Non-hospital-associated methicillin-resistant Staphylococcus aureus and MRSA chronic carrier patients in infection control.
(2011)
Journal - American journal of infection control (United States )
Abstract :
This study reports research on methicillin-resistant Staphylococcus aureus (MRSA) colonized-infected patients who were admitted to a 320-bed hospital. Specifically, we report on the difficulties related to MRSA infection control as a consequence of the increasing incidence of non-hospital-associated MRSA acquisition and patients as chronic carriers who are frequently readmitted to the hospital.Copyright © 2011 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Mosby, Inc. All rights reserved.
| ISSN : | 1527-3296 |
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| Mesh Heading : | Adolescent Adult Aged Aged, 80 and over Carrier State Child Child, Preschool Community-Acquired Infections Cross Infection Female Humans Infant Infection Control Male Methicillin-Resistant Staphylococcus aureus Middle Aged Staphylococcal Infections Young Adult microbiology microbiology microbiology |
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| Mesh Heading Relevant : | epidemiology epidemiology prevention & control methods isolation & purification epidemiology |
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Extrapulmonary tuberculosis: epidemiology and risk factors.
(2011)
Journal - Enfermedades infecciosas y microbiología clínica (Spain )
Abstract :
To describe the epidemiology and risk factors associated with extra-pulmonary tuberculosis (EPTB).Cases of tuberculosis (TB) diagnosed from 1991 to 2008 in a Caucasian population were classified as EPTB or pulmonary TB (PTB). Of all cases, 63.7% were followed up in a specialist TB unit. A standardised protocol for data collection was used, including: gender, age, BCG vaccination, contact with PTB patient, smoking habit, alcohol abuse, diabetes mellitus, immunosuppressive drugs/steroids and HIV-status. These variables were compared between EPTB and PTB groups. Statistical analysis was based on logistic regression. Odds ratios (OR) and their 95% confidence intervals (CI) were calculated.Among the 2,161 cases diagnosed, 1,186 were PTB and 705 EPTB. The overall TB incidence had fallen from 79.9/100,000 in 1992 to 27.1/100,000 in 2008, P<.05. The number of EPTB cases decreased more slowly than PTB. EPTB increased from 30.6% of cases in 1991-1996 to 37.6% in 2003-2008 (lymphatic site increased 27%), by trend test P<.05. At multivariate level, being female (OR 2.04; 95% CI: 1.56-2.66) and age (OR 1.02; 95% CI: 1.01-1.022) were associated with EPTB, while alcohol abuse (OR 0.33; 95% CI: 0.20-0.52), smoking habit (OR 0.45; 95%CI: 0.34-0.59), contact with PTB patients (OR 0.57; 95% CI: 0.44-0.76) and BCG vaccination (OR 0.64; 95% CI: 0.44-0.92) had a protective effect. The proportion of female gender and age of patients increased over time, whilst there was a decrease in BCG vaccinated patients.Whilst there has been a reduction in the overall incidence of TB, the proportion of EPTB increased. The proportional increase in EPTB could be explained by an increase in life expectancy and the predominance of women in the population, and by a decline in BCG vaccinated patients.Copyright © 2010 Elsevier España, S.L. All rights reserved.
