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Corredoira Sánchez J, Ayuso García B, Romay Lema EM, García-Pais MJ, Rodríguez-Macias AI, Capón González P, Otero López R, Rabuñal Rey R, Alonso García P. Streptococcus bovis infection of the central nervous system in adults: Report of 4 cases and literature review. ENFERMEDADES INFECCIOSAS Y MICROBIOLOGIA CLINICA (ENGLISH ED.) 2024; 42:4-12. [PMID: 37076331 DOI: 10.1016/j.eimce.2022.06.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/20/2022] [Accepted: 06/22/2022] [Indexed: 04/21/2023]
Abstract
OBJECTIVES To describe the clinical features, history and association with intestinal disease in central nervous system (CNS) S. bovis infections. METHODS Four cases of S. bovis CNS infections from our institution are presented. Additionally a systematic literature review of articles published between 1975 and 2021 in PubMed/MEDLINE was conducted. RESULTS 52 studies with 65 cases were found; five were excluded because of incomplete data. In total 64 cases were analyzed including our four cases: 55 with meningitis and 9 with intracranial focal infections. Both infections were frequently associated with underlying conditions (70.3%) such as immunosuppression (32.8%) or cancer (10.9%). In 23 cases a biotype was identified, with biotype II being the most frequent (69.6%) and S. pasteurianus the most common within this subgroup. Intestinal diseases were found in 60.9% of cases, most commonly neoplasms (41.0%) and Strongyloides infestation (30.8%). Overall mortality was 17.1%, with a higher rate in focal infection (44.4% vs 12.7%; p=0.001). CONCLUSIONS CNS infections due to S. bovis are infrequent and the most common clinical form is meningitis. Compared with focal infections, meningitis had a more acute course, was less associated with endocarditis and had a lower mortality. Immunosuppression and intestinal disease were frequent in both infections.
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Affiliation(s)
| | | | | | | | | | | | - Rocio Otero López
- Neurosurgery Department, Universitary Hospital Lucus Augusti, Lugo, Spain
| | - Ramón Rabuñal Rey
- Infectious Disease Unit, Universitary Hospital Lucus Augusti, Lugo, Spain
| | - Pilar Alonso García
- Clinical Microbiology Department, Universitary Hospital Lucus Augusti, Lugo, Spain
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2
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Corredoira Sánchez J, Ayuso García B, Romay Lema EM, García-Pais MJ, Rodríguez-Macias AI, Capón González P, Otero López R, Rabuñal Rey R, Alonso García P. Streptococcus bovis infection of the central nervous system in adults: Report of 4 cases and literature review. Enferm Infecc Microbiol Clin 2022. [DOI: 10.1016/j.eimc.2022.06.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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3
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Berg EJ, Davies JB, Buboltz MR, Samuelson TW. Late-onset bleb-associated endophthalmitis and continuous positive airway pressure. Am J Ophthalmol Case Rep 2018; 10:87-90. [PMID: 29468205 PMCID: PMC5814369 DOI: 10.1016/j.ajoc.2018.02.007] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2017] [Revised: 02/04/2018] [Accepted: 02/07/2018] [Indexed: 12/30/2022] Open
Abstract
PURPOSE To raise awareness of a possible association between continuous positive airway pressure (CPAP) devices and postoperative bleb-related infection. OBSERVATIONS A 57-year old patient on CPAP presented with unilateral bleb-associated endophthalmitis 32 months after routine ExPress Trabeculectomy with mitomycin C. The offending organism, Streptococcus mitis, is a nonmotile and generally non-virulent pathogen which predominates in the normal human respiratory flora. CONCLUSIONS AND IMPORTANCE This conceptual report underscores a potential relationship between CPAP use and bleb-associated endophthalmitis. Streptococcal species are the most commonly reported causative organisms in bleb-associated endophthalmitis, and S. mitis is of particular concern as the most abundant microbe among all human oral flora. A logical risk factor for infection, the CPAP device may inadvertently deliver such organisms to the vulnerable conjunctival filtering bleb.
