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

2012 ◽  
Vol 471 (1) ◽  
pp. 238-243 ◽  
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

Infection Control in a Country with Annual Inflation of 3,600%

1995 ◽  
Vol 16 (3) ◽  
pp. 175-178
Author(s):  
Sergio B. Wey
Keyword(s):  
Infection Control ◽  
Administrative Support ◽  
Cost Effective ◽  
Control Measures ◽  
Single Factor ◽  
Control Programs ◽  
Infection Control Rate ◽  
Infection Control Measures ◽  
Training Courses ◽  
Budget Shortfalls

AbstractThe economic crisis that has been seen worldwide affects developing countries such as Brazil even more severely. Worsening budget shortfalls for the healthcare system progressively threaten patient care. Infection control programs also are affected, and basic preventive policies are not implemented. Infection control practitioners face lack of equipment and poor microbiological support. In contrast, the motivation of the infection control people can be maintained through training courses, conferences, and meetings. Administrative support may be the most important single factor determining success in decreasing the infection control rate and should be (but is not always) provided, given that several infection control measures are cost effective.

scholarly journals Development and internal validation of a diagnostic prediction model for COVID-19 at time of admission to hospital

QJM ◽  
2020 ◽  
Author(s):  
D L Fink ◽  
P Y Khan ◽  
N Goldman ◽  
J Cai ◽  
L Hone ◽  
...  
Keyword(s):  
Infection Control ◽  
Prediction Model ◽  
Risk Score ◽  
Laboratory Testing ◽  
Internal Validation ◽  
High Resource ◽  
Final Multivariable Model ◽  
Hospital Infection Control ◽  
Clinical Records ◽  
And Function

Summary Background Early coronavirus disease 2019 (COVID-19) diagnosis prior to laboratory testing results is crucial for infection control in hospitals. Models exist predicting COVID-19 diagnosis, but significant concerns exist regarding methodology and generalizability. Aim To generate the first COVID-19 diagnosis risk score for use at the time of hospital admission using the TRIPOD (transparent reporting of a multivariable prediction model for individual prognosis or diagnosis) checklist. Design A multivariable diagnostic prediction model for COVID-19 using the TRIPOD checklist applied to a large single-centre retrospective observational study of patients with suspected COVID-19. Methods 581 individuals were admitted with suspected COVID-19; the majority had laboratory-confirmed COVID-19 (420/581, 72.2%). Retrospective collection was performed of electronic clinical records and pathology data. Results The final multivariable model demonstrated AUC 0.8535 (95% confidence interval 0.8121–0.8950). The final model used six clinical variables that are routinely available in most low and high-resource settings. Using a cut-off of 2, the derived risk score has a sensitivity of 78.1% and specificity of 86.8%. At COVID-19 prevalence of 10% the model has a negative predictive value (NPV) of 96.5%. Conclusions Our risk score is intended for diagnosis of COVID-19 in individuals admitted to hospital with suspected COVID-19. The score is the first developed for COVID-19 diagnosis using the TRIPOD checklist. It may be effective as a tool to rule out COVID-19 and function at different pandemic phases of variable COVID-19 prevalence. The simple score could be used by any healthcare worker to support hospital infection control prior to laboratory testing results.

Results at 10–24 years after single-stage revision arthroplasty of infected total hip arthroplasty in patients under 45 years of age

2019 ◽  
pp. 112070001988887 ◽  
Author(s):  
Matthias Wolff ◽  
Christian Lausmann ◽  
Thorsten Gehrke ◽  
Akos Zahar ◽  
Malte Ohlmeier ◽  
...  
Keyword(s):  
Infection Control ◽  
Revision Surgery ◽  
Single Stage ◽  
Long Term Results ◽  
Harris Hip Score ◽  
Study Cohort ◽  
One Stage ◽  
The Mean

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.

scholarly journals Variations in infection control practices suggest a need for guidelines in primary ciliary dyskinesia patient care

2021 ◽  
Author(s):  
Ayse Caliskan ◽  
Amjad Horani ◽  
Michele Manion ◽  
Steven Brody
Keyword(s):  
Respiratory Tract ◽  
Infection Control ◽  
Virus Transmission ◽  
Autosomal Recessive Disorder ◽  
Clinical Feature ◽  
Lung Function Decline ◽  
Web Based ◽  
Control And Prevention ◽  
Infection Respiratory Tract ◽  
And Function

