Five-Year Surveillance of Central Line Associated Bloodstream Infection in an Intensive Care Unit Population—A Retrospective Analysis

Theresia Lutufyo1,2 , Yuan Li2, Hui Han2, Weidong Qin2, Geofrey Mahiki Mranda1,3,

Xiaomei Chen1,2

1 Shandong University Cheelo College of Medicine, Jinan, China

2 Department of Critical Care Medicine, Qilu Hospital of Shandong University, Jinan, China

3 Department of Gastrointestinal Surgery, The Second Hospital of Shandong University, Jinan, China

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How to cite this paper: Lutufyo, T., Li, Y., Han, H., Qin, W.D., Mranda, G.M. and Chen, X.M. (2022) Five-Year Surveillance of Central Line Associated Bloodstream Infection in an Intensive Care Unit Population—A Retrospective Analysis. Advances in Infectious Diseases, 12, 281-297.

https://doi.org/10.4236/aid.2022.122023

Received: April 27, 2022

Accepted: June 7, 2022

Published: June 10, 2022

Copyright © 2022 by author(s) and Scientific Research Publishing Inc. This work is licensed under the Creative Commons Attribution International License (CC BY 4.0).

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Abstract

Background: Central venous catheters (CVCs) are essential to current intensive care unit (ICU) practices as a tool for treating critically ill patients. However, the use of CVCs is associated with substantial risk of infection. Central line associated bloodstream infection (CLABSI) is increasing in prevalence each year and is among the major causes of bloodstream infection in ICU patients. Therefore, investigating the epidemiology and risk factors of CLABSI in ICU patients is important. Objective: This study aimed to investigate the incidence rates, causative pathogens and risk factors of CLABSI in an ICU population. Methods: A retrospective observational study was performed in an ICU at Qilu Hospital of Shandong University in China from January 2016 to December 2020. Patients with at least one CVC were enrolled, and information relevant to CVC use was recorded. The prevalence was calculated, and related risk factors were analyzed. Results: A total of 1920 catheters were identified, 507 of which were eligible for analysis. For each of the years 2016-2020, the incidence rates of CLABSI were 1.91, 3.18, 1.69, 2.97 and 1.27 per 1000 catheter days, respectively. The yeast Candida albicans was the most prevalent pathogen (16 [(3.2%]), followed by Gram-positive methicillin-resistant Staphylococcus aureus (11 [2.2%]) and the Gram-negative multidrug-resistant pathogen Acinetobacter baumanii. Risk factors associated with CLABSI development were age, (p = 0.05), Charlson comorbidity index > 5 (p < 0.01) and duration of CVC placement (p = 0.01). Conclusion: Candida albicans was the most common causative microorganism, which was followed by Gram positive methicillin resistant Staphylococcus, MDR K. pneumoniae and Acinetobacter baumanii.

Keywords Central Venous Catheter, Insertion Site, Bloodstream Infection, ICU, Catheter Days

Cedecea lapagei in a Patient with Multiple Injuries: Report of a Rare Case

Xiaofan Xu1*, Kaiyue Chang1*, Dongxue Song1*, Guangtong Tian2*,Xiaohang Hu3, Liqing Jiang3, Bin Zhang3, Qingli Bie3, Shuhua Lu3, Xiaozhe Li3, Haixin Dong3, Chengqiang Jin3#

1 School of Clinical Medicine, Jining Medical University, Jining, China

2 Department of Clinical Laboratory, Jining Hospital of traditional Chinese Medicine, Jining, China

3 Department of Clinical Laboratory, The Affiliated Hospital of Jining Medical University, Jining, China

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How to cite this paper: Xu, X.F., Chang, K.Y., Song, D.X., Tian, G.T., Hu, X.H.,Jiang, L.Q., Zhang, B., Bie, Q.L., Lu, S.H., Li, X.Z., Dong, H.X. and Jin, C.Q. (2021) Cedecea lapagei in a Patient with Multiple Injuries: Report of a Rare Case. Journal of Biosciences and Medicines, 9, 1-5.

Received: September 28, 2021

Accepted: October 26, 2021

Published: October 29, 2021

Copyright © 2021 by author(s) and Scientific Research Publishing Inc.

This work is licensed under the Creative Commons Attribution International License (CC BY 4.0).

