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Takei K, Ogawa M, Sakata R, Kanamori H. Epidemiological Characteristics of Carbapenem-Resistant Enterobacterales in Japan: A Nationwide Analysis of Data from a Clinical Laboratory Center (2016-2022). Pathogens 2023; 12:1246. [PMID: 37887763 PMCID: PMC10609946 DOI: 10.3390/pathogens12101246] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2023] [Revised: 10/07/2023] [Accepted: 10/14/2023] [Indexed: 10/28/2023] Open
Abstract
In Japan, nationwide epidemiological surveys on carbapenem-resistant Enterobacterales (CREs), including comprehensive information, are scarce, with most data available only through public reports. This study analyzed data on the Enterobacterales family collected from nationwide testing centers between January 2016 and December 2022, focusing on isolates that met the criteria for CRE in Japan based on drug susceptibility. We investigated 5,323,875 Enterobacterales isolates of 12 different species; among 4696 (0.09%) CRE strains, the proportion of major CRE isolates was as follows: Escherichia coli, 31.3%; Klebsiella pneumoniae, 28.0%; Enterobacter cloacae, 18.5%; and Klebsiella aerogenes, 6.7%. Moreover, over a 7-year period, Providencia rettgeri, E. cloacae, K. aerogenes, and K. pneumoniae demonstrated relatively high CRE percentages of 0.6% (156/26,185), 0.47% (869/184,221), 0.28% (313/110,371), and 0.17% (1314/780,958), respectively. The number of CRE strains isolated from different samples was as follows: urine, 2390; respiratory specimens, 1254; stool, 425; blood, 252; others, 375. In the broader context, including colonization, the predominant isolates of CREs collected at nationwide testing centers are E. coli and K. pneumoniae. Furthermore, recently, attention has been directed toward less common CRE species, such as Klebsiella oxytoca and Providencia rettgeri, and thus, it might be necessary to continue monitoring these less common species.
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Affiliation(s)
- Kentarou Takei
- Department of Infectious Diseases, Internal Medicine, Tohoku University Graduate School of Medicine, Sendai 980-8575, Japan;
| | - Miho Ogawa
- Department of Bacteriology, BML Inc., Kawagoe 350-1101, Japan
| | - Ryuji Sakata
- Department of Bacteriology, BML Inc., Kawagoe 350-1101, Japan
| | - Hajime Kanamori
- Department of Infectious Diseases, Internal Medicine, Tohoku University Graduate School of Medicine, Sendai 980-8575, Japan;
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Ekwunife OH, Coleman PS, Mabanza KT, Suleiman IE, Mulbah RG, Mohammed S, Doe AN, Bekele BG, Cassel AK, Weh-Wesseh MY, Sahr OS, Ngaoja FL, Jabateh FA. Overview of Rate and Risk Factors of Surgical Site Infection in a Tertiary Hospital in Liberia: A Prospective Cohort Study. J West Afr Coll Surg 2023; 13:87-92. [PMID: 38449557 PMCID: PMC10914110 DOI: 10.4103/jwas.jwas_65_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/09/2023] [Accepted: 07/12/2023] [Indexed: 03/08/2024]
Abstract
Background Surgical site infection (SSI) is accountable for a third of postoperative deaths and for 8% of all deaths due to hospital-acquired infections. There is a wide disparity in the incidence and burden of SSI in low and high-income countries. Objectives To assess the rates and risk factors of SSI in a tertiary hospital in a resource-limited sub-Saharan African country and generate institutional baseline data for future monitoring and interventions. Materials and Methods This was a descriptive prospective cohort study done at John F Kennedy Memorial Hospital, a tertiary hospital in Monrovia, Liberia, from October 18 to December 18, 2021. Consecutive participants, including children and adults that had surgical operations within the study period, were recruited. Criteria for diagnosis of SSI were as defined by the Centre for Disease Control (1999). Data were collected on the demography of the participants, type of surgery done, presence of SSI, comorbidities, and risk factors for SSI. Results Of the 111 patients analyzed, thirty-two patients had SSI giving a hospital incident rate of 28.8%. This comprises superficial SSI (22/31; 71.0%), deep SSI (6/31; 19.4%), and organ/space SSI (3/31; 9.7%). Twelve out of 42 females (28.6%) and 20 of 69 males (29.0%) had SSI. There is no statistically significant difference in gender SSI rate (P = 0.963). SSI occurred more in dirty wounds (13/23; 56.5%), compared to contaminated wounds (6/11, 54.6%), clean contaminated (7/22; 31.8%), and clean wounds (6/55, 10.9%). There is a statistical difference in the rate of SSI among the wound classes (P = 0.001). The infection rate is also more in emergency surgeries (18/39, 46.2%) compared to elective surgeries (14/72, 19.4%), and it is significant (P = 0.003). Statistically, there was no significant difference between the two skin preparation agents used (P = 0.351). The abdomen was the most common site of surgical incision and had the highest rate of SSI (24/79; 30.4%) (P = 0.045). There was no statistical difference in SSI rate between those whose hairs were removed in the ward or in the theatre (P = 0.114); length of incision (P = 0.297), or duration of surgery (P = 0.715) (see table for classification and rates). Conclusion The SSI rate in our study is high at 28.8%. Abdominal surgeries, emergencies, and wound class accounted for the majority of the SSIs. The baseline data will be useful in developing infection control strategies.
