scholarly journals Hospital infections at the department of cardiovascular surgery

2010 ◽  
Vol 63 (11-12) ◽  
pp. 851-854 ◽  
Author(s):  
Ljiljana Markovic-Denic ◽  
Nada Cemerlic-Adjic ◽  
Bogoljub Mihajlovic ◽  
Katica Pavlovic ◽  
Svetozar Nicin ◽  
...  
Keyword(s):  
Incidence Rate ◽  
Surgical Procedures ◽  
Cardiovascular Surgery ◽  
Surgical Techniques ◽  
Bloodstream Infections ◽  
Hospital Infection ◽  
Incidence Density ◽  
Coagulase Negative Staphylococcus ◽  
Hospital Infections ◽  
Female Ratio

Introduction. Despite modern surgical techniques, preoperative preventive use of antibiotics and optimal treatment of operative site, patients who underwent surgical procedures are still at a risk of developing hospital infections. The aim of this paper was to estimate the frequency of hospital infections at the Department of Cardiovascular Surgery and their presence according to the anatomic localization as well as to identify the most frequent causes of hospital infections. Material and methods. During one-year period, all surgically treated patients were prospectively followed at the Department of Cardiovascular Surgery of the Institute of Cardiovascular Diseases, Vojvodina. There were 1302 patients who underwent 1396 surgical procedures during the period observed. The descriptive epidemiological method was applied in the study. The following odds ratio and rates were calculated: the incidence rate of patients with hospital infections, the incidence rate of hospital infections and the incidence rate in relation to hospital stay of each patient (incidence density). Results. During that period, 36 hospital infections were recorded in 33 patients. The average incidence rate of patients with hospital infection was 2.53% and hospital infection rate was 2.58% (from 0% to 5.13%). The male-female ratio was 3.1:1. The most frequent hospital infections were surgical site infections (incidence rate 0.86%), then gastroenteritis (incidence rate 0.77%) and bloodstream infections (incidence rate 0.46%). The most common causes of hospital infections were: Staphylococcus aureus (14.8%), Acinetobacter spp (22.2%) and coagulase negative staphylococcus (11.1%). Conclusion. The fact is that the incidence rate of hospital infections is relatively low, and such a trend can continue only if the continuous epidemiological control and preventive measures are implemented in the future.

scholarly journals Surgery at Cranio-vertebral (CV) Junction: Our Experience of 32 Cases

1970 ◽  
Vol 29 (2) ◽  
pp. 78-84
Author(s):  
FH Chowdhury ◽  
MR Haque ◽  
NKSM Chowdhury ◽  
MS Islam ◽  
Z Raihan ◽  
...  
Keyword(s):  
Surgical Procedures ◽  
Surgical Techniques ◽  
Clinical Findings ◽  
Type I ◽  
College Hospital ◽  
Chiari Malformation Type I ◽  
Female Ratio ◽  
Medical College ◽  
Neoplastic Lesion ◽  
Wide Range

Cranio vertebral (CV) junction is one of the critical sites for surgery. It's anatomy, physiological aspects and pathological involvement varies in a wide range of margins. Common problems are developmental anomalies, traumatic involvement, inflammatory, infective and neoplastic lesion. Management of these problems varies a lot from each other. Aim of the article is to overview the pathologies in this area and to study presentations, investigations, surgical procedures and results of these pathologies. We prospectively analyzed 32 cases of Cranio-vertebral (CV) region surgery in the Department of Neurosurgery Dhaka Medical College Hospital and Mitford Hospital, Dhaka, from 2000 to 2008. In our series, male and female ratio was 7.2:1. Pathologies were atlanto- axial dislocation (AAD), Chiari malformation type –I, schwannoma, meningioma, hydatid cyst and tuberculosis. Common clinical findings were- neck pain, quadriparesis, quadriplegia, hand atrophy, autonomic dysfunction and hypertension. Various types of surgical procedures were done in this series according to the pathology. Death was in 01 case, neurological deterioration seen in one case, 2 cases were neurologically stable and 28 cases (87.5%) improved neurologically where one was non useful improvement (Frankel grade-C). Complete pre operative radiological study is a very important adjunct for a successful surgical result. Proper evaluation of patients with selection of appropriate surgical procedures along with safe surgical techniques are the necessary things for successful surgery in this area. DOI: http://dx.doi.org/10.3329/jbcps.v29i2.7952 (J Bangladesh Coll Phys Surg 2011; 29: 78-84)

