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75% success rate after open debridement, exchange of tibial insert, and antibiotics in knee prosthetic joint infections.

https://arctichealth.org/en/permalink/ahliterature267766
Source
Acta Orthop. 2015;86(4):457-62
Publication Type
Article
Date
2015
Author
Anna Holmberg
Valdís Gudrún Thórhallsdóttir
Otto Robertsson
Annette W-Dahl
Anna Stefánsdóttir
Source
Acta Orthop. 2015;86(4):457-62
Date
2015
Language
English
Publication Type
Article
Keywords
Aged
Aged, 80 and over
Anti-Bacterial Agents - therapeutic use
Arthroplasty, Replacement, Knee - methods
Debridement - methods
Drug Therapy, Combination
Female
Follow-Up Studies
Humans
Knee Prosthesis - microbiology
Male
Middle Aged
Prosthesis-Related Infections - therapy
Registries
Reoperation
Retrospective Studies
Rifampin - therapeutic use
Staphylococcus aureus - isolation & purification
Sweden
Tibia - surgery
Time Factors
Treatment Outcome
Wound Healing
Abstract
Prosthetic joint infection (PJI) is a leading cause of early revision after total knee arthroplasty (TKA). Open debridement with exchange of tibial insert allows treatment of infection with retention of fixed components. We investigated the success rate of this procedure in the treatment of knee PJIs in a nationwide material, and determined whether the results were affected by microbiology, antibiotic treatment, or timing of debridement.
145 primary TKAs revised for the first time, due to infection, with debridement and exchange of the tibial insert were identified in the Swedish Knee Arthroplasty Register (SKAR). Staphylococcus aureus was the most common pathogen (37%) followed by coagulase-negative staphylococci (CNS) (23%). Failure was defined as death before the end of antibiotic treatment, revision of major components due to infection, life-long antibiotic treatment, or chronic infection.
The overall healing rate was 75%. The type of infecting pathogen did not statistically significantly affect outcome. Staphylococcal infections treated without a combination of antibiotics including rifampin had a higher failure rate than those treated with rifampin (RR = 4, 95% CI: 2-10). In the 16 cases with more than 3 weeks of symptoms before treatment, the healing rate was 62%, as compared to 77% in the other cases (p = 0.2). The few patients with a revision model of prosthesis at primary operation had a high failure rate (5 of 8).
Good results can be achieved by open debridement with exchange of tibial insert. It is important to use an antibiotic combination including rifampin in staphylococcal infections.
Notes
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PubMed ID
25753311 View in PubMed
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[A case report of toxic shock syndrome treated in Vefsn hospital].

https://arctichealth.org/en/permalink/ahliterature244186
Source
Tidsskr Nor Laegeforen. 1981 Sep 10;101(25):1396-7
Publication Type
Article
Date
Sep-10-1981

[Adult-onset mucoviscidosis: longer survival of patients in Moscow and Moscow Region].

https://arctichealth.org/en/permalink/ahliterature123358
Source
Ter Arkh. 2012;84(3):54-8
Publication Type
Article
Date
2012
Source
Ter Arkh. 2012;84(3):54-8
Date
2012
Language
Russian
Publication Type
Article
Keywords
Adolescent
Adult
Age of Onset
Cohort Studies
Cystic Fibrosis - genetics - microbiology - mortality
Female
Genetic Testing
Genome
Gram-Negative Bacteria - isolation & purification
Humans
Kaplan-Meier Estimate
Male
Moscow - epidemiology
Mutation - genetics
Staphylococcus aureus - isolation & purification
Survival Analysis
Young Adult
Abstract
To estimate survival median and its changes, number of patients over 18 years of age for 1991-2000 and 2001-2010 for 20-year period (1991-2010), to elucidate factors affecting survival for 2001-2010 in mucoviscidosis children living in Moscow and Moscow Region and treated outpatiently in specialized medical centers.
Case records were analysed for mucoviscidosis patients registered in specialized clinics of Moscow on 01.01.01 and 01.01.11. Survival was assessed with Kaplan-Meier curve.
Survival medians for 1991-2000 and 2001-2010 was 25.7 and 35.1 years, respectively In the group of mucoviscidosis patients with Staphylococcus aureus infection survival was significantly higher than in those infected with gram-negative microflora. Longer survival was reported in patients with "soft" mutation (p = 0.06927).
The survival median for mucoviscidosis patients for 2001-2010 was 35.1 years. The percentage of adult patients in the last decade significantly rose from 19.5 to 32%. Gram-negative microflora significantly reduces survival, while 'soft" mutation prolongs survival. Creation of National Register will specify survival of mucoviscidosis patients in all regions of the Russian Federation.
PubMed ID
22708424 View in PubMed
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An investigation of methicillin-resistant Staphylococcus aureus colonization in people and pets in the same household with an infected person or infected pet.