Primary ciliary dyskinesis (PCD) is an autosomal recessive disorder associated with impaired mucociliary clearance caused by defects in ciliary structure and function. The major clinical feature of PCD is recurring or persistent respiratory tract infection. Respiratory tract colonization with drug-resistant organisms impact the frequency of infections and lung function decline. Protective gear has been employed by caregivers in an attempt to control respiratory tract bacterial spread between patients with cystic fibrosis but use in PCD is not known. We conducted a web-based survey to investigate infection control and prevention practices of PCD centers in North America. The response rate was 87.0%. Prior to the COVID-19 pandemic, glove, gown and mask use was variable, and only 3.7% of centers used masks during encounters with PCD outpatients. After COVID-19 mandates are lifted, 48.1% of centers plan to continue to use masks during outpatient care, while the practice regarding use of gloves and gowns was not influenced by the current pandemic. There is no uniform practice for infection control in PCD care indicating the need for practice guidelines. Mitigation of respiratory virus transmission learned during the COVID-19 pandemic may impact future infection control approaches used for patients with PCD and other lung diseases.

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

2011 ◽  
Vol 470 (5) ◽  
pp. 1461-1471 ◽  
Author(s):  
Joachim Singer ◽  
Andreas Merz ◽  
Lars Frommelt ◽  
Bernd Fink
Keyword(s):  
Infection Control ◽  
High Rate ◽  
Knee Prostheses ◽  
One Stage

scholarly journals Antibiotic cement plate composite structure internal fixation after debridement of bone infection

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Xiaohua Wang ◽  
Shulin Wang ◽  
Jianzhong Xu ◽  
Dong Sun ◽  
Jie Shen ◽  
...  
Keyword(s):  
Infection Control ◽  
Internal Fixation ◽  
Composite Structure ◽  
Bone Infection ◽  
Control Effect ◽  
Fixation Failure ◽  
Infection Control Rate ◽  
Antibiotic Cement ◽  
Epidermal Necrosis

AbstractAn internal fixation composite structure of antibiotic cement plates was created. The aim of this study was to analyse the infection control effect of this structure when applied to treat a bone infection. We retrospectively analysed patients with bone infection admitted to our hospital between January 2013 and June 2019. After debridement, an antibiotic cement plate composite structure was used to fill and stabilize the defects. The treatment effect was evaluated at six months after surgery, and the infection control rate, factors associated with the recurrence of infection, and complications were analysed. If the patients had bone defects, the defect was repaired after infection control, and the infection control rate of all of the patients was re-evaluated at 12 months after surgery. A total of 548 patients were treated with this technique, including 418 men and 130 women. The infection sites included 309 tibias, 207 femurs, 16 radii and ulnae, 13 humeri, and 3 clavicles. After at least 6 months of follow-up, 92 patients (16.79%) had an infection recurrence and needed further treatment. The recurrence rate of the tibia was higher than that of the femur (P = 0.025). Eighty-nine out of 92 patients who relapsed underwent a second debridement with the same method, and the infection control rate after the second debridement was 94.71%. Complications included 8 cases of epidermal necrosis around the incision, 6 cases of internal fixation failure, and 30 cases of lower limb swelling. By the follow-up time of 12 months, another 6 patients had experienced recurrence of infection, and 4 cases were controlled after debridement. Finally, among all 548 cases, 7 patients remained persistently infected, and 6 underwent amputation. The infection control rate was 97.6% at the 1-year follow-up. The clinical efficacy of this new antibiotic cement plate composite structure for internal fixation after debridement of bone infection is stable and reliable.

scholarly journals Staged Revision with Antibiotic Spacers for Infected Hindfeet vs One-Stage Revision Using an Ilizarov Ringfixator: What’s Better?

2019 ◽  
Vol 4 (4) ◽  
pp. 2473011419S0020
Author(s):  
Rebecca Hartmann ◽  
Florian Grubhofer ◽  
Stephan Wirth
Keyword(s):  
Clinical Outcome ◽  
Infection Control ◽  
Cement Spacer ◽  
Two Stage ◽  
Aofas Score ◽  
Musculoskeletal Infection ◽  
Knee Amputation ◽  
One Stage ◽  
Successful Infection ◽  
The One

