scholarly journals Intracranial approach for sub-second monitoring of neurotransmitters during DBS electrode implantation does not increase infection rate

2021 ◽  
Author(s):  
Brittany Nicole Liebenow ◽  
Michelle Marie Williams ◽  
Thomas Wilson ◽  
Ihtsham ul Haq ◽  
Mustafa S Siddiqui ◽  
...  
Keyword(s):  
Infection Rate ◽  
Neurotransmitter Release ◽  
Time Window ◽  
Medical Center ◽  
Infection Risk ◽  
Research Protocol ◽  
Infection Rates ◽  
Electrode Implantation ◽  
Research Procedure ◽  
The Impact

Introduction: Currently, sub-second monitoring of neurotransmitter release in humans can only be performed during standard of care invasive procedures like DBS electrode implantation. The procedure requires acute insertion of a research probe and additional time in surgery, which may increase infection risk. We sought to determine the impact of our research procedure, particularly the extended time in surgery, on infection risk. Methods: We screened 607 DBS electrode implantation procedures performed at Wake Forest Baptist Medical Center between January 2011 through October 2020 using International Classification of Diseases (ICD) codes for infection. During this period, 116 cases included an IRB approved 30-minute research protocol, during the DBS electrode implantation surgery, to monitor sub-second neurotransmitter release. We used Fisher's Exact test (FET) to determine if there was a significant change in the infection rate following DBS electrode implantation procedures that included, versus those that did not include, the neurotransmitter monitoring research protocol. Results: Within 30-days following DBS electrode implantation, infection was observed in 7 (1.43%) out of 491 procedures that did not include the research procedure and 2 (1.72%) of the 116 procedures that did include the research procedure. Total infection rates (i.e., not constrained by 30-day time window) for all non-research cases was 28/491 (5.70%) and only 4/116 (3.45%) for research inclusive cases. Notably, all types of infection observed were typical of those expected for DBS electrode implantation. Conclusion: Total infection rates are not statistically different in patients who performed the research procedure (3.45% vs. 5.70%; p = 0.4872, FET) and not statistically different across research and non-research groups within 30-days following the research procedure (1.72% vs. 1.43%; p = 0.684, FET). Our results demonstrate that the research procedures used for sub-second monitoring of neurotransmitter release in humans can be performed without increasing the rate of infection.

scholarly journals The Effect of Vaccination Rates on the Infection of COVID-19 under the Vaccination Rate below the Herd Immunity Threshold

2021 ◽  
Vol 18 (14) ◽  
pp. 7491
Author(s):  
Yi-Tui Chen
Keyword(s):  
Infection Rate ◽  
Herd Immunity ◽  
The United States ◽  
Vaccination Rate ◽  
Infection Rates ◽  
Vaccination Rates ◽  
The United Kingdom ◽  
The World ◽  
Almost All ◽  
The Impact

Although vaccination is carried out worldwide, the vaccination rate varies greatly. As of 24 May 2021, in some countries, the proportion of the population fully vaccinated against COVID-19 has exceeded 50%, but in many countries, this proportion is still very low, less than 1%. This article aims to explore the impact of vaccination on the spread of the COVID-19 pandemic. As the herd immunity of almost all countries in the world has not been reached, several countries were selected as sample cases by employing the following criteria: more than 60 vaccine doses per 100 people and a population of more than one million people. In the end, a total of eight countries/regions were selected, including Israel, the UAE, Chile, the United Kingdom, the United States, Hungary, and Qatar. The results find that vaccination has a major impact on reducing infection rates in all countries. However, the infection rate after vaccination showed two trends. One is an inverted U-shaped trend, and the other is an L-shaped trend. For those countries with an inverted U-shaped trend, the infection rate begins to decline when the vaccination rate reaches 1.46–50.91 doses per 100 people.

scholarly journals Standardising intraoperative irrigation with 0.05% chlorhexidine gluconate in caesarean delivery to reduce surgical site infections: A single institution experience

