scholarly journals Surgical Site Infections in Gynaecological Surgeries

2021 ◽  
pp. 654-663
Author(s):  
Akshaya Iyengar ◽  
Shiven Nayyar ◽  
Vedika Jajoo
Keyword(s):  
Surgical Site Infections ◽  
Vaginal Cuff ◽  
Gynecologic Surgical Procedures ◽  
Surgical Infection ◽  
Duration Of Surgery ◽  
Extended Duration ◽  
The Common ◽  
Infectious Pathogen ◽  
Hospital Acquired ◽  
And Control

Surgical contaminations are one of the utmost familiar medical management related contamination within the economically developing nations. Gynecologic tactics constitute a completely distinctive venture within which the infectious pathogen arising out of pores and the underlying skin or the vagina and endo-cervix can also relocate up to the area of surgery and may bring about vaginal cuff cellulitis, cellulitis of the  pelvis, and abscesses of the pelvis. Numerous organisms along with operation threat elements were recognized as dangers that grow infectious sequelae after pelvic surgical treatment. The full-size use of antibiotic prophylaxis has decreased however now no longer removed severe postoperative infections; the common anticipated SSIs price being three–15% after c-section. Those costs are multiplied by the existence of various threat elements like surgical infection, which is compounded by untimely rupture of membranes, obstructed labour, chorioamnionitis, large obesity, extended duration of surgery, emergency surgeries, and immunodeficiency, all of that are not uncommon within aid-deficient nations. Other factors linked to physician ability, such as poor operation skills, insufficient hemostasis, and the presence of a useless region, lead to increased injury contamination. Working at the pinnacle, such as those medical conditions that occur during pregnancy and malnutrition, also contribute significantly to the problem. SSIs as the most common motive concerning hospital-acquired contamination in obstetrics, although the present contemporary era, remains as chief residence fitness hassle within growing nations. We may even evaluate the definitions, microbiology, pathogenesis, diagnosis, and control of pelvic SSIs after gynecologic surgical procedures.

scholarly journals Epidemiology of Surgical Site Infections Considering the NHSN Standardized Infection Ratio in Hip and Knee Arthroplasties

2020 ◽  
Vol 17 (9) ◽  
pp. 3167
Author(s):  
Róża Słowik ◽  
Małgorzata Kołpa ◽  
Marta Wałaszek ◽  
Anna Różańska ◽  
Barbara Jagiencarz-Starzec ◽  
...  
Keyword(s):  
Optimal Solution ◽  
Surgical Site Infections ◽  
Incidence Density ◽  
Coagulase Negative Staphylococci ◽  
Surveillance Network ◽  
Hospital Acquired Infections ◽  
Etiologic Agents ◽  
Healthcare Associated ◽  
Hospital Acquired ◽  
And Control

Introduction Surgical site infections (SSIs) are a predominant form of hospital-acquired infections in surgical wards. The objective of the study was analysis of the incidence of SSI in, both primary and revision, hip and knee arthroplasties. Material and methods: The study was conducted in 2012–2018 in a Trauma and Orthopedics Ward in Tarnów according to the methodology of the Healthcare-Associated Infections Surveillance Network (HAI-Net), European Centre for Disease Prevention and Control (ECDC). Results: The surveillance comprised 2340 surgery patients, including: 1756 Hip Arthroplasties (HPRO) and 584 Knee Arthroplasties (KPRO). In the group of patients under study, 37 cases of SSI were detected, including: 26 cases of SSI after HPRO and 11 cases in KPRO. The average incidence of SSI amounted to 1.6% (1.5% HPRO and 1.9% KPRO) and in-hospital incidence density rates were 1.23 and 1.53 per 1000 patient-days, respectively. Median age of surgical patients in both HPRO and KPRO was 70 years. Women were undergoing arthroplasty surgery more often than men, HPRO (p < 0.05) and KPRO (p < 0.001). Patients with SSI stayed in the ward longer (SSI-HPRO, p < 0.001) (SSI-KPRO p < 0.01). In KPRO operations, the incidence of SSI was higher than expected, calculated according to the Standardized Infection Ratio (SIR). The most common etiologic agents isolated from SSIs in both HPRO and KPRO were coagulase-negative staphylococci. Conclusions: Establishing a thorough surveillance of hospital-acquired infections that takes into consideration epidemiological indicators is indispensable to properly assess the epidemiological situation in the ward. The optimal solution is to carry out long-term and multi-center surveillance in the framework of a uniform program, however, even results of single-center studies provide valuable data indicating challenges and needs in improving patient safety.

