Effect of introduction of antibiotic-impregnated shunt catheters on cerebrospinal fluid shunt infection in children: a large single-center retrospective study

2014 ◽  
Vol 13 (1) ◽  
pp. 101-106 ◽  
Author(s):  
Greg James ◽  
John C. Hartley ◽  
Robert D. Morgan ◽  
Jessica Ternier
Keyword(s):  
Staphylococcus Aureus ◽  
Shunt Infection ◽  
Control Group ◽  
Coagulase Negative Staphylococcus ◽  
Study Group ◽  
Infection Rates ◽  
Gram Negative ◽  
Enterococcus Spp ◽  
Historical Group ◽  
Gram Negative Organisms

Object Infection after both primary and revision shunt surgeries remains a major problem in pediatric neurosurgical practice. Antibiotic-impregnated shunt (AIS) tubing has been proposed to reduce infection rates. The authors report their experience with AIS catheters in their large pediatric neurosurgery department. Methods The authors conducted a retrospective case review of consecutive shunt operations performed before (1993–2003) and after (2005–2009) introduction of AIS tubing, with analysis of shunt infection rates and causative organisms identified. Results The historical control group consisted of 1592 consecutive shunt operations (657 primary insertions), and the AIS study group consisted of 500 consecutive shunt operations (184 primary insertions). Patients ranged in age from 0–17 years. In the historical group, 135 infections were identified (8.4%). In the AIS study group, 25 infections were identified (5%), representing a significant reduction (p < 0.005). The latency to diagnosis of infection was 23 days in the historical group and 139 days in the AIS study group. The infection rates in infants 0–6 months of age were 12.2% (historical group) and 6.7% (AIS group, p < 0.005), and in infants 7–12 months of age the rates were 7.9% (historical group) and 2.7% (AIS group, p < 0.005). In the historical control group, the frequency rank order of causative organisms was coagulase-negative staphylococcus (51.9%), Staphylococcus aureus (31.6%), streptococcus or enterococcus spp. (8.8%), gram-negative organisms (4.4%), and Propionibacterium acnes (2.2%). Organisms responsible for infections in AIS were S. aureus (40%), followed by streptococcus or enterococcus spp. (20%), P. acnes and coagulase-negative staphylococcus (both 16%), and gram-negative organisms (4%). No unusually antibiotic-resistant bacteria were identified in either group. The authors further subdivided the AIS group into those undergoing primary AIS insertion (Subgroup 1), those undergoing revision of non-AIS systems using AIS components (Subgroup 2), and those undergoing revision of AIS systems using AIS components (Subgroup 3). Infection rates were 1.6% in Subgroup 1, 2.5% in Subgroup 2, and 11.7% in Subgroup 3. Staphylococcus aureus was the most common organism identified in infections of the Subgroups 2 and 3. Conclusions Use of AIS tubing significantly improves shunt infection rates in both general pediatric and infant populations with no evidence of increased antibiotic resistance, which is in agreement with previous studies. However, the increased infection rate in revision surgery in children with AIS catheters in situ raises questions about their long-term application.

scholarly journals 1554. Epidemiology of Adult Bacterial Hand Infections at Two Urban Hospitals

2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. S777-S778
Author(s):  
Arsheena Yassin ◽  
Christine Stavropoulos ◽  
Krystina L Woods ◽  
Jiashan Xu ◽  
Justin Carale ◽  
...  
Keyword(s):  
New York ◽  
Staphylococcus Aureus ◽  
Antibiotic Regimen ◽  
Gram Positive ◽  
Gram Negative ◽  
Streptococcus Species ◽  
Urban Hospitals ◽  
Haemophilus Parainfluenzae ◽  
Empiric Antibiotic ◽  
Gram Negative Organisms

