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Wu J, Lu W, Cheng G, Hu Q, Jiang B, Liao S. Assessing postoperative wound infection rates in ultrasound-guided microwave ablation versus conventional surgery for varicose veins. Int Wound J 2024; 21:e14584. [PMID: 38112035 PMCID: PMC10961856 DOI: 10.1111/iwj.14584] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2023] [Revised: 12/06/2023] [Accepted: 12/07/2023] [Indexed: 12/20/2023] Open
Abstract
Varicose veins are the prevalent vascular disorder that has conventionally been managed via risky postoperative wound infections and conventional surgery. While ultrasound-guided microwave ablation (UMA) has gained attention as a minimally invasive alternative, there is still a lack of research examining its comparative effectiveness. A prospective comparative investigation was undertaken in the Zhejiang region of China from January to November 2023, involving 140 patients who had received the diagnosis of primary varicose veins. An equal number of 70 patients underwent UMA and conventional surgery. Exclusion criteria for the study encompassed adult patients aged 18-65, with the exception of those who had undergone prior venous surgery, deep vein thrombosis or peripheral arterial disease. The demographical characteristics, procedural details and complication profiles of patients who developed postoperative wound infections within 30 days were analysed statistically. The outcomes demonstrated that postoperative wound infections were significantly diminished (5.7%) with UMA in comparison to conventional surgery (17.1%). In addition, the average duration of procedures and length of hospital stay for UMA patients were both reduced, although neither of these differences was found to be statistically significant (p > 0.05). Infection management, age and gender distribution of varicose veins were comparable between the two groups (p > 0.05). A significant inverse correlation was observed between the severity of varicose veins and postoperative outcomes, as determined by the regression analysis (p < 0.05). Using UMA to treat varicose veins showed promise as an alternative to conventional surgery, specifically in minimizing the incidence of postoperative wound infections. Additional research and clinical consideration are needed regarding the potential transition toward minimally invasive techniques in treatment of varicose veins, as suggested by these results.
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Affiliation(s)
- Jiawen Wu
- Department of Vascular SurgeryThe Quzhou Affiliated Hospital of Wenzhou Medical University, Quzhou People's HospitalQuzhouChina
| | - Wei Lu
- Department of Vascular SurgeryThe Quzhou Affiliated Hospital of Wenzhou Medical University, Quzhou People's HospitalQuzhouChina
| | - Guobing Cheng
- Department of Vascular SurgeryThe Quzhou Affiliated Hospital of Wenzhou Medical University, Quzhou People's HospitalQuzhouChina
| | - Qiang Hu
- Department of Vascular SurgeryThe Quzhou Affiliated Hospital of Wenzhou Medical University, Quzhou People's HospitalQuzhouChina
| | - Buping Jiang
- Department of Vascular SurgeryThe Quzhou Affiliated Hospital of Wenzhou Medical University, Quzhou People's HospitalQuzhouChina
| | - Sheng Liao
- Department of Vascular SurgeryThe Quzhou Affiliated Hospital of Wenzhou Medical University, Quzhou People's HospitalQuzhouChina
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Still WL, Tapia MD, Tennant SM, Sylla M, Touré A, Badji H, Keita AM, Sow SO, Levine MM, Kotloff KL. Surveillance for Invasive Salmonella Disease in Bamako, Mali, From 2002 to 2018. Clin Infect Dis 2020; 71:S130-S140. [PMID: 32725229 PMCID: PMC7388721 DOI: 10.1093/cid/ciaa482] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Salmonella enterica bloodstream infections are an important cause of childhood morbidity and mortality, including in Mali. We report 17 years of surveillance for nontyphoidal and typhoidal S. enterica infections among inpatients and outpatients at l'Hôpital Gabriel Touré, the main source of pediatric tertiary care in Bamako, Mali. METHODS Between June 2002 and December 2018, a blood culture was collected from 54 748 children aged ≤15 years with fever and/or suspected invasive bacterial infection who provided consent (38 152 inpatients, 16 596 outpatients). Bacterial pathogens were identified using standard microbiological techniques and serovars of S. enterica were determined by PCR and/or agglutination with antisera. RESULTS Nontyphoidal Salmonella (NTS) was identified in 671 enrolled inpatients (1.8% of all enrolled inpatients, 13.8% of enrolled inpatients with a positive culture). S. Enteritidis, the most common NTS serovar, accounted for 38.5% of all NTS isolates (n = 258), followed by S. Typhimurium (31.7%, n = 213). The median (SD) age of children with a culture positive for NTS was 1.8 (3) years. Overall case fatality was 20.9%. An additional 138 inpatients (0.4%) had a positive culture for typhoidal Salmonella. NTS was identified in 11 outpatients (0.07%), while typhoidal Salmonella was found in 49 outpatients (0.3%). The annual incidence of invasive NTS disease decreased over the study period, but case fatality remained high. CONCLUSIONS Although incidence decreased, NTS remained a major cause of invasive bacterial infection and mortality among hospitalized children in Bamako, while typhoidal Salmonella was uncommon. Because 87% of NTS belonged to only 4 serovars, a multivalent vaccine may be an effective strategy to reduce the burden and mortality of invasive NTS.
