| 38823452 |
Long versus short course anti-microbial therapy of uncomplicated Staphylococcus aureus bacteraemia: a systematic review |
Background:\nCurrent guidelines recommend at least 2 weeks duration of antibiotic therapy (DOT) for patients with uncomplicatedStaphylococcus aureus bacteraemia (SAB) but the evidence for this recommendation is unclear.\nObjectives:\nTo perform a systematic literature review assessing current evidence for recommended DOT for patients with SAB.\nMethods:\nThe following are the methods used for this study.\nData sources:\nWe searched MEDLINE, ISI Web of Science, the Cochrane Database and clinicaltrials.gov from inception to March 30, 2024.References of eligible studies were screened and experts in the field contacted for additional articles.\nStudy eligibility criteria:\nAll clinical studies, regardless of design, publication status and language.\nParticipants:\nAdult patients with uncomplicated SAB.\nInterventions:\nLong (>14 days; >18 days; 11-16 days) vs. short (≤14 days; 10-18 days; 6-10 days, respectively) DOT with the DOT beingdefined as the first until the last day of antibiotic therapy.\nAssessment of risk of bias:\nRisk of bias was assessed using the ROBINS-I-tool.\nMethods of data synthesis:\nThe primary outcome was 90-day all-cause mortality. Only studies presenting results of adjusted analyses formortality were included. Data synthesis could not be performed.\nResults:\nEleven nonrandomized studies were identified that fulfilled the pre-defined inclusion criteria, of which three studies reportedadjusted effect ratios. Only these were included in the final analysis. We did not find any RCT. Two studies with 1230 patients reported theprimary endpoint 90-day all-cause mortality. Neither found a statistically significant superiority for longer (>14 days; 11-16 days) or shorterDOT (≤14 days; 6-10 days, respectively) for patients with uncomplicated SAB. Two studies investigated the secondary endpoint 30-day all-cause mortality (>18 days; 11-16 days vs. 10-18 days; 6-10 days, respectively) and did not find a statistically significant difference. Allincluded studies had a moderate risk of bias.\nConclusions:\nSound evidence that supports any duration of antibiotic treatment for patients with uncomplicated SAB is lacking.\n\n |
Systematic review/Scoping review with large effect size |
10.1016/j.cmi.2024.05.015 |
Schnizer M, Schellong P, Rose N, Fleischmann-Struzek C, Hagel S, Abbas M, Payne B, Evans RN, Pletz MW, Weis S. |
Clin Microbiol Infect. 2024 Oct;30(10):1254-1260. doi: 10.1016/j.cmi.2024.05.015. Epub 2024 May 30. |
Clin Microbiol Infect |
2024 |
2024-06-01 |
NaN |
| 39092963 |
A randomized non-inferiority study comparing imipenem/cilastatin/relebactam with standard-of-care Gram-negative coverage in cancer patients with febrile neutropenia |
Background:\nAntibiotic overuse leads to the emergence of antibiotic resistance that threatens immunocompromised cancer patients.Infections caused by MDR Gram-negative pathogens are difficult to treat and associated with high mortality. Hence, empirical therapy withstandard-of-care (SOC) antibiotics could be suboptimal in these vulnerable patients. New antibiotics covering potential resistant pathogens may be considered.\nMethods:\nWe conducted a randomized non-inferiority study comparing safety and efficacy of imipenem/cilastatin/relebactam (IPM/REL), aβ-lactam/β-lactamase inhibitor combination, with SOC antibiotics (cefepime, piperacillin/tazobactam or meropenem) in cancer patients with febrile neutropenia. Patients received at least 48 h of IV antibiotics and were assessed at end-of-IV (EOIV) therapy, test of cure (TOC; Days21-28), and late follow-up (LFU; Days 35-42).\nResults:\nA total of 100 patients were enrolled (49 IPM/REL and 50 SOC). Demographics and rates of documented microbiological infections were similar in both groups. In the SOC arm, 86% of antibiotics consisted of cefepime. Patients on IPM/REL had a higher favourable clinical response at EOIV than those on SOC (90% versus 74%; P = 0.042); however, responses were similar at TOC and LFU. Microbiological eradication was comparable at all three time points. Study drug-related adverse events and adverse events leading to drug discontinuationwere similar in both groups, with no study drug-related mortality.\nConclusions:\nOur results suggest that compared with SOC antibiotics, predominantly cefepime, IPM/REL for empirical coverage of febrile neutropenia in cancer patients is generally safe and could be associated with a better clinical outcome at EOIV. The current SOC consisting mainly of agents that do not cover for ESBL-producing and carbapenem-resistant Enterobacterales bacteria should be reconsidered. |
RCTs having large positive / negative effect |
10.1093/jac/dkae254 |
Chaftari AM, Dagher H, Hachem R, Jiang Y, Lamie P, Wilson Dib R, John T, Haddad A, Philip A, Alii S, Mulanovich P, Yuan Y, Chaftari P, Raad I. |
J Antimicrob Chemother. 2024 Oct 1;79(10):2543-2553. doi: 10.1093/jac/dkae254. |
J Antimicrob Chemother |
2024 |
2024-08-02 |
NaN |
| 39004189 |
The CATERPILLAR study: an assessor-blinded randomized controlled trial comparing a taurolidine-citrate-heparin lock solution to a heparin-only lock solution for the prevention of central-line-associated bloodstream infections in paediatric oncology patients |
Background:\nTaurolidine-citrate(-heparin) lock solutions (TCHL) are suggested as a promising and safe method for the prevention ofcentral-line-associated bloodstream infections (CLABSI).\nAim:\nTo investigate the efficacy of TCHL for the prevention of CLABSI in paediatric oncology patients.\nMethods:\nAn assessor-blinded randomized controlled trial at the Princess Máxima Centre for paediatric oncology, the Netherlands, wasperformed from 2020 to 2023. Paediatric oncology patients receiving a tunnelled central venous access device (CVAD) were eligible. A totalof 462 patients were required to compare the TCHL to the heparin-only lock (HL). Patients were followed-up for the first 90 days after CVADinsertion. The primary outcome was the incidence of the first CLABSI from CVAD insertion until the end of follow-up. Intention-to-treat andper-protocol analyses were performed.\nFindings:\nIn total, 232 were randomized in the HL and 231 in the TCHL group. A total of 47 CLABSIs were observed. The intention-to-treatanalysis showed that a CLABSI was observed in 26 (11.2%) of the HL group patients versus 21 (9.1%) of the TCHL group patients; incidencerate ratio (IRR) of 0.81 (95% confidence interval (CI): 0.46-1.45) in favour of the TCHL group. The per-protocol analysis showed that aCLABSI was observed in 10 (7.9%) of the HL group patients versus 6 (4.8%) of the TCHL group patients; IRR of 0.59 (95% CI: 0.21-1.62) infavour of the TCHL group. Adverse events were more common in the TCHL group but rarely reported.\nConclusion:\nNo difference was detected between the TCHL and HL in the incidence of CLABSI in paediatric oncology patients. |
RCTs having large positive / negative effect |
10.1016/j.jhin.2024.06.009 |
van den Bosch CH, Loeffen YGT, van der Steeg AFW, van der Bruggen JT, Frakking FNJ, Fiocco M, van de Ven CP, Wijnen MHWA, van de Wetering MD. |
J Hosp Infect. 2024 Oct;152:56-65. doi: 10.1016/j.jhin.2024.06.009. Epub 2024 Jul 14. |
J Hosp Infect |
2024 |
2024-07-14 |
NaN |
| 39001923 |
Prophylactic antibiotics in sialendoscopy: a randomized clinical trial |
Objective:\nAntibiotics have been prescribed routinely in sialendoscopy procedures to reduce the risk of postoperative infection, despite the limited evidence supporting this practice. Being necessary to assess the need for antibiotics in Sialendoscopy, aiming to provide evidence-based guidance to clinicians regarding antibiotic administration in this procedure.\nMaterials & method:\nA prospective, randomized, double-blind, controlled clinical trial to evaluate the of prophylactic antibiotics in Sialendoscopy was designed.\nResults:\nA total of 80 patients were included in this study, including 57 females (71.8%) and 23 males (28.8%). In terms of prophylaxis, 36patients (45%) received prophylactic treatment, and 44 patients (55%) did not. The occurrence of infectious events was observed in 2patients (5.6%) with prophylaxis and 4 patients (9.1%) without prophylaxis. However, this difference was not statistically significant (p =0.556).\nConclusion:\nIn conclusion, our prospective, randomized clinical trial aimed to address the debate regarding the use of prophylactic antibiotics in sialendoscopy. Our study's findings suggest that the routine use antibiotics may not be necessary to prevent postoperative infections in sialendoscopy procedures. These results have important implications for clinical practice, potentially reducing the unnecessary use of antibiotics and addressing concerns related to antibiotic resistance and adverse drug reactions. |
RCTs having large positive / negative effect |
10.1007/s00405-024-08773-z |
Chiesa-Estomba CM, Sanchez-Barrueco A, Cammaroto G, Lechien JR, Mayo-Yanez M, Cenjor C, Capaccio P, Saga-Gutierrez C. |
Eur Arch Otorhinolaryngol. 2024 Oct;281(10):5511-5516. doi: 10.1007/s00405-024-08773-z. Epub 2024 Jul 13. |
Eur Arch Otorhinolaryngol |
2024 |
2024-07-13 |
NaN |
| 39029119 |
Infection rates during eras of intrathecal antibiotic use followed by antibiotic-impregnated catheter use in prevention of cerebrospinal fluid shunt infection |
