scholarly journals Acute haematogenous osteomyelitis: microbial conversion and unusual age presentation

2000 ◽  
Vol 6 (1) ◽  
pp. 89-92
Author(s):  
H. A. Mousa ◽  
M. G. Abaid

From 1983 to 1989, 110 cases of haematogenous osteomyelitis were studied retrospectively. The most commonly affected were children under 1 year. No adult cases were reported. Staphylococcus aureus was isolated from 72.7% of cases. During 1992-1997, 80 cases were studied prospectively. The most commonly affected were children aged 9 years. This group included 19 adults. S. aureus was isolated from 43.7% of the cases. There was a clear difference in the incidence of S. aureus and age presentation in the cases before and after the Gulf conflict. Working children and malnutrition might have caused changes in the infecting organisms and age presentation in recent years

Author(s):  
Е.Б. Ганина ◽  
Ю.В. Червинец ◽  
Н.В. Грудинин ◽  
В.Г. Шестакова ◽  
В.М. Червинец ◽  
...  

Цель исследования - охарактеризовать микробиологическую картину стоматита до и после его лечения высокоактивными культурами лактобацилл, дать оценку эффективности их применения при экспериментальном стоматите. Методика. Опыты проводились на 32 самках беспородных белых крыс массой 230 г. Моделирование стоматита включало 2 этапа: моделирование травматического стоматита и воспроизведение бактериального стоматита на базе травматического. У крыс контрольной и опытных серий на всех этапах эксперимента брали мазки с поверхности десен для характеристики микробиоценоза ротовой полости. Результаты. После обработки слизистой оболочки полости рта (СОПР) культурой патогенного штамма Staphylococcus aureus существенно снизились частота встречаемости и количество условно-патогенных микроорганизмов. Лечение стоматита у крыс культурами лактобацилл ( Lactobacillus 11 зв., Lactobacillus 2 п.рта, Lactobacillus 24 д.ст.) и их комбинацией приводило к снижению распространенности S. aureus вплоть до его исчезновения, а также к нормализации количества условно-патогенной микробиоты. Заключение. Исследования показали эффективность использования отдельных высокоактивных штаммов лактобацилл или их комбинации при лечении заболеваний СОПР, в частности бактериального стоматита. Aim. To characterize the microbiological picture of stomatitis in intact rats before and after the treatment with highly active cultured lactobacilli and to evaluate the effectiveness of this treatment in experiments on white rats. Methods. Experiments were carried out on 32 mongrel female white rats weighing 230 g. Smears were taken from the gum surface of control and experimental rats at all stages of the experiment to characterize the oral cavity microbiocenosis. Results. After treatment of the oral cavity with cultured Staphylococcus aureus , the occurrence and quantity of opportunistic microorganisms significantly decreased. The treatment of stomatitis in rats with cultured lactobacillus ( Lactobacillus 11 zv., Lactobacillus 2 p.r., Lactobacillus 24 d.st. and their combination) led to a decrease in S. aureus prevalence up to its extinction and to normalization of the quantitative composition of opportunistic microbiota. Conclusions. The study showed the effieacy of highly active lactobacillus strains individually or their combinations in the treatment of oral diseases, in particular, bacterial stomatitis.


2014 ◽  
Vol 35 (3) ◽  
pp. 243-250 ◽  
Author(s):  
Melissa A. Viray ◽  
James C. Morley ◽  
Craig M. Coopersmith ◽  
Marin H. Kollef ◽  
Victoria J. Fraser ◽  
...  