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Affiliation(s)
- Erich J. Berg
- Clinical Research Department, Minnesota Eye Consultants, P.A. 9801 Dupont Avenue S. #200, Bloomington, MN 55431, USA
| | - John B. Davies
- VitreoRetinal Surgery, P.A. 710 East 24th Street #103, Minneapolis, MN 55404, USA
| | - Mark R. Buboltz
- Clinical Research Department, Minnesota Eye Consultants, P.A. 9801 Dupont Avenue S. #200, Bloomington, MN 55431, USA
| | - Thomas W. Samuelson
- Clinical Research Department, Minnesota Eye Consultants, P.A. 9801 Dupont Avenue S. #200, Bloomington, MN 55431, USA
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Mirza SK, Tragon TR, Fukui MB, Hartman MS, Hartman AL. Microbiology for Radiologists: How to Minimize Infection Transmission in the Radiology Department. Radiographics 2015; 35:1231-44. [PMID: 26046943 DOI: 10.1148/rg.2015140034] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
The implementation of standardized infection control and prevention practices is increasingly relevant as modern radiology practice evolves into its more clinical role. Current Centers for Disease Control and Prevention, National Institutes of Health, and World Health Organization guidelines for the proper use of personal protective equipment, decontamination of reusable medical equipment, and appropriate management of bloodborne pathogen exposures will be reviewed. Standard precautions apply to all patients at all times and are the mainstay of infection control. Proper hand hygiene includes washing hands with soap and water when exposed to certain infectious particles, such as Clostridium difficile spores, which are not inactivated by alcohol-based hand rubs. The appropriate use of personal protective equipment in accordance with recommendations from the Centers for Disease Control and Prevention includes wearing a surgical mask during lumbar puncture. Because radiologists may perform lumbar punctures for patients with prion disease, it is important to appreciate that incineration is the most effective method of inactivating prion proteins. However, there is currently no consensus recommendation on the decontamination of prion-contaminated reusable items associated with lumbar puncture, and institutional policies should be consulted for directed management. In the event of a needlestick injury, radiology staff must be able to quickly provide appropriate initial management and seek medical attention, including laboratory testing for bloodborne pathogens.
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Affiliation(s)
- Sobia K Mirza
- From the Department of Diagnostic Radiology, Allegheny Health Network, Allegheny General Hospital, 320 E North Ave, Pittsburgh, PA 15212 (S.K.M., M.S.H.); Department of Medicine, University of Pittsburgh Medical Center, Pittsburgh, Pa (T.R.T.); Aurora Neuroscience Innovation Institute, Aurora St Luke's Medical Center, Milwaukee, Wis (M.B.F.); and Center for Vaccine Research, University of Pittsburgh, Pittsburgh, Pa (A.L.H.)
| | - Tyson R Tragon
- From the Department of Diagnostic Radiology, Allegheny Health Network, Allegheny General Hospital, 320 E North Ave, Pittsburgh, PA 15212 (S.K.M., M.S.H.); Department of Medicine, University of Pittsburgh Medical Center, Pittsburgh, Pa (T.R.T.); Aurora Neuroscience Innovation Institute, Aurora St Luke's Medical Center, Milwaukee, Wis (M.B.F.); and Center for Vaccine Research, University of Pittsburgh, Pittsburgh, Pa (A.L.H.)
| | - Melanie B Fukui
- From the Department of Diagnostic Radiology, Allegheny Health Network, Allegheny General Hospital, 320 E North Ave, Pittsburgh, PA 15212 (S.K.M., M.S.H.); Department of Medicine, University of Pittsburgh Medical Center, Pittsburgh, Pa (T.R.T.); Aurora Neuroscience Innovation Institute, Aurora St Luke's Medical Center, Milwaukee, Wis (M.B.F.); and Center for Vaccine Research, University of Pittsburgh, Pittsburgh, Pa (A.L.H.)
| | - Matthew S Hartman
- From the Department of Diagnostic Radiology, Allegheny Health Network, Allegheny General Hospital, 320 E North Ave, Pittsburgh, PA 15212 (S.K.M., M.S.H.); Department of Medicine, University of Pittsburgh Medical Center, Pittsburgh, Pa (T.R.T.); Aurora Neuroscience Innovation Institute, Aurora St Luke's Medical Center, Milwaukee, Wis (M.B.F.); and Center for Vaccine Research, University of Pittsburgh, Pittsburgh, Pa (A.L.H.)
| | - Amy L Hartman
- From the Department of Diagnostic Radiology, Allegheny Health Network, Allegheny General Hospital, 320 E North Ave, Pittsburgh, PA 15212 (S.K.M., M.S.H.); Department of Medicine, University of Pittsburgh Medical Center, Pittsburgh, Pa (T.R.T.); Aurora Neuroscience Innovation Institute, Aurora St Luke's Medical Center, Milwaukee, Wis (M.B.F.); and Center for Vaccine Research, University of Pittsburgh, Pittsburgh, Pa (A.L.H.)
