scholarly journals A Retrospective Audit of Clinically Significant Maternal Bacteraemia in a Specialist Maternity Hospital from 2001 to 2014

2015 ◽  
Vol 2015 ◽  
pp. 1-4 ◽  
Author(s):  
Richard John Drew ◽  
Zara Fonseca-Kelly ◽  
Maeve Eogan
Keyword(s):  
Blood Culture ◽  
Positive Blood Culture ◽  
Maternal Blood ◽  
Maternity Hospital ◽  
E Coli ◽  
Live Births ◽  
Retrospective Audit ◽  
Group A ◽  
Clinically Significant ◽  
Group B

Maternal sepsis is a significant problem in obstetrics, with almost one in four maternal deaths related to severe sepsis. We carried out a retrospective review of clinically significant bacteraemia in obstetric patients attending Rotunda Hospital over 14 years. From 2001 to 2014, there were 252 clinically significant positive blood culture episodes in obstetric patients. There were 112,361 live births >500 g during the study period giving an overall rate of 2.24 clinically significant positive maternal blood culture episodes per 1000 live births >500 g. The median rate over the 14 years was 2.12 episodes per 1000 live births >500 g, with an interquartile range of 1.74–2.43 per 1000 live births >500 g. There was no discernable increasing or decreasing trend over the 14 years.E. coliwas the most commonly isolated organism (n= 92/252, 37%), followed by group BStreptococcus(n= 64/252, 25%),Staphylococcus aureus(n= 28/252, 11%), and anaerobes (n= 11/252, 4%). These top four organisms represented three-quarters of all positive blood culture episodes (n= 195/252, 77.3%). Of note, there were only five cases of listeriosis, representing a rate of 4.4 cases per 100,000 live births >500 g. The rate of invasive group A streptococcal infection was also very low at 5.3 cases per 100,000 live births >500 g.

scholarly journals Does Systematic Preliminar Colour Doppler Study Reduce Kidney Biopsy Complication Incidence?

2011 ◽  
Vol 2011 ◽  
pp. 1-5
Author(s):  
Antonio Granata ◽  
Fulvio Floccari ◽  
Angelo Ferrantelli ◽  
Ugo Rotolo ◽  
Luca Di Lullo ◽  
...  
Keyword(s):  
Kidney Biopsy ◽  
Colour Doppler ◽  
Doppler Examination ◽  
Doppler Study ◽  
Group A ◽  
Clinically Significant ◽  
Perinephric Hematoma ◽  
Group B ◽  
Biopsy Complications ◽  
Optimal Site

While ultrasonography is widely performed prior to biopsy, colour Doppler examination is often used only to discover post-biopsy complications. Aim of this paper was to evaluate the usefulness of colour Doppler examination in planning the optimal site of puncture for renal biopsy. Present analysis includes 561 consecutive percutaneous renal biopsies performed from the same operator. Until August 2000 332 biopsies were performed after a preliminary ultrasonography (Group A). From September 2000, 229 patients underwent even a preliminary colour Doppler study (Group B). Postbioptic bleeding were categorized as minor (gross hematuria or subcapsular perinephric hematoma < 4 cmq of greater diameter) or major (hematoma >4 cmq of greater diameter; requiring blood transfusion or invasive procedures; leading to acute renal failure, urine tract obstruction, septicaemia, or death). Major complications were seen in 2.1% in Group A while in Group B only one case was reported (0.43%). Minor clinically significant complications occur in 7.8% in Group A and in 3.4% of cases of Group B. Colour Doppler reduced drastically the incidence of complications observed before the introduction of routine colour Doppler examination prior to biopsy. In our opinion, these data support the use of preliminary colour Doppler study when a biopsy is planned.

scholarly journals Role of enteric pathogens in the aetiology of neonatal diarrhoea in lambs and goat kids in Spain