Category: Hindfoot Introduction/Purpose: The treatment of hindfeet infections with a two-stage revision surgery using an antibiotic-loaded cement spacer is an established treatment strategy. If the soft tissue situation is critical or if patients do have severe comorbidities, the use of a one-stage procedure, using an Ilizarov ringfixator to perform the arthrodesis is also an option. We wanted to compare the outcome of patients who either received the two-stage revision or the one-stage procedure. The purpose of the study was to determine the likelihood of infection control and radiological consolidation of the arthrodesis after either two-stage or one-stage revision in patients with hindfoot infection, as defined by the Musculoskeletal Infection Society PJI criteria. The postoperative AOFAS score was used to measure the clinical outcome. Methods: Between 1995 and 2015, we treated 12 patients with a two-stage procedure using an antibiotic-loaded cement spacer, followed by antibiotic therapy. The second stage consisted of a hindfoot arthrodesis. Of those, 7 were available for review at a minimum of 24 months. 3 were excluded because they were deceased (due to old age). Two moved abroad, leaving 7 patients for analysis. During the same time period we treated 13 patients with a one-stage hindfoot arthrodesis using an Ilizarov ringfixator. Of those, 10 were available for review at a minimum of 24 months. 2 were excluded because they were deceased due to old age, leaving 10 patients for analysis. The primary outcome included the proportion of patients achieving infection control, defined as the absence of the Musculoskeletal Infection Society PJI criteria. Radiological consolidation on standard foot X-rays was also determined. The clinical outcome was assessed with the AOFAS hindfoot score. Results: Successful infection control in the two-stage revision group was achieved in 6 out of 7 patients (86%). One patient achieved infection control only after a below-knee amputation. The mean AOFAS score at the latest follow-up was 75. Radiological consolidation was achieved in 70% (5 out of 7, with one patient needing an amputation for infection control). In the Ilizarov-group, successful infection control was achieved in 9 out of 10 patients (90%). One patient achieved infection control only after a below-knee amputation. The mean AOFAS score at the latest follow-up was 70. Radiological consolidation was achieved in 80% (8 out of 10, with one patient needing an amputation for infection control). Conclusion: A one-stage arthrodesis using an Ilizarov ringfixator for infection control in infected hindfeet leads to comparable infection control and radiological consolidation as the established two-stage procedure with an antibiotic-loaded cement spacer. The clinical outcome, measured by the AOFAS hindfoot score, is also comparable in both groups. The one-stage procedure using an Ilizarov ringfixator should therefore be considered as a treatment option, when soft tissues or comorbidities do not allow a two-stage procedure. It is an option to avoid a below-knee amputation in those patients.

Effective treatment of single-stage revision using intra-articular antibiotic infusion for culture-negative prosthetic joint infection

2020 ◽  
Vol 102-B (3) ◽  
pp. 336-344 ◽  
Author(s):  
Baochao Ji ◽  
Guoqing Li ◽  
Xiaogang Zhang ◽  
Yang Wang ◽  
Wenbo Mu ◽  
...  
Keyword(s):  
Infection Control ◽  
Prosthetic Joint Infection ◽  
Joint Infection ◽  
Single Stage ◽  
Harris Hip Score ◽  
Infection Control Rate ◽  
Prosthetic Joint ◽  
Significant Difference ◽  
Culture Negative ◽  
Antibiotic Infusion

Aims In the absence of an identified organism, single-stage revision is contraindicated in prosthetic joint infection (PJI). However, no studies have examined the use of intra-articular antibiotics in combination with single-stage revision in these cases. In this study, we present the results of single-stage revision using intra-articular antibiotic infusion for treating culture-negative (CN) PJI. Methods A retrospective analysis between 2009 and 2016 included 51 patients with CN PJI who underwent single-stage revision using intra-articular antibiotic infusion; these were compared with 192 culture-positive (CP) patients. CN patients were treated according to a protocol including intravenous vancomycin and a direct intra-articular infusion of imipenem and vancomycin alternately used in the morning and afternoon. In the CP patients, pathogen-sensitive intravenous (IV) antibiotics were administered for a mean of 16 days (12 to 21), and for resistant cases, additional intra-articular antibiotics were used. The infection healing rate, Harris Hip Score (HHS), and Hospital for Special Surgery (HSS) knee score were compared between CN and CP groups. Results Of 51 CN patients, 46 (90.2%) required no additional medical treatment for recurrent infection at a mean of 53.2 months (24 to 72) of follow-up. Impaired kidney function occurred in two patients, and one patient had a local skin rash. No significant difference in the infection control rate was observed between CN and CP PJIs (90.2% (46/51) versus 94.3% (181/192); p = 0.297). The HHS of the CN group showed no substantial difference from that of CP cases (79 versus 81; p = 0.359). However, the CN group showed a mean HSS inferior to that of the CP group (76 versus 80; p = 0.027). Conclusion Single-stage revision with direct intra-articular antibiotic infusion can be effective in treating CN PJI, and can achieve an infection control rate similar to that in CP patients. However, in view of systemic toxicity, local adverse reactions, and higher costs, additional strong evidence is needed to verify these treatment regimens. Cite this article: Bone Joint J 2020;102-B(3):336–344

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