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Różańska A, Baranowska-Tateno K, Pac A, Gajda M, Wójkowska-Mach J. Post-discharge surveillance of urinary tract infections in patients following hip and knee arthroplasty: Identifying targets for infection prevention and control. Am J Infect Control 2024; 52:852-856. [PMID: 38583774 DOI: 10.1016/j.ajic.2024.04.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2023] [Revised: 04/02/2024] [Accepted: 04/03/2024] [Indexed: 04/09/2024]
Abstract
This population-based study aimed to evaluate the incidence of urinary tract infections following hip and knee arthroplasty (HPRO and KPRO) and identify urinary tract infection risk factors among Polish patients. The analysis included data from 83,525 patients, with incidence rates of 0.7% and 0.49% after HPRO and KPRO, respectively. We identified women, individuals over 65 years old, residents of long-term care facilities, patients with chronic circulatory, endocrine, or digestive diseases, and those operated on due to trauma as targets for infection prevention and control.
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Affiliation(s)
- Anna Różańska
- Chair of Microbiology, Jagiellonian University Medical College, Kraków, Poland; Department of Microbiology, Faculty of Medicine, Jagiellonian University Medical College, Kraków, Poland
| | - Katarzyna Baranowska-Tateno
- Department of Microbiology, Faculty of Medicine, Jagiellonian University Medical College, Kraków, Poland; Doctoral School of Medical and Health Sciences, Jagiellonian University Medical College, Kraków, Poland.
| | - Agnieszka Pac
- Department of Microbiology, Faculty of Medicine, Jagiellonian University Medical College, Kraków, Poland; Chair in Epidemiology and Preventive Medicine, Jagiellonian University Medical College, Kraków, Poland
| | - Mateusz Gajda
- Chair of Microbiology, Jagiellonian University Medical College, Kraków, Poland; Department of Microbiology, Faculty of Medicine, Jagiellonian University Medical College, Kraków, Poland
| | - Jadwiga Wójkowska-Mach
- Chair of Microbiology, Jagiellonian University Medical College, Kraków, Poland; Department of Microbiology, Faculty of Medicine, Jagiellonian University Medical College, Kraków, Poland
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Gajda M, Gajda P, Pac A, Gryglewska B, Wojnarski M, Różańska A, Lipińska-Tobiasz I, Wójkowska-Mach J. Post-discharge occurrence of surgical site infections after hip or knee arthroplasty surgery in Poland, a population-based study. Sci Rep 2023; 13:15940. [PMID: 37743386 PMCID: PMC10518305 DOI: 10.1038/s41598-023-43111-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2022] [Accepted: 09/20/2023] [Indexed: 09/26/2023] Open
Abstract
Arthroplasty is a common procedure improving functioning of patients and their quality of life. Infection is a serious complication that determines subsequent management of the prosthesis and the patient. The aim of the study was to investigate the incidence of post-discharge surgical site infections (SSI) and their risk factors. A retrospective analysis of an anonymized database from the National Health Found for 2017 of 56,068 adult patients undergoing hip replacement surgery (HPRO) and 27,457 patients undergoing knee replacement surgery (KPRO). The cumulative incidence of post-discharge SSI was 0.92% for HPRO and 0.95% for KPRO. The main risk factors for hip SSI were male gender, diseases of hematopoietic, musculoskeletal and nervous system. The risk factor for knee SSI was male gender. All comorbidities significantly increased the risk of SSI. The ICU stay and antibiotics administered at discharge in studied population increased the risk of detection of SSI after HPRO and KPRO by up to four and seven times, respectively. For both procedures rehabilitation after surgery and total endoprosthesis decreased incidence of SSIs. The lower experience of the center was related to higher SSI incidence in HPRO in primary (1.5% vs. 0.9%) and in revision surgeries (3.8% vs. 2.1%), but in KPRO, lower experience only in primary surgeries was significantly associated with SSI. The cumulative incidence of post-discharge SSI in Poland is higher than in other European countries. Special attention should be paid to patients with chronic diseases.
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Affiliation(s)
- Mateusz Gajda
- Department of Microbiology, Faculty of Medicine, Jagiellonian University Medical College, Czysta 18 St., 31-121, Kraków, Poland.
- Doctoral School of Medical and Health Sciences, Jagiellonian University Medical College, Łazarza 16 St., 31-530, Kraków, Poland.
