation in samples incubated in 1/3× or 1× TSBg, but not in samples incubated in 3× TSBg. The nutrient dependence of aminoglycoside susceptibility is not only associated with biofilm formation, as planktonic cultures incubated in 3× TSBg in the presence of gentamicin also showed antibiotic resistance. These findings appeared specific for aminoglycosides because biofilm formation was inhibited in all three growth media supplemented with bactericidal concentrations of the cell wall-active antibiotics, ampicillin and vancomycin. Additional experiments

  11. 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.

  12. 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

  13. Staphylococcus aureus carriage patterns and the risk of infections associated with continuous peritoneal dialysis.

    NARCIS (Netherlands)

    J.L. Nouwen (Jan); J. Schouten (Jeroen); P. Schneebergen (Peter); S.V. Snijders (Susan); J. Maaskant (Jolanda); M. Koolen (Marjan); A.F. van Belkum (Alex); H.A. Verbrugh (Henri)

    2006-01-01

    textabstractThe epidemiology and risks of Staphylococcus aureus carriage in continuous peritoneal dialysis (CPD) patients was studied in a single tertiary-care institution. On outpatient visits samples for culture were routinely taken prospectively from the CPD catheter exit site and the vestibulum

  14. Staphylococcus Aureus Nasal Carriage and Infection in Patients on Continuous Ambulatory Peritoneal Dialysis

    NARCIS (Netherlands)

    M.A. Luzar; G.A. Coles; B. Faller; A. Slingeneyer; G. Dah Dah; C. Briat; C. Wone; Y. Knefati; M. Kessler; F. Peluso

    1990-01-01

    textabstractWe studied 140 consecutive patients beginning continuous ambulatory peritoneal dialysis (CAPD) at one of seven hospitals to assess the relation of the nasal carriage of Staphylococcus aureus to subsequent catheter-exit-site infection or peritonitis. Shortly before the implantation of the

  15. 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.

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

    Science.gov (United States)

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

    2016-01-01

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

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

    OpenAIRE

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

    2003-01-01

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

  18. 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....

  19. Guide to Surgical Specialists

    Science.gov (United States)

    ... have expertise in the following areas of responsibility: neonatal surgery (specialized knowledge in the surgical repair of ... and non-operative management of certain types of pain. Common conditions managed by neurologic surgeons include disorders ...

  20. Ambulatory Surgical Measures - National

    Data.gov (United States)

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

  1. 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...

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

    Science.gov (United States)

    Płoneczka-Janeczko, Katarzyna; Rypuła, Krzysztof

    2016-01-01

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

  3. Comparative Transcriptomics Reveals Discrete Survival Responses of S. aureus and S. epidermidis to Sapienic Acid

    Science.gov (United States)

    Moran, Josephine C.; Alorabi, Jamal A.; Horsburgh, Malcolm J.

    2017-01-01

    Staphylococcal colonization of human skin is ubiquitous, with particular species more frequent at different body sites. Whereas Staphylococcus epidermidis can be isolated from the skin of every individual tested, Staphylococcus aureus is isolated from arginine deiminase, the oxygen-responsive NreABC nitrogen regulation system and the nitrate and nitrite reduction pathways. The role of S. aureus ACME and chromosomal arginine deiminase pathways in sapienic acid resistance was determined through mutational studies. We speculate that ammonia production could contribute to sapienic acid resistance in staphylococci. PMID:28179897

  4. Etudes structurales du ribosome de Staphylococcus aureus

    OpenAIRE

    Khusainov, Iskander

    2015-01-01

    The ribosome is a large cellular machinery that performs the protein synthesis in every living cell. Therefore, the ribosome is one of the major targets of naturally produced antibiotics, which can kill bacterial cells by blocking protein synthesis. However, some bacteria are resistant to these antibiotics due to small modifications of their ribosomes. Among them, Staphylococcus aureus (S. aureus) is a severe pathogen that causes numerous infections in humans. The crystal structures of comple...

  5. A Targeted E-Learning Program for Surgical Trainees to Enhance Patient Safety in Preventing Surgical Infection

    Science.gov (United States)

    McHugh, Seamus Mark; Corrigan, Mark; Dimitrov, Borislav; Cowman, Seamus; Tierney, Sean; Humphreys, Hilary; Hill, Arnold

    2010-01-01

    Introduction: Surgical site infection accounts for 20% of all health care-associated infections (HCAIs); however, a program incorporating the education of surgeons has yet to be established across the specialty. Methods: An audit of surgical practice in infection prevention was carried out in Beaumont Hospital from July to November 2009. An…

  6. Effect of non-surgical periodontal treatment on the subgingival microbiota of patients with chronic kidney disease.

    Science.gov (United States)

    Artese, Hilana Paula Carillo; de Sousa, Celso Oliveira; Torres, Maria Cynésia Medeiros de Barros; Silva-Boghossian, Carina Maciel; Colombo, Ana Paula Vieira

    2012-01-01

    This study investigated the effect of non-surgical periodontal therapy on the composition of subgingival microbiota of patients with chronic kidney disease (CKD). Sixteen CKD pre-dialysis individuals (CKD) and 14 individuals without clinical evidence of kidney disease (C) presenting chronic periodontitis were treated by scaling and root planing. Subgingival samples were collected from each patient and analyzed for their composition by checkerboard at baseline and 3 months post-therapy. Significant differences between groups at baseline were sought by the Mann-Whitney and χ² tests. Changes over time were examined by the Wilcoxon test. At baseline, the CKD group had significantly lower counts of E. faecalis compared to the C group (p < 0.05). After treatment, the levels of a greater number of species were reduced in the C group. Higher levels of A. israelii, C. rectus, F. periodonticum, P. micra, P. nigrescens, T. forsythia, N. mucosa, and S. anginosus (p < 0.05) were found in the CKD group compared to the C group. Also, non-responsive sites in CKD individuals harbored significantly higher levels of pathogenic species (T. forsythia, P. gingivalis, T. denticola, Fusobacterium spp., D. pneumosintes, E. faecalis and S. aureus; p < 0.05) than sites that responded to therapy, as well as non-responsive sites in the C group. The periodontitis-associated subgingival microbiota of CKD and systemically healthy individuals was similar in composition. However, high levels of pathogenic species persisted in the subgingival microbiota of patients with CKD after treatment.

  7. Changes in the Staphylococcus aureus transcriptome during early adaptation to the lung.

    Directory of Open Access Journals (Sweden)

    Donald O Chaffin

    Full Text Available Staphylococcus aureus is a common inhabitant of the human nasopharynx. It is also a cause of life-threatening illness, producing a potent array of virulence factors that enable survival in normally sterile sites. The transformation of S. aureus from commensal to pathogen is poorly understood. We analyzed S. aureus gene expression during adaptation to the lung using a mouse model of S. aureus pneumonia. Bacteria were isolated by bronchoalveolar lavage after residence in vivo for up to 6 hours. S. aureus in vivo RNA transcription was compared by microarray to that of shake flask grown stationary phase and early exponential phase cells. Compared to in vitro conditions, the in vivo transcriptome was dramatically altered within 30 minutes. Expression of central metabolic pathways changed significantly in response to the lung environment. Gluconeogenesis (fbs, pckA was down regulated, as was TCA cycle and fermentation pathway gene expression. Genes associated with amino acid synthesis, RNA translation and nitrate respiration were upregulated, indicative of a highly active metabolic state during the first 6 hours in the lung. Virulence factors regulated by agr were down regulated in vivo and in early exponential phase compared to stationary phase cells. Over time in vivo, expression of ahpCF, involved in H(2O(2 scavenging, and uspA, which encodes a universal stress regulator, increased. Transcription of leukotoxic α and β-type phenol-soluble modulins psmα1-4 and psmβ1-2 increased 13 and 8-fold respectively; hld mRNA, encoding δ-hemolysin, was increased 9-fold. These were the only toxins to be significantly upregulated in vivo. These data provide the first complete survey of the S. aureus transcriptome response to the mammalian airway. The results present intriguing contrasts with previous work in other in vitro and in vivo models and provide novel insights into the adaptive and temporal response of S. aureus early in the pathogenesis of pneumonia.

  8. Changes in the Staphylococcus aureus transcriptome during early adaptation to the lung.

    Science.gov (United States)

    Chaffin, Donald O; Taylor, Destry; Skerrett, Shawn J; Rubens, Craig E

    2012-01-01

    Staphylococcus aureus is a common inhabitant of the human nasopharynx. It is also a cause of life-threatening illness, producing a potent array of virulence factors that enable survival in normally sterile sites. The transformation of S. aureus from commensal to pathogen is poorly understood. We analyzed S. aureus gene expression during adaptation to the lung using a mouse model of S. aureus pneumonia. Bacteria were isolated by bronchoalveolar lavage after residence in vivo for up to 6 hours. S. aureus in vivo RNA transcription was compared by microarray to that of shake flask grown stationary phase and early exponential phase cells. Compared to in vitro conditions, the in vivo transcriptome was dramatically altered within 30 minutes. Expression of central metabolic pathways changed significantly in response to the lung environment. Gluconeogenesis (fbs, pckA) was down regulated, as was TCA cycle and fermentation pathway gene expression. Genes associated with amino acid synthesis, RNA translation and nitrate respiration were upregulated, indicative of a highly active metabolic state during the first 6 hours in the lung. Virulence factors regulated by agr were down regulated in vivo and in early exponential phase compared to stationary phase cells. Over time in vivo, expression of ahpCF, involved in H(2)O(2) scavenging, and uspA, which encodes a universal stress regulator, increased. Transcription of leukotoxic α and β-type phenol-soluble modulins psmα1-4 and psmβ1-2 increased 13 and 8-fold respectively; hld mRNA, encoding δ-hemolysin, was increased 9-fold. These were the only toxins to be significantly upregulated in vivo. These data provide the first complete survey of the S. aureus transcriptome response to the mammalian airway. The results present intriguing contrasts with previous work in other in vitro and in vivo models and provide novel insights into the adaptive and temporal response of S. aureus early in the pathogenesis of pneumonia.

  9. Performance of CHROMagar Staph aureus and CHROMagar MRSA for detection of Staphylococcus aureus in seawater and beach sand--comparison of culture, agglutination, and molecular analyses.

    Science.gov (United States)

    Goodwin, K D; Pobuda, M

    2009-11-01

    Beach seawater and sand were analyzed for Staphylococcus aureus and methicillin resistant S. aureus (MRSA) for samples collected from Avalon, and Doheny Beach, CA. Membrane filtration followed by incubation on CHROMagar Staph aureus (SCA) and CHROMagar MRSA (C-MRSA) was used to enumerate S. aureus and MRSA, respectively. Media performance was evaluated by comparing identification via colony morphology and latex agglutination tests to PCR (clfA, 16S, and mecA genes). Due to background color and crowding, picking colonies from membrane filters and streaking for isolation were sometimes necessary. The specificity of SCA and C-MRSA was improved if colony isolates were identified by the presence of a matte halo in addition to mauve color; however routine agglutination testing of isolates did not appear warranted. Using the appearance of a colony on the membrane filter in conjunction with isolate appearance, the positive % agreement, the negative % agreement, and the % positive predictive accuracy for SCA was 84%, 95%, and 99% respectively, and for C-MRSA it was 85%, 98%, and 92%, respectively. Sensitivity and specificity of SCA and C-MRSA with membrane-filtered beach samples were optimized through identification experience, control of filter volume and incubation time, and isolation of colonies needing further identification. With optimization, SCA and C-MRSA could be used for enumeration of S. aureus and MRSA from samples of beach water and sand. For the sites studied here, the frequency of detection of S. aureus ranged from 60 to 76% and 53 to 79% for samples of beach seawater and sand, respectively. The frequency of detection of MRSA ranged from 2 to 9% and 0 to 12% for samples of seawater and sand, respectively.

  10. Characterization of methicillin-resistant Staphylococcus aureus Sequence Type 398

    DEFF Research Database (Denmark)

    Christiansen, Mette Theilgaard

    and Transposon Directed Inserted site Sequencing (TraDIS) was for the first time assessed in an LA-MRSA ST398 strain. Using this high-throughput approach, genes essential for LA-MRSA ST398 survival under laboratory conditions and in whole porcine blood in vitro were identified. In manuscript II, genes important...... 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......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...

  11. Carotenoid Formation by Staphylococcus aureus

    Science.gov (United States)

    Hammond, Ray K.; White, David C.

    1970-01-01

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

  12. Postoperative Surgical Infection After Spinal Surgery in Rheumatoid Arthritis.

    Science.gov (United States)

    Koyama, Kensuke; Ohba, Tetsuro; Ebata, Shigeto; Haro, Hirotaka

    2016-05-01

    Individuals with rheumatoid arthritis are at higher risk for infection than the general population, and surgical site infection after spinal surgery in this population can result in clinically significant complications. The goal of this study was to identify risk factors for acute surgical site infection after spinal surgery in patients with rheumatoid arthritis who were treated with nonbiologic (conventional) disease-modifying antirheumatic drugs (DMARDs) alone or with biologic DMARDs. All patients treated with biologic agents were treated with nonbiologic agents as well. The authors performed a retrospective, single-center review of 47 consecutive patients with rheumatoid arthritis who underwent spinal surgery and had follow-up of 3 months or longer. The incidence of surgical site infection was examined, and multivariate logistic regression analysis was performed to test the association of surgical site infection with putative risk factors, including the use of biologic agents, methotrexate, and prednisolone, as well as the duration of rheumatoid arthritis, the presence of diabetes, patient age, length of surgery, and number of operative levels. After spinal surgery, 14.89% (7 of 47) of patients had surgical site infection. Use of methotrexate and/or prednisolone, patient age, diabetes, duration of rheumatoid arthritis, length of surgery, number of operative levels, and use of biologic DMARDs did not significantly increase the risk of infection associated with spinal surgery. All patients who had surgical site infection had undergone spinal surgery with instrumentation. The findings show that greater attention to preventing surgical site infection may be needed in patients with rheumatoid arthritis who undergo spinal surgery with instrumentation. To the authors' knowledge, this is the first study to show that the use of biologic agents did not increase the incidence of surgical site infection after spinal surgery in patients with rheumatoid arthritis

  13. Necrotizing fasciitis caused by Staphylococcus aureus: the emergence of methicillin-resistant strains.

    Science.gov (United States)

    Cheng, Nai-Chen; Wang, Jann-Tay; Chang, Shan-Chwen; Tai, Hao-Chih; Tang, Yueh-Bih

    2011-12-01

    Staphylococcus aureus is an uncommon causative agent of monomicrobial necrotizing fasciitis, but we have noted several cases over the years. The patients treated for necrotizing fasciitis between January 1998 and December 2008 in our institution were identified, and their medical records were reviewed. Of 105 necrotizing fasciitis cases during the study period, 18 were caused by monomicrobial S. aureus infection (17%). The median age was 62 years (range, 12-81 years). Among this cohort, 10 patients had coexisting medical conditions or risk factors, including diabetes and hypertension. Lower limbs and upper limbs are the most commonly involved sites. Among the bacterial isolates from these cases, 8 were methicillin-sensitive S. aureus (MSSA) and 10 were methicillin-resistant S. aureus (MRSA). One patient died in the MSSA group, and 5 patients died in the MRSA group. The mortality rate and other clinical characteristics were not significantly different between the 2 groups. However, all MRSA necrotizing fasciitis developed after the year 2000, and it was significantly different from MSSA necrotizing fasciitis that predominantly took place before the year 2000. In conclusion, S. aureus is an important pathogen of monomicrobial necrotizing fasciitis, and MRSA has emerged as the predominant causative agent in recent years. Therefore, MRSA-directed antibiotic therapy should be considered when treating patients suspected with necrotizing fasciitis in endemic areas.

  14. ω-Hydroxyemodin Limits Staphylococcus aureus Quorum Sensing-Mediated Pathogenesis and Inflammation

    Science.gov (United States)

    Daly, Seth M.; Elmore, Bradley O.; Kavanaugh, Jeffrey S.; Triplett, Kathleen D.; Figueroa, Mario; Raja, Huzefa A.; El-Elimat, Tamam; Crosby, Heidi A.; Femling, Jon K.; Cech, Nadja B.; Horswill, Alexander R.; Oberlies, Nicholas H.

    2015-01-01

    Antibiotic-resistant pathogens are a global health threat. Small molecules that inhibit bacterial virulence have been suggested as alternatives or adjuncts to conventional antibiotics, as they may limit pathogenesis and increase bacterial susceptibility to host killing. Staphylococcus aureus is a major cause of invasive skin and soft tissue infections (SSTIs) in both the hospital and community settings, and it is also becoming increasingly antibiotic resistant. Quorum sensing (QS) mediated by the accessory gene regulator (agr) controls virulence factor production essential for causing SSTIs. We recently identified ω-hydroxyemodin (OHM), a polyhydroxyanthraquinone isolated from solid-phase cultures of Penicillium restrictum, as a suppressor of QS and a compound sought for the further characterization of the mechanism of action. At concentrations that are nontoxic to eukaryotic cells and subinhibitory to bacterial growth, OHM prevented agr signaling by all four S. aureus agr alleles. OHM inhibited QS by direct binding to AgrA, the response regulator encoded by the agr operon, preventing the interaction of AgrA with the agr P2 promoter. Importantly, OHM was efficacious in a mouse model of S. aureus SSTI. Decreased dermonecrosis with OHM treatment was associated with enhanced bacterial clearance and reductions in inflammatory cytokine transcription and expression at the site of infection. Furthermore, OHM treatment enhanced the immune cell killing of S. aureus in vitro in an agr-dependent manner. These data suggest that bacterial disarmament through the suppression of S. aureus QS may bolster the host innate immune response and limit inflammation. PMID:25645827

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

    Science.gov (United States)

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

    2013-01-01

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

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

    Directory of Open Access Journals (Sweden)

    Ludmila Alekseeva

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

  17. 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.

  18. 3D Surgical Simulation

    Science.gov (United States)

    Cevidanes, Lucia; Tucker, Scott; Styner, Martin; Kim, Hyungmin; Chapuis, Jonas; Reyes, Mauricio; Proffit, William; Turvey, Timothy; Jaskolka, Michael

    2009-01-01

    This paper discusses the development of methods for computer-aided jaw surgery. Computer-aided jaw surgery allows us to incorporate the high level of precision necessary for transferring virtual plans into the operating room. We also present a complete computer-aided surgery (CAS) system developed in close collaboration with surgeons. Surgery planning and simulation include construction of 3D surface models from Cone-beam CT (CBCT), dynamic cephalometry, semi-automatic mirroring, interactive cutting of bone and bony segment repositioning. A virtual setup can be used to manufacture positioning splints for intra-operative guidance. The system provides further intra-operative assistance with the help of a computer display showing jaw positions and 3D positioning guides updated in real-time during the surgical procedure. The CAS system aids in dealing with complex cases with benefits for the patient, with surgical practice, and for orthodontic finishing. Advanced software tools for diagnosis and treatment planning allow preparation of detailed operative plans, osteotomy repositioning, bone reconstructions, surgical resident training and assessing the difficulties of the surgical procedures prior to the surgery. CAS has the potential to make the elaboration of the surgical plan a more flexible process, increase the level of detail and accuracy of the plan, yield higher operative precision and control, and enhance documentation of cases. Supported by NIDCR DE017727, and DE018962 PMID:20816308

  19. Anxiety in veterinary surgical students

    DEFF Research Database (Denmark)

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

    2012-01-01

    The surgical educational environment is potentially stressful and this can negatively affect students' learning. The aim of this study was to investigate whether veterinary students' level of anxiety is higher in a surgical course than in a non-surgical course and if pre-surgical training...... in a Surgical Skills Lab (SSL) has an anxiety reducing effect. Investigations were carried out as a comparative study and a parallel group study. Potential participants were fourth-year veterinary students who attended a surgical course (Basic Surgical Skills) and a non-surgical course (Clinical Examination...... and 28 students from 2010). Our results show that anxiety levels in veterinary students are significantly higher in a surgical course than in a non-surgical course (p...

  20. Surgical bleeding in microgravity

    Science.gov (United States)

    Campbell, M. R.; Billica, R. D.; Johnston, S. L. 3rd

    1993-01-01

    A surgical procedure performed during space flight would occur in a unique microgravity environment. Several experiments performed during weightlessness in parabolic flight were reviewed to ascertain the behavior of surgical bleeding in microgravity. Simulations of bleeding using dyed fluid and citrated bovine blood, as well as actual arterial and venous bleeding in rabbits, were examined. The high surface tension property of blood promotes the formation of large fluid domes, which have a tendency to adhere to the wound. The use of sponges and suction will be adequate to prevent cabin atmosphere contamination with all bleeding, with the exception of temporary arterial droplet streams. The control of the bleeding with standard surgical techniques should not be difficult.

  1. Surgical management of presbyopia

    Directory of Open Access Journals (Sweden)

    Torricelli AA

    2012-09-01

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

  2. Outcomes of managing the surgical site infection with local vancomycin following posterior cervical surgery%颈后路术中局部应用万古霉素对术后手术部位感染的影响

    Institute of Scientific and Technical Information of China (English)

    刘祥; 徐宏光; 赵泉来; 高智; 肖良

    2016-01-01

    目的:对比颈后路切口在术中是否局部应用万古霉素对术后切口愈合及感染的影响,探讨颈后路切口在术中局部应用万古霉素的优点。方法:前瞻性对照分析皖南医学院弋矶山医院脊柱外科2013年1月~2014年12月所选取的52个病例,分为A、B两组,其中男27人,女25人,平均年龄(52.25±11.00)岁,年龄32~68岁;术前、术后临床感染性指标变化的资料(体温、红细胞沉降率ESR、C-反应蛋白CRP、中性粒细胞比、淋巴细胞比),其中脊髓型或神经根型颈椎病42人、颈部外伤致颈椎不稳9人、椎管内肿瘤1人,所选病例都接受颈后路手术并排除颈部感染性疾病。结果:52例手术均顺利完成,无手术或围手术期死亡病例,术后随访3个月。 A、B两组术后第7天体温分别为(37.78±0.60)℃和(36.66±0.31)℃,P<0.05;ESR分别为(31.00±8.49)mm/h和(14.19±1.30)mm/h,P<0.05;CRP分别为(26.77±9.92)mg/L和(6.50±1.88)mg/L,P<0.05;中性粒细胞比分别为(80.58±4.06)%和(56.92±3.11)%,P<0.05;淋巴细胞比分别为(12.88±1.61)%和(23.08±3.77)%,P<0.05。 A、B两组间术前、术后第1天、术后第3天、术后第1个月、术后第3个月的体温、ESR、CRP、中性粒细胞比、淋巴细胞比均有统计学差异,P<0.05。 A组病例有9人在术后切口部位有轻微红肿发生并且A组病例平均住院天数比B组病例平均住院天数长5天。结论:颈后路手术切口在术中局部应用万古霉素可以有效地降低患者术后切口的感染率,减少患者的实际住院天数和医疗支出。%Objective:To observe the efficacy of managing the surgical site infection with local vancomycin following posterior cervical surgery .Methods:Retrospective analysis was performed in 52 cases undergone cervical surgery

  3. [Surgical therapy for entrapment neuropathy].

    Science.gov (United States)

    Tachibana, Shigekuni

    2012-01-01

    Entrapment neuropathy is not uncommon, and surgical treatment is followed by favorite result. Therefore, to obtain an accurate diagnosis based on precise knowledge of the peripheral nervous system is very important. The most popular and useful symptoms and signs of the entrapment neuropathy is paresthesia, dysesthesia and Tinel's like sign at the lesion site. Nerve conduction study is also valuable for the accurate diagnosis. For the last 30 years, the author operated on 1,399 lesions of entrapment neuropathy. They consist of 877 carpal tunnel syndrome (63%), 284 tarsal tunnel syndrome (20%), 135 ulnar neuropathy at the elbow (10%), 53 piriformis syndrome (4%), 15 thoracic outlet syndrome (1%), and others. From the pathophysiological point to view, except for the carpal tunnel syndrome, several locations and factors come into play producing the entrapment of the nerve. The author would like to stress that the entrapment neuropathy is not severe disease, though, it strongly insult the patient's quality of life.

  4. [Surgical dilemmas. Sinus floor elevation].

    Science.gov (United States)

    ten Bruggenkate, C M; Schulten, E A J M; Zijderveld, S A

    2008-12-01

    Limited alveolar bone height prevents the placement of dental implants. Sinus floor elevation is an internal augmentation of the maxillary sinus that allows implants to be placed. The principle of this surgical procedure is the preparation of a 'top hinge door', that is raised together with the Schneiderian membrane in the cranial direction. The space which created under this lid is filled with a bone transplant. Autogenous bone is the standard transplant material, despite the fact that a second surgery site is necessary. Under certain circumstances bone substitutes can be used, with a longer healing phase. If sufficient alveolar bone height is available to secure implant stability, simultaneous implantation and sinus floor elevation are possible. Considering the significant anatomical variation in the region of the maxillary sinus, a sound knowledge of the anatomy is of great importance.