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https://doi.org/10.4236/jbm.2021.911001

Abstract

      Cedecea lapagei (C. lapagei) is an opportunistic pathogen in old patients with many comorbid diseases and the immunosuppressed. It is a gram-negative, facultative anaerobe bacterium of the Enterobacteriaceae family. We present a rare case of a patient with multiple injuries, C. lapagei was found from the exudate of the wound, what’s more, the Proteus vulgaris was also found in blood culture medium at the same time. According to the available literature, this is the first case of simultaneous infection of two bacteria including C. lapagei and Proteus vulgaris from the exudate of the traumatic wound.

Keywords:  C. lapagei, Cedecea, Proteus vulgaris, Exudate

一例骨科牵引床手术体位造成会阴III期 压疮患者的护理

焦闪云，范文娟，桑莉莉，王 静*

上海市杨浦区同济大学附属杨浦医院，上海

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收稿日期：2020年7月27日；录用日期：2020年8月7日；发布日期：2020年8月14日

文章引用: 焦闪云, 范文娟, 桑莉莉, 王静. 一例骨科牵引床手术体位造成会阴 III 期压疮患者的护理[J]. 护理学, 2020,9(4): 294-298. DOI: 10.12677/ns.2020.94046

摘 要

      股骨转子间骨折(IFF)即股骨粗隆间骨折，是指股骨颈基底至小转子水平以上部位所发生的骨折，是老年人常见的损伤之一。IFF多见于老年患者，其身体耐受能力相对较差，因此创伤小，操作简便，且固定可靠的内固定方式越来越受到临床重视。因而股骨近端防旋髓内钉(PFNA)作为近年来治疗股骨粗隆间骨折的微创内固定方式，越来越得到广泛应用。股骨骨折因周围肌肉发达，手法不易整复，整复后也不易维持对位，应用牵引床可以很容易地在C型臂X线机下通过调整牵引床装置达到良好的复位，并且在术中操作时始终保持良好的复位效果，不会发生体位的改变。所以牵引床已广泛应用于IFF复位内固定手术。但在牵引床的使用中体位的摆放不像其他常用手术简单，由于体位的放置过程较复杂，且手术对体位的要求特殊，实际操作中极易发生相关的护理问题。

关键词：牵引床，股骨骨折，会阴，压力性损伤，护理

Nursing Care of a Patient with Perineal Stage III Pressure Sore Caused by Orthopaedic Traction Bed

Shanyun Jiao, Wenjuan Fan, Lili Sang, Jing Wang*

Yangpu Hospital Affiliated to Tongji University, Yangpu District, Shanghai

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Received: Jul. 27th, 2020; accepted: Aug. 7th, 2020; published: Aug. 14th, 2020

Abstract

      Femoral intertrochanteric fracture (IFF), the intertrochanteric fracture, refers to the fracture of the femoral neck from the basal to the small trochanter level, which is one of the common injuries in the elderly. IFF is more common in elderly patients, and its physical tolerance is relatively poor, so the trauma is small, the operation is simple, and the fixed and reliable internal fixation is more and more clinical attention. Therefore, the proximal femoral nail (PFNA) has been widely used as a minimally invasive internal fixation for the treatment of intertrochanteric fractures in recent years. Due to the surrounding muscles, the femur fracture is not easy to repair, and it is not easy to maintain the alignment after the recovery. The traction bed can be easily adjusted by the adjustment of the traction bed device under the C-arm X-ray machine, and during the operation. Always maintain a good reset effect during operation, no position change will occur. Therefore, the traction bed has been widely used in IFF reduction and internal fixation surgery. However, the position of the traction bed is not as simple as other common operations. Because the placement process of the posture is complicated, and the requirements for the posture of the operation are special, the related nursing problems are easily caused in actual operation.

Keywords：Traction Table, Femoral Fracture, Perineum, Pressure Injury, Nursing

Copyright © 2020 by author(s) and Hans Publishers Inc.

This work is licensed under the Creative Commons Attribution International License (CC BY 4.0).