2019 ◽  
Vol 30 (1-2) ◽  
pp. 24-33
Author(s):  
Theresa Mangold ◽  
Erin Kinzel Hamilton ◽  
Helen Boehm Johnson ◽  
Rene Perez
Keyword(s):  
Treatment Group ◽  
Surgical Site Infection ◽  
Infection Rate ◽  
Caesarean Delivery ◽  
Chlorhexidine Gluconate ◽  
Control Group ◽  
Antibiotic Administration ◽  
Site Infection ◽  
Infection Rates ◽  
The Impact

Background Surgical site infection is a significant cause of morbidity and mortality following caesarean delivery. Objective To determine whether standardising intraoperative irrigation with 0.05% chlorhexidine gluconate during caesarean delivery could decrease infection rates. Methods This was a process improvement project involving 742 women, 343 of whom received low-pressured 0.05% chlorhexidine gluconate irrigation during caesarean delivery over a one-year period. Infection rates were compared with a standard-of-care control group (399 women) undergoing caesarean delivery the preceding year. Results The treatment group infection rate met the study goal by achieving a lower infection rate than the control group, though this was not statistically significant. A significant interaction effect between irrigation with 0.05% chlorhexidine gluconate and antibiotic administration time existed, such that infection occurrence in the treatment group was not dependent on antibiotic timing, as opposed to the control group infection occurrence, which was dependent on antibiotic timing. Conclusion Intraoperative irrigation with 0.05% chlorhexidine gluconate during caesarean delivery did not statistically significantly reduce the rate of infections. It did render the impact of antibiotic administration timing irrelevant in prevention of surgical site infection. This suggests a role for 0.05% chlorhexidine gluconate irrigation in mitigating infection risk whether antibiotic prophylaxis timing is suboptimal or ideal.

The Impact of Observation Units on the Rate of Hospital-Acquired Infection

2013 ◽  
Vol 34 (12) ◽  
pp. 1318-1320
Author(s):  
Anna Dow Sheahan ◽  
Kent A. Sepkowitz
Keyword(s):  
Clostridium Difficile ◽  
Infection Rate ◽  
Infection Rates ◽  
Hospital Acquired Infection ◽  
Observation Units ◽  
Hospital Acquired ◽  
The Impact

Using Clostridium difficile as an example, we calculated the impact that reduced inpatient-day denominators resulting from implemen¬tation of hospital observation units would have on hospital-acquired infection rates. Using proposed scenarios of reduced inpatient-days, we estimated an increase in the hospital-acquired C. difficile infection rate of up to 12%.

scholarly journals Implementation of an infection prevention bundle is associated with reduced surgical site infections in cranial neurosurgery

2019 ◽  
Vol 47 (2) ◽  
pp. E3 ◽  
Author(s):  
Samuel L. Rubeli ◽  
Donato D’Alonzo ◽  
Beate Mueller ◽  
Nicole Bartlomé ◽  
Hans Fankhauser ◽  
...  
Keyword(s):  
Risk Factors ◽  
Infection Rate ◽  
Infection Prevention ◽  
Tertiary Care ◽  
Postoperative Bleeding ◽  
Care Hospital ◽  
Infection Rates ◽  
Senior Faculty ◽  
Cutibacterium Acnes ◽  
The Impact

OBJECTIVEThe objective of this study was to quantify surgical site infection (SSI) rates after cranial neurosurgery in a tertiary care hospital, identify risk factors for SSI, and evaluate the impact of standardized surveillance and an infection prevention bundle (IPB).METHODSThe authors compared SSI rates during 7 months before and after the intervention. The IPB included standardized patient preparation, perioperative antibiotic/antiseptic use, barrier precautions, coaching of surgeons, and the implementation of a specialized technical operation assistant team.RESULTSThree hundred twenty-two unselected consecutive patients were evaluated before the IPB, and 296 were evaluated after implementation. Infection rates after 1 year decreased from 7.8% (25/322) to 3.7% (11/296, p = 0.03) with similar mortality rates (14.7% vs 13.8%, p = 0.8). The isolated bacteria included Staphylococcus aureus (42%), Cutibacterium acnes (22%), and coagulase-negative staphylococci (14%). Organ/space infections dominated with 67%, and mostly consisted of subdural empyema and meningitis/ventriculitis. Among the 36 SSIs, 13 (36%) occurred during hospitalization, and 29 (81%) within the first 3 months of follow-up. In multivariable analysis including established risk factors described in the literature, non-CNS neoplasia (odds ratio [OR] 3.82, 95% confidence interval [CI] 1.39–10.53), postoperative bleeding (OR 4.09, 1.44–11.62), operations performed by or under supervision of a senior faculty surgeon (OR 0.38, 0.17–0.84), and operations performed after the implementation of standardized surveillance and an IPB (OR 0.38, 0.17–0.85) significantly influenced the infection rate.CONCLUSIONSThe introduction of an IPB combined with routine surveillance and personal feedback was associated with a 53% reduced infection rate. The lower infection rates of senior faculty and the strong association between postoperative bleeding and infection underline the importance of both surgical experience as well as thorough supervision and coaching of younger surgeons.

