scholarly journals Antibiotic use among twelve Canadian First Nations communities: a retrospective chart review of skin and soft tissue infections

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Dahn Jeong ◽  
Ha Nhan Thi Nguyen ◽  
Mark Tyndall ◽  
Yoko S. Schreiber
Keyword(s):  
Soft Tissue ◽  
First Nations ◽  
Chart Review ◽  
Retrospective Chart Review ◽  
Antibiotic Use ◽  
Soft Tissue Infections

scholarly journals Antibiotic use among twelve Canadian First Nations communities: A retrospective chart review of skin and soft tissue infections

2020 ◽  
Author(s):  
Dahn Jeong ◽  
Ha Nhan Thi Nguyen ◽  
Mark Tyndall ◽  
Yoko S Schreiber
Keyword(s):  
Soft Tissue ◽  
First Nations ◽  
Chart Review ◽  
Clinical Symptoms ◽  
Community Setting ◽  
Retrospective Chart Review ◽  
Indigenous Communities ◽  
Antibiotic Use ◽  
Soft Tissue Infections ◽  
Treatment And Prevention

Abstract Background Previous publications indicated an emerging issue with community-acquired methicillin-resistant Staphylococcus aureus (CA-MRSA), particularly skin and soft tissue infections (SSTIs), in Indigenous communities in Canada. The objectives of this analysis were to explore the prevalence of SSTIs due to CA-MRSA and patterns of antimicrobial use in the community setting. Methods A retrospective chart review was conducted as part of an environmental scan to assess antibiotic prescriptions in 12 First Nations communities across five provinces in Canada including Alberta, Saskatchewan, Manitoba, Ontario, and Québec. Charts were randomly selected from nursing stations and patients who had accessed care in the previous 12 months and were ≥18 years were included in the review. Data was collected from September to December, 2013 on antibiotic prescriptions, including SSTIs, clinical symptoms, diagnostic information including presence of CA-MRSA infection, and treatment. Results A total of 372 charts were reviewed, 60 from Alberta, 70 from Saskatchewan, 120 from Manitoba, 100 from Ontario, and 22 from Québec. Among 372 patients, 224 (60.2%) patients had at least one antibiotic prescription in the previous 12 months and 569 prescriptions were written in total. The prevalence of SSTIs was estimated at 36.8% (137 cases of SSTIs in 372 charts reviewed). In 137 cases of SSTIs, 34 (24.8%) were purulent infections, and 55 (40.2%) were due to CA-MRSA. Conclusions This study has identified a high prevalence of antibiotic use and SSTIs due to CA-MRSA in remote and isolated Indigenous communities across Canada. This population is currently hard to reach and under-represented in standard surveillance system and randomized retrospective chart reviews can offer complimentary methodology for monitoring disease burden, treatment and prevention.

scholarly journals Antibiotic use among twelve Canadian First Nations communities: A retrospective chart review of skin and soft tissue infections

2020 ◽  
Author(s):  
Dahn Jeong(Former Corresponding Author) ◽  
Ha Nhan Thi Nguyen ◽  
Mark Tyndall ◽  
Yoko S Schreiber(New Corresponding Author)
Keyword(s):  
Soft Tissue ◽  
First Nations ◽  
Chart Review ◽  
Clinical Symptoms ◽  
Retrospective Chart Review ◽  
Indigenous Communities ◽  
Antibiotic Use ◽  
Soft Tissue Infections ◽  
Treatment And Prevention ◽  
High Prevalence

Abstract Background Previous publications indicated an emerging issue with community-acquired methicillin-resistant Staphylococcus aureus (CA-MRSA), particularly skin and soft tissue infections (SSTIs), in Indigenous communities in Canada. The objectives of this analysis were to explore the prevalence of SSTIs due to CA-MRSA and patterns of antimicrobial use in the community setting.Methods A retrospective chart review was conducted as part of an environmental scan to assess antibiotic prescriptions in 12 First Nations communities across five provinces in Canada including Alberta, Saskatchewan, Manitoba, Ontario, and Québec. Charts were randomly selected from nursing stations and patients who had accessed care in the previous 12 months and were ≥18 years were included in the review. Data was collected from September to December, 2013 on antibiotic prescriptions, including SSTIs, clinical symptoms, diagnostic information including presence of CA-MRSA infection, and treatment.Results A total of 372 charts were reviewed, 60 from Alberta, 70 from Saskatchewan, 120 from Manitoba, 100 from Ontario, and 22 from Québec. Among 372 patients, 224 (60.2%) patients had at least one antibiotic prescription in the previous 12 months and 569 prescriptions were written in total. The prevalence of SSTIs was estimated at 36.8% (137 cases of SSTIs in 372 charts reviewed). In 137 cases of SSTIs, 34 (24.8%) were purulent infections, and 55 (40.2%) were due to CA-MRSA.Conclusions This study has identified a high prevalence of antibiotic use and SSTIs due to CA-MRSA in remote and isolated Indigenous communities across Canada. This population is currently hard to reach and under-represented in standard surveillance system and randomized retrospective chart reviews can offer complimentary methodology for monitoring disease burden, treatment and prevention.

