Nasal Carriage of Staphylococcus aureus: Is a Major Risk Factor for Surgical-Site Infections in Orthopedic Surgery

2000 ◽  
Vol 21 (5) ◽  
pp. 319-323 ◽  
Author(s):  
Mathijs D. Kalmeijer ◽  
Ella van Nieuwland-Bollen ◽  
Diane Bogaers-Hofman ◽  
Gerard A.J. de Baere ◽  
Jan A.J.W. Kluytmans
Keyword(s):  
Risk Factors ◽  
Staphylococcus Aureus ◽  
Risk Factor ◽  
Orthopedic Surgery ◽  
Independent Risk Factor ◽  
Multiple Logistic Regression Analysis ◽  
Surgical Site Infections ◽  
Nasal Carriage ◽  
Multiple Logistic Regression ◽  
High Level

AbstractObjective:To determine the relative importance of different risk factors for the development of surgical-site infections (SSIs) in orthopedic surgery with prosthetic implants.Design:In a cohort of 272 patients, the following possible risk factors were studied: age, gender, method of hair removal, duration of operation, surgeon, underlying illness, and nasal carriage of Staphylococcus aureus. Infections were recorded following the Centers for Disease Control criteria. The relation between risk factors and SSI was tested in univariate and multiple logistic regression analysis.Setting:Community hospital in Breda, The Netherlands.Results:18 (6.6%) of 272 patients experienced SSI: 11 superficial and 7 deep SSI. These infections led in three cases to removal of the prosthesis and caused 286 extra days in hospital. The main causative pathogen was S aureus. In multiple logistic regression analysis, the following factors were independent risk factors for the development of SSI: high-level nasal carriage of S aureus (P=.04), male gender (P=.005), and surgeon 1 (P=.006). The only independent risk factor for SSI with S aureus was high-level nasal carriage of S aureus (P=.002).Conclusion:High-level nasal carriage of S aureus was the most important and only significant independent risk factor for developing SSI with S aureus.

scholarly journals Risk factors for postoperative nausea and vomiting after the removal of impacted third molars: a cross-sectional study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Hiroaki Hasegawa ◽  
Atsushi Abe ◽  
Hiroki Hayashi ◽  
Hiroshi Furuta ◽  
Takanori Ishihama
Keyword(s):  
Risk Factors ◽  
Risk Factor ◽  
Multiple Logistic Regression Analysis ◽  
Third Molar ◽  
Postoperative Nausea And Vomiting ◽  
Volatile Anesthetics ◽  
Nausea And Vomiting ◽  
Patient Specific ◽  
Multiple Logistic Regression ◽  
Related Factors

Abstract Background A better understanding of the risk factors for postoperative nausea and vomiting (PONV) could improve patient outcomes. This study aimed to analyze the risk factors for PONV and its onset after third molar impaction surgery, and to demonstrate the importance of controlling anesthesia-related factors regardless of patient-specific factors. Methods We included patients who reported nausea and vomiting within 12 h of extubation. Patients with incomplete data, those who could not communicate, and those with gastrointestinal disorders were excluded. We evaluated patient-specific risk factors, and the use of volatile anesthetics and intraoperative fentanyl anesthetic-related factors. Multiple logistic regression analysis was performed taking patient background factors into account. Results In total, 182 patients who underwent disimpaction of the third molar under general anesthesia between January 2017 and December 2018 at Nagoya Ekisaikai Hospital, were included. Approximately 12.6% (n = 23) patients experienced PONV, with no significant difference in terms of sex, smoking status, age, and body mass index compared to patients without PONV. Multiple logistic regression analysis revealed no interaction between fentanyl and volatile anesthetics. The major risk factor for PONV was the use of volatile anesthetics. Patients in whom anesthesia was maintained by volatile anesthetics were 13.35 times more likely to have PONV than those in whom total intravenous anesthesia was induced (P < 0.001). Conclusion Maintenance of anesthesia with volatile anesthetics is a risk factor for PONV.

scholarly journals The Prevalence of MRSA Nasal Carriage in Preoperative Pediatric Orthopaedic Patients

2016 ◽  
Vol 2016 ◽  
pp. 1-6 ◽  
Author(s):  
J. J. Walrath ◽  
W. L. Hennrikus ◽  
C. Zalonis ◽  
A. M. Dyer ◽  
J. E. Latorre
Keyword(s):  
Staphylococcus Aureus ◽  
Risk Factor ◽  
Postoperative Infection ◽  
Pediatric Patients ◽  
Surgical Site Infections ◽  
Nasal Carriage ◽  
Surgical Prophylaxis ◽  
Methicillin Resistant ◽  
Orthopaedic Patients ◽  
Pediatric Orthopaedic

