High Rate of Infection Control with One-stage Revision of Septic Knee Prostheses Excluding MRSA and MRSE

Introduction: The management of periprosthetic joint infection (PJI) of the hip is a challenging procedure. One-stage exchange is carried out in specialist centres with comparable infection free survival rates. However, there is a paucity of long-term results of this approach in young patients. Methods: All patients undergoing one-stage exchange due to PJI with a known causative organism ⩽45 years of age with a minimum of 10-year follow-up (mean 15 years; range 10–24 years) were enrolled in this retrospective study. Patients older than 45 years of age or patients with a two-stage procedure were excluded from the study. The primary outcome measure was failure rate with special focus on reinfection at latest follow-up. Failure was defined as revision surgery for infection. Furthermore, functional outcome using the Harris Hip Score was determined initially and at latest follow-up. 26 patients fulfilled the inclusion criteria and were available for final follow-up. Results: The study cohort consists of 16 male and 10 female patients with a mean age of 36.8 years (range 20–45 years) and a mean BMI of 29.8 kg/m2 (range 20.7–40.6 kg/m2). Prior to the single-stage procedure, the patients underwent an average of 3.1 previous surgical interventions (range 1–9). The mean hospital stay after septic revision was 19.7 days (11–33 days). Most infections were caused by Staphylococcus epidermidis ( n = 8, 30.8%), followed by Staph. aureus ( n = 7, 26.9%) and Propionibacterium acnes ( n = 6, 23.1%). At latest follow-up, the overall survival rate was 76.9 %, while infection control could be achieved in 96.2%. At final examination, the mean Harris Hip Score improved from 46.2 to 78.9 (range 18.0–99; SD, 22.6). Conclusions: Single-stage revision surgery for the management of PJI in patients ⩽45 years is a successful treatment option with high infection control, even after long-term follow-up.

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Infection control strategy and primary care assistance in Campania region during the national lockdown due to COVID-19 outbreak: the experience of two tertiary emergency centers

Italian Journal of Pediatrics ◽

10.1186/s13052-021-00963-3 ◽

2021 ◽

Vol 47 (1) ◽

Author(s):

Angela Mauro ◽

Nicola Improda ◽

Letizia Zenzeri ◽

Francesco Valitutti ◽

Erica Vecchione ◽

...

Keyword(s):

Primary Care ◽

Health Care ◽

Infection Control ◽

Control Strategy ◽

Health Care Professionals ◽

Close Contact ◽

Time Lapse ◽

High Rate ◽

Self Medication ◽

Campania Region

Abstract Background COVID-19 pandemic has markedly affected emergency care, due to sudden limitation of health care capacity by general practitioners (GP) and urgent need for infection control strategies. We evaluated the activity of the Emergency Department (ED) during the national lockdown (March 8–April 30), as well as the outcomes of our infection control strategy. Results Despite a reduction in access by one fifth, a proportion of febrile patients comparable to 2019 was seen (829/2492, 33.3% vs 4580/13.342, 34.3%, p = 0.3). Diagnostic swab for COVID-19 was performed in 25% of patients, especially in subjects with co-morbidities or multiple access. Six infected cases were identified, all presenting with febrile disease. Only two positive patients fulfilled the criteria for diagnostic swab provided by the Italian Health Authorities, because of close contact with suspected or confirmed cases. The rate of admission for febrile or respiratory conditions was higher than the same period of 2019 (33.4% vs 25.9%, p < 0.0001). None of the 105 health-care professionals working during the study time lapse exhibited anti-SARS-CoV-2 seroconversion. Among the 589 patients with information available, 54.9% declared no medical consultation at all prior to coming to ED, while only 40 (of which 27 with fever) had been examined by their GP before coming to ED. Nevertheless, 35.6% of the cases were already taking medications. None of the 9 patients requiring intensive care reported recent pediatric consultation, despite symptoms duration up to 30 days. Conclusion Our results provide evidence that the reduced capacity of primary care facilities during the national lockdown may have caused a high rate of self-medication as well as a delayed provision of care in some patients. Identification of pediatric patients affected with SARS-CoV-2 infection remains a challenge because of the absence of reliable predictive factors. Finally, the use of specific triage centers, with dedicated pathways to diagnose SARS-CoV-2 infection, trace contacts and allow adequate care after swabs, is effective in preventing spreading of the infection.