scholarly journals Incidence of Surgical Site Infections in Multicenter Study—Implications for Surveillance Practice and Organization

2021 ◽  
Vol 18 (10) ◽  
pp. 5374
Author(s):  
Anna Różańska ◽  
Jerzy Rosiński ◽  
Andrzej Jarynowski ◽  
Katarzyna Baranowska-Tateno ◽  
Małgorzata Siewierska ◽  
...  
Keyword(s):  
Surgical Site Infections ◽  
Weather Conditions ◽  
Incidence Rates ◽  
Healthcare Associated Infections ◽  
Country Level ◽  
Significant Difference ◽  
Surveillance Practice ◽  
Healthcare Associated ◽  
Hospital Acquired ◽  
And Control

Introduction: WHO core components of healthcare-associated infections (HAIs) prevention and control include their surveillance system. In Poland, there are no widespread multi-center infection surveillance networks based on continuous, targeted, active methodology. One of the most important form of HAIs are surgical site infections (SSIs). The aim of this study was to analyze the incidence of SSIs, in the context of seasonal differentiation. Seasonal differentiation could be connected with weather conditions, but it also can be affected by personnel absence due to holidays and furlough. The second aspect may influence organization of work and increased absenteeism may contribute to lowering the quality of patient care. Healthcare associated infections are the phenomenon which can be especially affected by such factors. Methods: The data used originate from the targeted, active surveillance reports obtained from the six years period, based on the ECDC recommendations. Results: Highest incidence rates of SSIs were found after operations performed in June and August, equal to 1.8% and 1.5% respectively and the lowest in October was 0.8%. These differences were statistically significant: for June incidence: OR 1.6, 95% CI 1.03–2.5, p = 0.015. Another approach showed a significant difference between the level of incidence in the period from November to January together with from June to August (1.35%), comparing to the rest of the year (1.05%). Also the rates of enterococcal and Enterobacterales infections were significantly higher for the period comprising months from November till January and from June to August. In Poland these are periods of increased number of absences associated with summer, national and religious holidays. Conclusions: Our results show that the short-term surveillance data limited to several days or months are not sufficient to obtain a valuable description of the epidemiological situation due to HAI. Efforts should be undertaken in order to implement wide net of hospital acquired infections, including SSI on the country level.

Prevention of healthcare associated infections

2019 ◽  
pp. 233-304 ◽  
Author(s):  
Nizam Damani
Keyword(s):  
Prevention And Control ◽  
Bloodstream Infections ◽  
Surgical Site Infections ◽  
Central Line ◽  
Infection Prevention And Control ◽  
Healthcare Associated Infections ◽  
Tract Infections ◽  
Healthcare Associated ◽  
Hospital Acquired ◽  
And Control

This chapter provides the most up-to-date advice on infection prevention and control (IPC) of the four most common healthcare-associated infections (HAIs). These are: surgical site infections; infection associated with peripheral IV line/cannula and central line-associated bloodstream infections (CLABSIs); catheter-associated urinary tract infections (CAUTI); and hospital-acquired and ventilator-acquired pneumonias (VAP). The chapter examines and summarizes various key elements and discusses implementation of HAI care bundles and high impact interventions which are necessary to reduce these infections.