Objective:\nThe Hydrocephalus Clinical Research Network (HCRN) implemented a perioperative infection prevention bundle for all CSF shuntsurgeries in 2007 that included the relatively unproven technique of intrathecal instillation of the broad-spectrum antibiotics vancomycin andgentamicin into the shunt. In the meantime, the field debated the use of antibiotic-impregnated catheter (AIC) shunt tubing usingclindamycin and rifampin, an increasingly widespread, but expensive and controversial, technique. It is unknown whether there were changesin infecting organisms associated with the use of these techniques during CSF shunt surgery at the hospital level. Key comparison periodsinclude during the use of intrathecal antibiotics (period 1 from June 1, 2007, to December 31, 2011, at HCRN hospitals) and AIC (period 2 fromJanuary 1, 2012, to December 31, 2015, at HCRN as well as increasing over time at non-HCRN hospitals) and only standard use of routineprophylactic antibiotics (period 1 at non-HCRN hospitals). The aim of this study was to examine rates of CSF shunt surgery-related infectionsfrom 2007 to 2012 at the hospital level, including HCRN and non-HCRN hospitals, with a focus on infections with gram-negative organisms.\nMethods:\nThe authors conducted a retrospective observational cohort study at 6 children's hospitals with enrollment from 2007 to 2012 and surveillance through 2015. Bimonthly rates of shunt surgery-related infections were summarized to produce an overall hospital-specific timeseries, as well as by HCRN/non-HCRN status. An interrupted time series analysis was performed to assess the impact of change in HCRN perioperative infection prevention bundle on overall bimonthly infection rates. Quarterly rates of gram-negative shunt surgery-relatedinfections were summarized to produce an overall hospital-specific time series.\nResults:\nThe overall bimonthly CSF shunt infection rate over time did not change significantly from 2007 to 2012. There was no difference in the trajectory of infection rates between HCRN and non-HCRN hospitals during the entire study period. No change in distributions of gram-negative organism infections was observed in hospitals from 2007 to 2015.\nConclusions:\nThere were no differences observed in hospital-level infection rates for low-risk patients undergoing CSF shunt surgery. This included analyses based on participation in the HCRN network, given their regular use of intrathecal antibiotics in period 1 and a focus ongram-negative infections with increasing adoption of AICs in period 2.\n\n\n |
Multi-centric observational study with large effect |
10.3171/2024.5.PEDS23372 |
Simon TD, Hayati Rezvan P, Coffin SE, Hall M, Hauptman JS, Kronman MP, Mangano FT, Podkovik S, Pollack IF, Schaffzin JK, Thorell E, Warf BC, Zhou C, Whitlock KB. |
J Neurosurg Pediatr. 2024 Jul 19;34(4):357-364. doi: 10.3171/2024.5.PEDS23372. Print 2024 Oct 1. |
J Neurosurg Pediatr |
2024 |
2024-07-19 |
PMC11444882 |
| 39019103 |
Ciprofloxacin versus levofloxacin prophylaxis in hematopoietic stem cell transplantation: A randomized trial |
Objectives:\nWe aimed to assess whether there is a difference between ciprofloxacin and levofloxacin as prophylaxis in hematopoietic stemcell transplant (SCT) recipients.\nMethods:\nThis is a prospective, randomized trial in patients receiving SCT at Henry Ford Health in the United States of America. Werandomly assigned patients (1:1) to receive ciprofloxacin or levofloxacin. The primary outcome was incidence of bloodstream bacterialinfections (BSI) up to day 60 after SCT.\nResults:\nBetween June 4, 2018, and May 23, 2022, we randomly assigned 308 consecutive patients to receive ciprofloxacin (154 patients) orlevofloxacin (154 patients). BSI was similar in both the ciprofloxacin and levofloxacin groups (18 [11.7%] vs 18 [11.7%]). Pneumonia was more frequent in the ciprofloxacin group compared to the levofloxacin group (18 [18%] vs 7 [23%]; relative risk 2.57, 95% CI 1.11-5.98; p = 0.028).There were no differences in neutrophil engraftment, fever, Clostridium difficile infection, relapse incidence, overall survival, nonrelapsemortality, length of stay post-SCT, or intensive care unit admission.\nConclusion:\nAlthough both prophylaxis regimens demonstrated the same efficacy in SCT recipients, levofloxacin prophylaxis led to less pneumonia in the first 60 days post-SCT. |
Multi-centric observational study with large effect |
10.1016/j.ijid.2024.107172 |
Farhan S, Mazur I, Hartzell S, Xie P, Neme K, German A, Mikulandric N, Patel K, Wu M, Kortam N, Yaseen A, Sweidan A, Latack K, Emole J, Peres E, Abidi MH, Ramesh M. |
Int J Infect Dis. 2024 Oct;147:107172. doi: 10.1016/j.ijid.2024.107172. Epub 2024 Jul 15. |
Int J Infect Dis |
2024 |
2024-07-17 |
NaN |
| 38871055 |
Real-World Experience with Isavuconazole in Allogeneic Stem Cell Transplantation in Spain |
Invasive fungal infections (IFI) pose a significant complication after hematopoietic stem cell transplantation (HSCT). Isavuconazole (ISV) is anew generation azole with a favourable adverse effect and interaction profile approved for the treatment of invasive aspergillosis and mucormycosis. We analyzed the indications, effectiveness, adverse event profile and drug interaction management of ISV in the real-world setting in adults who received allogeneic-HSCT (allo-HSCT) within the Spanish Group of HSCT and Cell Therapy (GETH-TC). We conducteda multicenter retrospective study of all consecutive adult allo-HSCT recipients (≥18 years) who received ISV either for IFI treatment orprophylaxis, from December 2017 to August 2021, in 20 centers within the Spanish Group of Hematopoietic Stem Cell Transplantation andCell Therapy (GETH-TC). A total of 166 adult allografted patients who received ISV from 2017 to 2021 were included. Median age was 48years with 43% females. In 81 (49%) patients, ISV was used for treatment of IFI, and in 85 (51%) for prophylaxis. Median duration of ISV administration for IFI treatment was 57 days (range 31-126) and 86 days (range 33-196) for prophylaxis. Most frequent indication fortreatment was invasive aspergillosis (78%), followed by mucormycosis (6%). Therapeutic success (45%) was the most frequent reason for ISV withdrawal. In the prophylaxis group, the resolution of IFI risk factors was the most frequent reason for withdrawal (62%). Six (7%) breakthrough IFI were reported. The majority of patients (80%) presented pharmacologic interactions. Twenty-one patients (13%) reported adverse events related to ISV, mainly liver biochemistry abnormalities, which led to ISV withdrawal in 7 patients (4%). ISV was effective and well tolerated for IFI treatment and prophylaxis, with a manageable interaction profile. |
Multi-centric observational study with large effect |
10.1016/j.jtct.2024.06.009 |
Kwon M, Gómez-Centurión I, Oarbeascoa G, Torres M, Martinez AP, Suarez-Lledó M, Chinea A, Cascón MJP, Vazquez L, Espigado I, Izquierdo I, Parody R, Cadenas IG, Calbacho M, Sierra PG, Heras I, Yañez L, Torrent A, Bautista G, Gonzalez S, Roldan E, Vallejo JC, Bailen R, Borrero A, Lopez-Jiménez J, Casas MAC, Solano C; Spanish Group of Hematopoietic Stem Cell Transplantation and Cell Therapy (GETH-TC). |
Transplant Cell Ther. 2024 Oct;30(10):1033.e1-1033.e8. doi: 10.1016/j.jtct.2024.06.009. Epub 2024 Jun 12. |
Transplant Cell Ther |
2024 |
2024-06-13 |
NaN |
| 38830130 |
Are Invasive Group A Streptococcal Infections Preventable by Antibiotic Therapy?: A Collaborative Retrospective Study |
Background:\nIn winter 2022/2023, a resurgence of invasive group A streptococcal (iGAS) infections in children was observed in Europe, including Germany and Switzerland. While a simultaneous increase in consultations for scarlet fever and pharyngitis was reported in England, leading to the recommendation to treat any suspected GAS disease with antibiotics, guidelines in Germany and Switzerland remained unchanged. We aimed to investigate whether this policy was appropriate.\nMethods:\nWe conducted a retrospective multicenter study of children hospitalized for invasive GAS disease between September 2022 and March 2023 in pediatric departments in Dresden and Berlin (Germany) and Basel (Switzerland). We reviewed medical records and conductedstructured telephone interviews to analyze whether suspected GAS infections with or without antibiotic treatment were reportedprehospitalization.\nResults:\nIn total, 63 patients met the inclusion criteria (median age 4.2 years, 57% males); however, clinical information was not complete for all analyzed characteristics; 32/54 (59%) had ≥1 physician visit ≤4 weeks prehospitalization. In 4/32 (13%) patients, GAS disease, that is,tonsillitis or scarlet fever, was suspected; 2/4 of them received antibiotics, and a positive rapid antigen test for GAS was documented in 1 of them.\nConclusions:\nA small minority of patients had suspected GAS infection within 4 weeks before iGAS disease. These data suggest that there is little opportunity to prevent iGAS disease by antibiotic therapy, because in most patients-even if seen by a physician-there was either no evidence of GAS disease or when GAS disease was suspected and treated with antibiotics, consecutive invasive GAS disease was not prevented. |
Multi-centric observational study with large effect |
10.1097/INF.0000000000004403 |
Erlacher R, Toepfner N, Dressen S, Berner R, Bösch A, Tenenbaum T, Heininger U. |
Pediatr Infect Dis J. 2024 Oct 1;43(10):931-935. doi: 10.1097/INF.0000000000004403. Epub 2024 Sep 16. |
Pediatr Infect Dis J |
2024 |
2024-06-03 |
PMC11407772 |
| 38604442 |
International Nosocomial Infection Control Consortium (INICC) report of health care-associated infections, data summary of 25 countries for 2014 to 2023, Surgical Site Infections Module |
Background:\nSurgical site infection (SSI) rates are higher in low-resource countries (LRC) than in high-income counterparts.\nMethods:\nProspective cohort study using the INICC Surveillance Online System, from 116 hospitals in 75 cities across 25 Latin-American,Asian, Eastern-European, and Middle-Eastern countries: Argentina, Bahrain, Brazil, Colombia, Costa Rica, Dominican Republic, Ecuador,Egypt, Honduras, India, Kosovo, Kuwait, Lebanon, Mexico, Mongolia, Pakistan, Papua New Guinea, Philippines, Poland, Romania, SaudiArabia, Thailand, Turkey, Venezuela, Vietnam. CDC/NHSN definitions were applied. Surgical procedures (SPs) were categorized according tothe International Classification of Diseases criteria.\nResults:\nFrom 2014 to 2023, we collected data on 1,251 SSIs associated with 56,617 SPs. SSI rates were significantly higher in SPs of INICCcompared to CDC/NHSN data: hip prosthesis (3.68% vs 0.67%, relative risk [RR]=5.46, 95% confidence interval [CI]=3.71-8.03, P<.001),knee prosthesis (2.02% vs 0.58%, RR=3.49, 95% CI=1.87-6.49, P<.001), coronary artery bypass (4.16% vs 1.37%, RR=3.03, 95% CI=2.35-3.91, P<.001), peripheral vascular bypass (15.69% vs 2.93%, RR=5.35, 95% CI=2.30-12.48, P<.001), abdominal aortic aneurysm repair(8.51% vs 2.12%, RR=4.02, 95% CI=2.11-7.65, P<.001), spinal fusion (6.47% vs 0.70%, RR=9.27, 95% CI=6.21-13.84, P<.001), laminectomy(2.68% vs 0.72%, RR=3.75, 95% CI=2.36-5.95, P<.001), among others. |
