scholarly journals Surgical Site Infection after Renal Transplantation

2015 ◽  
Vol 36 (4) ◽  
pp. 417-423 ◽  
Author(s):  
Anthony D. Harris ◽  
Brandon Fleming ◽  
Jonathan S. Bromberg ◽  
Peter Rock ◽  
Grace Nkonge ◽  
...  
Keyword(s):  
Renal Transplantation ◽  
Surgical Site Infection ◽  
Vascular Disease ◽  
Risk Index ◽  
Tertiary Care ◽  
Adult Patients ◽  
Site Infection ◽  
Peripheral Vascular ◽  
Rheumatologic Disease ◽  
History Of

OBJECTIVETo identify factors associated with the development of surgical site infection (SSI) among adult patients undergoing renal transplantationDESIGNA retrospective cohort studySETTINGAn urban tertiary care center in Baltimore, Maryland, with a well-established renal transplantation program that performs ~200–250renal transplant procedures annuallyRESULTSAt total of 441 adult patients underwent renal transplantation between January 1, 2010, and December 31, 2011. Of these 441patients, 66 (15%) developed an SSI; of these 66, 31 (47%) were superficial incisional infections and 35 (53%) were deep-incisional or organ-space infections. The average body mass index (BMI) among this patient cohort was 29.7; 84 (42%) were obese (BMI >30). Patients who developed an SSI had a greater mean BMI (31.7 vs 29.4; P=.004) and were more likely to have a history of peripheral vascular disease, rheumatologic disease, and narcotic abuse. History of cerebral vascular disease was protective. Multivariate analysis showed BMI (odds ratio [OR] 1.06; 95% confidence interval [CI], 1.02–1.11) and past history of narcotic use/abuse (OR, 4.86; 95% CI, 1.24–19.12) to be significantly associated with development of SSI after controlling for National Healthcare Surveillance Network (NHSN) score and presence of cerebrovascular, peripheral vascular, and rheumatologic disease.CONCLUSIONSWe identified higher BMI as a risk factor for the development of SSI following renal transplantation. Notably, neither aggregate comorbidity scores nor NHSN risk index were associated with SSI in this population. Additional risk adjustment measures and research in this area are needed to compare SSIs across transplant centers.Infect Control Hosp Epidemiol 2015;00(0): 1–7

Risk Adjustment for Surgical Site Infection After Median Sternotomy in Children

2007 ◽  
Vol 28 (4) ◽  
pp. 398-405 ◽  
Author(s):  
Jessica Kagen ◽  
Warren B. Bilker ◽  
Ebbing Lautenbach ◽  
Louis M. Bell ◽  
Susan E. Coffin ◽  
...  
Keyword(s):  
Surgical Site Infection ◽  
Pediatric Patients ◽  
Characteristic Curve ◽  
Risk Index ◽  
Tertiary Care ◽  
Median Sternotomy ◽  
Case Definition ◽  
Site Infection ◽  
Retrospective Case ◽  
Risk Indices

Objective.To determine whether the National Nosocomial Infections Surveillance (NNIS) System risk index adequately stratified a population of pediatric patients undergoing cardiac surgery according to the risk of developing surgical site infection (SSI).Design.A retrospective, case-control study.Setting.An urban tertiary care children's hospital.Patients.Patients who had a median sternotomy performed between January 1,1995, and December 31, 2003, were eligible for inclusion in the study. For all case patients, medical records were reviewed to verify that all patients met the case definition for SSI. Control subjects were chosen randomly from among all patients who underwent median sternotomy during the study period who did not develop SSI.Results.Thirty-eight patients with SSI and 172 patients without SSI were included. One hundred six patients (50%) were male. The median patient age was 4 months. The sensitivity of the NNIS risk index with cutoff scores of 0 to 1 and 2 to 3 was 20%. The distribution of patients with SSI for an NNIS risk index score of 0 was 0%; for a score of 1, 80%; for a score of 2, 20%; and for a score of 3, 0%. The distribution of patients without SSI for a scores of 0 was 4%; for a score of 1, 87%; for a score of 2, 9%; and for a score of 3, 0%. The area under the receiver-operating characteristic curve (AUC) of the original NNIS risk index was 0.57. The modified risk indices did not perform significantly better, with an AUC range of 0.58 to 0.73.Conclusions.The NNIS risk index did not adequately stratify pediatric patients undergoing median sternotomy according to their risk of developing an SSI. Various modifications to the risk index yielded only slightly higher AUC values.

