Outbreak of Pseudomonas aeruginosa Surgical Site Infections after Arthroscopic Procedures: Texas, 2009

2011 ◽  
Vol 32 (12) ◽  
pp. 1179-1186 ◽  
Author(s):  
Pritish K. Tosh ◽  
Maureen Disbot ◽  
Jonathan M. Duffy ◽  
Marc L. Boom ◽  
Gary Heseltine ◽  
...  
Keyword(s):  
Pseudomonas Aeruginosa ◽  
Case Control Study ◽  
Shoulder Arthroscopy ◽  
Surgical Site Infections ◽  
Case Control ◽  
Surgical Instrument ◽  
Case Patient ◽  
Surgical Equipment ◽  
Control Study ◽  
Arthroscopic Procedures

Setting.Seven organ/space surgical site infections (SSIs) that occurred after arthroscopic procedures and were due to Pseudomonas aeruginosa of indistinguishable pulsed-field gel electrophoresis (PFGE) patterns occurred at hospital X in Texas from April 22, 2009, through May 7, 2009.Objective.To determine the source of the outbreak and prevent future infections.Design.Infection control observations and a case-control study.Methods.Laboratory records were reviewed for case finding. A case-control study was conducted. A case patient was defined as someone who underwent knee or shoulder arthroscopy at hospital X during the outbreak period and subsequently developed organ/space SSI due toP. aeruginosa. Cultures of environmental and surgical equipment samples were performed, and selected isolates were analyzed by PFGE. Surgical instrument reprocessing practices were reviewed, and surgical instrument lumens were inspected with a borescope after reprocessing to assess cleanliness.Results.The case-control study did not identify any significant patient-related or operator-related risk factors. P. aeruginosa grew from 62 of 388 environmental samples. An isolate from the gross decontamination sink had a PFGE pattern that was indistinguishable from that of the case patient isolates. All surgical instrument cultures showed no growth. Endoscopic evaluation of reprocessed arthroscopic equipment revealed retained tissue in the lumen of both the inflow/outflow cannulae and arthroscopic shaver handpiece. No additional cases occurred after changes in instrument reprocessing protocols were implemented. After this outbreak, the US Food and Drug Administration released a safety alert about the concern regarding retained tissue within arthroscopic shavers.Conclusions.These SSIs were likely related to surgical instrument contamination with P. aeruginosa during instrument reprocessing. Retained tissue in inflow/outflow cannulae and shaver handpieces could have allowed bacteria to survive sterilization procedures.

scholarly journals Diabetic Foot Infections: Local Prevalence of and Case–Control Study of Risk Factors for Methicillin-Resistant Staphylococcus aureus and Pseudomonas aeruginosa

2020 ◽  
Vol 7 (10) ◽  
Author(s):  
Justin J Kim ◽  
Alison Lydecker ◽  
Rohini Davé ◽  
Jacqueline T Bork ◽  
Mary-Claire Roghmann
Keyword(s):  
Risk Factors ◽  
Staphylococcus Aureus ◽  
Pseudomonas Aeruginosa ◽  
Diabetic Foot ◽  
Methicillin Resistant Staphylococcus Aureus ◽  
Case Control Study ◽  
Case Control ◽  
Methicillin Resistant ◽  
Diabetic Foot Infections ◽  
Control Study

Abstract We identified deep diabetic foot infections by culture and conducted a case–control study examining the risk factors for moderate to severe methicillin-resistant Staphylococcus aureus (MRSA) and Pseudomonas aeruginosa (PsA) diabetic foot infections. Our MRSA prevalence was lower than literature values; PsA was higher. Gangrene may be predictive of Pseudomonas infection.

Investigation of an Epidemic of Multi-Drug Resistant Pseudomonas aeruginosa

1982 ◽  
Vol 3 (6) ◽  
pp. 456-460 ◽  
Author(s):  
Susan A. Murray ◽  
David R. Snydman
Keyword(s):  
Pseudomonas Aeruginosa ◽  
Case Control Study ◽  
Environmental Control ◽  
Foley Catheter ◽  
Antibiotic Use ◽  
Case Control ◽  
Drug Resistant ◽  
Infected Case ◽  
Environmental Reservoir ◽  
Control Study

AbstractInter- and intrahospital epidemics of nosocomial infections due to gram-negative bacilli resistant to many antimicrobials have been well-documented. Prospective studies on the use of isolation along with epidemiologic analysis and appropriate environmental control have been lacking. In the six-month period from November 1978 to April 1979 Pseudomonas aeruginosa (MDR) resistant to all antibiotics except amikacin was isolated from 15 patients. This organism had not previously been seen in our hospital. Epidemiologic assessment of infected patients revealed that nine of 15 patients had contact either with a previously infected case or contaminated area. All strains of P. aeruginosa were identical by pyocin typing and antibiogram. The organism was present in an environmental reservoir, the urine graduated cylinder, and was found in three of eight receptacles (p = 0.002 vs. other environmental cultures). A case control study of patient risk factors showed aminoglycoside use, other antibiotic use, surgery, intravenous lines, Foley catheter use and mechanical ventilation to be no more frequent in cases than controls. The use of aminoglycosides in only 40% of cases suggests that antibiotic pressure was not the sole factor in perpetuating the epidemic.