[Cutaneous tuberculosis: a 15-year descriptive study]
(2008)
Journal - Enfermedades infecciosas y microbiología clínica (Spain )
Abstract :
INTRODUCTION: Cutaneous tuberculosis has experienced a resurgence following a period of decline. The aim of this study was to determine the clinical and epidemiological characteristics of cutaneous tuberculosis in the Ferrol Healthcare Area (Spain). METHODS: Between 1991-2005, 1139 new cases of tuberculosis were diagnosed in Ferrol and submitted to a descriptive analysis. Cutaneous involvement was investigated in all cases. RESULTS: Among 1139 patients, 55 cases of cutaneous tuberculosis were diagnosed (4.8%). The condition was more frequent in women (70.9%), average age was 44.1 +/- 23.3 years, and 56.4% of patients were treated with 6HR2Z-E. Among the 55 cases, 26 (2.3%) were true cutaneous tuberculosis and 29 (2.5%) were tuberculids. In the 26 cases of true tuberculosis, the most frequent form was scrofuloderma (32.7%), followed of lupus vulgaris (7.2%), tuberculous gumma (3.6%), and tuberculosis verrucosa cutis (3.6%). The most frequent locations were the neck, face and trunk, and in 76.9% other sites were involved (lymph nodes 14, bone 6, lung 4, and intestine 1). In the 29 cases with tuberculids, erythema nodosum was the most frequent form (49.1%) followed by erythema induratum of Bazin (3.6%). The lower extremities were affected in all cases and there was simultaneous involvement of other site in 51.9%. In patients with true cutaneous tuberculosis, the diagnostic yield was greater (necrotizing granulomas in 70.6% of biopsies and positive Löwenstein culture for Mycobacterium tuberculosis in 77.8%) and average age was higher than in patients with tuberculids (P < .05). CONCLUSION: Cutaneous tuberculosis is uncommon, preferentially affects women, and is usually associated with tuberculous disease in other locations, particularly in the case of scrofuloderma.
| ISSN : | 0213-005X |
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| Mesh Heading : | Adolescent Adult Aged Aged, 80 and over Child Child, Preschool Female Humans Male Middle Aged Tuberculosis, Cutaneous |
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| Mesh Heading Relevant : | diagnosis epidemiology |
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The effect of performance feedback on wound infection rate in abdominal hysterectomy.
(2006)
Journal - American journal of infection control (United States )
Abstract :
BACKGROUND: In many hospitals, infection of the surgical wound is the most common nosocomial infection. Its presence implies patient morbidity, a mortality risk, and an increase in procedure costs because of prolonged hospitalization. OBJECTIVES: Our objective was to ascertain the effect of an infection control program, using performance feedback, on wound infection (WI) rate in abdominal hysterectomy. METHODS: All patients undergoing abdominal hysterectomy in our center (Hospital A. Marcide, Ferrol, Spain) between 1999 and 2004 were prospectively followed up to determine the WI rate. A complete set of parameters, including age, underlying illnesses, cancer, diabetes mellitus, immunosuppressive therapy, albumin, American Society of Anesthesiologists preoperative assessment score (ASA) risk, days in hospital presurgery, date of surgery, hygiene and perioperative antimicrobial prophylaxis, type of surgical operation, duration of surgery, surgeon, and WI, were collected in each case. After data collection for 1999 concluded, we communicated surgical WI rates to surgeons every year. A logistic regression analysis was performed to compare WI rates with those observed in 1999. RESULTS: A total of 980 females was enrolled in the prospective surveillance: mean age, 50.7 +/- 10.7 years. Cases included 25.8% cancer, 4.9% diabetes, 0.5% immunosuppressive therapy, 26.6% ASA 1, 58.4% ASA 2, 13.9% ASA 3. In 9 patients, emergency surgery was performed and, in 971 patients, surgery was scheduled: Total abdominal hysterectomy, 878; subtotal abdominal hysterectomy, 65; Wertheim-Meigs, 37. The factors associated with WI were albumin (OR, 0.97; 95% CI: 0.94-0.99) and antimicrobial prophylaxis (OR, 0.08; 95% CI: 0.02-0.32). The mean values for albumin and the number of patients with antimicrobial prophylaxis fluctuated from year to year. The WI rate improved from 10.7% (95% CI: 5.8-15.6) in 1999 to 6% (-43.9%) in 2004. CONCLUSION: Performance feedback of surgical wound infection rates to individual surgeons reduces these rates.
| ISSN : | 0196-6553 |
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| Mesh Heading : | Adult Aged Aged, 80 and over Anti-Bacterial Agents Cross Infection Female Humans Hysterectomy Logistic Models Middle Aged Prospective Studies Serum Albumin Spain Surgical Wound Infection prevention & control methods statistics & numerical data epidemiology prevention & control |
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| Mesh Heading Relevant : | Antibiotic Prophylaxis therapeutic use epidemiology adverse effects analysis epidemiology |
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