Treatment Options for Wound Coverage and Infection Control in Open Tibia Fractures

Abstract Background: Carbapenemase-producing Enterobacteriales (CPE) are resistant to many antimicrobial agents and raise concerns about its treatment options as well as its infection control. Methods: It was conducted a multicenter study between 2015 and 2019 in order to clarify the molecular epidemiology of CPE in the Central Japan region.Results: Out of the 56,494 Enterobacteriales strains detected during the timeframe of this study, 341 (0.6%) strains which met our criteria were analyzed. 65 out of 341 strains were determined to be CPE, and the incidence rate of CPE in Enterobacteriales was 0.12% (65/56,494). Most of which were IMP-1 and only three were IMP-6 types. Three Escherichia coli strain producing NDM-5 were detected and MLST analysis also showed the ST78 type was most predominant in the E. cloacae complex CPE (n = 14, 60.9%). On the other hand, various STs were detected in CP-K. pneumoniae, in which ST37 and ST517 were the most common ST types. Conclusion: The incidence rate of CPE was slightly higher than the national data registers for this region, and it was possible to detect the spread of ST78 of carbapenemase-producing E. cloacae complex across hospitals by using this limited three-month follow-up analysis, which indicated the need to strengthen regional infection control programs.

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Molecular characterization and antibiotic resistance of Acinetobacter baumannii in cerebrospinal fluid and blood

PLoS ONE ◽

10.1371/journal.pone.0247418 ◽

2021 ◽

Vol 16 (2) ◽

pp. e0247418

Author(s):

Xiaohong Shi ◽

Hong Wang ◽

Xin Wang ◽

Huaiqi Jing ◽

Ran Duan ◽

...

Keyword(s):

Cerebrospinal Fluid ◽

Infection Control ◽

Acinetobacter Baumannii ◽

Detection Rate ◽

Genetic Relatedness ◽

Treatment Options ◽

Carbapenem Resistance ◽

Control Measures ◽

Carbapenem Resistant ◽

Carbapenemase Gene

The increasing prevalence of carbapenem-resistant Acinetobacter baumannii (CRAB) caused nosocomial infections generate significant comorbidity and can cause death among patients. Current treatment options are limited. These infections pose great difficulties for infection control and clinical treatment. To identify the antimicrobial resistance, carbapenemases and genetic relatedness of Acinetobacter baumannii isolates from cerebrospinal fluid (CSF) and blood, a total of 50 nonrepetitive CSF isolates and 44 blood isolates were collected. The resistance phenotypes were determined, and polymerase chain reaction (PCR) was performed to examine the mechanisms of carbapenem resistance. Finally, multilocus sequence typing (MLST) was conducted to determine the genetic relatedness of these isolates. It was observed that 88 of the 94 collected isolates were resistant to imipenem or meropenem. Among them, the blaOXA-23 gene was the most prevalent carbapenemase gene, with an observed detection rate of 91.5% (86/94), followed by the blaOXA-24 gene with a 2.1% detection rate (2/94). Among all carbapenem-resistant Acinetobacter baumannii (CRAB) observations, isolates with the blaOXA-23 gene were resistant to both imipenem and meropenem. Interestingly, isolates positive for the blaOXA-24 gene but negative for the blaOXA-23 gene showed an imipenem-sensitive but meropenem-resistant phenotype. The MLST analysis identified 21 different sequence types (STs), with ST195, ST540 and ST208 most frequently detected (25.5%, 12.8% and 11.7%, respectively). 80 of the 94 isolates (85.1%) were clustered into CC92 which showed a carbapenem resistance phenotype (except AB13). Five novel STs were detected, and most of them belong to CRAB. In conclusion, these findings provide additional observations and epidemiological data of CSF and blood A. baumannii strains, which may improve future infection-control measures and aid in potential clinical treatments in hospitals and other clinical settings.

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Quantitative measurements of aerosols from air-polishing and ultrasonic devices: (How) can we protect ourselves?

PLoS ONE ◽

10.1371/journal.pone.0244020 ◽

2020 ◽

Vol 15 (12) ◽

pp. e0244020

Author(s):

Manuela Kaufmann ◽

Alex Solderer ◽

Andrea Gubler ◽

Florian J. Wegehaupt ◽

Thomas Attin ◽

...