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Affiliation(s)
| | - Peter Sonpon Coleman
- Department of Surgery, John F Kennedy Memorial Medical Centre Monrovia, Monrovia, Liberia
| | - Kibuka Tresor Mabanza
- Department of Surgery, John F Kennedy Memorial Medical Centre Monrovia, Monrovia, Liberia
| | - Ibrahim Eneye Suleiman
- Department of Surgery, John F Kennedy Memorial Medical Centre Monrovia, Monrovia, Liberia
| | - Robert G Mulbah
- Department of Surgery, John F Kennedy Memorial Medical Centre Monrovia, Monrovia, Liberia
| | - Shamsuddeen Mohammed
- Department of Surgery, John F Kennedy Memorial Medical Centre Monrovia, Monrovia, Liberia
| | - Alvin Nah Doe
- Department of Surgery, John F Kennedy Memorial Medical Centre Monrovia, Monrovia, Liberia
| | - Biruk Gima Bekele
- Department of Surgery, John F Kennedy Memorial Medical Centre Monrovia, Monrovia, Liberia
| | - Ayun Kotokai Cassel
- Department of Surgery, John F Kennedy Memorial Medical Centre Monrovia, Monrovia, Liberia
| | - Mewaseh Yah Weh-Wesseh
- Department of Surgery, John F Kennedy Memorial Medical Centre Monrovia, Monrovia, Liberia
| | - Oscar Saturday Sahr
- Department of Surgery, John F Kennedy Memorial Medical Centre Monrovia, Monrovia, Liberia
| | - Faya Leno Ngaoja
- Department of Surgery, John F Kennedy Memorial Medical Centre Monrovia, Monrovia, Liberia
| | - Francis Abu Jabateh
- Department of Surgery, John F Kennedy Memorial Medical Centre Monrovia, Monrovia, Liberia
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Forrester JD, Bekele A, Stefan AM, Tshokey T, Berndtson AE, Beyene RT, Chou J, Sawyer RG, Valenzuela JY, Rickard J. Components of Existing National Surgical Site Infection Surveillance Programs Based on a Case Series of Low- and Middle-Income Countries: Building Blocks for Success and Opportunities for Improvement. Surg Infect (Larchmt) 2023; 24:112-118. [PMID: 36629853 DOI: 10.1089/sur.2022.331] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023] Open
Abstract
Background: Surgical site infection (SSI) surveillance programs are recommended to be included in national infection prevention and control (IPC) programs, yet few exist in low- or middle-income countries (LMICs). Our goal was to identify components of surveillance in existing programs that could be replicated elsewhere and note opportunities for improvement to build awareness for other countries in the process of developing their own national surgical site infection surveillance (nSSIS) programs. Methods: We administered a survey built upon the U.S. Centers for Disease Control and Prevention's framework for surveillance system evaluation to systematically deconstruct logistical infrastructure of existing nSSIS programs in LMICs. Qualitative analyses of survey responses by thematic elements were used to identify successful surveillance system components and recognize opportunities for improvement. Results: Three respondents representing countries in Europe and Central Asia, sub-Saharan Africa, and South Asia designated as upper middle-income, lower middle-income, and low-income responded. Notable strengths described by respondents included use of local paper documentation, staggered data entry, and limited data entry fields. Opportunities for improvement included outpatient data capture, broader coverage of healthcare centers within a nation, improved audit processes, defining the denominator of number of surgical procedures, and presence of an easily accessible, free SSI surveillance training program for healthcare workers. Conclusions: Outpatient post-surgery surveillance, national coverage of healthcare facilities, and training on how to take local SSI surveillance data and integrate it within a broader nSSIS program at the national level remain areas of opportunities for countries looking to implement a nSSIS program.
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Affiliation(s)
- Joseph D Forrester
- Section of Acute Care Surgery, Department of Surgery, Stanford University, Stanford, California, USA
| | - Abebe Bekele
- School of Medicine, University of Global Health Equity, Kigali, Rwanda
| | | | - Tshokey Tshokey
- Jigme Dorji Wangchuck National Referral Hospital, Thimphu, Bhutan
| | - Allison E Berndtson
- Department of Surgery, Division of Trauma, Surgical Critical Care, Burns and Acute Care Surgery, University of California, San Diego, San Diego, California, USA
| | - Robel T Beyene
- Division of Acute Care Surgery, Vanderbilt University, Nashville, Tennessee, USA
| | - Jesse Chou
- Department of Plastic and Maxillofacial Surgery, University of Virginia, Charlottesville, Virgina, USA
| | - Robert G Sawyer
- Department of Surgery, Western Michigan University Homer Stryker MD School of Medicine, Kalamazoo, Michigan, USA
| | - Julie Y Valenzuela
- Department of Surgery, Jamaica Hospital Medical Center, New York, New York, USA
| | - Jennifer Rickard
- Department of Surgery, University of Minnesota, Minneapolis, Minnesota, USA
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Hauschild J, Bruns N, Lainka E, Dohna-Schwake C. A European International Multicentre Survey on the Current Practice of Perioperative Antibiotic Prophylaxis for Paediatric Liver Transplantations. Antibiotics (Basel) 2023; 12. [PMID: 36830202 DOI: 10.3390/antibiotics12020292] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2022] [Revised: 01/27/2023] [Accepted: 01/30/2023] [Indexed: 02/04/2023] Open
Abstract
(1) Background: Postoperative infections are major contributors of morbidity and mortality after paediatric liver transplantation (pLTX). Evidence and recommendations regarding the most effective antimicrobial strategy are lacking. (2) Results: Of 39 pLTX centres, 20 responded. Aminopenicillins plus ß-lactamase inhibitors were used by six (30%) and third generation cephalosporins by three (15%), with the remaining centres reporting heterogenous regimens. Broad-spectrum regimens were the standard in 10 (50%) of centres and less frequent in the 16 (80%) centres with an infectious disease specialist. The duration ranged mainly between 24-48 h and 3-5 days in the absence and 3-5 days or 6-10 days in the presence of risk factors. Strategies regarding antifungal, antiviral, adjunctive antimicrobial, and surveillance strategies varied widely. (3) Methods: This international multicentre survey endorsed by the European Liver Transplant Registry queried all European pLTX centres from the registry on their current practice of perioperative antibiotic prophylaxis and antimicrobial strategies via an online questionnaire. (4) Conclusions: This survey found great heterogeneity regarding all aspects of postoperative antimicrobial treatment, surveillance, and prevention of infections in European pLTX centres. Evidence-based recommendations are urgently needed to optimise antimicrobial strategies and reduce the spectrum and duration of antimicrobial exposure.
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Parums DV. Editorial: The World Health Organization (WHO) Fungal Priority Pathogens List in Response to Emerging Fungal Pathogens During the COVID-19 Pandemic. Med Sci Monit 2022; 28:e939088. [PMID: 36453055 PMCID: PMC9724454 DOI: 10.12659/msm.939088] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2022] [Accepted: 11/29/2022] [Indexed: 07/29/2023] Open
Abstract
The COVID-19 pandemic, climate change, increased resistance to antifungal drugs, and an increased number of immunocompromised patients have driven a recent global surge in pathogenic fungal infections, including aspergillosis, candidiasis, and mucormycosis. On 25 October 2022, the World Health Organization (WHO) released a list of 19 fungal priority pathogens identified as having the greatest threat to public health. The WHO Fungal Priority Pathogens List represents the first global response to identify and prioritize fungal pathogens and their impact on global public health and to consider the unmet research and development needs. The WHO has grouped the priority fungal pathogens into those of critical, high, and medium priority. This Editorial aims to highlight the importance of identifying and prioritizing fungal pathogens and identifying emerging fungal pathogens and the global factors driving changing patterns of infection.