Abstract Background Hand infections represent a major source of morbidity, which can result in hand stiffness and amputation. Early appropriate empiric antibiotic regimen may reduce the associated morbidity, hence the importance to examine local epidemiology. The aim of this study was to define the current epidemiology of adult hand infections at two urban hospitals in New York City. Methods We performed a double center, retrospective study of adult patients hospitalized from March 2018 to May 2020. Patients with positive cultures associated with the hand infections were included. Retrospectively, 100 patients were reviewed. Data on baseline demographic, clinical, surgical, microbiology, and treatment parameters were collected. Results Of the 100 patients, 76% were male, with median age of 47.5 years (35, 58.25) and average C-reactive protein (CRP) of 50.66 mg/L (± 64.64) on admission (see Table 1). Previous hospitalization within 1 year (38%), previous surgical procedures (39%) and recent IV medication use (26%) were common. 130 bacterial isolates were identified (see Table 2). The most frequent organisms were Gram-positive, with Methicillin susceptible Staphylococcus aureus (MSSA, 25.38%), Streptococcus species (20.08%), and Methicillin resistant Staphylococcus aureus (MRSA, 15.38%) being the most common. Gram-negative organisms were infrequent, with Haemophilus parainfluenzae (3.85%), Enterobacter cloacae (3.85) and Pseudomonas aeruginosa (3.08%) being the most prevalent. Of the 100 patients, 27% had polymicrobial infections, associated with trauma (6%), illicit IV use (6%) and unknown (7%) etiologies. Table 1: Baseline demographics and co-morbid conditions Table 2: Types and numbers of organisms in relation to etiologies Conclusion Within our population, the most common organisms associated with hand infections were Gram-positive, with Staphylococcus aureus and Streptococcus species being the most prevalent. Gram-negative pathogens were infrequently isolated. The results within this study can provide guidance to clinicians on assessing the appropriate empiric antibiotic regimen in patients with hand infections, and can serve as a basis for further studies identifying risk factors associated with isolation of organisms associated with hand infections. Disclosures All Authors: No reported disclosures

Effect of a moustache on nasal Staphylococcus aureus colonisation and nasal cytology results in men

2015 ◽  
Vol 129 (2) ◽  
pp. 155-158 ◽  
Author(s):  
E Soylu ◽  
I Orhan ◽  
A Cakir ◽  
A Istanbullu ◽  
G Altin ◽  
...  
Keyword(s):  
Staphylococcus Aureus ◽  
Allergic Rhinitis ◽  
Nasal Cavity ◽  
Control Group ◽  
Study Group ◽  
Left Nasal Cavity ◽  
Adult Men ◽  
Nasal Cytology ◽  
Non Allergic Rhinitis

AbstractObjective:This study compared the results of nasal Staphylococcus aureus carriage and nasal cytology in men with and without a moustache.Methods:The study group comprised 118 adult men with a moustache, and the control group consisted of 123 adult men without a moustache. Samples were taken from the participants' right nasal cavity for cytology and from the left nasal cavity for microbiology.Results:The results for S aureus were positive in 19.5 per cent (n = 23) of participants with a moustache and in 20.3 per cent (n = 25) of men without a moustache. This difference was not significant (p > 0.05). However, nasal cytology revealed rich eosinophil clusters in participants with a moustache.Conclusion:The presence or absence of a moustache had no effect on nasal S aureus colonisation. However, further research is needed to understand whether the presence of a moustache increases the risk of allergic or non-allergic rhinitis.

scholarly journals Patient and Treatment Characteristics by Infecting Organism in Cerebrospinal Fluid Shunt Infection

2018 ◽  
Vol 8 (3) ◽  
pp. 235-243 ◽  
Author(s):  
Tamara D Simon ◽  
Matthew P Kronman ◽  
Kathryn B Whitlock ◽  
Samuel R Browd ◽  
Richard Holubkov ◽  
...  
Keyword(s):  
Cerebrospinal Fluid ◽  
Shunt Infection ◽  
Research Network ◽  
Csf Shunt ◽  
Coagulase Negative Staphylococcus ◽  
Gram Negative ◽  
Treatment Characteristics ◽  
Infection Treatment ◽  
Csf Shunt Infection ◽  
Univariate Analyses

Abstract Background Previous studies of cerebrospinal fluid (CSF) shunt infection treatment have been limited in size and unable to compare patient and treatment characteristics by infecting organism. Our objective was to describe variation in patient and treatment characteristics for children with first CSF shunt infection, stratified by infecting organism subgroups outlined in the 2017 Infectious Disease Society of America’s (IDSA) guidelines. Methods We studied a prospective cohort of children <18 years of age undergoing treatment for first CSF shunt infection at one of 7 Hydrocephalus Clinical Research Network hospitals from April 2008 to December 2012. Differences between infecting organism subgroups were described using univariate analyses and Fisher’s exact tests. Results There were 145 children whose infections were diagnosed by CSF culture and addressed by IDSA guidelines, including 47 with Staphylococcus aureus, 52 with coagulase-negative Staphylococcus, 37 with Gram-negative bacilli, and 9 with Propionibacterium acnes. No differences in many patient and treatment characteristics were seen between infecting organism subgroups, including age at initial shunt, gender, race, insurance, indication for shunt, gastrostomy, tracheostomy, ultrasound, and/or endoscope use at all surgeries before infection, or numbers of revisions before infection. A larger proportion of infections were caused by Gram-negative bacilli when antibiotic-impregnated catheters were used at initial shunt placement (12 of 23, 52%) and/or subsequent revisions (11 of 23, 48%) compared with all other infections (9 of 68 [13%] and 13 of 68 [19%], respectively). No differences in reinfection were observed between infecting organism subgroups. Conclusions The organism profile encountered at infection differs when antibiotic-impregnated catheters are used, with a higher proportion of Gram-negative bacilli. This warrants further investigation given increasing adoption of antibiotic-impregnated catheters.

