Abstract Higher PJI rates may be related to identifiable risk factors, which may or may not be modifiable. Identifying risk factors preoperatively provides opportunities for modification and ...potentially decreasing the incidence of PJI. The purposes of this study were to: (1) retrospectively identify and quantify risk factors for PJI following primary TKA, and (2) to classify those significant risk factors as either non-modifiable or modifiable for intervention prior to surgery. Optimization of modifiable risk factors such as Staphylococcus aureus colonization, and tobacco use prior to primary TKA may decrease the incidence of periprosthetic joint infection after primary TKA, thereby reducing morbidity and the costs associated with treating those infections.
Abstract Background A first-generation cephalosporin is the recommended antibiotic prophylaxis for implants. However, this standard does not address the increasing prevalence and virulence of ...gram-negative pathogens infecting patients. We found that gram-negative bacilli caused 30% of our surgical site infections (SSIs) following hip procedures, whereas only 10% of knee SSIs were caused by gram-negative bacilli. To address this, we instituted Expanded Gram-Negative Antimicrobial Prophylaxis (EGNAP) for our hip arthroplasty patients. The purpose of this study is to measure the effect of EGNAP on the SSI rates following primary total hip arthroplasty. Methods The study consisted of 10,084 total patients. Before July 2012, all patients were administered 1 g of cefazolin. After July 2012, our protocol was adjusted by adding the EGNAP with either gentamicin or aztreonam to hip patients (group 1) and not to the knee arthroplasty patients (group 2). Results Group 1 consisted of the 5389 primary hip arthroplasty patients. Of these patients, 4122 (before July 2012) did not receive weight-based high-dose gentamicin and 1267 (after July 2012) did. Before the introduction of EGNAP, group 1 SSI rate was 1.19% (49/4122). After July 2012 when EGNAP was added, the overall group 1 SSI rate decreased to 0.55% (7/1267) ( P = .05). During the study period, there was not a significant difference in SSI rate of knee arthroplasty (group 2): 1.08% vs 1.02% ( P = .999). Conclusions The addition of EGNAP for hip arthroplasty is a safe and effective method to decrease SSIs. Level of Evidence: III. Case-control study.
Accurate documentation of the use of invasive devices, such as urinary and central line catheters, is important to track potential catheter-associated infections. Real-time identification of device ...infections allows practitioners to initiate timely apparent-cause analyses, therefore allowing rapid improvement of practice. For this reason, it was crucial to ensure our institution's mechanism to capture possible catheter-associated infections is validated after the adoption of a new electronic medical record system.
Following a major rainstorm in the northeast United States, Infection Preventionists (IPs) played key roles in the recovery efforts to restore normal and safe clinical operations at a major academic ...medical center. Additionally, several hundred patients, including those on isolation precaution, had to be emergently evacuated and transferred to surrounding hospitals.