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Affiliation(s)
- Dinah V Parums
- Science Editor, Medical Science Monitor, International Scientific Information, Inc., Melville, NY, USA
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Alamer A, Alharbi F, Aldhilan A, Almushayti Z, Alghofaily K, Elbehiry A, Abalkhail A. Healthcare-Associated Infections (HAIs): Challenges and Measures Taken by the Radiology Department to Control Infection Transmission. Vaccines (Basel) 2022; 10. [PMID: 36560470 DOI: 10.3390/vaccines10122060] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2022] [Revised: 11/14/2022] [Accepted: 11/21/2022] [Indexed: 12/03/2022] Open
Abstract
Infections contracted during healthcare delivery in a hospital or ambulatory setting are collectively referred to as healthcare-associated infections (HAIs). Healthcare workers and patients alike are vulnerable to serious problems as a result of the risk of HAIs. In the healthcare system, HAIs are considered among the most common and serious health problems. However, the occurrence of HAIs differs between different types of clinical departments within the hospital. Recently, the risk of HAIs has been increasing in radiology departments globally due to the central role of radiology in guiding clinical decisions for the diagnosis, treatment, and monitoring of different diseases from almost all medical specialties. The radiology department is particularly vulnerable to HAIs because it serves as a transit hub for infected patients, non-infected patients, and healthcare workers. Furthermore, as the number of patients referred to radiology and the length of patient contact time has increased, thanks to modern imaging techniques such as computed tomography and magnetic resonance imaging, the risk of HAIs has also increased significantly. With the increasing use of interventional radiological procedures, patients and healthcare workers face a potentially greater risk of contracting HAIs due to the invasive nature of such procedures. Although not exhaustive, we attempted through a literature search to provide a general overview of infection prevention and control practices, address HAIs in the radiology departments, and highlight the challenges and measures taken to control infection transmission in the radiology departments.
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MacEwan SR, Gaughan AA, Beal EW, Hebert C, DeLancey JO, McAlearney AS. Concerns and frustrations about the public reporting of device-related healthcare-associated infections: Perspectives of hospital leaders and staff. Am J Infect Control 2022; 51:633-637. [PMID: 35948123 DOI: 10.1016/j.ajic.2022.08.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2022] [Revised: 08/02/2022] [Accepted: 08/03/2022] [Indexed: 11/25/2022]
Abstract
BACKGROUND Public reporting of healthcare-associated infections (HAIs) aims to incentivize improvement in infection prevention. The motivation and mechanisms of public reporting have raised concerns about the reliability of this data, but little is known about the specific concerns of hospital leaders and staff. This study sought to better understand perspectives of individuals in these roles regarding the identification and public reporting of HAIs. METHODS We conducted interviews with 471 participants including hospitals leaders (e.g., administrative and clinical leaders) and hospital staff (e.g., physicians and nurses) between 2017 and 2019 across 18 U.S. hospitals. A semi-structured interview guide was used to explore perspectives about the use of HAI data within the context of management strategies used to support infection prevention. RESULTS Interviewees described concerns about public reporting of HAI data, including a lack of trust in the data and inadvertent consequences of its public reporting, as well as specific frustrations related to the identification and accountability for publicly-reported HAIs. CONCLUSION Concerns and frustrations related to public reporting of HAI data highlight the need for improved guidelines, transparency, and incentives. Efforts to build trust in publicly-reported HAI data can help ensure this information is used effectively to improve infection prevention practices.
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Affiliation(s)
- Sarah R MacEwan
- Division of General Internal Medicine, College of Medicine, The Ohio State University, Columbus, Ohio, USA; The Center for the Advancement of Team Science, Analytics, and Systems Thinking (CATALYST), College of Medicine, The Ohio State University, Columbus, Ohio, USA.
| | - Alice A Gaughan
- The Center for the Advancement of Team Science, Analytics, and Systems Thinking (CATALYST), College of Medicine, The Ohio State University, Columbus, Ohio, USA
| | - Eliza W Beal
- The Center for the Advancement of Team Science, Analytics, and Systems Thinking (CATALYST), College of Medicine, The Ohio State University, Columbus, Ohio, USA; Department of Surgery, College of Medicine, The Ohio State University, Columbus, Ohio, USA
| | - Courtney Hebert
- The Center for the Advancement of Team Science, Analytics, and Systems Thinking (CATALYST), College of Medicine, The Ohio State University, Columbus, Ohio, USA; Department of Biomedical Informatics, College of Medicine, The Ohio State University, Columbus, Ohio, USA; Division of Infectious Diseases, College of Medicine, The Ohio State University, Columbus, Ohio, USA
| | - John Oliver DeLancey
- The Center for the Advancement of Team Science, Analytics, and Systems Thinking (CATALYST), College of Medicine, The Ohio State University, Columbus, Ohio, USA; Department of Urology, College of Medicine, The Ohio State University, Columbus, Ohio, USA
| | - Ann Scheck McAlearney
- The Center for the Advancement of Team Science, Analytics, and Systems Thinking (CATALYST), College of Medicine, The Ohio State University, Columbus, Ohio, USA; Department of Biomedical Informatics, College of Medicine, The Ohio State University, Columbus, Ohio, USA; Department of Family and Community Medicine, College of Medicine, The Ohio State University, Columbus, Ohio, USA
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8
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Chandra P, V R, M S, Cs S, Mk U. Multidrug-resistant Acinetobacter baumannii infections: looming threat in the Indian clinical setting. Expert Rev Anti Infect Ther 2021; 20:721-732. [PMID: 34878345 DOI: 10.1080/14787210.2022.2016393] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
INTRODUCTION The recent increase in multidrug-resistant strains of A. baumannii has increased the incidences of ventilator-associated pneumoniae, catheter-associated urinary tract infections, and central line-associated blood stream infections, together increasing hospital stay, treatment cost, and mortality. Resistance genes blaOXA and blaNDM are dominant in India. Carbapenem-resistant A. baumannii (CRAB) International clone-2 (IC-2) are rising in India. High dependency on carbapenems and last-resort combination of tigecycline and polymyxins have aggravated outcomes. Despite nursing barriers, ward closure, environmental disinfections etc for detecting and controlling transmission, MDR isolates and CRAB nosocomial outbreaks continue. Treatment cost overruns by AMR adversely affect 80% of Indians without insurance cover. AREA COVERED This narrative review will cover epidemiology, resistance pattern, genetic diversity, device-related infection, cost, and mortality due to multidrug-resistant and CRAB in India. A comprehensive literature search in PubMed and Google Scholar using appropriate keywords at different time points yielded relevant articles. EXPERT OPINION It is challenging to enforce policies to control MDR A. baumannii in India. Government and hospitals should enforce stringent infection control measures, surveillance, and antimicrobial stewardship to prevent further spread and emergence of more virulent and resistant strains. Knowledge on antibiotic resistance mechanisms can help design novel antibiotics that can evade, resistance.