1996 ◽  
Vol 117 (1) ◽  
pp. 203-211 ◽  
Author(s):  
M. Muñoz ◽  
M. Álvarez ◽  
I. Lanza ◽  
P. Cármenes
Keyword(s):  
Escherichia Coli ◽  
Synergistic Effect ◽  
Cryptosporidium Parvum ◽  
Clinical Characteristics ◽  
Enteric Pathogens ◽  
E Coli ◽  
Neonatal Diarrhoea ◽  
Group A ◽  
Group B

SummaryFaeces samples from diarrhoeic and non-diarrhoeic lambs and goat kids aged 1–45 days were examined for enteric pathogens.Cryptosporidium parvumwas detected in both diarrhoeic lambs (45%) and goat kids (42%) but not in non-diarrhoeic animals. F5+(K99+) and/or F41+Escherichia colistrains were isolated from 26% and 22% of the diarrhoeic lambs and goat kids, respectively, although these strains, which did not produce enterotoxins ST I or LT I, were found with similar frequencies in non-diarrhoeic animals. A F5−F41−ST I+E. colistrain was isolated from a diarrhoeic lamb (0·6%). VerotoxigenicE. coliwas isolated from both diarrhoeic and non-diarrhoeic lambs (4·1% and 8·2%, respectively) and there was no association between infection and diarrhoea. The prevalence of group A rotavirus infection in diarrhoeic lambs was very low (2·1%). Groups A and B rotaviruses were detected in three (8·1%) and five (13·5%) diarrhoeic goat kids from two single outbreaks. Group C rotaviruses were detected in four non-diarrhoeic goat kids. An association of diarrhoea and infection was demonstrated only for group B rotavirus.Clostridium perfringenswas isolated from 10·8% of the diarrhoeic goat kids but not from non-diarrhoeic goat kids or lambs.Salmonella arizonaewas isolated from a diarrhoeic goat kid (2·7%) and the clinical characteristics of the outbreaks where these two latter enteropathogens were found different from the rest. Picobirnaviruses were detected in a diarrhoeic lamb. No coronaviruses were detected using a bovine coronavirus ELISA. No evidence was found of synergistic effect between the agents studied. Enteric pathogens were not found in four (8·7%) and three (20%) outbreaks of diarrhoea in lambs and goat kids, respectively.

Effect of selective beta-blockade with bisoprolol in the treatment of recent-onset atrial fibrillation

Folia Medica ◽  
2012 ◽  
Vol 54 (2) ◽  
pp. 27-31 ◽  
Author(s):  
Maria N. Negreva ◽  
Atanas P. Penev
Keyword(s):  
Atrial Fibrillation ◽  
Sinus Rhythm ◽  
Combined Therapy ◽  
Beta Blockade ◽  
Recent Onset ◽  
Number Of Patients ◽  
Group A ◽  
Clinically Significant ◽  
Group B ◽  
Onset Atrial Fibrillation

ABSTRACT The incidence of atrial fibrillation has been rapidly increasing in recent years. The increased tonus of the sympathetic nervous system is related to the development of atrial fibrillation. OBJECTIVE: To study the effect of bisoprolol, a highly selective beta-blocker, on patients with recent-onset atrial fibrillation (< 48 hours) for regularization of the rhythm using propafenone. PATIENTS AND METHODS: The study includes 164 patients (81 women, 83 men, age 59.09 ± 10.81) with successfully restored sinus rhythm in recent-onset atrial fibrillation. The patients received either propafenone (group A, n = 82) or a combination of propafenone and bisoprolol (group B, n = 82). The studied patients were randomly allocated to the groups. Propafenone was administered intravenously as a 2 mg/kg bolus followed by infusion of 0.0078 mg/kg/min for 120 min and orally in dosage of 300 mg three times every 8 hours if arrhythmia persisted. Bisoprolol was administered in a single dose at the very beginning of propafenone treatment and only in patients from group B at a dose of 5 or 10 mg. Regularization of the rhythm was assessed at the 3rd, 6th, 12th and 24th hour. RESULTS: In the initial stages of regularization the combined therapy restored the sinus rhythm in a greater number of patients in comparison with the monotherapy (at the 6th hour 67.07% in group B versus 48.78% in group A, P < 0.05; at the 12th hour it was 87.80% versus 75.60%, respectively, P < 0.05). CONCLUSION: Early regularization of rhythm in patients with recent-onset atrial fibrillation reduces the likelihood of recurrent episodes of arrhythmia. This makes the application of selective beta-blockade clinically significant.