Risk Factors for Surgical Site Infection Complicating Laminectomy

2007 ◽  
Vol 28 (9) ◽  
pp. 1060-1065 ◽  
Author(s):  
N. Deborah Friedman ◽  
Daniel J. Sexton ◽  
Sarah M. Connelly ◽  
Keith S. Kaye
Keyword(s):  
Risk Factors ◽  
Surgical Site Infection ◽  
Risk Index ◽  
Tertiary Care ◽  
Operating Experience ◽  
Care Facility ◽  
Site Infection ◽  
Surgical Specialty ◽  
Tertiary Care Facility ◽  
Independent Risk Factors

Objective.To examine risk factors for surgical site infection (SSI) following spinal surgery and to analyze the associations between a surgeon's years of operating experience and surgical specialty and patients' SSI risk.Design.Case-control study.Setting.A tertiary care facility and a community hospital in Durham, North Carolina.Patients.Each case patient who developed an SSI complicating laminectomy was matched with 2 noninfected control patients by hospital, year of surgery, and National Nosocomial Infection Surveillance System risk index score.Results.Forty-one case patients with SSI complicating laminectomy and 82 matched control patients were analyzed. Nonwhite race, diabetes and an elevated body mass index (BMI) were more common among case patients than among control patients. Subjects with a BMI greater than 35 were more likely to undergo a prolonged procedure, compared with case patients who had a BMI of 35 or less. The SSI rate for patients operated on by neurosurgeons was 28%, compared with 43% for patients operated on by orthopedic surgeons (odds ratio [OR], 0.5; P = .12). The number of years of operating experience were not associated with SSI risk. Multivariate analysis revealed diabetes (OR, 4.2 [95% confidence interval {CI}, 1.1-16.3]; P = .04), BMI greater than 35 (OR, 7.1 [95% CI, 1.8-28.3]; P = .005), and laminectomy at a level other than cervical (OR, 6.7 [95% CI, 1.4-33.3]; P = .02) as independent risk factors for SSI following laminectomy.Conclusion.Diabetes, obesity, and laminectomy at a level other than cervical are independent risk factors for SSI following laminectomy. Preoperative weight loss and tight perioperative control of blood glucose levels may reduce the risk of SSI in laminectomy patients.

scholarly journals EFFECTS OF IRON DEFICIENCY ANEMIA IN SURGICAL SITE INFECTION

2021 ◽  
Vol 71 (3) ◽  
pp. 749-52
Author(s):  
Muhammad Umair Zulfiqar ◽  
Umer Fayyaz Ghani ◽  
Ayub Ashraf Mallhi ◽  
Khalid Mahmood ◽  
Maria Iqbal ◽  
...  
Keyword(s):  
Iron Deficiency ◽  
Surgical Site Infection ◽  
Iron Deficiency Anemia ◽  
Tertiary Care ◽  
Target Population ◽  
Deficiency Anemia ◽  
Military Hospital ◽  
Site Infection ◽  
Surgical Department ◽  
History Of

Objective: To determine effect of iron deficiency anemia on the patients developing surgical site infection at surgical department of a tertiary care setup in Pakistan. Study Design: Comparative prospective study. Place and Duration of Study: Department of Surgery, Pak Emirates Military Hospital Rawalpindi, from Nov 2018 to Mar 2019. Methodology: A total of 152 indoor hospitalized patients were included in the study. Surgical site infection was assessed by a consultant surgeon according to definitions provided by the Centers for Disease Control and Prevention (CDC) National nosocomial infections surveillance system. Iron deficiency anemia was classed on the basis of hemoglobin and ferritin levels. Results: Eighty six (56.6%) patients were male while 66 (43.4%) patients included in the study were female. Commonest surgical procedure was laparotomy 29 (19.1%) followed by the hernioplasty 27 (17.7%). Out of 152 patients undergoing surgery & admitted in ward, 35 (23.1%) showed the presence of surgical site infection while 117 (76.9%) had no infection. Seventy eight (51.3%) patients had iron deficiency anemia while 74 (48.7%) patients were not anemic. History of transfusion during the surgery and presence of iron deficiency anemia was significantly associated with surgical site infection in the target population. Conclusion: Study exhibited high frequency of surgical site infection in the target population. Regular screening for anemia should be performed at surgery department and patients with history of transfusion during the surgery should be looked after especially. Iron deficiency anemia emerged as an independent factor associated with presence of surgical site infection among surgical patients.