Nasal carriage of methicillin-resistantStaphylococcus aureus(MRSA) has been described as a risk factor for postsurgical infection. The purpose of this study is to determine the prevalence of MRSA in pediatric orthopaedic patients and whether being a MRSA carrier is a predictor of postoperative infection. Six hundred and ninety-nine consecutive pediatric patients who underwent MRSA nasal screening prior to surgery were studied. Postoperative cultures, total surgical site infections (SSIs), and epidemiological and surgical prophylaxis data were reviewed. Forty-four of 699 patients (6.29%) screened positive for MRSA. Nine of the 44 patients (20.5%) that screened positive for MRSA had a subsequent SSI compared to 10 of the 655 patients (1.52%) that screened negative (p<0.05). All 9 patients with a SSI had myelomeningocele. The prevalence of MRSA was 6.30% and was predictive of postoperative infection. Children with myelomeningocele were at the highest risk for having a positive MRSA screening and developing SSI.

scholarly journals Do the Severity of Peritonitis and Stoma Creation Influence the Occurrence of Incisional Surgical Site Infections in Patients With Colorectal Perforation?

2019 ◽  
Vol 104 (7-8) ◽  
pp. 338-343
Author(s):  
Takehito Yamamoto ◽  
Takeshi Morimoto ◽  
Hiroki Hashida ◽  
Satoshi Kaihara ◽  
Ryo Hosotani
Keyword(s):  
Risk Factors ◽  
Risk Factor ◽  
Emergency Surgery ◽  
Independent Risk Factor ◽  
Multivariate Logistic Regression Analysis ◽  
Surgical Site Infections ◽  
Wound Management ◽  
Colorectal Perforation ◽  
Stoma Creation ◽  
Incisional Surgical Site Infection

Objective To identify the risk factors for incisional surgical site infection (SSI) in patients undergoing emergency surgery for colorectal perforation. Summary of Background Data Emergency surgery for colorectal perforation carries an especially high risk of incisional SSI. Although the risk factors of incisional SSI after colorectal surgery have been analyzed, no study has focused exclusively on patients with colorectal perforation. Methods Patients with colorectal perforation who underwent emergent surgery from 2010 to 2015 were enrolled. The factors associated with the occurrence of postoperative incisional SSI were evaluated. Results We enrolled 108 patients with colorectal perforation who underwent an emergency operation. Of these, 13 patients who died within 30 days after surgery were excluded. The mean age of the 95 study patients was 70 ± 13 years; 48 (51%) patients were male. The incisional SSI group comprised 26 patients (27%). Multivariate logistic regression analysis showed that stoma creation [odds ratio: 11.34; 95% confidence interval: 2.06–214.14] was an independent risk factor for incisional SSI. However, none of the clinical indicators of severe peritonitis and sepsis, including body temperature, systolic blood pressure, heart rate, preoperative white blood cell count, and C-reactive protein, were associated with the occurrence of incisional SSI. Conclusions Stoma creation was an independent risk factor for postoperative incisional SSI. Therefore, in this patient population, meticulous postoperative wound management is essential.

Preoperative Albumin Level Serves as a Predictor for Postoperative Pulmonary Complications Following Elective Laparoscopic Gastrectomy

2018 ◽  
Vol 24 (27) ◽  
pp. 3250-3255 ◽  
Author(s):  
Yun Chen ◽  
Guorong Wu ◽  
Ruichun Wang ◽  
Junping Chen
Keyword(s):  
Risk Factors ◽  
Laparoscopic Gastrectomy ◽  
Independent Risk Factor ◽  
Multiple Logistic Regression Analysis ◽  
Albumin Level ◽  
Pulmonary Complications ◽  
Multiple Logistic Regression ◽  
Postoperative Pulmonary Complications ◽  
Potential Risk Factors ◽  
Preoperative Albumin