scholarly journals The Relevance of the Second Cesarean Delivery in the Reduction of Institutional Cesarean Delivery Rates

2018 ◽  
Vol 27 (6) ◽  
pp. 555-561 ◽  
Author(s):  
Michael F.E. Diejomaoh ◽  
Waleed Al-Jassar ◽  
Zainab Bello ◽  
Kavitha Karunakaran ◽  
Asiya Mohammed
Keyword(s):  
Cesarean Delivery ◽  
Maternity Hospital ◽  
Delivery Rate ◽  
Cesarean Deliveries ◽  
Fetal Birth Weight ◽  
Gestational Age At Delivery ◽  
Group A ◽  
Cesarean Delivery Rate ◽  
Group B ◽  
Repeat Cesarean Delivery

Objective: The cesarean delivery rate has increased worldwide. The aim of our study was to assess the events associated with the second cesarean deliveries in our institution. Subjects and Methods: All cesarean deliveries at the Maternity Hospital, Kuwait, from January 1 to December 31, 2013, were identified. A comparative study was undertaken on patients having their first and second cesarean deliveries. The social and clinical characteristics of these patients were extracted from our records and the antenatal, intrapartum, and postpartum course of the pregnancies and their outcomes documented. Results: During the study period, 10,586 deliveries were recorded, including 3,676 cesarean deliveries, i.e., a cesarean delivery rate of 34.7%. 840 of these patients were undergoing their first cesarean delivery (group A) and 607 patients were undergoing their second (group B); 484 patients from group A and 341 patients from group B with complete records were analyzed. Mean age (30.89 ± 4.93 vs. 29.94 ± 5.56 years, p = 0.008), parity (1.49 ± 1.22 vs. 0.98 ± 1.60, p < 0.0001), gestational age at delivery (38.12 ± 2.61 vs. 37.66 ± 3.11 weeks, p = 0.02), and fetal birth weight (3,211.60 ± 691.51 vs. 2,829.73 ± 863.26 g, p < 0.001) were significantly higher in group B than in group A. 53.2% of the patients in group B requested repeat cesarean delivery, their second cesarean. The rate of maternal morbidity was low. Conclusions: The incidence of repeat cesarean delivery in group B is high, and its reduction should contribute to a lowering of the overall cesarean delivery rate.

scholarly journals Effect of Germanium-Embedded Knee Sleeve on Osteoarthritis of the Knee

2019 ◽  
Vol 7 (10) ◽  
pp. 232596711987912 ◽  
Author(s):  
Katherine Marino ◽  
Rachel Lee ◽  
Paul Lee
Keyword(s):  
United Kingdom ◽  
Los Angeles ◽  
Skin Irritation ◽  
Oxford Knee Score ◽  
Osteoarthritis Of The Knee ◽  
Knee Oa ◽  
The United Kingdom ◽  
Group A ◽  
Clinically Significant ◽  
Group B