  5. Crystal Structure of an Invasivity-Associated Domain of SdrE in S. aureus

    Science.gov (United States)

    Zhang, Hongpeng; Yang, Wei; Zhu, Zhongliang; Chen, Ke; Bai, Lei; Wei, Jie; Huang, Ailong; Wang, Deqiang

    2017-01-01

    The surface protein SdrE, a microbial surface components recognizing adhesive matrix molecule (MSCRAMM) family protein expressed on the surface of Staphylococcus aureus (S. aureus), can recognize human complement regulator Factor H and C4BP, thus making it a potentially promising vaccine candidate. In this study, SdrE278-591 was found to directly affect S. aureus host cell invasion. Additionally, the crystal structure of SdrE278-591 at a resolution of 1.25 Å was established, with the three-dimensional structure revealing N2-N3 domains which fold in a manner similar to an IgG fold. Furthermore, a putative ligand binding site located at a conserved charged groove formed by the interface between N2 and N3 domains was identified, with β2 suspected to occupy the ligand recognizing site and undergo a structural rearrangement to allow ligand binding. Overall, these findings have further contributed to the understanding of SdrE as a key factor for S. aureus invasivity and will enable a better understanding of bacterial infection processes. PMID:28125581

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

  7. Staphylococcus aureus survival in human blood.

    Science.gov (United States)

    Malachowa, Natalia; DeLeo, Frank R

    2011-01-01

    Methicillin-resistant Staphylococcus aureus (MRSA) is abundant in hospitals and in the United States is a leading cause of mortality due to infectious agents. Community-associated MRSA (CA-MRSA) strains such as USA300, which typically cause disease outside of healthcare settings, are also prevalent in the United States. Although most CA-MRSA infections affect skin and soft tissue, the pathogen can enter the bloodstream and ultimately cause severe disease. In a recent paper, we used USA300-specific microarrays to generate a comprehensive view of the molecules that facilitate S. aureus immune evasion and survival in human blood. Notably, genes encoding proteins involved in iron-uptake and utilization and gamma-hemolysin (hlgABC) are highly up-regulated by USA300 during culture in human blood. Here we discuss the potential implication of these findings and the possible role of gamma-hemolysin in the success of S. aureus as a human pathogen.

  8. Genomics of Natural Populations of Staphylococcus aureus.

    Science.gov (United States)

    Fitzgerald, J Ross; Holden, Matthew T G

    2016-09-01

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

  9. Treatment of the positive surgical margin following radical prostatectomy

    Institute of Scientific and Technical Information of China (English)

    2008-01-01

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

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

    Science.gov (United States)

    Tyner, Harmony; Patel, Robin

    2016-08-01

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

  11. 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....

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

    Directory of Open Access Journals (Sweden)

    Sandra Davi Traverso

    2003-04-01

    Full Text Available Em uma criação composta por 1800 coelhos, 33% das matrizes apresentaram mastite e lesões cutâneas crostosas e purulentas. Estes animais apresentavam-se entre 10 a- 12 meses de idade e em segunda parição. Quinze coelhos afetados foram sacrificados e necropsiados. Na necropsia, além das lesões cutâneas haviam microabscessos em diversos órgãos. Das amostras coletadas isolou-se Staphylococcus aureus subesp. aureus. S. aureus subesp. aureus também foi isolado de "swab" nasal coletado do tratador encarregado de fazer o diagnóstico de gestação nas coelhas. Histologicamente, havia formação de múltiplos abscessos, presença de bactérias gram positivas em vasos sangüíneos e linfáticos, além de êmbolos bacterianos nos tecidos. Nas mamas, observou-se tecido glandular normal associado a abscessos multifocais delimitados.At a commercial rabbitry which was composed of 1800 New Zealand White rabbits, 30% of the does had presented mastitis and purulent cutaneal lesions. The age of the animals ranged from 10 to 12 months and were at the second parturition. At necropsy, microabscesses were observed in several organs. Bacteriological samples collected from affected animals resulted Staphylococcus aureus subesp. aureus.. Additionally, the same agent has been isolated from a nasal swab collected from the person responsible for the pregnancy diagnosis. Histologically, there were multiple abscesses, gram positive bacteria within blood and lymphatic vessels, and bacterial emboli scattered in the tissues. In the mammas, normal glandular tissue associated with multifocal abscesses were observed.

  13. [da Vinci surgical system].

    Science.gov (United States)

    Watanabe, Gou; Ishikawa, Norihiro

    2014-07-01

    The da Vinci surgical system was developed by Intuitive Surgical Inc. in the United States as an endoscopic surgical device to assist remote control surgeries. In 1998, the Da Vinci system was first used for cardiothoracic procedures. Currently a combination of robot-assisted internal thoracic artery harvest together with coronary artery bypass grafting (CABG) through a mini-incision (ThoraCAB) or totally endoscopic procedures including anastomoses under robotic assistance (TECAB) are being conducted for the treatment of coronary artery diseases. With the recent advances in catheter interventions, hybrid procedures combining catheter intervention with ThoraCAB or TECAB are anticipated in the future.On the other hand, with the decrease in number of coronary artery bypass surgeries, the share of valvular surgeries is expected to increase in the future. Among them, mitral valvuloplasty for mitral regurgitation is anticipated to be conducted mainly by low-invasive procedures, represented by minimally invasive cardiac surgery( MICS) and robot-assisted surgery. Apart from the intrinsic good surgical view, robotic-assisted systems offer additional advantages of the availability of an amplified view and the easy to observe the mitral valve in the physiological position. Thus, robotic surgical surgeries that make complicated procedures easier are expected to accomplish further developments in the future. Furthermore, while the number of surgeries for atrial septal defects has decreased dramatically following the widespread use of Amplatzer septal occluder, robotic surgery may become a good indication for cases in which the Amplatzer device is not indicated. In Japan, clinical trial of the da Vinci robotic system for heart surgeries has been completed. Statutory approval of the da Vinci system for mitral regurgitation and atrial septal defects is anticipated in the next few years.

  14. Staphylococcus aureus bacteraemia: 400 episodes in St Thomas's Hospital.

    Science.gov (United States)

    Gransden, W R; Eykyn, S J; Phillips, I

    1984-01-28

    Four hundred episodes of Staphylococcus aureus bacteraemia occurred in St Thomas's Hospital from 1969 to 1983, accounting for 17.5% of all episodes of bacteraemia. The mortality was 24%, half attributable to underlying disease, and was highest in patients over 50. Almost 60% of the bacteraemias were acquired in hospital, and the source of the organism was generally obvious, with vascular access sites the most common (37%). Bone and joint infections accounted for 11.5% of episodes and endocarditis for 7%. Most staphylococci were resistant to penicillin only; three isolates were resistant to methicillin and five to fusidic acid. Microbiologists seldom influenced directly the choice of initial antibiotic treatment (though this usually conformed to the hospital's antibiotic prescribing policy) but had considerable influence over definitive treatment, usually cloxacillin or flucloxacillin alone or in combination with fusidic acid. S aureus bacteraemia is easy to identify and treat, though underlying disease may influence the outcome. Efforts should be made to prevent the largely iatrogenic disease.

  15. Epidemiology of Staphylococcus aureus during space flight

    Science.gov (United States)

    Pierson, D. L.; Chidambaram, M.; Heath, J. D.; Mallary, L.; Mishra, S. K.; Sharma, B.; Weinstock, G. M.

    1996-01-01

    Staphylococcus aureus was isolated over 2 years from Space Shuttle mission crewmembers to determine dissemination and retention of bacteria. Samples before and after each mission were from nasal, throat, urine, and feces and from air and surface sampling of the Space Shuttle. DNA fingerprinting of samples by digestion of DNA with SmaI restriction endonuclease followed by pulsed-field gel electrophoresis showed S. aureus from each crewmember had a unique fingerprint and usually only one strain was carried by an individual. There was only one instance of transfer between crewmembers. Strains from interior surfaces after flight matched those of crewmembers, suggesting microbial fingerprinting may have forensic application.

  16. CHARACTERISATION OF AEROBIC BACTERIOLOGICAL ISOLATES FROM ORTHOPEDIC IMPLANT SITE INFECTIONS WITH SPECIAL REFERENCE TO BIOFILM FORMATION IN A TERITIARY CARE HOSPITAL

    Directory of Open Access Journals (Sweden)

    Roopa Shree

    2015-04-01

    Full Text Available INTRODUCTION: Orthopedic implant site infection is one of the major constituents of surgical site infection associated with high morbidity and mortality . Due to the use of implants for open reduction and internal fixation , which are foreign to the body , orthopedic trauma surgery is at grave risk of microbiological contamination . Often isolates causing these infections are assoc iated with biofilm formation resulting in increased antibiotic resistance . OBJECTIVES: To determine the aerobic bacteriological profile with their antibiotic susceptibility patterns from pus samples of patients with orthopedic implant site infections . To d etermine the potential of these isolates to produce biofilm . MATERIALS AND METHODS : Pus samples were collected and sent to the laboratory from patients with suspected implant infections over a period of 6 months were processed according to CLSI guidelines . Biofilm detection was done using Congo red Agar ( CRA method , tube method and Tissue culture plate method . RESULTS: Of the 46 culture positive cases out of 63 , most common isolate was Staphylococcus aureus 30 ( 65 . 21% followed by Coagulase negative Staphy lococcus 4 ( 8 . 69% , Escherichia coli 4 ( 8 . 69% , Klebsiella species 3 ( 6 . 52% , Pseudomonas species 3 ( 6 . 52% , enterococcus species 2 ( 4 . 32% . 13 . 33% of S . aureus was Methicillin resistant ( MRSA , 100% of gram negative bacilli were ESBL and AmpC producers , 27 . 27% of gram negative bacilli were resistant to Imepenem and Meropenem , 1 vancomycin resistant enterococci was isolated . 72% of the isolates were biofilm producers by Congo Red Agar method , 76% by Tube method , and 84% by tissue culture plate m ethod . CONCLUSIONS : Staphylococcus aureus ( MSSA is the most common organism causing orthopedic implant site infection . Gram negative isolates exhibit multidrug resistance patterns . Significant numbers of isolates causing implant infections are biofilm pro ducers . Antibiotic

  17. Coagulase gene polymorphism of Staphylococcus aureus isolates: A study on dairy food products and other foods in Tehran, Iran

    Directory of Open Access Journals (Sweden)

    Mohammad Mehdi Soltan Dallal

    2016-12-01

    Full Text Available Coagulase is considered as a major determinant factor for the identification of Staphylococcus aureus strains. The 3′-end coding region of the coagulase (coa gene contains a series of 81-bp tandem repeats, which differ in the number and location of enzymatic restriction sites among different isolates. coa PCR-RFLP has been used widely to type S. aureus isolates in epidemiological studies. The current study was conducted to investigate the coagulase gene polymorphisms in S. aureus isolated from various food samples using an in house PCR-RFLP method. A total of 100 strains of S. aureus were isolated from food samples. Isolates were typed by PCR-RFLP analysis using NdeI restriction digestion of the coagulase gene PCR products. Results showed that amplification of coagulase genes from S. aureus produced different PCR products. The isolates were grouped into 18 genotypes using RFLP analysis results of the genes. In this study, the S. aureus isolates have been shown to include more than one coagulase genotype, but only had a few coa genotypes predominated.

  18. Community-acquired methicillin-resistant Staphylococcus aureus in Central Australia.

    Science.gov (United States)

    Stevens, Claire L; Ralph, Anna; McLeod, James E T; McDonald, Malcolm I

    2006-01-01

    To date, there has been scant information about the burden of methicillin-resistant Staphylococcus aureus infections in Central Australia. Our aims were to determine the proportion of Staphylococcus aureus infections due to methicillin-resistant strains in Central Australia, to characterise resistance to non-beta lactam antibiotics and to correlate findings with available demographic information. We retrospectively reviewed S. aureus isolates identified by the Microbiology Laboratory of the Pathology Department, Alice Springs Hospital between September 2005 and February 2006. Multi-resistance was defined as resistance to three or more non-beta lactam antibiotics. We identified the recovery site and extended antibiotic resistance profile of each isolate. Demographic data included place of residence, discharge diagnosis and ethnicity. There were 524 S. aureus isolates: 417 (79.6%) methicillin-sensitive S. aureus, 104 (19.7%) non-multi-resistant MRSA (nmrMRSA) and 3 (0.7%) multi-resistant MRSA (mrMRSA). MRSA accounted for 7/22 (32%) invasive infections and 91/474 (19.2%) cases of staphylococcal skin infections. Aboriginal people comprised 89 per cent (93/104) of patients with nmrMRSA; 57 per cent lived in remote communities, 21 per cent in suburban Alice Springs, and 18 per cent in Alice Springs Town Camps. Six per cent (6/104) of nmrMRSA were hospital-acquired. Of the nmrMRSA isolates, 57 per cent (59/104) were resistant to erythromycin and 7 per cent (7/104) to fusidic acid. All MRSA isolates were susceptible to co-trimoxazole. In conclusion, Central Australia has high rates of community-acquired nmrMRSA and low rates of multi-resistant MRSA. Erythromycin resistance in S. aureus is also common. These findings should prompt the review of antimicrobial prescribing guidelines for the region, especially for treatment of skin and soft tissue infections.

  19. Divergent responses of different endothelial cell types to infection with Candida albicans and Staphylococcus aureus.

    Directory of Open Access Journals (Sweden)

    Kati Seidl

    Full Text Available Endothelial cells are important in the pathogenesis of bloodstream infections caused by Candida albicans and Staphylococcus aureus. Numerous investigations have used human umbilical vein endothelial cells (HUVECs to study microbial-endothelial cell interactions in vitro. However, the use of HUVECs requires a constant supply of umbilical cords, and there are significant donor-to-donor variations in these endothelial cells. The use of an immortalized endothelial cell line would obviate such difficulties. One candidate in this regard is HMEC-1, an immortalized human dermal microvascular endothelial cell line. To determine if HMEC-1 cells are suitable for studying the interactions of C. albicans and S. aureus with endothelial cells in vitro, we compared the interactions of these organisms with HMEC-1 cells and HUVECs. We found that wild-type C. albicans had significantly reduced adherence to and invasion of HMEC-1 cells as compared to HUVECs. Although wild-type S. aureus adhered to and invaded HMEC-1 cells similarly to HUVECs, an agr mutant strain had significantly reduced invasion of HMEC-1 cells, but not HUVECs. Furthermore, HMEC-1 cells were less susceptible to damage induced by C. albicans, but more susceptible to damage caused by S. aureus. In addition, HMEC-1 cells secreted very little IL-8 in response to infection with either organism, whereas infection of HUVECs induced substantial IL-8 secretion. This weak IL-8 response was likely due to the anatomic site from which HMEC-1 cells were obtained because infection of primary human dermal microvascular endothelial cells with C. albicans and S. aureus also induced little increase in IL-8 production above basal levels. Thus, C. albicans and S. aureus interact with HMEC-1 cells in a substantially different manner than with HUVECs, and data obtained with one type of endothelial cell cannot necessarily be extrapolated to other types.

  20. Evaluation of genetically inactivated alpha toxin for protection in multiple mouse models of Staphylococcus aureus infection.

    Directory of Open Access Journals (Sweden)

    Rebecca A Brady

    Full Text Available Staphylococcus aureus is a major human pathogen and a leading cause of nosocomial and community-acquired infections. Development of a vaccine against this pathogen is an important goal. While S. aureus protective antigens have been identified in the literature, the majority have only been tested in a single animal model of disease. We wished to evaluate the ability of one S. aureus vaccine antigen to protect in multiple mouse models, thus assessing whether protection in one model translates to protection in other models encompassing the full breadth of infections the pathogen can cause. We chose to focus on genetically inactivated alpha toxin mutant HlaH35L. We evaluated the protection afforded by this antigen in three models of infection using the same vaccine dose, regimen, route of immunization, adjuvant, and challenge strain. When mice were immunized with HlaH35L and challenged via a skin and soft tissue infection model, HlaH35L immunization led to a less severe infection and decreased S. aureus levels at the challenge site when compared to controls. Challenge of HlaH35L-immunized mice using a systemic infection model resulted in a limited, but statistically significant decrease in bacterial colonization as compared to that observed with control mice. In contrast, in a prosthetic implant model of chronic biofilm infection, there was no significant difference in bacterial levels when compared to controls. These results demonstrate that vaccines may confer protection against one form of S. aureus disease without conferring protection against other disease presentations and thus underscore a significant challenge in S. aureus vaccine development.

  1. Complement evasion by Staphylococcus aureus

    NARCIS (Netherlands)

    Jongerius, I.

    2010-01-01

    The complement system is the first line of defense against invading microorganisms. Activation of the complement system results in the coverage of bacteria with C3b, resulting in phagocytosis, and formation of C5a which is important for chemotaxis of neutrophils towards the site of infection. Staphy

  2. The molecular evolution of methicillin-resistant Staphylococcus aureus

    NARCIS (Netherlands)

    Deurenberg, R H; Vink, C; Kalenic, S; Friedrich, A W; Bruggeman, C A; Stobberingh, E E

    2007-01-01

    Staphylococcus aureus is a potentially pathogenic bacterium that causes a broad spectrum of diseases. S. aureus can adapt rapidly to the selective pressure of antibiotics, and this has resulted in the emergence and spread of methicillin-resistant S. aureus (MRSA). Resistance to methicillin and other

  3. 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...

  4. 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....

  5. Spacecraft surgical scrub system

    Science.gov (United States)

    Abbate, M.

    1980-01-01

    Ease of handling and control in zero gravity and minimizing the quantity of water required were prime considerations. The program tasks include the selection of biocidal agent from among the variety used for surgical scrub, formulation of a dispensing system, test, and delivery of flight dispensers. The choice of an iodophore was based on effectiveness on single applications, general familiarity among surgeons, and previous qualification for space use. The delivery system was a choice between the squeeze foamer system and impregnated polyurethane foam pads. The impregnated foam pad was recommended because it is a simpler system since the squeeze foamer requires some applicator to effectively clean the skin surfaces, whereas the form pad is the applicator and agent combined. Testing demonstrated that both systems are effective for use as surgical scrubs.

  6. Vitiligo- A surgical approach

    Directory of Open Access Journals (Sweden)

    Deepti Ghia

    2012-01-01

    Full Text Available Aims and objective- To describe the spectrum of surgical modalities for stable vitiligo patients Methods- Patients having stable vitiligo since past 2 years with no improvement with medical line of treatment were enrolled for surgery after informed consent. Depending upon the size and location of vitiligo patch different modalities were performed. Suction blister, mini-punch grafting, split thickness skin grafting, trypsinised melanocyte-keratinocyte transfer and non-trypsinised melanocyte- keratinocyte transfer (Jodhpur technique and follicular grafting technique have been described photographically which have been performed at a tertiary care hospital. Conclusion- Vitiligo is often difficult to treat, stable patches resistant to medical line of management do respond to surgical treatment; however it is very important to choose the modality of surgery according location of the patch, size of the lesion and available resources.

  7. Staphylococcus aureus entrance into the dairy chain: Tracking S. aureus from dairy cow to cheese

    Directory of Open Access Journals (Sweden)

    Judith Kümmel

    2016-10-01

    Full Text Available Staphylococcus aureus is one of the most important contagious mastitis pathogens in dairy cattle. Due to its zoonotic potential, control of S. aureus is not only of great economic importance in the dairy industry but also a significant public health concern. The aim of this study was to decipher the potential of bovine udder associated S. aureus as reservoir for S. aureus contamination in dairy production and processing. From 18 farms, delivering their milk to an alpine dairy plant for the production of smeared semi-hard and hard cheese. 1176 quarter milk (QM samples of all cows in lactation (n = 294 and representative samples form bulk tank milk (BTM of all farms were surveyed for coagulase positive (CPS and coagulase negative Staphylococci (CNS. Furthermore, samples from different steps of the cheese manufacturing process were tested for CPS and CNS. As revealed by chemometric-assisted FTIR spectroscopy and molecular subtyping (spa typing and multi locus sequence typing, dairy cattle represent indeed an important, yet underreported, entrance point of S. aureus into the dairy chain. Our data clearly show that certain S. aureus subtypes are present in primary production as well as in the cheese processing at the dairy plant. However, although a considerable diversity of S. aureus subtypes was observed in QM and BTM at the farms, only certain S. aureus subtypes were able to enter and persist in the cheese manufacturing at the dairy plant and could be isolated from cheese until day fourteen of ripening. Farm strains belonging to the FTIR cluster B1 and B3, which show genetic characteristics (t2953, ST8, enterotoxin profile: sea/sed/sej of the recently described S. aureus genotype B, most successfully contaminated the cheese production at the dairy plant. Thus our study fosters the hypothesis that genotype B S. aureus represent a specific challenge in control of S. aureus in the dairy chain that requires effective clearance strategies and hygienic

  8. Staphylococcus aureus Entrance into the Dairy Chain: Tracking S. aureus from Dairy Cow to Cheese

    Science.gov (United States)

    Kümmel, Judith; Stessl, Beatrix; Gonano, Monika; Walcher, Georg; Bereuter, Othmar; Fricker, Martina; Grunert, Tom; Wagner, Martin; Ehling-Schulz, Monika

    2016-01-01

    Staphylococcus aureus is one of the most important contagious mastitis pathogens in dairy cattle. Due to its zoonotic potential, control of S. aureus is not only of great economic importance in the dairy industry but also a significant public health concern. The aim of this study was to decipher the potential of bovine udder associated S. aureus as reservoir for S. aureus contamination in dairy production and processing. From 18 farms, delivering their milk to an alpine dairy plant for the production of smeared semi-hard and hard cheese. one thousand hundred seventy six one thousand hundred seventy six quarter milk (QM) samples of all cows in lactation (n = 294) and representative samples form bulk tank milk (BTM) of all farms were surveyed for coagulase positive (CPS) and coagulase negative Staphylococci (CNS). Furthermore, samples from different steps of the cheese manufacturing process were tested for CPS and CNS. As revealed by chemometric-assisted FTIR spectroscopy and molecular subtyping (spa typing and multi locus sequence typing), dairy cattle represent indeed an important, yet underreported, entrance point of S. aureus into the dairy chain. Our data clearly show that certain S. aureus subtypes are present in primary production as well as in the cheese processing at the dairy plant. However, although a considerable diversity of S. aureus subtypes was observed in QM and BTM at the farms, only certain S. aureus subtypes were able to enter and persist in the cheese manufacturing at the dairy plant and could be isolated from cheese until day 14 of ripening. Farm strains belonging to the FTIR cluster B1 and B3, which show genetic characteristics (t2953, ST8, enterotoxin profile: sea/sed/sej) of the recently described S. aureus genotype B, most successfully contaminated the cheese production at the dairy plant. Thus, our study fosters the hypothesis that genotype B S. aureus represent a specific challenge in control of S. aureus in the dairy chain that requires

  9. Hepatic surgical anatomy.

    Science.gov (United States)

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

    2004-04-01

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

  10. Meningitis causada por staphylococcus aureus catalasa negativa

    OpenAIRE

    Álvarez Moreno, Carlos Arturo; Arroyo A., Claudia Patricia; Rodríguez, Elizabeth; Martínez R., Luz Marina; Quevedo S., Ruth

    2011-01-01

    En un paciente con cáncer se aisló del liquido cefaloraquideo y ascitico un coco gram positivo coagulasa positivo. El germen aislado mostró las características típicas de un Staphylococcus aureus, a excepción de la actividad de la catalasa, la cual no pudo ser encontrada.

  11. Staphylococcus aureus spa type t437

    DEFF Research Database (Denmark)

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

    2015-01-01

    Methicillin-resistant Staphylococcus aureus (MRSA) belonging to the multilocus sequence type clonal complex 59 (MLST CC59) is the predominant community-associated MRSA clone in Asia. This clone, which is primarily linked with the spa type t437, has so far only been reported in low numbers among...

  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...

  13. Methicillin-resistant Staphylococcus aureus transmission

    DEFF Research Database (Denmark)

    Andersen, Leif Percival; Nielsen, Xiaohui

    2015-01-01

    INTRODUCTION: Even though methicillin-resistant Staphylococcus aureus (MRSA) is a common cause of nosocomial infections, it may often be difficult to evaluate the exact route of transmission. METHODS: In this study, we describe four cases of nosocomial transmission of MRSA in a hospital with a low...

  14. Profiling the surfacome of Staphylococcus aureus

    NARCIS (Netherlands)

    Dreisbach, Annette; Hempel, Kristina; Buist, Girbe; Hecker, Michael; Becher, Doerte; van Dijl, Jan Maarten

    2010-01-01

    Staphylococcus aureus is a widespread opportunistic pathogen that can cause a wide variety of life-threatening diseases. Especially for the colonization of human tissues and the development of invasiveness, surface-exposed proteins are of major importance. In the present studies, we optimized a prot

  15. 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.

  16. Surgical navigation with QR codes

    Directory of Open Access Journals (Sweden)

    Katanacho Manuel

    2016-09-01

    Full Text Available The presented work is an alternative to established measurement systems in surgical navigation. The system is based on camera based tracking of QR code markers. The application uses a single video camera, integrated in a surgical lamp, that captures the QR markers attached to surgical instruments and to the patient.

  17. Guideline implementation: Surgical attire.

    Science.gov (United States)

    Cowperthwaite, Liz; Holm, Rebecca L

    2015-02-01

    Surgical attire helps protect patients from microorganisms that may be shed from the hair and skin of perioperative personnel. The updated AORN "Guideline for surgical attire" provides guidance on scrub attire, shoes, head coverings, and masks worn in the semirestricted and restricted areas of the perioperative setting, as well as how to handle personal items (eg, jewelry, backpacks, cell phones) that may be taken into the perioperative suite. This article focuses on key points of the guideline to help perioperative personnel adhere to facility policies and regulatory requirements for attire. The key points address the potential benefits of wearing scrub attire made of antimicrobial fabric, covering the arms when in the restricted area of the surgical suite, removing or confining jewelry when wearing scrub attire, disinfecting personal items that will be taken into the perioperative suite, and sending reusable attire to a health care-accredited laundry facility after use. Perioperative RNs should review the complete guideline for additional information and for guidance when writing and updating policies and procedures.

  18. Louis Pasteur surgical revolution.

    Science.gov (United States)

    Toledo-Pereyra, Luis H

    2009-01-01

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

  19. Surgical education and the theoretical concept of communities of practice

    Directory of Open Access Journals (Sweden)

    Debra Nestel

    2014-01-01

    Full Text Available Surgical practice is largely learned in the workplace. Changes in health services and education provision have seen a shift from traditional apprenticeship-type learning to competency-based curricula with the workplace remaining the principal site for learning. Sociocultural learning theories offer valuable lenses through which to observe, design for, and analyze workplace-based learning. In this paper, we consider the theoretical concept of communities of practice in surgery. We describe notions of legitimate peripheral participation and development of professional identity. We highlight the benefits that communities of practice bring to surgical training, as well as the limitations. By understanding community of practice theory as applied to the surgical workplace and the factors that both drive and impede its development, surgical trainers may improve the learning environment, enhancing the attainment of competencies by surgical trainees.