Objective.Determine whether daily bathing with chlorhexidine-based soap decreased methicillin-resistant Staphylococcus aureus (MRSA) transmission and intensive care unit (ICU)-acquired S. aureus infection among ICU patients.Design.Prospective pre-post-intervention study with control unit.Setting.A 1,250-bed tertiary care teaching hospital.Patients.Medical and surgical ICU patients.Methods.Active surveillance for MRSA colonization was performed in both ICUs. In June 2005, a chlorhexidine bathing protocol was implemented in the surgical ICU. Changes in S. aureus transmission and infection rate before and after implementation were analyzed using time-series methodology.Results.The intervention unit had a 20.68% decrease in MRSA acquisition after institution of the bathing protocol (12.64 cases per 1,000 patient-days at risk before the intervention vs 10.03 cases per 1,000 patient-days at risk after the intervention; β, −2.62 [95% confidence interval (CI), −5.19 to −0.04]; P = .046). There was no significant change in MRSA acquisition in the control ICU during the study period (10.97 cases per 1,000 patient-days at risk before June 2005 vs 11.33 cases per 1,000 patient-days at risk after June 2005; β, −11.10 [95% CI, −37.40 to 15.19]; P = .40). There was a 20.77% decrease in all S. aureus (including MRSA) acquisition in the intervention ICU from 2002 through 2007 (19.73 cases per 1,000 patient-days at risk before the intervention to 15.63 cases per 1,000 patient-days at risk after the intervention [95% CI, −7.25 to −0.95]; P = .012)]. The incidence of ICU-acquired MRSA infections decreased by 41.37% in the intervention ICU (1.96 infections per 1,000 patient-days at risk before the intervention vs 1.15 infections per 1,000 patient-days at risk after the intervention; P = .001).Conclusions.Institution of daily chlorhexidine bathing in an ICU resulted in a decrease in the transmission of S. aureus, including MRSA. These data support the use of routine daily chlorhexidine baths to decrease rates of S. aureus transmission and infection.


2018 ◽  
Vol 12 (1) ◽  
pp. 36-44 ◽  
Author(s):  
Aires G. Santos-Junior ◽  
Adriano M. Ferreira ◽  
Oleci P. Frota ◽  
Marcelo A. Rigotti ◽  
Larissa da S. Barcelos ◽  
...  

Background: Failures in the processes of cleaning and disinfecting health service surfaces may result in the spread and transfer of pathogens that are often associated with healthcare-related infections and outbreaks. Aims: To assess the effectiveness of environmental surface cleaning and disinfection in a hospital clinic. Method: The study was conducted in a nursing ward with 45 beds. A total of 80 samples from five high-touch surfaces were evaluated before and after cleaning and disinfection, using the following methods: visual inspection, adenosine triphosphate bioluminescence assay, aerobic colony count, Staphylococcus aureus colony count, and evaluation of resistance to methicillin. The data analysis used nonparametric comparative and correlative tests to observe any differences in the pre- and post- cleaning and disinfection results for the surfaces assessed. Results: Effective cleaning and disinfection had a significant effect on only two surfaces when measured for the presence of adenosine triphosphate, the inner bathroom door handle (p=0.007) and the toilet bowl (p=0.01). When evaluated for Staphylococcus aureus colony count, the toilet flush handle also demonstrated a significant effect (p=0.04). Conclusion: The effectiveness of cleaning and disinfection of the surfaces tested was not satisfactory. An educational intervention is recommended for the cleaning and disinfection staff and the nursing team at the healthcare facility. Relevance to Clinical Practice: The data in the study revealed that daily hospital cleaning and disinfection in the sampled sites are not sufficient in medical and surgical wards. Hospital cleanliness must be reevaluated from the point of view of materials, such as an adequate supply of clean cloths, in addition to establishing more precise cleanliness protocols and accurate monitoring systems.


2018 ◽  
Vol 7 (2) ◽  
pp. 125-139
Author(s):  
Thais Nogueira Gonzaga ◽  
Dora Inés Kozusny-Andreani