P1173PERITONEAL DIALYSIS INFECTIONS IN MALTA - TRENDS OVER ELEVEN YEARS

2020 ◽  
Vol 35 (Supplement_3) ◽  
Author(s):  
Angela Borg Cauchi ◽  
Maria Angela Gauci ◽  
Theresia Dalli ◽  
James Gauci ◽  
James Farrugia ◽  
...  
Keyword(s):  
Peritoneal Dialysis ◽  
Coagulase Negative Staphylococcus ◽  
Distributed Data ◽  
Dialysis Modality ◽  
Gram Positive ◽  
Gram Negative ◽  
Male Predominance ◽  
E Coli ◽  
Number Of Patients ◽  
Gram Negative Organisms

Abstract Background and Aims Infections related to peritoneal dialysis (PD) are still a cause of morbidity and mortality. We describe an overview of PD peritonitis and catheter-related infections (CRI) in Malta over a period of eleven years. We also describe trends in dialysis modality over the years. Method All patients undergoing PD in Malta during 2008 and 2018 were analysed. Data from 2008-2012 was retrospective, shown as mean, that from 2013-2018 prospective. International Society for Peritoneal Dialysis (ISPD) definitions were used. Results for categorical responses were summarized using absolute numbers and percentages. Medians (range) were used to describe continuous non-normally distributed data. Results The total number of patients undergoing PD from 2008 till 2018 were 137 (2008-2012), 91, 80, 126, 117, 102, 103 respectively. There was an overall male predominance of 63.5% (61-67). Patient years at risk were 85.80, 85.25, 89.71, 83.70, 79.69, 72.88 since 2013 respectively. The overall incidence of diabetes mellitus was 45.3% (41.8-50), cardiovascular disease 34.2% (33.8-35), hypertension 79.3% (73.8-84.6). PD was used in 50% of dialysis modality prior to 2012, 39% in 2018. Initially 51% used Automated PD (APD), with 21% assisted PD, in 2018 39% used APD, with 6% assisted PD. PD peritonitis rates from 2008 were 0.38, 0.31, 0.35, 0.46, 0.43, 0.57, 0.54, 0.43, 0.39, 0.40, 0.46 episodes/patient year respectively There was marked dominance of Gram-positive peritonitis, mainly Staphylococcal, with a reduction of coagulase-negative-Staphylococcus from 0.26 episodes/patient in 2013 to 0.03 in 2017, 0.11 in 2018. Methicillin-resistant S. aureus (MRSA) peritonitis decreased from 0.03 episodes/patient to nil in 2016, 2017, 0.01 episodes/patient in 2018. Amongst Gram-negative peritonitis, Pseudomonas rates decreased from 0.06 to 0.03 episodes/patient in 2018, nil in 2016. Escherichia coli rates decreased from 0.02 episodes/patient to nil in the last three years. Fungal rates from 0.03 to 0.01 episodes/patient/year, with nil in 2016, 2017. Catheter-related infection rates were 0.39 (2008-2012), 0.35, 0.91, 0.37, 0.38, 0.25, 0.50 episodes/patient/year respectively. There was a higher incidence of recurrent infections in 2014, none in 2015 and 2016. Gram-negative organisms accounted for 57% of all CRI, predominantly Pseudomonas at 0.12 (2008-2012), 0.06, 0.09, 0.09, 0.14, 0.03, 017 episodes/patient/year respectively. Gram-positive CRI were mostly Staphylococcus aureus, peaking in 2014 at 0.38 episodes/patient/year. MRSA rates declined from 0.15 to 0.01 episodes/patient/year in 2018. Conclusion PD peritonitis rates in Malta between 2008 and 2018 were below the ISPD recommended threshold. There were no episodes of MRSA in 2016, 2017, no Pseudomonas in 2016, no E coli in the last three years and no fungal PD peritonitis in 2016, 2017. CRI rates also declined, with an overall predominance of Gram-negative infections.

scholarly journals Increasing incidence of Gram-negative organisms in bacterial agents isolated from diabetic foot ulcers