  20. 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

  1. 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.

  2. Natural Honey to Eradicate Nasal Methicillin resistant Staphylococcus aureus (MRSA) A Randomised Control Trial

    OpenAIRE

    Poovelikunnel, Toney Thomas

    2016-01-01

    Methicillin-resistant Staphylococcus aureus (MRSA) is an endemic pathogen of public health concern in Ireland, as in many other health systems. For the nasal clearance of MRSA, the site that is often colonised in humans, the antibiotic mupirocin remains one of the most successful topical antibiotics to date. However, increasing bacterial resistance to mupirocin and limited effective alternate antibiotic options necessitate the need for unconventional approaches to eradicate nasal MRSA. Coloni...

  3. 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.

  4. 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.

  5. Staphylococcus aureus Shifts toward Commensalism in Response to Corynebacterium Species.

    Science.gov (United States)

    Ramsey, Matthew M; Freire, Marcelo O; Gabrilska, Rebecca A; Rumbaugh, Kendra P; Lemon, Katherine P

    2016-01-01

    Staphylococcus aureus-human interactions result in a continuum of outcomes from commensalism to pathogenesis. S. aureus is a clinically important pathogen that asymptomatically colonizes ~25% of humans as a member of the nostril and skin microbiota, where it resides with other bacteria including commensal Corynebacterium species. Commensal Corynebacterium spp. are also positively correlated with S. aureus in chronic polymicrobial diabetic foot infections, distinct from acute monomicrobial S. aureus infections. Recent work by our lab and others indicates that microbe-microbe interactions between S. aureus and human skin/nasal commensals, including Corynebacterium species, affect S. aureus behavior and fitness. Thus, we hypothesized that S. aureus interactions with Corynebacterium spp. diminish S. aureus virulence. We tested this by assaying for changes in S. aureus gene expression during in vitro mono- versus coculture with Corynebacterium striatum, a common skin and nasal commensal. We observed a broad shift in S. aureus gene transcription during in vitro growth with C. striatum, including increased transcription of genes known to exhibit increased expression during human nasal colonization and decreased transcription of virulence genes. S. aureus uses several regulatory pathways to transition between commensal and pathogenic states. One of these, the quorum signal accessory gene regulator (agr) system, was strongly inhibited in response to Corynebacterium spp. Phenotypically, S. aureus exposed to C. striatum exhibited increased adhesion to epithelial cells, reflecting a commensal state, and decreased hemolysin activity, reflecting an attenuation of virulence. Consistent with this, S. aureus displayed diminished fitness in experimental in vivo coinfection with C. striatum when compared to monoinfection. These data support a model in which S. aureus shifts from virulence toward a commensal state when exposed to commensal Corynebacterium species.

  6. 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.

  7. Diverticulitis: selective surgical management.

    Science.gov (United States)

    Rugtiv, G M

    1975-08-01

    The surgical treatment of complications of diverticulitis remains most challenging. A review of twenty years' experience with one hundred fifteen cases is presented with one proved anastomotic leak and no deaths. Interval primary resection with anastomosis for chronic recurrent disease including colovesical fistula and mesocolic abscess was proved sate with low morbidity. The three-stage procedure for perforated diverticulitis with spreading peritonitis or pericolic abscess was associated with a high rate of complications and morbidity. An aggressive approach with resection without anastomosis in two stages is indicated.

  8. 术前剃毛与非剃毛对术后切口感染影响的系统评价%Effects of shaving and no hair removal to prevent of postoperative surgical site infections: a systematic literature review

    Institute of Scientific and Technical Information of China (English)

    应燕萍; 邓甲秀; 黄惠桥; 黄琨

    2010-01-01

    目的 系统评价剃毛与非剃毛对减少术后切口感染率的影响.方法 计算机检索国内外电子文献数据库,根据纳入标准进行筛选,并进行质量的评价,采用专用软件进行统计分析.结果 共纳入17个RCT,13个研究(n=4 104)采取清洁与剃毛的方式备皮,分析结果显示,实验组与对照组对减少切口感染率的差异有统计学意义;1个研究(n=382)采取剪毛与剃毛的备皮方式对减少切口感染率的差异没有统计学意义;3个研究(n=370)采取清洁与剃毛的备皮方式比较备皮前后消毒前细菌阳性率的差异没有统计学意义.结论 研究结果表明,采取清洁备皮的方式对减少切口感染率要优于剃毛组,采取清洁不去毛的方式引起的感染率要低于剃毛方式;没有证据表明采取剪毛的方式较剃毛的方式对减少切口感染有效.%Objective To explore the effects of shaving and no hair removal to reduce surgical site infections (SSIs). Methods Retrieved domestic and international electronic literature databases by using computer. Randomized controlled triaks (RCTs) according to inclusion criteria were selected and evaluated. Special software was used to analyze data. Results There were seventeen RCTs and thirteen studies involving 4104 peoples concerned two methods of preoperative preparation of skin: shaving hair removal and only cleaning the surgical site. One trial involving 382 peoples showed that there was no difference in SSIs between shearing hair group and removing hair with a razor group. Furthermore, three trials involving 370 people compared the difference in the positive rate of culturing bacteria of surgical sit between the two methods:shaving hair removal, and cleaning the surgical site only. The result showed there was no statistically significant difference between two methods. Conclusions As for the methods of preoperative preparation of skin, in the SSIs, cleaning hair is superior to removing hair with a

  9. 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.

  10. Vigilância pós-alta das infecções de sítio cirúrgico em crianças e adolescentes em um hospital universitário de Belo Horizonte, Minas Gerais, Brasil Post-discharge surveillance of children and adolescents treated for surgical site infections at a university hospital in Belo Horizonte, Minas Gerais State, Brazil

    Directory of Open Access Journals (Sweden)

    Maria A. Martins

    2008-05-01

    Full Text Available As infecções hospitalares são as principais complicações na prática cirúrgica e, dentre estas, as infecções de sítio cirúrgico são as mais freqüentes. Apesar dessas infecções poderem se manifestar após a alta, no Brasil, a maioria dos serviços não faz vigilância pós-alta. Para avaliar a importância dessa vigilância e o perfil das infecções em crianças e adolescentes, acompanhou-se uma coorte de 730 pacientes cirúrgicos de um hospital universitário de Belo Horizonte, Minas Gerais, Brasil, de 1999 a 2001. Calculou-se a incidência acumulada, aplicou-se o teste t de Student na comparação de médias e o método de Kaplan-Meier na análise do tempo de ocorrência das infecções; considerou-se significativo o valor p Hospital infections are the main complications in surgical practice. Surgical site infections are the most frequent, and can manifest after hospital discharge. In Brazil, the majority of clinical services do not maintain infection surveillance after discharge. In order to evaluate the importance of such surveillance and the profile of these post-discharge infections, a cohort of 730 child and adolescent surgical patients was followed in a teaching hospital, from 1999 to 2001. The accumulated incidence was calculated. Student's t test was used to compare mean values and the Kaplan-Meier method to analyze the period until infection, using a p value of < 0.05. A total of 87 surgical site infections were diagnosed, 37% of which after discharge. The overall surgical infection rate was 11.9%; without outpatient follow-up, the rate would have been 7.5%. Post-charge infections were diagnosed after a mean of 11.3 ± 6.4 days, and in these patients the preoperative and postoperative hospital stays were significantly lower than in the group with in-hospital infections. The study indicates the importance of post-discharge surveillance in determining the real incidence of surgical site infections.

  11. Staphylococcus aureus shifts towards commensalism in response to Corynebacterium species

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    Matthew M Ramsey

    2016-08-01

    Full Text Available Staphylococcus aureus–human interactions result in a continuum of outcomes from commensalism to pathogenesis. S. aureus is a clinically important pathogen that asymptomatically colonizes ~25% of humans as a member of the nostril and skin microbiota, where it resides with other bacteria including commensal Corynebacterium species. Commensal Corynebacterium spp. are also positively correlated with S. aureus in chronic polymicrobial diabetic foot infections, distinct from acute monomicrobial S. aureus infections. Recent work by our lab and others indicates that microbe-microbe interactions between S. aureus and human skin/nasal commensals, including Corynebacterium species, affect S. aureus behavior and fitness. Thus, we hypothesized that S. aureus interactions with Corynebacterium spp. diminish S. aureus virulence. We tested this by assaying for changes in S. aureus gene expression during in vitro mono- versus coculture with Corynebacterium striatum, a common skin and nasal commensal. We observed a broad shift in S. aureus gene transcription during in vitro growth with C. striatum, including increased transcription of genes known to exhibit increased expression during human nasal colonization and decreased transcription of virulence genes. S. aureus uses several regulatory pathways to transition between commensal and pathogenic states. One of these, the quorum signal accessory gene regulator (agr system, was strongly inhibited in response to Corynebacterium spp. Phenotypically, S. aureus exposed to C. striatum exhibited increased adhesion to epithelial cells, reflecting a commensal state, and decreased hemolysin activity, reflecting an attenuation of virulence. Consistent with this, S. aureus displayed diminished fitness in experimental in vivo coinfection with C. striatum when compared to monoinfection. These data support a model in which S. aureus shifts from virulence towards a commensal state when exposed to commensal Corynebacterium species.

  12. An enhanced chemiluminescence resonance energy transfer aptasensor based on rolling circle amplification and WS2 nanosheet for Staphylococcus aureus detection.

    Science.gov (United States)

    Hao, Liling; Gu, Huajie; Duan, Nuo; Wu, Shijia; Ma, Xiaoyuan; Xia, Yu; Tao, Zui; Wang, Zhouping

    2017-03-22

    A chemiluminescence resonance energy transfer aptasensor was fabricated for the detection of Staphylococcus aureus (S. aureus) with Co(2+) enhanced N-(aminobutyl)-N-(ethylisoluminol) (ABEI) functional flowerlike gold nanoparticles (Co(2+)/ABEI-AuNFs) as donor and WS2 nanosheet as acceptor. In the presence of S. aureus, rolling circle amplification (RCA) can be started. Partially complementary sequence of RCA product functional ABEI-AuNFs (cDNA-ABEI-AuNFs) were then annealed to multiple sites of the RCA product to form duplex complex. This complex is less adsorbed onto the WS2 nanosheet, thus attenuating the quenching of ABEI-AuNFs chemiluminescence by WS2 nanosheet. In the absence of target S. aureus (and hence the absence of RCA and duplex formation), the free cDNA-ABEI-AuNFs is completely adsorbed onto the WS2 nanosheet and chemiluminescence quenching ensues. Under optimal conditions, the logarithmic correlation between the concentration of S. aureus and the CL signal was found to be linear within the range of 50 cfu/mL to 1.5 × 10(5) cfu/mL (R(2) = 0.9913). The limits of detection of the developed method were found to be 15 cfu/mL for S. aureus. The selectivity and the capability of the biosensor in meat samples were also studied. Therefore, this simple and easy operation method can be used to detect S. aureus with high sensitivity and specificity.

  13. Impact of sub-inhibitory antibiotics on fibronectin-mediated host cell adhesion and invasion by Staphylococcus aureus

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    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. Surgical videos online: a survey of prominent sources and future trends.

    Science.gov (United States)

    Dinscore, Amanda; Andres, Amy

    2010-01-01

    This article determines the extent of the online availability and quality of surgical videos for the educational benefit of the surgical community. A comprehensive survey was performed that compared a number of online sites providing surgical videos according to their content, production quality, authority, audience, navigability, and other features. Methods for evaluating video content are discussed as well as possible future directions and emerging trends. Surgical videos are a valuable tool for demonstrating and teaching surgical technique and, despite room for growth in this area, advances in streaming video technology have made providing and accessing these resources easier than ever before.

  15. Staphylococcus aureus complex from animals and humans in three remote African regions.

    Science.gov (United States)

    Schaumburg, Frieder; Pauly, Maude; Anoh, Etile; Mossoun, Arsene; Wiersma, Lidewij; Schubert, Grit; Flammen, Arnaud; Alabi, Abraham S; Muyembe-Tamfum, Jean-Jacques; Grobusch, Martin P; Karhemere, Stomy; Akoua-Koffi, Chantal; Couacy-Hymann, Emmanuel; Kremsner, Peter G; Mellmann, Alexander; Becker, Karsten; Leendertz, Fabian H; Peters, Georg

    2015-04-01

    Staphylococcus schweitzeri has been recently considered to be a highly divergent Staphylococcus aureus clade and usually colonises nonhuman primates and bats in sub-Saharan Africa. Its transmissibility to humans remains unclear. We therefore investigated the transmission of S. aureus and S. schweitzeri among humans, domestic animals, and wildlife in three remote African regions. A cross-sectional study on nasal and pharyngeal colonisation in humans (n = 1288) and animals (n = 698) was performed in Côte d'Ivoire, Gabon, and Democratic Republic of Congo (DR Congo). Isolates were subjected to spa typing and multilocus sequence typing. Antimicrobial susceptibility and selected virulence factors were tested. S. schweitzeri was found in monkeys from all study sites but no transmission to humans was evident, despite frequent contact of humans with wildlife. In contrast, human-associated S. aureus sequence types (ST1, ST6, ST15) were detected in domestic animals and nonhuman primates, pointing toward a human-to-monkey transmission in the wild. The proportion of methicillin-resistant S. aureus (MRSA) among all S. aureus was 0% (Gabon), 1.7% (DR Congo), and 5.3% (Côte d'Ivoire). The majority of MRSA isolates belonged to the African clone ST88. In conclusion, we did not find any evidence for a transmission of S. schweitzeri from animals to humans. However, such a transmission might remain possible due to the close phylogenetic relation of humans and nonhuman primates. The ST88-MRSA clone was widespread in Côte d'Ivoire but not in Gabon and DR Congo.

  16. Molecular basis for the role of Staphylococcus aureus penicillin binding protein 4 in antimicrobial resistance.

    Science.gov (United States)

    Navratna, Vikas; Nadig, Savitha; Sood, Varun; Prasad, K; Arakere, Gayathri; Gopal, B

    2010-01-01

    Penicillin binding proteins (PBPs) are membrane-associated proteins that catalyze the final step of murein biosynthesis. These proteins function as either transpeptidases or carboxypeptidases and in a few cases demonstrate transglycosylase activity. Both transpeptidase and carboxypeptidase activities of PBPs occur at the D-Ala-D-Ala terminus of a murein precursor containing a disaccharide pentapeptide comprising N-acetylglucosamine and N-acetyl-muramic acid-L-Ala-D-Glu-L-Lys-D-Ala-D-Ala. Beta-lactam antibiotics inhibit these enzymes by competing with the pentapeptide precursor for binding to the active site of the enzyme. Here we describe the crystal structure, biochemical characteristics, and expression profile of PBP4, a low-molecular-mass PBP from Staphylococcus aureus strain COL. The crystal structures of PBP4-antibiotic complexes reported here were determined by molecular replacement, using the atomic coordinates deposited by the New York Structural Genomics Consortium. While the pbp4 gene is not essential for the viability of S. aureus, the knockout phenotype of this gene is characterized by a marked reduction in cross-linked muropeptide and increased vancomycin resistance. Unlike other PBPs, we note that expression of PBP4 was not substantially altered under different experimental conditions, nor did it change across representative hospital- or community-associated strains of S. aureus that were examined. In vitro data on purified recombinant S. aureus PBP4 suggest that it is a beta-lactamase and is not trapped as an acyl intermediate with beta-lactam antibiotics. Put together, the expression analysis and biochemical features of PBP4 provide a framework for understanding the function of this protein in S. aureus and its role in antimicrobial resistance.

  17. Docking and PLS studies on a set of thiophenes RNA polymerase inhibitors against Staphylococcus aureus.

    Science.gov (United States)

    Scotti, Luciana; Oliveira Lima, Edeltrudes de; da Silva, Marcelo Sobral; Ishiki, Hamilton; Oliveira Lima, Igara de; Oliveira Pereira, Fillipe de; Mendonça Junior, Francisco Jaime Bezerra; Scotti, Marcus Tullius

    2014-01-01

    Staphylococcus aureus lives in commensalism with the majority of the population, being recognized as an important pathogen in patients with chronic liver diseases and can cause a deadly infection. The use of antibiotics as rifampin for the chemotherapy of infections caused by S. aureus has resulted in the selection of mutants with resistance. In an attempt to combat resistant strains new research is continuously conducted, as example searching new biological targets or new inhibitors such as tiophenes derivatives that can inhibit the RNA polymerase enzyme. This work investigated the set of tiophenes, selected from of literature and with RNA polymerase enzyme inhibitory activity of S. aureus. After seeking further information on existing scientific literature, the compounds under study were applied the methodologies of PLS, docking and calculation of Molecular Interaction Fields (MIFs) using Pentacle and VolSurf programmes. In addition, a comparison was made with two tiophenes synthesized in our laboratory and which have been tested against the bacteria. Docking studies showed that active compounds had more interactions with the amino acids on active site when compared with rifampicin. The best model obtained in PLS, considering two LVs (latent variables), after leave-one-outvalidation, exhibited the statistical parameters qcv(2) = 0.68 and r(2) = 0.85. External prediction model presented a rext(2) = 0.67. The obtained model through PLS analyses was able to predict the behavior of compounds synthesized by us. So we extract structural features important for the activity of these compounds. In this paper, first we discussed the topics: S. aureus, tiophenes, RNA polymerase, docking and QSAR methodologies. Then we have selected a series of 56 tiophenes from literature, which have their biological activity tested against the RNA polymerase enzyme of S. aureus. The compounds were subsequently carried out for Partial Least Squares (PLS) Analysis.

  18. Characterization of inosine monophosphate dehydrogenase from Staphylococcus aureus ATCC12600 and its involvement in biofilm formation

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    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.

  19. Evaluation of the in vitro activity of ceftobiprole against clinical isolates of Staphylococcus aureus

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    Carola Mauri

    2016-12-01

    Full Text Available Background and aims: Ceftobiprole is a new cephalosporin characterized by a potent activity against Gram-positive and Gram-negative bacterial pathogens. It is noting that ceftobiprole has a strong affinity for penicillin binding proteins including PBP 2A, which mediates resistance to beta-lactams in methicillin (oxacillin-resistant coagulase- negative staphylococci and Staphylococcus aureus (MRSA. The aim of the current study was to examine the antimicrobial activity of ceftobiprole against clinical isolates of S. aureus recently collected at our institution. Materials and methods: One hundred and forty blood isolates of S. aureus were evaluated, including methicillin-susceptible (MSSA, n=70 and MRSA (n=70 strains. Twenty additional MRSA isolates obtained from different sites (including skin and soft tissues, blood, and lower respiratory tract and characterized by borderline susceptibility to vancomycin were also studied to assess the ability of ceftobiprole to overcome this worrisome trait. MIC values of ceftobiprole were determined by Etest strips and results were interpreted according to EUCAST guidelines. Results and conclusions: Study isolates were consistently susceptible to ceftobiprole, with MIC values ranging from 0.125 mg/L to 2 mg/L. Overall, MIC50 and MIC90 were 0.25 mg/L and 0.5 mg/L, respectively. Ceftobiprole showed in vitro activity against all S. aureus isolates, with small differences among groups selected on the basis of resistance to methicillin and/or reduced susceptibility to vancomycin. Thus, ceftobiprole appears a valid choice for treating infections caused by S. aureus, even when susceptibility results are not yet available. Additionally, ceftobiprole may be a valid option in the case of reduced susceptibility to vancomycin.

  20. Update on control of Staphylococcus aureus and Streptococcus agalactiae for management of mastitis.

    Science.gov (United States)

    Keefe, Greg

    2012-07-01

    The primary method of spread for S agalactiae and S aureus is from cow to cow, so prevention focuses on within and between herd biosecurity to reduce or eliminate the reservoir of infection. S agalactiae is an obligate pathogen of the mammary gland, whereas S aureus is more widespread on other cow body sites and in the environment. Both organisms cause persistent infections, with S agalactiae typically causing higher SCC and bacteria counts in milk. Conventional methods of detection through culture perform well at the cow level. In bulk tanks, augmented procedures should be considered. PCR methods show promise of high sensitivity and specificity, at both the cow and bulk tank level. In developed dairy industries, prevalence of infection has decreased dramatically over the past 30 years for S agalactiae. For S aureus, the herd level of infection remains very high, although with rigorous, consistent application of control measures, within-herd prevalence has decreased. Because the milking time is the primary period for new IMI, it is the focal point of most prevention activities. Premilking and postmilking teat disinfection and proper stimulation and milk-out with adequately functioning equipment are key factors. There is growing evidence that the use of milking gloves is an integral part of contagious mastitis control and the production of high-quality milk. Treatment success is dramatically different between the 2 pathogens. For S agalactiae, eradication can be completed rapidly through a culture and treatment program with minimal culling. For S aureus, treatment success, particularly during lactation, is often disappointing and depends on cow, pathogen, and treatment factors. These factors should be reviewed prior to initiating any treatment to determine the potential for cure. Blanket dry cow therapy and strategic culling are important control procedures for contagious mastitis pathogens. Maintaining a closed herd or, at minimum, adhering to clearly defined

  1. Aspartate inhibits Staphylococcus aureus biofilm formation.

    Science.gov (United States)

    Yang, Hang; Wang, Mengyue; Yu, Junping; Wei, Hongping

    2015-04-01

    Biofilm formation renders Staphylococcus aureus highly resistant to conventional antibiotics and host defenses. Four D-amino acids (D-Leu, D-Met, D-Trp and D-Tyr) have been reported to be able to inhibit biofilm formation and disassemble established S. aureus biofilms. We report here for the first time that both D- and L-isoforms of aspartate (Asp) inhibited S. aureus biofilm formation on tissue culture plates. Similar biofilm inhibition effects were also observed against other staphylococcal strains, including S. saprophyticus, S. equorum, S. chromogenes and S. haemolyticus. It was found that Asp at high concentrations (>10 mM) inhibited the growth of planktonic N315 cells, but at subinhibitory concentrations decreased the cellular metabolic activity without influencing cell growth. The decreased cellular metabolic activity might be the reason for the production of less protein and DNA in the matrix of the biofilms formed in the presence of Asp. However, varied inhibition efficacies of Asp were observed for biofilms formed by clinical staphylococcal isolates. There might be mechanisms other than decreasing the metabolic activity, e.g. the biofilm phenotypes, affecting biofilm formation in the presence of Asp.

  2. Toxin-Antitoxin Systems of Staphylococcus aureus

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    Christopher F. Schuster

    2016-05-01

    Full Text Available Toxin-antitoxin (TA systems are small genetic elements found in the majority of prokaryotes. They encode toxin proteins that interfere with vital cellular functions and are counteracted by antitoxins. Dependent on the chemical nature of the antitoxins (protein or RNA and how they control the activity of the toxin, TA systems are currently divided into six different types. Genes comprising the TA types I, II and III have been identified in Staphylococcus aureus. MazF, the toxin of the mazEF locus is a sequence-specific RNase that cleaves a number of transcripts, including those encoding pathogenicity factors. Two yefM-yoeB paralogs represent two independent, but auto-regulated TA systems that give rise to ribosome-dependent RNases. In addition, omega/epsilon/zeta constitutes a tripartite TA system that supposedly plays a role in the stabilization of resistance factors. The SprA1/SprA1AS and SprF1/SprG1 systems are post-transcriptionally regulated by RNA antitoxins and encode small membrane damaging proteins. TA systems controlled by interaction between toxin protein and antitoxin RNA have been identified in S. aureus in silico, but not yet experimentally proven. A closer inspection of possible links between TA systems and S. aureus pathophysiology will reveal, if these genetic loci may represent druggable targets. The modification of a staphylococcal TA toxin to a cyclopeptide antibiotic highlights the potential of TA systems as rather untapped sources of drug discovery.

  3. Toxin-Antitoxin Systems of Staphylococcus aureus.

    Science.gov (United States)

    Schuster, Christopher F; Bertram, Ralph

    2016-05-05

    Toxin-antitoxin (TA) systems are small genetic elements found in the majority of prokaryotes. They encode toxin proteins that interfere with vital cellular functions and are counteracted by antitoxins. Dependent on the chemical nature of the antitoxins (protein or RNA) and how they control the activity of the toxin, TA systems are currently divided into six different types. Genes comprising the TA types I, II and III have been identified in Staphylococcus aureus. MazF, the toxin of the mazEF locus is a sequence-specific RNase that cleaves a number of transcripts, including those encoding pathogenicity factors. Two yefM-yoeB paralogs represent two independent, but auto-regulated TA systems that give rise to ribosome-dependent RNases. In addition, omega/epsilon/zeta constitutes a tripartite TA system that supposedly plays a role in the stabilization of resistance factors. The SprA1/SprA1AS and SprF1/SprG1 systems are post-transcriptionally regulated by RNA antitoxins and encode small membrane damaging proteins. TA systems controlled by interaction between toxin protein and antitoxin RNA have been identified in S. aureus in silico, but not yet experimentally proven. A closer inspection of possible links between TA systems and S. aureus pathophysiology will reveal, if these genetic loci may represent druggable targets. The modification of a staphylococcal TA toxin to a cyclopeptide antibiotic highlights the potential of TA systems as rather untapped sources of drug discovery.