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Affiliation(s)
- Prashant Chandra
- Department of Pharmacy Practice, Centre for Pharmaceutical care, Manipal College of Pharmaceutical Sciences, Manipal Academy of Higher Education, Manipal, India
| | - Rajesh V
- Department of Pharmacy Practice, Centre for Pharmaceutical care, Manipal College of Pharmaceutical Sciences, Manipal Academy of Higher Education, Manipal, India.,Department of Pharmacy Practice, Nitte Gulabi Shetty Memorial Institute of Pharmaceutical Sciences, Nitte University, Mangaluru, India
| | - Surulivelrajan M
- Department of Pharmacy Practice, Centre for Pharmaceutical care, Manipal College of Pharmaceutical Sciences, Manipal Academy of Higher Education, Manipal, India
| | - Shastry Cs
- Department of Pharmacy Practice, Nitte Gulabi Shetty Memorial Institute of Pharmaceutical Sciences, Nitte University, Mangaluru, India
| | - Unnikrishnan Mk
- Department of Pharmacy Practice, Nitte Gulabi Shetty Memorial Institute of Pharmaceutical Sciences, Nitte University, Mangaluru, India
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Tischer C, Stupp C, Janson P, Willeke K, Hung CW, Flöter J, Kirchner A, Zink K, Eder L, Hackl C, Mühle U, Weidmann M, Nennstiel U, Kuhn J, Weidner C, Liebl B, Wildner M, Keil T. Evaluation of Screening Tests in Bavarian Healthcare Facilities during the Second Wave of the SARS-CoV-2 Pandemic. Int J Environ Res Public Health 2021; 18:ijerph18147371. [PMID: 34299821 PMCID: PMC8303425 DOI: 10.3390/ijerph18147371] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/02/2021] [Revised: 07/04/2021] [Accepted: 07/07/2021] [Indexed: 12/26/2022]
Abstract
Due to the lack of data on asymptomatic SARS-CoV-2-positive persons in healthcare institutions, they represent an inestimable risk. Therefore, the aim of the current study was to evaluate the first 1,000,000 reported screening tests of asymptomatic staff, patients, residents, and visitors in hospitals and long-term care (LTC) facilities in the State of Bavaria over a period of seven months. Data were used from the online database BayCoRei (Bavarian Corona Screening Tests), established in July 2020. Descriptive analyses were performed, describing the temporal pattern of persons that tested positive for SARS-CoV-2 by real-time polymerase chain reaction (RT-PCR) or antigen tests, stratified by facility. Until 15 March 2021, this database had collected 1,038,146 test results of asymptomatic subjects in healthcare facilities (382,240 by RT-PCR, and 655,906 by antigen tests). Of the RT-PCR tests, 2.2% (n = 8380) were positive: 3.0% in LTC facilities, 2.2% in hospitals, and 1.2% in rehabilitation institutions. Of the antigen tests, 0.4% (n = 2327) were positive: 0.5% in LTC facilities, and 0.3% in both hospitals and rehabilitation institutions, respectively. In LTC facilities and hospitals, infection surveillance using RT-PCR tests, or the less expensive but less sensitive, faster antigen tests, could facilitate the long-term management of the healthcare workforce, patients, and residents.
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Affiliation(s)
- Christina Tischer
- State Institute of Health, Bavarian Health and Food Safety Authority, Eggenreuther Weg 43, 91058 Erlangen, Germany; (C.S.); (P.J.); (K.W.); (C.-W.H.); (J.F.); (A.K.); (K.Z.); (L.E.); (C.H.); (U.M.); (U.N.); (J.K.); (B.L.); (M.W.); (T.K.)
- Institute of Clinical Epidemiology and Biometry, University of Wuerzburg, Josef-Schneider-Str. 2, 97080 Wuerzburg, Germany
- Correspondence: ; Tel.: +49-(0)9131-6808-7220
| | - Carolin Stupp
- State Institute of Health, Bavarian Health and Food Safety Authority, Eggenreuther Weg 43, 91058 Erlangen, Germany; (C.S.); (P.J.); (K.W.); (C.-W.H.); (J.F.); (A.K.); (K.Z.); (L.E.); (C.H.); (U.M.); (U.N.); (J.K.); (B.L.); (M.W.); (T.K.)
- Institute of Clinical Epidemiology and Biometry, University of Wuerzburg, Josef-Schneider-Str. 2, 97080 Wuerzburg, Germany
| | - Patrick Janson
- State Institute of Health, Bavarian Health and Food Safety Authority, Eggenreuther Weg 43, 91058 Erlangen, Germany; (C.S.); (P.J.); (K.W.); (C.-W.H.); (J.F.); (A.K.); (K.Z.); (L.E.); (C.H.); (U.M.); (U.N.); (J.K.); (B.L.); (M.W.); (T.K.)
- Institute of Clinical Epidemiology and Biometry, University of Wuerzburg, Josef-Schneider-Str. 2, 97080 Wuerzburg, Germany
| | - Kristina Willeke
- State Institute of Health, Bavarian Health and Food Safety Authority, Eggenreuther Weg 43, 91058 Erlangen, Germany; (C.S.); (P.J.); (K.W.); (C.-W.H.); (J.F.); (A.K.); (K.Z.); (L.E.); (C.H.); (U.M.); (U.N.); (J.K.); (B.L.); (M.W.); (T.K.)
