scholarly journals Pattern of antimicrobial usage for prophylaxis of surgical site infection in a tertiary care hospital of Western Uttar Pradesh

2019 ◽  
Vol 8 (3) ◽  
pp. 534
Author(s):  
Parul Kesar ◽  
Surabhi Gupta ◽  
H. L. Bhalla ◽  
Anita Panday
Keyword(s):  
Tertiary Care Hospital ◽  
Antimicrobial Prophylaxis ◽  
Tertiary Care ◽  
Uttar Pradesh ◽  
Surgical Site Infections ◽  
Blood Stream ◽  
Optimal Time ◽  
P Value ◽  
Care Hospital ◽  
Tract Infections

Background: The practice of giving antibiotic prophylaxis has resulted in the reduction of surgical site infections (SSI), thus reducing cost, morbidity, and mortality. Common nosocomial infections in surgical patients include SSIs, urinary tract infections (UTIs), pneumonias and blood stream infections (BSIs). The present study was, therefore, designed to analyze the efficacy of antimicrobials used for prophylaxis during surgery in a tertiary care hospital in India.Methods: Total 100 patients were enrolled. Name, timing, route, dose of antimicrobials given were recorded. All the relevant data was taken from the patient’s medication charts and medical records. Chi-square test and t-test were applied.Results: The optimal time of giving antimicrobial prophylaxis in present study was 1 hour before the surgery. A total of 8 different antimicrobials were prescribed to 100 patients, out of which most commonly prescribed were cephalosporin i.e. 82%. Majority of SSI (57.12%) occurred when the duration of surgical antimicrobial prophylaxis (SAP) was for ≥2 hours (p value <0.05). Common organisms seen in SSI were E. coli, S. aureus, Pseudomonas and Kleibsella species. The hospital stay of patients with SSI was more as compared to patients without SSI in present study (p value <0.05).Conclusions: It has been observed that inappropriate selection and timing of giving SAP play an important role in developing SSI, which can be adequately controlled by adopting SAP guidelines, good infection control practices and risk factor analysis.

scholarly journals Implementation of Antimicrobial Stewardship Measures in Cardiac Surgery: Change of Protocol for Surgical Antibiotic Prophylaxis and Its Impact on Surgical Site Infections

2020 ◽  
Author(s):  
Güzin Surat ◽  
Dominik Bernsen ◽  
Christoph Schimmer
Keyword(s):  
Cardiac Surgery ◽  
Antimicrobial Stewardship ◽  
Antimicrobial Prophylaxis ◽  
Tertiary Care ◽  
Surgical Site Infections ◽  
Care Hospital ◽  
Wound Infections ◽  
Surgical Antimicrobial Prophylaxis ◽  
Tract Infections ◽  
The Impact

Abstract Objectives:The goal of this study was to evaluate the impact on a protocol change of surgical antimicrobial prophylaxis in cardiac surgery comparing the new in hospital prophylactic agent cefazolin versus the former standard antibiotic cefuroxime, initiated by the antimicrobial stewardship team. Methods: This retrospective observational study was performed in a tertiary care hospital in collaboration with the department of cardiothoracic surgery and the antimicrobial stewardship team following a new recommendation of the surgical antimicrobial prophylaxis and included 1029 patients who underwent cardiac surgery. Two patient groups including 582 patients receiving Cefuroxime and 447 patients receiving Cefazolin respectively were compared without altering any other preventative perioperative measures. Adherence, overall infection rates, leg wound infections and deep sternal wound infections were compiled and analysed as well as a broad profile of preoperative, intraoperative and postoperative patient data. Results:A complete adherence on the change of the agent was achieved.Overall surgical site infections occurred in 37 (6.6%) of the cases, with 20 (3,4%) SSI in cefuroxime patients and 17 (3,8%) in cefazolin patients (p-value=0,754). No statistically significant differences could be found in any of the primary and secondary endpoints including DSWI (2,1% for cefuroxime, 1,3% for cefazolin), vein harvesting site infections (1,2% for cefuroxime, 2,2% for cefazolin) as well as urinary tract infections, pneumonia, sepsis and overall mortality of all causes. Conclusions:These results demonstrate that compliance to antimicrobial stewardship standards is not associated with more surgical site infections.

scholarly journals Antimicrobial stewardship measures in cardiac surgery and its impact on surgical site infections

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Güzin Surat ◽  
Dominik Bernsen ◽  
Christoph Schimmer
Keyword(s):  
Cardiac Surgery ◽  
Antimicrobial Stewardship ◽  
Antimicrobial Prophylaxis ◽  
Tertiary Care ◽  
Surgical Site Infections ◽  
Antibiotic Use ◽  
P Value ◽  
Care Hospital ◽  
Surgical Antimicrobial Prophylaxis ◽  
Sternal Wound Infections