Keyword(s):

Infection Control ◽

Treatment Options ◽

Aerosol Deposition ◽

Protective Equipment ◽

Dental Practice ◽

Air Polishing ◽

Quantitative Measurements ◽

Ultrasonic Devices ◽

Contamination Levels ◽

Filter Papers

Aim To assess the distribution and deposition of aerosols during simulated periodontal therapy. Methods A manikin with simulated fluorescein salivation was treated by four experienced dentists applying two different periodontal treatment options, i.e. air-polishing with an airflow device or ultrasonic scaling in the upper and lower anterior front for 5 minutes, respectively. Aerosol deposition was quantitatively measured on 21 pre-defined locations with varying distances to the manikins mouth in triplicates using absorbent filter papers. Results The selected periodontal interventions resulted in different contamination levels around the patient’s mouth. The highest contamination could be measured on probes on the patient’s chest and forehead but also on the practitioner’s glove. With increasing distance to the working site contamination of the probes decreased with both devices. Air-polishing led to greater contamination than ultrasonic. Conclusion Both devices showed contamination of the nearby structures, less contamination was detected when using the ultrasonic. Affirming the value of wearing protective equipment we support the need for universal barrier precautions and effective routine infection control in dental practice.

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Methicillin-resistant Staphylococcus aureus : An update on the epidemiology, treatment options and infection control

Current Medicine Research and Practice ◽

10.1016/j.cmrp.2018.01.001 ◽

2018 ◽

Vol 8 (1) ◽

pp. 18-24 ◽

Cited By ~ 43

Author(s):

Samar S. Boswihi ◽

Edet E. Udo

Keyword(s):

Staphylococcus Aureus ◽

Infection Control ◽

Methicillin Resistant Staphylococcus Aureus ◽

Treatment Options ◽

Methicillin Resistant

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Outbreak of Extended Spectrum Beta Lactamase Producing Klebsiella Species Causing Neonatal Sepsis at Patan Hospital in Nepal

Journal of Patan Academy of Health Sciences ◽

10.3126/jpahs.v1i1.13011 ◽

2015 ◽

Vol 1 (1) ◽

pp. 20-25

Author(s):

Puja Amatya ◽

Suchita Joshi ◽

Shrijana Shrestha

Keyword(s):

Infection Control ◽

Treatment Options ◽

Multidrug Resistant ◽

Control Measures ◽

Beta Lactamase ◽

Plain Language ◽

Klebsiella Species ◽

Extended Spectrum Beta Lactamase ◽

Infection Control Measures ◽

Extended Spectrum

Introductions: Klebsiella sepsis is the most important nosocomial infection in neonates. The objectives of this study were to review an outbreak in a neonatal unit caused by Klebsiella species, to identify the source of the infections, and to identify infection control measures for eradication and prevention of these infections. Methods: The case notes and investigation reports of all sepsis cases admitted in neonatal units of Patan hospital from July to December 2011 caused by Klebsiella species were retrospectively reviewed. The demographic profile, risk factors along with clinical features and management of sepsis were reviewed. Results: Twenty three out of 37 neonatal blood cultures grew Klebsiella species. Thirty one were K. pneumoniae and six K. oxytoca. Seventeen of the 31 (55%) K. pneumoniae isolates were multidrug resistant and extended spectrum beta lactamase producers. Eighteen of 23 (78%) neonates with Klebsiella sepsis died. After extensive cleaning methods and identifying an intermittently leaking roof in one of the nurseries below a vescicovaginal fistula room of gynecological ward above, the infection outbreak was finally controlled. Conclusions: Infections with extended spectrum beta lactamase producing Klebsiella spp. are a threat in neonatal units because of limited treatment options for these multidrug resistant organisms. Identification of the source and control of the outbreak can be a challenge. Plain Language Summary: The study was done to review an outbreak caused by Klebsiella species, to identify the source of the infections along with infection control measures for eradication and prevention of these infections in neonate unit. Identification of the source and eradication of the outbreak of Klebsiella species can be a challenge. Hand washing remains one of the most important methods to prevent cross infections and nosocomial infections. DOI: http://dx.doi.org/10.3126/jpahs.v1i1.13011 Journal of Patan Academy of Health Sciences. 2014 Jun;1(1):20-25

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