scholarly journals Pelvic Surgical Site Infections in Gynecologic Surgery

2015 ◽  
Vol 2015 ◽  
pp. 1-8 ◽  
Author(s):  
Mark P. Lachiewicz ◽  
Laura J. Moulton ◽  
Oluwatosin Jaiyeoba
Keyword(s):  
Risk Factors ◽  
Surgical Site Infections ◽  
Pelvic Surgery ◽  
Gynecologic Surgery ◽  
Pathogenic Microorganisms ◽  
Common Complication ◽  
Vaginal Cuff ◽  
Unique Challenge ◽  
Gynecologic Surgical Procedures ◽  
Patient Morbidity

The development of surgical site infection (SSI) remains the most common complication of gynecologic surgical procedures and results in significant patient morbidity. Gynecologic procedures pose a unique challenge in that potential pathogenic microorganisms from the skin or vagina and endocervix may migrate to operative sites and can result in vaginal cuff cellulitis, pelvic cellulitis, and pelvic abscesses. Multiple host and surgical risk factors have been identified as risks that increase infectious sequelae after pelvic surgery. This paper will review these risk factors as many are modifiable and care should be taken to address such factors in order to decrease the chance of infection. We will also review the definitions, microbiology, pathogenesis, diagnosis, and management of pelvic SSIs after gynecologic surgery.

FINANCIAL CONTROLLING IN THE SYSTEM OF FINANCIAL MANAGEMENT

2018 ◽  
Vol 28 (1) ◽  
pp. 137-141
Author(s):  
Petya Yordanova – Dinova
Keyword(s):  
Comparative Analysis ◽  
Financial Management ◽  
Financial Stability ◽  
Business Environment ◽  
Innovative Approach ◽  
Financial Sustainability ◽  
The Common ◽  
The Difference ◽  
Effective Use ◽  
And Control

This paper explores the comparative analysis of the financial controlling, who is a result from the common controlling concept and the financial management. In the specialized literature, financial controlling is seen as an innovative approach to financial management. It is often presented as the most promising instrument of financial diagnostics. Generally speaking, financial controlling is seen as a process of managing the company`s assets which are valued in monetary measures. The difference between the financial management and the financial controlling is that the second covers all functions of management, analysis and control of finances, aiming at maximizing their effective use and increasing the value of the enterprise. Financial controlling is often seen as a function of the common practice of financial management. Its objective is to preserve the financial stability and financial sustainability of enterprises operating in a highly aggressive business environment.

scholarly journals Protection and Response of a Tertiary Hospital in Shenzhen, China to the COVID-19 Outbreak—the Practice of the Comprehensive Response Mode

2021 ◽  
pp. 1-17
Author(s):  
Benling Hu ◽  
Le Yang ◽  
Chan Wei ◽  
Min Luo
Keyword(s):  
Prevention And Control ◽  
Tertiary Hospital ◽  
Control Model ◽  
Normal Operation ◽  
Process Reengineering ◽  
Equipment Management ◽  
Hospital Acquired Infection ◽  
Public Health Emergencies ◽  
Hospital Acquired ◽  
And Control

ABSTRACT Objective: To evaluate the management mode for the prevention and control of coronavirus 2019 (COVID-19) transmission utilized at a general hospital in Shenzhen, China, with the aim to maintain the normal operation of the hospital. Methods: From January 2, 2020 to April 23, 2020, Hong Kong–Shenzhen Hospital, a tertiary hospital in Shenzhen, has operated a special response protocol named comprehensive pandemic prevention and control model, which mainly includes six aspects: 1) human resource management; 2) equipment management; 3) logistics management; 4) cleaning, disinfection and process reengineering; 5) environment layout; 6) and training and assessment. The detail of every aspect was described and its efficiency was evaluated. Results: A total of 198,802 patients were received. Of those, 10,821 were hospitalized; 26,767 were received by the emergency department and fever clinics; 288 patients were admitted for observation with fever; and 324 were admitted as suspected cases for isolation. Under the protocol of comprehensive pandemic prevention and control model, no case of hospital-acquired infection with COVID-19 occurred among the inpatients or staff. Conclusion: The present comprehensive response model may be useful in large public health emergencies to ensure appropriate management and protect the health and life of individuals.