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Tse R, Nixon JN, Iyer RS, Kuhlman-Wood KA, Ishak GE. The diagnostic value of CT myelography, MR myelography, and both in neonatal brachial plexus palsy. AJNR Am J Neuroradiol 2014; 35:1425-32. [PMID: 24676008 DOI: 10.3174/ajnr.a3878] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
BACKGROUND AND PURPOSE Although most infants with brachial plexus palsy recover function spontaneously, approximately 10-30% benefit from surgical treatment. Pre-operative screening for nerve root avulsions is helpful in planning reconstruction. Our aim was to compare the diagnostic value of CT myelography, MR myelography, and both against a surgical criterion standard for detection of complete nerve root avulsions in birth brachial plexus palsy. MATERIALS AND METHODS Nineteen patients who underwent a preoperative CT and/or MR myelography and subsequent brachial plexus exploration were included. Imaging studies were analyzed for the presence of abnormalities potentially predictive of nerve root avulsion. Findings of nerve root avulsion on surgical exploration were used as the criterion standard to assess the predictive value of imaging findings. RESULTS Ninety-five root levels were examined. When the presence of any pseudomeningocele was used as a predictor, the sensitivity was 0.73 for CT and 0.68 for MR imaging and the specificity was 0.96 for CT and 0.97 for MR imaging. When presence of pseudomeningocele with absent rootlets was used as the predictor, the sensitivity was 0.68 for CT and 0.68 for MR imaging and the specificity was 0.96 for CT and 0.97 for MR imaging. The use of both CT and MR imaging did not increase diagnostic accuracy. Rootlet findings in the absence of pseudomeningocele were not helpful in predicting complete nerve root avulsion. CONCLUSIONS Findings of CT and MR myelography were highly correlated. Given the advantages of MR myelography, it is now the single technique for preoperative evaluation of nerve root avulsion at our institution.
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Affiliation(s)
- R Tse
- the Division of Plastic Surgery, Department of Surgery (R.T., K.A.K.-W.), the Seattle Children's Hospital, University of Washington, Seattle, Washington.
| | - J N Nixon
- From the Department of Radiology (J.N.N., R.S.L., G.E.I.)
| | - R S Iyer
- From the Department of Radiology (J.N.N., R.S.L., G.E.I.)
| | - K A Kuhlman-Wood
- the Division of Plastic Surgery, Department of Surgery (R.T., K.A.K.-W.), the Seattle Children's Hospital, University of Washington, Seattle, Washington
| | - G E Ishak
- From the Department of Radiology (J.N.N., R.S.L., G.E.I.)
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Chitnis AS, Guh AY, Benowitz I, Srinivasan V, Gertz RE, Shewmaker PL, Beall BW, O'Connell H, Noble-Wang J, Gornet MF, Van Beneden C, Patrick SL, Turabelidze G, Patel PR. Outbreak of bacterial meningitis among patients undergoing myelography at an outpatient radiology clinic. J Am Coll Radiol 2012; 9:185-90. [PMID: 22386165 DOI: 10.1016/j.jacr.2011.09.018] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2011] [Accepted: 09/26/2011] [Indexed: 11/24/2022]
Abstract
PURPOSE To investigate an outbreak of bacterial meningitis at an outpatient radiology clinic (clinic A) and to determine the source and implement measures to prevent additional infections. METHODS A case was defined as bacterial meningitis in a patient undergoing myelography at clinic A from October 11 to 25, 2010. Patients who underwent myelography and other procedures at clinic A during that period were interviewed, medical records were reviewed, and infection prevention practices were assessed. Case-patient cerebrospinal fluid (CSF) specimens, oral specimens from health care personnel (HCP), and opened iohexol vials were tested for bacteria. Bacterial isolates were compared using pulsed-field gel electrophoresis. A culture-negative CSF specimen was tested using a real-time polymerase chain reaction assay. RESULTS Three cases were identified among 35 clinic A patients who underwent procedures from October 11 to 25, 2010. All case-patients required hospitalization, 2 in an intensive care unit. Case-patients had myelography performed by the same radiology physician assistant and technician on October 25; all patients who underwent myelography on October 25 were affected. HCP did not wear facemasks and reused single-dose iohexol vials for multiple patients. Streptococcus salivarius (a bacteria commonly found in oral flora) was detected in the CSF of 2 case-patients (1 by culture, 1 using real-time polymerase chain reaction) and in HCP oral specimens; 1 opened iohexol vial contained Staphylococcus epidermidis. Pulsed-field gel electrophoresis profiles from the case-patient S salivarius and the radiology physician assistant were indistinguishable. CONCLUSIONS Bacterial meningitis likely occurred because HCP performing myelography did not wear facemasks; lapses in injection practices may have contributed to transmission. Targeted education regarding mask use and safe injection practices is needed among radiology HCP.