Objective: Postoperative Pulmonary Complications (PPCs) can contribute to increased mortality and prolonged hospital stay in surgical patients with Gastric Cancer (GC). This study aimed to investigate potential risk factors for PPCs in elderly GC patients following elective laparoscopic gastrectomy. Methods: Eligible consecutive elderly GC patients (aged over 65 years) who were scheduled to undergo elective laparoscopic gastrectomy were enrolled in this study. The demographic, clinicopathological characteristics and laboratory variables were compared in patients with or without PPCs within postoperative 30 days. Risk factors for PPCs were analyzed by multiple logistic regression analysis and receiver operating characteristic (ROC) curve analysis. Results: 35 of all the 262 enrolled patients have developed PPCs with an incidence of 13.4%. Age, chronic obstructive pulmonary disease (COPD), congestive heart failure (CHF), forced expiratory volume in one second/ forced vital capacity (FEV1/FVC) ratio, duration of operation, hemoglobin, albumin and C-reactive protein (CRP) were potential risk factors for PPCs by univariate analysis. The preoperative albumin level was the only independent risk factor for PPCs (OR: 1.15, 95%CI: 1.06-1.28, P=0.011) by multiple logistic regression analysis. Preoperative albumin level was a predictor for PPCs with an area under the curve (AUC) of 0.728 and a cut-off value of 33.8 mg/dl (specificity: 54.19%, sensitivity: 77.14%, P<0.001). Conclusions: Preoperative albumin level was an independent risk factor for PPCs in elderly GC patients after elective laparoscopic gastrectomy.

scholarly journals The Relationship between Nasal Carriage of Staphylococcus aureus and Surgical Site Infections in a Hospital Center in Morocco

2021 ◽  
Vol 2021 ◽  
pp. 1-9
Author(s):  
Rachid Flouchi ◽  
Abderrahim Elmniai ◽  
Abdelaziz Hibatallah ◽  
Karim Fahsi ◽  
Ibrahim Touzani ◽  
...  
Keyword(s):  
Public Health ◽  
Risk Factors ◽  
Staphylococcus Aureus ◽  
Methicillin Resistant Staphylococcus Aureus ◽  
Surgical Site Infections ◽  
Nasal Carriage ◽  
Diffusion Method ◽  
Postoperative Phase ◽  
Methicillin Resistant ◽  
Hospital Center

Background. Surgical site infection is a major public health problem in the world. Nasal carriage is a major risk factor for the development of nosocomial Staphylococcus aureus infection, especially methicillin-resistant Staphylococcus aureus (MRSA). Our work aims to determine the prevalence of Staphylococcus aureus, methicillin-resistant Staphylococcus aureus, and the associated risk factors and to evaluate their sensitivity to 27 antibiotics. Methods. A cross-sectional study was carried out on 100 patients, hospitalized in preoperative care of surgery units at the Taza Provincial Hospital Center in the Fez-Meknes region, from January to June 2019. Samples were taken from the patient’s anterior nostril using single-use sterile dry or wet cotton swabs and then analyzed in the Provincial Public Health Laboratory in Taza. The carriage of Staphylococcus aureus was studied by conventional bacteriological methods by spreading nasal swabs on Chapman culture medium, while antibiotic resistance was determined by the Mueller–Hinton agar disc diffusion method according to the recommendations described by the Antibiogram Committee of the French Society of Microbiology 2019 (CA SFM 2019). Results. Of the 84 patients found to be positive, 45.24% had coagulase-positive Staphylococcus aureus and 54.76% had coagulase-negative Staphylococcus. After surgery in the postoperative phase, 16 patients developed surgical site infections, of which two had a negative nasal culture and 14 had positive nasal culture. Among the Staphylococcus aureus-positive patients, 36.84% were colonized by a methicillin-resistant Staphylococcus aureus (MRSA) and 63.16% by a methicillin-sensitive Staphylococcus aureus (MSSA). Of these, 57.14% of MRSA colonized patients developed an infection of the surgical site and 42.85% showed no sign of SSI, while for patients colonized by MSSA, 16.67% developed SSI and 83.33% showed no sign of SSI. Moreover, children were the most affected by MRSA. Concerning antibiotic sensitivity, multiresistance of MRSA to more than 3 antibiotics has been found. Conclusion. To the best of our knowledge, this is the first study carried out in this hospital center with the aim of knowing the prevalence of nasal carriage of Staphylococcus aureus and MRSA and to identify the risk factors in order to prevent infections related to nasal carriage of Staphylococcus aureus and MRSA.

scholarly journals Echolucent carotid plaque is associated with restenosis after carotid endarterectomy

2020 ◽  
pp. 1-7
Author(s):  
Qing Li ◽  
Beibei Liu ◽  
Yue Zhao ◽  
Yumei Liu ◽  
Mingjie Gao ◽  
...  
Keyword(s):  
Risk Factor ◽  
Carotid Endarterectomy ◽  
Carotid Plaque ◽  
Independent Risk Factor ◽  
Multiple Logistic Regression Analysis ◽  
Clinical Manifestations ◽  
Area Under The Curve ◽  
Multiple Logistic Regression ◽  
Significant Independent Risk Factor ◽  
The Relationship