Abstract Objective The goal of this study was to monitor the compliance and impact on a protocol change of surgical antimicrobial prophylaxis in cardiac surgery favouring cefazolin instead cefuroxime, initiated by the hospital’s antimicrobial stewardship team. Methods This quality improvement study was performed in a tertiary care hospital in collaboration with the department of cardiothoracic surgery and the hospitals antimicrobial stewardship team following a revision of the standard for surgical antimicrobial prophylaxis including 1029 patients who underwent cardiac surgery. 582 patients receiving cefuroxime and 447 patients receiving cefazolin respectively were compared without altering any other preventative perioperative measures including its postoperative duration of less than 24 h. Adherence and surgical site infections were compiled and analysed. Results A complete adherence was achieved. Overall surgical site infections occurred in 37 (3.6%) of the cases, 20 (3.4%) in cefuroxime patients and 17 (3.8%) in cefazolin patients (p value = 0.754). No statistically significant differences could be found in any of the primary endpoints, but there was a trend towards less deep sternal wound infections in the cefazolin group. Conclusions The study supports the role of antimicrobial stewardship in cardiac surgery and mirrors the success of a multidisciplinary team aiming to minimize adverse events by optimizing antibiotic use.

scholarly journals Modelling of COVID-19 positive cases at tertiary care hospital of Bundelkhand region of Uttar Pradesh using regression models

2021 ◽  
Vol 8 (4) ◽  
pp. 1899
Author(s):  
Suneel Kumar Kaushal ◽  
Navin Kumar ◽  
Mukesh Yadav ◽  
Ashok Kumar Patel
Keyword(s):  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Uttar Pradesh ◽  
Signs And Symptoms ◽  
P Value ◽  
Care Hospital ◽  
Age Group ◽  
Human Beings ◽  
Male Population ◽  
Cubic Model

Background: Corona viruses signify a most important group of viruses mostly affecting human beings. It is a respiratory infection with common signs and symptoms of fever, cough, sore throat, headache, and loss of taste, loss of smell, respiratory symptoms. In India till 31st December 2020, the total number of confirmed cases were 1,02,86,310; with active number of cases were 2,52,699 number of cases recovered were 98,81,732 while number of deaths were 1,49,018. Objective of the study was to find the quadratic and cubic model of COVID-19 positive cases at tertiary care hospital of Bundelkhand region of Uttar Pradesh.Methods: A hospital based study was carried out with confirmed covid-19 cases admitted to Government Medical College Banda, UP. 1486 cases have been taken from the period of 1st April 2020 up to 31st December 2020.Results: In this study maximum cases (30.14%) belongs to the age group of 30-45 years. Male population is more than females in all districts. In this study the cubic model shows the best fit with the highest R-square value. Difference in the proportion in each age group (p value<0.001) and sign and symptoms (p value < 0.001) were statistically significant.Conclusions: The current study focused on presenting trends in the Bundelkhand region, Uttar Pradesh with respect to the outbreak of COVID-19. The spread of COVID-19 cases follow cubic model. We conclude that cases of COVID-19 will decline in the coming days heading towards the reduction in daily number of cases. 

scholarly journals SURGICAL SITE INFECTIONS, AN EXPERIENCE AT TERTIARY CARE HOSPITAL

2021 ◽  
Vol 12 (3) ◽  
Author(s):  
Lailama Shah ◽  
Shahzada Amir Muhammad Baber ◽  
Shabir Ahmed Lehri ◽  
Muhammad iqbal Khan ◽  
Ibrahim Baloch
Keyword(s):  
Surgical Site Infection ◽  
Tertiary Care Hospital ◽  
Antimicrobial Prophylaxis ◽  
Tertiary Care ◽  
Medical Institute ◽  
P Value ◽  
Care Hospital ◽  
Site Infection ◽  
Cross Sectional ◽  
Duration Of Surgery

BACKGROUND & OBJECTIVE: Surgical site (SSI) infections are important cause of morbidity and mortality in admitted patients worldwide. The objective is to determine the incidence of surgical site infection in General Surgical ward of tertiary care hospital. METHODOLOGY: Analytical cross-sectional study conducted at Department of General Surgery, Bolan Medical College/ Post-Graduate Medical Institute Quetta (PGMI) for a period of one year from 1st August 2019 to 31st July 2020.  Descriptive statistics were used to present social economics, factors related to surgery and surgical antimicrobial prophylaxis received. Chi square test was used for checking association between infections and different factors keeping p≤ 0.05 as significant. RESULTS: A total of 1500 patients underwent surgery, of which 500 (33.33%) patients were operated as elective cases and 1000 (66.66%) cases as emergency. Out of total 600 (40%) patients developed Surgical Site Infection (SSI). Risk associated with higher incidence of SSI was found to be age (30-45 years) and Diabetes mellitus (uncontrolled diabetes in perioperative period). Postoperatively obesity was noted to be having significant effect with p=0.002, American Society of Anesthesiologists (ASA) score having p-value 0.045, hospital stay with p<0.001 and surgical type and previous surgical history with p<0.001, were as duration of surgery was having <0.001. CONCLUSION: Prevention of SSI’s requires a multipronged approach with emphasis on optimizing preoperative issues, adhering to strict protocols during the intraoperative period and addressing and optimizing metabolic and nutritional status in post-operative period.

