scholarly journals Organizational and technological algorithm of primary specialized health care at cardiovascular diseases

2020 ◽  
Vol 101 (3) ◽  
pp. 394-402
Author(s):  
A Yu Abramov ◽  
R S Goloshchapov-Aksenov ◽  
D I Kicha ◽  
O V Rukodayny
Keyword(s):  
Russian Federation ◽  
Limb Ischemia ◽  
Scientific Publications ◽  
Quality Healthcare ◽  
Significant Atherosclerosis ◽  
Group A ◽  
The Russian Federation ◽  
Clinically Significant ◽  
Group B ◽  
Cardiovascular Care

Aim. To develop an algorithm for primary specialized cardiovascular care with a priority of endovascular strategy. Methods. The study was conducted in 20182019 based on the Central Clinical Hospital Russian Railways-Medicine and 14 polyclinics in the regions of the Russian Federation. The subject of the study is cardiovascular surgeons (n=2), possessing the skills of endovascular care. The object of the study was patients (n=1018) attended regional polyclinics of the Russian Federation. Patients were divided into two groups: group A consisting of 673 patients with clinically significant atherosclerosis of the coronary, brachiocephalic and peripheral arteries and abdominal aortic aneurysm; group B consisting of 345 patients with chronic lower limb ischemia that does not require surgical treatment. The average age of patients in group A was 696.1 years, in group B 637.2 years. There were 467 men in group A (69.4%), and 339 in group B (98.3%). An organizational and technological algorithm was developed to improve the primary specialized cardiovascular care. The results were assessed by the presence of outcomes (heart attack, stroke, bleeding, death), the availability of endovascular care and patient survival follow up 12 and 24 months. A content analysis of scientific publications on the issue under study has been performed. Results. An organizational and technological algorithm of primary specialized cardiovascular care has been developed, including the activities of the cardiovascular surgeon, who has the skills of endovascular care and a nurse in an outpatient clinic. The implementation of the algorithm ensured continuity, 100% availability, safety and quality of cardiovascular care using endovascular technology. Outcomes are not registered in both groups. Both patient groups showed 100% one and two-year survival. Conclusion. The developed algorithm of primary specialized cardiovascular care has provided high quality healthcare.

scholarly journals Trends in the doses of the population of the Russian Federation in 2003–2018

2020 ◽  
Vol 12 (4) ◽  
pp. 96-122 ◽  
Author(s):  
Anatoly N. Barkovsky ◽  
Anzhelika A. Bratilova ◽  
Tatyana A. Kormanovskaya ◽  
Ruslan R. Akhmatdinov ◽  
Rustam R. Akhmatdinov
Keyword(s):  
Effective Dose ◽  
Russian Federation ◽  
Radiation Safety ◽  
Information Bulletin ◽  
Group A ◽  
Effective Doses ◽  
The Russian Federation ◽  
Medical Exposure ◽  
The Mean ◽  
Group B