Multi-centric observational study with large effect |
10.1016/j.ajic.2024.04.007 |
Rosenthal VD, Yin R, Jin Z, Alkhawaja SA, Zuñiga-Chavarria MA, Salgado E, El-Kholy A, Zuniga Moya JC, Patil P, Nadimpalli G, Pattabhiramarao RN, Zala D, Villegas-Mota I, Ider BE, Tumu N, Duszynska W, Nguyet LTT, Nair PK, Memish ZA. |
Am J Infect Control. 2024 Oct;52(10):1144-1151. doi: 10.1016/j.ajic.2024.04.007. Epub 2024 Apr 9. |
Am J Infect Control |
2024 |
2024-04-11 |
NaN |
| 38537776 |
Novel β-lactam-β-lactamase inhibitors as monotherapy versus combination for the treatment of drug-resistant Pseudomonas aeruginosa infections: A multicenter cohort study |
Background:\nData comparing the clinical outcomes of novel β-lactam-β-lactamase inhibitors given in combination versus monotherapy forthe treatment of multidrug-resistant (MDR) P. aeruginosa infections are lacking.\nMethod:\nThis retrospective cohort study included patients who received novel β-lactam-β-lactamase inhibitors as monotherapy or incombination for the treatment of MDR P. aeruginosa infections. The study was conducted between 2017 and 2022 in 6 tertiary care hospitalsin Saudi Arabia. Overall in-hospital mortality, 30-day mortality, clinical cure, and acute kidney injury (AKI) were compared between recipientsof monotherapy versus combination using multivariate logistic regression analysis.\nResult:\n118 patients and 82 patients were included in monotherapy and combination therapy arms, respectively. The cohort represented anill population with 56% in the intensive care unit and 37% in septic shock. A total of 19% of patients presented with bacteremia. Compared tomonotherapy, combination therapy did not significantly differ in clinical cure (57% vs. 68%; P = 0.313; OR, 0.63; 95% CI, 0.36-1.14) in-hospital mortality (45% vs. 37%; P = 0.267; OR, 1.38; 95% CI, 0.78-2.45), or 30-day mortality (27% vs. 24%; P = 0.619; OR, 1.18; 95% CI,0.62-1.25). However, AKI (32% vs. 12%; P = 0.0006; OR, 3.45; 95% CI, 1.67-7.13) was significantly more common in patients who receivedcombination therapy.\nConclusion:\nNovel β-lactam-β-lactamase inhibitors when used in combination with other antibiotics did not add clinical benefit compared to their use as monotherapy in the treatment of MDR P. aeruginosa infections. A Combination regimen was associated with an increased risk ofnephrotoxicity. |
Multi-centric observational study with large effect |
10.1016/j.jiac.2024.03.015 |
Almangour TA, Ghonem L, Alassiri D, Aljurbua A, Al Musawa M, Alharbi A, Almuhisen S, Alghaith J, Damfu N, Aljefri D, Alfahad W, Alrasheed M, Khormi Y, Almohaizeie A. |
J Infect Chemother. 2024 Oct;30(10):1008-1014. doi: 10.1016/j.jiac.2024.03.015. Epub 2024 Mar 25. |
J Infect Chemother |
2024 |
2024-03-27 |
NaN |
| 39326674 |
Enhancing infection control in dialysis at a resource limited public healthcare institute: A cross-sectional study on microbiological quality assessment of dialysis water and dialysate |
Purpose:\nTo evaluate the microbiological quality of dialysis water and dialysate samples from hemodialysis units at a tertiary care government hospital and to assess the use of culture, endotoxin and periodicity of testing these assays to guide the actions of monitoring the quality of hemodialysis fluids, implement preventive and corrective actions, and improve the safety and outcomes of the dialysis process.\nMethods:\nA cross-sectional study was conducted at a 250-bedded super-specialty government hospital with a 24/7 hemodialysis unit equipped with 40 dialysis machines. Dialysis water and dialysate samples were collected monthly and analysed for microbial contamination and endotoxin levels as per AAMI guidelines. Bacterial cultures were done using Reasoner's Agar plates, and endotoxin analysis was performed using gel clot assay. Interpretation of results was based on predefined thresholds.\nResults:\nAmong the 740 samples processed for microbial culture 19.6 % and 80.4% were unacceptable and acceptable respectively.Among the acceptable samples 10.5 % were at action level. At the end of 2 days of incubation, 15.2% dialysis water samples and 5.1% dialysate samples had unacceptable levels of bacterial colonies and at 5 days additional 10.6 % dialysis water samples and 7.7% dialysate samples were unacceptable. 21.5 % of the samples tested for endotoxin had unacceptable levels.\nConclusions:\nRegular monitoring of water quality in government healthcare hemodialysis units is crucial for quality of care, timely preventive and corrective actions for mitigating adverse outcomes. Processing cultures for 5-7 days is essential for detecting all contaminated specimens. While there might be a link between endotoxin levels and bacterial contamination, both endotoxin testing and bacterial culture independently are vital for evaluating water quality in dialysis settings. A comprehensive approach integrating various testing methods isnecessary to uphold patient safety and enable necessary improvements. |
Other specific ISP article suggested by Editorial Board |
10.1016/j.ijmmb.2024.100734 |
Suravaram S, Gopikonda SS, Siddiqui IA, Kanugula H, Gorakanti D, Vaddanapu L. |
Indian J Med Microbiol. 2024 Oct 1;52:100734. doi: 10.1016/j.ijmmb.2024.100734. Online ahead of print. |
Indian J Med Microbiol |
2024 |
2024-09-26 |
NaN |
| 39290826 |
Evidence summary of prevention strategies for catheter-related infections among cancer patients with home parenteral nutrition |
Objective:\nTo provide a comprehensive summary of evidence on prevention strategies for catheter-related infections among cancer patients with home parenteral nutrition.\nMethods:\nA systematic literature search was conducted for identifying prevention strategies for catheter-related infections among cancer patients with home parenteral nutrition, including clinical decisions, guidelines, best practices, expert consensus, evidence summaries, and systematic reviews. The search period includes publications from January 2000 to April 2024.\nResults:\nSeven articles were included in the review, comprising four guidelines, one expert consensus, and two systematic reviews. This resulted in the identification of five evidence themes and 33 best evidence statements, addressing safety and monitoring, team and education training, hand hygiene and aseptic techniques, catheter and exit site selection, and catheter care and protection.\nConclusions:\nThis evidence summary identifies the prevention of catheter-related infections in home parenteral nutrition, and offers valuable resources for clinical application and guidance for preventing infections among cancer patients receiving home parenteral nutrition. |
Other specific ISP article suggested by Editorial Board |
10.1016/j.apjon.2024.100570 |
Zhong Y, Chen X, He S, Zhang P, Zeng Y. |
Asia Pac J Oncol Nurs. 2024 Aug 10;11(10):100570. doi: 10.1016/j.apjon.2024.100570. eCollection 2024 Oct. |
Asia Pac J Oncol Nurs |
2024 |
2024-09-18 |
PMC11405632 |
| 39264828 |
Development and Validation of Nosocomial Bacterial Infection Prediction Models for Patients With Systemic Lupus Erythematosus |
Background:\nHospital-acquired bacterial infections are associated with high morbidity and mortality rates in patients with systemic lupus erythematosus (SLE). This study aimed to develop and validate predictive models for the risk of hospital-acquired bacterial infections inpatients with SLE.\nMethods:\nA historical cohort study was designed for development, and another bidirectional cohort study was used for external validation.The risk of bacterial infection was assessed upon admission and after 5 days of hospitalization. Predictor selection employed the least absolute shrinkage and selection operator (LASSO) techniques. Multiple imputations were used to handle missing data. Logistic regression models were applied, and the properties of discrimination, calibration, and decision curve analysis were evaluated.\nResults:\nThe development cohort comprised 1686 patients and 237 events (14.1%) from 3 tertiary hospitals. The external validation cohort included 531 patients and 84 infection outcomes (15.8%) from 10 hospital centers in Colombia (secondary and tertiary level). The models applied at admission and after 120 hours of stay exhibited good discrimination (AUC > 0.74). External validation demonstrated goodperformance among patients from the same tertiary institutions where the models were developed. However, geographic validation at other institutions has been suboptimal.\nConclusions:\nTwo predictive models for nosocomial bacterial infections in patients with SLE are presented. All infection prevention recommendations should be maximized in patients at moderate/high risk. Further validation studies in diverse contexts, as well as clinical impact trials, are necessary before potential applications in research and clinical care. |
Other specific ISP article suggested by Editorial Board |
10.1097/RHU.0000000000002120 |
Restrepo Escobar M, Jaimes Barragán F, Vásquez Duque GM, Aguirre Acevedo DC, Peñaranda Parada ÉA, Prieto-Alvarado J, Mesa-Navas MA, Calle-Botero E, Arbeláez-Cortés Á, Velásquez-Franco CJ, Vergara-Serpa Ó, Del-Castillo-Gil DJ, Gordillo-González CA, Guzmán-Naranjo LC, Granda-Carvajal PA, Jaramillo-Arroyave D, Muñoz-Vahos CH, Vélez-Marín M, Hernández-Zapata J, Eraso-Garnica R, Vanegas-García AL, González-Naranjo LA. |
J Clin Rheumatol. 2024 Oct 1;30(7):264-270. doi: 10.1097/RHU.0000000000002120. Epub 2024 Sep 12. |
J Clin Rheumatol |
2024 |
2024-09-12 |
NaN |
| 39197751 |