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Fast startup of one-stage nitritation-ANAMMOX reactor for high-rate nitrogen removal from mature landfill leachate

10.5004/dwt.2019.23859 ◽

2019 ◽

Vol 149 ◽

pp. 1-10 ◽

Cited By ~ 2

Author(s):

Huosheng Li ◽

Shaoqi Zhou ◽

Yujie Qin ◽

Jianyou Long ◽

Fanson Zheng ◽

...

Keyword(s):

Nitrogen Removal ◽

Landfill Leachate ◽

High Rate ◽

One Stage ◽

Mature Landfill Leachate

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Developing Traﬃc Congestion Detection Model Using Deep Learning Approach: A Case Study of Addis Ababa City Road

10.21203/rs.3.rs-113234/v1 ◽

2020 ◽

Author(s):

Bedada Bekele ◽

Kula Kekeba

Keyword(s):

Deep Learning ◽

Video Processing ◽

Traffic Congestion ◽

Addis Ababa ◽

Video Data ◽

High Rate ◽

Detection Model ◽

Video Footage ◽

One Stage ◽

Core Requirements

Abstract The traﬃc system is one of the core requirements of a civilized world and the development of the country depends on it in many aspects. In Ethiopia, the number of vehicles and pedestrians is increasing at a high rate from time to time. Excessive numbers of traﬃc on roads and improper control of traﬃc create traﬃc congestion. Uncontrolled traﬃc congestion hinders the transportation of goods and commuters from place to place and increases the volume of carbon emitted into the air. It can also either hampers or stagnates schedule, business, and commerce. Many images and video processing approaches have been researched in the literature on how to detect traﬃc congestion. One such approach is that of using background and foreground subtraction, convolutional neural network, and Average frame diﬀerence and deep learning method used to detect traﬃc congestion from diﬀerent video sources. From the review one-stage object detector identiﬁed as the best methods to detect traﬃc congestion with acceptable accuracy and speed. In this study one-stage object detectors are used to detect traﬃc congestion from recorded video. Data is collected from diﬀerent video footage and frames extracted from videos to prepare a dataset for the thesis. The extracted frames were labeled manually as congested and uncongested. To train, the models pre-trained weights were used. YOLOV3 and YOLOV5 model used for experimentation. Accuracy and speed metrics used to evaluate the performance of the models. A YOLOV3 model achieved 41.6 FPS and 68.6 % mAP on a testing dataset.

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High Rate of Reinfection With New Bacteria Following One-Stage Exchange for Enterococcal Periprosthetic Infection of the Knee: A Single-Center Study

The Journal of Arthroplasty ◽

10.1016/j.arth.2020.08.015 ◽

2020 ◽

Author(s):

Markus Rossmann ◽

Thore Minde ◽

Mustafa Citak ◽

Thorsten Gehrke ◽

Nemandra A. Sandiford ◽

...

Keyword(s):

Periprosthetic Infection ◽

High Rate ◽

Single Center ◽

One Stage ◽

Single Center Study ◽

Center Study

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High Infection Control Rate and Function After Routine One-stage Exchange for Chronically Infected TKA

Clinical Orthopaedics and Related Research ◽

10.1007/s11999-012-2480-7 ◽

2012 ◽

Vol 471 (1) ◽

pp. 238-243 ◽

Cited By ~ 40

Author(s):

Jean-Yves Jenny ◽

Bruno Barbe ◽

Jeannot Gaudias ◽

Cyril Boeri ◽

Jean-Noël Argenson

Keyword(s):

Infection Control ◽

Infection Control Rate ◽

One Stage ◽

High Infection ◽

And Function

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Prevalence of Nosocomial Infection and Antibiotic Use at a University Medical Center in Malaysia

Infection Control and Hospital Epidemiology ◽

10.1086/502494 ◽

2005 ◽

Vol 26 (1) ◽

pp. 100-104 ◽

Cited By ~ 42

Author(s):

Andrew J. Hughes ◽

Norliza Ariffin ◽

Tan Lien Huat ◽

Habibah Abdul Molok ◽

Salbiah Hashim ◽

...