In the last years radiation-hygienic passportization and Joint state system of control and accounting of the individual doses of the citizens have become a trusted source of the validated data on the state of the radiation safety in the Russian Federation and have become the basis of the Russian system of the information provision of the radiation safety. Annual analysis of that data is presented in the annual information bulletin “Doses of the population of the Russian Federation”. The current study is focused on the analysis of the data from the information bulletins to evaluate the trends in the doses of the Russian population from main sources of ionizing exposure in 2003–2018. It is indicated that the mean annual doses from man-made exposure of the group A staff in that period varies from 1,0–1,4 mSv per year, group B – 0,65–0,8 mSv per year. The number of exceedances of the annual dose limits from group A staff varied from 5 to 52 per year; for group B – 0–22 per year. For the whole investigated period there were only three cases of the exceedance of the 50 mSv annual individual dose for group A staff and four cases of the exceedance of the 12,5 mSv annual effective dose for group B staff. Mean effective dose per X-ray examination in 2006–2013 was decreasing from 0,56 mSv to 0,26 mSv and started to slowly increase leading to 0,29 mSv in 2018. The same trends were identified for the mean dose from medical exposure per citizen: reduction in 2003-2013 from 0,86 mSv to 0,45 mSv with the subsequent increase up to 0,56 mSv. The biggest contributor for the dose from medical exposure is computed tomography: the number of CT examinations increased from 1,3 mln in 2003 to 11,7 mln in 2018; contribution to the collective dose – from 5,7% to 54%. Mean annual effective doses from natural exposure of the population of the Russian regions varied from 1,6 to 15,1 mSv per year with the mean value for Russia of 3,11 – 3,79 mSv/year. The highest mean annual doses exceeding 5 mSv in each year were observed in Republic of Altay, Jewish Independent Region, Stavropol and Zabaikalskiy Krai, Republic of Tyva and Irkutsk region. Total effective doses exceeding 10 mSv/year were observed in Republic of Altay and Jewish Independent Region. For ten subjects of the Russain Federation (Republics of Buryatia, Altay, Tyva, Stavropol and Zabaikalskiy Krai, Irkutsk and Chita regions, Jewish Independent Region, Aginsko-Buryatskiy and Ust’-Ordinskiy independent districts) they exceed 5 mSv/year for the whole assessed period.

scholarly journals Radiation doses to the population of the Russian Federation in 2020

2021 ◽  
Vol 14 (4) ◽  
pp. 103-113
Author(s):  
A. N. Barkovsky ◽  
Ruslan R. Akhmatdinov ◽  
Rustam R. Akhmatdinov ◽  
N. К. Baryshkov ◽  
A. M. Biblin ◽  
...  
Keyword(s):  
Effective Dose ◽  
Russian Federation ◽  
Annual Effective Dose ◽  
Dose Limit ◽  
The Public ◽  
Dose Control ◽  
Group A ◽  
The Russian Federation ◽  
Group B ◽  
Average Individual

The article presents estimates of radiation doses of technogenic exposure to personnel and the public due to the normal operation of radiation facilities, exposure to the public due to natural sources and technogenically altered radiation environment, and medical exposure of patients. The doses values were obtained using the Unified System of Individual Dose Control of the Russian Federation citizens for 2020. The authors have analyzed the data contained in the forms of state statistical observation No. 1-DOZ, No. 2-DOZ, No. 3-DOZ and No. 4-DOZ for 2020 submitted by the organizations and territories, the state sanitary and epidemiological supervision of which was carried out by Rospotrebnadzor and Federal Medical Biological Agency of Russia. In the article also were used data obtained within the framework of Radiation-Hygiene Passportization. In 2020, 19 737 organizations dealing with technogenic sources of ionizing radiation submitted forms No. 1-DOZ with the information on the doses to personnel with a total number of 230 318 persons, of which 230 318 persons belonged to the personnel group A and 21 303 persons belonged to the personnel group B. For these groups, the doses were assessed based on results of individual dosimetric control. In 2020, according to Unified System of Individual Dose Control of the Russian Federation citizens data, the average individual annual effective dose of technogenic exposure to the personnel group A was 1.11 mSv, and for the personnel group B it was 0.63 mSv. In 2020, 6 cases of exceeding the average annual effective dose limit (20 mSv) for Group A personnel and 18 cases of exceeding the average annual effective dose limit (5 mSv) for Group B personnel were registered. The total number of X-ray and radiological diagnostic procedures performed in the Russian Federation in 2020 exceeded 275.4 million, or 1.83 procedures per a citizen. The average annual effective dose of medical radiation exposure per one resident of Russia in 2020 was 0.81 mSv, and per procedure – 0.44 mSv. The average annual effective dose of radiation to residents of the Russian Federation from natural sources, according to all measurements for the period from 2001 to 2020, was 3.36 mSv. More than 59% of this dose is associated with the inhalation of radon and its progenies. The average individual annual effective radiation dose to residents the Russian Federation subjects in 2020 ranged from 2.47 mSv (Kamchatka Krai) to 9.06 mSv (Altai Republic) with an average value for the Russian Federation of 4.18 mSv. For eight subjects of the Russian Federation, the average individual annual effective dose to public in 2020 exceeded 5 mSv: the Republics of Buryatia (5.31 mSv), Altai (9.06 mSv), Tyva (6.31 mSv), Magadan (5.07 mSv) and Irkutsk (6.13 mSv) regions, Stavropol (6.31 mSv) and Zabaykalsky (8.19 mSv) krai and the Evreiskaya Autonomous oblast (6.77 mSv).

