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.

scholarly journals Complicated Posterior Cervical Skin and Soft Tissue Infections at a Single Referral Center

2020 ◽  
Vol 2020 ◽  
pp. 1-10
Author(s):  
Jing-Chun Zhao ◽  
Xiu-Hang Zhang ◽  
Nan Zhang ◽  
Zhen-Dong Wu ◽  
Jian Wang ◽  
...  
Keyword(s):  
Soft Tissue ◽  
Hospital Stay ◽  
Clinical Symptoms ◽  
Retrospective Chart Review ◽  
Final Diagnosis ◽  
Predisposing Factors ◽  
Soft Tissue Infections ◽  
Predisposing Factor ◽  
Incidence And Mortality ◽  
Complicated Skin

Background. Although the incidence and mortality of complicated skin and soft tissue infections have decreased, this infection is still relatively frequent and can be associated with lethal complications. In this study, the authors present our clinical experience of patients with complicated posterior cervical skin and soft tissue infections (CPCSSTIs) diagnosed and treated in a reconstructive unit in northeastern China. Methods. A retrospective chart review of patients diagnosed with CPCSSTIs from January 2009 to December 2018 was performed. To make the results objective and convincing, a data analysis was performed relating to demographic characteristics, clinical presentation, predisposing factor, bacterial culture, laboratory and radiographic evaluations, diagnostic clues, management, and complications as well as the clinical course and outcome. Results. During the ten-year period, there were 174 consecutive patients admitted to our reconstructive center with final diagnosis of CPCSSTIs included. All the patients were adults, and the majority were male (67.2%). The patient’s mean age was 51.3 years (range, 15-88 years). There were 114 patients (65.5%) that had associated systemic diseases, with diabetes mellitus (40.2%) as the most common predisposing factor. Common presented clinical symptoms were pain (90.8%), swelling (85.1%), and erythema (77%) of the neck. Surgical treatment was performed in all the patients, and most of them (83.9%) received the first surgery within 24 h. The most commonly isolated pathogen was Staphylococcus aureus (30%). Vancomycin (21.3%) was the most commonly used antibiotics, followed by cefepime (18.4%). All the patients survived and were discharged with a mean duration of hospitalization of 28.7 days. Those patients with predisposing factors (31.4±12.35 days) or complications (41.0±12.5 days) tended to have a longer hospital stay. The mean total costs of admission per patient were 47 644 RMB. Conclusion. This study highlights the high cost burden of CPCSSTI patients. Those patients with predisposing factors or complications tended to have a longer hospital stay.

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).

When 'home' means another nation: The power and pitfalls of repatriation at the end of life from a tertiary cancer centre.

2016 ◽  
Vol 34 (26_suppl) ◽  
pp. 46-46
Author(s):  
Ros Taylor
Keyword(s):  
End Of Life ◽  
Chart Review ◽  
Community Setting ◽  
Retrospective Chart Review ◽  
Metabolic Effects ◽  
Loved One ◽  
Cancer Centre ◽  
Windows Of Opportunity ◽  
Knowledge Deficit

46 Background: How people die lives on in the memory of those who survive. It is therefore pivotal for palliative teams to help craft an ending in line with patient and family goals. It has been observed in a tertiary cancer centre that there is often a spiritual imperative for patients to return to their nation of birth, once treatment is stopped and mortality accepted. Methods: Retrospective chart review of 3 patients repatriated for end of life care to their nation of birth (Romania, Portugal, Ireland), focusing on: the conversations about the goal of repatriation and its meaning to the patient; the practical barriers and enablers of repatriation of patients with advanced cancer. Follow-up interview with bereaved families to establish impact of repatriation. Results: Chart review revealed multi-layered hesitant conversations, often facilitated by the palliative care team, to establish that getting ‘home’ meant returning to the country of birth. This became an overarching pre-occupation for the patient, family and team. Patients were not concerned whether they were transferred to a hospital, hospice or family home – it was the country that mattered. There was huge anxiety and little objectivity about fitness to travel. Nurses were more anxious than doctors. Patient and family expressed least anxiety. There was a knowledge deficit regarding fitness to fly, whether an escort was needed, the respiratory and metabolic effects of flight, and how to maximize wellbeing on the journey. Reassurance was gained if the transfer was to a hospital, with greater concern if the transfer was to a community setting. Follow-up interviews with bereaved families are still in progress. Initial findings suggest no regrets in terms of the decision to fly home, and that self-esteem improved with familiarity and social connection. Conclusions: The practical anxieties of health professionals often act as delays to repatriation at the end of life. Checklists to facilitate these journeys would ensure that the process does not need to be learnt each time, and that windows of opportunity are not missed. Achievement of spiritual goals for a loved one is hugely important to those who live on.

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