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Affiliation(s)
- William L Still
- Department of Epidemiology and Public Health, University of Maryland Graduate School, Baltimore, Maryland, USA
| | - Milagritos D Tapia
- Department of Pediatrics and Center for Vaccine Development and Global Health, University of Maryland School of Medicine, Baltimore, Maryland, USA
| | - Sharon M Tennant
- Department of Pediatrics and Center for Vaccine Development and Global Health, University of Maryland School of Medicine, Baltimore, Maryland, USA
| | - Mamadou Sylla
- Centre Pour le Développement des Vaccins–Mali, Bamako, Mali
| | - Aliou Touré
- Centre Pour le Développement des Vaccins–Mali, Bamako, Mali
| | - Henry Badji
- Centre Pour le Développement des Vaccins–Mali, Bamako, Mali
| | | | - Samba O Sow
- Centre Pour le Développement des Vaccins–Mali, Bamako, Mali
| | - Myron M Levine
- Centre Pour le Développement des Vaccins–Mali, Bamako, Mali
| | - Karen L Kotloff
- Department of Pediatrics and Center for Vaccine Development and Global Health, University of Maryland School of Medicine, Baltimore, Maryland, USA
- Correspondence: K. L. Kotloff, Center for Vaccine Development and Global Health, University of Maryland School of Medicine, 685 West Baltimore Street, Room 480, Baltimore, MD 21201–1509 ()
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Kennedy B, Shobo CO, Zishiri OT, Bester LA. Surveillance of Salmonella spp. in the environment of public hospitals in KwaZulu-Natal, South Africa. J Hosp Infect 2020; 105:205-212. [PMID: 32114055 DOI: 10.1016/j.jhin.2020.02.019] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2019] [Accepted: 02/21/2020] [Indexed: 10/24/2022]
Abstract
AIM To investigate the dissemination of Salmonella spp. within four levels of government hospitals in KwaZulu-Natal, South Africa. METHODS The identification of Salmonella spp. was performed by amplification of the invA gene. Isolates were subjected to antimicrobial susceptibility testing and molecular characterization of eight resistance genes (qnrA, qnrB, qnrS, tetA, tetB, tetC, tetG, ermB) and three virulence genes (sitC, spvA, spv). Genetic relatedness between isolates was determined using enterobacterial repetitive intergenic consensus (ERIC) polymerase chain reaction. FINDINGS Ninety-four isolates were obtained. The largest source of isolates was the regional hospital. Paediatric wards had the highest prevalence of isolates. Nurses' tables contained the most isolates out of all sites sampled. Twenty-two clusters indicating diverse isolates were obtained via molecular typing. Four main ERIC types were identified, each unique to a specific hospital. A possibility of dissemination across the wards was noted as highly related isolates were present at various sites within the wards. Many of these sites were highly trafficked areas by healthcare staff. Ten multi-drug-resistant isolates were found. CONCLUSIONS This study suggests that infection prevention and control strategies that involve environmental cleaning and decontamination may not be enough, or adhered to sufficiently, to prevent the dissemination of Salmonella spp.