scholarly journals THE RESULTS OF FUNCTIONING OF THE UNIFIED SYSTEM OF INDIVIDUAL DOSE CONTROL OF THE RUSSIAN FEDERATION CITIZENS BASED ON THE 2017 DATA

2018 ◽  
Vol 11 (4) ◽  
pp. 98-128 ◽  
Author(s):  
A. N. Barkovsky ◽  
R. R. Akhmatdinov ◽  
R. R. Akhmatdinov ◽  
N. K. Baryshkov ◽  
A. M. Biblin ◽  
...  
Keyword(s):  
Ionizing Radiation ◽  
Russian Federation ◽  
Individual Dose ◽  
X Ray ◽  
Radiation Sources ◽  
Dose Control ◽  
Group A ◽  
Staff Group ◽  
The Russian Federation ◽  
Group B

The article presents the results of the generalized analysis of the data on staff, patient, and public doses from ionizing radiation obtained from the Unified System of Individual Dose Control for 2017. The analysis is conducted on the basis of the annual data from the forms of Federal State Statistical. Observation No.1-DOZ (staff individual doses), No.2-DOZ (doses from radiation accidents), No.3-DOZ (patient doses) and No.4- DOZ (public doses from natural and technogenically impacted background). The information is submitted by the organizations and territories under the supervision of the Rospotrebnadzor and FMBA of the Russian Federation. The article is based on the data obtained within the framework of Radiation-Hygiene passportization. In 2017, 18 324 organizations working with the artificial radiation sources submitted the form No.1-DOZ. The form No.1-DOZ contains data on 235 271 staff individual doses, 215 290 of the staff group A and 19 981 the staff group B with individual monitoring. In 2017, the average individual dose for the staff group A was 1,23 mSv, the staff group B – 0,67 mSv. In 2017, 13 036 healthcare organizations submitted the form No.3- DOZ. According to the No.3-DOZ data, more than 286 mln. X-ray procedures were conducted in the Russian Federation in 2017. An average dose per capita from medical exposure was 0,55 mSv/year and a mean dose per an X-ray examination was 0,28 mSv. In 2017, the form No.4-DOZ contained data on 8 130 measurements of gamma-radiation dose rate in wooden houses, 1 557 measurements in one-storey stone houses, 126 550 measurements in multi-storey stone houses and 178 138 measurements on the open ground As well as the results of 4 417 measurements of radon concentration levels in wooden houses, 5 971 measurements in one-storey stone houses, 57 461 measurements in multi-storey stone houses. The public average effective dose from natural ionizing radiation sources corresponded to 3.34 mSv/year, the average values for the subjects of the Russian Federation fall in the range from 2,15 mSv/year (Nenets Autonomous Okrug) to 8,9 mSv/year (Altai republic). The article includes the Annexes with the final generalized forms of the Unified System of Individual Dose Control in 2017 based on the forms of statistical observations No. 1-, 3- and 4-DOZ of the subjects of the Russian Federation.

scholarly journals Does Systematic Preliminar Colour Doppler Study Reduce Kidney Biopsy Complication Incidence?