scholarly journals Prevalence of Peripheral Vascular Disease in Diabetic Foot Infections and its Effect on Management Outcome

2019 ◽  
Vol 38 (1) ◽  
pp. 12-17
Author(s):  
Farah Nobi ◽  
Syed Al Nahian ◽  
Afrin Sultana ◽  
Rokhsana Sarmin ◽  
Ayesha Rahman ◽  
...  
Keyword(s):  
Vascular Disease ◽  
Peripheral Vascular Disease ◽  
Lower Limb ◽  
Diabetic Foot ◽  
Tertiary Care ◽  
Peripheral Vascular ◽  
Tertiary Care Centre ◽  
Term Care ◽  
Diabetic Foot Infection ◽  
Diabetic Foot Infections

Background: Foot infection is a common problem affecting diabetics. Ischemia is a major factor contributing to progress and morbidity of the disease. The prevalence of peripheral vascular disease is higher in diabetics with faster progression. Aim: This study aimed to observe the prevalence of peripheral vascular disease in patients with diabetic foot infections presenting to this tertiary care centre. Methods: This prospective observational study evaluated 250 patients with diabetic foot infection admitted to Ibrahim Medical College and BIRDEM General Hospital, Dhaka, from 1st January 2015 to 31st December 2015.Total 72 patients were selected for Duplex study of lower limb vessels, Ankle Brachial Pressure Index (ABPI) and Pulse oxymetrywhich established the diagnosis of peripheral vascular disease and all patients were treated according to the standard protocol. Results: Of the 72 patients peripheral vascular disease was found in 25 patients (34.7%) and majority of them (88%) had distal below the knee vessel stenosis. There was significant correlation with older age (75%) and history of tobacco use (64%). The clinical presentations and outcomes such as hospital stay, healing time, pain were worse in individuals with peripheral vascular compromise on Duplex study of lower limb vessels, ABPI and pulse oxymetry. Conclusion: In this study we observed that significant number of diabetics presenting with foot infections have underlying peripheral vascular disease .The patients might not all be symptomatic or show obvious signs of PVD but need to be investigated for the same. Early detection of peripheral vascular disease in patients presenting with diabetic foot infection, using Duplex study,ABPI and Pulse oxymetrywith routine clinical and laboratory assessment can be of great value in long term care of these individuals. J Bangladesh Coll Phys Surg 2020; 38(1): 12-17

Surgical site infection in colorectal surgeries: Experience in tertiary care hospital

2015 ◽  
Vol 12 ◽  
pp. S11
Author(s):  
Afshan Anjum Wani ◽  
Nisar Ahmad Chowdri ◽  
Fazal Q. Parray ◽  
Rouf A. Wani
Keyword(s):  
Surgical Site Infection ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Care Hospital ◽  
Site Infection

scholarly journals Independent risk factors for surgical site infection after cesarean delivery in a rural tertiary care medical center

2016 ◽  
Vol 31 (1) ◽  
pp. 120-126 ◽  
Author(s):  
Manuel C. Vallejo ◽  
Ahmed F. Attaallah ◽  
Robert E. Shapiro ◽  
Osama M. Elzamzamy ◽  
Michael G. Mueller ◽  
...  
Keyword(s):  
Risk Factors ◽  
Surgical Site Infection ◽  
Cesarean Delivery ◽  
Medical Center ◽  
Tertiary Care ◽  
Site Infection ◽  
Tertiary Care Medical Center ◽  
Independent Risk Factors

scholarly journals Experience of Laparoscopic Cholecystectomies in a Tertiary Care Hospital: a Retrospective Study