Reusable surgical headwear has a reduced carbon footprint and matches disposables regarding surgical site infection: a systematic review and meta-analysis |
Surgical headwear is designed to maintain sterility and prevent microbial contamination. However, the environmental impact of the healthcare industry carries an obligation to develop sustainable alternatives. We aim to explore the environmental impact and safety of reusable surgical headwear. A systematic review and meta-analysis were performed using MEDLINE, Embase, Scopus, Google Scholar, PubMed, and the Cochrane Library until December 10, 2023. Studies were reviewed for suitability and risk of bias using the ROBINS-I tool, with the results aggregated using Review Manager Version 5.4 for odds ratios (ORs) and 95% confidence intervals (CIs), and the I2 was used to assess heterogeneity. This systematic review included nine studies, and the meta-analysis included six studies involving 45,708 procedural cases.There was no significant difference in surgical site infection (SSI) rates between the reusable and disposable groups (OR: 0.79; 95% CI:0.59-1.07; P=0.13). Policy implementation did not affect SSI rates (OR: 1.21; 95% CI: 0.85-1.73; P=0.30). Reusable surgical head covers demonstrated a significantly lower carbon footprint (P<0.001), ozone depletion (P<0.005), fossil fuel depletion (P<0.005), terrestrial acidification (P<0.005), and fine particulate matter formation (P<0.005) than disposable alternatives. Reusable surgical headwear matches disposable options for SSI incidence and offers environmental advantages. These findings support a shift towards reusable alternatives in healthcare, aligning patient safety with ecological responsibility. By adopting reusable alternatives, healthcare systems can actively contribute to planetary health, thereby highlighting the significant role of sustainable practices in modern medical settings. |
Other specific ISP article suggested by Editorial Board |
10.1016/j.jhin.2024.07.017 |
Gumera A, Mil M, Hains L, Fanshaw SR, Dunne B. |
J Hosp Infect. 2024 Oct;152:164-172. doi: 10.1016/j.jhin.2024.07.017. Epub 2024 Aug 26. |
J Hosp Infect |
2024 |
2024-08-28 |
NaN |
| 39186983 |
Antibiotic-free ocular sterilization while suppressing immune response to protect corneal transparency in infectious keratitis treatment |
Clinical guidelines for infectious keratitis treatment require that anti-inflammatory drugs can only be used after infection elimination, which causes irreversible inflammatory damage to the cornea. In this work, photodynamic metal organic frameworks (PCN-224) were used as drug carrier to load Pt NPs with catalase-like activity and anti-inflammatory drug (Dexamethasone, DXMS) for endogenous oxygen generation and reduced corneal damage, respectively. The photodynamic therapy (PDT) effect was greatly enhanced in bacteria elimination and bacterial biofilms removal through catalysis of overexpressed hydrogen peroxide (HO, ∼8.0 and 31.0 μM in bacterial solution and biofilms,respectively) into oxygen by Pt NPs. More importantly, the cationic liposome modified PCN-224@Pt@DXMS@Liposomes (PPDL NPs) greatly enhanced the adhesion to negatively charged ocular surface and penetration into corneal barrier and bacterial biofilms. Both in vitro cell viability test and in vivo eye irritation tests proved good biocompatibility of PPDL NPs under 660 nm laser irradiation. Furthermore, PDT ofPPDL NPs in rapid bacteria killing was verified through infectious keratitis animal model. The superior bactericidal effect of antibacterial materials could largely replace the bactericidal effect of the immune system. It is worth mentioning that this simultaneous sterilization and anti-inflammation treatment mode is a new exploration against the clinical treatment guidelines. |
Other specific ISP article suggested by Editorial Board |
10.1016/j.jconrel.2024.08.038 |
Peng Y, Pang S, Zeng Y, Wei J, Lu J, Ruan Y, Hong X, He X, Chu X, Guo Y, Guo H, Qian S, Jiang Z, Jiang Z, Wang B. |
J Control Release. 2024 Oct;374:563-576. doi: 10.1016/j.jconrel.2024.08.038. Epub 2024 Aug 30. |
J Control Release |
2024 |
2024-08-26 |
NaN |
| 39154896 |
Cleaning time and motion: an observational study on the time required to clean shared medical equipment in hospitals effectively |
Background:\nDespite the important role that cleaning plays in reducing the risk of healthcare-associated infections, no research has been undertaken to quantify the time required for effective cleaning and disinfection of different pieces of shared medical equipment commonly used in hospitals. This short report presents the results from a study that aimed to quantify the time required to clean common pieces of shared medical equipment effectively.\nMethods:\nAn observational time and motion study was conducted in a nursing simulation laboratory to determine the time required for effective cleaning and disinfection of 12 pieces of shared medical equipment commonly used in hospital. After training, the participants cleaned and disinfected equipment, with the time taken to clean recorded. Cleaning was deemed to be effective if ≥80% of ultraviolet fluorescent dots were removed during the cleaning process.\nMain results:\nThe time to clean equipment effectively ranged from 50 s [blood glucose testing kit; 95% confidence interval (CI) 0:40-1:00(min:s)] to 3 min 53 s [medication trolley; 95% CI 3:36-4:11 (min:s)]. The intravenous stand was cleaned most effectively, with 100% of dots removed (N = 100 dots). In contrast, the bladder scanner was the most difficult to clean, with 12 attempts required to meet the 80% threshold for effective cleaning.\nConclusion:\nThis study will inform staffing and training requirements to plan the cleaning and disinfection of shared medical equipment effectively. The findings can also be used for business cases, and in future cost-effectiveness evaluations of cleaning interventions that include shared medical equipment. |
Other specific ISP article suggested by Editorial Board |
10.1016/j.jhin.2024.08.001 |
Matterson G, Browne K, Tehan PE, Russo PL, Kiernan M, Mitchell BG. |
J Hosp Infect. 2024 Oct;152:138-141. doi: 10.1016/j.jhin.2024.08.001. Epub 2024 Aug 21. |
J Hosp Infect |
2024 |
2024-08-18 |
NaN |
| 39154895 |
Luminous intensity and efficacy of the HUSKY-UV® mobile UVC-emitting robot: surface disinfection in the hospital setting applied to the SARS-CoV-2 model |
The current health crisis linked to the COVID-19 epidemic has highlighted the necessity to continue to innovate, in particular by developing effective surface-disinfection systems. UVCs seem to be particularly effective and could be an interesting complement to the bio-cleaning already done by nursing staff. In recent years, several UVC technologies have been developed. |
Other specific ISP article suggested by Editorial Board |
10.1016/j.jhin.2024.07.015 |
Mangeant R, Chipoy C, Metten D, Ambiehl A, Ecault S, Riche VP, Collet P, Lepelletier D. |
J Hosp Infect. 2024 Oct;152:182-184. doi: 10.1016/j.jhin.2024.07.015. Epub 2024 Aug 16. |
J Hosp Infect |
2024 |
2024-08-18 |
NaN |
| 39150794 |
Sterile Draping of Operative Microscopes in Breast Free Flaps and Surgical Site Infections |
Background:\nOperative microscopes are traditionally draped in single-use plastic to prevent infection theoretically. The necessity of this routine in breast free flap surgery is unclear. Alternatively, sterile wrapping of microscope handles would reduce operating room waste and provide a more cost-effective and environmentally sustainable approach to sterility. This study aimed to determine whether the draping technique used during abdominally based free flaps (Ab-FF) influenced the rate of surgical site infections.\nMethods:\nWe conducted a retrospective review of Ab-FF performed consecutively between March 2017 and August 2022. Patient demographics, comorbidities, perioperative data, and postoperative complications were collected. The primary outcomes included postoperative surgical site infections and environmental impact.\nResults:\nOf the 281 identified breasts reconstructed with Ab-FF, operating microscopes were sterilely covered with microscope drapes (n =215) or handle covers (n = 66) composed of polyethylene-based plastic. Overall, postoperative infections occurred in 9.3% of cases (n = 26)in either the recipient breast (n = 11, 3.9%) or abdominal donor site (n = 15, 5.3%), primarily due to S. aureus and Streptococcus species .The handle (n = 6, 9.1%) and drape (n = 20, 9.3%) cohorts had similar infection rates with no sequelae of operative complications. In multivariate analysis, radiation was the only independent predictor of postoperative infection, while bilateral reconstructions were independently protective. Replacing a microscope drape with a handle reduces carbon emissions by 1276 grams of CO 2 and direct costs by$7.84 per item.\nConclusions:\nThe principles of "Lean and Green" surgery prioritize reducing operating room generated waste to achieve financial and environmental sustainability. This cohort study of 281 breast free flaps demonstrates that switching from whole microscope draping to handle wrapping was not associated with an increased rate or odds of infection. Adopting a microscope handle wrapping protocol decreased the carbon footprint and operative costs. The results of this study offer evidence to support adoption and further exploration of pragmatic,cost-effective, and sustainable approaches to microsurgical breast reconstruction. |
Other specific ISP article suggested by Editorial Board |
10.1097/SAP.0000000000004067 |
Marable JK, Spoer DL, Harish V, Berger LE, Song DH, Fan KL. |
Ann Plast Surg. 2024 Oct 1;93(4):e26-e35. doi: 10.1097/SAP.0000000000004067. Epub 2024 Aug 15. |
Ann Plast Surg |
2024 |
2024-08-16 |
NaN |
| 39127499 |
Letter to the editor: Impact of combined cluster nursing and Plan-Do-Check-Act cycle on postoperative infection risk and clinical outcomes in patients with open fractures and multidrug resistance |