2011 ◽  
Vol 2011 ◽  
pp. 1-5
Author(s):  
Antonio Granata ◽  
Fulvio Floccari ◽  
Angelo Ferrantelli ◽  
Ugo Rotolo ◽  
Luca Di Lullo ◽  
...  
Keyword(s):  
Kidney Biopsy ◽  
Colour Doppler ◽  
Doppler Examination ◽  
Doppler Study ◽  
Group A ◽  
Clinically Significant ◽  
Perinephric Hematoma ◽  
Group B ◽  
Biopsy Complications ◽  
Optimal Site

While ultrasonography is widely performed prior to biopsy, colour Doppler examination is often used only to discover post-biopsy complications. Aim of this paper was to evaluate the usefulness of colour Doppler examination in planning the optimal site of puncture for renal biopsy. Present analysis includes 561 consecutive percutaneous renal biopsies performed from the same operator. Until August 2000 332 biopsies were performed after a preliminary ultrasonography (Group A). From September 2000, 229 patients underwent even a preliminary colour Doppler study (Group B). Postbioptic bleeding were categorized as minor (gross hematuria or subcapsular perinephric hematoma < 4 cmq of greater diameter) or major (hematoma >4 cmq of greater diameter; requiring blood transfusion or invasive procedures; leading to acute renal failure, urine tract obstruction, septicaemia, or death). Major complications were seen in 2.1% in Group A while in Group B only one case was reported (0.43%). Minor clinically significant complications occur in 7.8% in Group A and in 3.4% of cases of Group B. Colour Doppler reduced drastically the incidence of complications observed before the introduction of routine colour Doppler examination prior to biopsy. In our opinion, these data support the use of preliminary colour Doppler study when a biopsy is planned.

On the issue of improving the legal framework in the framework of the system of children health in the Russian Federation (review)

2021 ◽  
pp. 28-44
Author(s):  
Oksana Borisovna Karpova ◽  
Anna Anatolyevna Zagoruichenko
Keyword(s):  
Child Health ◽  
Russian Federation ◽  
Maternal And Child Health ◽  
The State ◽  
State Of Health ◽  
Scientific Publications ◽  
Legal Provisions ◽  
Mothers And Children ◽  
The Russian Federation ◽  
And Child Health

The state of maternal and child health plays a key role in promoting and protecting public health. The article analyzes and summarizes the results of the analysis of legislative support for maternal and child health. The analysis of individual indicators that determine the current state of medical organizations ‘activities is presented. The purpose of the study is to determine the current directions for improving the system of maternal and child health in Russia. Materials and methods. The following methods were used: information and analytical, content analysis, comparative analysis, and statistical analysis. Sources of primary information — scientific publications, Rosstat data, regulatory legal materials. Results and discussion. Proposals for the use of the current legislation of the Russian Federation in protecting the health of mothers and children are identified. There is a need to improve the use of the current regulatory and legislative framework to improve individual indicators of the state of health of mothers and children. The analysis showed that positive results were achieved in 2012–2019 in the Russian Federation in terms of improving maternal and child health. Conclusion. The implementation of regulatory legal provisions in this area should be based on a comprehensive coordination of all activities between various departments and structures, regional characteristics of the state of health of mothers and children and such areas as prevention of neglect, medical and social assistance to orphans and children left without parental care, maintaining a healthy lifestyle and providing the children’s population with sanatorium-resort medical organizations should be taken into account.

The Subject of a Crime Under Part 1 of Art. 282 of the Criminal Code of the Russian Federation

2021 ◽  
Vol 7 ◽  
pp. 87-92
Author(s):  
E. G. Bykova ◽  
◽  
A. A. Kazakov
Keyword(s):  
Russian Federation ◽  
Criminal Law ◽  
Criminal Code ◽  
Practical Significance ◽  
Constitutional Court ◽  
Scientific Publications ◽  
Legal Method ◽  
The Subject ◽  
The Russian Federation ◽  
Administrative Code