2013 ◽  
Vol 7 (10) ◽  
pp. 707-712 ◽  
Author(s):  
Vedat Turhan ◽  
Mesut Mutluoglu ◽  
Ali Acar ◽  
Mustafa Hatipoglu ◽  
Yalcın Onem ◽  
...  
Keyword(s):  
Staphylococcus Aureus ◽  
Diabetic Foot ◽  
Geographical Location ◽  
Antibiotic Sensitivity ◽  
Diabetic Patients ◽  
Tissue Samples ◽  
Gram Negative ◽  
Diabetic Foot Infections ◽  
Pseudomonas Species ◽  
Gram Negative Organisms

Introduction: In the present study, we sought to identify the bacterial organisms associated with diabetic foot infections (DFIs) and their antibiotic sensitivity profiles. Methodology: We retrospectively reviewed the records of wound cultures collected from diabetic patients with foot infections between May 2005 and July 2010. Results: We identified a total of 298 culture specimens (165 [55%] wound swab, 108 [36%] tissue samples, and 25 [9%] bone samples) from 107 patients (74 [69%] males and 33 [31%] females, mean age 62 ± 13 yr) with a DFI. Among all cultures 83.5% (223/267) were monomicrobial and 16.4% (44/267) were polymicrobial. Gram-negative bacterial isolates (n = 191; 61.3%) significantly outnumbered Gram-positive isolates (n = 121; 38.7%). The most frequently isolated bacteria were Pseudomonas species (29.8%), Staphylococcus aureus (16.7%), Enterococcus species (11.5%), Escherichia coli (7.1%), and Enterobacter species (7.1%), respectively. While 13.2% of the Gram-negative isolates were inducible beta-lactamase positive, 44.2% of Staphylococcus aureus isolates were methicillin resistant. Conclusions: Our results support the recent view that Gram-negative organisms, depending on the geographical location, may predominate in DFIs.

scholarly journals Microbiological Profile of Uropathogens and their Antibiotic Susceptibility Pattern in Pediatric Population from A Tertiary Care Hospital in Amritsar, Punjab

2021 ◽  
Vol 10 (11) ◽  
pp. 306-312
Author(s):  
Manpreet Kaur Bhatha Loveena Oberoi ◽  
Sapna Soneja Anuradha Malhotra ◽  
Kamaldeep Singh
Keyword(s):  
Staphylococcus Aureus ◽  
Antibiotic Susceptibility ◽  
Pediatric Population ◽  
Age Group ◽  
Susceptibility Pattern ◽  
Gram Positive ◽  
Antibiotic Susceptibility Pattern ◽  
Gram Negative ◽  
Gram Negative Organisms ◽  
Gram Positive Cocci

Urinary tract infection(UTI) is one of the most commonest bacterial infection encountered in the pediatric age group. Early diagnosis is of utmost importance to preserve renal function and reduce long term complications such as renal scarring. The objective of this study was to determine the prevalence of UTI in pediatric population, identify the common uropathogens and study the antibiotic susceptibility pattern of bacterial isolates. Materials and Methods: A retrospective study was carried out in Department of Microbiology, GMC Amritsar for a period of 6 months from 1 Jan 2021 till 30 June 2021 amongst the pediatric patients (1 month-12 years age group) with clinically suspected UTI including both indoor and outdoor patients. Clean catch midstream urine samples received in the laboratory were processed as per the standard microbiological guidelines. Antibiotic susceptibility testing was done using Kirby-Bauer disc diffusion method as per CLSI guidelines. Results: A total of 549 samples were received and processed during study period from which 164(29.87%) were culture positive. Culture positivity was more prevalent in females (61.58%) than males (38.41%). Gram negative organisms were predominant (74.4%) followed by gram positive cocci (22.56%) and Candida (3.05%). Among gram negative organisms Escherichia coli was most predominant followed by Klebsiella spp., Pseudomonas spp., Acinetobacter spp., Proteus spp. and Citrobacter spp. Among gram positive cocci Staphylococcus aureus was most predominant followed by Coagulase negative Staphylococci and Enterococcus spp. Majority of gram negative bacilli were resistant to fluroquinolones, 3rd generation cephalosporins and co-trimoxazole while nitrofurantoin, piperacillin-tazobactam and gentamicin were most sensitive drugs. Among Staphylococcus aureus, methicillin resistance was seen in 17% isolates. High sensitivity was seen to linezolid and vancomycin in gram positive cocci. Conclusion: This study highlights increased prevalence of MDR uropathogens in pediatric population which indicates that antibiotic selection should be based on knowledge of local prevalence of bacterial organisms and their antibiotic sensitivities with rational use of antibiotics.