In patients with open fractures and multidrug resistance, the application of the PDCA cycle combined with preoperative cluster nursing can decrease the postoperative infection rate and improve clinical efficacy. Additionally, this approach significantly increases nursing efficiency and provides patients with a relatively favorable nursing experience. |
Other specific ISP article suggested by Editorial Board |
10.1016/j.asjsur.2024.07.287 |
Bao WJ, Wang C, Zhang LL, Yu HX. |
Asian J Surg. 2024 Oct;47(10):4613-4614. doi: 10.1016/j.asjsur.2024.07.287. Epub 2024 Aug 10. |
Asian J Surg |
2024 |
2024-08-10 |
NaN |
| 39098393 |
Decontamination of patient bathroom surfaces with 405 nm violet-blue light irradiation in a real-life setting |
Background:\nIrradiation with violet-blue light (VBL), in the spectrum of 405-450 nm, has been reported to be effective against pathogenic bacteria.\nAim:\nTo investigate whether VBL irradiation could reduce the level of surface contamination at seven shared patient bathrooms in two wardsat a hospital in Sweden.\nMethods:\nRepeated sampling of five separate surfaces (door handle, tap water handle, floor, toilet seat, and toilet armrest) was performed in the bathrooms where 405 nm light-emitting diode spotlights had been installed. A prospective study with a cross-over design was carriedout, which included two study periods, first with the spotlights either switched on or off and a second study period with the opposites potlight status.\nFindings:\nIn total, 665 surface samples were collected during the study (133 samples per surface). Bacterial growth was found in 84% of all samples. The most common findings were coagulase-negative staphylococci and Bacillus spp. The median number of colony-forming units(cfu)/cm was 15 (interquartile range: 5-40) for all surfaces. In our main outcome, mean cfu/cm of all surfaces in a bathroom, no differencewas observed with or without VBL. Clean surfaces (<5 cfu/cm) were more commonly observed in bathrooms with VBL, also when controlling for confounding factors. No difference was observed in the number of heavily contaminated surfaces.\nConclusion:\nThis study did not safely demonstrate an additive effect on bacterial surface levels when adding VBL to routine cleaning in shared patient bathrooms. |
Other specific ISP article suggested by Editorial Board |
10.1016/j.jhin.2024.06.022 |
Senneby E, Holmberg A, Thörnqvist A, Fraenkel CJ. |
J Hosp Infect. 2024 Oct;152:93-98. doi: 10.1016/j.jhin.2024.06.022. Epub 2024 Aug 5. |
J Hosp Infect |
2024 |
2024-08-04 |
NaN |
| 39069006 |
Regional variation in the interpretation of contact precautions for multi-drug-resistant Gram-negative bacteria: a cross-sectional survey |
Background:\nContact precautions are recommended when caring for patients with carbapenemase-producing Enterobacterales (CPE), carbapenemase-producing Pseudomonas aeruginosa (CPPA), and extended-spectrum β-lactamase-producing Enterobacterales (ESBL-E).\nAim:\nOur aim was to determine the interpretation of contact precautions and associated infection prevention and control (IPC) measures inthe non-ICU hospital setting for patients with CPE, CPPA or ESBL-E in 11 hospitals in the Southwest of the Netherlands.\nMethods:\nA cross-sectional survey was developed to collect information on all implemented IPC measures, including use of personal protective equipment, IPC measures for visitors, cleaning and disinfection, precautions during outpatient care and follow-up strategies. All 11hospitals were invited to participate between November 2020 and April 2021.\nFindings:\nThe survey was filled together with each hospital. All hospitals installed isolation precautions for patients with CPE and CPPA during inpatient care and day admissions, whereas 10 hospitals (90.9%) applied isolation precautions for patients with ESBL-E. Gloves andgowns were always used during physical contact with the patient in isolation. Large variations were identified in IPC measures for visitors,cleaning and disinfection products used, and precautions during outpatient care. Four hospitals (36.4%) actively followed up on CPE or CPPA patients with the aim of declaring them CPE- or CPPA-negative as timely as possible, and two hospitals (20.0%) actively followed upon ESBL-E patients.\nConclusion:\nContact precautions are interpreted differently between hospitals, leading to regional differences in IPC measures applied inclinical settings. Harmonizing infection-control policies between the hospitals could facilitate patient transfers and benefit collective efforts of preventing transmission of multi-drug-resistant Gram-negative bacteria. |
Other specific ISP article suggested by Editorial Board |
10.1016/j.jhin.2024.06.020 |
van Veen A, de Goeij I, Damen M, Huijskens EGW, Paltansing S, van Rijn M, Bentvelsen RG, Veenemans J, van der Linden M, Vos MC, Severin JA; Infection Prevention and Antimicrobial Resistance Care Network South-western Netherlands. |
J Hosp Infect. 2024 Oct;152:1-12. doi: 10.1016/j.jhin.2024.06.020. Epub 2024 Jul 26. |
J Hosp Infect |
2024 |
2024-07-28 |
NaN |
| 39032568 |
Cost-effectiveness of a new multi-lumen infusion device to reduce central-venous-line-associated bloodstream infections in neonates |
Background:\nA new medical device was developed for multi-infusion in neonatal intensive care units (NICUs) with the aim of addressingissues related to drug incompatibilities and central-line-associated bloodstream infections (CLABSIs).\nAim:\nTo assess the cost-effectiveness of implementing this new perfusion system in an NICU setting.\nMethods:\nThis single-centre, observational study was conducted in all infants admitted to the NICU within 3 days of birth, and who requireda central venous line, to evaluate the cost and effectiveness before (2019) and after (2020) implementation of the new perfusion system.Costs were calculated from the hospital perspective, and the incidence of CLABSIs was examined over a time horizon from NICU admissionto discharge. Resource utilization was measured (infusion device, infection-treating drugs and biological analyses), and corresponding costswere valued using tariffs for 2019. The incremental cost-effectiveness ratio (ICER) was calculated, expressed as Euros per CLABSI avoided,and one-way and multi-variate sensitivity analyses were conducted.\nFindings:\nAmong 609 infants selected, clinical characteristics were similar across both periods. The CLABSI rate decreased significantly(rate ratio 0.22, 95% confidence interval 0.07-0.56), and total costs reduced from €65,666 to €63,932 per 1000 catheter-days (P<0.001)after implementation of the new perfusion system, giving an ICER of €251 saved per CLABSI avoided. The majority of sensitivity analysesshowed that the new intervention remained economically dominant.\nConclusion:\nThis single-centre study showed a significant decrease in the incidence of CLABSIs after implementation of the new perfusion system, without incurring additional costs. Further prospective multi-centre randomized studies are needed to confirm these results in otherNICUs. |
Other specific ISP article suggested by Editorial Board |
10.1016/j.jhin.2024.06.019 |
Martelin A, Picaud JC, Faton S, Pradat P, Pastor-Diez B, Haÿs S, Armoiry X. |
J Hosp Infect. 2024 Oct;152:114-121. doi: 10.1016/j.jhin.2024.06.019. Epub 2024 Jul 18. |
J Hosp Infect |
2024 |
2024-07-20 |
NaN |
| 39032566 |
Is screening of patients for Pseudomonas aeruginosa groin/rectal carriage useful in identifying those at risk of bacteraemia in haematology and other high-risk clinical settings? |
Background:\nPseudomonas aeruginosa is a leading cause of healthcare-associated infections in patients exposed to hospital waters. Arising incidence of P. aeruginosa bacteraemia at our tertiary teaching hospital prompted investigation.\nAim:\nMicrobiological screening at patient admission to support early identification of acquisition.\nMethods:\nA 41-bed haematology ward (800-bed teaching-hospital, London) was surveyed between January 24, 2020 and May 13, 2020.Concurrent rectal and groin swabs were collected in duplicate upon admission weekly. Results were compared with historical shower, drain,and tap water contamination data.\nFindings:\nA total of 606 groin/rectal swabs were collected from 154 patients; 61 female and 93 male. Six out of 154 patients admitted (3.9%)were positive for P. aeruginosa. Two patients (1.3%; 95% confidence interval (CI): 0.16 to 4.6) were colonized at admission while four patients(2.6%; CI: 0.7 to 6.5) became colonized by 33 days (interquartile range: 13 to 54) of stay. Concurrent duplicate sampling yielded bothpositive and negative results in all colonized patient-cases. One patient subsequently developed P. aeruginosa bacteraemia. Shower waterand corresponding drains from the four patient rooms where P. aeruginosa was acquired were heavily contaminated (>300 cfu/100 mL) withP. aeruginosa 265 days (median; range: 247-283) before patient admission.\nConclusion:\nRectal/groin swab-screening at admission to hospital might be valuable for early detection of patient colonization but it isintrusive, resource-demanding, and yield may be low. In high-risk settings, enhanced environmental monitoring, decontamination of surfacesand drains, and point-of-use filter-barriers is recommended, especially if expected duration of stay exceeds 30 days. |
Other specific ISP article suggested by Editorial Board |
10.1016/j.jhin.2024.07.005 |
Yetiş Ö, Ali S, Coen P, Wilson P. |
J Hosp Infect. 2024 Oct;152:42-46. doi: 10.1016/j.jhin.2024.07.005. Epub 2024 Jul 18. |
J Hosp Infect |
2024 |
2024-07-20 |
NaN |
| 38992839 |
Comparison of methods for sampling and detection of carbapenemase-producing organisms in clinical handwash basin drains in health care |