scholarly journals Incidencija infekcija operativnog mesta posle operacija na otvorenom srcu

2010 ◽  
Vol 57 (2) ◽  
pp. 45-48
Author(s):  
Lj. Markovic-Denic ◽  
B. Mihajlovic ◽  
N. Cemerlic-Adjic ◽  
S. Nicin ◽  
K. Pavlovic ◽  
...  
Keyword(s):  
Incidence Rate ◽  
Heart Surgery ◽  
Open Heart Surgery ◽  
Surgical Techniques ◽  
Surgical Site Infections ◽  
Medical Problem ◽  
Incidence Rates ◽  
Hospital Infections ◽  
Antimicrobial Drugs ◽  
Microbiological Methods

Introduction: Despite modern surgical techniques, preoperative preventive use of antibiotics and optimal treatment of operative site, surgical site infections (SSI) are significant medical problem in the countries worldwide. Objective: The aim of this paper was to estimate the frequency of SSI after open heart surgery and to identify the most frequent causes of these infections. Material and methods: A prospective cohort study was performed during the period from January 2008 to December 2009 at the Clinic of Cardiovascular Surgery of the Institute of Cardiovascular Diseases, Vojvodina. The surveillance was consistent throughout the study period. During hospitalization, patients were evaluated daily by the infection control nurse. Isolation, identification and sensitivity tests of causative agents to antimicrobial drugs, obtained from patients' material, were carried out by standard microbiological methods. The descriptive epidemiological method was used. The incidence rates of hospital infections were calculated. Results: During the study period, among 23 patients, 24 SSIs were registered. The average incidence rate of patients with SSI was 0.98% and SSI rate was 1.02% (ranged from 0% to 3.7%). There was no difference in the incidence rates according to gender (p=0.65).The mean age of patients with SSI was 64.7 years. Except one, all patients had the ASA score higher than 2. The patients with SSIs were hospitalized approximately 3.8 times longer than the patient without SSI (p=0.03). The most common causes of SSI were: Staphylococcus aureus (30%), coagulasa-negative Staphylococcus spp, Acinetobacter spp (8%), Enterococcus spp and Klebsiella pneumoniae. Conclusion: Although the incidence rate of hospital infections is low, it is necessary to maintain continuous surveillance of surgical site infections and to implement the preventive measures.

scholarly journals Presence of the neonatal Staphylococcus capitis outbreak clone (NRCS-A) in prosthetic joint infections

2020 ◽  
Vol 10 (1) ◽  
Author(s):  
Staffan Tevell ◽  
Sharmin Baig ◽  
Bengt Hellmark ◽  
Patricia Martins Simoes ◽  
Thierry Wirth ◽  
...  
Keyword(s):  
Neonatal Intensive Care ◽  
Bloodstream Infections ◽  
Multidrug Resistant ◽  
Coagulase Negative Staphylococcus ◽  
Nasal Carrier ◽  
Joint Infections ◽  
Staphylococcus Capitis ◽  
Prosthetic Joint ◽  
Strain Collection ◽  
Prosthetic Joint Infections