Healthcare associated infections caused by non-fermenting Gram negative rods (NFGNR): six years of experience of a tertiary hospital

2013 ◽  
Vol 7 (2) ◽  
pp. 06-12
Author(s):  
Zahidul Hasan ◽  
Md. Kamrul Islam ◽  
Arifa Hossain
Keyword(s):  
Blood Stream Infection ◽  
Tertiary Care ◽  
Blood Stream ◽  
Tertiary Hospital ◽  
Healthcare Associated Infections ◽  
Care Hospital ◽  
Gram Negative ◽  
Acinetobacter Spp ◽  
Tract Infections ◽  
Healthcare Associated

Recently non-fermenting Gram negative rods (NFGNR) are playing an important role in healthcare associated infections. This observational study in a tertiary care hospital of Dhaka city conducted during 01August 2007 to 30 June 2013 found that 34.8% isolated organisms from patients with healthcare associated infections were NFGNR. Majority (74.3 %) of these infections were occurring inside critical care areas. Pseudomonas and Acinetobacter together constituted 79.6% of the total NFGNR whereas Burkholderia cephacia complex (15.4%), Stenotrophomonas (4.3%) and Chryseobacterium species (0.7%) combined constituted remaining 20.4%. Out of total NFGNRs, Pseudomonas was responsible for highest number of catheter associated urinary tract infections (55.6%), ventilator associated pneumonia (46.3%), respiratory tract infection (65.8%) and surgical site infection (70.6%). Blood stream infection was predominantly caused by Burkholderia cephacia complex (33.5%) and Acinetobacter spp. (39.5%). Other than colistin most of the organisms were resistant to antibiotics commonly recommended for NFGNR.DOI: http://dx.doi.org/10.3329/bjmm.v7i2.19326 Bangladesh J Med Microbiol 2013; 07(02): 6-12

scholarly journals In Vitro activity of a Novel Benzoquinolizine Antibiotic, Levonadifloxacin (WCK 771) against Blood Stream Gram-Positive Isolates from a Tertiary Care Hospital

2020 ◽  
Vol 12 (03) ◽  
pp. 230-232
Author(s):  
Dhruv Mamtora ◽  
Sanjith Saseedharan ◽  
Ritika Rampal ◽  
Prashant Joshi ◽  
Pallavi Bhalekar ◽  
...  
Keyword(s):  
Staphylococcus Aureus ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Blood Stream ◽  
Tolerability Profile ◽  
Care Hospital ◽  
Coagulase Negative Staphylococci ◽  
Gram Positive ◽  
Methicillin Resistant

Abstract Background Blood stream infections (BSIs) due to Gram-positive pathogens such as methicillin-resistant Staphylococcus aureus (MRSA) are associated with high mortality ranging from 10 to 60%. The current anti-MRSA agents have limitations with regards to safety and tolerability profile which limits their prolonged usage. Levonadifloxacin and its oral prodrug alalevonadifloxacin, a novel benzoquinolizine antibiotic, have recently been approved for acute bacterial skin and skin structure infections including diabetic foot infections and concurrent bacteremia in India. Methods The present study assessed the potency of levonadifloxacin, a novel benzoquinolizine antibiotic, against Gram-positive blood stream clinical isolates (n = 31) collected from January to June 2019 at a tertiary care hospital in Mumbai, India. The susceptibility of isolates to antibacterial agents was defined following the Clinical and Laboratory Standard Institute interpretive criteria (M100 E29). Results High prevalence of MRSA (62.5%), quinolone-resistant Staphylococcus aureus (QRSA) (87.5%), and methicillin-resistant coagulase-negative staphylococci (MR-CoNS) (82.35%) were observed among bacteremic isolates. Levonadifloxacin demonstrated potent activity against MRSA, QRSA, and MR-CoNS strains with significantly lower minimum inhibitory concentration MIC50/90 values of 0.5/1 mg/L as compared with levofloxacin (8/32 mg/L) and moxifloxacin (2/8 mg/L). Conclusion Potent bactericidal activity coupled with low MICs support usage of levonadifloxacin for the management of BSIs caused by multidrug resistant Gram-positive bacteria.

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