- Institute of Clinical Epidemiology and Biometry, University of Wuerzburg, Josef-Schneider-Str. 2, 97080 Wuerzburg, Germany
| | - Chu-Wei Hung
- State Institute of Health, Bavarian Health and Food Safety Authority, Eggenreuther Weg 43, 91058 Erlangen, Germany; (C.S.); (P.J.); (K.W.); (C.-W.H.); (J.F.); (A.K.); (K.Z.); (L.E.); (C.H.); (U.M.); (U.N.); (J.K.); (B.L.); (M.W.); (T.K.)
| | - Jessica Flöter
- State Institute of Health, Bavarian Health and Food Safety Authority, Eggenreuther Weg 43, 91058 Erlangen, Germany; (C.S.); (P.J.); (K.W.); (C.-W.H.); (J.F.); (A.K.); (K.Z.); (L.E.); (C.H.); (U.M.); (U.N.); (J.K.); (B.L.); (M.W.); (T.K.)
| | - Anna Kirchner
- State Institute of Health, Bavarian Health and Food Safety Authority, Eggenreuther Weg 43, 91058 Erlangen, Germany; (C.S.); (P.J.); (K.W.); (C.-W.H.); (J.F.); (A.K.); (K.Z.); (L.E.); (C.H.); (U.M.); (U.N.); (J.K.); (B.L.); (M.W.); (T.K.)
| | - Katharina Zink
- State Institute of Health, Bavarian Health and Food Safety Authority, Eggenreuther Weg 43, 91058 Erlangen, Germany; (C.S.); (P.J.); (K.W.); (C.-W.H.); (J.F.); (A.K.); (K.Z.); (L.E.); (C.H.); (U.M.); (U.N.); (J.K.); (B.L.); (M.W.); (T.K.)
| | - Lisa Eder
- State Institute of Health, Bavarian Health and Food Safety Authority, Eggenreuther Weg 43, 91058 Erlangen, Germany; (C.S.); (P.J.); (K.W.); (C.-W.H.); (J.F.); (A.K.); (K.Z.); (L.E.); (C.H.); (U.M.); (U.N.); (J.K.); (B.L.); (M.W.); (T.K.)
| | - Christina Hackl
- State Institute of Health, Bavarian Health and Food Safety Authority, Eggenreuther Weg 43, 91058 Erlangen, Germany; (C.S.); (P.J.); (K.W.); (C.-W.H.); (J.F.); (A.K.); (K.Z.); (L.E.); (C.H.); (U.M.); (U.N.); (J.K.); (B.L.); (M.W.); (T.K.)
- Pettenkofer School of Public Health, Ludwig Maximilians University, Marchionistrasse 15, 81377 Munich, Germany
- Institute for Medical Information Processing, Biometry, and Epidemiology—IBE, Ludwig Maximilians University, Marchionistrasse 15, 81377 Munich, Germany
| | - Ursula Mühle
- State Institute of Health, Bavarian Health and Food Safety Authority, Eggenreuther Weg 43, 91058 Erlangen, Germany; (C.S.); (P.J.); (K.W.); (C.-W.H.); (J.F.); (A.K.); (K.Z.); (L.E.); (C.H.); (U.M.); (U.N.); (J.K.); (B.L.); (M.W.); (T.K.)
| | - Manfred Weidmann
- Institute of Microbiology and Virology, Medical School Brandenburg Theodor Fontane, Universitätsplatz 1, Gebäude 14, 01968 Senftenberg, Germany;
- Midge Medical GmbH, Colditzstarße 34-36, 12099 Berlin, Germany
| | - Uta Nennstiel
- State Institute of Health, Bavarian Health and Food Safety Authority, Eggenreuther Weg 43, 91058 Erlangen, Germany; (C.S.); (P.J.); (K.W.); (C.-W.H.); (J.F.); (A.K.); (K.Z.); (L.E.); (C.H.); (U.M.); (U.N.); (J.K.); (B.L.); (M.W.); (T.K.)
| | - Joseph Kuhn
- State Institute of Health, Bavarian Health and Food Safety Authority, Eggenreuther Weg 43, 91058 Erlangen, Germany; (C.S.); (P.J.); (K.W.); (C.-W.H.); (J.F.); (A.K.); (K.Z.); (L.E.); (C.H.); (U.M.); (U.N.); (J.K.); (B.L.); (M.W.); (T.K.)
| | - Christian Weidner
- Bavarian Health and Food Safety Authority, Eggenreuther Weg 43, 91058 Erlangen, Germany;
| | - Bernhard Liebl
- State Institute of Health, Bavarian Health and Food Safety Authority, Eggenreuther Weg 43, 91058 Erlangen, Germany; (C.S.); (P.J.); (K.W.); (C.-W.H.); (J.F.); (A.K.); (K.Z.); (L.E.); (C.H.); (U.M.); (U.N.); (J.K.); (B.L.); (M.W.); (T.K.)
- Walther Straub Institute of Pharmacology and Toxicology, Faculty of Medicine, Ludwig Maximilians University, Pettenkoferstrasse 12, 80336 Munich, Germany
| | - Manfred Wildner
- State Institute of Health, Bavarian Health and Food Safety Authority, Eggenreuther Weg 43, 91058 Erlangen, Germany; (C.S.); (P.J.); (K.W.); (C.-W.H.); (J.F.); (A.K.); (K.Z.); (L.E.); (C.H.); (U.M.); (U.N.); (J.K.); (B.L.); (M.W.); (T.K.)
- Pettenkofer School of Public Health, Ludwig Maximilians University, Marchionistrasse 15, 81377 Munich, Germany
| | - Thomas Keil
- State Institute of Health, Bavarian Health and Food Safety Authority, Eggenreuther Weg 43, 91058 Erlangen, Germany; (C.S.); (P.J.); (K.W.); (C.-W.H.); (J.F.); (A.K.); (K.Z.); (L.E.); (C.H.); (U.M.); (U.N.); (J.K.); (B.L.); (M.W.); (T.K.)