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Affiliation(s)
- Amit S Chitnis
- Centers for Disease Control and Prevention, National Center for Emerging and Zoonotic Infectious Diseases, Division of Healthcare Quality Promotion, Atlanta, GA 30333, USA.
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7
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Using PCR-based detection and genotyping to trace Streptococcus salivarius meningitis outbreak strain to oral flora of radiology physician assistant. PLoS One 2012; 7:e32169. [PMID: 22384169 PMCID: PMC3285201 DOI: 10.1371/journal.pone.0032169] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2012] [Accepted: 01/23/2012] [Indexed: 11/19/2022] Open
Abstract
We recently investigated three cases of bacterial meningitis that were reported from a midwestern radiology clinic where facemasks were not worn during spinal injection of contrast agent during myelography procedures. Using pulsed field gel electrophoresis we linked a case strain of S. salivarius to an oral specimen of a radiology physician assistant (RPA). We also used a real-time PCR assay to detect S. salivarius DNA within a culture-negative cerebrospinal fluid (CSF) specimen. Here we extend this investigation through using a nested PCR/sequencing strategy to link the culture-negative CSF specimen to the case strain. We also provide validation of the real-time PCR assay used, demonstrating that it is not solely specific for Streptococcus salivarius, but is also highly sensitive for detection of the closely related oral species Streptococcus vestibularis. Through using multilocus sequence typing and 16S rDNA sequencing we further strengthen the link between the CSF case isolate and the RPA carriage isolate. We also demonstrate that the newly characterized strains from this study are distinct from previously characterized S. salivarius strains associated with carriage and meningitis.
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8
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Abstract
PURPOSE OF REVIEW Regional anesthesia is commonly used to provide intraoperative anesthesia and postoperative analgesia. Potential complications of both neuraxial and peripheral regional techniques include infectious sequelae. This review examines important components of practice that are known to minimize the risk of infection associated with regional anesthesia. RECENT FINDINGS Healthcare-associated infections increase morbidity and mortality, patient pain and suffering, direct medical costs, and hospital length-of-stay. Recently published national guidelines from subspecialty societies and government agencies emphasize the importance of strict aseptic technique in the prevention of infectious complications associated with regional anesthesia. Proper hand hygiene, the use of surgical masks, appropriate antiseptic selection and application, and proper preparation of local anesthetic infusate solutions are all considered essential components of asepsis. Anesthesia providers need to adhere to strict aseptic guidelines to minimize the risk of potentially devastating infectious complications. SUMMARY Infectious complications associated with regional anesthesia are exceedingly rare events. Adherence to strict aseptic guidelines as published by the American Society of Regional Anesthesia and Pain Medicine, American Society of Anesthesiologists, and the Royal College of Anaesthetists may reduce the risk of infectious complications.
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9
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Zunt JR. Infections of the central nervous system in the neurosurgical patient. HANDBOOK OF CLINICAL NEUROLOGY 2010; 96:125-141. [PMID: 20109679 DOI: 10.1016/s0072-9752(09)96009-2] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Affiliation(s)
- Joseph R Zunt
- Department of Neurology, Harborview Medical Center, Seattle, WA 98104, USA.
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11
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Cervero M. Meningitis por Streptococcus salivarus tras anestesia subaracnoidea. Enferm Infecc Microbiol Clin 2009; 27:371-2. [DOI: 10.1016/j.eimc.2008.11.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2008] [Accepted: 11/07/2008] [Indexed: 10/20/2022]
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Siegel JD, Rhinehart E, Jackson M, Chiarello L. 2007 Guideline for Isolation Precautions: Preventing Transmission of Infectious Agents in Health Care Settings. Am J Infect Control 2007; 35:S65-164. [PMID: 18068815 PMCID: PMC7119119 DOI: 10.1016/j.ajic.2007.10.007] [Citation(s) in RCA: 1615] [Impact Index Per Article: 95.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
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13
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Risi GF, Spangler CA. Capnocytophaga canimorsus meningitis after routine myelography: a sentinel event identifies multiple opportunities for improvement of standard practices in radiology. Am J Infect Control 2006; 34:540-2. [PMID: 17015163 DOI: 10.1016/j.ajic.2005.10.012] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2005] [Revised: 08/30/2005] [Accepted: 10/18/2005] [Indexed: 11/26/2022]
Abstract
Meningitis developed after a routine myelogram in a healthy patient. When Capnocytophaga canimorsus was identified, investigations revealed that the patient, the radiologist, and the staff were all dog owners. Multiple deviations from recommended practices in radiology were identified and corrected. The investigation of an unusual sentinel event allowed multiple interventions to be implemented simultaneously, with resultant risk reduction for subsequent radiologic procedures.