There are currently no standardized methods for the sampling and testing of clinical handwash basin (HWB) samples for the detection of carbapenemase-producing organisms (CPOs). Methods used for sampling (drain aspirate vs swab from top of drain) and detection of CPOsin clinical HWB drains in two different healthcare settings, one which was dealing with a hospital-wide CPO outbreak (Hospital A) andanother with no reported outbreaks (Hospital B), were compared. Drain aspirates and swabs from HWB drains were tested using multiplexpolymerase chain reaction (PCR) together with culture-based methods. No significant difference in detection of CPOs was found betweendrain aspirate or swab methods of sampling. Direct PCR on samples detected significantly more carbapenemase genes than culture on CARBA agar (P<0.0001 and 0.0045, respectively). A higher percentage of HWB drains were positive in Hospital A both by culture and bydirect PCR, and a significantly higher number of carbapenemase genes were detected in HWB drain aspirates at Hospital A, both by PCR andby culture (P=0.014 and 0.0071, respectively). There was high correlation between drain swab positivity by PCR and culture in Hospital A(91%) compared with Hospital B (33%). No difference in drain contamination rates was found when HWBs with a rear drain were comparedwith HWBs with the drain directly below the tap. Colonization of HWBs at the top of the drain may be related to risk of cross-transmission of CPOs from the healthcare environment to patients. |
Other specific ISP article suggested by Editorial Board |
10.1016/j.jhin.2024.06.008 |
Meda M, Sagair MM, Weinbren M, Wells C, Ezie S, Navarro M, Cherupuzhathottathil S, Nagy C, Fortes-Aguila M, Da Silva Martins N, Gentry V. |
J Hosp Infect. 2024 Oct;152:28-35. doi: 10.1016/j.jhin.2024.06.008. Epub 2024 Jul 9. |
J Hosp Infect |
2024 |
2024-07-11 |
NaN |
| 38925500 |
Infection prevention and control among paramedics: A scoping review |
Background:\nParamedics are exposed to many infectious diseases in their professional activities, leading to a high risk of transmitting infectious diseases to patients in out-of-hospital settings, possibly leading to health care associated infections in hospitals and the community. The COVID-19 pandemic highlighted the importance of infection prevention and control in health care and the role of paramedicsin infection control is considered even more critical. Despite this, in many countries such as Australia, research into infection prevention and control research has mainly been focused on in-hospital health care professionals with limited out-of-hospital studies.\nMethods:\nThis scoping review was based upon Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines. Literatureon knowledge and awareness of infection prevention and control in paramedics in Australia and other countries was evaluated.\nResults:\nBased upon selection criteria applied, six papers were identified for inclusion in this review. In many studies, infection prevention and control was identified as being important, however compliance with hand hygiene practices was low and most studies highlighted the need for more education and training on infectious disease for paramedics.\nConclusion:\nCurrent evidence suggests that paramedics have poor compliance with recommended IPC practices. The profession needs to improve IPC education, training, and culture. |
Other specific ISP article suggested by Editorial Board |
10.1016/j.ajic.2024.06.014 |
Taylor N, Simpson M, Cox J, Ebbs P, Vanniasinkam T. |
Am J Infect Control. 2024 Oct;52(10):1128-1134. doi: 10.1016/j.ajic.2024.06.014. Epub 2024 Jun 24. |
Am J Infect Control |
2024 |
2024-06-26 |
NaN |
| 38885791 |
Frequency, characteristics, and outcome of adult patients with multiple consecutive health care-associated infections undergoing extracorporeal membrane oxygenation: A retrospective analysis |
Background:\nData on multiple consecutive health care-associated infections (HAIs) in patients undergoing extracorporeal membraneoxygenation (ECMO) are limited. We aim to identify the characteristics and outcomes of multiple, consecutive HAIs.\nMethods:\nThis retrospective study included adult patients who underwent ECMO in a single cardiac ICU in China from May 2015 to December 2022. The incidence, clinical characteristics, risk factors, and impact on in-hospital mortality among patients with non-HAI, singleHAI, and multiple HAIs were analyzed. Pathogens and infection sites for each new episode were compared.\nResults:\nOf 192 patients, 92 (47.92%) developed 141 separate infections, with 41 (21.35%) experiencing multiple infections during a single ECMO period. Respiratory tract infections (RTIs) constituted the majority (75.89%), and gram-negative bacteria were the predominant pathogens (71.63%). RTIs decreased from 86.9% in the first infection to 14.3% in the third (P < .001), while bloodstream infections increasedfrom 10.9 % to 57.1% (P < .001). The proportion of gram-positive bacteria increased from 9.8% to 42.9% (P = .03). Prolonged ECMO duration was the only independent risk factor for multiple consecutive HAIs (odds ratio (OR)=1.220, P < .001).\nConclusions:\nMultiple consecutive HAIs during ECMO were frequent, with distinct microbiological changes between initial and subsequent HAIs. |
Other specific ISP article suggested by Editorial Board |
10.1016/j.ajic.2024.06.008 |
Deng Q, Wang W, Ming J, Zhou L, Lv Y, Liu J, Lu H. |
Am J Infect Control. 2024 Oct;52(10):1188-1194. doi: 10.1016/j.ajic.2024.06.008. Epub 2024 Jun 15. |
Am J Infect Control |
2024 |
2024-06-17 |
NaN |
| 38841920 |
A practical approach to preparing your ICU for epidemics and pandemics |
Purpose of review:\nMajor outbreaks of infectious diseases, including epidemics and pandemics, are increasing in scope and frequency, threatening public health and straining the capacity of health systems worldwide. High-consequence infectious diseases (HCIDs), including highly pathogenic respiratory viruses and viral hemorrhagic fevers, are both contagious and virulent, and these pathogens thus are topics ofspecial concern for pandemic planning.\nRecent findings:\nThe COVID-19 pandemic demonstrated how a major disease outbreak can negatively impact all aspects of hospital functioning. Identification of patients with HCIDs needs careful clinical evaluation and coordination with public health authorities. Staff safety and patient care require appropriate infection prevention precautions, including personal protective equipment. Surges of ill patients maylead to significant strain, with increased ICU patient mortality. Strategies to reduce the impact of surge appear to reduce mortality, such astiered staffing models and load-leveling across health systems.\nSummary:\nPandemics and HCIDs are a significant threat to global health, and ICUs play a major role in the care of affected patients. Critical care professionals must work to ensure that our hospitals are prepared to identify and care for these patients in advance of the next emergency. |
Other specific ISP article suggested by Editorial Board |
10.1097/MCC.0000000000001174 |
Maves RC, Cawcutt KA. |
Curr Opin Crit Care. 2024 Oct 1;30(5):414-419. doi: 10.1097/MCC.0000000000001174. Epub 2024 May 31. |
Curr Opin Crit Care |
2024 |
2024-06-06 |
NaN |
| 39117169 |
A novel and low-cost cross-priming amplification assay for rapid detection of Babesia duncani infection |
Babesia duncani, responsible for human babesiosis, is one of the most important tick-borne intraerythrocytic pathogens. Traditionally,babesiosis is definitively diagnosed by detecting parasite DNA in blood samples and examining Babesia parasites in Giemsa-stained peripheral blood smears. Although these techniques are valuable for determining Babesia duncani, they are often time-consuming and laborious. Therefore, developing rapid and reliable B. duncani identification assays is essential for subsequent epidemiological investigations and prevention and control. In this study, a cross-priming amplification (CPA) assay was developed, combined with a vertical flow visualization strip, to rapidly and accurately detect B. duncani infection. The detection limit of this method was as low as 0.98 pg/μl of genomic DNA from B. duncani merozoites per reaction at 59 °C for 60 min. There were no cross-reactions between B. duncani and other piroplasms infective to humans and mammals. A total of 592 blood samples from patients bitten by ticks and experimental infected hamsters were accurately assessed using CPA assay. The average cost of the CPA assay is as low as approximately $ 0.2 per person. These findings indicate that the CPA assay may therefore be a rapid screening tool for detection B. duncani infection, based on its accuracy, speed, and cost-effectiveness, particularly in resource-limited regions with a high prevalence of human babesiosis. |
Other specific DSP article suggested by Editorial Board |
10.1016/j.exppara.2024.108813 |
Nian Y, Zhang S, Wang J, Li X, Wang Y, Liu J, Liu Z, Ye Y, You C, Yin H, Guan G. |
Exp Parasitol. 2024 Oct;265:108813. doi: 10.1016/j.exppara.2024.108813. Epub 2024 Aug 6. |
Exp Parasitol |
2024 |
2024-08-08 |
NaN |
| 39097005 |
Bloodstream infection': A valuable concept we should keep in our toolbox |
We write in response to the letter advocating for the retirement of the term ‘bloodstream infection’. As the authors of the two examples from the Journal of Infection cited as using the term, we would like to highlight why we feel it has continued relevance and utility in both clinical and research settings. We appreciate the authors’ points regarding the possible imprecision of the term and accept there is often interchangeable and poorly defined use of 'bacteraemia' and 'bloodstream infection'. However, the increasing use of ‘bloodstream infection’ suggests many do find it helpful; the marked rise in its use remains even adjusting for the overall astronomical rise in medical publications |
Other specific DSP article suggested by Editorial Board |
10.1016/j.jinf.2024.106236 |
Danielsen AS, Gu Q, Fostervold A, Eyre DW, Bjørnholt JV. |
J Infect. 2024 Oct;89(4):106236. doi: 10.1016/j.jinf.2024.106236. Epub 2024 Aug 2. |
J Infect |
2024 |
2024-08-03 |
NaN |
| 39073778 |
Comparative in vitro efficacy of antibiotics against the intracellular reservoir of Staphylococcus aureus |