Controlling the Clonal Spread ofPseudomonas aeruginosaInfection

2008 ◽  
Vol 29 (6) ◽  
pp. 549-552 ◽  
Author(s):  
Graziella H. Pereira ◽  
Anna S. Levin ◽  
Helenice Bosco Oliveira ◽  
Maria Luiza Moretti
Keyword(s):  
Pseudomonas Aeruginosa ◽  
Nosocomial Infections ◽  
Case Control Study ◽  
Case Control ◽  
Resistant Organism ◽  
Single Clone ◽  
Clonal Spread ◽  
Control Study

To evaluate nosocomial infections due to imipenem-resistant and imipenem-susceptiblePseudomonas aeruginosa, a case-control study that included genotyping was performed. Hospitalization for more than 15 days was independently associated with infection with an imipenem-resistant organism. Sixty-seven percent of the imipenem-resistant isolates analyzed and 23% of the imipenem-susceptible isolates analyzed belonged to a single clone. Intervention led to a decrease in the number of infections due to imipenem-resistant and imipenem-susceptibleP. aeruginosa.

Surgical site infections at the National Cancer Institute in Mexico: A case-control study

2000 ◽  
Vol 28 (1) ◽  
pp. 14-20 ◽  
Author(s):  
Diana Vilar-Compte ◽  
Alejandro Mohar ◽  
Silvia Sandoval ◽  
Margarita de la Rosa ◽  
Patricia Gordillo ◽  
...  
Keyword(s):  
National Cancer Institute ◽  
Case Control Study ◽  
Surgical Site Infections ◽  
Case Control ◽  
Control Study

A Multistate Outbreak of Salmonella enterica Serotype Typhimurium Infection Linked to Raw Milk Consumption—Ohio, 2003

2004 ◽  
Vol 67 (10) ◽  
pp. 2165-2170 ◽  
Author(s):  
JACEK MAZUREK ◽  
ELLEN SALEHI ◽  
DENNIS PROPES ◽  
JO HOLT ◽  
TAMMY BANNERMAN ◽  
...  
Keyword(s):  
Salmonella Enterica ◽  
Case Control Study ◽  
Raw Milk ◽  
Case Control ◽  
Case Definition ◽  
Salmonella Infection ◽  
Case Patient ◽  
Department Of Health ◽  
History Of ◽  
Control Study

In December 2002, the Ohio Department of Health was notified of two children with Salmonella infection. Both had a history of drinking raw milk from a combination dairy-restaurant-petting zoo (dairy). The dairy was the only establishment in Ohio licensed to sell raw milk and reported 1.35 million visitors annually. We investigated to determine the extent of the outbreak and identify illness risk factors. A case patient was any person with pulsed-field gel electrophoresis–matched Salmonella enterica serotype Typhimurium from 30 November 2002 to 18 February 2003. Sixty-two met the confirmed case definition. Forty dairy case patient patrons were included in a case-control study; 56 controls were their well meal companions. Consumption of raw milk was found to be associated with illness (odds ratio, 45.1; 95% confidence interval, 8.8 to 311.9). The dairy discontinued selling raw milk. Because 27 other states still allow the sale of raw milk, awareness of the hazards of its consumption should be raised and relevant regulations carefully reviewed.

Spinal Fusion Surgical Site Infections at an Acute Care Hospital: A Case Control Study

2018 ◽  
Vol 46 (6) ◽  
pp. S43
Author(s):  
Tasha M. Turner ◽  
Shannon Kavish ◽  
Jeanne Yegge ◽  
Katherine Yohnke ◽  
Ashleigh J. Goris ◽  
...  
Keyword(s):  
Spinal Fusion ◽  
Acute Care ◽  
Case Control Study ◽  
Acute Care Hospital ◽  
Surgical Site Infections ◽  
Case Control ◽  
Care Hospital ◽  
Control Study

scholarly journals Non-PSEUDO-AntiBiotiCs Score—A Predictor of Bacteraemia Caused by Pseudomonas aeruginosa: A Case-control Study

2021 ◽  
Author(s):  
Kaori Iwami ◽  
Takahiro Matsuo ◽  
Kuniyoshi Hayashi ◽  
Nobuyoshi Mori
Keyword(s):  
Pseudomonas Aeruginosa ◽  
Bloodstream Infection ◽  
Broad Spectrum ◽  
Case Control Study ◽  
Characteristic Curve ◽  
Multivariable Analysis ◽  
Case Control ◽  
Resistant Bacteria ◽  
Multivariable Logistic Regression Analysis ◽  
Control Study

Abstract Background: Immoderate use of broad-spectrum antimicrobials could lead to emergence of resistant bacteria. The purpose of this study was to identify factors associated with Pseudomonas aeruginosa bacteraemia and develop an exclusion scoring system to help clinicians select an appropriate antimicrobial treatment. Methods: This single-centre case-control study recruited inpatients and outpatients (age ≥ 20 years) with P. aeruginosa or Escherichia coli bacteraemia at St. Luke’s International Hospital in Tokyo from April 2005 to March 2020. Bivariate associations were assessed using χ2 test, Fisher's exact test, or Mann–Whitney U test, and the relationship between P. aeruginosa bacteraemia and other variables was determined using multivariable logistic regression analysis. Results: A total of 1562 patients (208 patients with P. aeruginosa bacteraemia and 1354 patients with E. coli bacteraemia) were included. Multivariable analysis revealed 11 variables associated with P. aeruginosa bacteraemia: Nosocomial infections, Pneumonia, Sex (males), Exposure to antibiotics within 90 days, Urinary tract infection, Urinary catheterization, abDOminal infection, Age < 77 years, Body mass index < 19, presence of Central venous catheter, and Central line-associated bloodstream infection/peripheral line-associated bloodstream infection; these variables were used to develop the Non-PSEUDO-AntiBiotiCs score. The area under the receiver operating characteristic curve was 0.89 (95% confidence interval: 0.88–­0.92), and the best cut-off-point was 5; a score of ≥ 5 had a sensitivity of 80% and a specificity of 83%. Conclusion: We developed the Non-PSEUDO-AntiBiotiCs score. This score may allow clinicians to rule out the possibility of P. aeruginosa bacteraemia and prevent the abuse of broad-spectrum antimicrobials.

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