scholarly journals Family factors and Helicobacter pylori infection in schoolchildren in the Republic of Tuva with a high prevalence of gastric cancer

2020 ◽  
Vol 23 (3) ◽  
pp. 165-170
Author(s):  
Tamara V. Polivanova ◽  
Vitaliy A. Vshivkov
Keyword(s):  
Infection Rate ◽  
Employment Status ◽  
Family Factors ◽  
Bacterial Invasion ◽  
Infection Rates ◽  
Cross Sectional ◽  
The Republic ◽  
Education And Employment ◽  
H Pylori ◽  
The Impact

Aim. To study the prevalence of H. pylori in Tuva schoolchildren with gastrointestinal manifestations and to assess the impact of the number of children in the family, education, and employment status of parents on its indices. Materials and methods. The study of H. pylori infection in 270 students aged 7-17 years (123 Caucasian, 147 Tuvans) with gastrointestinal complaints there was used morphological method, considering the affiliation of a microorganism to a CagA strain in the Republic of Tuva and evaluation of the influence of family factors on the level of bacterial invasion in children. The study groups were formed by random selection from among children with complaints in a cross-sectional clinical examination of 1535 schoolchildren. Statistical processing of the results was performed using the Pearson Chi-square criterion and logistic regression analysis - calculating the odds ratio (OR) and 95% confidence interval (CI). Results. The infection rate of H. pylori in Tuva schoolchildren accounted of 55.9%. Younger Tuvans had higher infection rates, indicating earlier bacterial infestation. In more than half of the cases in schoolchildren, the bacterium was identified to belong to the CagA strain, and in both ethnic populations. Among the factors considered, a positive influence of the mother’s higher education (0.33 (0.11-0.96), p = 0.043), and her social status (working profession: 3.87 (1.33-11.29), p = 0.014) on the infection rate was found in the population of Caucasians. The father’s education and employment status did not play a significant role. In the population of Tuvans, there was no association between the studied factors and the level of infection. Conclusion. In the Republic of Tuva, there is a high infection rate of H. pylori with the predominant belonging of the bacterium to the CagA strain, which is typical for territories with low sanitary and socio-economic living standards of the population. There are ethnic features of the influence of family factors on the infection rates of schoolchildren.

scholarly journals 807. Effect of Inter-Hospital Transfer on Nosocomial Infection Rates in Patients Receiving Extracorporeal Membrane Oxygenation

2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. S446-S447
Author(s):  
Joseph E Marcus ◽  
Jason Okulicz ◽  
Valerie Sams ◽  
Andriy Batchinsky ◽  
Alice Barsoumian
Keyword(s):  
Nosocomial Infection ◽  
Infection Rate ◽  
Nosocomial Infections ◽  
Life Support ◽  
Medical Center ◽  
Infectious Complications ◽  
Nosocomial Infection Rate ◽  
Significant Difference ◽  
Hospital Transfer ◽  
The Impact

