The clinical management of cesarean section-acquired Mycobacterium abscessus surgical site infections

Introduction: Rapidly growing mycobacteria (RGM) can cause a broad spectrum of both community and healthcare-associated infections in humans. The aim of this study was to report the clinical management and outcomes of successive patients following cesarean delivery with healthcare-associated surgical site infections (SSIs) caused by RGM. Methodology: Patients who were admitted to Chung Shan Medical University Hospital, Taichung, Taiwan, between September 2006 and July 2008, and who developed SSIs following cesarean delivery at an obstetrics hospital and were then referred to our hospital, were enrolled. Demographic characteristics of the patients and clinical isolates were obtained retrospectively and an environmental investigation was performed. PCR-restriction fragment length polymorphism (PCR-RFLP) analysis of the hsp65gene and pulsed-field gel electrophoresis (PFGE) of large genomic DNA restriction fragments were applied to differentiate Mycobacterium species. Results: Seventeen patients were diagnosed with RGM infections by microbiology and/or histopathology. Mycobacterial isolates by PCR-RFLP analysis from 15 patients revealed Mycobacterium abscessus (M. abscessus) and M. lentiflavum. Most of the patients received surgical debridement and combination antimicrobial therapy and were eventually cured. Conclusions: Our study demonstrates the potential that RGM infections have in causing healthcare-associated SSIs. Surgery plus prolonged combination antimicrobial therapy seemed to be an effective option for the management of M. abscessus infections.

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Molecular Characterization of Pathogenicity Locus (PaLoc) and tcdC Genetic Diversity Among tcdA+B+ Clostridioides Difficile Clinical Isolates in Tehran, Iran

10.21203/rs.3.rs-56651/v1 ◽

2020 ◽

Author(s):

Mansoor Kodori ◽

Zohreh Ghalavand ◽

Abbas Yadegar ◽

Gita Eslami ◽

Masoumeh Azimirad ◽

...

Keyword(s):

Genetic Diversity ◽

Molecular Characterization ◽

Disease Severity ◽

Genetic Variants ◽

Rflp Analysis ◽

Clostridioides Difficile ◽

Pcr Rflp ◽

The Common ◽

Healthcare Associated

Abstract Background: Clostridioides difficile is the main cause of healthcare-associated diarrhea worldwide. It is proposed that certain C. difficile toxinotypes with distinct pathogenicity locus (PaLoc) variants are associated with disease severity and outcomes. Additionally, few studies have described the common C. difficile toxinotypes, and also little is known about the tcdC variants in Iranian isolates. We characterized the toxinotypes and the tcdC genotypes from a collection of Iranian clinical C. difficile tcdA+B+ isolates with known ribotypes (RTs).Methods: Fifty C. difficile isolates with known RTs and carrying the tcdA and tcdB toxin genes were analyzed. Toxinotyping was carried out based on a PCR-RFLP analysis of a 19.6 kb region encompassing the PaLoc. Genetic diversity of the tcdC gene was determined by the sequencing of the gene.Results: Of the 50 C. difficile isolates investigated, five distinct toxinotypes were recognized. Toxinotypes 0 (33/50, 66%) and V (11/50, 22%) were the most frequently found. C. difficile isolates of the toxinotype 0 mostly belonged to RT 001 (12/33, 36.4%), whereas toxinotype V consisted of RT 126 (9/11, 81.8%). The tcdC sequencing showed six variants (35/50, 70%); tcdC-sc3 (24%), tcdC-A (22%), tcdC-sc9 (18%), tcdC-B (2%), tcdC-sc14 (2%), and tcdC-sc15 (2%). The remaining isolates were wild-types (15/50, 30%) in the tcdC gene.Conclusions: The present study demonstrates that the majority of clinical tcdA+B+ isolates of C. difficile frequently harbor tcdC genetic variants. We also found that the RT 001/ toxinotype 0 and the RT 126/ toxinotype V are the most common types among Iranian isolates. Further studies are needed to investigate the putative association of various tcdC genotypes with CDI severity and its recurrence.

