Dumville, J.C et al. (2016) Cochrane Database of Systematic Reviews . Issue 12. Art. No.: CD00309
Background: Surgical wounds (incisions) heal by primary intention when the wound edges are brought together and secured, often with sutures, staples, or clips. Wound dressings applied after wound closure may provide physical support, protection and absorb exudate. There are many different types of wound dressings available and wounds can also be left uncovered (exposed). Surgical site infection (SSI) is a common complication of wounds and this may be associated with using (or not using) dressings, or different types of dressing.
Authors’ conclusions: It is uncertain whether covering surgical wounds healing by primary intention with wound dressings reduces the risk of SSI, or whether any particular wound dressing is more effective than others in reducing the risk of SSI, improving scarring, reducing pain, improving acceptability to patients, or is easier to remove. Most studies in this review were small and at a high or unclear risk of bias. Based on the current evidence, decision makers may wish to base decisions about how to dress a wound following surgery on dressing costs as well as patient preference.
Mumps may seem like a contagion relegated to history books, but like many other diseases of the past now preventable with a vaccine, mumps has been making a resurgence | Infection Control Today
Cases are at 10-year high and are especially common on college campuses across the country. Now the Dallas area is seeing the largest outbreak in Texas in years. Cristie Columbus, MD, vice dean of the Texas A&M College of Medicine’s Dallas campus and an infectious disease specialist, explains what people need to know about the mumps.
What is mumps?: Mumps is caused by a virus, specifically a type of Rubulavirus in the Paramyxovirus family. Before the vaccine was widely introduced in the United States in 1967, nearly every child would become infected. Although cases have declined more than 99 percent since then, outbreaks do still occasionally occur.
What are the symptoms of mumps?: The classic symptom of mumps is swollen salivary glands, which causes puffy cheeks and a swollen jaw that can make it difficult to eat. Other symptoms, which last seven to 10 days, may include a fever, fatigue and head and muscle aches. Some people—possibly as many as 40 percent of those infected—may have only very mild symptoms (if they have any at all), and therefore might not realize they have the disease. Still, they may be able to spread the virus to others.
How long after being infected do symptoms usually appear?: Symptoms can appear between 12 and 25 days after the initial infection, but usually people begin experiencing them 16 to 18 days after they are infected.
Bond, S.E. et al. The Journal of Hospital Infections. Published online: December 18 2016
Objective: Healthcare-associated Clostridium difficile infection (HCA-CDI) remains a major cause of morbidity and mortality in industrialised countries. However, few data exist on the burden of HCA-CDI in multisite non-metropolitan settings. This study examined the introduction of an antimicrobial stewardship program (ASP) in relation to HCA-CDI rates and the effect of HCA-CDI on length of stay (LOS) and hospital costs.
Conclusions: HCA-CDI placed a significant burden on our regional and rural health service through increased LOS and hospital costs. Interventions targeting HCA-CDI could be employed to consolidate the effects of ASPs.
A team of UCLA researchers has developed an automated diagnostic test reader for antimicrobial resistance using a smartphone | Infection Control Today
The technology could lead to routine testing for antimicrobial susceptibility in areas with limited resources. Antimicrobial-resistant bacteria are posing a severe threat to global public health. In particular, they are becoming more common in bacterial pathogens responsible for high-mortality diseases such as pneumonia, diarrhea and sepsis. Part of the challenge in combatting the spread of these organisms has been the limited ability to conduct antimicrobial susceptibility testing in regions that do not have access to labs, testing equipment and trained diagnostic technicians to read such tests.
Sepsis awareness campaign will help parents and carers of young children recognise the symptoms of sepsis.
A nationwide campaign has been launched to help parents spot the symptoms of sepsis to protect young children and save lives.The campaign is principally aimed at parents and carers of young children aged 0 to 4.
The campaign, delivered by Public Health England and the UK Sepsis Trust, follows a number of measures already taken by the NHS to improve early recognition and timely treatment of sepsis. This includes a national scheme to make sure at-risk patients are screened for sepsis as quickly as possible and receive timely treatment on admission to hospital.
Leaflets and posters are being sent to GP surgeries and hospitals across the country. These materials, developed with experts, will urge parents to call 999 or take their child to A&E if they display any of the following signs:
looks mottled, bluish or pale
is very lethargic or difficult to wake
feels abnormally cold to touch
is breathing very fast
has a rash that does not fade when you press it
has a fit or convulsion
The UK Sepsis Trust estimates that there are more than 120,000 cases of sepsis and around 37,000 deaths each year in England.
This annual report covers surgical site infection (SSI) data collected by NHS hospitals and independent sector NHS treatment centres.
This report is a summary of data on surgical site infections (SSIs) collected by NHS hospitals and independent sector (IS) NHS treatment centres in England participating in one of 17 surgical categories of surveillance between April 2004 and March 2015. The results include orthopaedic data submitted by hospitals following the mandatory surveillance requirement introduced by the Department of Health in April 2004 . This requires all NHS trusts undertaking orthopaedic surgical procedures to carry out a minimum of three months’ surveillance in each financial year in at least one of four categories (hip prosthesis, knee prosthesis, repair of neck of femur or reduction of long bone fracture). Trusts with very small volumes are exempt from the mandatory surveillance but are expected to undertake surveillance in a category that reflects the largest component of their surgical activity.
Kerbaj, J. et al. American Journal of Infection Control. Published online 9 December 2016
Background: Health care-associated infections are a major worldwide public health issue. Hand hygiene is a major component in the prevention of pathogen transmission in hospitals, and hand hygiene adherence by health care workers is low in many studies. We report an intervention using text messages as reminders and feedback to improve hand hygiene adherence.
Conclusions: Text message feedback should be incorporated into multimodal approaches for improving hand hygiene compliance.
Lowe, C.F. et al. American Journal of Infection Control. Published online 8 December 2016
Image shows transmission electron microscopy of vancomycin resistant enterococcus faecalis.
Background: Daily bathing with chlorhexidine gluconate (CHG) is increasingly used in intensive care units to prevent hospital-associated infections, but limited evidence exists for noncritical care settings.
Conclusions: This prospective pragmatic study to assess daily bathing for CHG on inpatient medical units was effective in reducing hospital-associated MRSA and VRE. A critical component of CHG bathing on medical units is sustained and appropriate application, which can be a challenge to accurately assess and needs to be considered before systematic implementation.
Pellegrini, J. et al. Anesthesia & Analgesia. Published online: December 1 2016
The primary purpose of this safety bundle is to provide recommendations that can be implemented into any surgical environment in an effort to reduce the incidence of surgical site infection. This bundle was developed by a multidisciplinary team convened by the Council on Patient Safety in Women’s Health Care. The bundle is organized into four domains: Readiness, Recognition and Prevention, Response, and Reporting and Systems Learning. In addition to recommendations for practice, each of the domains stresses communication and teamwork between all members of the surgical team. Although the bundle components are designed to be adaptable to work in a variety of clinical settings, standardization within institutions is encouraged.