scholarly journals Deep Neck Space Infections in Northern Ghana

2020 ◽  
pp. 265-270
Author(s):  
Theophilus Adjeso ◽  
Mawutor Dzogbefia ◽  
Edem Kojo Dzantor
Keyword(s):  
Antibiotic Use ◽  
Northern Ghana ◽  
Common Source ◽  
Odontogenic Infections ◽  
Source Of Infection ◽  
Lethal Complications ◽  
Deep Neck Space Infections ◽  
Hospital Stays ◽  
Age Range ◽  
Tamale Teaching Hospital

Background: Deep neck space infections (DNSI) continue to pose a challenge due to its potentially lethal complications that can arise despite the reduced prevalence as a result of widespread antibiotic use and improved dental care. We conducted a review of our experience with DNSI at the Ear, Nose and Throat (ENT) Unit, Tamale Teaching Hospital (TTH). Materials and Methods: We performed a retrospective analysis of patients hospitalized with a diagnosis DNSI at the ENT Unit, TTH from January 2013 to June 2020. Parameters analyzed included the age and sex distribution of patients, source of infection, sites involved, duration of admission and outcomes. Data analysis was done using SPSS version 20.0 (Chicago, IBM 2010). Results: The study involved 135 cases of DNSIs with age range of 5 months to 76 years (35.7± 19.0 years). Majority of the DNSIs cases occurred within the third decade of life and slightly more common among males (50.4%). The duration of hospital stays ranged from a day to 41 days (10.1± 8.2 days). Multi-space abscesses were the most common diagnosed DNSIs with odontogenic infections (63%) being the most common source of DNSIs. Majority (83.7%) of the patients were successfully treated with a mortality rate of 12.6%. Conclusion: DNSIs was most common among males with patients in their third decade most affected. Odontogenic infections were the most common source of DNSI with multi-space abscesses being the most common presentation. Majority of the patients were treated successfully.

scholarly journals Evaluation of the Involvement of Facial and Cervical Spaces in Odontogenic Infections in Patients Referred to Shahid Rahnemoon Hospital from 2014 to 2018

2020 ◽  
Vol 9 (40) ◽  
pp. 2960-2964
Author(s):  
Mohsen Barzegar ◽  
Amir Vaghefi ◽  
Adele Pouyafard ◽  
Seyed Mojtaba Alavikia
Keyword(s):  
Statistical Tests ◽  
Systemic Disease ◽  
Cross Sectional Study ◽  
Mean Body Temperature ◽  
Cross Sectional ◽  
Odontogenic Infections ◽  
Source Of Infection ◽  
The Mean ◽  
Buccal Space ◽  
Age Range

BACKGROUND Odontogenic infections are recognized as one of the most common diseases in the world. Organisms that cause dental infection and are a part of the oral normal flora include dental plaque bacteria, mucosal surface bacteria, and gingival bacteria. This study aimed to investigate the prevalence of odontogenic infections by involving the facial and cervical spaces in patients referred to Shahid Rahnemoon Hospital from 2014 to 2018. METHODS This was a descriptive cross-sectional study. The sampling method was census and 308 patients with all types of odontogenic infections associated with the involvement of the facial and cervical spaces referred to Shahid Rahnemoon Hospital from 2014 to 2018 were included in the study. Questionnaire was used for data collection. The data was entered into SPSS version 23 software and analysed using statistical tests. RESULTS The mean age of participants was 31.10 ± 14.48; the mean number of hospitalization days was 4.83 ± 2.52 days; the mean body temperature was 37.45 ± 0.54. Of the 308 patients studied, 221 (71.8 %) had no history of systemic disease. Also, 294 (5 %) had no airway involvement. The most commonly prescribed antibiotic was penicillin + metronidazole with a frequency of 54.9 %, The most common tooth that was the source of infection was mandibular tooth no. 6 with a frequency of 22.7 %, the most common type of treatment was incision + drainage + antibiotic therapy with a frequency of 44.2 %; the most common involved area was the submandibular + buccal space with a frequency of 20.1 % and the most common age range of involvement was 20 - 29 years. CONCLUSIONS In odontogenic infections, penicillin + metronidazole is the most commonly used antibiotic and buccal + submandibular space is the most common area involved. KEY WORDS Odontogenic Infection, Facial Spaces, Cervical Spaces

scholarly journals Clinicopathological, microbiological and radiological evaluation of deep neck spaces infections

