scholarly journals 1240. Evaluation of Preoperative Staphylococcus aureus (SA) Decolonization with Nasal Iodine for Hips/Knees and Fusion Surgeries

2019 ◽  
Vol 6 (Supplement_2) ◽  
pp. S446-S447
Author(s):  
Anupama Neelakanta ◽  
Kristi Clutts ◽  
Stephanie Strollo ◽  
Catherine Passaretti
Keyword(s):  
Staphylococcus Aureus ◽  
Large Scale ◽  
Nasal Carriage ◽  
Pcr Screening ◽  
Total Knee Replacements ◽  
Alternative Approach ◽  
Hip Replacements ◽  
Intranasal Mupirocin ◽  
History Of ◽  
Total Knee

Abstract Background Preoperative decolonization for patients with known nasal carriage of Staphylococcus aureus is recommended in some surgical site infection (SSI) guidelines, however, meaningful implementation is often challenging with poor compliance. We evaluated utilization of nasal iodine with S. aureus polymerase chain reaction (PCR) screening on the day of surgery as an alternative approach. Methods For all total hip replacements (THR), total knee replacements (TKR) and fusion patients in a 250-bed community hospital, we implemented day of surgery S. aureus PCR for all patients who had not been screened in the 2 weeks prior in August 2018. Those known to have S. aureus colonization in the 2 weeks prior to surgery as well as those who had no screen in the 2 weeks prior were treated with nasal iodine and received a chlorhexidine (CHG) bath in the preoperative area. Postoperatively any patient found to have (methicillin-resistant S. aureus) MRSA from preoperative screen or who had a history of MRSA in the past year were automatically decolonized with 5 days of intranasal mupirocin and CHG baths in addition. Compliance with S. aureus screening in preoperative area, results of screens and rates of THR, TKR and fusion SSI per National Health Safety Network (NHSN) definitions were monitored throughout the study period. SSI standardized infection ratios (SIR) during the study were compared with data 1 year prior to intervention date. Results Between August 2018 and January 2019, 694 THR, TKR and fusion surgeries were performed. Preoperative nursing compliance with completing the SA screen was 79. 2% and percent compliance with administering/documenting nasal iodine was 77.8%. Of those screened 21.7% (126/578) were found to have SA. Only 15% (n = 19) of SA positive PCRs were positive for MRSA. SSIs decreased in intervention period compared with preintervention (August 2017–July 2018) as shown in Table 1. Conclusion Preoperative nasal iodine has been effective and helped reduce our infection SIR to below 1. These results could be confounded by the presence of other initiatives but looks promising and large-scale studies would be helpful to make these results generalizable. Disclosures All authors: No reported disclosures.

Staphylococcus aureus nasal colonization among Vietnamese adults: prevalence, risk factors and antibiotic susceptibility profile

MedPharmRes ◽  
2018 ◽  
Vol 2 (2) ◽  
pp. 21-31
Author(s):  
Nguyen Phan ◽  
Hien Pham ◽  
Thuc Nguyen ◽  
Hoai Nguyen
Keyword(s):  
Risk Factors ◽  
Staphylococcus Aureus ◽  
Antibiotic Susceptibility ◽  
Nasal Carriage ◽  
Resistance Rate ◽  
High Rate ◽  
Weight History ◽  
Potential Risk Factors ◽  
History Of ◽  
Vietnamese Community

Staphylococcus aureus (S. aureus) has long been recognized as an important human pathogen causing many severe diseases. It is also a part of human normal flora with its ecological niche in the human anterior nares. This study focused on screening S. aureus nasal carriage in community and its relationship to human physiological and pathological factors which have not been studied in Vietnam previously. Two hundred and five volunteers in Ho Chi Minh City from 18 to 35 and over 59 years old both male and female participated in the study. Result showed that the prevalence of S. aureus nasal carriage in southern Vietnamese community was relatively low, only 11.2% (23/205), much lower than that in other international reports on human S. aureus. In addition, nasal carriage of the older age group (> 59 years old, 13.7%) was higher than that of younger age (18-35 years old, 10.4%). Other potential risk factors such as gender, career, height, weight, history of antibiotic usage, daily nasal wash, use of nasal medication sprays, acne problems, smoking and nasal problems showed no significant impact on S. aureus carriage. The obtained S. aureus nasal isolates were all sensitive to vancomycin. Lincomycin and tetracycline had low resistance rate with 4.3 % and 17.4 %, respectively. However, the isolates showed particularly high rate of multidrug resistance (54.2%) In summary, our data provided researchers an overview on S. aureus nasal carriage and antibiotic susceptibility profile of the community- isolated S. aureus in Vietnam. This would serve as valuable information on assessing risk of community-acquired S. aureus infections.