| | - Paulina Gajda
- Chair of Epidemiology and Preventive Medicine, Department of Epidemiology, Jagiellonian University Medical College, Kopernika 7 St., 31-034, Kraków, Poland
| | - Agnieszka Pac
- Chair of Epidemiology and Preventive Medicine, Department of Epidemiology, Jagiellonian University Medical College, Kopernika 7 St., 31-034, Kraków, Poland
| | - Barbara Gryglewska
- Department of Internal Medicine and Gerontology, Jagiellonian University Medical College, Jakubowskiego 2 St., 30-886, Kraków, Poland
| | - Marcin Wojnarski
- Faculty of Medicine, Jagiellonian University Medical College, St. Anna 12 St., 33-332, Kraków, Poland
| | - Anna Różańska
- Department of Microbiology, Faculty of Medicine, Jagiellonian University Medical College, Czysta 18 St., 31-121, Kraków, Poland
| | - Inga Lipińska-Tobiasz
- Department of Orthopedics and Traumatology, Hospital in Proszowice, Kopernika 13 St, 32-100, Proszowice, Poland
| | - Jadwiga Wójkowska-Mach
- Department of Microbiology, Faculty of Medicine, Jagiellonian University Medical College, Czysta 18 St., 31-121, Kraków, Poland
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Szczuka J, Sandomierski M, Voelkel A, Grochalski K, Buchwald T. Surface Modification of Ti6Al4V ELI Titanium Alloy by Poly(ethylene-alt-maleic anhydride) and Risedronate Sodium. MATERIALS (BASEL, SWITZERLAND) 2023; 16:5404. [PMID: 37570108 PMCID: PMC10419809 DOI: 10.3390/ma16155404] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/01/2023] [Revised: 06/25/2023] [Accepted: 06/27/2023] [Indexed: 08/13/2023]
Abstract
With the simultaneous increase in the number of endoprostheses being performed, advances in the field of biomaterials are becoming apparent-whereby the materials and technologies used to construct implants clearly improve the implants' quality and, ultimately, the life of the patient after surgery. The aim of this study was to modify the titanium alloy Ti6Al4V ELI used in the construction of hip joint endoprostheses. This is why the continuous development of biomaterials is so important. This paper presents the results of research for a new application of polymer poly(ethylene-alt-maleic anhydride) as a drug release layer, placed on the surface of a titanium alloy. The obtained layers were analyzed using Raman spectroscopy (spectra and maps), Fourier transform infrared spectroscopy (spectra and maps), contact angle measurements as well as scanning electron microscopy and energy dispersive spectroscopy imaging and topography analysis. The results confirmed that the polymer layer obtained on the plate surface after the alkali heat treatment process is much better-it binds much more polymer and thus the applied drug. In addition, a longer and more gradual release of the drug was observed for the alkali heat treatment modification than for H2O2 solution.
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Affiliation(s)
- Joanna Szczuka
- Institute of Materials Research and Quantum Engineering, Poznan University of Technology, 60-965 Poznan, Poland;
| | - Mariusz Sandomierski
- Institute of Chemical Technology and Engineering, Poznan University of Technology, 60-965 Poznan, Poland; (M.S.); (A.V.)
| | - Adam Voelkel
- Institute of Chemical Technology and Engineering, Poznan University of Technology, 60-965 Poznan, Poland; (M.S.); (A.V.)
| | - Karol Grochalski
- Faculty of Mechanical Engineering, Poznan University of Technology, 60-965 Poznan, Poland;
| | - Tomasz Buchwald
- Institute of Materials Research and Quantum Engineering, Poznan University of Technology, 60-965 Poznan, Poland;
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Skrzep-Poloczek B, Idzik M, Michalczyk K, Chełmecka E, Kukla M, Zalejska-Fiolka J, Poloczek J, Bogielski B, Jochem J, Nowak D, Stygar D. A 21-Day Individual Rehabilitation Exercise Training Program Changes Irisin, Chemerin, and BDNF Levels in Patients after Hip or Knee Replacement Surgery. J Clin Med 2023; 12:4881. [PMID: 37568282 PMCID: PMC10419925 DOI: 10.3390/jcm12154881] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2023] [Revised: 06/28/2023] [Accepted: 07/10/2023] [Indexed: 08/13/2023] Open
Abstract
Osteoarthritis (OA) is the most frequent worldwide cause of adult population disabilities. The study evaluated the effects of a 21-day individual rehabilitation exercise training program focused on improving patients' functional capacity. The study analyzed the changes in irisin, chemerin, and BDNF serum levels in 36 OA patients subjected to an individually-adjusted rehabilitation program 90 days after surgical hip or knee replacement. The changes in irisin, chemerin, and BDNF serum levels were measured using enzyme-linked immunosorbent assay (ELISA) kits. A 21-day individual rehabilitation exercise training program significantly increased irisin and BDNF, and decreased chemerin serum levels. The presented study indicates that individually-adjusted exercise training is an important modulator influencing serum levels of anti- and pro-inflammatory factors, leading to positive clinical outcomes in osteoarthritis therapy. Selected factors are considered potential markers of various pathophysiological conditions. The presented study brings new details to the discussion.