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Affiliation(s)
- B Kennedy
- Biomedical Resource Unit, School of Laboratory Medicine and Medical Sciences, College of Health Sciences, University of KwaZulu-Natal, Durban, South Africa
| | - C O Shobo
- Biomedical Resource Unit, School of Laboratory Medicine and Medical Sciences, College of Health Sciences, University of KwaZulu-Natal, Durban, South Africa
| | - O T Zishiri
- Genetics Department, School of Life Sciences, College of Agriculture Engineering and Science, University of KwaZulu-Natal, Durban, South Africa
| | - L A Bester
- Biomedical Resource Unit, School of Laboratory Medicine and Medical Sciences, College of Health Sciences, University of KwaZulu-Natal, Durban, South Africa.
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Guyomard-Rabenirina S, Muanza B, Bastian S, Malpote E, Jestin P, Guerin M, Talarmin A, Weill FX, Legrand A, Breurec S. Salmonella enterica serovars Panama and Arechavaleta: Risk Factors for Invasive Non-Typhoidal Salmonella Disease in Guadeloupe, French West Indies. Am J Trop Med Hyg 2018; 99:584-589. [PMID: 30014811 DOI: 10.4269/ajtmh.18-0192] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
A retrospective study was conducted to identify the risk factors associated with Salmonella enterica bacteremia in infants and children in Guadeloupe, French West Indies. The 171 patients with S. enterica infection seen between 2010 and 2014 included 155 (90.6%) with acute gastroenteritis, of whom 42 (27.1%) had concomitant bacteremia, and 16 (9.4%) with primary bacteremia. Most cases (97.7%) were in infants and children with no underlying health condition. Two subspecies were recovered: enterica (N = 161, 94.2%) and houtenae (N = 10, 5.8%). All but one (serovar Typhi) were non-typhoidal Salmonella. The most common serovars were Panama (N = 57, 33.3% of isolates) and Arechavaleta (N = 28, 16.4%). Univariate analysis showed a strong association only between age > 6 months and infection with the Panama or Arechavaleta serovar (P = 0.002). The rate of resistance to all classes of antibiotics during the study period was low (< 15%); however, the detection of one extended-spectrum beta-lactamase-producing S. enterica strain highlights the need for continued monitoring of antimicrobial drug susceptibility. Infection with Panama (P < 0.001) or Arechavaleta (P < 0.001) serovar was significantly associated with bacteremia in a multivariate analysis. These serovars are probably poorly adapted to humans or are more virulent. A delay between onset of symptoms and hospital admission > 5 days (P = 0.01), vomiting (P = 0.001), and increased respiratory rate (P = 0.001) contributed independently to bacteremia in the multivariate analysis. Thus, if non-typhoidal infection is suspected, blood should be cultured and antibiotic treatment initiated in all patients who meet these criteria.
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Affiliation(s)
| | - Blandine Muanza
- Service de Pédiatrie, Centre Hospitalier Universitaire de Pointe-à-Pitre/les Abymes, Pointe-à-Pitre, France
| | - Sylvaine Bastian
- Laboratoire de Microbiologie Clinique et Environnementale, Centre Hospitalier Universitaire de Pointe-à-Pitre/les Abymes, Pointe-à-Pitre, France
| | - Edith Malpote
- Laboratoire de Microbiologie Clinique et Environnementale, Centre Hospitalier Universitaire de Pointe-à-Pitre/les Abymes, Pointe-à-Pitre, France
| | - Pauline Jestin
- Laboratoire de Microbiologie Clinique et Environnementale, Centre Hospitalier Universitaire de Pointe-à-Pitre/les Abymes, Pointe-à-Pitre, France
| | - Meggie Guerin
- Laboratoire de Microbiologie Clinique et Environnementale, Centre Hospitalier Universitaire de Pointe-à-Pitre/les Abymes, Pointe-à-Pitre, France
| | - Antoine Talarmin
- Unité Environnement et Santé, Institut Pasteur de Guadeloupe, Pointe-à-Pitre, France
| | - François-Xavier Weill
- Unité des Bactéries Pathogènes Entériques, Centre National de Référence des Escherichia coli, Shigella et Salmonella, Institut Pasteur, Paris, France
| | - Arnaud Legrand
- Direction de la Recherche Clinique et de L'innovation, Centre Hospitalier Universitaire de Nantes, Nantes, France