AbstractStaphylococcus capitis is a coagulase-negative staphylococcus that has been described primarily as causing bloodstream infections in neonatal intensive care units (NICUs), but has also recently been described in prosthetic joint infections (PJIs). The multidrug-resistant S. capitis subsp. urealyticus clone NRCS-A, comprising three sublineages, is prevalent in NICUs across the world, but its impact on other patient groups such as those suffering from PJIs or among adults planned for arthroplasty is unknown. Genome sequencing and subsequent analysis were performed on a Swedish collection of PJI isolates (n = 21), nasal commensals from patients planned to undergo arthroplasty (n = 20), NICU blood isolates (n = 9), operating theatre air isolates (n = 4), and reference strains (n = 2), in conjunction with an international strain collection (n = 248). The NRCS-A Outbreak sublineage containing the composite type V SCCmec-SCCcad/ars/cop element was present in PJIs across three Swedish hospitals. However, it was not found among nasal carrier strains, where the less virulent S. capitis subsp. capitis was most prevalent. The presence of the NRCS-A Outbreak clone in adult patients with PJIs demonstrates that dissemination occurs beyond NICUs. As this clone has several properties which facilitate invasive infections in patients with medical implants or immunosuppression, such as biofilm forming ability and multidrug resistance including heterogeneous glycopeptide-intermediate susceptibility, further research is needed to understand the reservoirs and distribution of this hospital-associated pathogen.

scholarly journals COVID-19 Pandemic, CLABSI, and CAUTI: The Urgent Need to Refocus on Hardwiring Prevention Efforts

2021 ◽  
pp. 1-22
Author(s):  
Mohamad G. Fakih ◽  
Angelo Bufalino ◽  
Lisa Sturm ◽  
Ren-Huai Huang ◽  
Allison Ottenbacher ◽  
...  
Keyword(s):  
Urinary Catheter ◽  
Bloodstream Infections ◽  
Central Line ◽  
Coagulase Negative Staphylococcus ◽  
Safe Environment ◽  
Candida Sp ◽  
Optimal Line ◽  
Considerable Impact ◽  
Tract Infections ◽  
The Impact

Abstract Background: The coronavirus disease 2019 (COVID-19) pandemic has had a considerable impact on US hospitalizations, affecting processes and patient population. Methods: We evaluated the impact of COVID-19 pandemic in 78 US hospitals on central line associated bloodstream infections (CLABSI) and catheter associated urinary tract infections (CAUTI) events 12 months pre-COVID-19 and 6 months during COVID-19 pandemic. Results: There were 795,022 central line-days and 817,267 urinary catheter-days over the two study periods. Compared to pre-COVID-19 period, CLABSI rates increased during the pandemic period from 0.56 to 0.85 (51.0%) per 1,000 line-days (p<0.001) and from 1.00 to 1.64 (62.9%) per 10,000 patient-days (p<0.001). Hospitals with monthly COVID-19 patients representing >10% of admissions had a NHSN device standardized infection ratio for CLABSI that was 2.38 times higher compared to those with <5% prevalence during the pandemic period (p=0.004). Coagulase-negative staphylococcus CLABSI increased by 130% from 0.07 to 0.17 events per 1,000 line-days (p<0.001), and Candida sp. by 56.9% from 0.14 to 0.21 per 1,000 line-days (p=0.01). In contrast, no significant changes were identified for CAUTI (0.86 vs. 0.77 per 1,000 catheter-days; p=0.19). Conclusions: The COVID-19 pandemic was associated with substantial increases in CLABSI but not CAUTI events. Our findings underscore the importance of hardwiring processes for optimal line care, and regular feedback on performance to maintain a safe environment.

scholarly journals Time trend and clinical pattern of extrapulmonary tuberculosis in Serbia, 1993-2007

2012 ◽  
Vol 69 (3) ◽  
pp. 227-230 ◽  
Author(s):  
Dragica Pesut ◽  
Milica Bulajic ◽  
Aleksandar Lesic
Keyword(s):  
Incidence Rate ◽  
Census Data ◽  
Economic Transition ◽  
Transition Period ◽  
Extrapulmonary Tuberculosis ◽  
High Coverage ◽  
Female Ratio ◽  
Bcg Vaccination ◽  
Tb Treatment ◽  
Directly Observed Treatment