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Acute Burns in Pregnancy

Ali Alrida Rahal1, Sinan Alboudi1, Israa Ali Haidar2 , Anwar Alhassanieh1

1 Department of Plastic Surgery, Faculty of Medicine, Damascus University, Damascus, Syrian Arab Republic

2 Obstetrics and Gynecology Department, Faculty of Medicine, Damascus University, Damascus, Syrian Arab Republic

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How to cite this paper: Rahal, A.A., Alboudi, S., Haidar, I.A. and Alhassanieh, A. (2020) Acute Burns in Pregnancy. Open Journal of Obstetrics and Gynecology, 10, 1702-1707. https://doi.org/10.4236/ojog.2020.10120154

Received: November 19, 2020

Accepted: December 18, 2020

Published: December 21, 2020

Copyright © 2020 by author(s) and Scientific Research Publishing Inc. This work is licensed under the Creative Commons Attribution International License (CC BY 4.0). http://creativecommons.org/licenses/by/4.0/

Abstract

Background: Acute burns injury in pregnant women is relatively rare especially in developed countries. There is a paucity of published data on the specific problems of burns in pregnancy, despite the high mortality for both the mother and the fetus. Aim: In this paper we will discuss all cases of acute burns in pregnant women admitted to the Burns Department in Al-Mouassat University Hospital in Damascus during the period between October 2017 and October 2019. Materials and Methods: A retrospective study of records over 2 years was conducted. The study included all pregnant burn injury women who were managed and followed up at the Burns Department in Al-Mouassat University Hospital. Patients were classified according to gestational age , burn characteristics, and maternal and fetal outcome. Results: Eleven patients were included , with mean age of 22.5 years (range 16 - 37 years). Of the 11 pregnant patients, 4 (36%) were in the first trimester, 3 in the second trimester (27%), and 4 in the third trimester (36%). The mean percentage of total body surface area (TBSA) burned was 40.9% (range: 17% -76%). Maternal death occurred in 2 of the cases (18%) and fetal death in 7 (63.6%). Conclusion: Maternal mortality is correlated to the percentage of the total burned area and inhalation injury. Burns in pregnant women have a profound effect on the fetal wellbeing, with a high rate of mortality especially in the first trimester.

Keywords: Acute Burns, Pregnancy, Mortality

Place of Total Self-Skin Transplant in the Management of Burns in Children: Results and Predictive Factors

Fatoumata Binta Balde1*, Zineb Benmassaoud1, Thierry Mukenge1, Majdouline Zemmari1, Hicham Abdellaoui1,2, Tazi Mohammed Charki1,2, Karima Atarraf1,2, My Abderrahmane Afifi1,2

1 Department of Pediatric Surgery, Hassan II University Hospital, Fez, Morocco

2 Faulty of Medecine and Pharmacy, Sidi Mohamed Ben Abdallah University, Faz, Morocco

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How to cite this paper: Balde, F.B., Benmassaoud, Z., Mukenge, T., Zemmari, M.,Abdellaoui, H., Charki, T.M., Atarraf, K. and Afifi, M.A. (2021) Place of Total Self-Skin Transplant in the Management of

Burns in Children: Results and Predictive Factors. Open Journal of Pediatrics, 11, 676-683.

https://doi.org/10.4236/ojped.2021.114063

Received: October 10, 2021

Accepted: December 5, 2021

Published: December 8, 2021

Copyright © 2021 by author(s) and Scientific Research Publishing Inc.

This work is licensed under the Creative Commons Attribution International

Abstract

Introduction: Skin transplant is essential in the management of skin substance losses, especially in deep burns. Our work aims to present, through a series of cases, the results of the skin self-transplant carried out to supplement the treatment of skin burns.

Materials and Methods: A one-year prospective study of the total self-skin transplant performed in the management of burns in children was included. After clinic and biologic considerations, a total self-skin transplant was performed.

Results: Forty-five burns were hospitalized, of which six patients received a total self-skin transplant. The average age was 7.43 years with male predominance. The burns were deep thermal burns, preferentially located on the trunk and upper limbs covering over 10% - 25% of the body surface of which 3% - 13% was transplanted. Transplant held in all patients. The surfaces left in spontaneous healing took at least 6 months to heal with some complications. Discussion: We performed a total self-skin transplant beyond technical reasons, for the best aesthetic and functional result it offers. The transplant significantly reduced the healing time with better aesthetic and functional results. The burned surfaces left to direct healing took an average of 6 months to heal and there were associated complications such as formation of keloid scars, hypertrophic plaques and skin retractions leading to cosmetic deformities. The final results appear to be independent of the time required to complete the transplant, and it will be necessary to ensure that there is no local and systemic infection and anaemia.

Conclusion: Total self-skin grafting still has its place in the initial management of burns in children. It offers good aesthetic and functional results. License (CC BY 4.0).

