Multirezisztens kórokozók szűrése szürkehályog-műtét előtt

Összefoglaló. Bevezetés: A multirezisztens kórokozók által okozott fertőzések komoly gondot okoznak. Szemészeti szempontból az ebbe a körbe tartozó meticillinrezisztens Staphylococcus aureus (MRSA) baktérium bír kiemelkedő jelentőséggel. Célkitűzés: Multirezisztens kórokozók irányában cataractaműtét előtt álló betegektől mintavétel és adatelemzés. Módszer: 257, cataractaműtét előtt álló beteg esetében végeztünk multirezisztens kórokozók szűrésére vizsgálatot a conjunctivazsákból. A mikrobiológiai tenyésztés során multirezisztens kórokozóra pozitív eredményt adó betegek esetében a preoperatív kórtörténetet és az általános kísérő betegségeket feltártuk és elemeztük. Eredmények: A minták 17 beteg esetében multirezisztens kórokozóra pozitívak voltak. 11 esetben szisztémás rizikófaktorokat is találtunk. A pozitív betegeknél a műtétet csak a felszabadító mikrobiológiai eredmények birtokában végeztük el. A dekolonizált betegeknél ezt követően a szakmai protokoll normális antibiotikumprevencióját alkalmaztuk. A 257 beteg 6,6%-ában találtunk multirezisztenskórokozó- és 5%-ában MRSA-pozitivitást. Posztoperatív endophthalmitis nem fordult elő. Következtetés: A cataractaműtéteknél alkalmazott antibiotikus endophthalmitisprevenció multirezisztens kórokozóra pozitív betegeknél kevéssé hatékony lehet. Ezért javasolt a veszélyeztetett betegek multirezisztens kórokozókra történő szűrése és dekolonizációja. Orv Hetil. 2021; 162(3): 106–111. Summary. Introduction: Infections caused by multiresistant pathogens may have serious consequences. In ophthalmological practice, methicillin-resistant Staphylococcus aureus (MRSA) is the most important multiresistant pathogen. Objective: We took samples for multiresistant pathogens from patients assigned for cataract surgery. Method: We carried out multiresistant pathogen screening from conjunctival sac in 257 patients, who were assigned for cataract surgery. Preoperative case history and concomitant systemic diseases were evaluated in patients, who turned out to be positive for multiresistant pathogens during the screening procedure. Results: The samples were positive for multiresistant pathogens in 17 patients. In the case history of 11 multiresistant pathogen positive patients, previous systemic risk factors could be explored. Multiresistant pathogen positive patients were operated only after the decolonisation. After the decolonisation, the normal antibiotic prevention was used before the surgery. Multiresistant pathogen positive was 6.6%, MRSA positive was 5% of the 257 patients. There were no cases of endophthalmitis in any of these patients. Conclusion: Endophthalmitis prevention with antibiotics, according to the guidelines, may not be efficient in multiresistant pathogen positive patients. Therefore, it is advisable to screen multiresistant pathogens and decolonisation at risk patients before cataract surgery. Orv Hetil. 2021; 162(3): 106–111.

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Pre-operative conjunctival flora in patients with local and/or systemic risk factors for post cataract surgery infection in Northern Italy

European Journal of Ophthalmology ◽

10.1177/1120672120934991 ◽

2020 ◽

pp. 112067212093499

Author(s):

Carlo Bruttini ◽

Carlotta Pallone ◽

Alice Verticchio Vercellin ◽

Giovanni Acerbi ◽

Santina Baschetti ◽

...