Background/Aim. Increased incidence of extrapulmonary tuberculosis (XPTB) is reported worldwide. Serbia is a country in socio-economic transition period with lowmiddle HIV prevalence and intermediate-to-low tuberculosis (TB) incidence rate, 100% directly observed treatment (DOT) coverage, and mandatory BCG vaccination at birth. The aim of the study was to examine the incidence trend and clinical features of XPTB in Serbia during a 15-year period. Methods. This retrospective observational study included XPTB cases diagnosed in the period between 1st January 1993 and 31st Decembre 2007, according to the reports of the National Referral Institute of Lung Diseases and Tuberculosis in Belgrade and Central Tuberculosis Register. Population estimates with extrapolations were based on 1991 and 2002 census data. Results. While the overall TB incidence rate showed a slight, not significant decreasing trend (p = 0.535), a significant increase was found for XPTB (y = 1.7996 + 0.089x; R2 = 0.4141; p = 0.01). A total of 2,858 XPTB cases (newly diagnosed and 10% relapses) gave an average age specific incidence rate of 2.51/100,000 population (95% confidence interval, SD = 0.6182) with 8.9% annual increase. The male-to-female ratio was 0.54. Lymph nodes were most frequently affected site (48.5%) followed by genitourinary (20.5%), pleural (12%), and osseo-arthicular (10.3%) TB. Treatment outcome was successful in 88.29% of patients (cured and completed), 3.64% died, 5.18% interrupted, 0.57% displaced, and 2.3% unknown. Conclusion. Increasing trend of XPTB incidence rate may be a result of increased morbidity due to still present risk factors, possible higher detection rate in Serbia and better notification. A high coverage of newborns with BCG vaccination at birth might contribute to a decreased number and rare XPTB cases in children.

Healthcare-associated Infections in Pediatric Cardiovascular Surgery Intensive Care Unit between 2016-2020

2021 ◽  
Author(s):  
Mehmet Emirhan Işık ◽  
Ergin Arslanoğlu ◽  
Ömer Faruk Şavluk ◽  
Hakan Ceyran
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Cardiovascular Surgery ◽  
Heart Diseases ◽  
Bloodstream Infections ◽  
Healthcare Associated Infections ◽  
Developmental Problems ◽  
Pediatric Cardiovascular Surgery ◽  
Tract Infections ◽  
Healthcare Associated

Objectives: Healthcare-associated infections are the most common problem in intensive care unit worldwide. Children with congenital heart diseases have many complications such as developmental problems, respiratory tract infections, endocarditis,pneumonia and after long-term hospital and intensive care stays and surgeries patients become vulnerable to healthcare-associated infections. Patients and Methods: The study presents the frequency of infection, microorganisms in patients hospitalized at SBÜ Koşuyolu High Spesialization Research and Training Hospital pediatric cardiovascular surgery intensive care unit between 2016-2020. Results: One hundred-eight HAI episodes were seen in 83 of 1920 patients hospitalized in pediatric cardiovascular surgery intensive care unit between 2016-2020.HAI rates varied between 4.8% and 7.77%. In the 5-year period,a total of 118 different microorganisms were detected.Among all microorganisms, Candida species (n: 43, 36.4%) ranked first. central line-associated bloodstream infections (CLABSI) 53 (49%), ventilator-associated pneumonia (VAP)40 (37%), surgical site infection (SSI) 8 (6.5%), catheter -associated urinary tract infection (CAUTI) 7 (6%) Conclusion: Healthcare-associated infections are require special attention in pediatric cardiovascular intensive care units. In order to prevent, innovations such as bundle applications should be implemented as well as personnel training.

scholarly journals Therapeutic efficacy of connective tissue autotransplants with periosteum and platelet rich plasma in the management of gingival recession