OBJECTIVEThe mechanism of carotid endarterectomy (CEA) restenosis remains unclear. Our research aimed to investigate the relationship between the carotid plaque grayscale median (GSM) value and restenosis after CEA.METHODSBetween January 2010 and January 2018, 1280 consecutive patients underwent CEA at our institution; 32 patients were diagnosed with restenosis by ultrasound at 1 year after CEA. The correlations between plaque GSM, plaque echogenicity, clinical manifestations, shunting, and restenosis were analyzed.RESULTSIn total, 829 patients were ultimately enrolled; 32 (4%) presented diagnoses of restenosis (mean age 67.3 ± 8.0 years, 81.2% men). The GSM value was lower in the restenosis group (68.1 ± 19.9 vs 59.9 ± 14.7, p = 0.02). After multiple logistic regression analysis, the GSM value was found to be an independent risk factor for restenosis (OR 0.976, 95% CI 0.957–0.995). Shunting was another significant independent risk factor for restenosis (OR 2.39, 95% CI 1.07–5.34). The GSM cutoff value for predicting restenosis was 75 (sensitivity 0.38, specificity 0.84, area under the curve 0.62). We separated the patients into 2 groups by GSM (GSM ≤ 75 and GSM > 75 subgroups). Comparison of the 2 groups indicated that symptomatic manifestation was related to restenosis in the subgroup with GSM ≤ 75, indicating predominantly echolucent plaques, but not in the subgroup with GSM > 75, indicating predominantly echogenic plaques.CONCLUSIONSPredominantly echolucent carotid plaques, as measured by GSM, had a higher restenosis risk at 1 year than echogenic plaques.

Staphylococcus aureus nasal colonization among Vietnamese adults: prevalence, risk factors and antibiotic susceptibility profile

MedPharmRes ◽  
2018 ◽  
Vol 2 (2) ◽  
pp. 21-31
Author(s):  
Nguyen Phan ◽  
Hien Pham ◽  
Thuc Nguyen ◽  
Hoai Nguyen
Keyword(s):  
Risk Factors ◽  
Staphylococcus Aureus ◽  
Antibiotic Susceptibility ◽  
Nasal Carriage ◽  
Resistance Rate ◽  
High Rate ◽  
Weight History ◽  
Potential Risk Factors ◽  
History Of ◽  
Vietnamese Community

Staphylococcus aureus (S. aureus) has long been recognized as an important human pathogen causing many severe diseases. It is also a part of human normal flora with its ecological niche in the human anterior nares. This study focused on screening S. aureus nasal carriage in community and its relationship to human physiological and pathological factors which have not been studied in Vietnam previously. Two hundred and five volunteers in Ho Chi Minh City from 18 to 35 and over 59 years old both male and female participated in the study. Result showed that the prevalence of S. aureus nasal carriage in southern Vietnamese community was relatively low, only 11.2% (23/205), much lower than that in other international reports on human S. aureus. In addition, nasal carriage of the older age group (> 59 years old, 13.7%) was higher than that of younger age (18-35 years old, 10.4%). Other potential risk factors such as gender, career, height, weight, history of antibiotic usage, daily nasal wash, use of nasal medication sprays, acne problems, smoking and nasal problems showed no significant impact on S. aureus carriage. The obtained S. aureus nasal isolates were all sensitive to vancomycin. Lincomycin and tetracycline had low resistance rate with 4.3 % and 17.4 %, respectively. However, the isolates showed particularly high rate of multidrug resistance (54.2%) In summary, our data provided researchers an overview on S. aureus nasal carriage and antibiotic susceptibility profile of the community- isolated S. aureus in Vietnam. This would serve as valuable information on assessing risk of community-acquired S. aureus infections.