scholarly journals Antibiotic use among twelve Canadian First Nations communities: A retrospective chart review of skin and soft tissue infections

2019 ◽  
Author(s):  
Dahn Jeong ◽  
Ha Nhan Thi Nguyen ◽  
Mark Tyndall ◽  
Yoko S Schreiber
Keyword(s):  
Soft Tissue ◽  
First Nations ◽  
Chart Review ◽  
Clinical Symptoms ◽  
Retrospective Chart Review ◽  
Indigenous Communities ◽  
Antibiotic Use ◽  
Soft Tissue Infections ◽  
Treatment And Prevention ◽  
High Prevalence

Abstract Background Previous publications indicated an emerging issue with community-acquired methicillin-resistant Staphylococcus aureus (CA-MRSA), particularly skin and soft tissue infections (SSTIs), in Indigenous communities in Canada. The objectives of this analysis were to explore the prevalence of SSTIs due to CA-MRSA and patterns of antimicrobial use in the community setting.Methods A retrospective chart review was conducted as part of an environmental scan to assess antibiotic prescriptions in 12 First Nations communities across five provinces in Canada including Alberta, Saskatchewan, Manitoba, Ontario, and Québec. Charts were randomly selected from nursing stations and patients who had accessed care in the previous 12 months and were ≥18 years were included in the review. Data was collected from September to December, 2013 on antibiotic prescriptions, including SSTIs, clinical symptoms, diagnostic information including presence of CA-MRSA infection, and treatment.Results A total of 372 charts were reviewed, 60 from Alberta, 70 from Saskatchewan, 120 from Manitoba, 100 from Ontario, and 22 from Québec. Among 372 patients, 224 (60.2%) patients had at least one antibiotic prescription in the previous 12 months and 569 prescriptions were written in total. The prevalence of SSTIs was estimated at 36.8% (137 cases of SSTIs in 372 charts reviewed). In 137 cases of SSTIs, 34 (24.8%) were purulent infections, and 55 (40.2%) were due to CA-MRSA.Conclusions This study has identified a high prevalence of antibiotic use and SSTIs due to CA-MRSA in remote and isolated Indigenous communities across Canada. This population is currently hard to reach and under-represented in standard surveillance system and randomized retrospective chart reviews can offer complimentary methodology for monitoring disease burden, treatment and prevention.

Utilization of Alexandrite Laser for Hair Removal in Pediatric Auricular Reconstruction

2021 ◽  
pp. 019459982110419
Author(s):  
Peng You ◽  
Tara L. Rosenberg ◽  
Yi-Chun Carol Liu
Keyword(s):  
Soft Tissue ◽  
Chart Review ◽  
Laser System ◽  
Retrospective Chart Review ◽  
Hair Removal ◽  
Procedural Sedation ◽  
Alexandrite Laser ◽  
Auricular Reconstruction ◽  
Laser Hair Removal ◽  
Soft Tissue Envelope

Auricular reconstruction with autologous rib cartilage involves using a soft tissue envelope to cover the cartilage framework. In patients with a low hairline, hair-bearing skin may be incorporated on the reconstructed ear, creating a difficult and conspicuous aesthetic problem. A retrospective chart review was conducted to summarize and share the experience of using the Candela GentleMax Pro 755-nm alexandrite laser system (Candela Corp) in children following auricular reconstruction. Nine patients received laser hair removal via the alexandrite laser system with good results. The number of completed sessions ranged from 1 to 5. The procedures were completed without the need for premedication or procedural sedation. Laser hair removal with an alexandrite laser system was safe, fast, and effective. With multistage auricular reconstruction, it was feasible to incorporate laser hair removal between the stages.

Management of Skin and Soft-Tissue Infections Before and After Clinical Pathway Implementation

2017 ◽  
Vol 57 (6) ◽  
pp. 660-666 ◽  
Author(s):  
Courtney E. Nelson ◽  
Aaron Chen ◽  
Lisa McAndrew ◽  
Khoon-Yen Tay ◽  
Fran Balamuth
Keyword(s):  
Emergency Department ◽  
Staphylococcus Aureus ◽  
Soft Tissue ◽  
Length Of Stay ◽  
Clinical Pathway ◽  
Methicillin Resistant Staphylococcus Aureus ◽  
Antibiotic Use ◽  
Soft Tissue Infections ◽  
Before And After ◽  
Systemic Antibiotics

We evaluated if the introduction of a clinical pathway for skin and soft-tissue infections (SSTIs) would reduce methicillin-resistant Staphylococcus aureus (MRSA)-directed therapy for simple cellulitis and antibiotic use for simple abscess after drainage. We compared the treatment of SSTI during a 3-month prepathway and 11-month postpathway period. We included patients 57 days to 18 years old discharged from the emergency department (ED) with a diagnosis of cellulitis or abscess. Balancing measures included 72-hour revisit rate and ED length of stay (LOS). A total of 291 patients prepathway and 781 patients postpathway were included. The proportion of patients with simple cellulitis prescribed MRSA-directed therapy decreased from 81% to 54% postpathway. The proportion of patients with a drained abscess prescribed systemic antibiotics decreased from 88% to 75%. There was no increase in 72-hour revisit rates (3.8% vs 3.2%, P = .64) or ED LOS (2.8 vs 2.7 hours, P = .05).