2013 ◽  
Vol 70 (7) ◽  
pp. 664-669 ◽  
Author(s):  
Bojan Jovicic ◽  
Zoran Lazic ◽  
Milica Nedic ◽  
Stevo Matijevic ◽  
Aleksandra Gostovic-Spadijer
Keyword(s):  
Connective Tissue ◽  
Surgical Procedures ◽  
Platelet Rich Plasma ◽  
Statistical Significance ◽  
Surgical Techniques ◽  
Gingival Recession ◽  
Contralateral Side ◽  
Test Results ◽  
Keratinized Tissue ◽  
Student’S T

Background/Aim. Gingival recession progression in clinical practaice has influenced the development of various surgical procedures and techniques for solving esthetic imperfections and subjective difficulties coused by gingival recession. The aim of this study was to verify efficacy of surgical procedures and to compare both of surgical procedures through the keratinized tissue width. Methods. The study included 20 teeth with gingival recesion, M?ller class I and II. Ten teeth with gingival recession were treated with connective tissue autotransplants with periosteum in combination with coronary guided surgical flap (CTG group). On the contralateral side 10 teeth with gingival recession were treated with the same surgical procedures but in combination with platelet-rich plasma (CTGPRP group). We measured the keratinized tissue width. For statistical significance we used the Student's t-test. Results. The study reveled a statistical significance in reducing vertical deepress of recession by both used treatments. Root deepness in CTG and CTG-PRP group was 90% and 93.5%, respectively. With both surgical techniques we achieved larger zone of keratinized gingiva but with a wide zone of keratinized tissue in CTG - the PRP group. Conclusion. The concept regeneration technique with PRP and with the stimulating influence of platele activated growth factors results in the regeneration of deep periodontal tissue as an important prerequisite for the successful treatment of gingival recession.

scholarly journals MECHANISM OF ACTION AND CHARACTERISTICS OF CERTAIN ANTISEPTICS AND DISINFECTANTS IN CORRELATION WITH THEIR ACTIVITY ON SELECTED MICROORGANISMS

2018 ◽  
Vol 28 (2) ◽  
pp. 423-428
Author(s):  
Biljana Gjorgjeska ◽  
Dino Karpicarov
Keyword(s):  
Chemical Compounds ◽  
Modern Medicine ◽  
Hospital Infection ◽  
Target Area ◽  
Hospital Inpatient ◽  
Hospital Infections ◽  
Inappropriate Use ◽  
Acid And Base ◽  
Living Tissues ◽  
Ammonium Compounds

Antiseptics and disinfectants represent a large group of compounds such as: alcohols, aldehydes, acid and base compounds, anilides, biguanides, diamidines, halogen release agents, heavy metals and their compounds, peroxygens, phenols, bis–phenols, halophenols, quaternary ammonium compounds and volatile compounds for sterilization. Both antiseptics and disinfectants are labeled as biocides which are compounds that have the ability to destroy microorganisms or prevent their growth, development and reproduction. Usually, when referring to biocides that inhibit growth, other terms may be more specific, such as “–static” and when referring to biocides that kill the target microorganism the term “–cidal” is often used. These chemical compounds have different effects depending on the concentration in which they are used. The main difference between antiseptics and disinfectants is the place of application. As such, antiseptics remove microorganisms (bacteria, fungi, viruses, parasites that have varying degree of pathogenicity and virulence) from living tissues while disinfectants remove the same type of microorganisms from variety of objects and equipment, or to remove pathogens from the immediate environment. The action of antiseptics and disinfectants is due to mutual reaction with the cell surface of the microorganisms, followed by their penetration into the cells and the influence on a certain target area. As a result of that, antiseptics and disinfectants are an integral part of the practices for controlling infections and preventing the occurrence of intra–hospital infections. One of the biggest problems facing modern medicine is the occurrence of the intra–hospital (inpatient, nosocomial) infections. These infections can be defined as localized or generalized infections caused by microorganisms acquired during hospitalization. More specifically, an intra–hospital infection is one for which there is no evidence that the infection was present or incubating at the time of a hospital admission. In fact, these infections can result from inappropriate use of antiseptics and disinfectants. To be used in hospital conditions, antiseptics and disinfectants must meet several criteria: easy to use; non–volatile; not harmful to equipment, staff or patients; free from unpleasant smells and effective within a relatively short time.The goals of this study are to present the most common microorganisms that cause the occurrence of intra–hospital infections; to present the characteristics and mechanisms of action of the most frequently used antiseptics and disinfectants in hospital conditions; to give guidance as to which antiseptic or disinfectant would be most suitable for use against the microorganism which occurs in the function of the causative agent of the intra–hospital infection. The establishment of such an approach is crucial because it is necessary to know which antiseptic or disinfectant has the greatest activity against the microorganism which is the cause of the intra–hospital (nosocomial) infection. As a result of that, the incidence of intra–hospital infections will be minimized.