Staphylococcus aureus (SA) is a leading cause of bloodstream infection. The liver represents the sentinel immune organ for clearance of bloodstream pathogens and eradication of intracellular SA from liver-resident macrophages (Kupffer cells, KCs) eliminates the likely pathogenic reservoir that contributes to persistent bacteraemia.\nObjectives:\nWe assessed antimicrobial activity at phagolysosome-mimicking pH, intracellular penetration, and SA eradication within KCs invitro for clinically prescribed antistaphylococcal agents alone or in combination: vancomycin, daptomycin, ceftaroline, ceftobiprole,oritavancin, oxacillin, cefazolin; rifampin and fosfomycin.\nMethods:\npH-adjusted broth microdilution assays, intracellular bioaccumulation assays, and intracellular killing assays against clinical bloodstream isolates were performed using a murine KC line with study agents.\nResults:\nRifampin and β-lactams exhibited enhanced activity [2- to 16-fold minimum inhibitory concentrations (MIC) decrease] at phagolysosomal pH while vancomycin, oritavancin, daptomycin and fosfomycin demonstrated reduced activity (2- to 32-fold MIC increase inorder of least to greatest potency reduction). All agents evaluated had poor to modest intracellular to extracellular concentration ratios(0.024-7.8), with exceptions of rifampin and oritavancin (intracellular to extracellular ratios of 17.4 and 78.2, respectively). Finally, we showedthat the first-line treatment for SA bacteraemia (SAB), vancomycin, performed worse than all other tested antibiotics in eradicating intracellular SA at human Cmax concentration (0.20 log cfu decrease), while oritavancin performed better than all other agents alone (2.05versus 1.06-1.36 log cfu decrease). |
Other specific DSP article suggested by Editorial Board |
10.1093/jac/dkae241 |
Beadell B, Yamauchi J, Wong-Beringer A. |
J Antimicrob Chemother. 2024 Oct 1;79(10):2471-2478. doi: 10.1093/jac/dkae241. |
J Antimicrob Chemother |
2024 |
2024-07-29 |
PMC11441993 |
| 39028649 |
Evaluation of target area under the concentration-time curve of vancomycin in an initial dosing design: a retrospective cohort study |
Objectives:\nArea under the concentration-time curve (AUC)-guided dosing of vancomycin was introduced in a clinical setting; however, thetarget range of non-steady-state AUCs, such as Day 1 AUC and Day 2 AUC, remains controversial. Therefore, we sought to determinepharmacokinetic parameter thresholds and identify independent risk factors associated with acute kidney injury (AKI) to establish a safeinitial dosing design for vancomycin administration.\nMethods:\nA single-centre, retrospective, cohort study of hospitalized patients treated with vancomycin was conducted to determine thethreshold of both non-steady-state AUCs (Day 1 and 2 AUCs) and trough levels at the first blood sampling point (therapeutic drugmonitoring, TDM). In addition, independent risk factors associated with AKI were evaluated using univariate and multivariate logisticregression analyses.\nResults:\nThe thresholds for predicting AKI were estimated as 456.6 mg·h/L for AUC0-24h, 554.8 mg·h/L for AUC24-48h, 1080.8 mg·h/L forAUC0-48h and 14.0 μg/mL for measured trough levels, respectively. In a multivariate analysis, Day 2 AUC ≥ 554.8 mg·h/L [adjusted oddsratio (OR), 57.16; 95% confidence interval (CI), 11.95-504.05], piperacillin/tazobactam (adjusted OR, 15.84; 95% CI, 2.73-127.70) anddiuretics (adjusted OR, 4.72; 95% CI, 1.13-21.01) were identified as risk factors for AKI.\nConclusions:\nWe identified thresholds for both AUCs in the non-steady-state and trough levels at the first TDM. Our results highlight the importance of monitoring not only the AUC but also trough levels during vancomycin treatment to reduce the likelihood of AKI. |
Other specific DSP article suggested by Editorial Board |
10.1093/jac/dkae249 |
Iida M, Horita Y, Asaoka M, Ohashi K, Noda M, Wachino C, Hirose T, Nomura Y, Hisada Y, Nagamizu M, Kawahara M, Morishita N, Kondo M, Hotta Y, Nakamura A, Furukawa-Hibi Y. |
J Antimicrob Chemother. 2024 Oct 1;79(10):2518-2527. doi: 10.1093/jac/dkae249. |
J Antimicrob Chemother |
2024 |
2024-07-19 |
NaN |
| 39012767 |
RENIN AND ANGIOTENSIN (1-7) OFFER PREDICTIVE VALUE IN PEDIATRIC SEPSIS: FINDINGS FROM PROSPECTIVE OBSERVATIONAL COHORTS |
Background: Pediatric sepsis is a common and complex syndrome characterized by a dysregulated immune response to infection.Aberrations in the renin-angiotensin system (RAS) are factors in several infections of adults. However, the precise impact of RASdysregulation in pediatric sepsis remains unclear. Methods: Serum samples were collected from a derivation cohort (58 patients with sepsis,14 critically ill control subjects, and 37 healthy controls) and validation cohort (50 patients with sepsis, 37 critically ill control subjects, and46 healthy controls). Serum RAS levels on day of pediatric intensive care unit admission were determined and compared with survival statusand organ dysfunction. Results: In the derivation cohort, the serum renin concentration was significantly higher in patients with sepsis (3,678± 4,746) than that in healthy controls (635.6 ± 199.8) ( P < 0.0001). Meanwhile, the serum angiotensin (1-7) was significantly lower inpatients with sepsis (89.7 ± 59.7) compared to that in healthy controls (131.4 ± 66.4) ( P < 0.01). These trends were confirmed in a validationcohort. Nonsurvivors had higher levels of renin (8,207 ± 7,903) compared to survivors (2,433 ± 3,193) ( P = 0.0001) and lower levels of angiotensin (1-7) (60.9 ± 51.1) compared to survivors (104.0 ± 85.1) ( P < 0.05). A combination of renin, angiotensin (1-7) and procalcitoninachieved a model for diagnosis with an area under the receiver operating curve of 0.87 (95% CI: 0.81-0.92). Conclusion: Circulating renin andangiotensin (1-7) have predictive value in pediatric sepsis. |
Other specific DSP article suggested by Editorial Board |
10.1097/SHK.0000000000002417 |
Pi D, Zheng L, Gao C, Xiao C, Yu Z, Fu Y, Li J, Chen C, Liu C, Zou Z, Xu F. |
Shock. 2024 Oct 1;62(4):488-495. doi: 10.1097/SHK.0000000000002417. Epub 2024 Jul 1. |
Shock |
2024 |
2024-07-16 |
NaN |
| 38197133 |
Detection of Carbapenem Resistance in Enterobacterales Directly From Positive Blood Cultures Using Matrix-Assisted Laser Desorption Ionization Time-of-Flight Mass Spectrometry |
Context.—:\nCarbapenem-resistant Enterobacterales are disseminated worldwide and associated with infections with high rates of morbidityand mortality. Matrix-assisted laser desorption/ionization time-of-flight mass spectrometry (MALDI-TOF MS) is a useful tool for identificationof pathogens directly from blood cultures in clinical microbiology laboratories. Furthermore, it has been applied for the detection ofcarbapenemase production, by evaluating carbapenem hydrolysis.\nObjective.—:\nTo determine meropenem hydrolysis to detect carbapenemase production directly from positive blood cultures, using logRQ toestablish a quantitative measure of hydrolysis.\nDesign.—:\nWe evaluated 100 Enterobacterales from positive blood cultures, with 81 carrying a carbapenemase gene (blaKPC, blaGES,blaNDM-1, blaIMP, blaVIM, and blaOXA-48-like), as determined by real-time multiplex polymerase chain reaction with high-resolution melting(HRM-qPCR). Bacterial proteins extracted from positive blood culture bottles were incubated in a meropenem solution (2-4 hours) followedby centrifugation for MALDI-TOF MS analysis. The intensity of peaks of the hydrolyzed and nonhydrolyzed forms were used to calculate thelogRQ value.\nResults.—:\nOverall, sensitivity was 86.8% and specificity, 89.5%. Of note, sensitivity varied depending on enzyme type. For blaKPC-positiveisolates, sensitivity was 97.9%, while it reduced significantly for blaNDM-1 and blaOXA-48-like isolates: 62.5% (10 of 16) and 66.7% (6 of 9),respectively. Indeed, logRQ was higher in blaKPC-positive isolates (0.37-1.97) than in blaNDM-1 (-1.37 to 0.83) and blaOXA-48-like isolates(-1.08 to 1.79).\nConclusions.—:\nThis is an inexpensive and rapid test to identify carbapenemase activity directly from blood culture bottles, whichcontributes to early adequate antimicrobial therapy and implementation of infection control measures. |
Other specific DSP article suggested by Editorial Board |
10.5858/arpa.2023-0199-OA |
Moreira NK, Wilhelm CM, Volpato FCZ, Barth AL, Caierão J. |
Arch Pathol Lab Med. 2024 Oct 1;148(10):1145-1151. doi: 10.5858/arpa.2023-0199-OA. |
Arch Pathol Lab Med |
2024 |
2024-01-10 |
NaN |
| 39168743 |
Duration of perioperative antibiotic prophylaxis in neonatal surgery: Less is more |
Background:\nThe ideal duration of neonatal antibiotic prophylaxis is not determined with wide variance in practice. This study aims to evaluate the association between duration of antibiotics and surgical site infection (SSI) in neonatal surgery.\nMethods:\nA retrospective review regarding antibiotic prophylaxis was performed on <30-day-old surgical patients at a children's hospital from 2014 to 2019. The patients were analyzed based on demographics, presence of SSI, and antibiotic duration. The primary outcome was the development of SSI with ANOVA, chi-square, and recursive partitioning used for statistical analysis.\nResults:\n19/155 patients developed an SSI (12.26 %). Those with an SSI had a lower weight at surgery (p = 0.03). Additionally, wound classification (p = 0.17) and antibiotic duration >48hrs (p = 0.94) made no statistical difference in SSI rate. The two variables most closely linked to SSI development were gestational age (100 %) and weight at time of procedure (80.76 %).\nConclusions:\nAntibiotic prophylaxis >48 h did not decrease the incidence of SSI. Risk factors for SSI development in neonatal surgery were lower gestational age, decreased weight at time of procedure and total length of procedure. |
Other specific ASP article suggested by Editorial Board |
10.1016/j.amjsurg.2024.115901 |
Wilhelm S, Tolkacz M, Kopel L, Stallion A, Novotny NM, Akay B, Brahmamdam P. |