2020 ◽  
Vol 27 (4) ◽  
pp. E202043
Author(s):  
Aamir Hussain Hela ◽  
Haseeb Mohammad Khandwaw ◽  
Rahul Kumar ◽  
Mir Adnan Samad
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Retrospective Study ◽  
Bile Duct ◽  
Surgical Site Infection ◽  
Tertiary Care Hospital ◽  
Open Cholecystectomy ◽  
Tertiary Care ◽  
Care Hospital ◽  
Site Infection ◽  
The Mean

Introduction: Laparoscopic cholecystectomy is the most commonly performed surgical procedure of digestive tract. It has replaced open cholecystectomy as gold standard treatment for cholelithiasis and inflammation of gallbladder.  It is estimated that approximately 90% of cholecystectomies in the  United States are performed using a laparoscopic approach.  The aim of this study was to evaluate the outcome of Laparoscopic cholecystectomy in context to its complications, morbidity and mortality in a tertiary care hospital.  Methods: This retrospective study was conducted on 1200 patients, who underwent laparoscopic cholecystectomies, during the period from January 2019 to December 2019, at Government Medical College Jammu J & K, India and necessary data was collected and reviewed. Results: In our study, a total of 1200 patients were studied including 216 males (18%) and 984 females (82%). The mean age of the patients was 43.35±8.61. The mean operative time in our study was 55.5±10.60 minutes with range of 45 – 90 minutes. Conversion rate was 2.6%. 2 patients were re-explored. Bile duct injury was found in 6 patients (0.5%).  Conclusions: Gallstone disease is a global health problem. Laparoscopic cholecystectomy has now replaced open cholecystectomy as the first choice of treatment for gallstones. Gall stone diseases is most frequently encountered in female population. The risk factors for conversion to open cholecystectomy include male gender, previous abdominal surgery, acute cholecystitis, dense adhesions and fibrosis in Calot’ s triangle, anatomical variations, advanced age, comorbidity, obesity, suspicion of common bile duct stones, jaundice, and decreased surgeon experience. The incidence of surgical site infection has significantly decreased in laparoscopic cholecystectomy compared to open cholecystectomy. In our study we could not find any case of surgical site infection.

scholarly journals To study the effectiveness of prophylactic use of ceftriaxone (single dose) in caesarean section in low risk patients in a tertiary care center, Moradabad, India

2017 ◽  
Vol 5 (12) ◽  
pp. 5278
Author(s):  
Ruby Kumari ◽  
Arti Sharma ◽  
. Sheetal ◽  
Pratibha Roy ◽  
. Anupriya
Keyword(s):  
Single Dose ◽  
Caesarean Section ◽  
Surgical Site Infection ◽  
Care Center ◽  
Tertiary Care ◽  
Infectious Complications ◽  
Low Risk ◽  
Tertiary Care Center ◽  
Site Infection ◽  
Risk Patients

Background: There is increasing incidence of caesarean section throughout the world. As caesarean section is associated with infectious complications which increase the rate of morbidity and mortality of mothers. For prevention of infectious complications antibiotics are used but careless use of antibiotics increasing incidence of antibiotic resistance. Many guidelines and studies recommend single dose antibiotic prophylaxis for women undergoing elective or non-elective caesarean section. The aim of this study was to assess the effectiveness of Ceftriaxone as prophylactic antibiotic (single dose) in caesarean section in low risk patients.Methods: A Prospective single blind study was carried out in the department of obstetrics and gynaecology, TMMC and RC Moradabad, a tertiary care center, in all low risk patients underwent for Elective and Emergency Lower segment caesarean section for 1 year from 1st June 2015 to May 2016 on 110 patients. Data was collected and analyzed by percentage and proportion.Results: Prevalence of caesarean section was maximum in women of 26-35years age group (52.72%),about 67.27% was emergency LSCS, most common indication of caesarean section was Fetal distress (29.09%),refusal for vaginal delivery after caesarean section (10.90%) was one of the cause for increasing rate of repeat caesarean section, 41.81% women in labour,72.27% cases were with intact membrane, in 9.09% cases, antibiotic had to change in post-operative period due to urinary tract infection and surgical site infection, most common post-operative complication was superficial surgical site infection with purulent discharge (2.72%). No major life-threatening complication occurred.Conclusions: Single dose of Ceftriaxone is effective for prevention of post-caesarean infectious complication.

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