  4. NVC-422 inactivates Staphylococcus aureus toxins.

    Science.gov (United States)

    Jekle, Andreas; Yoon, Jungjoo; Zuck, Meghan; Najafi, Ramin; Wang, Lu; Shiau, Timothy; Francavilla, Charles; Rani, Suriani Abdul; Eitzinger, Christian; Nagl, Markus; Anderson, Mark; Debabov, Dmitri

    2013-02-01

    Bacterial pathogens have specific virulence factors (e.g., toxins) that contribute significantly to the virulence and infectivity of microorganisms within the human hosts. Virulence factors are molecules expressed by pathogens that enable colonization, immunoevasion, and immunosuppression, obtaining nutrients from the host or gaining entry into host cells. They can cause pathogenesis by inhibiting or stimulating certain host functions. For example, in systemic Staphylococcus aureus infections, virulence factors such as toxic shock syndrome toxin 1 (TSST-1), staphylococcal enterotoxin A (SEA), and staphylococcal enterotoxin B (SEB) cause sepsis or toxic shock by uncontrolled stimulation of T lymphocytes and by triggering a cytokine storm. In vitro, these superantigens stimulate the proliferation of human peripheral blood mononuclear cells (PBMC) and the release of many cytokines. NVC-422 (N,N-dichloro-2,2-dimethyltaurine) is a broad-spectrum, fast-acting topical anti-infective agent against microbial pathogens, including antibiotic-resistant microbes. Using mass spectrometry, we demonstrate here that NVC-422 oxidizes methionine residues of TSST-1, SEA, SEB, and exfoliative toxin A (ETA). Exposure of virulence factors to 0.1% NVC-422 for 1 h prevented TSST-1-, SEA-, SEB-, and ETA-induced cell proliferation and cytokine release. Moreover, NVC-422 also delayed and reduced the protein A- and clumping factor-associated agglutination of S. aureus cultures. These results show that, in addition to its well-described direct microbicidal activity, NVC-422 can inactivate S. aureus virulence factors through rapid oxidation of methionines.

  5. Surgical scar revision: An overview

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    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.

  6. Empiric therapy for pneumonia in the surgical intensive care unit.

    Science.gov (United States)

    Fabian, T C

    2000-02-01

    Empiri c therapy of ventilator-associated pneumonia (VAP) in surgical patients should be based on intensive care unit (ICU)-specific surveillance data, because microbial flora patterns vary widely between geographic regions as well as within hospitals. Surgical ICUs have higher VAP rates than other units. Data from the National Nosocomial Infection Surveillance (NNIS) System report Pseudomonas aeruginosa and Staphylococcus aureus to be the most frequent isolates (each 17.4%). Data from the NNIS documents high resistance patterns in ICUs compared with hospitals at large, as well as unit-specific patterns. VAP risk factors for surgical patients include thoracoabdominal surgery, altered level of consciousness, advanced age, diabetes mellitus, malnutrition, chronic obstructive pulmonary disease, and prior antibiotic administration. Promising prevention strategies include restricting ventilator circuit changes, in-line heat moisture exchange filters, semi-recumbant positioning, and continuous subglottic aspiration. Pharmacodynamics should be considered when choosing antibiotic regimens. Postantibiotic effect and time-dependent versus concentration-dependent killing should be studied in clinical trials. Current guidelines for choosing regimens have been well developed by the American Thoracic Society.

  7. Clinical implementation of a scrubless chlorhexidine/ethanol pre-operative surgical hand rub.

    Science.gov (United States)

    Marchand, Richard; Theoret, Sylvie; Dion, Danielle; Pellerin, Michel

    2008-06-01

    The objective of surgical scrubbing is to reduce the bioburden on the hands of the surgical team in hope that if gloves are punctured or torn, the number of bacteria released at the operation site will be minimal and therefore reduce the risk of site infection. Long procedures with scrubbing and soaping can, however, be counterproductive because with repetition they tend to cause skin abrasions, damages and injuries without further reducing the risk of bacterial release. Within a general review of OR processes, it was decided to substitute to the standard surgical scrub a "new" scrubless pre-op surgical hand rub procedure. This article summarizes the results.

  8. Investigations of the pathogenesis of Staphylococcus aureus and Enterococcus faecalis in an experimental footpad infection model in broiler breeders

    DEFF Research Database (Denmark)

    Thoefner, Ida; Olsen, Rikke Heidemann; Poulsen, Louise Ladefoged

    2016-01-01

    in the central foot pad. Birds underwent full post mortem and bacteriological investigation 3, 7 and 14 days after infection. Inoculation of the S. aureus resulted in systemic lesions (sepsis, endocarditis and arthritis) as well as injection site abscesses. The lesions and bacterial re-isolation in the birds...... and heavy breeds as predisposing factors. Although the pathogenesis of these infections is not fully elucidated, the aetiology is often Gram positive cocci, such as Staphylococcus aureus and Enterococcus spp. It is hypothesized that footpad lesions serve as port of entry for systemic or localised bacterial...... receiving the S. aureus originating from bumble foot were restricted to the footpad only. Similar to the S. aureus the E. faecalis infected birds contracted both systemic and local lesions. Bacterial re-isolation was demonstrated in a pattern similar to the pathological findings. Both systemic and local...

  9. Intravital two-photon microscopy of host-pathogen interactions in a mouse model of Staphylococcus aureus skin abscess formation.

    Science.gov (United States)

    Liese, Jan; Rooijakkers, Suzan H M; van Strijp, Jos A G; Novick, Richard P; Dustin, Michael L

    2013-06-01

    Staphylococcus (S.) aureus is a frequent cause of severe skin infections. The ability to control the infection is largely dependent on the rapid recruitment of neutrophils (PMN). To gain more insight into the dynamics of PMN migration and host-pathogen interactions in vivo, we used intravital two-photon (2-P) microscopy to visualize S. aureus skin infections in the mouse. Reporter S. aureus strains expressing fluorescent proteins were developed, which allowed for detection of the bacteria in vivo. By employing LysM-EGFP mice to visualize PMN, we observed the rapid appearance of PMN in the extravascular space of the dermis and their directed movement towards the focus of infection, which led to the delineation of an abscess within 1 day. Moreover, tracking of transferred labelled bone-marrow neutrophils showed that PMN localization to the site of infection is dependent on the presence of G-protein-coupled receptors on the PMN, whereas Interleukin-1 receptor was required on host cells other than PMN. Furthermore, the S. aureus complement inhibitor Ecb could block PMN accumulation at thesite of infection. Our results establish that 2-P microscopy is a powerful tool to investigate the orchestration of the immune cells, S. aureus location and gene expression in vivo on a single cell level.

  10. SAMMD: Staphylococcus aureus Microarray Meta-Database

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    Elasri Mohamed O

    2007-10-01

    Full Text Available Abstract Background Staphylococcus aureus is an important human pathogen, causing a wide variety of diseases ranging from superficial skin infections to severe life threatening infections. S. aureus is one of the leading causes of nosocomial infections. Its ability to resist multiple antibiotics poses a growing public health problem. In order to understand the mechanism of pathogenesis of S. aureus, several global expression profiles have been developed. These transcriptional profiles included regulatory mutants of S. aureus and growth of wild type under different growth conditions. The abundance of these profiles has generated a large amount of data without a uniform annotation system to comprehensively examine them. We report the development of the Staphylococcus aureus Microarray meta-database (SAMMD which includes data from all the published transcriptional profiles. SAMMD is a web-accessible database that helps users to perform a variety of analysis against and within the existing transcriptional profiles. Description SAMMD is a relational database that uses MySQL as the back end and PHP/JavaScript/DHTML as the front end. The database is normalized and consists of five tables, which holds information about gene annotations, regulated gene lists, experimental details, references, and other details. SAMMD data is collected from the peer-reviewed published articles. Data extraction and conversion was done using perl scripts while data entry was done through phpMyAdmin tool. The database is accessible via a web interface that contains several features such as a simple search by ORF ID, gene name, gene product name, advanced search using gene lists, comparing among datasets, browsing, downloading, statistics, and help. The database is licensed under General Public License (GPL. Conclusion SAMMD is hosted and available at http://www.bioinformatics.org/sammd/. Currently there are over 9500 entries for regulated genes, from 67 microarray

  11. Bacillithiol: a key protective thiol in Staphylococcus aureus.

    Science.gov (United States)

    Perera, Varahenage R; Newton, Gerald L; Pogliano, Kit

    2015-01-01

    Bacillithiol is a low-molecular-weight thiol analogous to glutathione and is found in several Firmicutes, including Staphylococcus aureus. Since its discovery in 2009, bacillithiol has been a topic of interest because it has been found to contribute to resistance during oxidative stress and detoxification of electrophiles, such as the antibiotic fosfomycin, in S. aureus. The rapid increase in resistance of methicillin-resistant Staphylococcus aureus (MRSA) to available therapeutic agents is a great health concern, and many research efforts are focused on identifying new drugs and targets to combat this organism. This review describes the discovery of bacillithiol, studies that have elucidated the physiological roles of this molecule in S. aureus and other Bacilli, and the contribution of bacillithiol to S. aureus fitness during pathogenesis. Additionally, the bacillithiol biosynthesis pathway is evaluated as a novel drug target that can be utilized in combination with existing therapies to treat S. aureus infections.

  12. Risk of surgical site infection in patients undergoing orthopedic surgery Riesgo para infección de sitio quirúrgico en pacientes sometidos a cirugías ortopédicas Risco para infecção de sítio cirúrgico em pacientes submetidos a cirurgias ortopédicas

    Directory of Open Access Journals (Sweden)

    Flávia Falci Ercole

    2011-12-01

    Full Text Available This study aimed to identify risk factors associated with surgical site infections in orthopedic surgical patients at a public hospital in Minas Gerais, Brazil, between 2005 and 2007. A historical cohort of 3,543 patients submitted to orthopedic surgical procedures. A descriptive analysis was conducted and surgical site infection incidence rates were estimated. To verify the association between infection and risk factors, the Chi-square Test was used. The strength of association of the event with the independent variables was estimated using Relative Risk, with a 95% confidence interval and pEstudio para identificar factores de riesgo asociados a infecciones de sitio quirúrgico en pacientes quirúrgicos ortopédicos de un hospital público de Minas Gerais, Brasil, entre 2005 y 2007. Cohorte histórica de 3.543 pacientes sometidos a cirugías ortopédicas. Un análisis descriptivo fue realizado y la tasa de incidencia de infección fue estimada. Para verificar la asociación entre la infección y los factores de riesgo se usó el test chi-cuadrado. La fuerza de la asociación del evento con las variables independientes fue estimada por el Riesgo Relativo, con un intervalo de confianza de 95% y p Objetivou-se, neste estudo, identificar fatores de risco associados às infecções de sítio cirúrgico, em pacientes cirúrgicos ortopédicos, de um hospital público de Minas Gerais, Brasil, entre 2005 e 2007. Como método usou-se coorte histórica em 3.543 pacientes submetidos a cirurgias ortopédicas. Análise descritiva e taxa de incidência de infecção foram estimadas. Para verificar a associação entre a infecção e os fatores de risco usou-se o teste qui-quadrado. A força da associação do evento com as variáveis independentes foi estimada pelo risco relativo, intervalo de confiança de 95% e p<0,05. A incidência de infecção de sítio cirúrgico foi de 1,8%. Potencial de contaminação da ferida cirúrgica, condições clínicas do

  13. Tophi - surgical treatment.

    Science.gov (United States)

    Słowińska, Iwona; Słowiński, Radosław; Rutkowska-Sak, Lidia

    2016-01-01

    Gout is an inflammatory joint disease associated with deposition of monosodium urate crystals in the bones forming the joints, in periarticular tissues and in other organs. The disease is one of the most frequent causes of disability. This paper presents the case of a 57-year-old male patient treated for generalised gout. A "clinical mask" suggesting another disease was the cause of making the correct diagnosis only six years after the occurrence of the first manifestations. The patient, with high values of inflammatory markers, severe pain and advanced joint destruction, was given an aggressive anti-inflammatory treatment. The unsatisfactory effect of the conservative treatment forced the authors to perform surgical resection of the gouty nodules in the hands. After several operations the function of the hand joints operated on, appearance of the hands and the quality of the patient's life improved significantly.

  14. Tophi – surgical treatment

    Science.gov (United States)

    Słowińska, Iwona; Słowiński, Radosław

    2016-01-01

    Gout is an inflammatory joint disease associated with deposition of monosodium urate crystals in the bones forming the joints, in periarticular tissues and in other organs. The disease is one of the most frequent causes of disability. This paper presents the case of a 57-year-old male patient treated for generalised gout. A “clinical mask” suggesting another disease was the cause of making the correct diagnosis only six years after the occurrence of the first manifestations. The patient, with high values of inflammatory markers, severe pain and advanced joint destruction, was given an aggressive anti-inflammatory treatment. The unsatisfactory effect of the conservative treatment forced the authors to perform surgical resection of the gouty nodules in the hands. After several operations the function of the hand joints operated on, appearance of the hands and the quality of the patient’s life improved significantly. PMID:27994273

  15. Neuronavigation. Principles. Surgical technique.

    Science.gov (United States)

    Ivanov, Marcel; Ciurea, Alexandru Vlad

    2009-01-01

    Neuronavigation and stereotaxy are techniques designed to help neurosurgeons precisely localize different intracerebral pathological processes by using a set of preoperative images (CT, MRI, fMRI, PET, SPECT etc.). The development of computer assisted surgery was possible only after a significant technological progress, especially in the area of informatics and imagistics. The main indications of neuronavigation are represented by the targeting of small and deep intracerebral lesions and choosing the best way to treat them, in order to preserve the neurological function. Stereotaxis also allows lesioning or stimulation of basal ganglia for the treatment of movement disorders. These techniques can bring an important amount of confort both to the patient and to the neurosurgeon. Neuronavigation was introduced in Romania around 2003, in four neurosurgical centers. We present our five-years experience in neuronavigation and describe the main principles and surgical techniques.

  16. Novel high efficient coatings for anti-microbial surgical sutures using chlorhexidine in fatty acid slow-release carrier systems.

    Directory of Open Access Journals (Sweden)

    Andreas Obermeier

    Full Text Available Sutures can cause challenging surgical site infections, due to capillary effects resulting in bacteria permeating wounds. Anti-microbial sutures may avoid these complications by inhibiting bacterial pathogens. Recently, first triclosan-resistances were reported and therefore alternative substances are becoming clinically relevant. As triclosan alternative chlorhexidine, the "gold standard" in oral antiseptics was used. The aim of the study was to optimize novel slow release chlorhexidine coatings based on fatty acids in surgical sutures, to reach a high anti-microbial efficacy and simultaneously high biocompatibility. Sutures were coated with chlorhexidine laurate and chlorhexidine palmitate solutions leading to 11, 22 or 33 µg/cm drug concentration per length. Drug release profiles were determined in aqueous elutions. Antibacterial efficacy against Staphylococcus aureus was assessed in agar diffusion tests. Biocompatibility was evaluated via established cytotoxicity assay (WST-1. A commercially triclosan-containing suture (Vicryl Plus, was used as anti-microbial reference. All coated sutures fulfilled European Pharmacopoeia required tensile strength and proved continuous slow drug release over 96 hours without complete wash out of the coated drug. High anti-microbial efficacy for up to 5 days was observed. Regarding biocompatibility, sutures using 11 µg/cm drug content displayed acceptable cytotoxic levels according to ISO 10993-5. The highest potential for human application were shown by the 11 µg/cm chlorhexidine coated sutures with palmitic acid. These novel coated sutures might be alternatives to already established anti-microbial sutures such as Vicryl Plus in case of triclosan-resistance. Chlorhexidine is already an established oral antiseptic, safety and efficacy should be proven for clinical applications in anti-microbial sutures.

  17. Phagocytosis and Killing of Staphylococcus aureus by Human Neutrophils

    OpenAIRE

    Lu, Thea; Porter, Adeline R.; Kennedy, Adam D.; Kobayashi, Scott D.; Frank R DeLeo

    2014-01-01

    Neutrophils are essential for host defense against Staphylococcus aureus infections. Although significant progress has been made, our understanding of neutrophil interactions with S. aureus remains incomplete. To provide a more comprehensive view of this process, we investigated phagocytosis and killing of S. aureus by human neutrophils using varied assay conditions in vitro. A greater percentage of bacteria were internalized by adherent neutrophils compared to those in suspension, and unexpe...

  18. Epidemiology of Staphylococcus aureus harboring the mecA or Panton-Valentine leukocidin genes in hospitals in Java and Bali, Indonesia.

    Science.gov (United States)

    Santosaningsih, Dewi; Santoso, Sanarto; Budayanti, Nyoman S; Kuntaman, Kuntaman; Lestari, Endang S; Farida, Helmia; Hapsari, Rebriarina; Hadi, Purnomo; Winarto, Winarto; Milheiriço, Catarina; Maquelin, Kees; Willemse-Erix, Diana; van Belkum, Alex; Severin, Juliëtte A; Verbrugh, Henri A

    2014-04-01

    Data of Staphylococcus aureus carriage in Indonesian hospitals are scarce. Therefore, the epidemiology of S. aureus among surgery patients in three academic hospitals in Indonesia was studied. In total, 366 of 1,502 (24.4%) patients carried S. aureus. The methicillin-resistant S. aureus (MRSA) carriage rate was 4.3%, whereas 1.5% of the patients carried Panton-Valentine leukocidin (PVL)-positive methicillin-sensitive S. aureus (MSSA). Semarang and Malang city (odds ratio [OR] 9.4 and OR 9.0), being male (OR 2.4), hospitalization for more than 5 days (OR 11.708), and antibiotic therapy during hospitalization (OR 2.6) were independent determinants for MRSA carriage, whereas prior hospitalization (OR 2.5) was the only one risk factor for PVL-positive MSSA carriage. Typing of MRSA strains by Raman spectroscopy showed three large clusters assigned type 21, 24, and 38, all corresponding to ST239-MRSA-SCCmec type III. In conclusion, MRSA and PVL-positive MSSA are present among patients in surgical wards in Indonesian academic hospitals.

  19. Quercitrin, an Inhibitor of Sortase A, Interferes with the Adhesion of Staphylococcal aureus

    Directory of Open Access Journals (Sweden)

    Bingrun Liu

    2015-04-01

    Full Text Available Sortase A (SrtA is a cysteine transpeptidase of most Gram-positive bacteria that is responsible for the anchorage of many surface protein virulence factors to the cell wall layer. SrtA mutants are unable to display surface proteins and are defective in the establishment of infections without affecting microbial viability. In this study, we report that quercitrin (QEN, a natural compound that does not affect Staphylococcus aureus growth, can inhibit the catalytic activity of SrtA in fibrinogen (Fg cell-clumping and immobilized fibronectin (Fn adhesion assays. Molecular dynamics simulations and mutagenesis assays suggest that QEN binds to the binding sites of the SrtA G167A and V193A mutants. These findings indicate that QEN is a potential lead compound for the development of new anti-virulence agents against S. aureus infections.

  20. 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.

  1. Resistance in Staphylococcus Aureus: The Never-Ending Story

    Directory of Open Access Journals (Sweden)

    Orlović Jovan

    2016-09-01

    Full Text Available Combating Staphylococcus aureus (S. aureus infections using antibacterial drugs is actually an ongoing effort to overcome resistance mechanism of this microorganism. In this paper, we discussed (1 the mechanisms of resistance to some of the most commonly used antimicrobial agents in the treatment of S. aureus: methicillin, vancomicyn and quinolones. In addition, (2 efflux pump mechanisms involved in maintaining homeostasis in the presence of compounds that inhibit S. aureus growth and reproduction, as well as mechanisms of resistance to a number of antibiotics, have been reviewed.

  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...

  3. Phagocytosis and killing of Staphylococcus aureus by human neutrophils.

    Science.gov (United States)

    Lu, Thea; Porter, Adeline R; Kennedy, Adam D; Kobayashi, Scott D; DeLeo, Frank R

    2014-01-01

    Neutrophils are essential for host defense against Staphylococcus aureus infections. Although significant progress has been made, our understanding of neutrophil interactions with S. aureus remains incomplete. To provide a more comprehensive view of this process, we investigated phagocytosis and killing of S. aureus by human neutrophils using varied assay conditions in vitro. A greater percentage of bacteria were internalized by adherent neutrophils compared to those in suspension, and, unexpectedly, uptake of S. aureus by adherent neutrophils occurred efficiently in the absence of opsonins. An antibody specific for S. aureus promoted uptake of unopsonized bacteria in suspension, but had little or no capacity to enhance phagocytosis of S. aureus opsonized with normal human serum or by adherent neutrophils. Collectively, these results indicate that assay conditions can have a significant influence on the phagocytosis and killing of S. aureus by neutrophils. More importantly, the results suggest a vaccine approach directed to enhance opsonophagocytosis alone is not sufficient to promote increased killing of S. aureus by human neutrophils. With the emergence and reemergence of antibiotic-resistant microorganisms, establishing parameters that are optimal for studying neutrophil-S. aureus interactions will pave the way towards developing immune-directed strategies for anti-staphylococcal therapies.

  4. Effect of non-surgical periodontal treatment on the subgingival microbiota of patients with chronic kidney disease

    Directory of Open Access Journals (Sweden)

    Hilana Paula Carillo Artese

    2012-08-01

    Full Text Available This study investigated the effect of non-surgical periodontal therapy on the composition of subgingival microbiota of patients with chronic kidney disease (CKD. Sixteen CKD pre-dialysis individuals (CKD and 14 individuals without clinical evidence of kidney disease (C presenting chronic periodontitis were treated by scaling and root planing. Subgingival samples were collected from each patient and analyzed for their composition by checkerboard at baseline and 3 months post-therapy. Significant differences between groups at baseline were sought by the Mann-Whitney and χ² tests. Changes over time were examined by the Wilcoxon test. At baseline, the CKD group had significantly lower counts of E. faecalis compared to the C group (p < 0.05. After treatment, the levels of a greater number of species were reduced in the C group. Higher levels of A. israelii, C. rectus, F. periodonticum, P. micra, P. nigrescens, T. forsythia, N. mucosa, and S. anginosus (p < 0.05 were found in the CKD group compared to the C group. Also, non-responsive sites in CKD individuals harbored significantly higher levels of pathogenic species (T. forsythia, P. gingivalis, T. denticola, Fusobacterium spp., D. pneumosintes, E. faecalis and S. aureus; p < 0.05 than sites that responded to therapy, as well as non-responsive sites in the C group. The periodontitis-associated subgingival microbiota of CKD and systemically healthy individuals was similar in composition. However, high levels of pathogenic species persisted in the subgingival microbiota of patients with CKD after treatment.

  5. Surgical treatment of acquired tracheocele.

    Science.gov (United States)

    Porubsky, Edward A; Gourin, Christine G

    2006-06-01

    Acquired tracheoceles are rare clinical entities that can cause a variety of chronic and recurrent aerodigestive tract symptoms. The management of acquired tracheoceles is primarily conservative, but surgical intervention may be indicated for patients with refractory symptoms. We present a case of acquired tracheocele and describe a method of successful surgical management.

  6. 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

  7. Acquiring minimally invasive surgical skills

    NARCIS (Netherlands)

    Hiemstra, Ellen

    2012-01-01

    Many topics in surgical skills education have been implemented without a solid scientific basis. For that reason we have tried to find this scientific basis. We have focused on training and evaluation of minimally invasive surgical skills in a training setting and in practice in the operating room.

  8. Dissecting the role of ADAM10 as a mediator of Staphylococcus aureus α-toxin action.

    Science.gov (United States)

    von Hoven, Gisela; Rivas, Amable J; Neukirch, Claudia; Klein, Stefan; Hamm, Christian; Qin, Qianqian; Meyenburg, Martina; Füser, Sabine; Saftig, Paul; Hellmann, Nadja; Postina, Rolf; Husmann, Matthias

    2016-07-01

    Staphylococcus aureus is a leading cause of bacterial infections in humans, including life-threatening diseases such as pneumonia and sepsis. Its small membrane-pore-forming α-toxin is considered an important virulence factor. By destroying cell-cell contacts through cleavage of cadherins, the metalloproteinase ADAM10 (a disintegrin and metalloproteinase 10) critically contributes to α-toxin-dependent pathology of experimental S. aureus infections in mice. Moreover, ADAM10 was proposed to be a receptor for α-toxin. However, it is unclear whether the catalytic activity or specific domains of ADAM10 are involved in mediating binding and/or subsequent cytotoxicity of α-toxin. Also, it is not known how α-toxin triggers ADAM10's enzymatic activity, and whether ADAM10 is invariably required for all α-toxin action on cells. In the present study, we show that efficient cleavage of the ADAM10 substrate epithelial cadherin (E-cadherin) requires supra-cytotoxic concentrations of α-toxin, leading to significant increases in intracellular [Ca(2+)]; the fall in cellular ATP levels, typically following membrane perforation, became observable at far lower concentrations. Surprisingly, ADAM10 was dispensable for α-toxin-dependent xenophagic targeting of S. aureus, whereas a role for α-toxin attack on the plasma membrane was confirmed. The catalytic site of ADAM10, furin cleavage site, cysteine switch and intracellular domain of ADAM10 were not required for α-toxin binding and subsequent cytotoxicity. In contrast, an essential role for the disintegrin domain and the prodomain emerged. Thus, co-expression of the prodomain with prodomain-deficient ADAM10 reconstituted binding of α-toxin and susceptibility of ADAM10-deficient cells. The results of the present study may help to inform structural analyses of α-toxin-ADAM10 interactions and to design novel strategies to counteract S. aureus α-toxin action.