Am J Surg. 2024 Oct;236:115901. doi: 10.1016/j.amjsurg.2024.115901. Epub 2024 Aug 15. |
Am J Surg |
2024 |
2024-08-21 |
NaN |
| 39146997 |
Predictive performance of multi-model approaches for model-informed precision dosing of piperacillin in critically ill patients |
Objectives:\nPiperacillin (PIP)/tazobactam is a frequently prescribed antibiotic; however, over- or underdosing may contribute to toxicity, therapeutic failure, and development of antimicrobial resistance. An external evaluation of 24 published PIP-models demonstrated that model-informed precision dosing (MIPD) can enhance target attainment. Employing various candidate models, this study aimed to assess the predictive performance of different MIPD-approaches comparing (i) a single-model approach, (ii) a model selection algorithm (MSA) and (iii) a model averaging algorithm (MAA).\nMethods:\nPrecision, accuracy and expected target attainment, considering either initial (B1) or initial and secondary (B2) therapeutic drug monitoring (TDM)-samples per patient, were assessed in a multicentre dataset (561 patients, 11 German centres, 3654 TDM-samples).\nResults:\nThe results demonstrated a slight superiority in predictive performance using MAA in B1, regardless of the candidate models,compared to MSA and the best single models (MAA, MSA, best single models: inaccuracy ±3%, ±10%, ±8%; imprecision: <25%, <31%,<28%; expected target attainment >77%, >71%, >73%). The inclusion of a second TDM-sample notably improved precision and target attainment for all MIPD-approaches, particularly within the context of MSA and most of the single models. The expected target attainment is maximized (up to >90%) when the TDM-sample is integrated within 24 h.\nConclusions:\nIn conclusion, MAA streamlines MIPD by reducing the risk of selecting an inappropriate model for specific patients. Therefore,MIPD of PIP using MAA implicates further optimisation of antibiotic exposure in critically ill patients, by improving predictive performance with only one sample available for Bayesian forecasting, safety, and usability in clinical practice. |
Other specific ASP article suggested by Editorial Board |
10.1016/j.ijantimicag.2024.107305 |
Schatz LM, Greppmair S, Kunzelmann AK, Starp J, Brinkmann A, Roehr A, Frey O, Hagel S, Dorn C, Zoller M, Scharf C, Wicha SG, Liebchen U. |
Int J Antimicrob Agents. 2024 Oct;64(4):107305. doi: 10.1016/j.ijantimicag.2024.107305. Epub 2024 Aug 13. |
Int J Antimicrob Agents |
2024 |
2024-08-15 |
NaN |
| 39121548 |
Letter to the editor: Postoperative infections associated with microvascular free flaps in head and neck reconstruction: Analysis of risk factors and results with a standardized prophylaxis protocol |
Our team has conducted a comprehensive review of the article "Postoperative infections associated with microvascular free flaps in head and neck reconstruction: Analysis of risk factors and results with a standardized prophylaxis protocol" by Y. Gugliotta and his colleagues. We are sincerely appreciative of the author's dedication to the completion of their investigation on this significant topic. The fundamental conclusion of the article is that surgical site infections (SSIs) have the same impact on the patient's overall and surgical outcomes as medical procedure infections (MPIs) and that both types of infections can be prevented by providing the patient with appropriate pre- and postoperative therapy. We concur with this assertion. However, there are a few points that necessitate additional explication to improve the article's conclusion. |
Other specific ASP article suggested by Editorial Board |
10.1016/j.bjps.2024.07.034 |
Hassan A, Hamza A, Azhar N. |
J Plast Reconstr Aesthet Surg. 2024 Oct;97:4-5. doi: 10.1016/j.bjps.2024.07.034. Epub 2024 Jul 25. |
J Plast Reconstr Aesthet Surg |
2024 |
2024-08-09 |
NaN |
| 39110722 |
Challenges and considerations for antifungal prophylaxis in children with acute myeloid leukemia |
Introduction:\nChildren receiving treatment for acute myeloid leukemia (AML) are at high risk of invasive fungal disease (IFD). Evidence from pediatric studies support the efficacy of antifungal prophylaxis in reducing the burden of IFD in children receiving therapy for AML, yet existing antifungal agents have specific limitations and comparative data to inform the optimal prophylactic approach are lacking.\nAreas covered:\nThis review summarizes the epidemiology of invasive fungal disease (IFD) and current antifungal prophylaxis recommendations for children with acute myeloid leukemia (AML). Challenges with currently available antifungal agents and considerations related to the changing landscape of AML therapy are reviewed. A keyword search was conducted to identify pediatric studies regarding IFDand antifungal prophylaxis in children with AML up to December 2023.\nExpert opinion:\nChildren undergoing treatment for AML are recommended to receive antifungal prophylaxis to reduce risk of IFD, with tolerability, pharmacokinetics, feasibility of administration, and drug interactions all factors that require consideration in this context. With increased use of novel targeted agents for AML therapy, together with the development of new antifungal agents, data from well-designed clinical studies to optimize prophylactic approaches will be essential to limit the burden of IFD in this vulnerable cohort. |
Other specific ASP article suggested by Editorial Board |
10.1080/17474086.2024.2390639 |
Yeoh DK, Haeusler GM, Slavin MA, Kotecha RS. |
Expert Rev Hematol. 2024 Oct;17(10):679-686. doi: 10.1080/17474086.2024.2390639. Epub 2024 Aug 12. |
Expert Rev Hematol |
2024 |
2024-08-07 |
NaN |
| 38218333 |
Postoperative infections after sinus lifts and onlay grafts in penicillin allergic patients |
Introduction:\nThe primary objective of this retrospective study was to determine whether patients treated with clindamycin due to areported allergy to penicillin have an increased risk of postsurgical infections after sinus lifts and onlay grafts.\nMaterial and methods:\nA retrospective cohort study was performed on patients who underwent bone reconstruction procedures betweenOctober 2018 and December 2020. Data from all patients operated at the Pitié Salpêtrière University Hospital for sinus lifts or onlay graftswere collected. All surgical procedures studied were performed under preoperative and postoperative antibiotic prophylaxis with eitheramoxicillin (+/- clavulanic acid) or clindamycin for patients with reported penicillin allergy. Bone graft-associated infections as well as graftfailures were recorded.\nResults:\nIn this study, 111 patients received bone reconstructions (89 sinus lifts and 148 onlay grafts). In the sinus lifts group, infectionsoccurred in 5 of 89 sites (5.6 %). The infection rate was 28.5 % (7 graft sites) and only 3.9 % (82 graft sites) for clindamycin and foramoxicillin, respectively. In the onlay graft group, infections occurred in 25 of 148 sites (16.8 %). The infection rate was 56 % and only 12 %for clindamycin (18 graft sites) and for amoxicillin, respectively (130 graft sites). Non-Penicillin treated patients had a higher risk of infectionwith an odd ratio of 7.8 (95 % CI 1.1-54.8, P = 0.04) and 4.8 (95 % CI 1.9-12.3, P = 0.001) compared with patients receiving amoxicillin foronlay grafts and sinus lifts.\nConclusion:\nPenicillin allergy and clindamycin use after sinus lift and on lay graft procedures were associated with a higher rate of infectionand may be a risk factor for complications related to bone reconstruction surgery. |
Other specific ASP article suggested by Editorial Board |
10.1016/j.jormas.2024.101764 |
Boussaïd M, Samama M, Foy JP, Bleibtreu A, Bertolus C, Gellee T. |
J Stomatol Oral Maxillofac Surg. 2024 Oct;125(5):101764. doi: 10.1016/j.jormas.2024.101764. Epub 2024 Jan 11. |
J Stomatol Oral Maxillofac Surg |
2024 |
2024-01-13 |
NaN |
| 37931904 |
Impact of a Pharmacist-Conducted Preoperative Beta-Lactam Allergy Assessment on Perioperative Cefazolin Prescribing |
Background:\nCefazolin is guideline recommended for perioperative prophylaxis in orthopedic surgery. Despite its unique R1 side chain,cefazolin is often avoided in patients with beta-lactam allergy with concern for cross reactivity.\nObjectives:\nThe primary outcome was thepercentage of patients who received cefazolin perioperatively. Secondary outcomes included the percentage of patients with a beta-lactamallergy clarified following the telephone interview and clinical outcomes including acute kidney injury, surgical site infection,\nClostridioidesdifficile\ninfection, and re-admission at 30 and 90 days.\nMethods:\nThis single-center, quasi-experimental study evaluated a pilot program inwhich a pharmacist phoned patients\n>\n18 years of age with a scheduled orthopedic surgery and a documented beta-lactam allergy to assesstheir allergy preoperatively. Recommendations to use cefazolin were based on an algorithm. Patients were divided into pre- and post-intervention cohorts.\nResults:\nA total of 832 patients were screened for inclusion with 135 and 66 patients included in the pre- and post-intervention cohorts. No significant difference was identified in the primary outcome. In the post-intervention cohort, 62% had a beta-lactamreaction updated in the electronic medical record. Those with a beta-lactam allergy delabeled or made less severe were numerically morelikely to receive cefazolin than those with an unchanged reaction or a reaction made more severe (95.2% vs 68% vs 65%). There were nodifferences in clinical outcomes between groups.\nConclusion:\nA pharmacist-conducted preoperative beta-lactam allergy interview in adultpatients undergoing elective orthopedic surgery improved beta-lactam allergy documentation but, did not result in increased utilization ofcefazolin. |
Other specific ASP article suggested by Editorial Board |
10.1177/08971900231214581 |
Hitchcock AM, Kufel WD, Seabury RW, Steele JM. |
J Pharm Pract. 2024 Oct;37(5):1073-1081. doi: 10.1177/08971900231214581. Epub 2023 Nov 6. |
J Pharm Pract |
2024 |
2023-11-06 |
NaN |