2018 ◽  
Vol 4 (2) ◽  
pp. 409
Author(s):  
M. Santhosh Reddy ◽  
C. R. Vijay Bharath Reddy
Keyword(s):  
Common Source ◽  
Medical College ◽  
Biological Features ◽  
Space Infection ◽  
Source Of Infection ◽  
New Antibiotics ◽  
Deep Neck Space Infections ◽  
Deep Neck Infections ◽  
General Populations ◽  
Prompt Diagnosis

<p class="abstract"><strong>Background:</strong> <span lang="EN-IN">More and more use of antibiotics and development of new antibiotics have helped in reducing the morbidity associated with “deep neck infections”, but still their incidence is found in the general populations. Prompt diagnosis and early treatment are key. The objective of the study was to study deep neck infections regarding etiological factors, micro-biological features.</span></p><p class="abstract"><strong>Methods:</strong> <span lang="EN-IN">A total of 24 patients were identified and diagnosed at S.V.S Medical College and Hospital Mahabubnagar over a period of 3 years, among them 12 patients were picked up at random basis for detailed study.  </span></p><p class="abstract"><strong>Results:</strong> <span lang="EN-IN">It has been observed that the incidence of deep neck space infection was 3% till June 2010 and then it reduced to 1.76% by June 2011 and remained constant till October 2011. Sub-mandibular abscess was the most common in 58.3% of the cases. The most common source of infection of deep neck space infections was odontogenic in 45.8% of the cases. Airway obstruction was seen in 29% of the cases and mediastinitis was seen in only two patients. The most commonly observed organism involved in the deep neck space infections was streptococcus pyogenes in 75% of the cases. </span></p><p class="abstract"><strong>Conclusions:</strong> <span lang="EN-IN">Deep neck space infections though rare, are associated with complications and most importantly antimicrobial resistance. Hence it is very important that these must not be neglected.</span></p>

scholarly journals 284. Evaluation of Oral Step-Down Therapy for Enterobacteriaceae Bloodstream Infection

2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. S143-S143
Author(s):  
Sara Utley ◽  
Dawn Bouknight ◽  
Radha Patel ◽  
Kent Stock
Keyword(s):  
Bloodstream Infection ◽  
Oral Therapy ◽  
Common Source ◽  
Oral Antibiotic ◽  
Beta Lactam ◽  
Hospital System ◽  
Source Of Infection ◽  
Complete Treatment ◽  
Antibiotic Duration ◽  
Alternate Source

Abstract Background Oral antibiotic stepdown therapy for Gram-negative (GN) bloodstream infection (BSI) appears to be a safe option, though high bioavailability drugs like fluoroquinolones (FQ) and trimethoprim-sulfamethoxazole are often recommended without clear evidence demonstrating superiority. Due to increasing concerns of FQ resistance and collateral damage with an increasing community C. difficile rate, our organization sought to reduce overall FQ use and a shift toward oral beta-lactams (BL) was observed. A review was conducted to assess the outcomes of this shift. Methods This retrospective cohort included all patients within our 3-hospital system who had a positive GN blood culture and were transitioned to oral therapy to complete treatment outpatient for bacteremia between Jan 2017-Sept 2019. The primary outcome was recurrent BSI within 30 days of completing initial treatment. Secondary outcomes included 30-day mortality, 30-day recurrence of organism at an alternate source, 30-day readmission, and 90-day BSI relapse. Results Of 191 GN BSIs, 77 patients were transitioned to oral therapy. The mean age was 68 years, 60% were female. The most common source of infection was described as urine (39/77), intra-abdominal (16/77), unknown (13/77). Mean total antibiotic duration (IV plus PO) was 14 days (range 7–33). Patients received an average of 5 days IV prior to transitioning to PO therapy. The most common PO class was a 1st gen cephalosporin (29/77), followed by BL/BL inhibitor (16/77), and a FQ (13/77). There were no 30-day relapse BSIs observed in this cohort. There was 1 patient discharged to inpatient hospice, and no other 30-day mortality observed. There were 4 recurrent UTIs observed within 30 days, none of which required readmission. Of the twelve 30-day readmissions, 1 was considered by the investigators to be related to the initial infection. Conclusion An opportunity for education regarding duration of therapy was identified. Oral beta lactam use in our limited population appears to be a reasonable option to facilitate discharge. Results should be confirmed in additional, larger studies. Disclosures All Authors: No reported disclosures

scholarly journals Application of a Polymerase Chain Reaction Assay for Detection of Proliferative Enteritis-Affected Swine Herds