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Microbiology of Surgical Site Infections and Associated Antimicrobial Use Among Vietnamese Orthopedic and Neurosurgical Patients

Infection Control and Hospital Epidemiology ◽

10.1086/506400 ◽

2006 ◽

Vol 27 (08) ◽

pp. 855-862 ◽

Cited By ~ 11

Author(s):

Le Thi Anh Thu ◽

Annette H. Sohn ◽

Nguyen Phuc Tien ◽

Vo Thi Chi Mai ◽

Vo Van Nho ◽

...

Keyword(s):

Antimicrobial Therapy ◽

Surgical Site Infections ◽

University Hospital ◽

Antimicrobial Use ◽

Combination Drug ◽

E Coli ◽

Neurosurgical Patients ◽

Drug Regimens ◽

Study Population ◽

Orthopedic Patients

Objectives. To determine the pathogens associated with surgical site infections (SSIs) and describe patterns of antimicrobial use and resistance in orthopedic and neurosurgical patients in a large university hospital in Vietnam. Design. Prospective cohort study. Setting. Cho Ray Hospital, Ho Chi Minh City, Vietnam. Patients. All patients who had operations during a 5-week study period. Results. Of 702 surgical patients, 80 (11.4%) developed an SSI. The incidence of SSI among orthopedic patients was 15.2% (48 of 315), and among neurosurgical patients it was 8.3% (32 of 387). Postoperative bacterial cultures of samples from the surgical sites were performed for 55 (68.8%) of the 80 patients with SSI; 68 wound swab specimens and 10 cerebrospinal fluid samples were cultured. Of these 78 cultures, 60 (76.9%) were positive for a pathogen, and 15 (25%) of those 60 cultures yielded multiple pathogens. The 3 most frequently isolated pathogens were Pseudomonas aeruginosa (29.5% of isolates), Staphylococcus aureus (11.5% of isolates), and Escherichia coli (10.3% of isolates). Ninety percent of S. aureus isolates were methicillin resistant, 91% of P. aeruginosa isolates were ceftazidime resistant, and 38% of E. coli isolates were cefotaxime resistant. All but 1 of the 702 patients received antimicrobial therapy after surgery, and the median duration of antimicrobial therapy was 11 days. Commonly used antimicrobials included aminopenicillins and second- and third-generation cephalosporins. Two or, more agents were given to 634 (90%) of the patients, and most combination drug regimens (86%) included an aminoglycoside. Conclusions. Our data indicate that the incidence of SSI is high in our study population, that the main pathogens causing SSI are gram-negative bacteria and are often resistant to commonly used antimicrobials, that the use of broad-spectrum antimicrobials after surgery is widespread, and that implementation of interventions aimed at promoting appropriate and evidence-based use of antimicrobials are needed in Vietnam.

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Prevalence of Healthcare-Associated Infections in Acute Care Hospitals in Jacksonville, Florida

Infection Control and Hospital Epidemiology ◽

10.1086/664048 ◽

2012 ◽

Vol 33 (3) ◽

pp. 283-291 ◽

Cited By ~ 152

Author(s):

Shelley S. Magill ◽

Walter Hellinger ◽

Jessica Cohen ◽

Robyn Kay ◽

Christine Bailey ◽

...