scholarly journals Surgical site infection metrics: Dissecting the differences between the National Health and Safety Network and the National Surgical Quality Improvement Program

2021 ◽  
Vol 1 (1) ◽  
Author(s):  
Alaia M. M. Christensen ◽  
Karen Dowler ◽  
Shira Doron
Keyword(s):  
Quality Improvement ◽  
Health And Safety ◽  
Surgical Site Infections ◽  
Cost Of Care ◽  
Quality Improvement Program ◽  
Surveillance Systems ◽  
Improvement Program ◽  
Surgical Quality ◽  
National Healthcare Safety Network ◽  
Hospital Acquired

Abstract Surgical site infections (SSIs) are associated with readmissions, reoperations, increased cost of care, and overall morbidity and mortality risk. The National Healthcare Safety Network (NHSN) and the National Surgical Quality Improvement Program (NSQIP) have developed an array of metrics to monitor hospital-acquired complications. The only metric collected by both is SSI, but performance as benchmarked against peer hospitals is often discordant between the 2 systems. In this commentary, we outline the differences between these 2 surveillance systems as they relate to this potential for discordance.

Inhibition of IL-13: A New Pathway for Atopic Dermatitis

2020 ◽  
pp. 120347542098255
Author(s):  
Kayadri Ratnarajah ◽  
Michelle Le ◽  
Anastasiya Muntyanu ◽  
Steve Mathieu ◽  
Simon Nigen ◽  
...  
Keyword(s):  
Monoclonal Antibody ◽  
Atopic Dermatitis ◽  
Severity Index ◽  
Severe Atopic Dermatitis ◽  
Treatment Alternative ◽  
Control Groups ◽  
Rapid Improvement ◽  
Common Receptor ◽  
The Common ◽  
And Control

Dupilumab, a monoclonal antibody against the common receptor of interleukin (IL)-4 and IL-13, was the first biologic therapy approved in Canada for treatment of moderate-to-severe atopic dermatitis (AD). While it is considered safe and effective, dupilumab is not universally effective and 8%-38% of patients develop conjunctivitis, while some patients develop head and neck dermatitis. Thus, new therapeutic options are warranted. While both IL-4 and IL-13 play important roles in the pathogenesis of AD, it has been recently demonstrated that IL-13 is the primary upregulated cytokine in AD skin biopsy samples. A placebo-controlled phase 2b clinical trial evaluating the efficacy and safety of lebrikizumab, an IL-13 inhibitor, in AD demonstrated that, at 16 weeks, Eczema Area and Severity Index (EASI) 75 and Investigator’s Global Assessment (IGA) 0/1 were achieved by 60.6% and 44.6% of patients taking lebrikizumab at its highest dose (vs 24.3% and 15.3% of patients taking placebo, respectively). Moreover, treatment with lebrikizumab was associated with rapid improvement of pruritus and low rates of conjunctivitis (1.4%-3.8%). Another IL-13 monoclonal antibody, tralokinumab, was evaluated for safety and efficacy in moderate-to-severe AD. By week 12, among adults receiving 300 mg tralokinumab, 42.5% achieved EASI-75 and 26.7% achieved IGA 0/1 score (vs 15.5% and 11.8% in the placebo group, respectively). Both lebrikizumab and tralokinumab demonstrated acceptable safety profiles in AD (and non-AD) trials with adverse events often being comparable between treatment and control groups. Thus, IL-13 inhibitors may provide a safe and effective treatment alternative for patients with moderate-to-severe AD.

scholarly journals 10 Years of Pulsed-Xenon Ultraviolet Disinfection

2020 ◽  
Vol 41 (S1) ◽  
pp. s438-s438
Author(s):  
Mark Stibich ◽  
Sarah Simmons ◽  
Deborah Passey
Keyword(s):  
Relative Risk ◽  
Meta Analysis ◽  
Outcome Studies ◽  
Uv Disinfection ◽  
Clostridioides Difficile ◽  
Environmental Effectiveness ◽  
Meta Analyses ◽  
Hospital Acquired ◽  
And Control ◽  
Effectiveness Studies

