scholarly journals Sources of staphylococcal infection in surgical wound sepsis

1963 ◽  
Vol 61 (1) ◽  
pp. 83-94 ◽  
Author(s):  
H. F. M. Bassett ◽  
W. G. Ferguson ◽  
E. Hoffman ◽  
M. Walton ◽  
Robert Blowers ◽  
...  
Keyword(s):  
Operating Room ◽  
Nasal Carriage ◽  
Staphylococcal Infection ◽  
Surgical Team ◽  
Equal Frequency ◽  
Hospital Workers ◽  
Wound Sepsis ◽  
Skin Preparation ◽  
Staph Aureus ◽  
Different Types

1. In two hospitals, post-operative staphylococcal wound sepsis occurred with equal frequency in patients who were and in those who were not nasal carriers of Staph. aureus.2. Nasal carriage of Staph. aureus was not always associated with skin carriage at the site of operation, but even patients who were skin carriers suffered no more sepsis than non-carriers.3. Self-infection was a less frequent cause of sepsis than was cross-infection. Other investigations of this type have revealed conflicting findings on the frequency of self-infection. These may be due to differences in the epidemiological properties of staphylococci infesting the hospitals; to different methods of preoperative skin preparation; and to the different types of operation concerned.4. In one of the hospitals, 31% of probable operating-room infections were with organisms similar to those carried by some member of the surgical team. In infections thought to have occurred in the ward, only 10% showed this similarity. In 11 of 35 presumed operating-room infections, the source may have been a member of the surgical team.For help and co-operation we are grateful to Mr G. A. Mason, Senior Surgeon, Newcastle Regional Thoracic Surgery Service; and Dr Joan Millar, Miss G. Jones, Miss E. Smith, Mrs Jean Best, Miss Winifred Mahon, Dr K. Hodgkin, Dr W. Stewart, Mr S. Griffin, Mr W. C. Barnsley, Mr R. Dobson, Mr W. H. Bound, and many nurses and other hospital workers. Our especial thanks are due to Professor R. E. O. Williams, who phage-typed many of the staphylococci, and then taught us to do this for ourselves.

scholarly journals Acquisition of Staphylococcus aureus by patients undergoing cytotoxic therapy in an ultra-clean isolation unit

1966 ◽  
Vol 64 (4) ◽  
pp. 501-511 ◽  
Author(s):  
H. J. Andrews ◽  
K. D. Bagshawe
Keyword(s):  
Nasal Carriage ◽  
Staphylococcal Infection ◽  
Host Susceptibility ◽  
Cytotoxic Therapy ◽  
Carriage Rate ◽  
Staph Aureus ◽  
Clean Environment ◽  
Resistant Strains ◽  
Low Incidence ◽  
Isolation Ward

The twenty-four young women and one man treated in an ultra-clean isolation ward should have had a low incidence of staphylococcal infection on grounds of age, sex and clean environment alone. However, they apparently acquired new strains of Staph. aureus at the rate of 4·7/100 patient weeks (3·9 multiple resistant strains/100 patient weeks) from the sixth week after admission onwards.Environmental factors contributing to infection included introduction of resistant strains by the patients on admission, contact between patients in the unit, and failure to eliminate nasal carriage in staff and patients.Host susceptibility was increased by malignancy, and by antibiotic and cytotoxic therapy. The nasal carriage rate of Staph. aureus was significantly greater for patients with repeated episodes of leucopenia induced by cytotoxic drugs.

scholarly journals Incidence and penicillin sensitivity ofStaphylococcus aureusin the nose in infants and their mothers

1953 ◽  
Vol 51 (1) ◽  
pp. 64-74 ◽  
Author(s):  
G. B. Ludlam
Keyword(s):  
Phage Type ◽  
Nasal Carriage ◽  
First Year ◽  
Staph Aureus ◽  
Maternity Hospitals ◽  
Different Types ◽  
Resistant Strains ◽  
First Year Of Life ◽  
Very High ◽  
At Home

1. Among infants attending Child Welfare Clinics there was a steady decline in the incidence of nasal carriage ofStaph. aureusover the first year of life.2. Infants born in hospital showed a much higher incidence ofStaph. aureusin the first 2 months of life than infants born at home. A similar difference was also very distinct in the later part of the first year of life.3. Mothers delivered 2 weeks to 2 months previously had a higher incidence of nasal carriage ofStaph. aureuswhen delivered in hospital than when delivered at home. After this interval the incidence was similar in all groups of mothers throughout the rest of the year.4. In the first few months of life there was a tendency for carriage in infants to be associated with carriage in the mother, but towards the end of the year there was no such relationship. This association appeared most clearly in infants born at home and in infants 2–5 months old born in hospital F.5. A very high proportion (25 out of 30) of the strains tested from infants born in hospital F less than 5 months previously were penicillin-resistant. Infants born at home had a much lower incidence of resistant strains.6. A high proportion of strains ofStaph. aureusisolated from mothers delivered in hospital F were resistant throughout the first year. Strains from mothers delivered in hospital C or at home showed a much lower proportion of resistant strains.7. Phage-typing showed a great variety of types, but those found among the penicillin-resistant strains were rather less varied than among the sensitive strains. WhenStaph. aureuswas found both in infant and mother, although the same phage type was commonly present in both, in 16 out of 35 couples different types were found.8. Investigation in maternity hospitals C and F showed a high proportion of penicillin-resistant strains ofStaph. aureusamong the nurses and infants and in the dust of the nurseries, but not among the mothers. There was no important difference between the two hospitals as regards the incidence of resistant strains isolated from nurses and infants in spite of the differences found in babies from the two hospitals when swabbed at the clinics.9. The significance of these results is discussed.