scholarly journals Clinico-bacteriological profile of neonatal sepsis

2019 ◽  
Vol 6 (2) ◽  
pp. 796 ◽  
Author(s):  
Rashmi P. ◽  
Praveen B. K.
Keyword(s):  
Neonatal Sepsis ◽  
Clinical Suspicion ◽  
Coagulase Negative Staphylococcus ◽  
Gram Positive ◽  
Gram Negative ◽  
Methicillin Resistant ◽  
Early Onset Sepsis ◽  
Sensitivity Pattern ◽  
Gram Negative Organisms ◽  
Culture Positive

Background: Neonatal sepsis is the commonest cause of neonatal mortality responsible for about 30-50% of total neonatal deaths in developing countries. Surveillance of causative organisms and their antibiotic sensitivity pattern promotes rational use of antibiotics and antibiotic stewardship.Methods: A retrospective study, relevant data regarding the neonates diagnosed with culture positive sepsis was obtained from the case records during the period from July 2014 to June 2017. Culture positive sepsis was defined as isolation of bacterial pathogen from blood in neonates with clinical suspicion of sepsis.Results: Of the 414 neonates with clinical suspicion of sepsis, 110 neonates had blood culture positive sepsis. Sepsis was predominant in males (64.5%). Low birth weight (47.2%) and prematurity (40.9 %) were important neonatal risk factors for sepsis. Early onset sepsis occurred in 58.1% of the cases and late onset sepsis in 41.9% of the neonates. Gram-positive cocci constituted 67.52% of all isolates and gram negative 30.76%. The most frequently isolated organism in blood was methicillin resistant coagulase negative staphylococcus(MRCONS) (32.47%). Gram positive organisms included MRCONS, methicillin resistant Staphylococci aureus (MRSA), group B Streptococci (GBS), Staphylococcus aureus and Enterococci. Among Gram-negative organisms, Acinetobacter was most frequently isolated followed by Klebsiella, Escherichia coli, Pseudomonas, Citrobacter and Burkholderia species. The mortality in the study group was 13.5%. Gram negative organisms were most resistant to ampicillin and cephalosporins. Gram positive isolates were least resistant to vancomycin and linezolid.Conclusions: Gram positive sepsis was the most common type of sepsis among the neonates, although mortality was more in gram negative sepsis.

scholarly journals Antimicrobial activity of antiseptics in the prevention of postoperative infectious complications

2021 ◽  
pp. 33-36
Author(s):  
N. A. Bagnyuk ◽  
O. A. Nazarchuk ◽  
Y. M. Babina ◽  
R. M. Chornopyshchuk ◽  
A. V. Kulyk
Keyword(s):  
Staphylococcus Aureus ◽  
Antimicrobial Activity ◽  
Antimicrobial Properties ◽  
Bactericidal Effect ◽  
Infectious Complications ◽  
Antimicrobial Efficacy ◽  
Gram Positive ◽  
Gram Negative ◽  
Clinical Strains ◽  
Enterococcus Spp

Recently, among hospital strains of microorganisms, an increase in the number of antiseptic-resistant strains of opportunistic pathogens has been registered, which significantly affects the effectiveness of these drugs. It is important to study their antimicrobial efficacy to justify rational use. The aim is to conduct a comparative study of the antimicrobial efficacy of antiseptics of decamethoxine, chlorhexidine, polyhexanide. During study we examined the antimicrobial activity against 186 clinical strains of microorganisms (Acinetobacter baumannii, Staphylococcus aureus, Pseudomonas aeruginosa, Enterococcus spp., Enterobacter spp.) isolated from patients with infectious complications in the postoperative period. The minimum inhibitory (MIC) and bactericidal concentrations (MBC) of 0.02 % and 0.1 % decamethoxine, 0.05 % chlorhexidine bigluconate, 0.1 % polyhexanide were determined; antimicrobial efficacy of drugs was evaluated by the index of antiseptic activity by conventional methods. The study found high antimicrobial properties of decamethoxine, chlorhexidine, which had a high bactericidal effect on clinical strains of S. aureus, Enterococcus spp., Enterobacter spp. Proved the benefits of antimicrobial activity of the drug based on decamethoxine (p<0.001). The polyhexanide has pronounced antimicrobial properties against A. baumannii, bacteria of the family Enterobactericae, P. aeruginosa. Thus, the leading gram-positive (Staphylococcus aureus, enterococci) and gram-negative pathogens (enterobacteria, acinetobacteria, pseudomonads) are sensitive to polyhexanide, chlorhexidine and the domestic drug decamethoxin, with a probable advantage of the antimicrobial properties of the latter over all gram-positive and most gram-negative microorganisms.

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