Keyword(s):

Data Collection ◽

Acute Care ◽

Antimicrobial Therapy ◽

Bloodstream Infections ◽

Surgical Site Infections ◽

Healthcare Associated Infection ◽

Prevalence Survey ◽

Proxy Indicators ◽

Tract Infections ◽

Healthcare Associated

Objective.To determine healthcare-associated infection (HAI) prevalence in 9 hospitals in Jacksonville, Florida; to evaluate the performance of proxy indicators for HAIs; and to refine methodology in preparation for a multistate survey.Design.Point prevalence survey.Patients.Acute care inpatients of any age.Methods.HAIs were defined using National Healthcare Safety Network criteria. In each facility a trained primary team (PT) of infection prevention (IP) staff performed the survey on 1 day, reviewing records and collecting data on a random sample of inpatients. PTs assessed patients with one or more proxy indicators (abnormal white blood cell count, abnormal temperature, or antimicrobial therapy) for the presence of HAIs. An external IP expert team collected data from a subset of patient records reviewed by PTs to assess proxy indicator performance and PT data collection.Results.Of 851 patients surveyed by PTs, 51 had one or more HAIs (6.0%; 95% confidence interval, 4.5%–7.7%). Surgical site infections (n = 18), urinary tract infections (n = 9), pneumonia (n = 9), and bloodstream infections (n = 8) accounted for 75.8% of 58 HAIs detected by PTs. Staphylococcus aureus was the most common pathogen, causing 9 HAIs (15.5%). Antimicrobial therapy was the most sensitive proxy indicator, identifying 95.5% of patients with HAIs.Conclusions.HAI prevalence in this pilot was similar to that reported in the 1970s by the Centers for Disease Control and Prevention's Study on the Efficacy of Nosocomial Infection Control. Antimicrobial therapy was a sensitive screening variable with which to identify those patients at higher risk for infection and reduce data collection burden. Additional work is needed on validation and feasibility to extend this methodology to a national scale.Infect Control Hosp Epidemiol 2012;33(3):283-291

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Molecular authentication of Thai medicinal plant Khamin khruea by PCR-RFLP analysis

Planta Medica ◽

10.1055/s-0028-1084538 ◽

2008 ◽

Vol 74 (09) ◽

Author(s):

P Rojsanga ◽

W Gritsanapan ◽

W Leelamanit ◽

S Sukrong

Keyword(s):

Medicinal Plant ◽

Rflp Analysis ◽

Molecular Authentication ◽

Pcr Rflp

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Genetic Variation in Yellowfin Tuna Thunnus Albacares (Bonnaterre, 1788) Along Indian Coast Using Pcr-Rflp Analysis of Mitochondrial Dna D-Loop Region

International Journal of Scientific Research ◽

10.15373/22778179/jan2014/8 ◽

2012 ◽

Vol 3 (1) ◽

pp. 25-30

Author(s):

Swaraj Priyaranjan Kunal ◽

◽

Girish Kumar Girish Kumar ◽

Maria Rosalia Menezes

Keyword(s):

Mitochondrial Dna ◽

Genetic Variation ◽

Rflp Analysis ◽

Yellowfin Tuna ◽

Thunnus Albacares ◽

Indian Coast ◽

Loop Region ◽

Pcr Rflp ◽

D Loop

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PCR-RFLP Analysis Of Insulin-Like Growth Factor-I Gene In Bali Cattle

Jurnal Ilmu Peternakan Dan Veteriner ◽

10.30862/jipv.v5i1.756 ◽

2018 ◽

Vol 5 (1) ◽

Author(s):

Muhamad Affan Mu’in

Keyword(s):

Growth Factor ◽

Rflp Analysis ◽

Insulin Like Growth Factor ◽

Factor I ◽

Pcr Rflp ◽

Growth Factor I ◽

Bali Cattle ◽

I Gene

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Genetic and Biochemical Markers of Ovarian Function and Their Impact on Women Reproductive Status

Revista de Chimie ◽

10.37358/rc.20.10.8365 ◽

2020 ◽

Vol 71 (10) ◽

pp. 212-217

Author(s):

Adina-Elena Tanase ◽

Roxana Popescu ◽

Mircea Onofriescu ◽

Roxana Daniela Matasariu

Keyword(s):