- Institute of Clinical Epidemiology and Biometry, University of Wuerzburg, Josef-Schneider-Str. 2, 97080 Wuerzburg, Germany
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10
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Rittmeier S, Waeschle RM, Artelt T, Fehling P, Suckow A, Siess M, Scheithauer S. Surveillance of surgical site infections: methodical comparison of the IQTIG and KISS strategies. GMS Hyg Infect Control 2021; 16:Doc18. [PMID: 34123706 PMCID: PMC8165488 DOI: 10.3205/dgkh000389] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Aim: In 2017, the Institute for Quality Assurance and Transparency in Healthcare (IQTIG) introduced a quality assurance system for the surveillance of surgical site infections (SSI) on behalf the Federal Joint Committee. The establishment of the new system was made in parallel to existing methods, such as the “Krankenhaus-Infektions-Surveillance-System” (KISS). The aim of this work was to perform a comparative analysis. Methods: All 2,233 cases at the University Medical Center Goettingen requiring an assessment of the presence of SSI as part of the IQTIG procedure in 2018 and 2019 were evaluated retrospectively according to the KISS protocol. Results: In total, 2,050 patients were included in the comparative evaluation. Overall, 1,779 (79.7%) had a surgical anamnesis (surgery during the stay or in the past), and 1,716 (83.7%) showed identical results for both surveillance strategies. Different results were found for 334 patients (16.3%), with 160 of these (7.8%) positive for SSI according to IQTIG and 174 (8.5%) positive for KISS. Risk factors were identified for a discordant assessment between the methods. Conclusion: The congruence of the two strategies was consistently high over the study period. There is evidence that the efficiency of the documentation algorithm can be increased without the loss of documentation of SSI, while preserving the precision of the documentation through training.
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Affiliation(s)
- Sascha Rittmeier
- Institute for Infection Control and Infectious Diseases, University Medical Center Goettingen, Goettingen, Germany
| | - Reiner M Waeschle
- Department of Anesthesiology, University Medical Center Goettingen, Goettingen, Germany
| | - Tanja Artelt
- Institute for Infection Control and Infectious Diseases, University Medical Center Goettingen, Goettingen, Germany
| | - Patrick Fehling
- Institute for Infection Control and Infectious Diseases, University Medical Center Goettingen, Goettingen, Germany
| | - Arnt Suckow
- Quality and Risk Management Department, University Medical Center Goettingen, Goettingen, Germany
| | - Martin Siess
- Board of Health Care, University Medical Center Goettingen, Goettingen, Germany
| | - Simone Scheithauer
- Institute for Infection Control and Infectious Diseases, University Medical Center Goettingen, Goettingen, Germany
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11
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Mbwogge M. Mass Testing With Contact Tracing Compared to Test and Trace for the Effective Suppression of COVID-19 in the United Kingdom: Systematic Review. JMIRx Med 2021; 2:e27254. [PMID: 33857269 PMCID: PMC8045129 DOI: 10.2196/27254] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/18/2021] [Revised: 03/08/2021] [Accepted: 03/10/2021] [Indexed: 12/12/2022]
Abstract
BACKGROUND Making testing available to everyone and tracing contacts might be the gold standard to control COVID-19. Many countries including the United Kingdom have relied on the symptom-based test and trace strategy in bringing the COVID-19 pandemic under control. The effectiveness of a test and trace strategy based on symptoms has been questionable and has failed to meet testing and tracing needs. This is further exacerbated by it not being delivered at the point of care, leading to rising cases and deaths. Increases in COVID-19 cases and deaths in the United Kingdom despite performing the highest number of tests in Europe suggest that symptom-based testing and contact tracing might not be effective as a control strategy. An alternative strategy is making testing available to all. OBJECTIVE The primary objective of this review was to compare mass testing and contact tracing with the conventional test and trace method in the suppression of SARS-CoV-2 infections. The secondary objective was to determine the proportion of asymptomatic COVID-19 cases reported during mass testing interventions. METHODS Literature in English was searched from September through December 2020 in Google Scholar, ScienceDirect, Mendeley, and PubMed. Search terms included "mass testing," "test and trace," "contact tracing," "COVID-19," "SARS-CoV-2," "effectiveness," "asymptomatic," "symptomatic," "community screening," "UK," and "2020." Search results were synthesized without meta-analysis using the direction of effect as the standardized metric and vote counting as the synthesis metric. A statistical synthesis was performed using Stata 14.2. Tabular and graphical methods were used to present findings. RESULTS The literature search yielded 286 articles from Google Scholar, 20 from ScienceDirect, 14 from Mendeley, 27 from PubMed, and 15 through manual search. A total of 35 articles were included in the review, with a sample size of nearly 1 million participants. We found a 76.9% (10/13, 95% CI 46.2%-95.0%; P=.09) majority vote in favor of the intervention under the primary objective. The overall proportion of asymptomatic cases among those who tested positive and in the tested sample populations under the secondary objective was 40.7% (1084/2661, 95% CI 38.9%-42.6%) and 0.0% (1084/9,942,878, 95% CI 0.0%-0.0%), respectively. CONCLUSIONS There was low-level but promising evidence that mass testing and contact tracing could be more effective in bringing the virus under control and even more effective if combined with social distancing and face coverings. The conventional test and trace method should be superseded by decentralized and regular mass rapid testing and contact tracing, championed by general practitioner surgeries and low-cost community services.
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Affiliation(s)
- Mathew Mbwogge
- London School of Hygiene & Tropical Medicine London United Kingdom
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12
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Michel-Backofen A, Steinke D, Katzer C, Brenck F, Böning A. Generating Surveillance Data for Nosocomial Infections from Routine Charting in Intensive Care Units. Stud Health Technol Inform 2020; 270:1295-1296. [PMID: 32570626 DOI: 10.3233/shti200409] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
The University Hospital of Giessen and Marburg (UKGM), Giessen, Germany participates in a country wide nosocomial infections surveillance project on intensive care units (ICU) called KISS. KISS data must be gathered daily and is comprised of detailed clinical data like patient movements, ward utilization, presence of central venous and urinary catheters and types of artificial respiration. This happens for all of the 10 ICU's at UKGM Giessen and proved to be very tedious and time consuming for the institute for hospital hygiene. The goal of this project was the automated generation of the KISS reports from routinely collected data in the patient data management system (PDMS). The results show that this is largely feasible without changing the documentation habits of physicians and nurses.