Nesta pesquisa objetivou-se avaliar a viabilidade técnica da aplicação de ozônio como bactericida e fungicida em amostras de resíduos de serviços de saúde potencialmente infectantes. Foram determinados os     micro-organismos presentes nos resíduos gerados em um hospital particular. Para realização das análises microbiológicas e o tratamento com ozônio o material foi particulado e homogeneizado. As análises microbiológicas foram realizadas antes e após a ozonização.Para os testes de desinfecção foram retirados 10,0g de amostra que foi submetida à ozonização por 5, 10, 15, 20 e 25 minutos com doses de 140,0; 280,0; 420,0; 560,0 e 700,0mg L-1 de ozônio, respectivamente. Verificou-se presença de mesófilos totais, coliformes totais e termotolerantes, Escherichia coli, Pseudomonas aeruginosa, Proteus spp., Staphylococcus aureus, Staphylococcus spp, Candida albicans e Rhizopus spp. O ozônio foi eficiente para eliminação de todos os micro-organismos em 20 minutos; nos primeiros cinco minutos de exposição ao gás verificou-se redução superior a 98%.Palavras-chave: Bactérias patogênicas. Fungos. Ozonização. USING OZONE GAS FOR DISINFECTION OF SOLID WASTE FROM HEALTH CARE SERVICES ABSTRACT: The aim of this research was to evaluate the technical viability of the application of ozone as bactericide and fungicide in samples of potentially infectious health services residues. The microorganisms present in the waste generated in a private hospital were determined. The material was particulated and homogenized to perform the microbiological analysis and to undergo ozone treatment. Microbiological analysis was performed before and after ozonization. For the disinfection tests, 10.0g of sample were removed and submitted to ozonization for 5, 10, 15, 20 and 25 minutes with 140,0; 280,0; 420,0; 560,0 and 700,0mg doses of L-1 of ozone, respectively. It was verified the presence of total mesophiles, total and thermotolerant coliforms, Escherichia coli, Pseudomonas aeruginosa, Proteus spp., Staphylococcus aureus, Staphylococcus spp, Candida albicans and Rhizopus spp. Ozone was efficient while eliminating all microorganisms in 20 minutes; in the first five minutes of gas exposure, the reduction was greater than 98%.Keywords: Pathogenic bacteria. Fungi. Ozonization.


Antibiotics ◽  
2020 ◽  
Vol 9 (4) ◽  
pp. 141
Author(s):  
Iris Kobusch ◽  
Hannah Müller ◽  
Alexander Mellmann ◽  
Robin Köck ◽  
Marc Boelhauve

In countries with intensive pig husbandry in stables, the prevalence of livestock-associated (LA) methicillin-resistant Staphylococcus aureus (MRSA) on such farms has remained high in the last few years or has also further increased. Simple measures to reduce the LA-MRSA among pigs have not yet been successfully implemented. Earlier publications showed a decontamination of LA-MRSA was only possible with great effort. The aim of this study is to determine the suitability of routine cleaning and disinfection (C&D) for adequate LA-MRSA decontamination. For this purpose, at least 115 locations in a piglet-rearing compartment were examined before and after cleaning and disinfection. The sample locations were stratified according to accessibility for pigs and the difficulty of cleaning. The cleaning work was carried out routinely by farm employees, who were not informed about the sampling (single blinded). While before cleaning and disinfection, 85% of the samples from the surfaces were LA-MRSA positive, while only 2% were positive thereafter. All LA-MRSA-positive samples after cleaning and disinfection were outside the animal area. Air samples also showed no LA-MRSA after cleaning and disinfection. Conclusion: In well-managed livestock farms, decontamination of the LA-MRSA barn is quite possible; after C&D no LA-MRSA was detectable at animal height.


2003 ◽  
Vol 23 (5) ◽  
pp. 456-459 ◽  
Author(s):  
Beth Piraino ◽  
Judith Bernardini ◽  
Tracey Florio ◽  
Linda Fried

Objective To examine gram-negative exit-site infection and peritonitis rates before and after the implementation of Staphylococcus aureus prophylaxis in peritoneal dialysis (PD) patients. Design Prospective data collection with periodic implementation of protocols to decrease infection rates in two PD programs. Patients 663 incident patients on PD. Interventions Implementation of S. aureus prophylaxis, beginning in 1990. Main Outcome Measures Rates of S. aureus, gram-negative, and Pseudomonas aeruginosa exit-site infections and peritonitis. Results Staphylococcus aureus exit-site infection and peritonitis rates fluctuated without significant trends during the first decade (without prophylaxis), then began to decline during the 1990s subsequent to implementation of prophylaxis, reaching levels of 0.02/year at risk and zero in the year 2000. Gram-negative infections fell toward the end of the 1980s, due probably to the implementation of better connectology. However, there have been no significant changes for the past 6 years. There was little change in P. aeruginosa infections over the entire time period. Pseudomonas aeruginosa is now the most common cause of catheter infection and catheter-related peritonitis. Conclusions Prophylaxis against S. aureus is highly effective in reducing the rate of S. aureus infections but has no effect on gram-negative infections. Pseudomonas aeruginosa is now the most serious cause of catheter-related peritonitis.