Ovarian Function ◽

Rflp Analysis ◽

Fsh Receptor ◽

Gene Encoding ◽

Female Population ◽

Fshr Gene ◽

Pcr Rflp ◽

Regulation Mechanisms ◽

American Society ◽

Dependent Mechanism

Endometriosis is a disease very common nowadays affecting 1-2% of the female population, by estrogen-dependent mechanism. The identification of mutations in the gene encoding for the FSH receptor (FSHR) has been reported since 1995. Physiology teaches us that follicle-stimulating hormone (FSH) is a hormone that is vital in the steroidogenesis regulation mechanisms, while FSH receptor (FSHR) activation helps to promote folliculogenesis and estrogensynthesis. Therefore, studies to show if there are any correlations between endometriosis and FSHR are acquired. Genotyping of FSHR gene polymorphisms were performed using PCR - Restriction Fragment Length Polymorphism (PCR-RFLP) analysis. We analysed a total of 78 patients, 44 infertile patients with endometriosis and 34 controls (non-infertile, pregnant patients). The endometriosis group included women with diagnosis of endo-metriosis confirmed by laparoscopy and /or laparotomy and histological evidence of disease with the endometriosis staging according to American Society for Reproductive Medicine (ASRM). Corroborated with the severity of endometriosis, A919G and A2039G tests found that 71.4% of the M (GG) results were associated with primary infertility, not statistically significant (p=0.994) and 42.9% of the total M results had moderate or severe forms of endometriosis (p = 0.185). The genetic involvement in different pathologies such as endometriosis, has yet to be understood, but knowing more about its mechanism, will help physician target the disease at a more profound level.

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Validation of an algorithm for semiautomated surveillance to detect deep surgical site infections after primary total hip or knee arthroplasty—A multicenter study

Infection Control and Hospital Epidemiology ◽

10.1017/ice.2020.377 ◽

2020 ◽

Vol 42 (1) ◽

pp. 69-74

Author(s):

Janneke D. M. Verberk ◽

Stephanie M. van Rooden ◽

Mayke B. G. Koek ◽

David J. Hetem ◽

Annelies E. Smilde ◽

...

Keyword(s):

Knee Arthroplasty ◽

High Probability ◽

Surgical Site Infections ◽

Data Interpretation ◽

Routine Care ◽

Successful Implementation ◽

Subjective Data ◽

Essential Information ◽

Total Hip ◽

Healthcare Associated

AbstractObjective:Surveillance of healthcare-associated infections is often performed by manual chart review. Semiautomated surveillance may substantially reduce workload and subjective data interpretation. We assessed the validity of a previously published algorithm for semiautomated surveillance of deep surgical site infections (SSIs) after total hip arthroplasty (THA) or total knee arthroplasty (TKA) in Dutch hospitals. In addition, we explored the ability of a hospital to automatically select the patients under surveillance.Design:Multicenter retrospective cohort study.Methods:Hospitals identified patients who underwent THA or TKA either by procedure codes or by conventional surveillance. For these patients, routine care data regarding microbiology results, antibiotics, (re)admissions, and surgeries within 120 days following THA or TKA were extracted from electronic health records. Patient selection was compared with conventional surveillance and patients were retrospectively classified as low or high probability of having developed deep SSI by the algorithm. Sensitivity, positive predictive value (PPV), and workload reduction were calculated and compared to conventional surveillance.Results:Of 9,554 extracted THA and TKA surgeries, 1,175 (12.3%) were revisions, and 8,378 primary surgeries remained for algorithm validation (95 deep SSIs, 1.1%). Sensitivity ranged from 93.6% to 100% and PPV ranged from 55.8% to 72.2%. Workload was reduced by ≥98%. Also, 2 SSIs (2.1%) missed by the algorithm were explained by flaws in data selection.Conclusions:This algorithm reliably detects patients with a high probability of having developed deep SSI after THA or TKA in Dutch hospitals. Our results provide essential information for successful implementation of semiautomated surveillance for deep SSIs after THA or TKA.

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