  9. Laparoendoscopic single-site partial nephrectomy using a novel Spider surgical platform in pigs%新型Spider单孔腹腔镜平台下猪肾部分切除术

    Institute of Scientific and Technical Information of China (English)

    杨波; 王辉清; Riccardo Autorino; 肖亮; 王林辉; 许传亮; Jihad H. Kaouk; 孙颖浩

    2011-01-01

    目的 在新型Spider单孔腹腔镜平台下进行猪肾部分切除术,评估新型Spider单孔腹腔镜平台的操作特点及人机工程学特性.方法 猪麻醉固定后切开2 cm长的皮肤切口,按Spider平台置入法建立通道.接气腹并置入5 mm观察镜,调整好角度后,固定在床边悬挂架上.按常规手术方式行肾脏部分切除术,其中肾脏缺损以2-0 V-loc带倒刺的可吸收缝线连续全层缝合.结果 成功完成猪左肾部分切除术2例,手术时间为100、102 min,肾脏温缺血23、28 min,出血20~50ml,开放肾动脉后肾实质无继发性出血.结论 Spider单孔腹腔镜平台下猪肾部分切除术安全可行,较好地解决了单孔腹腔镜“交叉操作”的难题,器械碰撞干扰明显减少.但仍存在诸多缺陷,尤其是依靠内鞘管带动的可弯器械无法提供足够的牵拉力量,使得术中视野显露不够满意.%Objective To use Spider system, a novel laparoendoscopic single-site (LESS) platform, for partial nephrectomy in pigs, so as to evaluate the feasibility and ergonomic features of the Spider system. Methods A 2 cm incision was made on the lateral border of the rectus muscle; the subcutaneous tissues and muscle layer were dissected bluntly by the Kelly clamp. With the outside sheath the Spider system was introduced into the peritoneal cavity. After establishment of pneumoperitoneum, a 5 mm scopy was introduced. The whole Spider platform was fixed using the suspension system on the bedside. The procedures of partial nephrectomy were performed according to the conventional steps. Renal reconstruction was done by the 2-0 V-loc barbed suture using the knotless closure technique. Results The procedure of partial nephrectomy was successfully performed in 2 cases, with the operation time being 100 and 102 min, the docking time being 7 and 11 min, and the time periods of warm ischemia being 23 and 28 min. The V-loc barbed suture was used to close the defect of kidney without

  10. Directed peer review in surgical pathology.

    Science.gov (United States)

    Smith, Maxwell L; Raab, Stephen S

    2012-09-01

    Second pathologist peer review is used in many surgical laboratory quality-assurance programs to detect error. Directed peer review is 1 method of second review and involves the selection of specific case types, such as cases from a particular site of anatomic origin. The benefits of using the directed peer review method are unique and directed peer review detects both errors in diagnostic accuracy and precision and this detection may be used to improve practice. We utilize the Lean quality improvement A3 method of problem solving to investigate these issues. The A3 method defines surgical pathology diagnostic error and describes the current state in surgical pathology, performs root cause analysis, hypothesizes an ideal state, and provides opportunities for improvement in error reduction. Published data indicate that directed peer review practices may be used to prevent active cognitive errors that lead to patient harm. Pathologists also may use directed peer review data to target latent factors that contribute to error and improve diagnostic precision.

  11. 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

  12. Diabetic foot infections: stepwise medical and surgical management.

    Science.gov (United States)

    Armstrong, David G; Lipsky, Benjamin A

    2004-06-01

    Foot complications are common among diabetic patients; foot ulcers are among the more serious consequences. These ulcers frequently become infected, with potentially disastrous progression to deeper spaces and tissues. If not treated promptly and appropriately, diabetic foot infections can become incurable or even lead to septic gangrene, which may require foot amputation. Diagnosing infection in a diabetic foot ulcer is based on clinical signs and symptoms of inflammation. Properly culturing an infected lesion can disclose the pathogens and provide their antibiotic susceptibilities. Specimens for culture should be obtained after wound debridement to avoid contamination and optimise identification of pathogens. Staphylococcus aureus is the most common isolate in these infections; the increasing incidence of methicillin-resistant S. aureus over the past two decades has further complicated antibiotic treatment. While chronic infections are often polymicrobial, many acute infections in patients not previously treated with antibiotics are caused by a single pathogen, usually a gram-positive coccus. We offer a stepwise approach to treating diabetic foot infections. Most patients must first be medically stabilised and any metabolic aberrations should be addressed. Antibiotic therapy is not required for uninfected wounds but should be carefully selected for all infected lesions. Initial therapy is usually empirical but may be modified according to the culture and sensitivity results and the patient's clinical response. Surgical intervention is usually required in cases of retained purulence or advancing infection despite optimal medical therapy. Possible additional indications for surgical procedures include incision and drainage of an abscess, debridement of necrotic material, removal of any foreign bodies, arterial revascularisation and, when needed, amputation. Most foot ulcers occur on the plantar surface of the foot, thus requiring a plantar incision for any drainage

  13. 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.

  14. Curcumin Reverse Methicillin Resistance in Staphylococcus aureus

    Directory of Open Access Journals (Sweden)

    Su-Hyun Mun

    2014-11-01

    Full Text Available 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 action of curcumin was analyzed by the viability assay in the presence of detergents, ATPase inhibitors and peptidoglycan (PGN from S. aureus, and the PBP2a protein level was analyzed by western blotting. The morphological changes in the curcumin-treated MRSA strains were investigated by transmission electron microscopy (TEM. We analyzed increased susceptibility to MRSA isolates in the presence of curcumin. The optical densities at 600 nm (OD600 of the suspensions treated with the combinations of curcumin with triton X-100 and Tris were reduced to 63% and 59%, respectively, compared to curcumin without treatment. N,N'-dicyclohexylcarbodiimide (DCCD and sodium azide (NaN3 were reduced to 94% and 55%, respectively. When peptidoglycan (PGN from S. aureus was combined with curcumin, PGN (0–125 μg/mL gradually blocked the antibacterial activity of curcumin (125 μg/mL; however, at a concentration of 125 µg/mL PGN, it did not completely block curcumin. Curcumin has a significant effect on the protein level of PBP2a. The TEM images of MRSA showed damage of the cell wall, disruption of the cytoplasmic contents, broken cell membrane and cell lysis after the treatment of curcumin. These data indicate a remarkable antibacterial effect of curcumin, with membrane permeability enhancers and ATPase inhibitors, and curcumin did not directly bind to PGN on the cell wall. Further, the antimicrobial action of curcumin involved in the PBP2a-mediated resistance mechanism was

  15. Staphylococcus aureus reservoirs during traditional Austrian raw milk cheese production.

    Science.gov (United States)

    Walcher, Georg; Gonano, Monika; Kümmel, Judith; Barker, Gary C; Lebl, Karin; Bereuter, Othmar; Ehling-Schulz, Monika; Wagner, Martin; Stessl, Beatrix

    2014-11-01

    Sampling approaches following the dairy chain, including microbiological hygiene status of critical processing steps and physicochemical parameters, contribute to our understanding of how Staphylococcus aureus contamination risks can be minimised. Such a sampling approach was adopted in this study, together with rapid culture-independent quantification of Staph. aureus to supplement standard microbiological methods. A regional cheese production chain, involving 18 farms, was sampled on two separate occasions. Overall, 51·4% of bulk milk samples were found to be Staph. aureus positive, most of them (34·3%) at the limit of culture-based detection. Staph. aureus positive samples >100 cfu/ml were recorded in 17·1% of bulk milk samples collected mainly during the sampling in November. A higher number of Staph. aureus positive bulk milk samples (94·3%) were detected after applying the culture-independent approach. A concentration effect of Staph. aureus was observed during curd processing. Staph. aureus were not consistently detectable with cultural methods during the late ripening phase, but >100 Staph. aureus cell equivalents (CE)/ml or g were quantifiable by the culture-independent approach until the end of ripening. Enterotoxin gene PCR and pulsed-field gel electrophoresis (PFGE) typing provided evidence that livestock adapted strains of Staph. aureus mostly dominate the post processing level and substantiates the belief that animal hygiene plays a pivotal role in minimising the risk of Staph. aureus associated contamination in cheese making. Therefore, the actual data strongly support the need for additional sampling activities and recording of physicochemical parameters during semi-hard cheese-making and cheese ripening, to estimate the risk of Staph. aureus contamination before consumption.

  16. Surgical infection in art.

    Science.gov (United States)

    Meakins, J L

    1996-12-01

    The earliest images of medicine and surgery in Western art are from the late Middle Ages. Although often attractive, at that time they were illustrative and mirrored the text on how to diagnose or treat a specific condition. These drawings in medieval manuscripts represent management of abscesses, perianal infection and fistulas, amputation, and wound dressings. With the Renaissance, art in all its forms flourished, and surgeons were represented at work draining carbuncles, infected bursae, and mastoiditis; managing ulcers, scrofula, and skin infections; and performing amputations. Specific diagnosis can be made, such as streptococcal infection in the discarded leg of the miraculous transplantation performed by Saints Cosmas and Damian and in the works of Rembrandt van Rijn and Frederic Bazille. Evocations of cytokine activity are evident in works by Albrecht Dürer, Edvard Munch, and James Tissot. The iconography of society's view of a surgeon is apparent and often not complimentary. The surgeon's art is a visual art. Astute observation leads to early diagnosis and better results in surgical infection and the septic state. Learning to see what we look at enhances our appreciation of the world around us but, quite specifically, makes us better clinicians.

  17. Methicillin-resistant Staphylococcus aureus laryngitis.

    Science.gov (United States)

    Liakos, Tracey; Kaye, Keith; Rubin, Adam D

    2010-09-01

    Infections due to methicillin-resistant Staphylococcus aureus (MRSA) have become more prevalent, in part because of the emergence and spread of community-acquired MRSA. This trend is particularly concerning because of the significant rates of morbidity and mortality associated with MRSA infections, and because MRSA strains are often resistant to many classes of antibiotics. Reports of infections of the head and neck, including wound infections, cellulitis, sinusitis, otitis media, and otitis externa, are well documented. However, to our knowledge, there have been no reports of bacterial laryngitis due to MRSA. We report the first published case of bacterial laryngitis caused by MRSA.

  18. Resistencia antimicrobiana de cepas de Staphylococcus aureus, Costa Rica Antimicrobial resistance of Staphylococcus aureus, Costa Rica

    Directory of Open Access Journals (Sweden)

    Víctor Hugo Alvarado

    2011-12-01

    Full Text Available Objetivo: Determinar y comparar los perfiles de resistencia de cepas de S. aureus aisladas de quesos, producidos en la Zona Sur de Costa Rica y de un centro hospitalario de la misma región. Materiales y Métodos: Se analizaron 35 muestras de queso fresco, adquiridas durante los meses de setiembre y octubre del 2010 en la zona de San Vito de Coto Brus. A cada muestra se le realizaron recuentos de coliformes totales, coliformes fecales y Staphylococcus aureus. Adicionalmente se analizó presencia/ausencia de Listeria monocytogenes en 25 gramos del producto. A las cepas identificadas como S. aureus se les realizó la prueba de sensibilidad a los antibióticos mediante el sistema automatizado Vitek y la interpretación de los datos se realizó siguiendo las pautas del Clinical and Laboratory Standards Institute antimicrobial susceptibility testing 2011. Adicional a esto se recolectaron datos acerca de la sensibilidad de las cepas de S. aureus aisladas e identificadas en el Hospital de San Vito de Coto Brus en el mismo período. Resultados: El promedio obtenido para el recuento de coliformes totales fue de 9,7 X 10(6 UFC/g, para coliformes fecales de 6,7 X 10(5 y para S. aureus de 2,8 X 10(5 UFC/g, obteniéndose un 83 % de muestras positivas por esta bacteria. En cuanto a la resistencia antimicrobiana, se obtuvieron porcentajes de resistencia mayores en las cepas de origen clínico. Se encontró también que 23 de las cepas (96% provenientes de muestras clínicas, presentaban resistencia a más de un antibiótico, mientras que siete de las obtenidas a partir de queso (27% presentaban esta característica. Con respecto a los betalactamicos (ampicilina, oxacilina y penicilina se observó la existencia de una diferencia estadísticamente significativa (pObjective: determined and compared the resistance patters of S. aureus strains isolated from cheese produced in the southern zone of Costa Rica and from clinical samples isolated at the hospital center

  19. A Comparison of Betadine, Sterillium and Silver Nanocolloid Immediate Effect on Surgical Hand Antiseptic

    OpenAIRE

    Seyyed Mostafa Shiryazdi; Mohaddeseh Aboueian-Jahromi; Hajieih-Fatemeh Mollahoseini; Khadijeh Amrollahi; Hamid Reza paydar; Hasan Barzegar Bafrouei

    2014-01-01

    Background and Aim: To reduce surgical site infections and its complications, hand antiseptic is performed on the basis of product type either by rubbing or washing method. Silver Nanocolloid is a wide range disinfectant entered in world and also Iran markets as a surgical hand antiseptic, but any study about this subject hasn’t yet conducted. The aim of this study is comparing of Betadine, Sterillium and Silver Nanocolloid immediate effect on surgical hand antiseptic. Materials and Method...

  20. The effects of high perioperative inspiratory oxygen fraction for adult surgical patients

    DEFF Research Database (Denmark)

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

    2015-01-01

    -analyses have led to different conclusions on whether a high fraction of supplemental inspired oxygen during anaesthesia may decrease or increase mortality and surgical site infections in surgical patients. OBJECTIVES: To assess the benefits and harms of an FIO2 equal to or greater than 60% compared...... with a control FIO2 at or below 40% in the perioperative setting in terms of mortality, surgical site infection, respiratory insufficiency, serious adverse events and length of stay during the index admission for adult surgical patients.We looked at various outcomes, conducted subgroup and sensitivity analyses......BACKGROUND: Available evidence on the effects of a high fraction of inspired oxygen (FIO2) of 60% to 90% compared with a routine fraction of inspired oxygen of 30% to 40%, during anaesthesia and surgery, on mortality and surgical site infection has been inconclusive. Previous trials and meta...

  1. 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.

  2. 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.

  3. The changing epidemiology of Staphylococcus aureus bloodstream infection

    DEFF Research Database (Denmark)

    Laupland, K B; Lyytikäinen, O; Søgaard, M;

    2012-01-01

    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...

  4. Daya Hambat Ekstrak Aloe Vera terhadap pertumbuhan Staphylococcus Aureus

    OpenAIRE

    Rahmat, drg.Sp,Pros

    2011-01-01

    Dari hasil penelitian , maka dapat disimpulkan bahwa ekstrak Aloe Vera dapat menghambat pertumbuhan bakteri Stafhylococcus aureus, dan kadar hambat minimal ekstrak Aloe Vera adalah pada konsentrasi 25%. Tujuan Penelitan Ini adalah untuk mengetahui efektifitas ekstrak Aloe vera dalam menghambat pertumbuhan bakteri Stafhylococcus aureus dan daya hambat menimal, (DHM) terhadap pertumbuhan bakteri tersebut. Metode yang digunakan adalah pertumbuhan ekstrak Aloe vera, penegnceran ekstrak , pemur...

  5. Pneumonia and new methicillin-resistant Staphylococcus aureus clone.

    NARCIS (Netherlands)

    Garnier, Fabien; Tristan, Anne; François, Bruno; Etienne, Jerome; Delage-Corre, Manuella; Martin, Christian; Liassine, Nadia; Wannet, Wim; Denis, François; Ploy, Marie-Cécile

    2006-01-01

    Necrotizing pneumonia caused by Staphylococcus aureus strains carrying the Panton-Valentin leukocidin gene is a newly described disease entity. We report a new fatal case of necrotizing pneumonia. An S. aureus strain with an agr1 allele and of a new sequence type 377 was recovered, representing a ne

  6. Intracellular Staphylococcus aureus : live-in and let die

    NARCIS (Netherlands)

    Fraunholz, Martin; Sinha, Bhanu

    2012-01-01

    Staphylococcus aureus uses a plethora of virulence factors to accommodate a diversity of niches in its human host. Aside from the classical manifestations of S. aureus-induced diseases, the pathogen also invades and survives within mammalian host cells. The survival strategies of the pathogen are as

  7. Retained surgical sponge: An enigma

    Directory of Open Access Journals (Sweden)

    Gurjit Singh

    2013-01-01

    Full Text Available Retained surgical sponge in the body following a surgery is called "gossypiboma". A 27-year-old female who had undergone lower segment cesarean section 4 months earlier was admitted with complaints of pain abdomen with a palpable mass in left iliac fossa. X-ray, ultrasonography, and CT scan findings were suggestive of retained surgical sponge. Surgical sponge was removed following laparotomy. Surgeons must be aware of the risk factors that lead to gossypiboma, and measures should be taken to prevent it. Besides increasing morbidity and possible mortality, it may result in libel suit for compensation.

  8. Surgical treatment of pediatric rhinosinusitis.

    Science.gov (United States)

    Isaacson, G

    2015-08-01

    Pediatric rhinosinusitis is a common sequela of upper respiratory infections in children. It is usually a self-limited disease, sometimes requiring antibiotic therapy. Surgery may be indicated in children who suffer complication of acute rhinosinusitis, severe recurrent acute rhinosinusitis, rhinosinusitis in cystic fibrosis with or without polyposis, chronic rhinosinusitis refractory to maximal medical management, allergic fungal sinusitis, and paranasal sinus mucoceles. Surgical options include, adenoidectomy, sinus puncture and lavage, open surgical approaches, endoscopic sinus surgery, balloon sinuplasty, and turbinectomy or turbinate reduction. This paper reviews the anatomy and physiology of rhinosinusitis in children and current knowledge of the indications and best methods of surgical treatment.

  9. Towards Safe Robotic Surgical Systems

    DEFF Research Database (Denmark)

    Sloth, Christoffer; Wisniewski, Rafael

    2015-01-01

    A proof of safety is paramount for an autonomous robotic surgical system to ensure that it does not cause trauma to patients. However, a proof of safety is rarely constructed, as surgical systems are too complex to be dealt with by most formal verification methods. In this paper, we design...... a controller for motion compensation in beating-heart surgery, and prove that it is safe, i.e., the surgical tool is kept within an allowable distance and orientation of the heart. We solve the problem by simultaneously finding a control law and a barrier function. The motion compensation system is simulated...

  10. Surgical Skills Beyond Scientific Management

    Science.gov (United States)

    Whitfield, Nicholas

    2015-01-01

    During the Great War, the French surgeon Alexis Carrel, in collaboration with the English chemist Henry Dakin, devised an antiseptic treatment for infected wounds. This paper focuses on Carrel’s attempt to standardise knowledge of infected wounds and their treatment, and looks closely at the vision of surgical skill he espoused and its difference from those associated with the doctrines of scientific management. Examining contemporary claims that the Carrel–Dakin method increased rather than diminished demands on surgical work, this paper further shows how debates about antiseptic wound treatment opened up a critical space for considering the nature of skill as a vital dynamic in surgical innovation and practice. PMID:26090737

  11. Surgical education through video broadcasting.

    Science.gov (United States)

    Nagengast, Eric S; Ramos, Margarita S; Sarma, Hiteswar; Deshpande, Gaurav; Hatcher, Kristin; Magee, William P; Campbell, Alex

    2014-09-01

    Surgical training is facing new obstacles. As advancements in medicine are made, surgeons are expected to know more and to be able to perform more procedures. In the western world, increasing restrictions on residency work hours are adding a new hurdle to surgical training. In low-resource settings, a low attending-to-resident ratio results in limited operative experience for residents. Advances in telemedicine may offer new methods for surgical training. In this article, the authors share their unique experience using live video broadcasting of surgery for educational purposes at a comprehensive cleft care center in Guwahati, India.

  12. Survival of Staphylococcus aureus on fomites.

    Science.gov (United States)

    Cuesta, Alicia; Nastri, Natalia; Bernat, Maria; Brusca, Maria; Turcot, Liliana; Nastri, Maria; Rosa, Alcira C

    2008-01-01

    The aim of this study was to evaluate duration of survival of Staphylococcus aureus on contaminated standardized fomites, such as sterilization paper (SP) and polyester previously sterilized in a steam autoclave, and to determine the potential inhibitory effects of the substrates (fabrics used to manufacture garments and special wrapping paper used in the dental setting) using the bacteriostasis test. The test was performed on two types of sterile standardized samples (T1 and T2). Sterility of the samples was validated following the protocol in use at the Department of Microbiology, after which the samples were inoculated with 50 microl of a calibrated suspension of Staphylococcus aureus (reference strain ATCC 25923) in the exponential growth phase, in a final concentration of 10(7) cfu/ml and 10(6) cfu/ml). The samples were incubated at 27 degrees C and survival and concentration of microorganisms attached to the surface of the substrates was determined at the following experimental time points: immediately post-contamination, and 3 hours, 24 hours, 3 days, and 7 days post-contamination. Recovery was determined and expressed as a percentage; the bacteriostasis test was performed and showed negative results. Our results suggest that the quantity of recovered microorganisms varies according to the type of substrate and that there is a relation between survival and incubation time of the inoculated substrate serving as an artificial niche.

  13. CD36 Is Essential for Regulation of the Host Innate Response to Staphylococcus aureus α-Toxin-Mediated Dermonecrosis.

    Science.gov (United States)

    Castleman, Moriah J; Febbraio, Maria; Hall, Pamela R

    2015-09-01

    Staphylococcus aureus is the primary cause of skin and skin structure infections (SSSIs) in the United States. α-Hemolysin (Hla), a pore-forming toxin secreted by S. aureus and a major contributor to tissue necrosis, prompts recruitment of neutrophils critical for host defense against S. aureus infections. However, the failure to clear apoptotic neutrophils can result in damage to host tissues, suggesting that mechanisms of neutrophil clearance are essential to limiting Hla-mediated dermonecrosis. We hypothesized that CD36, a scavenger receptor which facilitates recognition of apoptosing cells, would play a significant role in regulating Hla-mediated inflammation and tissue injury during S. aureus SSSI. In this study, we show that CD36 on macrophages negatively regulates dermonecrosis caused by Hla-producing S. aureus. This regulation is independent of bacterial burden, as CD36 also limits dermonecrosis caused by intoxication with sterile bacterial supernatant or purified Hla. Dermonecrotic lesions of supernatant intoxicated CD36(-/-) mice are significantly larger, with increased neutrophil accumulation and IL-1β expression, compared with CD36(+/+) (wild-type) mice. Neutrophil depletion of CD36(-/-) mice prevents this phenotype, demonstrating the contribution of neutrophils to tissue injury in this model. Furthermore, administration of CD36(+/+) but not CD36(-/-) macrophages near the site of intoxication reduces dermonecrosis, IL-1β production and neutrophil accumulation to levels seen in wild-type mice. This therapeutic effect is reversed by inhibiting actin polymerization in the CD36(+/+) macrophages, supporting a mechanism of action whereby CD36-dependent macrophage phagocytosis of apoptotic neutrophils regulates Hla-mediated dermonecrosis. Taken together, these data demonstrate that CD36 is essential for controlling the host innate response to S. aureus skin infection.

  14. 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

  15. Antimicrobial drug resistance ofStaphylococcus aureus in dairy products

    Institute of Scientific and Technical Information of China (English)

    Sasidharan S; Prema B; Yoga Latha L

    2011-01-01

    Objective:To evaluate the prevalence of multidrug resistantStaphylococcus aureus(S. aureus) in dairy products.Methods:Isolation and identification ofS. aureus were performed in3 dairy-based food products. The isolates were tested for their susceptibility to5 different common antimicrobial drugs.Results:Of50 samples examined,5 (10%) were contaminated with S. aureus. Subsequently, the5 isolates were subjected to antimicrobial resistance pattern using five antibiotic discs (methicillin, vancomycin, kanamycin, chloramphenicol and tetracycline). Sample 29 showed resistance to methicillin and vancomycin. Sample18 showed intermediate response to tetracycline. The other samples were susceptible to all the antibiotics tested.Conclusions:The results provide preliminary data on sources of food contamination which may act as vehicles for the transmission of antimicrobial-resistantStaphylococcus.Therefore, it enables us to develop preventive strategies to avoid the emergence of new strains of resistantS. aureus.

  16. Quantitation of Staphylococcus aureus in seawater using CHROMagar SA.

    Science.gov (United States)

    Tice, Alan D; Pombo, David; Hui, Jennifer; Kurano, Michelle; Bankowski, Matthew J; Seifried, Steven E

    2010-01-01

    A microbiological algorithm has been developed to analyze beach water samples for the determination of viable colony forming units (CFU) of Staphylococcus aureus (S. aureus). Membrane filtration enumeration of S. aureus from recreational beach waters using the chromogenic media CHROMagar SA alone yields a positive predictive value (PPV) of 70%. Presumptive CHROMagar SA colonies were confirmed as S. aureus by 24-hour tube coagulase test. Combined, these two tests yield a PPV of 100%. This algorithm enables accurate quantitation of S. aureus in seawater in 72 hours and could support risk-prediction processes for recreational waters. A more rapid protocol, utilizing a 4-hour tube coagulase confirmatory test, enables a 48-hour turnaround time with a modest false negative rate of less than 10%.

  17. Specificity for human hemoglobin enhances Staphylococcus aureus infection

    Science.gov (United States)

    Pishchany, Gleb; McCoy, Amanda L.; Torres, Victor J.; Krause, Jens C.; Crowe, James E.; Fabry, Mary E.; Skaar, Eric P.

    2010-01-01

    SUMMARY Iron is required for bacterial proliferation and Staphylococcus aureus steals this metal from host hemoglobin during invasive infections. This process involves hemoglobin binding to the cell wall of S. aureus, heme extraction, passage through the cell envelope, and degradation to release free iron. Herein we demonstrate an enhanced ability of S. aureus to bind hemoglobin derived from humans as compared to other mammals. Increased specificity for human hemoglobin (hHb) translates into an improved ability to acquire iron and is entirely dependent on the staphylococcal hemoglobin receptor IsdB. This feature affects host-pathogen interaction as demonstrated by the increased susceptibility of hHb expressing mice to systemic staphylococcal infection. Interestingly, enhanced utilization of human hemoglobin is not a uniform property of all bacterial pathogens. These results suggest a step in the evolution of S. aureus to better colonize the human host and establish hHb expressing mice as a model of S. aureus pathogenesis. PMID:21147468

  18. Evidence-based surgical wound care on surgical wound infection.

    Science.gov (United States)

    Reilly, Jaqueline

    2002-09-01

    Surgical wound infection is an important outcome indicator in the postoperative period. A 3-year prospective cohort epidemiological study of 2202 surgical patients from seven surgical wards across two hospitals was carried out using gold standard surveillance methodology. This involved following patients up as inpatients and postdischarge surveillance to 30 days by an independent observer. The results led to the development of a mathematical model for risk of clean, elective surgical wound infection. Risk of surgical wound infection was increased by smoking, higher body mass index, presence of malignancy, haematoma formation, increasing numbers of people in theatre, adherent dressing usage, and higher times to suture removal (P<0.05). The results show that this type of surveillance is an effective way of collecting accurate data on wound infection rates. It was noted that patient care practices affected the surgical wound infection rate and the surveillance was used to facilitate the adoption of evidence-based practice, through recommendations for clean surgery, to reduce the risk from extrinsic risk factors for wound infection. As a result of the implementation of this evidence-based practice there was a significant reduction (P<0.05) in the clean wound infection rate.