2020 ◽  
Vol 41 (8) ◽  
pp. 921-925
Author(s):  
Tara H. Lines ◽  
Whitney J. Nesbitt ◽  
Matthew H. Greene ◽  
George E. Nelson

AbstractObjective:To evaluate the impact of a pharmacist-driven Staphylococcus aureus bacteremia (SAB) safety bundle supported by leadership and to compare compliance before and after implementation.Design:Retrospective cohort study with descriptive and before-and-after analyses.Setting:Tertiary-care academic medical center.Patients:All patients with documented SAB, regardless of the source of infection, were included. Patients transitioned to palliative care were excluded from before-and-after analysis.Methods:A pharmacist-driven safety bundle including documented clearance of bacteremia, echocardiography, removal of central venous catheters, and targeted intravenous therapy of at least 2 weeks duration was implemented in November 2015 and was supported by leadership with stepwise escalation for nonresponse. A descriptive analysis of all patients with SAB during the study period included pharmacy interventions, acceptance rates, and escalation rates. A pre–post implementation analysis of 100 sequential patients compared bundle compliance and descriptive parameters.Results:Overall, 391 interventions were made in the 20-month period following implementation, including 20 “good saves” avoiding potentially major adverse events. No statistically significant differences in complete bundle compliance were detected between the periods (74% vs 84%; P = .08). However, we detected a significant increase in echocardiography after the bundle was implemented (83% vs 94%; P = .02) and fewer patients received suboptimal definitive therapy after the bundle was implemented (10% vs 3%; P = .045).Conclusions:This pharmacist-driven SAB safety bundle with leadership support showed improvement in process measures, which may have prevented major adverse events, even with available infectious diseases (ID) consultation. It provides a critical safety net for institutions without mandatory ID consultation or with limited antimicrobial stewardship resources.


2017 ◽  
Vol 57 (6) ◽  
pp. 660-666 ◽  
Author(s):  
Courtney E. Nelson ◽  
Aaron Chen ◽  
Lisa McAndrew ◽  
Khoon-Yen Tay ◽  
Fran Balamuth

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).


2017 ◽  
Vol 61 (4) ◽  
Author(s):  
Nidhu Baby ◽  
Andrew C. Faust ◽  
Terri Smith ◽  
Lyndsay A. Sheperd ◽  
Laura Knoll ◽  
...  

ABSTRACT The objective of this study was to evaluate the impact of pharmacist-ordered methicillin-resistant Staphylococcus aureus (MRSA) PCR testing on the duration of empirical MRSA-targeted antibiotic therapy in patients with suspected pneumonia. This is a retrospective analysis of patients who received vancomycin or linezolid for suspected pneumonia before and after the implementation of a pharmacist-driven protocol for nasal MRSA PCR testing. Patients were included if they were adults of >18 years of age and initiated on vancomycin or linezolid for suspected MRSA pneumonia. The primary endpoint was the duration of vancomycin or linezolid therapy. After screening 368 patients, 57 patients met inclusion criteria (27 pre-PCR and 30 post-PCR). Baseline characteristics were similar between the two groups, with the majority of patients classified as having health care-associated pneumonia (68.4%). The use of the nasal MRSA PCR test reduced the mean duration of MRSA-targeted therapy by 46.6 h (74.0 ± 48.9 h versus 27.4 ± 18.7 h; 95% confidence interval [CI], 27.3 to 65.8 h; P < 0.0001). Fewer patients in the post-PCR group required vancomycin serum levels and dose adjustment (48.1% versus 16.7%; P = 0.02). There were no significant differences between the pre- and post-PCR groups regarding days to clinical improvement (1.78 ± 2.52 versus 2.27 ± 3.34; P = 0.54), length of hospital stay (11.04 ± 9.5 versus 8.2 ± 7.8; P = 0.22), or hospital mortality (14.8% versus 6.7%; P = 0.41). The use of nasal MRSA PCR testing in patients with suspected MRSA pneumonia reduced the duration of empirical MRSA-targeted therapy by approximately 2 days without increasing adverse clinical outcomes.


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