Abstract Background Extracorporeal Oxygenation (ECMO) has been increasingly used as a life support modality for cardiac and pulmonary failure. Due to improved survival in patients treated in high volume ECMO centers, inter-hospital transport of these critically ill patients is on the rise. These patients may be transported via ambulance locally, or by aircraft over long distances. However, potential risks of nosocomial infectious complications associated with transfers has not been reported. We evaluated the impact of transfers on nosocomial infections for patients who received ECMO at Brooke Army Medical Center (BAMC). Methods All patients who received ECMO for ≥48 hours at BAMC between May 2012 and October 2019 were included. Chart review was performed to determine transport status, infectious complications while on ECMO, and antimicrobial susceptibility of isolated organisms. Statistical analyses were performed using Chi-squared, Fisher’s exact, or Mann-Whitney U tests as appropriate. Factors associated with nosocomial infections were evaluated by multivariate logistic regression. Results Compared to patients who were cannulated locally (n=33), patients who underwent cannulation at referral facility and inter-hospital transfer (n=76) had no difference in infections per 1000 ECMO days (33.1 vs. 30.5, p=0.74) or in infections with multidrug resistant organisms (MDRO) (50% vs. 55%, p=1). Of transferred patients, those transferred by aircraft (n=11) had no difference in infection rate (22.4 vs. 31.8 per 1000 ECMO days, p= 0.39) or MDRO incidence (52% vs 75%, p=0.61) compared to those only transferred by ambulance (n=65). Multivariate analysis showed the greatest risk factor for nosocomial infection was time on ECMO (OR 12.2 for longest tertile time on ECMO vs. shortest tertile, p=0.0001); transport was not significantly associated with infection (OR 2.1, p=0.06). Nosocomial infection rate by site of ECMO cannulation Conclusion This study did not find a significant difference in nosocomial infection rate or recovery of MDROs between transported and non-transported patients on ECMO, regardless of transport modality. This study suggests that transportation is not the primary driver of nosocomial infections in this cohort. Disclosures All Authors: No reported disclosures

The Impact of Discontinuing Contact Precautions for VRE and MRSA on Device-Associated Infections

2015 ◽  
Vol 36 (8) ◽  
pp. 978-980 ◽  
Author(s):  
Michael B. Edmond ◽  
Nadia Masroor ◽  
Michael P. Stevens ◽  
Janis Ober ◽  
Gonzalo Bearman
Keyword(s):  
Medical Center ◽  
Academic Medical Center ◽  
Infection Rates ◽  
Hospital Acquired Infection ◽  
Contact Precautions ◽  
Academic Medical ◽  
Before And After ◽  
Hospital Acquired ◽  
The Impact ◽  
Before And After Study

The impact of discontinuing contact precautions for patients with MRSA and VRE colonization/infection on device-associated hospital-acquired infection rates at an academic medical center was investigated in this before-and-after study. In the setting of a strong horizontal infection prevention platform, discontinuation of contact precautions had no impact on device-associated hospital-acquired infection rates.Infect. Control Hosp. Epidemiol. 2015;36(8):978–980

The Impact of a Pediatric Shunt Surgery Checklist on Infection Rate at a Single Institution

Neurosurgery ◽  
2017 ◽  
Vol 83 (3) ◽  
pp. 508-520 ◽  
Author(s):  
Ryan P Lee ◽  
Garrett T Venable ◽  
Brandy N Vaughn ◽  
Jock C Lillard ◽  
Chesney S Oravec ◽  
...  
Keyword(s):  
Risk Reduction ◽  
Infection Rate ◽  
Absolute Risk ◽  
Compliance Rate ◽  
Shunt Infection ◽  
Shunt Surgery ◽  
Infection Rates ◽  
Protocol Implementation ◽  
The Impact ◽  
Shunt Infections