The Wear of UHMWPE in Total Knee Replacements: Experimental and Finite Element Analysis of Contact Behaviour

2001 ◽  
Author(s):  
Dorothy M. Murphy ◽  
Alan Kavanagh ◽  
Tim M. McGloughlin
Keyword(s):  
Molecular Weight ◽  
Finite Element Analysis ◽  
Element Analysis ◽  
Total Knee Replacements ◽  
Total Hip Replacements ◽  
Contact Behaviour ◽  
Knee Replacements ◽  
Hip Replacements ◽  
Total Knee ◽  
Ultra High Molecular Weight

Abstract Upon examination of failed total knee replacements, it has been concluded that it is the performance of the ultra high molecular weight polyethylene (UHMWPE) tibial component that governs the useful lifespan of such a joint. Severe wear of UHMWPE is associated more with tibial components of the knee than with the acetabular cups of total hip replacements. This is due to a notable lack of congruity between the articulating surfaces which leads to the presence of significant localised stresses in the femoro-tibial interface.

scholarly journals Evaluation of methicillin-resistant Staphylococcus aureus nasal carriage in Malagasy patients

2013 ◽  
Vol 7 (04) ◽  
pp. 318-322 ◽  
Author(s):  
Tsiry Rasamiravaka ◽  
Saida Rasoanandrasana ◽  
Norosoa Julie Julie Zafindraibe ◽  
Aimee Olivat Rakoto Alson ◽  
Andry Rasamindrakotroka
Keyword(s):  
Staphylococcus Aureus ◽  
Risk Factor ◽  
Methicillin Resistant Staphylococcus Aureus ◽  
Nasal Carriage ◽  
Multidrug Resistant ◽  
High Rate ◽  
Methicillin Resistant ◽  
History Of ◽  
Training And Research ◽  
Strategic Policy

Introduction: Methicillin-resistant Staphylococcus aureus (MRSA) is an important cause of infections. It is well recognized that nasal carriage of S. aureus represents a potent and increasingly prevalent risk factor for subsequent S. aureus infection. However, in Madagascar no data exist concerning this nasal carriage of S. aureus. Methodology: Nasal swabs from 304 different patients attending the Laboratory of Training and Research in Medical Biology of Madagascar were cultured for methicillin sensitive (MSSA) and MRSA. Results: One hundred and sixteen patients had S. aureus in their noses (38.16 ± 5.46%) of whom 45 (14.80 ± 3.99%) had MRSA.  A risk factor for MSSA nasal carriage included a history of hospitalization when antibiotics were administered (odds ratio [OR] 2.25, 1.09 - 4.64). Among MRSA nasal isolates, high rate of resistance to other antibiotics was observed, particularly for trimethoprim-sulfamethoxazole (68.89%), erythromycin (66.67%) and ofloxacin (53.33%). Conclusion: Our data showed a high rate of MRSA nasal carriage and a high rate of multidrug resistance. A strategic policy against the spread of multidrug resistant strains is desirable.

scholarly journals Polyaminosteroid Analogues as Potent Antibacterial Agents Against Mupirocin- Resistant Staphylococcus aureus Strains

2020 ◽  
Vol 18 (3) ◽  
pp. 239-244
Author(s):  
Adèle Sakr ◽  
Fréderic Laurent ◽  
Jean-Michel Brunel ◽  
Tania Nawfal Dagher ◽  
Olivier Blin ◽  
...  
Keyword(s):  
Staphylococcus Aureus ◽  
Preventive Measure ◽  
Nasal Carriage ◽  
Repeated Exposure ◽  
Aureus Strain ◽  
Resistant Bacteria ◽  
Microdilution Method ◽  
Broth Microdilution Method ◽  
Intranasal Mupirocin ◽  
Emergence Of Resistance

Background: Nasal carriage of Staphylococcus aureus (S. aureus) constitutes an important risk factor for subsequent infections in some types of patient populations. Decolonization of carriers using intranasal mupirocin is widely used as a preventive measure. However, resistance to this agent has been rising and causing failure in the decolonization, highlighting the need for new alternatives. Objective: The objective of our study was to evaluate the antibacterial activity of polyaminosteroid analogues (squalamine and BSQ-1) against S. aureus strains with different levels of mupirocin-resistance. Methods: Using the broth microdilution method, we evaluated the minimum inhibitory concentration (MIC) of these molecules against S. aureus clinical strains including mupirocin-resistant strains. The emergence of resistance was evaluated by long-term and repeated exposure of a susceptible S. aureus strain to subinhibitory concentrations of squalamine, BSQ-1 or mupirocin. Results: We found that squalamine and BSQ-1 are active against mupirocin-susceptible and -resistant clinical isolates with MIC values of 3.125 μg/mL. Additionally, repeated exposure of a S. aureus strain to squalamine and BSQ-1 did not lead to the emergence of resistant bacteria, contrarily to mupirocin. Conclusion: Our study suggests that these molecules constitute promising new alternatives to mupirocin for nasal decolonization and prevention of endogenous infections.