  19. Central nervous system infection caused by vancomycin-intermediate Staphylococcus aureus (SCCmec type IV, ST8).

    Science.gov (United States)

    Kino, Hiroyoshi; Suzuki, Hiromichi; Yamaguchi, Tetsuo; Notake, Shigeyuki; Oishi, Tsuyoshi; Ito, Yoshiro; Nakamura, Kazuhiro; Miyazaki, Haruko; Matsumoto, Tetsuya; Uemura, Kazuya; Matsumura, Akira

    2014-10-01

    A 77-year-old Japanese man with a history of surgical treatment of chronic subdural hemorrhage was hospitalized for drainage of a subdural abscess and brain abscess in the right occipital area. Pus obtained from both the subdural abscess and brain abscess grew vancomycin-intermediate Staphylococcus aureus (VISA) (minimum inhibitory concentration = 4 μg/mL), which was confirmed by population analysis. The SCCmec type and sequence type were subsequently identified as IV and ST8, respectively. The VISA strains were both sensitive to levofloxacin, clindamycin, minocycline, and linezolid. The patient was successfully treated with linezolid and discharged on day 51 after admission. We herein describe the first reported case of a brain abscess and subdural abscess caused by VISA in Japan.

  20. Audit of antibiotic therapy in surgical neonates in a tertiary hospital in Benin City, Nigeria

    Directory of Open Access Journals (Sweden)

    Osifo Osarumwense

    2011-01-01

    Full Text Available Objective: To report the outcome of commonly used antibiotic combinations in surgical neonates in sub-Saharan African settings. Methods: A retrospective analysis that determines the outcome of commonly combined antibiotics in surgical neonates between January 2006 and December 2008 at two referral paediatric surgical centres in Benin city was carried out. Results: Ampicillin ampiclox, metronidazole, gentamicin, cefuroxime and ceftriaxone were variously combined in the management of 161 neonates with a mean age at presentation of 9.2 ± 2.6 days, mean weight 3.1 ± 1.4 kg and a male:female ratio 1.6:1. Polymicrobial postoperative wound infections and sepsis caused by Staphylococcus aureus, Escherichia coli, Neisseria meningitidis, Klebsiella pneumonia, Pseudomonas aeroginosa and anaerobes, were mainly encountered. The most common aerobes isolated from wound cultures were S. aureus and P. aeroginosa while the ones from that of blood cultures were E. coli and K. pneumonia. Overall postoperative infections recorded were: wound infection 19 (11.8%, sepsis 16 (9.9% and sepsis-related deaths 6 (3.7%. Conclusion: Combinations of gentamicin/metronidazole/cefuroxime and gentamicin/cefuroxime were adequate for gastrointestinal and extra-gastrointestinal neonatal operations, respectively, in these sub-Saharan African settings, which may be useful in similar regions.

  1. Bactericidal Effect of a Photoresponsive Carbon Monoxide-Releasing Nonwoven against Staphylococcus aureus Biofilms.

    Science.gov (United States)

    Klinger-Strobel, Mareike; Gläser, Steve; Makarewicz, Oliwia; Wyrwa, Ralf; Weisser, Jürgen; Pletz, Mathias W; Schiller, Alexander

    2016-07-01

    Staphylococcus aureus is a leading pathogen in skin and skin structure infections, including surgical and traumatic infections that are associated with biofilm formation. Because biofilm formation is accompanied by high phenotypic resistance of the embedded bacteria, they are almost impossible to eradicate by conventional antibiotics. Therefore, alternative therapeutic strategies are of high interest. We generated nanostructured hybrid nonwovens via the electrospinning of a photoresponsive carbon monoxide (CO)-releasing molecule [CORM-1, Mn2(CO)10] and the polymer polylactide. This nonwoven showed a CO-induced antimicrobial activity that was sufficient to reduce the biofilm-embedded bacteria by 70% after photostimulation at 405 nm. The released CO increased the concentration of reactive oxygen species (ROS) in the biofilms, suggesting that in addition to inhibiting the electron transport chain, ROS might play a role in the antimicrobial activity of CORMs on S. aureus The nonwoven showed increased cytotoxicity on eukaryotic cells after longer exposure, most probably due to the released lactic acid, that might be acceptable for local and short-time treatments. Therefore, CO-releasing nonwovens might be a promising local antimicrobial therapy against biofilm-associated skin wound infections.

  2. Prevalence of Staphylococcus aureus Nasal Carriage in Human Immunodeficiency Virus-Infected and Uninfected Children in Botswana: Prevalence and Risk Factors.

    Science.gov (United States)

    Reid, Michael J A; Fischer, Rebecca S B; Mannathoko, Naledi; Muthoga, Charles; McHugh, Erin; Essigmann, Heather; Brown, Eric L; Steenhoff, Andrew P

    2017-02-06

    Staphylococcus aureus is an important cause of morbidity and mortality in children in sub-Saharan Africa (SSA). A major risk factor for staphylococcal infection is S. aureus colonization of the anterior nares. We sought to define risk factors for S. aureus carriage and characterize antimicrobial resistance patterns in children in Botswana. A cross-sectional study was conducted at two clinical sites in southern Botswana. Patients under 18 years of age underwent two nasal swabs and brief interviews, 4 weeks apart. Standard microbiological techniques were used. For persistent carriers, S. aureus was isolated from swabs at both time points, and for intermittent carriers, S. aureus was isolated from only one swab. Poisson regression with robust variance estimator was used to compare prevalence of carriage and the resistance phenotypes. Among 56 enrollees, prevalence of S. aureus colonization was 55% (N = 31), of whom 42% (N = 13) were persistent carriers. Of human immunodeficiency virus-infected children, 64% (N = 9) were carriers. Risk factors for nasal carriage included a history of tuberculosis (prevalence ratio [PR] = 1.60; 95% confidence interval [CI] = 1.02, 2.51; P = 0.040) and closer proximity to health care (PR = 0.89; 95% CI = 0.80, 0.99; P = 0.048). Prior pneumonia was more common among persistent rather than intermittent carriers (PR = 2.64; 95% CI = 1.64, 4.23; P < 0.001). Methicillin-resistant S. aureus (MRSA) prevalence was 13%. Of isolates tested, 16% were resistant to three or more drugs (N = 7/44). In summary, children in southern Botswana are frequently colonized with S. aureus Antibiotic resistance, especially MRSA, is also widespread. Antibiotic recommendations for treatment of staphylococcal infections in SSA should take cognizance of these resistance patterns.

  3. Loop-Mediated Isothermal Amplification for Detection of Staphylococcus aureus in Dairy Cow Suffering from Mastitis

    Directory of Open Access Journals (Sweden)

    Zhang Tie

    2012-01-01

    Full Text Available To develop a rapid detection method of Staphylococcus aureus using loop-mediated isothermal amplification (LAMP, four specific primers were designed according to six distinct sequences of the nuc gene. In addition, the specificity and sensitivity of LAMP were verified and compared with those of PCR. Results showed that the LAMP reaction was completed within 45 min at 62.5°C, and ladder bands were appeared in LAMP products analyzed by gel electrophoresis. After adding 1x SYBR Green l, the positive reaction tube showed green color and the negative reaction tube remained orange, indicating that the LAMP has high specificity. The minimal detectable concentration of LAMP was 1×102 CFU/mL and that of PCR was 1×104 CFU/mL, indicating that the LAMP was 100 times more sensitive than the PCR. The LAMP method for detection of Staphylococcus aureus has many advantages, such as simple operation, high sensitivity, high specificity, and rapid analysis. Therefore, this method is more suitable for the rapid on-site detection of Staphylococcus aureus.

  4. Structure of the adenylation domain of NAD(+)-dependent DNA ligase from Staphylococcus aureus.

    Science.gov (United States)

    Han, Seungil; Chang, Jeanne S; Griffor, Matt

    2009-11-01

    DNA ligase catalyzes phosphodiester-bond formation between immediately adjacent 5'-phosphate and 3'-hydroxyl groups in double-stranded DNA and plays a central role in many cellular and biochemical processes, including DNA replication, repair and recombination. Bacterial NAD(+)-dependent DNA ligases have been extensively characterized as potential antibacterial targets because of their essentiality and their structural distinction from human ATP-dependent DNA ligases. The high-resolution structure of the adenylation domain of Staphylococcus aureus NAD(+)-dependent DNA ligase establishes the conserved domain architecture with other bacterial adenylation domains. Two apo crystal structures revealed that the active site possesses the preformed NAD(+)-binding pocket and the 'C2 tunnel' lined with hydrophobic residues: Leu80, Phe224, Leu287, Phe295 and Trp302. The C2 tunnel is unique to bacterial DNA ligases and the Leu80 side chain at the mouth of the tunnel points inside the tunnel and forms a narrow funnel in the S. aureus DNA ligase structure. Taken together with other DNA ligase structures, the S. aureus DNA ligase structure provides a basis for a more integrated understanding of substrate recognition and catalysis and will be also be of help in the development of small-molecule inhibitors.

  5. Structure of the adenylation domain of NAD[superscript +]-dependent DNA ligase from Staphylococcus aureus

    Energy Technology Data Exchange (ETDEWEB)

    Han, Seungil; Chang, Jeanne S.; Griffor, Matt; Pfizer

    2010-09-17

    DNA ligase catalyzes phosphodiester-bond formation between immediately adjacent 5'-phosphate and 3''-hydroxyl groups in double-stranded DNA and plays a central role in many cellular and biochemical processes, including DNA replication, repair and recombination. Bacterial NAD{sup +}-dependent DNA ligases have been extensively characterized as potential antibacterial targets because of their essentiality and their structural distinction from human ATP-dependent DNA ligases. The high-resolution structure of the adenylation domain of Staphylococcus aureus NAD{sup +}-dependent DNA ligase establishes the conserved domain architecture with other bacterial adenylation domains. Two apo crystal structures revealed that the active site possesses the preformed NAD{sup +}-binding pocket and the 'C2 tunnel' lined with hydrophobic residues: Leu80, Phe224, Leu287, Phe295 and Trp302. The C2 tunnel is unique to bacterial DNA ligases and the Leu80 side chain at the mouth of the tunnel points inside the tunnel and forms a narrow funnel in the S. aureus DNA ligase structure. Taken together with other DNA ligase structures, the S. aureus DNA ligase structure provides a basis for a more integrated understanding of substrate recognition and catalysis and will be also be of help in the development of small-molecule inhibitors.

  6. 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...

  7. Essential Tremor (ET): Surgical Options

    Science.gov (United States)

    ... t respond to propranolol, primidone, or other common ET medications and whose tremor has become debilitating, there ... treatments were first introduced. Current surgical options for ET include Deep Brain Stimulation (DBS) , Focused Ultrasound , and ...

  8. Surgical trainees and trauma emergencies.

    Science.gov (United States)

    Wybaillie, E; Broos, P L O

    2010-01-01

    An accident and emergency (A&E) training has been suggested as an essential part of the basic surgical training. The A&E curriculum should be divided into three sections: a critical curriculum, a core curriculum and a comprehensive curriculum. For instance, the critical curriculum contains topics that provide the opportunity to translate the ABCDE principles of trauma management into practice. Furthermore, a post in the A&E department provides the surgical trainee with significant exposure to the management of the polytrauma patient and to the management of other acute general surgical, urological and orthopaedic conditions. By presenting better educational programs and by reducing the non-medical tasks a trainee has to deal with, the education of surgical trainees during A&E attachment can be improved.

  9. Surgical treatment of cranial neuralgias.

    Science.gov (United States)

    Franzini, Angelo; Ferroli, Paolo; Messina, Giuseppe; Broggi, Giovanni

    2010-01-01

    The most common types of cranial neuralgias amenable to surgical therapeutic options are trigeminal neuralgia and glossopharyngeal neuralgia, the former having an approximate incidence of 5/100000 cases per year and the latter of 0.05/100000 cases per year. Surgical therapy of these pathological conditions encompasses several strategies, going from ablative procedures to neurovascular decompression, to radiosurgery. The choice of the most appropriate surgical option (which must be taken into account when all conservative treatments have proven to be unsuccessful) has to take into account many factors, the most important ones being neuroradiological evidence of a neurovascular conflict, severity of symptoms, the age and clinical history of the patient, and the patient's overall medical condition. In this chapter we report our experience with the treatment of trigeminal and glossopharyngeal neuralgia, describing the surgical procedures performed and reviewing the most recent aspects on this subject in the past literature.

  10. Biofouling of surgical power tools during routine use.

    Science.gov (United States)

    Deshpande, A; Smith, G W G; Smith, A J

    2015-07-01

    Surgical power tools (SPTs) are frequently used in many surgical specialties such as dentistry, orthopaedics, ophthalmology, neurology, and podiatry. They have complex designs that may restrict access to cleaning and sterilization agents and frequently become contaminated with microbial and tissue residues following use. Due to these challenges, surgical power tools can be considered the weak link in the decontamination cycle and present a potential for iatrogenic transmission of infection. We aimed to review the existing literature on the decontamination of surgical power tools and associated iatrogenic transmission of infection. A search of the medical literature was performed using Ovid online using the following databases: Ovid Medline 1950-2014, Embase 1980-2014, and EBM Reviews Full Text--Cochrane DSR, ACP Journal Club, and Dare. Despite challenges to decontamination processes, reported episodes of iatrogenic infection directly linked to SPTs appear rare. This may reflect a true picture but more likely represents incomplete reporting, failure to investigate power tools, or lack of surveillance linking surgical site infections (SSIs) to power tools. Healthcare professionals should be aware of the complexities associated with the decontamination of different SPTs, and should review manufacturers' reprocessing instructions prior to purchase. More clarity is required in the manufacturers' validation of these reprocessing instructions. This particularly applies to the emerging surgical robot systems that present extreme challenges to decontamination between uses. Investigation of cross-infection incidents or SSI surveillance should include an element of assessment of SPT decontamination to further elucidate the contribution of SPTs to skin and soft tissue infections.

  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. Innovation in pediatric surgical education.

    Science.gov (United States)

    Clifton, Matthew S; Wulkan, Mark L

    2015-06-01

    Pediatric surgical training in the United States remained basically unchanged from the model developed by Ladd and Gross in the 1930s until recently. Standardized curriculum and novel evaluation methods are now being implemented. Pediatric Surgical education is currently undergoing a transition to competency-based evaluation and promotion. Unfortunately, there is little data on the efficacy of these changes. This presents an opportunity for further study of how we conduct training, and how we evaluate and promote our trainees.

  13. Aesthetic Surgical Crown Lengthening Procedure

    Science.gov (United States)

    de Oliveira, Pablo Santos; Chiarelli, Fabio; Rodrigues, José A.; Shibli, Jamil A.; Zizzari, Vincenzo Luca; Piattelli, Adriano; Iezzi, Giovanna; Perrotti, Vittoria

    2015-01-01

    The aim of this case report was to describe the surgical sequence of crown lengthening to apically reposition the dentogingival complex, in addition to an esthetic restorative procedure. Many different causes can be responsible for short clinical crown. In these cases, the correct execution of a restorative or prosthetic rehabilitation requires an increasing of the crown length. According to the 2003 American Academy of Periodontology (Practice Profile Survey), crown lengthening is the most habitual surgical periodontal treatment. PMID:26609452

  14. Aesthetic Surgical Crown Lengthening Procedure

    Directory of Open Access Journals (Sweden)

    Pablo Santos de Oliveira

    2015-01-01

    Full Text Available The aim of this case report was to describe the surgical sequence of crown lengthening to apically reposition the dentogingival complex, in addition to an esthetic restorative procedure. Many different causes can be responsible for short clinical crown. In these cases, the correct execution of a restorative or prosthetic rehabilitation requires an increasing of the crown length. According to the 2003 American Academy of Periodontology (Practice Profile Survey, crown lengthening is the most habitual surgical periodontal treatment.

  15. Surgical Treatment of Facial Paralysis

    OpenAIRE

    Mehta, Ritvik P.

    2009-01-01

    The management of facial paralysis is one of the most complex areas of reconstructive surgery. Given the wide variety of functional and cosmetic deficits in the facial paralysis patient, the reconstructive surgeon requires a thorough understanding of the surgical techniques available to treat this condition. This review article will focus on surgical management of facial paralysis and the treatment options available for acute facial paralysis (2 yr). For acute facial paralysis, the main surgi...

  16. Aesthetic Surgical Crown Lengthening Procedure.

    Science.gov (United States)

    de Oliveira, Pablo Santos; Chiarelli, Fabio; Rodrigues, José A; Shibli, Jamil A; Zizzari, Vincenzo Luca; Piattelli, Adriano; Iezzi, Giovanna; Perrotti, Vittoria

    2015-01-01

    The aim of this case report was to describe the surgical sequence of crown lengthening to apically reposition the dentogingival complex, in addition to an esthetic restorative procedure. Many different causes can be responsible for short clinical crown. In these cases, the correct execution of a restorative or prosthetic rehabilitation requires an increasing of the crown length. According to the 2003 American Academy of Periodontology (Practice Profile Survey), crown lengthening is the most habitual surgical periodontal treatment.

  17. [Risk factors related to surgical site infection in elective surgery].

    Science.gov (United States)

    Angeles-Garay, Ulises; Morales-Márquez, Lucy Isabel; Sandoval-Balanzarios, Miguel Antonio; Velázquez-García, José Arturo; Maldonado-Torres, Lulia; Méndez-Cano, Andrea Fernanda

    2014-01-01

    Antecedentes: desde el ingreso del paciente hasta 30 días después del procedimiento quirúrgico es necesario identificar y vigilar los factores de riesgo de infección del sitio quirúrgico, debido a que 30% de esas infecciones se detectan cuando el paciente sale del hospital. Objetivo: calcular el riesgo relativo de los factores asociados con las infecciones del sitio quirúrgico en adultos con cirugía programada. Material y métodos: estudio de cohorte prospectiva de pacientes quirúrgicos clasificados según el grado de contaminación de la cirugía; expuesto si fue limpia-contaminada o contaminada, no expuesto si fue limpia. Los factores de riesgo estudiados fueron: los inherentes al paciente, pre-quirúrgicos, intraquirúrgicos y posquirúrgicos. El análisis bivariado se realizó con t de Student o U de Mann-Withney, ?2 para riesgo multivariado de riesgos proporcionales de Cox. Resultados: se estudiaron 403 pacientes durante 30 días después de operados (59.8% mujeres); 8.7% resultaron con infección del sitio quirúrgico. Los factores asociados con el análisis multivariado fueron: índice tabáquico con un riesgo relativo de 3.21, índice de masa corporal en bajo peso 3.4, técnica inadecuada de lavado de manos 4.61, transfusión durante la cirugía 3.22, cirugía contaminada 60, estancia de 8 a 14 días en terapia intensiva 11.64, permanencia 1 a 3 días con venoclisis 2.4 y con sonda vesical 1 a 3 días 2.27. Conclusión: es imposible evitar todos los factores de riesgo para infecciones del sitio quirúrgico; sin embargo, la vigilancia formal de los pacientes puede prevenir complicaciones.

  18. Petrifilm rapid S. aureus Count Plate method for rapid enumeration of Staphylococcus aureus in selected foods: collaborative study.

    Science.gov (United States)

    Silbernagel, K M; Lindberg, K G

    2001-01-01

    A rehydratable dry-film plating method for Staphylococcus aureus in foods, the 3M Petrifilm Rapid S. aureus Count Plate method, was compared with AOAC Official Method 975.55 (Staphylococcus aureus in Foods). Nine foods-instant nonfat dried milk, dry seasoned vegetable coating, frozen hash browns, frozen cooked chicken patty, frozen ground raw pork, shredded cheddar cheese, fresh green beans, pasta filled with beef and cheese, and egg custard-were analyzed for S. aureus by 13 collaborating laboratories. For each food tested, the collaborators received 8 blind test samples consisting of a control sample and 3 levels of inoculated test sample, each in duplicate. The mean log counts for the methods were comparable for pasta filled with beef and cheese; frozen hash browns; cooked chicken patty; egg custard; frozen ground raw pork; and instant nonfat dried milk. The repeatability and reproducibility variances of the Petrifilm Rapid S. aureus Count Plate method were similar to those of the standard method.

  19. 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.

  20. 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.

  1. 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.

  2. Stpahylococcus aureus biofilms on central venous haemodialysis catheters Biofilmes de Staphylococcus aureus em cateter venoso central em hemodiálise

    Directory of Open Access Journals (Sweden)

    Elisabeth Eyko Aoki

    2005-12-01

    Full Text Available Biofilm bacterial infections are common in patients undergoing treatment with haemodialysis. This study involved 16 patients (7 males, 9 females; ages from 22 to 81 with an average age of 50 who had had a total of 25 temporary haemodialysis polyurethane catheter insertions into the subclavian vein (22 dual-lumen and 3 triple-lumen. The catheters remained in place from 3 to 91 days, on an average of 47 days. The reasons for catheter removal were: bad functioning (44%, suspicion of catheter-related infection (20%, availability of permanent access (16%, accidental removal (12%, signs and symptoms of infection at the site of catheter insertion (4%, and exogenous contamination (4%. Positive tip cultures were observed on seven of the catheters (28%, showing three positive blood cultures. The Staphylococcus aureus were identified in 12% of the blood cultures and isolated from one of the hubs, and biofilms were observed on all catheter tips. The S. aureus retrieved from both blood and catheters (tips and hubs were resistant to penicillin and susceptible to azithromycin, ciprofloxacin, clindamycin, chloramphenicol, gentamicin, oxacillin, rifampin, sulfamethoxazole, tetracycline, and vancomycin. The S. aureus strains isolated from both blood and catheters (tips and hubs were considered to be identical based on antibiotic susceptibility patterns and genetic similarity assessed using an automated ribotyping system.As infecções devido a biofilmes bacterianos são comuns em pacientes sob tratamento em hemodiálise. Neste estudo, 16 pacientes (7 homens, 9 mulheres, de 22 a 81 anos, média 50 anos de idade, com um total de 25 cateteres de hemodiálise (3 de triplo-lúmen e 22 de duplo-lúmen de poliuretano inseridos em veia subclávia foram estudados. Os cateteres permaneceram no local de 3 a 91 dias (média de 47 dias. Os cateteres foram removidos devido ao: mau funcionamento (44%, suspeita de infecção relacionada ao cateter (20%, viabilidade de um acesso

  3. 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.

  4. 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.

  5. Surgical versus non-surgical treatment of congenital hyperinsulinism.

    Science.gov (United States)

    Mazor-Aronovitch, Kineret; Landau, Heddy; Gillis, David

    2009-03-01

    Congenital hyperinsulinism is a functional disorder of insulin secretion. In its diffuse severe form, it is traditionally treated with over 95% pancreatectomy. However, even after this procedure normoglycemia is not always achieved. Non-surgical therapy with frequent or continuous feeding, medication and close monitoring is another alternative. In this review we compare the two approaches to this condition focusing on early complications, diabetes, neurological outcome and home management issues. Early complications of pancreatectomy include mechanical, metabolic and infectious complications. Non-surgical interventions can be complicated by unwarranted effects of medications and of invasive procedures. Diabetes occurs with both approaches but much less frequently and years later with non-surgical treatment. Regarding neurodevelopmental outcome, most data come from heterogeneous groups. Nevertheless, it appears that outcome is not adversely affected by avoiding surgery. Home management is far more difficult for the non-surgical form. When the non-surgical approach is successful in achieving normoglycemia and parents are highly motivated, this mode of therapy should be considered.

  6. Salicylic acid enhances Staphylococcus aureus extracellular adhesin protein expression.

    Science.gov (United States)

    Alvarez, Lucía P; Barbagelata, María S; Cheung, Ambrose L; Sordelli, Daniel O; Buzzola, Fernanda R

    2011-11-01

    One of the virulence factors required by Staphylococcus aureus at the early stages of infection is Eap, a secreted adhesin that binds many host proteins and is upregulated by the two-component regulatory system saeRS. The S. aureus Newman strain harbors a mutation in saeS that is thought to be responsible for the high level of Eap expression in this strain. This study was designed to ascertain whether salicylic acid (SAL) affects the expression of Eap and the internalization of S. aureus into epithelial cells. The strain Newman treated with SAL exhibited increased levels of eap transcription and protein expression. Furthermore, SAL treatment increased the eap promoter activity. SAL treatment enhanced Eap expression in the Newman and in other S. aureus strains that do not carry the mutation in saeS. Internalization of S. aureus eap and sae mutants into the MAC-T epithelial cells was significantly decreased compared with the wild-type counterparts. In conclusion, we demonstrated that a low concentration of SAL increased S. aureus Eap expression possibly due to enhancement of sae. SAL may create the conditions for S. aureus persistence in the host, not only by decreasing the capsular polysaccharide expression as shown before, but also by enhancing Eap expression.

  7. Neutrophil-mediated phagocytosis of Staphylococcus aureus

    Directory of Open Access Journals (Sweden)

    Jos A.G. Van Strijp

    2014-09-01

    Full Text Available For invading staphylococci, phagocytosis an killing bij human neutrophils is the biggest threat. Neutrophils are the only cells that can effectively kill staphylococci by engulfment and subsequent bombardment with proteases, amidases, antimicrobial peptides and proteins in concert with reactive oxygen species that are generated during the metabolic burst.Both complement and antibodies are crucial for effective uptake and neutrophil activation. S. aureus is not an innocent bystander in this process. It actively secretes several proteins to impair every single step in this process from receptor modulation, to complement inhibition to neutrophil lysis to protease, antimicrobial peptide inhibition and resistance to reactive oxygen species. For the design of future novel antimicrobial strategies: therapeutic antibodies, vaccines, novel antibiotics, all this should be taken into account. Still the best way to treat diseases is to help to enhance the natural defence mechanism that are already in place.