The change in the disposition of Part 1 of Art. 282 of the Criminal Code of the Russian Federation led to questions from law enforcement officers about from what moment a person is considered to be held administratively liable and what to mean by the commission of a similar act. The article carries out a systematic legal analysis of the provisions of the Criminal Code of the Russian Federation and the Administrative Code of the Russian Federation, as well as the position of the Constitutional Court of the Russian Federation and the Supreme Court of the Russian Federation in order to formulate proposals for solving the indicated problems. The fundamental method was dialectical. The formal legal method was used in the study of regulations governing certain aspects of the legal assessment of unlawful acts that take into account administrative precedence. Using a comparative legal method, a distinction was made between situations where a person was ordered to be held administratively liable and an administrative penalty was imposed. Scientific publications on the subject were analyzed. It was concluded that the current version of Part 1 of Art. 282 of the Criminal Code of the Russian Federation, containing a formally indefinite legal category, raises the problem of calculating the one-year period during which a person can be prosecuted under this norm if there is an administrative precedence. In addition, it is justified that a «similar act» should be understood only as an administrative offense, responsibility for which is provided for in Art. 20.3.1 Administrative Code of the Russian Federation. The use of criminal law by analogy is unacceptable, therefore, it is proposed to amend the disposition of Part 1 of Art. 282 of the Criminal Code to eliminate the identified gap. The problem identified could be the basis for further scientific research. The practical significance is due to the fact that the positions formulated by the authors can be taken into account in the process of improving criminal law, when amending the relevant explanations of the highest court in this category of cases in order to form a unified practice of applying criminal law.

Effect of selective beta-blockade with bisoprolol in the treatment of recent-onset atrial fibrillation

Folia Medica ◽  
2012 ◽  
Vol 54 (2) ◽  
pp. 27-31 ◽  
Author(s):  
Maria N. Negreva ◽  
Atanas P. Penev
Keyword(s):  
Atrial Fibrillation ◽  
Sinus Rhythm ◽  
Combined Therapy ◽  
Beta Blockade ◽  
Recent Onset ◽  
Number Of Patients ◽  
Group A ◽  
Clinically Significant ◽  
Group B ◽  
Onset Atrial Fibrillation

ABSTRACT The incidence of atrial fibrillation has been rapidly increasing in recent years. The increased tonus of the sympathetic nervous system is related to the development of atrial fibrillation. OBJECTIVE: To study the effect of bisoprolol, a highly selective beta-blocker, on patients with recent-onset atrial fibrillation (< 48 hours) for regularization of the rhythm using propafenone. PATIENTS AND METHODS: The study includes 164 patients (81 women, 83 men, age 59.09 ± 10.81) with successfully restored sinus rhythm in recent-onset atrial fibrillation. The patients received either propafenone (group A, n = 82) or a combination of propafenone and bisoprolol (group B, n = 82). The studied patients were randomly allocated to the groups. Propafenone was administered intravenously as a 2 mg/kg bolus followed by infusion of 0.0078 mg/kg/min for 120 min and orally in dosage of 300 mg three times every 8 hours if arrhythmia persisted. Bisoprolol was administered in a single dose at the very beginning of propafenone treatment and only in patients from group B at a dose of 5 or 10 mg. Regularization of the rhythm was assessed at the 3rd, 6th, 12th and 24th hour. RESULTS: In the initial stages of regularization the combined therapy restored the sinus rhythm in a greater number of patients in comparison with the monotherapy (at the 6th hour 67.07% in group B versus 48.78% in group A, P < 0.05; at the 12th hour it was 87.80% versus 75.60%, respectively, P < 0.05). CONCLUSION: Early regularization of rhythm in patients with recent-onset atrial fibrillation reduces the likelihood of recurrent episodes of arrhythmia. This makes the application of selective beta-blockade clinically significant.

scholarly journals Risk factors for critical limb ischemia in patients undergoing femoral cannulation for venoarterial extracorporeal membrane oxygenation: Is distal limb perfusion a mandatory approach?