Polyethylene Wear Debris Produced in a Knee Simulator Model: Effect of Crosslinking and Counterface Material

2007 ◽  
Author(s):  
Paul A. Williams ◽  
Cindy M. Brown ◽  
Riichro Tsukamoto ◽  
Takashi Nakamura ◽  
Ian C. Clarke
Keyword(s):  
Wear Debris ◽  
Polyethylene Wear ◽  
Total Hip ◽  
Total Knee Replacements ◽  
Knee Simulator ◽  
Total Hip Replacements ◽  
Gravimetric Measurements ◽  
Knee Replacements ◽  
Hip Replacements ◽  
Total Knee

Polyethylene (PE) debris has been examined in total hip replacements from clinical retrievals and laboratory simulator studies, but little is known about PE debris from total knee replacements. In this study we investigated the effects of crosslinking PE and the counterface material. Mildly and highly crosslinked PE were studied in combination with CoCr and Zirconia femoral components. Wear was determined by gravimetric measurements and the wear debris was isolated and morphologically characterized. Although the zirconia counterface with 7 Mrad PE did not exhibit measurable wear, wear debris was found. This indicated that wear occurred below the limits of the gravimetric approach. This study showed that the amount of crosslinking of PE and the counterface material were important factors in the wear of PE in a knee simulator model.

scholarly journals Methicillin-Resistant Staphylococcus aureus Nasal Carriageamong Patients and Healthcare Workers in a Hospital in Kelantan, Malaysia

2013 ◽  
Vol 62 (1) ◽  
pp. 109-112 ◽  
Author(s):  
HASSANAIN AL-TALIB ◽  
CHAN YEAN YEAN ◽  
HABSAH HASAN ◽  
NMN NIK ZURAINA ◽  
MANICKAM RAVICHANDRAN
Keyword(s):  
Staphylococcus Aureus ◽  
High Risk ◽  
Healthcare Workers ◽  
Methicillin Resistant Staphylococcus Aureus ◽  
Genetic Relationships ◽  
Nasal Carriage ◽  
Common Source ◽  
Methicillin Resistant ◽  
History Of ◽  
Relationship Of

Staphylococcus aureus nasal carriage is a common source of nosocomial infection and colonization. The aim of the present study was to assess the burden of methicillin-resistant S. aureus nasal carriage, its association with factors of interest including its genetic relationships. The prevalence of S. aureus nasal carriage was found to be 28.7%. This study showed that patients with a history of previous antibiotic intake, nasogastric tube, and longer hospitalization had a significantly high risk of being MRSA nasal carriers. The genetic relationship of all 34 nasal MRSA isolates revealed four major clusters of isolates, and there was a relationship between MRSA isolated from inpatients and healthcare workers.

scholarly journals The presence of total knee or hip replacements due to osteoarthritis enhances the positive association between hand osteoarthritis and atherosclerosis in women: the AGES–Reykjavik study

2011 ◽  
Vol 70 (6) ◽  
pp. 1087-1090 ◽  
Author(s):  
Helgi Jonsson ◽  
Gudrun P Helgadottir ◽  
Thor Aspelund ◽  
Gudny Eiriksdottir ◽  
Sigurdur Sigurdsson ◽  
...  
Keyword(s):  
White Matter ◽  
Carotid Plaque ◽  
Large Population ◽  
Positive Association ◽  
Periventricular White Matter ◽  
Hand Osteoarthritis ◽  
Coronary Calcifications ◽  
Hip Replacements ◽  
History Of ◽  
Total Knee

ObjectiveThis study examines the relationship between total knee replacements (TKR), total hip replacements (THR) or replacements of either joint (total joint replacement; TJR) due to osteoarthritis and atherosclerosis in a large population-based study.MethodsThe participants were 2195 men and 2975 women, mean age 76±6 years. The osteoarthritis data were analysed in relation to measures of atherosclerosis, including carotid artery intima media thickness and plaque severity (ultrasound), coronary and aortic calcifications (CT), cerebral white matter lesions (MRI) and a history of previous cardiac and cerebral events.ResultsThe prevalence of TKR was 223 (4.3%) and THR 316 (6.1%). The presence of TJR in women was associated with a non-significant trend towards increased carotid plaque severity, coronary calcifications and periventricular white matter hyperintensities (PVH) but not with a history of cardiac or cerebral events. No associations were seen in men. When TJR were grouped according to the presence or absence of hand osteoarthritis (HOA) there was a highly significant association in the order −TJR/−HOA < +TJR/−HOA < −TJR/+HOA < +TJR/+HOA, for carotid plaque severity, coronary calcifications and PVH.ConclusionThe presence of TJR did not show a significant independent association with atherosclerosis but enhanced the strength of the positive association between HOA and subclinical atherosclerosis in women.

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