scholarly journals Variability in Anesthesia Models of Care in Cardiac Surgery

Surgeries ◽  
2021 ◽  
Vol 2 (1) ◽  
pp. 1-8
Author(s):  
Dianne McCallister ◽  
Bethany Malone ◽  
Jennifer Hanna ◽  
Michael S. Firstenberg
Keyword(s):  
Cardiac Surgery ◽  
Best Practices ◽  
Operating Room ◽  
Models Of Care ◽  
Surgical Team ◽  
Cardiac Anesthesia ◽  
Complex Environment ◽  
Surgical Case ◽  
Cardiac Procedures ◽  
Cardiac Operations

The operating room in a cardiothoracic surgical case is a complex environment, with multiple handoffs often required by staffing changes, and can be variable from program to program. This study was done to characterize what types of practitioners provide anesthesia during cardiac operations to determine the variability in this aspect of care. A survey was sent out via a list serve of members of the cardiac surgical team. Responses from 40 programs from a variety of countries showed variability across every dimension requested of the cardiac anesthesia team. Given that anesthesia is proven to have an influence on the outcome of cardiac procedures, this study indicates the opportunity to further study how this variability influences outcomes and to identify best practices.

Perioperative considerations in the management of cold agglutinin disease in laparoscopic surgery

2021 ◽  
Vol 14 (5) ◽  
pp. e241294
Author(s):  
Yisi D Ji ◽  
Paul M Cavallaro ◽  
Britlyn D Orgill
Keyword(s):  
Case Report ◽  
Laparoscopic Surgery ◽  
Acute Cholecystitis ◽  
Operating Room ◽  
Patient Outcomes ◽  
Cold Agglutinin ◽  
Surgical Team ◽  
Cold Agglutinin Disease ◽  
Disease Exacerbation ◽  
Multidisciplinary Collaboration

An 80-year-old man with idiopathic cold agglutinin disease presented with acute cholecystitis. We describe operating room and anaesthetic considerations for patients with cold agglutinin disease and measures that can be taken to prevent disease exacerbation in this case report. Multidisciplinary collaboration and planning between the operative room staff, anaesthesia team and surgical team are needed to ensure safe surgery and optimal patient outcomes.

scholarly journals Factors Predicting Operating Room Time in Ureteroscopy and Ureterorenoscopy

2018 ◽  
Vol 12 (4) ◽  
pp. 195-200
Author(s):  
Ioannis KatafigiotisItay ◽  
Itay M. Sabler ◽  
Eliyahu M. Heifetz ◽  
Ayman Isid ◽  
Stavros Sfoungaristos ◽  
...  
Keyword(s):  
Operating Room ◽  
Renal Stones ◽  
Demographic Parameters ◽  
Surgical Team ◽  
X Ray ◽  
Multiple Parameters ◽  
Surgeon Experience ◽  
Regression Test ◽  
Room Time ◽  
Operating Room Time

Backgrounds/Aims: Operation room (OR) time is of great value affecting surgical outcome, complications and the daily surgical program with financial implications. Methods: We retrospectively evaluated 570 consecutive patients submitted to ureteroscopy or ureterorenoscopy for the treatment of ureteral or renal stones. Demographic parameters, patient's stones characteristics, type of ureteroscope, surgeon experience and surgical theater characteristics were analyzed. OR time was calculated from the initiation of anesthesia to patient extubation. Multivariate analysis was conducted using a linear regression test with multiple parameters to identify predictors of OR time. Results: Eight factors were identified as significant. These include total stones volume, ureteroscope used, stone number, nurses experience, radio-opacity of the stone on kidney-ureter-bladder X-ray, main surgeon experience, operating room type, and having a nephrostomy tube prior to surgery. Conclusions: The surgical team experience and familiarity with endourological procedure, and the surgical room characteristics has a crucial impact on OR time and effectiveness.

Identification of Staphylococcus aureus from enriched nasal swabs within 24 h is improved with use of multiple culture media

2013 ◽  
Vol 62 (9) ◽  
pp. 1365-1367 ◽  
Author(s):  
Maya Nadimpalli ◽  
Christopher Heaney ◽  
Jill R. Stewart
Keyword(s):  
Staphylococcus Aureus ◽  
Culture Media ◽  
Nasal Carriage ◽  
Healthy Population ◽  
Staph Aureus ◽  
Nasal Swabs

Nasal carriage of Staphylococcus aureus is commonly evaluated via culture-based methods. We found that parallel use of two media, Baird-Parker and CHROMagar™ Staph aureus, increased detection of S. aureus from a healthy population by 29 %. We suggest use of both media for optimal identification of S. aureus from healthy cohorts.

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