scholarly journals Clinical study on complicated presentations of groin hernias

2017 ◽  
Vol 5 (8) ◽  
pp. 3303 ◽  
Author(s):  
Hariprasad S. ◽  
Teerthanath Srinivas
Keyword(s):  
Femoral Hernia ◽  
Groin Hernia ◽  
Cumulative Risk ◽  
Surgical Techniques ◽  
Postoperative Outcome ◽  
Subsequent Treatment ◽  
High Rate ◽  
Age Group ◽  
Female Ratio ◽  
Groin Hernias

Background: Groin hernia is a very common type abdominal wall hernia encountered in surgical practice. Irreducibility, obstruction and strangulation are its commonest complications which usually presents as acute emergencies. Emergency repair of complicated hernias is associated with poor prognosis and a high rate of post-operative complications even with better care, improved anaesthetic management and advanced surgical techniques. The aim of this study was to determine the various modes of presentation, clinical finding, diagnostic and therapeutic strategies and to evaluate the postoperative outcome in complicated groin hernia surgeries in our set up.Methods: The study was carried out among 40 patients of groin hernia, who had complicated clinical presentation like irreducibility, strangulation and obstruction in the department of general surgery, during the period from March 2012 to June 2014. Patients were enrolled into the study after proper consent for detailed clinical examination, investigation and subsequent treatment. The Data obtained included demographic characteristics, presentation, operative findings and outcome. The patients were followed up for immediate and late complications for once a week for 1 months, once every month for the next 6 months. After data collection, analysis was done with help of by SPSS software version 21.Results: A total of 40 groin hernia patients with complicated presentation were evaluated during the study period. Among these cases 38 cases had inguinal hernias and two cases had femoral hernia. Majority of the patients were in 5th and 6th decade. Complicated presentation of groin hernia was commonly seen in males (95%) than in females (5%) with male to female ratio of 19:1. Inguinal hernia complications were seen predominantly in males and femoral hernia complications in females. Right sided hernias were more common. Incarceration was the commonest complication seen in 70% of case followed by strangulation (30%). Incarceration was high (17.5%) in the age group of 64-73 years and 44 - 53 years. Strangulation was high in the age group of 54-63 years. The duration of hernia varied for 1-2 years in 42.5% of cases and 3-6 years in 27.5% of cases. Majority of the patients (30%) presented with localized groin pain, vomiting, constipation and abdominal distension. All patients presented with swelling in the inguinoscrotal region, which was tender, and there was no impulse on coughing and 35% of patients had cardiorespiratory illness. Majority of the cases (34 numbers) were operated as emergency procedure. Viable bowel was seen in 77.5% of cases. Bowel resection and end-to-end anastomosis was done in all cases of non-viable bowel and orchidectomy in atrophied and gangrenous testis. The commonest postoperative complication encountered in the study was wound infection (22.5%) and scrotal seroma (17.50%). There was no evidence of recurrence in any of the operated cases.Conclusions: Complicated presentations of groin hernias like, incarceration and strangulation are seen in low and middle socio-economic category of people and may be associated with chronic illness. The cumulative risk of strangulation increases with time and type of hernias. Timely diagnosis and prompted surgical repair is essential to prevent the complications. 

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