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Affiliation(s)
- Bronisława Skrzep-Poloczek
- Department of Physiology, Faculty of Medical Sciences in Zabrze, Medical University of Silesia, Jordana 19 Street, 41-808 Zabrze, Poland; (B.S.-P.); (B.B.)
| | - Maciej Idzik
- Independent Public Health Care, Opole Cancer Center Prof. Tadeusz Koszarowski, Katowicka 45-061 Street, 46-020 Opole, Poland;
| | - Katarzyna Michalczyk
- Department of Physiology, Faculty of Medical Sciences in Zabrze, Medical University of Silesia, Jordana 19 Street, 41-808 Zabrze, Poland; (B.S.-P.); (B.B.)
| | - Elżbieta Chełmecka
- Department of Statistics, Department of Instrumental Analysis, Faculty of Pharmaceutical Sciences in Sosnowiec, Medical University of Silesia, Ostrogórska 31 Street, 41-200 Sosnowiec, Poland;
| | - Michał Kukla
- Department of Internal Medicine and Geriatrics, Jagiellonian University Medical College in Cracow, Jakubowskiego 28 Street, 31-501 Cracow, Poland;
- Department of Endoscopy, University Hospital in Cracow, Jakubowskiego 28 Street, 31-501 Cracow, Poland
| | - Jolanta Zalejska-Fiolka
- Department of Biochemistry, Faculty of Medical Sciences in Zabrze, Medical University of Silesia, Jordana 19 Street, 41-808 Zabrze, Poland;
| | - Jakub Poloczek
- Department of Rehabilitation, 3rd Specialist Hospital in Rybnik, Energetyków 46 Street, 44-200 Rybnik, Poland
| | - Bartosz Bogielski
- Department of Physiology, Faculty of Medical Sciences in Zabrze, Medical University of Silesia, Jordana 19 Street, 41-808 Zabrze, Poland; (B.S.-P.); (B.B.)
| | - Jerzy Jochem
- Department of Physiology, Faculty of Medical Sciences in Zabrze, Medical University of Silesia, Jordana 19 Street, 41-808 Zabrze, Poland; (B.S.-P.); (B.B.)
| | - Damian Nowak
- Department of Physiology, Faculty of Medical Sciences in Zabrze, Medical University of Silesia, Jordana 19 Street, 41-808 Zabrze, Poland; (B.S.-P.); (B.B.)
| | - Dominika Stygar
- Department of Physiology, Faculty of Medical Sciences in Zabrze, Medical University of Silesia, Jordana 19 Street, 41-808 Zabrze, Poland; (B.S.-P.); (B.B.)
- SLU University Animal Hospital, Swedish University of Agricultural Sciences, SE-750 07 Uppsala, Sweden
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Jachowicz E, Pac A, Różańska A, Gryglewska B, Wojkowska-Mach J. Post-Discharge Clostridioides difficile Infection after Arthroplasties in Poland, Infection Prevention and Control as the Key Element of Prevention of C. difficile Infections. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19063155. [PMID: 35328843 PMCID: PMC8949811 DOI: 10.3390/ijerph19063155] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 01/22/2022] [Revised: 03/02/2022] [Accepted: 03/06/2022] [Indexed: 02/05/2023]
Abstract
Clostridioides difficile is still one of the most common causes of hospital-acquired infectious diarrhea (CDI), and the incidence of CDI is one of the indicators that allows conclusions to be derived on the correctness of antibiotic administration. The objective of this observational study was the analysis of post-discharge CDI incidence in patients undergoing hip or knee arthroplasty, in order to specify optimum conditions for the surgical procedures and outpatient postoperative care. One-year observational study. Public Polish hospitals. Retrospective records for 83,525 surgery patients having undergone hip or knee arthroplasty were extracted from the Polish National Health Fund databases. CDI and/or antibiotic prescriptions in the 30 day post-surgery period were expressed per 1000 surgeries with antibiotic prescription on discharge or in ambulatory care, respectively. The CDI incidence rate was 34.4 per 10,000 patients, and 7.7 cases per 100,000 post-surgery patient-days. Patients who were prescribed at least one antibiotic were diagnosed with CDI more often than patients who had no antibiotic treatment (55.0/1000 patients vs. 1.8/1000 patients). In the multifactorial analysis, the following factors were significant: being at least 65 years of age, trauma as the cause of surgery, length of stay over 7 days, HAIs other than CDI and taking beta-lactams and/or quinolones but not macrolides in the post-discharge period. Postoperative antibiotic prescription in patients undergoing joint replacement surgery is the main risk factor for CDI. These observations indicate the necessity of improvement of infection control programs as the key factor for CDI prevention.
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Affiliation(s)
- Estera Jachowicz
- Department of Microbiology, Faculty of Medicine, Medical College, Jagiellonian University, 31-121 Krakow, Poland; (E.J.); (A.R.)
| | - Agnieszka Pac
- Department of Epidemiology, Medical College, Jagiellonian University, 31-034 Krakow, Poland;
| | - Anna Różańska
- Department of Microbiology, Faculty of Medicine, Medical College, Jagiellonian University, 31-121 Krakow, Poland; (E.J.); (A.R.)
| | - Barbara Gryglewska
- Department of Internal Medicine and Gerontology, Medical College, Jagiellonian University, 31-501 Krakow, Poland;
| | - Jadwiga Wojkowska-Mach
- Department of Microbiology, Faculty of Medicine, Medical College, Jagiellonian University, 31-121 Krakow, Poland; (E.J.); (A.R.)
- Correspondence:
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