  8. Mild forms of toxic shock syndrome toxin-1-mediated exanthematous disease related to Staphylococcus aureus infection.

    Science.gov (United States)

    Moriguchi, Naohiko; Kano, Tomowa; Yoshimatsu, Yutaka; Yanagida, Hidehiko

    2016-08-01

    The present report describes three patients with toxic shock syndrome toxin (TSST)-1-associated exanthematous disease. In all patients, fever and systemic erythema without hemodynamic disturbance occurred following cellulitis of the lower limbs. At the site of infection, TSST-1 producing Methicillin-susceptible Staphylococcus aureus was detected. They defervesced and erythema resolved in response to administration of an antimicrobial drug, thereby avoiding severe illness. These patients did not meet the criteria for a clinical diagnosis of toxic shock syndrome. Measurement of T-cell receptor Vβ2-positive T cells in the peripheral blood early after onset of symptoms was useful for diagnosis.

  9. Expression of enterotoxin-coding genes in methicillin-resistant Staphylococcus aureus strains isolated from Mexican haemodialysis patients

    OpenAIRE

    Paniagua-Contreras, Gloria Luz; Monroy-Pérez, Eric; Vaca-Paniagua, Felipe; RODRÍGUEZ-MOCTEZUMA,JOSÉ RAYMUNDO; Vaca, Sergio

    2014-01-01

    Background Methicillin-resistant Staphylococcus aureus (MRSA) causes severe catheter-related infections in haemodialysis patients ranging from local-site infections and septic thrombophlebitis to bacteraemia but the associated virulence factors and exotoxins remain unclear. Findings We employed an in vitro infection model using reconstituted human epithelium (RHE) to analyse the expression profiles of 4 virulence genes and 12 exotoxin-coding virulence genes in 21 MRSA strains isolated from ca...

  10. Clinical efficacy of intravenous administration of marbofloxacin in a Staphylococcus aureus infection in tissue cages in ponies.

    Science.gov (United States)

    Voermans, M; van Soest, J M; van Duijkeren, E; Ensink, J M

    2006-12-01

    Tissue cages (TC), implanted subcutaneously in the neck in eight ponies, were inoculated with Staphylococcus aureus (S. aureus) to determine the clinical efficacy of marbofloxacin in the treatment of this infection. From 21 h after inoculation, marbofloxacin (6 mg/kg) was administered intravenously (i.v.) once daily for 7 days. Samples of the tissue cage fluid (TCF) were taken to determine marbofloxacin concentrations (days 1, 3 and 7), using high-pressure liquid chromatography, and numbers of viable bacteria [colony forming units (CFU)] (days 1, 3, 7, 14 and 21). Statistical analysis was used to compare CFU before and after treatment. Clinical signs and CFU were used to evaluate the efficacy of treatment. Although, there was a slight decrease in CFU in all TC initially, the infection was not eliminated by marbofloxacin treatment in any of the ponies and abscesses formed. As the MIC (0.25 microg/mL) did not change during treatment and the concentration of marbofloxacin during treatment (mean concentration in TCF was 0.89 microg/mL on day 1, 0.80 microg/mL on day 3 and 2.77 microg/mL on day 7) was above MIC, we consider that the treatment failure might be attributable to the formation of a biofilm by S. aureus. Based on the present results, i.v. administration of marbofloxacin alone is not suitable for the elimination of S. aureus infections from secluded sites.

  11. The selection of resistance to and the mutagenicity of different fluoroquinolones in Staphylococcus aureus and Streptococcus pneumoniae.

    Science.gov (United States)

    Sierra, J M; Cabeza, J G; Ruiz Chaler, M; Montero, T; Hernandez, J; Mensa, J; Llagostera, M; Vila, J

    2005-09-01

    Two quinolone-susceptible Staphylococcus aureus and five quinolone-susceptible Streptococcus pneumoniae isolates were used to obtain in-vitro quinolone-resistant mutants in a multistep resistance selection process. The fluoroquinolones used were ciprofloxacin, moxifloxacin, levofloxacin, gemifloxacin, trovafloxacin and clinafloxacin. The mutagenicity of these quinolones was determined by the Salmonella and the Escherichia coli retromutation assays. All quinolone-resistant Staph. aureus mutants had at least one mutation in the grlA gene, while 86.6% of quinolone-resistant Strep. pneumoniae mutants had mutations in either or both the gyrA and parC genes. Moxifloxacin and levofloxacin selected resistant mutants later than the other quinolones, but this difference was more obvious in Staph. aureus. Accumulation of the fluoroquinolones by Staph. aureus did not explain these differences, since levofloxacin and moxifloxacin accumulated inside bacteria to the same extent as clinafloxacin and trovafloxacin. The results also showed that moxifloxacin and levofloxacin had less mutagenic potency in both mutagenicity assays, suggesting a possible relationship between the selection of resistance to quinolones and the mutagenic potency of the molecule. Furthermore, gemifloxacin selected efflux mutants more frequently than the other quinolones used. Thus, the risk of developing quinolone resistance may depend on the density of the microorganism at the infection site and the concentration of the fluoroquinolone, and also on the mutagenicity of the quinolone used, with moxifloxacin and levofloxacin being the least mutagenic.

  12. Neutrophil-derived IL-1β is sufficient for abscess formation in immunity against Staphylococcus aureus in mice.

    Directory of Open Access Journals (Sweden)

    John S Cho

    Full Text Available Neutrophil abscess formation is critical in innate immunity against many pathogens. Here, the mechanism of neutrophil abscess formation was investigated using a mouse model of Staphylococcus aureus cutaneous infection. Gene expression analysis and in vivo multispectral noninvasive imaging during the S. aureus infection revealed a strong functional and temporal association between neutrophil recruitment and IL-1β/IL-1R activation. Unexpectedly, neutrophils but not monocytes/macrophages or other MHCII-expressing antigen presenting cells were the predominant source of IL-1β at the site of infection. Furthermore, neutrophil-derived IL-1β was essential for host defense since adoptive transfer of IL-1β-expressing neutrophils was sufficient to restore the impaired neutrophil abscess formation in S. aureus-infected IL-1β-deficient mice. S. aureus-induced IL-1β production by neutrophils required TLR2, NOD2, FPR1 and the ASC/NLRP3 inflammasome in an α-toxin-dependent mechanism. Taken together, IL-1β and neutrophil abscess formation during an infection are functionally, temporally and spatially linked as a consequence of direct IL-1β production by neutrophils.

  13. Structural and functional characterization of Staphylococcus aureus dihydrodipicolinate synthase.

    Science.gov (United States)

    Girish, Tavarekere S; Sharma, Eshita; Gopal, B

    2008-08-20

    Lysine biosynthesis is crucial for cell-wall formation in bacteria. Enzymes involved in lysine biosynthesis are thus potential targets for anti-microbial therapeutics. Dihydrodipicolinate synthase (DHDPS) catalyzes the first step of this pathway. Unlike its homologues, Staphylococcus aureus DHDPS is a dimer both in solution and in the crystal and is not feedback inhibited by lysine. The crystal structure of S. aureus DHDPS in the free and substrate bound forms provides a structural rationale for its catalytic mechanism. The structure also reveals unique conformational features of the S. aureus enzyme that could be crucial for the design of specific non-competitive inhibitors.

  14. The Effect of Essential Oils on Staphylococcus aureus

    Directory of Open Access Journals (Sweden)

    Seda Ozdikmenli

    2014-05-01

    Full Text Available Diseases caused by Staphylococcus aureus are widespread through the world in spite of developing technology. S. aureus is an important pathogen causing food intoxications besides hospital infections by its antibiotic resistant strains. Nowadays, there has been worldwide increasing concern on usage of natural products to control microorganisms. One of these natural products is essential oils. They are produced from plants especially from spices and composed of many components and volatiles. This review summarizes informative literature on essential oils and their mode of antimicrobial action. In addition, current knowledge on in vitro researches on antibacterial activity of essential oils and food applications to control S. aureus has been discussed.

  15. 21 CFR 878.4040 - Surgical apparel.

    Science.gov (United States)

    2010-04-01

    ... known as scrub suits, are excluded. (b) Classification. (1) Class II (special controls) for surgical... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Surgical apparel. 878.4040 Section 878.4040 Food... DEVICES GENERAL AND PLASTIC SURGERY DEVICES Surgical Devices § 878.4040 Surgical apparel....

  16. Impact of strain typing methods on assessment of relationship between paired nares and wound isolates of methicillin-resistant Staphylococcus aureus

    NARCIS (Netherlands)

    J.E. Clarridge III (Jill); R.A. Harrington (Robert Alex); M.C. Roberts (Marilyn); O.O. Soge (Olusegun); K. Maquelin (Kees)

    2013-01-01

    textabstractThe anterior nares are the site of choice for the Veterans Administration methicillin-resistant Staphylococcus aureus (MRSA) surveillance program; however, a correlation between nares colonization and concomitant wound infections has not been well established. The purpose of this study w

  17. A STUDY ON THE POST SURGICAL WOUND INFECTIONS IN A TERTIARY CARE HOSPITAL IN KANCHIPURAM

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    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. Staphylococcus aureus 'Down Under': contemporary epidemiology of S. aureus in Australia, New Zealand, and the South West Pacific.

    Science.gov (United States)

    Williamson, D A; Coombs, G W; Nimmo, G R

    2014-07-01

    The clinical and molecular epidemiology of Staphylococcus aureus disease has changed considerably over the past two decades, particularly with the emergence and spread of community-associated methicillin-resistant S. aureus (CA-MRSA) clones. Indeed, some of the first global descriptions of CA-MRSA were from remote indigenous communities in Western Australia, and from Pacific Peoples in New Zealand. The epidemiology of S. aureus infections in the South West Pacific has several unique features, largely because of the relative geographical isolation and unique indigenous communities residing in this region. In particular, a number of distinct CA-MRSA clones circulate in Australia and New Zealand, such as sequence type (ST) 93 methicillin-resistant S. aureus (MRSA) (Queensland clone) and clonal complex 75 S. aureus (Staphylococcus argenteus) in Australia, and ST30 MRSA (Southwest Pacific clone) in New Zealand. In addition, there is a disproportionate burden of S. aureus disease in indigenous paediatric populations, particularly in remote Aboriginal communities in Australia, and in Pacific Peoples and Maori in New Zealand. In this review, we provide a contemporary overview of the clinical and molecular epidemiology of S. aureus disease in the South West Pacific region, with a particular focus on features distinct to this region.

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

    Energy Technology Data Exchange (ETDEWEB)

    Nishimura, Reiki; Nagao, Kazuharu; Miyayama, Haruhiko [Kumamoto City Hospital (Japan)

    1999-09-01

    Out of 484 cases with breast conserving surgery between April 1989 and March 1999, surgical procedures of 34 cases were changed to total mastectomy due to positive surgical margins. In this study we evaluated a clinical significance of surgical margin in relation to clinicopathological factors and prognoses. Ninety-nine cases (20.5%) had positive margins that were judged when cancer cells existed within 5 mm from margin. In multivariate analysis of factors for surgical margin, EIC-comedo status, ly, located site, proliferative activity, and age were significant and independent factors. Regarding local recurrence, positive margin, age, ER and proliferative activity were significant factors in multivariate analysis, especially in cases not receiving postoperative radiation therapy. Radiation therapy may be beneficial for patients with positive surgical margin. And patients with breast recurrence alone had significantly higher survival rates. Therefore, it is suggested that surgical margin may not reflect survival, although it is a significant factor for local recurrence. (author)

  20. Surgical treatment for male prolactinoma

    Science.gov (United States)

    Song, Yi-Jun; Chen, Mei-Ting; Lian, Wei; Xing, Bing; Yao, Yong; Feng, Ming; Wang, Ren-Zhi

    2017-01-01

    Abstract A total of 184 cases of surgically treated male prolactinoma were analyzed retrospectively to summarize the outcome of this surgical intervention. We analyzed the general characteristics, clinical manifestations, hormone levels, imaging features, preoperative treatments, surgical outcomes, pathology results, and follow-up records for all included patients. The most common clinical manifestations included sexual dysfunction (47.4%), headache (55.9%), and visual disturbance (46.7%). Serum prolactin levels ranged from 150 to 204,952 ng/mL. Tumor size varied from 6 to 70 mm. Pituitary adenomas grew in a parasellar pattern with visual deficits occurring 40.7% of the time. After surgical therapy, 88.6% of patients achieved symptom relief, and 98.4% experienced an immediate postoperative decline in prolactin level. Fifty-seven patients (31.0%) achieved initial remission, and 26 patients (45.6%) experienced recurrence. Hence, our results suggest that in male prolactinoma characterized by a large pituitary diameter and high serum prolactin level, tumor size predicts the degree of gross resection. The prognostic predictors included preoperative tumor growth pattern and Ki-67 index. Citation: Yi-jun S, Mei-ting C, Wei L, Bing X, Yong Y, Ming F, Ren-zhi W. (2016) Surgical treatment for male prolactinoma: a retrospective study of 184 cases PMID:28079813

  1. Can we measure surgical resilience?

    Science.gov (United States)

    Graham, David; Becerril-Martinez, Guillermo; Quinto, Lena; Zhao, Dong Fang

    2016-01-01

    Surgical resilience describes psychological resilience within a surgical setting. Within a surgical setting, psychologically resilient patients have improved recovery and wound-healing. The search for biological correlates in resilient patients has led to the hypothesis that certain endogenous biomarkers (namely neuropeptide Y (NPY), testosterone, and dehydroepiandrosterone (DHEA)) are altered in resilient patients. The concept of surgical resilience raises the question of whether enhanced recovery following surgery can be demonstrated in patients with high titres of resilience biomarkers as compared to patients with low titres of resilience biomarkers. To determine the prognostic value of resilience biomarkers in surgical recovery, a cohort of patients undergoing major surgery should initially be psychometrically tested for their resilience levels before and after surgery so that biomarker levels of NPY, testosterone and DHEA can be compared to a validated psychometric test of resilience. The primary outcome would be length of hospital stay with and without an enhanced recovery program. Secondary outcome measures such as complications, time in rehabilitation and readmission could also be included. If the hypothesis is upheld, resilience biomarkers could be used to support more individualised perioperative management and lead to more efficient and effective allocation of healthcare resources.

  2. Staphylococcus aureus intestinal colonization is associated with increased frequency of S. aureus on skin of hospitalized patients

    Directory of Open Access Journals (Sweden)

    Donskey Curtis J

    2007-09-01

    Full Text Available Abstract Background Intestinal colonization by Staphylococcus aureus among hospitalized patients has been associated with increased risk of staphylococcal infection and could potentially contribute to transmission. We hypothesized that S. aureus intestinal colonization is associated with increased frequency of S. aureus on patients' skin and nearby environmental surfaces. Methods Selected inpatients were cultured weekly for S. aureus from stool, nares, skin (groin and axilla, and environmental surfaces (bed rail and bedside table. Investigator's hands were cultured after contacting the patients' skin and the environmental surfaces. Results Of 71 subjects, 32 (45.1% had negative nares and stool cultures, 23 (32.4% had positive nares and stool cultures, 13 (18.3% were nares carriers only, and 3 (4.2% were stool carriers only. Of the 39 patients with S. aureus carriage, 30 (76.9% had methicillin-resistant isolates. In comparison to nares colonization only, nares and intestinal colonization was associated with increased frequency of positive skin cultures (41% versus 77%; p = 0.001 and trends toward increased environmental contamination (45% versus 62%; p = 0.188 and acquisition on investigator's hands (36% versus 60%; p = 0.057. Patients with negative nares and stool cultures had low frequency of S. aureus on skin and the environment (4.8% and 11.3%, respectively. Conclusion We found that hospitalized patients with S. aureus nares and/or stool carriage frequently had S. aureus on their skin and on nearby environmental surfaces. S. aureus intestinal colonization was associated with increased frequency of positive skin cultures, which could potentially facilitate staphylococcal infections and nosocomial transmission.

  3. Mechanical performance of disposable surgical needle holders.

    Science.gov (United States)

    Francis, E H; Towler, M A; Moody, F P; McGregor, W; Himel, H N; Rodeheaver, G T; Edlich, R F

    1992-01-01

    The mechanical performance of disposable Webster surgical needle holders supplied by three different surgical instrument companies was determined by recording the forces (clamping moment) applied by the different needle holder jaws to curved surgical needles. This investigation demonstrated that there was a large variability in the mechanical performance of the disposable needle holders supplied by each surgical instrument company. In addition, the mechanical performance of the disposable needle holder of each surgical instrument company was distinctly different.

  4. Towards an in vivo wireless mobile robot for surgical assistance.

    Science.gov (United States)

    Hawks, Jeff A; Rentschler, Mark E; Redden, Lee; Infanger, Roger; Dumpert, Jason; Farritor, Shane; Oleynikov, Dmitry; Platt, Stephen R

    2008-01-01

    The use of miniature in vivo robots that fit entirely inside the peritoneal cavity represents a novel approach to laparoscopic surgery. Previous work has demonstrated that mobile and fixed-base in vivo robots can be used to improve visualization of the surgical field and perform surgical tasks such as collecting biopsy tissue samples. All of these robots used tethers to provide for power and data transmission. This paper describes recent work focused on developing a modular wireless mobile platform that could be used for in vivo robotic sensing and manipulation applications. One vision for these types of self-contained in vivo robotic devices is that they could be easily carried and deployed by non-medical personnel at the site of an injury. Such wireless in vivo robots are much more transportable and lower cost than current robotic surgical assistants, and could ultimately allow a surgeon to become a remote first responder irrespective of the location of the patient.

  5. Medicare Payment: Surgical Dressings and Topical Wound Care Products.

    Science.gov (United States)

    Schaum, Kathleen D

    2014-08-01

    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 they are developing new surgical dressings and topical wound care products. Due to the importance of the Medicare payment systems, this article reviews the Medicare payment systems in acute care hospitals, long-term acute care hospitals, skilled nursing facilities, home health agencies, durable medical equipment suppliers, hospital-based outpatient wound care departments, and qualified healthcare professional offices.

  6. MALNUTRITION IN THE SURGICAL PATIENTS

    Directory of Open Access Journals (Sweden)

    Andonovska Biljana J.

    2016-12-01

    Full Text Available The term 'malnutrition' is a broad term used to describe any imbalance in the diet. In 2009 it was confirmed that malnutrition is an urgent health problem. The reasons for which malnutrition may develop are different. Loss on cellular, physical and physiological level happens as a consequence of malnutrition. Studies show that in surgical practice there is malnutrition in 50% of patients and that there is an association between inadequate nutritional status and surgical result. It leads to prolonged treatment, increasing of the level of morbidity and mortality, increased hospital costs, etc. Sometimes malnutrition is unrecognised, untreated and worsened in hospitals. For this reason this paper will elaborate: nutrition and a surgical patient, assessment of a nutritional status, assessment of energy requirements, and enteral and parenteral nutrition in order to determine the conditions and procedures that affect the appearance, recognition and treatment of malnutrition.

  7. Surgical Complications of Cochlear Implantation

    Directory of Open Access Journals (Sweden)

    Basir Hashemi

    2010-03-01

    Full Text Available Cochlear implantation is a method used for the treatment ofpatients with profound hearing loss. This procedure may theaccompanied by some major or minor complications. Weevaluated the surgical complications of cochlear implantationin Fars province (south of Iran. A total of 150 patients withcochlear implantation were enrolled in the present study. Mostof the patients were pre-lingual children and most of our deviceswere nucleus prosthesis. We had three device failuresand four major complications, including one misplaced electrode,one case of meningitis, one case of foreign body reactionto suture and one case with extensive hematoma. Thesecomplications were managed successfully by surgical interventionor re-implantation. Facial nerve damage or woundbreakdown was not seen. Minor complications including smallhematoma, edema, stitch infection and dizziness were found in15 cases, which were managed medically. In our center, therate of minor complications was comparable to other centersin the world. But the rate of major surgical complications waslower than other centers.

  8. Nutrition support in surgical oncology.

    Science.gov (United States)

    Huhmann, Maureen B; August, David A

    2009-01-01

    This review article, the second in a series of articles to examine the American Society for Parenteral and Enteral Nutrition (A.S.P.E.N.) Guidelines for the Use of Parenteral and Enteral Nutrition in Adult and Pediatric Patients, evaluates the evidence related to the use of nutrition support in surgical oncology patients. Cancer patients develop complex nutrition issues. Nutrition support may be indicated in malnourished cancer patients undergoing surgery, depending on individual patient characteristics. As with the first article in this series, this article provides background concerning nutrition issues in cancer patients, as well as discusses the role of nutrition support in the care of surgical cancer patients. The goal of this review is to enrich the discussion contained in the clinical guidelines as they relate to recommendations made for surgical patients, cite the primary literature more completely, and suggest updates to the guideline statements in light of subsequently published studies.

  9. Surgical treatment of facial paralysis.

    Science.gov (United States)

    Mehta, Ritvik P

    2009-03-01

    The management of facial paralysis is one of the most complex areas of reconstructive surgery. Given the wide variety of functional and cosmetic deficits in the facial paralysis patient, the reconstructive surgeon requires a thorough understanding of the surgical techniques available to treat this condition. This review article will focus on surgical management of facial paralysis and the treatment options available for acute facial paralysis (facial paralysis (3 weeks to 2 yr) and chronic facial paralysis (>2 yr). For acute facial paralysis, the main surgical therapies are facial nerve decompression and facial nerve repair. For facial paralysis of intermediate duration, nerve transfer procedures are appropriate. For chronic facial paralysis, treatment typically requires regional or free muscle transfer. Static techniques of facial reanimation can be used for acute, intermediate, or chronic facial paralysis as these techniques are often important adjuncts to the overall management strategy.

  10. New epidemiology of Staphylococcus aureus infection in Africa.

    Science.gov (United States)

    Schaumburg, F; Alabi, A S; Peters, G; Becker, K

    2014-07-01

    Research on African Staphylococcus aureus has been largely neglected in the past, despite the cultural and geographical diversity in Africa, which has a significant impact on the epidemiology of this pathogen. The polarity between developed urban societies and remote rural populations (e.g. Pygmies), combined with close contact with animals (e.g. livestock and domestic animals, and wildlife), makes the epidemiology of S. aureus on the African continent unique and fascinating. Here, we try to draw an epidemiological picture of S. aureus colonization and infection in Africa, and focus on the wide spread of Panton-Valentine leukocidin-positive isolates, the emergence of the hypervirulent methicillin-resistant S. aureus (MRSA) clone USA300, and the dissemination of the typical African clone MRSA sequence type 88.

  11. [Recovery of Staphylococcus aureus after acid injury in milk products].

    Science.gov (United States)

    Assis, E M; De Carvalho, E P; Asquieri, E R; Robbs, P G

    1994-01-01

    The growth behavior of Staphylococcus aureus in fresh Cheese (Minas and Muzzarella) during their shelf-life was studied. The possible injury of this microorganism caused by the increasing acidity was also investigated. Raw milk was inoculated with 10(6) cells/ml (S. aureus FRIA-100) and the cheese production was performed according to normal procedures. Minas and muzzarella cheese were stored at 7 degrees C for 40 and 60 days, respectively. At 2-3 days intervals, the following analysis were performed: acidity, pH, S. aureus counting using agar Baird Parker by the traditional methods and by the method recommended by the American Public Health Association to evaluate the reparation of injured cells. We had a secure indication of the presence of injured S. aureus when acidity was in the range of 0.7 to 0.8% expressed in lactic acid and when the cycle was 1.3 log higher than the traditional one.

  12. 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

  13. Environmental Staphylococcus aureus contamination in a Tunisian hospital.

    Science.gov (United States)

    Gharsa, Haythem; Dziri, Raoudha; Klibi, Naouel; Chairat, Sarra; Lozano, Carmen; Torres, Carmen; Bellaaj, Ridha; Slama, Karim Ben

    2016-12-01

    One hundred hospital environment samples were obtained in 2012 in a Tunisian hospital and tested for Staphylococcus aureus recovery. Antimicrobial resistance profile and virulence gene content were determined. Multilocus-sequence-typing (MLST), spa-typing, agr-typing and SmaI-pulsed-field gel electrophoresis (PFGE) were performed. Two methicillin-resistant S. aureus (MRSA) isolates typed as: ST247-t052-SCCmecI-agrI were recovered from the intensive care unit (ICU). Ten samples contained methicillin-susceptible S. aureus (MSSA) and these samples were collected in different services, highlighting the presence of the tst gene encoding the toxic shock syndrome toxin as well as the lukED, hla, hlb, hld and hlgv virulence genes in some of the isolates. In conclusion, we have shown that the hospital environment could be a reservoir contributing to dissemination of virulent S. aureus and MRSA.

  14. METHICILLIN-RESISTANT STAPHYLOCOCCUS AUREUS STRAINS IN FOOD AND ANIMAL

    Directory of Open Access Journals (Sweden)

    A. Traversa

    2010-03-01

    Full Text Available Some authors reported the possibility of a methicillin-resistant Staphylococcus aureus (MRSA human infections from meat and dairy products and methicillin-resistant Staphylococcus intermedius isolation in animals. The aim of this study is to investigate the methicillin-resistance in S. aureus strains and in S. intermedius strains (food and wild animals. 236 S.aureus strains from food, 36 S.aureus strains and 1 S. intermedius strain from wild animals were analyzed. 2 (0.74% MRSA strains from bovine milk were phenotipically resistant to cefoxitin, grew on chromogenic medium (MRSA Brilliance Oxoid and were mecA positive. All MRSA strains had the spa-type t899. All mecA positive strains showed at least resistance to eight of the antibiotics tested but none to glicopeptides. Both MRSA strains were enterotoxigenic.

  15. Rapid, Culture-Free Detection of Staphylococcus aureus Bacteremia

    Science.gov (United States)

    Burghardt, Elliot L.; Flenker, Katie S.; Clark, Karen C.; Miguel, Jeff; Ince, Dilek; Winokur, Patricia; Ford, Bradley; McNamara, James O.