Keyword(s):

Risk Factors ◽

Cataract Surgery ◽

Systemic Risk ◽

Microbial Flora ◽

Published Data ◽

Sensitivity Testing ◽

System Disease ◽

Conjunctival Flora ◽

Local Risk ◽

Systemic Risk Factors

Purpose: To investigate the pre-operative conjunctival flora in patients undergoing cataract surgery with major local and/or systemic risk factors for developing post-operative infection. Methods: A total of 83 patients underwent bacterial culture and sensitivity testing of conjunctival swabs obtained from both eyes because of local risk factors at the pre-operative visit (i.e. chronic blepharitis, conjunctivitis, or lacrimal system disease), and/or systemic risk factors (i.e. autoimmune or skin disorders) for developing post-operative infection. If the swab was found positive, an antimicrobial susceptibility test was performed, and a specific antibiotic therapy was administered. Surgery was performed when a repeat conjunctival swab (after antibiotic treatment) showed negative cultures. Results: Cultures were found positive in 25.3% of patients. Staphylococcus aureus (18%) and Staphylococcus epidermidis (15%) were the most frequently isolated microorganisms. Gram-negative bacteria, including Pseudomonas aeruginosa, were present in nine cases (8%). Conclusion: Present results showed a low rate of swab positivity compared to previous published data, and slightly different microbial flora. The differences observed may be caused by geographical factors and/or to the specific characteristics of the subgroup of studied patients. Considering that the surface microbial flora is one of the major causes of endophthalmitis, this information may be useful in selecting antibacterial regimens to prevent serious ocular infections, and restrain the increasing problem of antibiotic resistance.

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Clinical Characteristics and Outcome of Staphylococcus aureus Prostate Abscess From Ten Years of Experience at a Tertiary Care Center

Open Forum Infectious Diseases ◽

10.1093/ofid/ofz372 ◽

2019 ◽

Vol 6 (10) ◽

Cited By ~ 1

Author(s):

Bryan Walker ◽

Eric Heidel ◽

Mahmoud Shorman

Keyword(s):

Staphylococcus Aureus ◽

Rare Complication ◽

Care Center ◽

Tertiary Care ◽

Care Hospital ◽

Risk Patients ◽

History Of ◽

A Site ◽

Lost To Follow Up

Abstract Objective Prostatic abscess (PA) is an uncommon infection that is generally secondary to Escherichia coli and other members of the Enterobacteriaceae family. In recent years, although rare, more reports of Staphylococcus aureus (S. aureus) PA have been reported, especially with increasing reports of bacteremia associated with injection drug use (IDU). Method This was a retrospective review of adult patients admitted to a tertiary care hospital between 2008 and 2018 and who had a diagnosis of S. aureus PA. Results Twenty-one patients were included. The average age was 46 years. Fourteen (67%) patients presented with genitourinary concerns. Main risk factors included concurrent skin or soft tissue infections (52%), history of genitourinary disease or instrumentation (48%), IDU (38%), and diabetes mellitus (38%). Methicillin-resistant Staphylococcus aureus (MRSA) was identified in 57% and concomitant bacteremia in 81% of patients. Surgical or a radiologically guided drainage was performed in 81% of patients. Antibiotic treatment duration ranged from 3 to 8 weeks. Six patients were lost to follow-up. Clinical resolution was observed in the remaining 15 (81%) patients who had follow-up. Conclusions S. aureus PA continues to be a rare complication of S.aureus infections. In most published reports, MRSA is the culprit. In high risk patients with persistent bacteremia, physicians need to consider the prostate as a site of infection.

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Review of The Birth of Language: The Case History of a Non-Verbal Child.

Contemporary Psychology ◽

10.1037/008967 ◽

1967 ◽

Vol 12 (1) ◽

pp. 36-36

Author(s):

George A. Miller

Keyword(s):

Case History ◽

History Of

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An improved link between industry, management and science: review of case history of the Southwestern Gulf of St. Lawrence snow crab fishery

Aquatic Living Resources ◽

10.1051/alr:1995025 ◽

1995 ◽

Vol 8 (3) ◽

pp. 253-265 ◽

Cited By ~ 6

Author(s):

John S. Loch ◽

Mikio Moriyasu ◽

James B. Jones

Keyword(s):

Case History ◽

Snow Crab ◽

Science Review ◽

History Of

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

MedPharmRes ◽

10.32895/ump.mpr.2.2.21 ◽

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.

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