Perfusion ◽  
2019 ◽  
Vol 34 (6) ◽  
pp. 453-459 ◽  
Author(s):  
Tim Kaufeld ◽  
Eric Beckmann ◽  
Fabio Ius ◽  
Nurbol Koigeldiev ◽  
Wiebke Sommer ◽  
...  
Keyword(s):  
Risk Factors ◽  
Risk Factor ◽  
Extracorporeal Membrane Oxygenation ◽  
Limb Ischemia ◽  
Distal Limb ◽  
Membrane Oxygenation ◽  
Venoarterial Extracorporeal Membrane Oxygenation ◽  
Limb Perfusion ◽  
Group A ◽  
Group B

Background: Venoarterial extracorporeal membrane oxygenation support is a well-established tool in the care of severe refractory cardiac and respiratory failure. The application of this support may serve as a bridge to transplant, recovery or to implantation of a ventricular assist device. Venoarterial extracorporeal membrane oxygenation support can be administered through an open surgical access via the common femoral or axillary artery or a percutaneous approach using Seldinger technique. Both techniques may obstruct the blood flow to the lower limb and may cause a significant ischemia with possible limb loss. Malperfusion of the distal limb can be avoided using an ipsilateral distal limb perfusion, which may be established by adding a single-lumen catheter during venoarterial extracorporeal membrane oxygenation treatment to overcome the obstruction. The aim of this study is to distinguish the presence or absence of a distal limb perfusion regarding the incidence of distal limb ischemia. Furthermore, expected risk factors of open and percutaneous femoral venoarterial extracorporeal membrane oxygenation installation were evaluated for the development of distal limb ischemia. Methods: Between January 2012 and September 2015, 489 patients received venoarterial extracorporeal membrane oxygenation support at our institution. In total, 307 patients (204 male, 103 female) with femoral cannulation were included in the analysis. The cohort was distinguished by the presence (group A; n = 237) or absence (group B; n = 70) of a distal limb perfusion during peripheral venoarterial extracorporeal membrane oxygenation treatment. Furthermore, a risk factor analysis for the development of distal limb ischemia was performed. Results: The main indications for venoarterial extracorporeal membrane oxygenation therapy were a low cardiac output syndrome (LCOS) (53%) and failed weaning of extracorporeal circulation (23%). A total of 23 patients (7.49%) under venoarterial extracorporeal membrane oxygenation support developed severe distal limb malperfusion (3.38% in group A vs 21.42% in group B). Preemptive installation of distal limb perfusion extended the intervention-free intervals to 7.8 ± 19.3 days in group A and 6.3 ± 12.5 in group B. A missing distal limb perfusion (p = 0.001) was identified as a main risk factor for critical limb ischemia. Other comorbidities such as arterial occlusion disease (p = 0.738) were not statistically significantly associated. Surgical intervention due to vascular complications after extracorporeal membrane oxygenation explantation was needed in 14 cases (4.22% in group A and 5.71% in group B). Conclusion: We were able to identify the absence of distal limb perfusion as an independent risk factor for the development of critical distal limb ischemia during femoral venoarterial extracorporeal membrane oxygenation treatment. The application of a distal limb perfusion should be considered as a mandatory approach in the context of femoral venoarterial extracorporeal membrane oxygenation treatment regardless of the implantation technique.

scholarly journals Effect of Germanium-Embedded Knee Sleeve on Osteoarthritis of the Knee

2019 ◽  
Vol 7 (10) ◽  
pp. 232596711987912 ◽  
Author(s):  
Katherine Marino ◽  
Rachel Lee ◽  
Paul Lee
Keyword(s):  
United Kingdom ◽  
Los Angeles ◽  
Skin Irritation ◽  
Oxford Knee Score ◽  
Osteoarthritis Of The Knee ◽  
Knee Oa ◽  
The United Kingdom ◽  
Group A ◽  
Clinically Significant ◽  
Group B