scholarly journals 1360. Prevalence of Bacteremia in Hospitalized Patients with Skin and Soft Tissue Infections (SSTI)

2021 ◽  
Vol 8 (Supplement_1) ◽  
pp. S766-S766
Author(s):  
Maria J Suarez ◽  
Yu Shia Lin
Keyword(s):  
Soft Tissue ◽  
Laboratory Data ◽  
Foot Ulcer ◽  
Antibiotic Use ◽  
Blood Cultures ◽  
Hospitalized Patients ◽  
Published Data ◽  
Soft Tissue Infections ◽  
Beta Lactam ◽  
True Negative

Abstract Background Skin and soft tissue infections (SSTI) are common in outpatient and inpatient settings. The prevalence of positive blood cultures (BC) ranges from 2% to 52%. Because of the variations in published data, the exact prevalence of bacteremia in hospitalized patients with SSTI is unknown. Our objective is to determine the prevalence of bacteremia in hospitalized patients with SSTI. Methods Retrospective chart review from January 2017 to December 2018. Patients older than 18 years admitted with SSTI who required BC on admission were included. Patients who met the criteria for systemic inflammatory response syndrome (SIRS)/sepsis or severe SSTI, or had an underlying immunodeficiency underwent BC collection. Patients with diabetic foot ulcer, device related SSTI, necrotizing fasciitis, and osteomyelitis were excluded. Patients were divided into 3 groups: true positive (TP) defined as a true pathogen, false positive (FP) defined as a contaminant, and true negative (TN) defined as no growth in BC. Physician assessment, microorganisms isolated, number of positive bottles/culture sets, and timing of growth were reviewed. Patients’ comorbidities, presence of SIRS, laboratory data, duration of antibiotic use, and length of stay (LOS) were compared. Results We screened 583 patients and included 541 patients. The mean age was 62 ± 18.4 years, and 60% were male. 47/ 541 (8.6%) had skin abscesses. 57 patients (11%) had positive BC, of whom 32 were TP (6%), and 25 were FP (5%). 89% of patients (484) had TN BC. The organisms isolated are described in Figures 1 and 2. Patients in the FP and TN groups had prior antibiotic use, compared to TP (P< 0.05). The FP group had a longer LOS and duration of antibiotic use compared to the TN group (p< 0.05). 76% of FP had repeated BC. Beta-lactam antibiotics were mostly used, followed by anti-MRSA antibiotics (40%). We did not find risk factors to predict the likelihood of bacteremia. The outcome was not different among the 3 groups. Figure 1. Microorganisms isolated from blood cultures of patients with SSTI – True pathogens Figure 2. Microorganisms isolated from blood cultures of patients with SSTI – Isolated contaminants Conclusion There was a low incidence of true bacteremia (6%) in hospitalized patients with SSTI. More than 90% of TP were predictable causal microorganisms, which are covered by empiric antibiotics. BC may not affect the initial treatment of SSTI. FP BC were associated with an increased LOS, longer antibiotic use, and increased healthcare cost. Disclosures All Authors: No reported disclosures

Survival of the 8.5 mm osseointegrated abutment, and its utility in the obese patient

2013 ◽  
Vol 127 (7) ◽  
pp. 643-649 ◽  
Author(s):  
M D Darley ◽  
A A Mikulec
Keyword(s):  
Cohort Study ◽  
Soft Tissue ◽  
Retrospective Cohort ◽  
Chart Review ◽  
Retrospective Chart Review ◽  
Mechanical Forces ◽  
Obese Patients ◽  
Hearing Rehabilitation ◽  
Obese Population ◽  
Bone Anchored Hearing Aid

AbstractBackground:Most of the literature regarding osseointegrated implantation for hearing rehabilitation focuses on the 5.5 mm abutment. This study aimed to add to the data available on the survival of the 8.5 mm abutment, and to describe its utility in obese patients.Objective:To review the outcomes of patients who received a bone-anchored hearing aid implant, and create a model comparing the mechanical forces acting upon combinations of fixture and abutment lengths.Methods:Retrospective chart review and mathematical modelling.Results:In this retrospective cohort study comprising 25 patients, less abutment overgrowth was observed in the 8.5 mm abutment recipients versus recipients of the 5.5 mm abutment. When the principle of equilibrium of a rigid body was applied, the 8.5 mm abutment was at a calculated mechanical disadvantage compared with the 5.5 mm abutment.Conclusion:The 8.5 mm abutment may be useful in patients with copious subcutaneous soft tissue as in the obese population. The 8.5 mm abutment has a calculated mechanical disadvantage, potentially putting the implant under greater mechanical stress; however, the clinical relevance of this is unclear.

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