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14
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15
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Henkel K, Bengel D. [Crossed central neuropathic pain syndrome after bacterial meningoencephalitis]. Schmerz 2005; 19:55-8. [PMID: 15712006 DOI: 10.1007/s00482-004-0312-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
We report on a 48 year old female patient who acquired a bacterial meningoencephalitis as a result of a cervical myelography. Examination of the cerebrospinal fluid (CSF) revealed 309 cells per microliter and Streptococcus acidominimus was isolated as the infectious agent. Cranial MRI demonstrated disseminated lesions predominantly in the pontine and medullary brain stem as well as in thalamic nuclei. The patient developed a crossed central neuropathic pain syndrome. Neurological examination showed mechanic allodynia and hyperpathy along the left-sided extremities as well as right-sided neuropathic facial pain. On the MRI a dorsolateral medullary lesion on the right side, in the territory of the posterior inferior cerebellar artery was found. The localization of the lesion is suggestive of involvement of the spinal trigeminal tract or nucleus and the spinothalamic tract that would explain the neuropathic pain syndrome.A combination of gabapentine and amitriptyline reduced the pain markedly whereas opioids failed to provide sufficient analgesia.
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Affiliation(s)
- K Henkel
- Neurologische Poliklinik, Universität Ulm
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16
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Sellors JE, Cyna AM, Simmons SW. Aseptic precautions for inserting an epidural catheter: a survey of obstetric anaesthetists. Anaesthesia 2002; 57:593-6. [PMID: 12073948 DOI: 10.1046/j.1365-2044.2002.02509_3.x] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
We performed a postal survey of Fellows of the Australian and New Zealand College of Anaesthetists with a special interest in obstetric practice, about their beliefs regarding aseptic precautions for insertion of an epidural catheter in the labour ward. Of the 435 consultant anaesthetists surveyed, 367 responded (84%), revealing a wide variation in practice. It was not thought to be essential practice to remove a watch before washing hands by 51 respondents (14%), to wear a facemask by 105 (29%) or to wear a sterile gown by 45 (12%). Three anaesthetists (1%) did not believe sterile gloves were essential. However, all respondents indicated that an antiseptic skin preparation was essential. Our results raise questions regarding an acceptable standard of aseptic practice for the insertion of an epidural catheter in labour and we propose a minimal standard of essential precautions.
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Affiliation(s)
- J E Sellors
- Department of Obstetric Anaesthesia, Women and Children's Hospital, Adelaide, SA, Australia
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Black SR, Weinstein RA. The case for face masks-zorro or zero? Clin Infect Dis 2000; 31:522-3. [PMID: 10987716 DOI: 10.1086/313956] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2000] [Revised: 07/28/2000] [Indexed: 11/04/2022] Open
Affiliation(s)
- S R Black
- Cook County Hospital and Rush Medical College, Chicago, IL 60612, USA
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Baer ET. Iatrogenic meningitis: the case for face masks. Clin Infect Dis 2000; 31:519-21. [PMID: 10987715 DOI: 10.1086/313991] [Citation(s) in RCA: 32] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/1999] [Revised: 01/20/2000] [Indexed: 11/03/2022] Open
Affiliation(s)
- E T Baer
- Department of Medicine, Kaiser/Permanente Medical Center, Richmond, CA, USA.
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Bibes B, Camus C, Le Corre C, Garré M, Cartier F. Méningites à streptocoque après ponction lombaire: à propos de cinq cas et revue de la littérature. Med Mal Infect 2000. [DOI: 10.1016/s0399-077x(00)88807-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/16/2022]
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Affiliation(s)
- C Cabellos
- Infectious Diseases Service, Ciutat Sanitaria i Universitaria de Bellvitge, Barcelona, Spain.
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Watanakunakorn C. Meningitis due to viridans streptococci. Clin Infect Dis 2000; 30:238-9. [PMID: 10619783 DOI: 10.1086/313614] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
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Kanoun F, Ben Jemaa M, Mahjoubi F, Maaloul I, Khemakhem B, Ben Hamed S. Méningite à Streptococcus oralis après myélographie. Med Mal Infect 1998. [DOI: 10.1016/s0399-077x(98)80028-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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