Keywords

Skin Transplant, Burn, Child

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负压封闭引流(VSD)联合间断快速冲洗技术在 下肢开放性骨折合并软组织缺损中的应用研究

龙奇军1 ，杨梅春2* ，杨 娟3 ，黄丽珍1 ，张钰婷1

1 右江民族医学院，广西 百色

2 右江民族医学院附属医院，广西 百色

3 右江民族医学院重金属与氟砷毒物研究实验室，广西 百色

收稿日期：2021年3月19日；录用日期：2021年4月15日；发布日期：2021年4月22日

摘 要

目的：探讨负压封闭引流(VSD)联合间断快速冲洗技术在下肢开放性骨折合并软组织缺损的应用研究。

方法：选取我院创伤骨科2020年1月~2020年10月收治的50例下肢开放性骨折合并软组织缺损行VSD负压引流术后的患者，分为实验组25例用生理盐水快速间断冲洗创面及对照组25例用生理盐水持续冲洗创面，分别对两组护理效果进行比较。通过记录每例发生引流管堵塞的次数、患者疼痛指数评分、使用VSD平均治疗时间、创面愈合效果及疗效显现时间、出院患者满意度进行对比。结果：VSD负压引流术后采用间断冲洗与持续冲洗防止引流管管道堵塞的效果无差别(P > 0.05)，实验组的疼痛程度低于对照组(P <0.05)，实验组使用VSD平均治疗时间短于对照组，实验组创面愈合效果优于对照组(P < 0.05)，实验组疗效显现时间短于对照组(P < 0.05)，实验组的满意度高于对照组(P < 0.05)。结论：负压封闭引流(VSD)联合间断快速冲洗技术能显著促进下肢开放性骨折合并软组织缺损创面的愈合，降低患者的疼痛程度，缩短治疗时间，提高患者满意度，值得推广应用。

关键词：负压封闭引流，VSD，间断快速冲洗，下肢开放性骨折，软组织缺损

文章引用: 龙奇军, 杨梅春, 杨娟, 黄丽珍, 张钰婷. 负压封闭引流(VSD)联合间断快速冲洗技术在下肢开放性骨折合并软组织缺损中的应用研究[J]. 临床医学进展, 2021, 11(4): 1762-1767. DOI: 10.12677/acm.2021.114253

Study on the Application of Negative Pressure Sealed Drainage (VSD) Combined with Intermittent Rapid Irrigation in the Treatment of Open Fractures of Lower Limbs Complicated with Soft Tissue Defects

Qijun Long1, Meichun Yang2*, Juan Yang3, Lizhen Huang1, Yuting Zhang1

1 Youjiang Medical University for Nationalities, Baise Guangxi

2 Affiliated Hospital of Youjiang Medical University for Nationalities, Baise Guangxi

3 Heavy Metal and Arsenic Fluoride Research Laboratory, Youjiang Medical College for Nationalities, Baise Guangxi

Received: Mar. 19th, 2021; accepted: Apr. 15th, 2021; published: Apr. 22nd, 2021

Abstract

Objective: To investigate the application of negative pressure closed drainage (VSD) combined with intermittent rapid irrigation in the treatment of open fractures of lower limbs complicated with soft tissue defects. Methods: A total of 50 patients with open fractures of lower extremity combined with soft tissue defects admitted to the Department of Trauma and Orthopedics of our hospital from January 2020 to October 2020 were selected after VSD negative pressure drainage. The patients were divided into the experimental group (n = 25) and the control group (n = 25), who were rapidly and discontinuously irrigated with normal saline. The nursing effects of the two groups were compared respectively. The frequency of blockage of drainage tube, pain index score of patients, average treatment time with VSD, wound healing effect and curative effect appearance time, and satisfaction of discharged patients were recorded. Results: After VSD negative pressure drainage by intermittent flush with continuous irrigation to prevent drainage pipe blockage effect difference (P > 0.05), the experimental group level of pain is lower than the control group (P <0.05), the experimental group used the VSD treatment time is shorter than the control group on average, the experimental group wound healing effect is better than that of control group (P <0.05), the experimental group curative effect appears shorter than the control group (P < 0.05), the satisfaction degree of the experimental group is higher than control group (P < 0.05). Conclusion: The technique of negative pressure sealed drainage (VSD) combined with intermittent rapid irrigation can significantly promote the wound healing of lower extremity open fracture combined with soft tissue defect, reduce the pain degree of patients, shorten the treatment time and improve patient satisfaction, which is worthy of promotion and application.

Keywords

Negative Pressure Closed Drainage, VSD, Intermittent Quick Washing, Open Fractures of Lower Limbs, Soft Tissue Defect

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