Keyword(s):

Nosocomial Infection ◽

Infection Control ◽

Medical Center ◽

Tertiary Care ◽

Bloodstream Infections ◽

Antibiotic Use ◽

Developed Countries ◽

High Rate ◽

Antibiotic Prescribing ◽

Tract Infections

AbstractBackground and Objective:Most reports of nosocomial infection (NI) prevalence have come from developed countries with established infection control programs. In developing countries, infection control is often not as well established due to lack of staff and resources. We exMnined the rate of N1 in our institution.Methods:A point-prevalence study of N1 and antibiotic prescribing was conducted. On July 16 and 17, 2001, all inpatients were surveyed for N1, risk factors, pathogens isolated, and antibiotics prescribed and their indication. NIs were diagnosed according to CDC criteria. Cost of antibiotic acquisition was calculated by treatment indication.Setting:Tertiary-care referral center in Malaysia.Patients:All inpatients during the time of the study.Results:Five hundred thirty-eight patients were surveyed. Seventy-five had 103 NIs for a prevalence of 13.9%. The most common NIs were urinary tract infections (12.29-6), pneumonia (21.4%), laboratory-confirmed bloodstream infections (12.2%), deep surgical wound infections (11.2%), and clinical sepsis (22.4%).Pseudomonas aeruginosa, MRSA, and MSSA were the most common pathogens. Two hundred thirty-seven patients were taking 347 courses of antibiotics, for an overall prevalence of antibiotic use of 44%. N1 treatment accounted for 36% of antibiotic courses prescribed but 47% of antibiotic cost. Cost of antibiotic acquisition for N1 treatment was estimated to be approximately 2 million per year (Malaysian dollars).Conclusion:Whereas the rate of N1 is relatively high at our center compared with rates from previous reports, antibiotic use is among the highest reported in any study of this kind. Further research into this high rate of antibiotic use is urgently required.

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Two-stage Treatment of Hip Periprosthetic Joint Infection Is Associated With a High Rate of Infection Control but High Mortality

Clinical Orthopaedics and Related Research ◽

10.1007/s11999-012-2595-x ◽

2012 ◽

Vol 471 (2) ◽

pp. 510-518 ◽

Cited By ~ 186

Author(s):

Keith R. Berend ◽

Adolph V. Lombardi ◽

Michael J. Morris ◽

Adam G. Bergeson ◽

Joanne B. Adams ◽

...

Keyword(s):

Infection Control ◽

High Mortality ◽

Periprosthetic Joint Infection ◽

Joint Infection ◽

High Rate ◽

Two Stage

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Theory and Practice of Meniscal Knee Replacement: Designing against Wear

Proceedings of the Institution of Mechanical Engineers Part H Journal of Engineering in Medicine ◽

10.1243/pime_proc_1996_210_415_02 ◽

1996 ◽

Vol 210 (3) ◽

pp. 217-222 ◽

Cited By ~ 71

Author(s):

J J O'Connor ◽

J W Goodfellow

Keyword(s):

Anterior Cruciate Ligament ◽

Knee Replacement ◽

High Density Polyethylene ◽

Cruciate Ligament ◽

High Density ◽

Theory And Practice ◽

High Rate ◽

Knee Prostheses ◽

Articular Surfaces ◽

Anterior Cruciate

This paper attributes the high rate of high-density polyethylene (HDP) wear in many knee prostheses to incongruity of their articular surfaces. The authors discuss the anatomical and kinematic features of the knee which have led most designers to choose incongruous surfaces and review the reasons for employing free bearings, analogues of the natural menisci, to provide congruity without restriction of movement. There are theoretical reasons against employing freely mobile bearings in the absence of a functioning anterior cruciate ligament (ACL) and the authors' experience has confirmed this limitation in practice. It is concluded that, in bicompartmental replacement, the movements of the meniscal bearing should be limited in the anteroposterior direction. For unicompartmental arthritis, an unconstrained bearing can be employed if, as is usually the case, all ligaments are intact.

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