    2016-01-01

    S. aureus bacteremia (SAB) is a common condition with high rates of morbidity and mortality. Current methods used to diagnose SAB take at least a day, and often longer. Patients with suspected bacteremia must therefore be empirically treated, often unnecessarily, while assay results are pending. In this proof-of-concept study, we describe an inexpensive assay that detects SAB via the detection of micrococcal nuclease (an enzyme secreted by S. aureus) in patient plasma samples in less than three hours. In total, 17 patient plasma samples from culture-confirmed S. aureus bacteremic individuals were tested. 16 of these yielded greater nuclease assay signals than samples from uninfected controls or individuals with non-S. aureus bacteremia. These results suggest that a nuclease-detecting assay may enable the rapid and inexpensive diagnosis of SAB, which is expected to substantially reduce the mortality and morbidity that result from this condition. PMID:27305148

  16. Emotions in veterinary surgical students

    DEFF Research Database (Denmark)

    Langebæk, Rikke; Eika, Berit; Pedersen, Lene Tanggaard

    2012-01-01

    A surgical educational environment is potentially stressful and can negatively affect students' learning. The aim of the present study was to investigate the emotions experienced by veterinary students in relation to their first encounter with live-animal surgery and to identify possible sources...... of positive and negative emotions, respectively. During a Basic Surgical Skills course, 155 veterinary fourth-year students completed a survey. Of these, 26 students additionally participated in individual semi-structured interviews. The results of the study show that students often experienced a combination...

  17. CcpA-independent glucose regulation of lactate dehydrogenase 1 in Staphylococcus aureus.

    Directory of Open Access Journals (Sweden)

    Adrianne K Crooke

    Full Text Available Lactate Dehydrogenase 1 (Ldh1 is a key enzyme involved in Staphylococcus aureus NO·-resistance. Full ldh1-induction requires the presence of glucose, and mutants lacking the Carbon-Catabolite Protein (CcpA exhibit decreased ldh1 transcription and diminished Ldh1 activity. The redox-regulator Rex represses ldh1 directly by binding to Rex-sites within the ldh1 promoter (P(ldh1. In the absence of Rex, neither glucose nor CcpA affect ldh1 expression implying that glucose/CcpA-mediated activation requires Rex activity. Rex-mediated repression of ldh1 depends on cellular redox status and is maximal when NADH levels are low. However, compared to WT cells, the ΔccpA mutant exhibited impaired redox balance with relatively high NADH levels, yet ldh1 was still poorly expressed. Furthermore, CcpA did not drastically alter Rex transcript levels, nor did glucose or CcpA affect the expression of other Rex-regulated genes indicating that the glucose/CcpA effect is specific for P(ldh1. A putative catabolite response element (CRE is located ∼30 bp upstream of the promoter-distal Rex-binding site in P(ldh1. However, CcpA had no affinity for P(ldh1 in vitro and a genomic mutation of CRE upstream of P(ldh1 in S. aureus had no affect on Ldh1 expression in vivo. In contrast to WT, ΔccpA S. aureus preferentially consumes non-glycolytic carbon sources. However when grown in defined medium with glucose as the primary carbon source, ΔccpA mutants express high levels of Ldh1 compared to growth in media devoid of glucose. Thus, the actual consumption of glucose stimulates Ldh1 expression rather than direct CcpA interaction at P(ldh1.

  18. Long-term mortality after Staphylococcus aureus spondylodiscitis

    DEFF Research Database (Denmark)

    Aagaard, Theis; Larsen, Anders R; Roed-Petersen, Casper;

    2014-01-01

    Patients diagnosed with Staphylococcus aureus spondylodiscitis have increased long-term mortality compared with the background population mainly due to infectious, endocrine, cardiovascular, gastrointestinal and alcohol and drug abuse-related diseases.......Patients diagnosed with Staphylococcus aureus spondylodiscitis have increased long-term mortality compared with the background population mainly due to infectious, endocrine, cardiovascular, gastrointestinal and alcohol and drug abuse-related diseases....

  19. Tea Tree Oil-Induced Transcriptional Alterations in Staphylococcus aureus

    OpenAIRE

    Cuaron, Jesus A.; Dulal, Santosh; Song, Yang; Singh, Atul K; Montelongo, Cesar E.; Yu, Wanqin; Nagarajan, Vijayaraj; Jayaswal, Radheshyam K.; Wilkinson, Brian J; Gustafson, John E.

    2012-01-01

    Tea tree oil (TTO) is a steam distillate of Melaleuca alternifolia that demonstrates broad-spectrum antibacterial activity. This study was designed to document how TTO challenge influences the Staphylococcus aureus transcriptome. Overall, bioinformatic analyses (S. aureus microarray meta-database) revealed that both ethanol and TTO induce related transcriptional alterations. TTO challenge led to the down-regulation of genes involved with energy-intensive transcription and translation, and alt...

  20. Phenotype Switching Is a Natural Consequence of Staphylococcus aureus Replication

    OpenAIRE

    Edwards, Andrew M.

    2012-01-01

    The pathogen Staphylococcus aureus undergoes phenotype switching in vivo from its normal colony phenotype (NCP) to a slow-growing, antibiotic-resistant small-colony-variant (SCV) phenotype that is associated with persistence in host cells and tissues. However, it is not clear whether phenotype switching is the result of a constitutive process that is selected for under certain conditions or is triggered by particular environmental stimuli. Examination of cultures of diverse S. aureus strains ...

  1. Staphylococcus aureus nasal carriage in hemodialysis centers of Fez, Morocco.

    Directory of Open Access Journals (Sweden)

    Idrissa Diawara

    2014-06-01

    Full Text Available Staphylococcus aureus (S. aureus nasal carriage may be responsible for some serious infections in hemodialyzed patients. The main target of this study was to estimate the prevalence of S. aureus nasal carriage in hemodialysis outpatients and medical staff in hemodialysis centers specifically in Fez region. The second target is to identify the risks of colonization, resistance pattern of isolates and their virulence toxin genes.Nasal swab specimens were obtained from 143 hemodialyzed outpatients and 32 medical staff from January to June 2012. Each participant completed a short questionnaire. Nasal carriage of S. aureus was demographically related (age, gender, hemodialysis duration, comorbidity (diabetes, malignancy and exposure to health care (dialysis staff, hospitalization. PCR (Polymerase Chain Reaction were used on all the isolates in the research of twelve staphylococcal enterotoxins genes. Also the PCR was used to investigate on the three factors epidermal cell differentiation inhibitors; three exfoliatin toxins; two leukotoxins; the toxic shock syndrome toxin-1 and the hemolysin beta genes.Nasal screening revealed 38.16%, 50% and 18.75% S. aureus carries in chronic, acute hemodialysis patients and medical staff, respectively. Only young participants were likely to be S. aureus carries (p = 0.002. But there were no gender differences between the isolate carriers and non-carriers or some comorbidity factors such as viral hepatitis B and C, HIV (Human Immunodeficiency Virus infections, diabetes, chronic smoking, recent hospitalization or antibiotic therapy. Out of all isolates, only one (1.61% was methicillin-resistant and Twenty-one (33.87% had at least two virulence toxin genes.Knowledge and monitoring of antibiotic resistance profile and virulence of S. aureus carriage are essential in the treatment of infections generated by this pathogen, as well as in the control of clonal dissemination and prevent the spread of S. aureus resistance.

  2. Prevalence of Staphylococcus aureus in Shrimps in Tehran during 2013

    OpenAIRE

    Mohammad Mehdi Soltan Dallal; Abbas Rahimi Foroushani; Sara Sharifi –Yazdi; Mohammad Kazem Sharifi -Yazdi; Noushin Arfatahery

    2016-01-01

    Background During fishing and transport, preservation and quality of fish products are importantas well as storage to prevent the growth of pathogenic and toxin producing bacteria.Staphylococcus aureus is one of the most common causes of sea food-borne diseases worldwidedue to contamination of food by preformed enterotoxins. The aim of this study was to compare theprevalence and contamination of S. aureus in marine and farmed shrimps in Tehran fishery center.Methods: A total of 300 samples, i...

  3. IDENTIFIKASI MIKROORGANISE STAPHYLOCOCCUS AUREUS PADA PENDERITA ANGULAR CHEILITIS

    OpenAIRE

    MINARTI, NURHAERATUL

    2012-01-01

    2011 Pada suatu penelitian tentang Angular cheilitis ditemukan Staphylococcus aureus hampir dua kali dari candida albicans. Oleh karena itu tujuan penelitian ini adalah untuk mengidentifikasi pengaruh Staphylococcus aureus pada penyakit Angular cheilitis. Sampel penelitian adalah 30 pasien yang datang ke Rumah Sakit Gigi dan Mulut Halimah Daeng Sikati Kandea Bagian Penyakit Gigi dan Mulut dalam periode waktu bulan Oktober-November 2011. Apusan pada permukaan lesi angular cheilitis dima...

  4. Detoxification of toxins by bacillithiol in Staphylococcus aureus.

    Science.gov (United States)

    Newton, Gerald L; Fahey, Robert C; Rawat, Mamta

    2012-04-01

    Bacillithiol (BSH), an α-anomeric glycoside of l-cysteinyl-d-glucosaminyl-l-malate, is a major low-molecular-mass thiol found in bacteria such as Bacillus sp., Staphylococcus aureus and Deinococcus radiodurans. Like other low-molecular-mass thiols such as glutathione and mycothiol, BSH is likely to be involved in protection against environmental toxins including thiol-reactive antibiotics. We report here a BSH-dependent detoxification mechanism in S. aureus. When S. aureus Newman strain was treated with monobromobimane and monochlorobimane, the cellular BSH was converted to the fluorescent S-conjugate BS-bimane. A bacillithiol conjugate amidase activity acted upon the BS-bimane to produce Cys-bimane, which was then acetylated by an N-acetyltransferase to generate N-acetyl-Cys-bimane, a mercapturic acid. An S. aureus mutant lacking BSH did not produce mercapturic acid when treated with monobromobimane and monochlorobimane, confirming the involvement of bacillithiol. Furthermore, treatment of S. aureus Newman with rifamycin, the parent compound of the first-line anti-tuberculosis drug, rifampicin, indicated that this thiol-reactive antibiotic is also detoxified in a BSH-dependent manner, since mercapturic acids of rifamycin were observed in the culture medium. These data indicate that toxins and thiol-reactive antibiotics are detoxified to less potent mercapturic acids in a BSH-dependent manner and then exported out of the cell in S. aureus.

  5. Determining of antibiotic resistance profile inStaphylococcus aureus isolates

    Institute of Scientific and Technical Information of China (English)

    Hossein Motamedi; Hadis Mirzabeigi; Tahere Shirali

    2010-01-01

    Objective:To determine the pattern of antibiotic resistance amongStaphylococcus aureus (S. aureus) isolates from clinical specimens and to identify community-acquired methicillin-resistantStaphylococcus aureus(CA-MRSA)in specimens that have been collected from patients referring to one of the hospitals of Ahvaz.Methods:S. aureus isolates from a hospital in Ahvaz were screened for resistance to various antibiotics including methicillin. The susceptibility of the isolates was determined by Kirby-Bauer disc diffusion method. TheMRSA was also treated with ethidium bromide to find the origin of resistance.Results: Among the bacterial isolates, all of 11S. aureus were resistant to methicillin and cefixime,2 were resistant to ciprofloxacine,6 were resistant to tetracycline and the reminder were sensitive or intermediate to other antibiotics. The treated isolates were reminded resistant to methicillin and this suggested that the plasmid was not the origin of resistance in these isolates.Conclusions: These results showed that infection due toMRSA is widespread in Ahvaz and with respect to the spread of vancomycin resistance among MRSA and appearance of overwhelming infections. It is necessary to identify continuously the profile of antibiotic resistance amongS. aureus isolates in other regions and finding appropriate antibiotic for infection control and eradication.

  6. CLINICAL DISTRIBUTION CHARACTER OF METHICILLIN - RESISTANT Staphylococcus aureus INFECTION%耐甲氧西林金黄色葡萄球菌感染临床分布特征

    Institute of Scientific and Technical Information of China (English)

    丁丽丽; 沈艳玲; 喻玲丽; 韦艳; 古力夏提; 王鹏

    2012-01-01

    Objective To study the clinical character of patients with methicillin - resistant Staphylococcus aureus ( MR-SA) infection, in order to provide a basis for effective preservation measures of MRSA infection. Methods The prospective monitoring methods was used to investigate and analyze clinical data of patients who were hospitalized from January 2011 to June 2011 and infected with MRSA. Results There were 71 patients infected with MRSA. Of them 76.06% were gained in hospital, other were gained in community. The hospital - acquired MRSA were mainly the surgical site infection (35. 19% ) and skin - soft tissue infection(29. 63% ). The community - associated MRSA infections were mainly skin -soft infection(58. 82% ) and respiratory tract infection(29. 41% ). The respiratory tract infection was the main infection site in ICU, the surgical site was the main infection site in the general ward. Conclusion There are close relationship between MRSA infection character and acquired infection source, and we should take appropriate control measures.%目的 研究耐甲氧西林金黄色葡萄球菌(MRSA)感染患者临床分布特征,为制定预防控制方案提供依据.方法 采用前瞻性调查方法,对新疆某医院MRSA感染患者进行现场调查与分析.结果 调查期间该医院共查出MRSA感染患者71例,其中医院内获得感染患者54例,占76.06%;其余为社区获得感染17例.医院内获得MRSA感染以手术部位感染和呼吸道感染为主,分别占35.19%和29.63%;社区获得MRSA感染部位以皮肤软组织和呼吸道为主,分别占58.82%和29.41%.重症监护病区MRSA感染以呼吸道感染居首位,普通病区以手术部位感染居首位.结论 MRSA感染临床分布特征与获得感染来源有密切关系,应有针对性地提出有效控制措施.

  7. ROLE OF PRE-OPERATIVE NO HAIR REMOVAL ON SURGICAL S ITE INFECTION

    Directory of Open Access Journals (Sweden)

    Ashok Y.

    2013-05-01

    Full Text Available ABSTRACT: This prospective study evaluate the influence of p re-operative no hair removal on surgical site infection in all abdominal and groin surgeries. As there are very few articles about pre - operative no hair removal and its effect at surgica l site in all types of wound. We are presenting thi s original article. Prospective review of 417 patients operated in Kris hna Hospital and Research Center, Karad. Between JAN-2010 to JAN-2011. The study contains cl ean, clean contaminated and dirty wound with two type of skin preparation. All the endogenous an d exogenous factors affecting post-operative surgical site are kept constant except surgical sit e skin preparation like shaving by razor or no hair removal at surgical site. In this study, we are compared role of hair removal and it impact of SSI. We had 8.21 % SSI rate by using razor shaving as skin preparation whi ch is compared with pre-operative no hair removal. It had only 2.38% rate of SSI. The differe nce between standard error of two prospective is more than twice (P<0.05. So it is clear that preop erative no hair removal at surgical site is effecti ve procedure to prevent SSI in all wound type. We are using this pre-operative no hair removal practically for all surgical intervention in our ho spital.

  8. Fatores predisponentes à infecção do sítio cirúrgico em gastrectomia Factores predisponentes a infección del sitio quirúrgico en gastrectomía Predisposing factors for surgical site infection in case of gastrectomy

    Directory of Open Access Journals (Sweden)

    Vanessa de Brito Poveda

    2005-03-01

    ,6% clasificadas como infección incisional superficial; 52,9% infección incisional profunda y 23,6% de infección de órgano / espacio. Las variables período de internación postoperatorio, período de internación total, tiempo de cirugía, período de permanencia del catéter vesical a permanencia presentaron diferencias estadísticamente significativos entre los grupos con y sin infección.This research aimed to identify the predisposing factors for surgical site infection related to the surgical procedure in patients submitted to a potentially contaminated elective gastrectomy, as a part of Gastric surgery, in the period between 1998 and 2002, at a public hospital in the interior of São Paulo, Brazil. Therefore, a retrospective study was carried out by means of a medical record information survey, using the following non-parametric tests for statistical data analysis: Mann-Whitney (quantitative variables and contingency coefficient (qualitative variables. Out of the 181 cases that were examined, the occurrence of surgical site infection was detected in 17 situations (9.4%, 23.6% of which were categorized as superficial incisional infection, 52.9% as deep incisional infection and 23.6% as organ/space infection. Statistically significant differences between the groups with and without infection were found for the following variables: post-operative hospitalization period, total hospitalization period, surgery time, time to dwelling vesical catheter removal.

  9. Intraretinal Foreign Bodies: Surgical Techniques and Outcomes

    Directory of Open Access Journals (Sweden)

    Mostafa Feghhi

    2013-01-01

    Full Text Available Purpose: To report the clinical features of eyes with intraretinal foreign bodies (IRFBs and to evaluate the results of surgical management in these eyes. Methods: Hospital records of 34 eyes of 33 patients with IRFBs were reviewed. All eyes underwent pars plana vitrectomy to remove the foreign bodies using intraocular forceps or by magnetic extraction. Results: All patients were male with mean age of 28΁12.3 years and were followed for a mean period of 24.5΁2.3 months. The IRFBs were ferromagnetic in 29 (85.3% cases and were removed using an external magnet in 13 eyes (38.4% or intraocular forceps in 21 eyes (61.6%. Laser photocoagulation was performed around the IRFB prior to surgery in 7 (20.6% eyes. Macular pucker and scars developed in 8 (23.5% eyes and retinal breaks posterior to the sclerotomy were formed in 12 eyes (35.3% postoperatively. Final visual acuity was 20/40 or better in 12 (35.3% eyes and 20/200 or better in 23 (67.7% eyes. Final visual acuity of 20/200 or better had no significant relationship with the site, size, or type of the IRFB or with the interval from trauma to surgery. Conclusion: Despite the complexity of surgical management of IRFBs, anatomic and visual outcomes of vitreoretinal surgery in these cases are generally good. The appropriate route of removal may be determined by the type, size, and site of the IRFB. Removal of magnetic IRFBs using external magnets versus intraocular forceps seems to entail comparable results.

  10. Structure-based functional characterization of repressor of toxin (Rot), a central regulator of Staphylococcus aureus virulence.

    Science.gov (United States)

    Killikelly, April; Benson, Meredith A; Ohneck, Elizabeth A; Sampson, Jared M; Jakoncic, Jean; Spurrier, Brett; Torres, Victor J; Kong, Xiang-Peng

    2015-01-01

    Staphylococcus aureus is responsible for a large number of diverse infections worldwide. In order to support its pathogenic lifestyle, S. aureus has to regulate the expression of virulence factors in a coordinated fashion. One of the central regulators of the S. aureus virulence regulatory networks is the transcription factor repressor of toxin (Rot). Rot plays a key role in regulating S. aureus virulence through activation or repression of promoters that control expression of a large number of critical virulence factors. However, the mechanism by which Rot mediates gene regulation has remained elusive. Here, we have determined the crystal structure of Rot and used this information to probe the contribution made by specific residues to Rot function. Rot was found to form a dimer, with each monomer harboring a winged helix-turn-helix (WHTH) DNA-binding motif. Despite an overall acidic pI, the asymmetric electrostatic charge profile suggests that Rot can orient the WHTH domain to bind DNA. Structure-based site-directed mutagenesis studies demonstrated that R(91), at the tip of the wing, plays an important role in DNA binding, likely through interaction with the minor groove. We also found that Y(66), predicted to bind within the major groove, contributes to Rot interaction with target promoters. Evaluation of Rot binding to different activated and repressed promoters revealed that certain mutations on Rot exhibit promoter-specific effects, suggesting for the first time that Rot differentially interacts with target promoters. This work provides insight into a precise mechanism by which Rot controls virulence factor regulation in S. aureus.

  11. Utilization of the chromogenic agar MRSA ID in the surveillance of methicillin-resistant Staphylococcus aureus in a low endemic unit for MRSA

    Directory of Open Access Journals (Sweden)

    Laura Squarzon

    2008-06-01

    Full Text Available Methicillin-resistant Staphylococcus aureus (MRSA is one of the most common pathogen responsible for nosocomial infections.Approximately 20% of patients undergoing surgical operations acquires at least one nosocomial infection. Nasal carriers of S. aureus have been identified as one of the populations at major risk to develop this type of infection, particularly, after operations, dialysis, transplants and admission in intensive care unit. Our study was conducted on patients who came from a Neurosurgery Intensive Care Unit, where the incidence of MRSA is very low (8% and where it is very important to identify MRSA carriers in order to adopt measures to avoid transmission.The use of chromogenic agar MRSA ID allowed us to identify green colonies of MRSA within 24 hours and to make a timely and careful diagnosis.

  12. [Surgical education has its price].

    Science.gov (United States)

    Schröder, W; Krones, C J

    2012-04-01

    The radical economisation of the German health-care system has caused an increasing cost awareness. Following this trend, medical education has been identified as a possible expense factor. The theoretical and practical training of young doctors needs time and costs money. However, a detailed cost analysis is still not available, since the complex daily work schedule of young professionals only allows the calculation of single cost factors. Investigations in the USA estimate the costs of surgical training at US$ 80 000 per year and per resident. At present in Germany, surgical training is indirectly financed by the DRG flat rates of the health insurance companies. Possible alternatives include the implementation of a "training fond" which is financed by a percentage fee of the DRG's as well as an on-top funding by the federal government. This "training fond" would support only those surgical units that offer a structured and certified training to surgical residents. However, a systematic cost analysis of such a structured curriculum is necessary for any further discussion.

  13. Surgical Lasers In Veterinary Medicine

    Science.gov (United States)

    Newman, H. C.

    1987-03-01

    Veterinary medicine is a latecomer in benefiting from the advent of surgical lasers. It is ironic that although most of the basic work in lasers is carried out in animal species with which we are most conversant, veterinary medicine as a profession has not been very extensively involved.

  14. Surgical management of tubal pregnancy

    NARCIS (Netherlands)

    Mol, F.

    2013-01-01

    The work presented in this thesis first addresses the magnitude of the clinical problem of surgically treated tubal pregnancy in The Netherlands. Next, we studied the adherence to recommendations from the Dutch guideline on diagnosis and management of ectopic pregnancy. A systematic review and meta-

  15. Pseudothrombocytopenia in cardiac surgical practice.

    Science.gov (United States)

    Nair, Sukumaran K; Shah, Roma; Petko, Matus; Keogh, Bruce E

    2007-08-01

    Pseudothrombocytopenia is observed occasionally in post-cardiac surgical patients. It is commonly due to EDTA-mediated immunological mechanisms, which lead to agglutination of functionally intact platelets. This condition is harmless and does not warrant platelet transfusion. We describe an instance of pseudothrombocytopenia in our practice and discuss its clinical relevance.

  16. Surgical smoke and infection control.

    NARCIS (Netherlands)

    Alp, E.; Bijl, D.; Bleichrodt, R.P.; Hansson, B.M.; Voss, A.

    2006-01-01

    Gaseous byproducts produced during electrocautery, laser surgery or the use of ultrasonic scalpels are usually referred to as 'surgical smoke'. This smoke, produced with or without a heating process, contains bio-aerosols with viable and non-viable cellular material that subsequently poses a risk of

  17. Surgical options after Fontan failure

    DEFF Research Database (Denmark)

    van Melle, Joost P; Wolff, Djoeke; Hörer, Jürgen;

    2016-01-01

    OBJECTIVE: The objective of this European multicenter study was to report surgical outcomes of Fontan takedown, Fontan conversion and heart transplantation (HTX) for failing Fontan patients in terms of all-cause mortality and (re-)HTX. METHODS: A retrospective international study was conducted by...

  18. Surgical Training in the Netherlands

    NARCIS (Netherlands)

    Borel Rinkes, I.H.M.; Gouma, D.J.; Hamming, J.F.

    2008-01-01

    Surgical training in the Netherlands has traditionally been characterized by learning on the job under the classic master-trainee doctrine. Over the past decades, it has become regionally organized with intensive structural training courses, and a peer-based quality control system. Recently, the nat

  19. Surgical treatment of primary hyperparathyroidism

    DEFF Research Database (Denmark)

    Brasso, K; Karstrup, S; Lundby, C M

    1994-01-01

    .9%). Permanent paralysis of the recurrent nerve occurred in three patients (2.9%). Twenty-one patients developed other postoperative complications from which they all recovered without sequelae. No postoperative deaths occurred. Our results show that surgical treatment of primary hyperparathyroidism...

  20. Prevalence of Staphylococcus aureus and Methicillin-Resistant Staphylococcus aureus in Retail Ready-to-Eat Foods in China.

    Science.gov (United States)

    Yang, Xiaojuan; Zhang, Jumei; Yu, Shubo; Wu, Qingping; Guo, Weipeng; Huang, Jiahui; Cai, Shuzhen

    2016-01-01

    Staphylococcus aureus, particularly methicillin-resistant S.aureus (MRSA), is a life-threatening pathogen in humans, and its presence in food is a public health concern. MRSA has been identified in foods in China, but little information is available regarding MRSA in ready-to-eat (RTE) foods. We aimed to investigate the prevalence of S. aureus and MRSA in Chinese retail RTE foods. All isolated S. aureus were tested for antimicrobial susceptibility, and MRSA isolates were further characterized by multilocus sequence typing (MLST) and staphylococcal cassette chromosome mec (SCCmec) typing. Of the 550 RTE foods collected from 2011 to 2014, 69 (12.5%) were positive for S. aureus. Contamination levels were mostly in the range of 0.3-10 most probable number (MPN)/g, with five samples exceeding 10 MPN/g. Of the 69 S. aureus isolates, seven were identified as MRSA by cefoxitin disc diffusion test. Six isolates were mecA-positive, while no mecC-positive isolates were identified. In total, 75.8% (47/62) of the methicillin-susceptible S. aureus isolates and all of the MRSA isolates were resistant to three or more antibiotics. Amongst the MRSA isolates, four were identified as community-acquired strains (ST59-MRSA-IVa (n = 2), ST338-MRSA-V, ST1-MRSA-V), while one was a livestock-associated strain (ST9, harboring an unreported SCCmec type 2C2). One novel sequence type was identified (ST3239), the SCCmec gene of which could not be typed. Overall, our findings showed that Chinese retail RTE foods are likely vehicles for transmission of multidrug-resistant S. aureus and MRSA lineages. This is a serious public health risk and highlights the need to implement good hygiene practices.