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Affiliation(s)
- Achim Michel-Backofen
- Department for clinical and administrative data processing, University Hospital of Giessen and Marburg, Giessen
| | - Dorothee Steinke
- Institute for hospital hygiene, University Hospital of Giessen and Marburg, Giessen
| | - Christian Katzer
- Department for anesthesiology, surgical intensive care medicine and pain therapy, University Hospital of Giessen and Marburg, Giessen
| | - Florian Brenck
- Department for anesthesiology, surgical intensive care medicine and pain therapy, University Hospital of Giessen and Marburg, Giessen
| | - Andreas Böning
- Department for cardio surgery, University Hospital of Giessen and Marburg, Giessen
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13
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Forrester JD, Berndtson AE, Santorelli J, Raschke E, Weiser TG, Coombs AV, Sawyer RG, Chou J, Knight HP, Valenzuela JY, Rickard J. Survey of National Surgical Site Infection Surveillance Programs in Low- and Middle-Income Countries. Surg Infect (Larchmt) 2020; 21:621-625. [PMID: 32397833 DOI: 10.1089/sur.2020.053] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Background: Surgical site infection (SSI) surveillance programs are strongly recommended as a core component of effective national infection prevention and control (IPC) programs. Participation in national SSI surveillance (nSSIS) programs has been shown to decrease reported SSIs among high-income countries (HICs), and it is expected that the same is possible among low- and middle-income countries (LMICs). We sought to determine what, if any nSSIS programs exist among LMICs. Methods: A cross-sectional survey was performed to evaluate existence of nSSIS of World Bank-defined LMICs. A digital survey assessment for presence of national IPC and nSSIS programs was delivered to persons capable of identifying the presence of such a program. Statistical analysis was performed using STATA. Institutional Review Board approval was obtained for this study. Results: Of the 137 countries identified, 55 (40%) were upper middle income (UMI), 47 (34%) were lower middle income (LMI), and 34 (25%) were low income. Representatives from 39 (28%) LMICs completed the survey. Of these respondent countries, 13 (33%) reported the presence of a national IPC program. There was no difference between countries with IPC programs and those without with respect to country income designation, population size, World Health Organization region, or conflict status. Only five (13% of all respondents) reported presence of a nSSIS program. Conclusions: National surgical site infection surveillance programs are an integral component of a country's ability to provide safe surgical procedures. Presence of nSSIS was reported infrequently in LMICs. International governing bodies should be encouraged to guide LMIC leadership in establishing a nSSIS infrastructure that will help enable safe surgical procedures.
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Affiliation(s)
- Joseph D Forrester
- Section of Acute Care Surgery, Department of Surgery, Stanford University, Stanford, California, USA
| | - Allison E Berndtson
- Division of Trauma, Surgical Critical Care, Burns and Acute Care Surgery, University of California, San Diego, La Jolla, California, USA
| | - Jarrett Santorelli
- Division of Trauma, Surgical Critical Care, Burns and Acute Care Surgery, University of California, San Diego, La Jolla, California, USA
| | - Eric Raschke
- Division of Trauma, Surgical Critical Care, Burns and Acute Care Surgery, University of California, San Diego, La Jolla, California, USA
| | - Thomas G Weiser
- Section of Acute Care Surgery, Department of Surgery, Stanford University, Stanford, California, USA
| | - Andre V Coombs
- Section of Acute Care Surgery, Department of Surgery, Stanford University, Stanford, California, USA
| | - Robert G Sawyer
- Department of Surgery, Western Michigan University Homer Stryker MD School of Medicine, Kalamazoo, Michigan, USA
| | - Jesse Chou
- Department of Surgery, Western Michigan University Homer Stryker MD School of Medicine, Kalamazoo, Michigan, USA
| | - Hunter P Knight
- Department of Surgery, Western Michigan University Homer Stryker MD School of Medicine, Kalamazoo, Michigan, USA
| | - Julie Y Valenzuela
- Division of Trauma Critical Care, Southside Hospital/Northwell Health, Glen Cove, New York, USA
| | - Jennifer Rickard
- Department of Surgery, University of Minnesota, Minneapolis, Minnesota, USA
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14
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Okeke TI, P Musa BO, Babadoko AA, Jamoh BY. Complement Levels in Nigeria Patients with Sickle Cell Anaemia in the Asymptomatic State. Niger J Clin Pract 2018; 21:1139-1143. [PMID: 30156198 DOI: 10.4103/njcp.njcp_412_17] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Objectives Significantly low serum levels of complement components have been reported in patients with Sickle cell anaemia (SCA) which may result in a high susceptibility to infections. However some studies have reported a normal or high complement level. The aim of our study was to assess some haematological parameters and Complement levels in adult patients with steady state SCA in Zaria, North western Nigeria. This will serve as a guide towards infection surveillance in the quest to reduce significant morbidity and mortality in our setting. Methods A cross sectional study of 40 patients with SCA in steady state and 40 healthy (non-matched) non-SCA controls at the Haematology clinic of Ahmadu Bello University Teaching Hospital Zaria, was carried out over a 6 month period in 2016. Institutional ethical approval and informed written consentwere obtained. Venous blood was analyzed for haematological parameters by an automated method and complement levels; alternative pathway was assessed by measuring C3, classical pathway by C4 and Terminal pathways by C5 levels using ELISA technique. Data was analyzed with statistical package for social science(SPSS) software version 20.0(2001) and a p value of ≤ 0.05 was considered significant. Results The age range of patients with SCA and controls were 18 to 46years and 18 to 48years respectively and these were not significantly different p > 0.05. The median levels of C3 (245μg/ml), C4 (245μg/ml) and C5 (40μg/ml) were within normal range in the study subjects but significantly higher (p < 0.05), than those of the controls C3 (165μg/ml), C4 (125μg/ml) and C5(35μg/ml). Haematological parameters showed no correlation with the levels of Complement components studied. Conclusion Although Complement components C3, C4, and C5 levels in patients with SCA are significantly high, the infectious susceptibility may be due to other immunological abnormalities.