1996 ◽  
Vol 8 (2) ◽  
pp. 181-185 ◽  
Author(s):  
Patricia K. Holyoake ◽  
Gary F. Jones ◽  
Peter R. Davies ◽  
Dennis L. Foss ◽  
Michael P. Murtaugh
Keyword(s):  
Polymerase Chain Reaction ◽  
Chain Reaction ◽  
Pcr Assay ◽  
Nursery Pigs ◽  
Clinically Normal ◽  
Source Of Infection ◽  
History Of ◽  
Polymerase Chain ◽  
Swine Herds ◽  
Age Range

A polymerase chain reaction (PCR) assay was used to confirm the presence of ileal symbiont (IS) intracellularis in 3 swine herds with a history of proliferative enteritis (PE). Two pooled fecal specimens, each comprising 5 individual stool samples, were collected from pen floors to screen for the presence of IS intracellularis and determine the age range of pigs shedding the organism. IS intracellularis was detected in the feces of clinically normal 10–25week-old grower/finisher pigs, indicating that this age range of pigs was the main source of infection for younger nursery pigs. Shedding continued without clinical disease when 10–100 g/ton of tylosin or 10 g/ton of chlortetracycline was added to the feed. PCR testing of pooled fecal samples can be used to identify groups of pigs affected with PE. The results of this study indicate that this PCR assay has the potential to accurately assess the IS intracellularis infection status of swine herds and the association of IS intracellular-is with PE and growth performance.

scholarly journals Mapping, cluster detection and evaluation of risk factors of ovine toxoplasmosis in Southern Italy

2016 ◽  
Vol 11 (2) ◽  
Author(s):  
Roberto Condoleo ◽  
Vincenzo Musella ◽  
Maria Paola Maurelli ◽  
Antonio Bosco ◽  
Giuseppe Cringoli ◽  
...  
Keyword(s):  
Risk Factors ◽  
Geographical Information Systems ◽  
Southern Italy ◽  
Geographical Information ◽  
Economic Losses ◽  
Common Source ◽  
High Exposure ◽  
Campania Region ◽  
Source Of Infection ◽  
Serological Data

Toxoplasmosis, an important cause of reproductive failure in sheep, is responsible for significant economic losses to the ovine industry worldwide. Moreover, ovine meat contaminated by the parasite <em>Toxoplasma gondii</em> is considered as a common source of infection for humans. The aim of this study was to develop point and risk profiling maps of <em>T. gondii</em> seroprevalence in sheep bred in Campania Region (Southern Italy) and analyse risk factors associated at the flock-level. We used serological data from a previous survey of 117 sheep flocks, while environmental and farm management information were obtained from an analysis based on geographical information systems and a questionnaire purveyance, respectively. An univariate Poisson regression model revealed that the type of farm production (milk and meat vs only meat) was the only independent variable associated with <em>T. gondii</em> positivity (P&lt;0.02); the higher within-flock seroprevalence in milking herds suggests that milking practices might influence the spread of the infection on the farm. Neither environmental nor other management variables were significant. Since a majority of flocks were seasonally or permanently on pasture, the animals have a high exposure to infectious <em>T. gondii</em> oocysts, so the high within-flock seroprevalence might derive from this management factor. However, further studies are needed to better assess the actual epidemiological situation of toxoplasmosis in sheep and to clarify the factors that influence its presence and distribution.

scholarly journals Epidemiological investigations onCampylobacter jejuniin households with a primary infection