Abstract BACKGROUND Shunt infections remain a significant challenge in pediatric neurosurgery. Numerous surgical checklists have been introduced to reduce infection rates. OBJECTIVE To introduce an evidence-based shunt surgery checklist and its impact on our shunt infection rate. METHODS Between January 1, 2008 and December 31, 2015, pediatric patients who underwent shunt surgery at our institution were indexed in a prospectively maintained database. All definitive shunt procedures were included. Shunt infection was defined according to the Center for Disease Control and Prevention's National Hospital Safety Network surveillance definition for surgical site infection. Clinical and procedural variables were abstracted per procedure. Infection data were compared for the 4 year before and 4 year after protocol implementation. Compliance was calculated from retrospective review of our checklists. RESULTS Over the 8-year study period, 1813 procedures met inclusion criteria with a total of 37 shunt infections (2%). Prechecklist (2008-2011) infection rate was 3.03% (28/924) and decreased to 1.01% (9/889; P = .003) postchecklist (2012-2015), representing an absolute risk reduction of 2.02% and relative risk reduction of 66.6%. One shunt infection was prevented for every 50 times the checklist was used. Those patients who developed an infection after protocol implementation were younger (0.95 years vs 3.40 years (P = .027)), but there were no other clinical or procedural variables, including time to infection, that were significantly different between the cohorts. Average compliance rate among required checklist components was 97% (range 85%-100%). CONCLUSION Shunt surgery checklist implementation correlated with lower infection rates that persisted in the 4 years after implementation.

The Impact of Postdischarge Infection on Surgical Wound Infection Rates

1987 ◽  
Vol 8 (6) ◽  
pp. 237-240 ◽  
Author(s):  
K. Reimer ◽  
C. Gleed ◽  
L.E. Nicolle
Keyword(s):  
Wound Infection ◽  
Infection Rate ◽  
Day Surgery ◽  
Wound Infection Rate ◽  
Surgical Wound Infection ◽  
Surveillance Program ◽  
Surgical Wound ◽  
Infection Rates ◽  
Surgical Infection ◽  
The Impact

AbstractWe undertook a study of postdischarge infections to assess the reliability of a surgical wound surveillance program in a 930-bed teaching hospital. During a six-month period, a subset of operations performed each day was randomly selected and patients interviewed by telephone one month postsurgery using a standard set of questions. The infection rate for all patients contacted directly postdischarge was 5.4%, whereas the surgical wound infection rate determined for all procedures through the standard hospital program was 1.5%. For day-surgery patients, who are not routinely followed in the hospital surveillance program, 8 (7.8%) of 103 patients contacted had infection. Thus, the overall surgical infection rate determined in this study was over three times higher than that calculated using standard surveillance. A reliable method for identifying postdischarge wound infections is necessary to ensure accurate surgical wound infection rates.

Analysis of the role of copper impregnated composite hard surfaces, bed linens and patient gowns in reducing healthcare-associated infection rates

2018 ◽  
Vol 14 (1) ◽  
Author(s):  
Gene H Burke ◽  
Jacqueline P Butler
Keyword(s):  
Infection Risk ◽  
Healthcare Associated Infections ◽  
Drug Resistant ◽  
Infection Rates ◽  
Healthcare Associated Infection ◽  
Before And After ◽  
New Construction ◽  
Healthcare Associated ◽  
The Impact

The aim of this study was to evaluate the impact of copper-impregnated composite hard surfaces, bed linens and patient gowns on healthcare-associated infections (HAIs). We took in account potentially confounding factors of new construction and Det Norse Veritas Managing Infection Risk (DNV MIR) certification to mitigate risk of HAIs, multi drug resistant organisms (MDRO) and Clostridium difficile HAIs. The study was conducted in the acute care units from three hospitals within a regional healthcare system and these were assessed retrospectively. Facility 1 and Facility 2 shared the circumstance of new construction. Facility 1 and Facility 3 shared the processes of DNV-MIR. Only Facility 1 undertook the intervention of copper-impregnated hard surfaces, bed linens and patient gowns. We compared infection rates (IR) following their normalization per 10,000 patient hospitalization days before and after complete implementation of copper-impregnated composite hard surfaces, bed linens and patient gowns. Facility 1 had a 28% reduction in total C. difficile and MDRO IR, while Facilities 2 and 3 had 103% and 48% increases in total IR respectively. Although the rate changes per facility were not statistically significantly changed from baseline (p>0.05), there was consistent divergence between the IR at the copper enabled facility and the others. As this divergence occurred when other pertinent factors were constant between them, including new construction and new processes for mitigation of infection risks, these outcomes support the contention that copper-impregnated linens and composite hard surfaces were shown to reduce HAI rates.

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