https://arctichealth.org/en/permalink/ahliterature148824
Source
J Am Vet Med Assoc. 2009 Sep 1;235(5):540-3
Publication Type
Article
Date
Sep-1-2009
Author
Meredith C Faires
Kathy C Tater
J Scott Weese
Author Affiliation
Department of Population Medicine, Ontario Veterinary College, University of Guelph, Guelph, ON N1G 2W1, Canada.
Source
J Am Vet Med Assoc. 2009 Sep 1;235(5):540-3
Date
Sep-1-2009
Language
English
Publication Type
Article
Keywords
Animals
Animals, Domestic
Canada - epidemiology
Carrier state
Cat Diseases - epidemiology - microbiology - transmission
Cats
Cross Infection
Dog Diseases - epidemiology - microbiology - transmission
Dogs
Family Characteristics
Humans
Methicillin-Resistant Staphylococcus aureus - isolation & purification
Staphylococcal Infections - epidemiology - microbiology - transmission - veterinary
United States - epidemiology
Zoonoses
Abstract
To investigate the prevalence of concurrent methicillin-resistant Staphylococcus aureus (MRSA) colonization in people and pets in the same household with a person or pet with an MRSA infection and to compare MRSA isolates by use of molecular techniques.
2 cross-sectional evaluations conducted concurrently.
24 dogs, 10 cats, and 56 humans in part 1 and 21 dogs, 4 cats, and 16 humans in part 2 of the study.
In both parts of the study, nasal swab specimens were collected from humans and nasal and rectal swab specimens were collected from household pets. Selective culture for MRSA was performed, and isolates were typed via pulsed-field gel electrophoresis (PFGE) and spa typing. Households were defined as positive when MRSA was isolated from at least 1 person (part 1) or 1 pet (part 2).
In part 1, 6 of 22 (27.3%) households were identified with MRSA colonization in a person. In these households, 10 of 56 (17.9%) humans, 2 of 24 (8.3%) dogs, and 1 of 10 (10%) cats were colonized with MRSA. In part 2, only 1 of 8 households was identified with MRSA colonization in a pet. Most MRSA isolates obtained from humans and pets in the same household were indistinguishable by use of PFGE.
The high prevalence of concurrent MRSA colonization as well as identification of indistinguishable strains in humans and pet dogs and cats in the same household suggested that interspecies transmission of MRSA is possible. Longitudinal studies are required to identify factors associated with interspecies transmission.
PubMed ID
19719444 View in PubMed
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An outbreak of community-onset methicillin-resistant Staphylococcus aureus skin infections in southwestern Alaska.

https://arctichealth.org/en/permalink/ahliterature30882
Source
Infect Control Hosp Epidemiol. 2003 Jun;24(6):397-402
Publication Type
Article
Date
Jun-2003
Author
Henry C Baggett
Thomas W Hennessy
Richard Leman
Cindy Hamlin
Dana Bruden
Alisa Reasonover
Patricia Martinez
Jay C Butler
Author Affiliation
Arctic Investigations Program, National Center for Infectious Diseases, Centers for Disease Control and Prevention, Anchorage, Alaska 99508, USA.
Source
Infect Control Hosp Epidemiol. 2003 Jun;24(6):397-402
Date
Jun-2003
Language
English
Publication Type
Article
Keywords
Adolescent
Adult
Aged
Alaska - epidemiology
Anti-Bacterial Agents - therapeutic use
Child
Child, Preschool
Cohort Studies
Community-Acquired Infections - epidemiology
Disease Outbreaks
Female
Humans
Infant
Male
Methicillin Resistance
Middle Aged
Research Support, Non-U.S. Gov't
Research Support, U.S. Gov't, P.H.S.
Retrospective Studies
Rural Population
Staphylococcal Skin Infections - drug therapy - epidemiology - microbiology
Staphylococcus aureus - isolation & purification
Abstract
OBJECTIVE: We investigated a large outbreak of community-onset methicillin-resistant Staphylococcus aureus (MRSA) infections in southwestern Alaska to determine the extent of these infections and whether MRSA isolates were likely community acquired. DESIGN: Retrospective cohort study. SETTING: Rural southwestern Alaska. PATIENTS: All patients with a history of culture-confirmed S. aureus infection from March 1, 1999, through August 10, 2000. RESULTS: More than 80% of culture-confirmed S. aureus infections were methicillin resistant, and 84% of MRSA infections involved skin or soft tissue; invasive disease was rare. Most (77%) of the patients with MRSA skin infections had community-acquired MRSA (no hospitalization, surgery, dialysis, indwelling line or catheter, or admission to a long-term-care facility in the 12 months before infection). Patients with MRSA skin infections were more likely to have received a prescription for an antimicrobial agent in the 180 days before infection than were patients with methicillin-susceptible S. aureus skin infections. CONCLUSIONS: Our findings indicate that the epidemiology of MRSA in rural southwestern Alaska has changed and suggest that the emergence of community-onset MRSA in this region was not related to spread of a hospital organism. Treatment guidelines were developed recommending that beta-lactam antimicrobial agents not be used as a first-line therapy for suspected S. aureus infections.
Notes
Comment In: Infect Control Hosp Epidemiol. 2003 Jun;24(6):392-612828313
PubMed ID
12828314 View in PubMed
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An outbreak of methicillin resistant Staphylococcus aureus on a burn unit: potential role of contaminated hydrotherapy equipment.