1984 ◽  
Vol 93 (2) ◽  
pp. 325-332 ◽  
Author(s):  
J. Oosterom ◽  
C. H. den Uyl ◽  
J. R. J. Bänffer ◽  
J. Huisman
Keyword(s):  
Campylobacter Jejuni ◽  
Primary Infection ◽  
Index Patient ◽  
Chicken Meat ◽  
Circumstantial Evidence ◽  
Common Source ◽  
Household Contacts ◽  
Control Subjects ◽  
Source Of Infection ◽  
Spread Of Infection

SummaryFifty-four Rotterdam patients in which a primary infection withCampylobacter jejunihad been detected (index patients) were compared with 54 control subjects with regard to the consumption and preparation of foods 7 days before onset of illness and the keeping of pet animals. Significantly more index patients than controls had eaten chicken meat (47v. 29;P= 0·0002), particularly at barbecues (14v. 2;P= 0·0015). Marginally more index patients had eaten pork (47v. 39;P= 0·048) or inadequately heated meat (13v. 8), though in the last case numbers were too small to be statistically significant. The consumption of beef or mutton and outdoor eating (other than at barbecues) were essentially the same in both groups. There was no significant association with the keeping of pet animals, although a few more index patients had cage birds than controls (18v. 12).Twenty-one (15%) of 130 household contacts of index patients also suffered from diarrhoea during the same period. Circumstantial evidence pointed to a common source of infection with the index patient in 13 instances (nine households) and probable intrafamilial spread of infection in six instances.Campylobacters were isolated from one of 110 swabs of kitchen work surfaces and eight of 107 swabs taken from lavatory bowls in index households.

scholarly journals 189. Validating a Hospitalist-Specific Antibiotic Prescribing Metric across Four Acute Care Hospitals

2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. S100-S101
Author(s):  
Jessica Howard-Anderson ◽  
Cara Nys ◽  
Julianne N Kubes ◽  
William C Dube ◽  
Benjamin Albrecht ◽  
...  
Keyword(s):  
Research Training ◽  
Antibiotic Use ◽  
Primary Diagnosis ◽  
Chronic Obstructive ◽  
Antibiotic Prescribing ◽  
Antibiotic Administration ◽  
Obstructive Pulmonary Disease ◽  
Leadership Group ◽  
Immunocompromised Status ◽  
Hospital Stays

Abstract Background Peer comparison reduces unnecessary outpatient antibiotic prescribing, but no prescribing metric has been validated for inpatient comparison. We aimed to evaluate if an electronically derived antibiotic prescribing metric correlated with indicated antibiotic days in hospitalized patients. Methods We previously created a hospitalist-specific adjusted antibiotic use metric (observed:expected [O:E]) for National Healthcare Safety Network-defined broad-spectrum antibiotics. From May-Oct 2019 at four Emory Healthcare hospitals, we identified outlier hospitalists prescribing in the top (high O:E) and bottom (low O:E) 15th percentile. We randomly selected 10 days of antibiotic administration from each outlier and reviewed days with &gt; 2 days of consecutive days of antibiotics. For pneumonia, chronic obstructive pulmonary disease (COPD), or urinary tract infection (UTI) we determined if each day of antibiotics was indicated, assuming the diagnosis was accurate. We compared high vs. low O:E providers and used regression modeling to determine if the metric predicted indicated days of antibiotics. Results Among 997 days, 510 (51%) were from high and 487 (49%) from low O:E providers. High O:E providers had a greater proportion of days with &gt; 2 prior days of antibiotics (60%) compared to low O:E providers (54%, p = 0.03). In the subset of days with &gt; 2 prior days of antibiotics (n = 569), high O:E providers had more patient-days with longer hospital stays, diabetes and Charlson comorbidity index (CCI) &gt;3, and fewer days supervising (resident/advanced practice provider, Table 1). The primary diagnosis was pneumonia, COPD exacerbation or UTI in 260 (25%) days; 91% were indicated based on duration with no difference between high and low O:E providers (88% vs. 94%, p = 0.1). After controlling for days of hospitalization, CCI, immunocompromised status, and supervisory role, a high O:E was not associated with indicated antibiotic use (OR 0.5, 95% CI 0.2 – 1.3). Description of days with a patient on greater than two days of antibiotics, comparing high- versus low-metric providers Conclusion A high hospitalist antibiotic prescribing metric correlated with patients receiving &gt; 2 consecutive days of antibiotics on any given day but did not predict unindicated antibiotic use for a subset of diagnoses. Evaluating indicated use by validating diagnoses may improve metric performance. Disclosures Jessica Howard-Anderson, MD, Antibacterial Resistance Leadership Group (ARLG) (Other Financial or Material Support, The ARLG fellowship provides salary support for ID fellowship and mentored research training)