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Affiliation(s)
- T I Okeke
- Department of Chemical Pathology, Dala Orthopaedic Hospital, Kano, Nigeria
| | - B O P Musa
- Department of Medicine, Immunology Unit, Ahmadu Bello University Teaching Hospital, Zaria, Nigeria
| | - A A Babadoko
- Department of Haematology and Blood Transfusion, Ahmadu Bello University Teaching Hospital, Zaria, Nigeria
| | - B Y Jamoh
- Department of Medicine, Immunology Unit, Ahmadu Bello University Teaching Hospital, Zaria, Nigeria
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15
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Childs C, Siraj MR, Fair FJ, Selvan AN, Soltani H, Wilmott J, Farrell T. Thermal territories of the abdomen after caesarean section birth: infrared thermography and analysis. J Wound Care 2017; 25:499-512. [PMID: 27608511 DOI: 10.12968/jowc.2016.25.9.499] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
OBJECTIVE To develop and refine qualitative mapping and quantitative analysis techniques to define 'thermal territories' of the post-partum abdomen, the caesarean section site and the infected surgical wound. In addition, to explore women's perspectives on thermal imaging and acceptability as a method for infection screening. METHOD Prospective feasibility study undertaken at a large University teaching hospital, Sheffield UK. Infrared thermal imaging of the abdomen was undertaken at the bedside on the first two days after elective caesarean section. Target recruitment: six women in each of three body mass index (BMI) categories (normal, 18.5-24.9 kg/m²; overweight 25-29.9 kg/m²; obese ≥30 kg/m²). Additionally, women presenting to the ward with wound infection were eligible for inclusion in the study. Perspectives on the use of thermal imaging and its practicality were also explored via semi-structured interviews and analysed using thematic content analysis. RESULTS We recruited 20 women who had all undergone caesarean section. From the booking BMI, eight women were obese (including two women with infected wounds), seven women were overweight and five women had a normal BMI. Temperature (ºC) profiling and pixel clustering segmentation (hierarchical clustering-based segmentation, HCS) revealed characteristic features of thermal territories between scar and adjacent regions. Differences in scar thermal intensity profiles exist between healthy scars and infected wounds; features that have potential for wound surveillance. The maximum temperature differences (∆T) between healthy skin and the wound site exceed 2º C in women with established wound infection. At day two, two women had a scar thermogram with features observed in the 'infected' wound thermogram. CONCLUSION Thermal imaging at early and later times after caesarean birth is feasible and acceptable. Women reported potential benefits of the technique for future wound infection screening. Thermal intensity profiling and HCS for pixel cluster dissimilarity between scar and adjacent healthy skin has potential as a method for the development of techniques targeted to early infection surveillance in women after caesarean section.
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Affiliation(s)
- C Childs
- Professor of Clinical Science, Midwifery Researcher, Professor of Maternal and Infant Health, Centre for Health and Social Care Research, Sheffield Hallam University, Montgomery House, 32 Collegiate Crescent, Sheffield
| | - M R Siraj
- ST7 Obstetrics and Gynaecology, Consultant, Jessop Wing, Sheffield Teaching Hospital NHS Trust, Tree Root Walk, Sheffield
| | - F J Fair
- Professor of Clinical Science, Midwifery Researcher, Professor of Maternal and Infant Health, Centre for Health and Social Care Research, Sheffield Hallam University, Montgomery House, 32 Collegiate Crescent, Sheffield
| | - A N Selvan
- Associate Lecturer, Materials and Engineering Research Institute, Sheffield Hallam University, Howard Street, Sheffield
| | - H Soltani
- Professor of Clinical Science, Midwifery Researcher, Professor of Maternal and Infant Health, Centre for Health and Social Care Research, Sheffield Hallam University, Montgomery House, 32 Collegiate Crescent, Sheffield
| | - J Wilmott
- EPSRC Research Fellow, University of Sheffield, Portobello Centre, Sheffield
| | - T Farrell
- ST7 Obstetrics and Gynaecology, Consultant, Jessop Wing, Sheffield Teaching Hospital NHS Trust, Tree Root Walk, Sheffield
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16
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Kovacs CS, Fatica C, Butler R, Gordon SM, Fraser TG. Hospital-acquired Staphylococcus aureus primary bloodstream infection: A comparison of events that do and do not meet the central line-associated bloodstream infection definition. Am J Infect Control 2016; 44:1252-1255. [PMID: 27158091 DOI: 10.1016/j.ajic.2016.03.038] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2015] [Revised: 03/07/2016] [Accepted: 03/08/2016] [Indexed: 11/28/2022]
Abstract
BACKGROUND This study was done to describe the incidence and outcomes of primary hospital-acquired bloodstream infection (HABSI) secondary to Staphylococcus aureus (SA) that did and did not meet the National Healthcare Safety Network's (NHSN's) definition for central line-associated bloodstream infection (CLABSI). METHODS Consecutive hospitalized patients during a 48-month study period with an SA HABSI were categorized according to those who did and did not meet the NHSN's definitions for CLABSI and non-CLABSI. Primary outcomes were mortality at 30 days and 1 year. Secondary outcomes were the incidence of complicated bacteremia and the need for operative intervention secondary to the HABSI event. RESULTS A total of 122 episodes of primary SA HABSIs were identified: 78 (64%) were CLABSIs, and 44 (36%) were non-CLABSIs. Overall 30-day and 1-year mortality in the cohort was 21.3% and 38.5%, respectively, and did not differ significantly between the 2 groups. Complicated SA HABSI was significantly more common in the non-CLABSI group (15.9% [n = 7] vs 0% [n = 0], P ≤ .001). CONCLUSIONS Primary SA HABSI was associated with significant 30-day and 1-year mortality. Complications from SA non-CLABSI requiring surgical intervention were significantly more common than in those with a CLABSI event. Our findings affirm the significance of non-device-related hospital-acquired infections.
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Affiliation(s)
- Christopher S Kovacs
- Department of Infectious Disease, Medicine Institute, Cleveland Clinic, Cleveland, OH.
| | - Cynthia Fatica
- Department of Infection Prevention, Quality and Patient Safety Institute, Cleveland Clinic, Cleveland, OH
| | - Robert Butler
- Department of Qualitative Health Sciences, Lerner Research Institute, Cleveland Clinic, Cleveland, OH
| | - Steven M Gordon
- Department of Infectious Disease, Medicine Institute, Cleveland Clinic, Cleveland, OH
| | - Thomas G Fraser
- Department of Infectious Disease, Medicine Institute, Cleveland Clinic, Cleveland, OH; Department of Infection Prevention, Quality and Patient Safety Institute, Cleveland Clinic, Cleveland, OH
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