Clinical characteristics and prognosis in patients with premature coronary artery disease of different genders after intervention

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
X.F Tang ◽  
Y Yao ◽  
S.D Jia ◽  
Y Liu ◽  
B Xu ◽  
...  
Keyword(s):  
Risk Factors ◽  
Risk Factor ◽  
Independent Risk Factor ◽  
Coronary Intervention ◽  
Premature Coronary Artery Disease ◽  
Minor Bleeding ◽  
Bleeding Events ◽  
Cerebrovascular Events ◽  
Independent Risk Factors ◽  
Artery Disease

Abstract Objective To investigate the clinical characteristics and long-term prognosis of coronary intervention in patients with premature coronary artery disease (PCAD) between different genders. Methods From January 2013 to December 2013, 4 744 patients diagnosed as PCAD with percutaneous coronary intervention (PCI) in our hospital were enrolled. The general clinical data, laboratory results and interventional treatment data of all patients were collected, and the occurrence of major adverse cardio-cerebrovascular events (MACCE) within 2 years after PCI was followed up. Results Of the 4 744 patients undergoing PCI, 3 390 (71.5%) were males and 1 354 (28.5%) were females. The 2-year follow-up results showed that the incidence of BARC grade 1 hemorrhage in female patients was significantly higher than that in male patients (6.9% vs. 3.7%; P&lt;0.001); however, there was no significant difference in the incidence of major adverse cardiovascular and cerebrovascular events (MACCE), all-cause death, cardiac death, recurrent myocardial infarction, revascularization (target vessel revascularization and target lesion revascularization), stent thrombosis, stroke and BARC grade 2–5 hemorrhage between the two groups (P&gt;0.05). Multivariate COX regression analysis showed that gender was an independent risk factor for BARC grade 1 bleeding events in PCAD patients (HR=2.180, 95% CI: 1.392–3.416, P&lt;0.001), but it was not an independent risk factor for MACCE and BARC grade 2–5 bleeding. Hyperlipidemia, preoperative SYNTAX score, multivessel lesions and NSTE-ACS were the independent risk factors for MACCE in PCAD patients with PCI (HR=1.289, 95% CI: 1.052–1.580, P=0.014; HR=1.030, 95% CI: 1.019–1.042, P&lt;0.001; HR=1.758, 95% CI: 1.365–2.264, P&lt;0.001; HR=1.264, 95% CI: 1.040–1.537, P=0.019); gender, hyperlipidemia, anticoagulant drugs like low molecular weight heparin or sulfonate were the independent risk factors for bleeding events (HR=1.579,95% CI 1.085–2. 297, P=0.017; HR=1.305, 95% CI 1.005–1.695, P=0.046; HR=1.321, 95% CI 1.002–1.741, P=0.048; HR=1.659, 95% CI 1.198–2.298, P=0.002). Conclusion The incidence of minor bleeding in women with PCAD is significantly higher than that in men; After adjusting for various risk factors, gender is an independent risk factor for minor bleeding events, but not an independent risk factor for MACCE in patients with PCAD. Funding Acknowledgement Type of funding source: Public grant(s) – National budget only. Main funding source(s): National Science and Technology Support Program of China

Risk Factors for Aortic Valve Calcification in Patients on Regular Hemodialysis

2009 ◽  
Vol 32 (3) ◽  
pp. 173-179 ◽  
Author(s):  
Dejan Petrović ◽  
Radmila Obrenović ◽  
Biljana Stojimirović
Keyword(s):  
Risk Factors ◽  
Regression Analysis ◽  
Risk Factor ◽  
Aortic Valve ◽  
Independent Risk Factor ◽  
Multivariate Logistic Regression Analysis ◽  
Multivariate Logistic Regression ◽  
Aortic Valve Calcification ◽  
Valve Calcification ◽  
Regular Hemodialysis

Introduction Aortic valve calcification (AVC) accelerates development of aortic valve stenosis and cardiovascular complications. Hyperphosphatemia is one of the key risk factors for aortic valve calcification. Aim The aim of this study was to evaluate the prevalence of AVC in patients on regular hemodialysis and to assess the impact of different factors on its appearance. Method: The study investigated a total of 115 patients treated in the Hemodialysis Department of the Urology and Nephrology Clinic at the Kragujevac Clinical Center in Serbia. The variables investigated were: serum albumin, C-reactive protein (CRP), homocysteine, total cholesterol, LDL-cholesterol (LDL-C), HDL-cholesterol (HDL-C), triglycerides (TG), Apolipoprotein A-I (Apo A-I), Apolipoprotein B (Apo B) and lipoprotein (a), calcium, phosphate and parathormone, and calcium-phosphorus product (Ca × P). Patients were evaluated by echocardiography for AVC. Statistical analysis included univariate and multivariate logistic regression analysis. Results Univariate regression analysis showed that serum phosphate levels and Ca × P are the most important risk factors for AVC (p<0.001). Multivariate logistic regression analysis revealed that hyperphosphatemia is an independent risk factor for AVC (p<0.001). Conclusion Hyperphosphatemia is an independent risk factor for aortic valve calcification.

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