Background: Knee osteoarthritis (OA) affects an estimated 1 in 5 individuals older than 45 years of age in the United Kingdom. Previous studies have suggested that germanium-infused garments may provide improved clinical outcomes in OA. Germanium-embedded (GE) knee sleeves embrace this fabric technology. Purpose: To assess the outcomes of GE knee sleeves for patients with knee OA. Study Design: Cohort study; Level of evidence, 2. Methods: This study was undertaken at a hospital in the United Kingdom. Patients who had radiographic features of OA, experienced knee pain for at least 6 months, and opted for nonsurgical intervention were included. Patients were recruited over 3 months. The University of California, Los Angeles activity score, Lysholm score, visual analog scale (VAS) score, and Oxford Knee Score (OKS) were collected at monthly intervals for 6 months. Patients were followed to determine their compliance with wearing the knee sleeves at all times, as advised, and whether any adverse effects had occurred. Results: A total of 50 participants were recruited for the study; 4 participants were excluded due to pain and were converted to surgical management. Therefore, 46 patients were analyzed and placed into 2 groups according to severity of OA, as classified by the Kellgren-Lawrence system: group A had grade 1 or 2 OA, and group B had grade 3 or 4 OA. There were 25 patients in group A and 21 in group B. Improvements were seen in OKS, VAS, and Lysholm scores in both groups. Clinically significant improvements were seen in group A only for OKS (mean increase, 14), VAS (mean decrease, 4.1), and Lysholm (mean increase, 17.2) scores. These results were also statistically significant (OKS, P = 5.8 × 10-7; VAS, P = 7.7 × 10-12; Lysholm, P = 4.2 × 10-11). The data from this study demonstrated that GE knee sleeves gave better outcomes for patients with grades 1 and 2 OA compared with patients with more advanced disease, which is consistent with previous studies. A total of 3 patients reported skin irritation, which resolved with simple skin ointment application. No patients reported infection, deep vein thrombosis, or circulation problems. Conclusion: GE knee sleeves could play an important role in optimizing nonsurgical management of patients with knee OA, especially patients with grades 1 and 2 OA, as demonstrated by the clinically significant improvements.

scholarly journals Quinolone Prophylaxis in Transrectal Ultrasound Guided Prostate Biopsy: An Eight-Year Single Center Experience

2013 ◽  
Vol 2013 ◽  
pp. 1-6 ◽  
Author(s):  
Bing-Juin Chiang ◽  
Yeong Shiau Pu ◽  
Shiu-Dong Chung ◽  
Shih-Ping Liu ◽  
Hong-Jeng Yu ◽  
...  
Keyword(s):  
Prostate Biopsy ◽  
Transrectal Ultrasound ◽  
Infectious Complications ◽  
Pipemidic Acid ◽  
Ultrasound Guided ◽  
E Coli ◽  
Single Center Experience ◽  
Significant Difference ◽  
Group A ◽  
Group B

We retrospectively evaluated the efficacy of prophylaxis with pipemidic acid and levofloxacin in transrectal ultrasound guided prostate biopsy (TRUSP-Bx). From January 2002 to December 2004, patients receiving oral pipemidic acid 500 mg twice daily for three days with or without a preoperative intravenous cefazolin 1 gm injection comprised group A. Between January 2005 and December 2009, patients receiving oral levofloxacin 500 mg one hour before biopsy comprised group B. We calculated the annual febrile urinary tract infection (fUTI) rates. Patients’ characteristics, including age, prophylactic antibiotics, biopsy core numbers, pathologic results, PSA, and the spectrums and susceptibility of pathogens, were also evaluated. A total of 1313 (35.5%) patients belonged to group A, while 2381 (64.5%) patients belonged to group B. Seventy-three patients experienced postoperative infectious complications. There was a significant difference in the fUTI rate between groups A and B (3.7% versus 1.0%,P<0.001). The yearly fUTI rates varied from 0.6 to 3.9% between 2002 and 2009. Of the 73 patients with fUTI, those receiving levofloxacin prophylaxis were more likely to harbor fluoroquinolone-resistant pathogens (P<0.001).E. coliwas the most common pathogen in both groups. Levofloxacin remains effective and appears superior to pipemidic acid based prophylaxis.

scholarly journals A comparative trial between the therapeutic efficacy of topical 2% sertaconazole cream and 1% terbinafine cream in the treatment of tinea cruris/tinea corporis

2017 ◽  
Vol 3 (1) ◽  
pp. 59
Author(s):  
Sumyuktha J. ◽  
Murali Narasimhan ◽  
Parveen Basher Ahamed
Keyword(s):  
Comparative Trial ◽  
Treated Group ◽  
Tinea Corporis ◽  
Fungal Culture ◽  
Tinea Cruris ◽  
Complete Cure ◽  
Group A ◽  
Clinically Significant ◽  
Group B ◽  
Cure Rates