Electrical Impedance Spectroscopy as a Powerful Analytical Tool for Monitoring Microbiological Growth on Medical Implants

2008 ◽  
pp. 487-496
Author(s):  
Louise M. Oliver ◽  
E. T. McAdams ◽  
P. S.M. Dunlop ◽  
J. A. Byrne ◽  
I. S. Blair ◽  
...  
Keyword(s):  
Electrical Impedance Spectroscopy ◽  
Common Source ◽  
Hospital Acquired Infection ◽  
Hospital Acquired Infections ◽  
Source Of Infection ◽  
Powerful Analytical Tool ◽  
Catheter Surface ◽  
Intravascular Catheters ◽  
Micro Organisms ◽  
Hospital Acquired

Hospital-acquired infections (HAI) are defined as infections that are neither present nor incubating when a patient enters the hospital (Bourn, 2000). Their effects vary from discomfort to prolonged or permanent disability and they may contribute directly or substantially to a patient’s death. HAI’s are estimated to cost the National Health Service (NHS) in England £1 billion annually (Bourn, 2000) with as many as 5,000 patients dying as a result of acquiring such an infection (Anon, 2001). Not all hospital-acquired infections are preventable but Infection Control Teams believe that they could be reduced by at least 15%, with yearly savings of £150 million (Anon, 2001). Central intravascular catheters have been found to be a common source of infection. Catheters can become infected via a number of different routes with the infection proliferating in multiple areas along the catheter surface. It has been reported that over 40% of the identified micro-organisms causing hospital-acquired infection were Staphylococci, an organism that is typically found on the natural skin flora (Bourn, 2000).

Simultaneous norovirus outbreak in three Portuguese army bases in the Lisbon region, December 2017

2019 ◽  
pp. jramc-2019-001242
Author(s):  
António Lopes-João ◽  
J R Mesquita ◽  
R de Sousa ◽  
M Oleastro ◽  
C Penha-Gonçalves ◽  
...  
Keyword(s):  
Armed Forces ◽  
Food Samples ◽  
Common Source ◽  
Microbiological Analysis ◽  
Pcr Assay ◽  
Institutional Settings ◽  
Enteropathogenic Bacteria ◽  
Source Of Infection ◽  
Positive Stool ◽  
Stool Specimens

IntroductionNorovirus outbreaks frequently occur in communities and institutional settings acquiring a particular significance in armed forces where prompt reporting is critical. Here we describe the epidemiological, clinical and laboratorial investigation of a multicentre gastroenteritis outbreak that was detected simultaneously in three Portuguese army units with a common food supplier, Lisbon region, between 5 and 6 December 2017.MethodsQuestionnaires were distributed to all soldiers stationed in the three affected army units, and stool specimens were collected from soldiers with acute gastrointestinal illness. Stool specimens were tested for common enteropathogenic bacteria by standard methods and screened for a panel of enteric viruses using a multiplex real-time PCR assay. Food samples were also collected for microbiological analysis. Positive stool specimens for norovirus were further genotyped.ResultsThe three simultaneous acute gastroenteritis outbreaks affected a 31 (3.5%) soldiers from a total of 874 stationed at the three units and lasted for 2 days. No secondary cases were reported. Stool specimens (N=11) were negative for all studied enteropathogenic agents but tested positive for norovirus. The recombinant norovirus GII.P16-GII.4 Sydney was identified in all positive samples with 100% identity.ConclusionsThe results are suggestive of a common source of infection plausibly related to the food supplying chain. Although centralisation of food supplying in the army has economic advantages, it may contribute to the multifocal occurrence of outbreaks. A rapid intervention is key in the mitigation of outbreak consequences and in reducing secondary transmission.

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