https://arctichealth.org/en/permalink/ahliterature192932
Source
Burns. 2001 Nov;27(7):681-8
Publication Type
Article
Date
Nov-2001
Author
J M Embil
J A McLeod
A M Al-Barrak
G M Thompson
F Y Aoki
E J Witwicki
M F Stranc
A M Kabani
D R Nicoll
L E Nicolle
Author Affiliation
Infection Control Unit, Health Sciences Centre, MS673, 820 Sherbrook Street, Manitoba, R3A 1R9, Winnipeg, Canada
Source
Burns. 2001 Nov;27(7):681-8
Date
Nov-2001
Language
English
Publication Type
Article
Keywords
Adult
Aged
Aged, 80 and over
Burns - therapy
Cross Infection - epidemiology - microbiology
Disease Outbreaks
Equipment Contamination
Female
Humans
Hydrotherapy - instrumentation
Male
Manitoba - epidemiology
Methicillin Resistance
Middle Aged
Staphylococcal Infections - epidemiology - microbiology
Staphylococcus aureus - isolation & purification
Abstract
To report a multi-institution outbreak caused by a single strain of methicillin-resistant Staphylococcus aureus (MRSA).
Between September 19 and November 20, 1996 an index case and five secondary cases of nosocomial MRSA occurred on a 26 bed adult plastic surgery/burn unit (PSBU) at a tertiary care teaching hospital. Between November 11 and December 23, 1996, six additional cases were identified at a community hospital. One of the community hospital cases was transferred from the PSBU. All strains were identical by pulsed-field gel electrophoresis. MRSA may have contributed to skin graft breakdown in one case, and delayed wound healing in others. Patients required 2 to 226 isolation days.
A hand held shower and stretcher for showering in the hydrotherapy room of the PSBU were culture positive for the outbreak strain, and the presumed means of transmission. Replacement of stretcher showering with bedside sterile burn wound compresses terminated the outbreak. The PSBU was closed to new admissions and transfers out for 11 days during the investigation. Seven of 12 patients had effective decolonization therapy.
Environmental contamination is a potential source of nosocomial MRSA transmission on a burn unit. Notification among institutions and community care providers of shared patients infected or colonized with an antimicrobial resistant microorganism is necessary.
PubMed ID
11600247 View in PubMed
Less detail

[An outbreak of MRSA in a nursing home in Oslo].

https://arctichealth.org/en/permalink/ahliterature153688
Source
Tidsskr Nor Laegeforen. 2008 Dec 4;128(23):2734-7
Publication Type
Article
Date
Dec-4-2008
Author
Hans Frederik Leendert van der Werff
Tore Waelgaard Steen
Kirsten Marie Knutsen Garder
Bjørg Marit Andersen
Mette Rasch
Bente Jørgen
Anne Bråthen
Merete Helland
Lina Torvund
Aslak Heldal Haugen
Author Affiliation
Hovseterhjemmet Landingsveien 12 0767 Oslo. hlfvanderwerff@hotmail.com
Source
Tidsskr Nor Laegeforen. 2008 Dec 4;128(23):2734-7
Date
Dec-4-2008
Language
Norwegian
Publication Type
Article
Keywords
Adult
Aged
Aged, 80 and over
Carrier State - microbiology
Disease Outbreaks
Female
Humans
Infection Control
Male
Methicillin-Resistant Staphylococcus aureus - isolation & purification
Middle Aged
Norway - epidemiology
Nursing Homes
Patient Isolation
Risk factors
Staphylococcal Infections - epidemiology - microbiology - transmission
Abstract
Infections caused by methicillin-resistant Staphylococcus aureus (MRSA) represent an increasing problem in Norway, also in nursing homes and other institutions for long-term care. We describe an outbreak of MRSA in a nursing home in Oslo 2004-5.
The nursing home has six wards with 185 beds. The building is old, all rooms have toilets and sinks, but showers are shared. Standard screening procedures were carried out according to the national MRSA guide and by using the nursing home's infection control programme. Later on we used more extensive screening of staff and patients.
The outbreak started in a ward for short-term care, but spread to a ward for patients with dementia after some months. Ten patients, seven staff members and two relatives of infected persons were diagnosed with MRSA. All bacteria probably belonged to the same strain. Four staff members and five patients who were infected had pre-existing wounds or eczema. The nursing home was declared free of MRSA 20 months after the outbreak started, but one member of staff remained a carrier for two years, and one patient became a chronic carrier of MRSA. During the first six months, infected patients were restricted to their rooms, and standard eradication procedures were carried out for five days. Later on, we introduced cohort isolation for infected, exposed and recently treated patients, a different screening routine, a prolonged eradication procedure, restrictions on staff working elsewhere and more stringent precautions for visitors.
An old building and insufficient isolation procedures during the first phase of the outbreak contributed to spreading MRSA and prolonging the outbreak. Cohort isolation seemed to be the most important measure to control the outbreak. All nursing homes should have a designated single patient room for contact precautions. Long-term carriers of MRSA in nursing homes represent a big challenge.
PubMed ID
19079422 View in PubMed
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171 records – page 1 of 18.