<p class="abstract"><strong>Background:</strong> Skin infections caused by dermatophyte fungi account for 6% of dermatology consultations at our hospital and 3 to 4% worldwide. A variety of antifungal agents are available for topical use. Terbinafine 1% cream is considered the first line topical medication in the treatment of dermatophytosis. Sertaconazole 2% cream is a relatively new drug having antifungal as well as antiflammatory property. In this prospective study we sought to compare the safety and efficacy of topical 2% Sertaconazole and 1% Terbinafine creams in the treatment of localized tinea cruris and/or tinea corporis<span lang="EN-IN">.</span></p><p class="abstract"><strong>Methods:</strong> In this study, 80 patients were randomized into two groups of 40 each. Group A received 2% Sertaconazole cream while group B received Terbinafine 1% cream topical application twice daily for 4 weeks. Patients were followed up at the end of 2<sup>nd</sup> and 4<sup>th</sup> weeks for clinical, mycological (KOH mount and fungal culture) and complete cure (both clinical and mycological).<strong></strong></p><p class="abstract"><strong>Results:</strong> The mean age of the patients studied was 27.97 years. Complete cure was achieved in 59.5% and 80% in group A and 71.4% and 90.9% in group B at the end of 2<sup>nd</sup> and 4<sup>th</sup> weeks respectively. Significant P values were observed if the results were compared within the group, between baseline and 2 weeks, baseline and 4<sup>th</sup> week and also 2<sup>nd</sup> and 4<sup>th</sup> week. Clinically significant side effects were not observed in both the groups<span lang="EN-IN">. </span></p><p class="abstract"><strong>Conclusions:</strong> Although higher cure rates were observed in the Terbinafine treated group, the results were not statistically significant. It can be concluded from our study that Sertaconazole 2% cream is similar in efficacy to Terbinafine 1% cream in the treatment of localized tinea cruris and corporis<span lang="EN-IN">.</span></p>

scholarly journals Comparison of efficacy of chlorhexidine alcohol with povidone iodine for prevention of surgical site infection: a prospective study

2018 ◽  
Vol 5 (5) ◽  
pp. 1668
Author(s):  
Binni John ◽  
Rajith Kishore K. K. ◽  
Vipinchandran C.
Keyword(s):  
Prospective Study ◽  
Povidone Iodine ◽  
Surgical Site Infections ◽  
E Coli ◽  
Prophylactic Measures ◽  
Group A ◽  
The Difference ◽  
Group B ◽  
Clean Contaminated ◽  
Culture Positive

Background: Surgical site infections (SSI’s)are the major risk factors of postoperative morbidity and mortality. The incidence of these SSI’scan be minimized by taking prophylactic measures such as using effective preoperative antiseptics such as chlorhexidine (CHG) or povidone-iodine (PVI). The aim of the present study was to compare the efficacy of 2.5% chlorhexidine-alcohol with that of 10% povidone iodine for preventing SSI’sin clean contaminated elective surgeries.Methods: This prospective study included 100 patients who were undergoing for clean contaminated elective surgeries at Government Medical College, Kottayam from April 2014 to September 2015. Group A included 50 patients in which 2.5% chlorhexidine alcohol (chlorhexidine 2.5% in 70% ethanol) was used for preoperative skin cleansing and Group B included 50 patients in which 10%povidone-iodine aqueous was used. Incidence of SSI’s in terms of efficacy was compared between the groups.Results: Female preponderance was seen in both the groups, but the difference was not significant statistically. The SSI’swere seen in 5 patients in group A and in 12 patients in group B and this difference was found statistically significant (p=0.0084).Out of 5, in group A, 3 sites were culture positive showing the presence of S. aureus culture in 1 case and E. coli in 2 cases and in group B, out of 12, 6 sites were culture positive consisting of S. aureus and E. coli in 3 cases each.Conclusions: Chlorhexidine (2.5%) significantly reduced the risk of postoperative SSIs and colonization of bacteria in elective surgeries when compared to 10% povidone iodine.

scholarly journals Phagocytic resistance of Escherichia coli K-1 isolates and relationship to virulence