Background: Ultraviolet light (UV) disinfection using low-pressure mercury lamps has been around since the 1940s. The advent of pulsed-xenon UV for hospital use in 2010 has provided a nontoxic and novel technology for hospital disinfection with the first data presented at the 2010 SHEA Decennial. The purpose of this systematic review and meta-analysis is to examine the current body of evidence for pulsed xenon UV disinfection. Methods: The literature search criteria included the following: research conducted in domestic and international settings using pulsed-xenon for surface disinfection, published between 2000 and 2019, and reporting on environmental effectiveness or hospital-acquired reductions (HAIs). We searched PubMed, Google Scholar, and Web of Science. The meta-analysis included 24 studies: 12 HAI outcome studies and 12 environmental effectiveness studies. Meta-analyses were conducted by calculating the percentage reductions for environmental effectiveness, and for the HAI outcome studies, we used a random-effects model to pool the relative risk of HAI. The outcome studies used 272 and 299 months of data for the experimental and control groups, respectively. Results: There was an overall benefit of using pulsed-xenon UV. The overall relative risk of infection decreased compared to the control arm (RR, 0.64; 95% CI, 0.54–0.76). The percentage reductions in environmental studies were as follows: Clostridioides difficile (94.8%), methicillin-resistant Staphylococcus aureus (91.5%), vancomycin-resistant Enterococcus (99.2%), and aerobic bacteria (94.2%). Conclusions: Overall, pulsed-xenon UV was effective for reducing environmental contamination and had the ability to significantly reduce HAIs.Funding: Xenex, Inc., funded this study.Disclosures: Mark Stibich receives a salary from Xenex and is a shareholder of Xenex. Deborah Passey receives a salary from Xenex Disinfection Services.

scholarly journals Risk factors and biofilm formation analyses of hospital-acquired infection of Candida pelliculosa in a neonatal intensive care unit

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Zhijie Zhang ◽  
Yu Cao ◽  
Yanjian Li ◽  
Xufang Chen ◽  
Chen Ding ◽  
...  
Keyword(s):  
Risk Factors ◽  
Intensive Care Unit ◽  
Biofilm Formation ◽  
Prevention And Control ◽  
Neonatal Intensive Care ◽  
Infection Prevention ◽  
Infection Prevention And Control ◽  
Anti Fungal ◽  
Hospital Acquired ◽  
And Control

Abstract Background Candida pelliculosa is an ecological fungal species that can cause infections in immunocompromised individuals. Numerous studies globally have shown that C. pelliculosa infects neonates. An outbreak recently occurred in our neonatal intensive care unit; therefore, we aimed to evaluate the risk factors in this hospital-acquired fungal infection. Methods We performed a case-control study, analysing the potential risk factors for neonatal infections of C. pelliculosa so that infection prevention and control could be implemented in our units. Isolated strains were tested for drug resistance and biofilm formation, important factors for fungal transmission that give rise to hospital-acquired infections. Results The use of three or more broad-spectrum antimicrobials or long hospital stays were associated with higher likelihoods of infection with C. pelliculosa. The fungus was not identified on the hands of healthcare workers or in the environment. All fungal isolates were susceptible to anti-fungal medications, and after anti-fungal treatment, all infected patients recovered. Strict infection prevention and control procedures efficiently suppressed infection transmission. Intact adhesin-encoding genes, shown by genome analysis, indicated possible routes for fungal transmission. Conclusions The use of three or more broad-spectrum antimicrobials or a lengthy hospital stay is theoretically associated with the risk of infection with C. pelliculosa. Strains that we isolated are susceptible to anti-fungal medications, and these were eliminated by treating all patients with an antifungal. Transmission is likely via adhesion to the cell surface and biofilm formation.

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