Background: Knee osteoarthritis (OA) affects an estimated 1 in 5 individuals older than 45 years of age in the United Kingdom. Previous studies have suggested that germanium-infused garments may provide improved clinical outcomes in OA. Germanium-embedded (GE) knee sleeves embrace this fabric technology. Purpose: To assess the outcomes of GE knee sleeves for patients with knee OA. Study Design: Cohort study; Level of evidence, 2. Methods: This study was undertaken at a hospital in the United Kingdom. Patients who had radiographic features of OA, experienced knee pain for at least 6 months, and opted for nonsurgical intervention were included. Patients were recruited over 3 months. The University of California, Los Angeles activity score, Lysholm score, visual analog scale (VAS) score, and Oxford Knee Score (OKS) were collected at monthly intervals for 6 months. Patients were followed to determine their compliance with wearing the knee sleeves at all times, as advised, and whether any adverse effects had occurred. Results: A total of 50 participants were recruited for the study; 4 participants were excluded due to pain and were converted to surgical management. Therefore, 46 patients were analyzed and placed into 2 groups according to severity of OA, as classified by the Kellgren-Lawrence system: group A had grade 1 or 2 OA, and group B had grade 3 or 4 OA. There were 25 patients in group A and 21 in group B. Improvements were seen in OKS, VAS, and Lysholm scores in both groups. Clinically significant improvements were seen in group A only for OKS (mean increase, 14), VAS (mean decrease, 4.1), and Lysholm (mean increase, 17.2) scores. These results were also statistically significant (OKS, P = 5.8 × 10-7; VAS, P = 7.7 × 10-12; Lysholm, P = 4.2 × 10-11). The data from this study demonstrated that GE knee sleeves gave better outcomes for patients with grades 1 and 2 OA compared with patients with more advanced disease, which is consistent with previous studies. A total of 3 patients reported skin irritation, which resolved with simple skin ointment application. No patients reported infection, deep vein thrombosis, or circulation problems. Conclusion: GE knee sleeves could play an important role in optimizing nonsurgical management of patients with knee OA, especially patients with grades 1 and 2 OA, as demonstrated by the clinically significant improvements.

scholarly journals A Retrospective Audit of Clinically Significant Maternal Bacteraemia in a Specialist Maternity Hospital from 2001 to 2014

2015 ◽  
Vol 2015 ◽  
pp. 1-4 ◽  
Author(s):  
Richard John Drew ◽  
Zara Fonseca-Kelly ◽  
Maeve Eogan
Keyword(s):  
Blood Culture ◽  
Positive Blood Culture ◽  
Maternal Blood ◽  
Maternity Hospital ◽  
E Coli ◽  
Live Births ◽  
Retrospective Audit ◽  
Group A ◽  
Clinically Significant ◽  
Group B

Maternal sepsis is a significant problem in obstetrics, with almost one in four maternal deaths related to severe sepsis. We carried out a retrospective review of clinically significant bacteraemia in obstetric patients attending Rotunda Hospital over 14 years. From 2001 to 2014, there were 252 clinically significant positive blood culture episodes in obstetric patients. There were 112,361 live births >500 g during the study period giving an overall rate of 2.24 clinically significant positive maternal blood culture episodes per 1000 live births >500 g. The median rate over the 14 years was 2.12 episodes per 1000 live births >500 g, with an interquartile range of 1.74–2.43 per 1000 live births >500 g. There was no discernable increasing or decreasing trend over the 14 years.E. coliwas the most commonly isolated organism (n= 92/252, 37%), followed by group BStreptococcus(n= 64/252, 25%),Staphylococcus aureus(n= 28/252, 11%), and anaerobes (n= 11/252, 4%). These top four organisms represented three-quarters of all positive blood culture episodes (n= 195/252, 77.3%). Of note, there were only five cases of listeriosis, representing a rate of 4.4 cases per 100,000 live births >500 g. The rate of invasive group A streptococcal infection was also very low at 5.3 cases per 100,000 live births >500 g.

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