1978 ◽  
Vol 8 (6) ◽  
pp. 748-755
Author(s):  
R Weinstein ◽  
L S Young
Keyword(s):  
Escherichia Coli ◽  
Blood Culture ◽  
Similar Degree ◽  
E Coli ◽  
Meningococcal Group ◽  
Human Granulocytes ◽  
Normal Human ◽  
Group B ◽  
Opsonophagocytic Killing

Blood culture isolates from 133 episodes of Escherichia coli bacteremia were typed for K-1 capsular antigen by immunodiffusion, utilizing equine antiserum raised against meningococcal group B polysaccharide. Twenty-six percent (34 of 133) of these isolates were positive for K-1 antigen. These 133 strains, 34 K-1 and 99 non-K-1, were tested for susceptibility to phagocytosis. K-1 strains were found to be more resistant to clearance (27%) than non-K-1 strains (71%) when tested in an in vitro opsonophagocytic/killing assay containing normal human granulocytes and plasma. Additional studies demonstrated that resistance was due to decreased phagocytosis rather than diminished intraleukocytic killing. K-1 strains obtained from stool showed a similar degree of resistance to phagocytosis when compared with K-1 blood isolates. A comparison of clinical data on non-neonatal patients with E. coli K-1 and non-K-1 bacteremia showed no significant differences in mortality for these two groups. The incidence of shock for patients bacteremic with K-1 strains (74%) was significantly greater than that for patients bacteremic with non-K-1 strains (33%). These differences are attributed to the increased resistance to phagocytosis observed for K-1 versus non-K-1 E. coli isolates.

K-1 Antigen Content and the Presence of an Additional Sialic Acid-Containing Antigen Among Bacteremic K-1 Escherichia coli : Correlation with Susceptibility to Opsonophagocytosis

1980 ◽  
Vol 29 (3) ◽  
pp. 1055-1061 ◽  
Author(s):  
Paul Stevens ◽  
Chung L. Chu ◽  
Lowell S. Young
Keyword(s):  
Escherichia Coli ◽  
Sialic Acid ◽  
Blood Culture ◽  
Reference Group ◽  
Dry Weight ◽  
E Coli ◽  
Crossed Immunoelectrophoresis ◽  
Fresh Serum ◽  
Group B

Eighty percent of blood culture isolates of Escherichia coli K-1 are resistant to in vitro opsonophagocytosis by normal human granulocytes and fresh serum. To determine the basis for susceptibility to phagocytosis in 20% of bacteremic K-1 E. coli , we investigated possible quantitative and qualitative immunochemical differences in the K-1 antigen content among resistant and sensitive isolates. We prepared extracts of blood culture K-1 E. coli by sonication and determined the K-1 polysaccharide content per dry weight of bacteria by rocket immunoelectrophoresis using cross-reactive equine anti-group B meningococcal sera. We assessed qualitative differences in the antigen content by crossed immunoelectrophoresis, using an immune globulin fraction and isolated immunoglobulin G (IgG) and IgM from the group B antisera. Three different resistant K-1 isolates contained a mean K-1 content of 48.5 ± 7.6 μg/mg ± standard deviation of dry bacteria, and three sensitive isolates contained 23.2 ± 5.6 μg/mg ( P < 0.005). Crossed immunoelectrophoresis of extracts from both sensitive and resistant strains revealed a secondary sialic acid-containing antigen that was electrophoretically different from both the major K-1 antigen and a reference group B meningococcal antigen. This negatively charged secondary antigen was susceptible to Clostridium perfringens neuraminidase degradation and reacted only with IgG whereas the major K-1 antigen reacted only with IgM. This antigen was detected in the extracts of resistant isolates only at 10 10 but not at 10 9 colony-forming units per milliliter. This study demonstrates that (i) the degree of phagocytosis of bacteremic E. coli K-1 isolates is inversely associated with K-1 content, and (ii) more easily phagocytosed (sensitive) K-1 isolates have greater amounts of an additional sialic acid-containing antigen that appears to be unrelated to the previously described O acetyl K-1 antigen.

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