| | - Sebastien Breurec
- Faculté de Médecine Hyacinthe Bastaraud, Université des Antilles, Pointe-à-Pitre, France.,Unité des Bactéries Pathogènes Entériques, Centre National de Référence des Escherichia coli, Shigella et Salmonella, Institut Pasteur, Paris, France.,Unité Environnement et Santé, Institut Pasteur de Guadeloupe, Pointe-à-Pitre, France
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Immunogenicity and Induction of Functional Antibodies in Rabbits Immunized with a Trivalent Typhoid-Invasive Nontyphoidal Salmonella Glycoconjugate Formulation. Molecules 2018; 23:molecules23071749. [PMID: 30018230 PMCID: PMC6099966 DOI: 10.3390/molecules23071749] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2018] [Revised: 07/12/2018] [Accepted: 07/14/2018] [Indexed: 12/19/2022] Open
Abstract
Typhoid fever due to Salmonella Typhi and invasive nontyphoidal Salmonella (iNTS) infections caused by serovars Enteritidis (SE) and Typhimurium (STm) are major pediatric health problems in sub-Saharan Africa. Typhoid has high complication rates, and iNTS infections have high case fatality rates; moreover, emerging antimicrobial resistance is diminishing treatment options. Vi capsule-based typhoid conjugate vaccine (Typbar-TCV™), licensed in India and pre-qualified by the World Health Organization, elicits durable immunity when administered to infants, but no iNTS vaccines are licensed or imminent. We have developed monovalent SE and STm glycoconjugate vaccines based on coupling lipopolysaccharide-derived core-O polysaccharide (COPS) to phase 1 flagellin protein (FliC) from the homologous serovar. Herein, we report the immunogenicity of multivalent formulations of iNTS COPS:FliC conjugates with Typbar-TCV™. Rabbits immunized with the trivalent typhoid-iNTS glycoconjugate vaccine generated high titers of serum IgG antibody to all three polysaccharide antigens for which anti-COPS IgG antibodies were directed primarily against serogroup-specific OPS epitopes. Responses to SE and STm FliC were lower relative to anti-COPS titers. Post-vaccination rabbit sera mediated bactericidal activity in-vitro, and protected mice after passive transfer against challenge with virulent SE or STm Malian blood isolates. These results support accelerated progression to clinical trials.
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Truong TMN, McGilvery TN, Goldson TM, Forjuoh SN. Nontypical Salmonella meningitis in an infant. Proc AMIA Symp 2018; 31:367-369. [PMID: 29904315 DOI: 10.1080/08998280.2018.1463037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2017] [Revised: 03/21/2018] [Accepted: 04/02/2018] [Indexed: 10/17/2022] Open
Abstract
A previously healthy 3-month-old girl was admitted to the hospital after 1 day of fever, decreased oral intake, irritability, lethargy, and decreased activity. Examination disclosed a bulging anterior fontanelle, tachycardia (heart rate of 160 beats/minute), and urate crystals in her diaper. Lumbar puncture revealed meningitis. She was treated with broad-spectrum antibiotics and fluids. A urine culture was negative, but blood and cerebrospinal fluid cultures came back positive for Salmonella species, nontyphoid. During her hospitalization, she developed seizures but quickly improved with treatment and made a complete recovery with no sequela. Additional inquiry disclosed that the baby spent several days a week at her grandparents' house, where they raised chickens and ate fresh chicken eggs, which are well-known carriers for Salmonella.
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Affiliation(s)
- Thuy-My N Truong
- Department of Family and Community Medicine, Baylor Scott & White Health, and College of Medicine, Texas A&M Health Science Center, Temple, Texas
| | - Taryn N McGilvery
- Department of Family and Community Medicine, Baylor Scott & White Health, and College of Medicine, Texas A&M Health Science Center, Temple, Texas
| | - Tove M Goldson
- Department of Family and Community Medicine, Baylor Scott & White Health, and College of Medicine, Texas A&M Health Science Center, Temple, Texas
| | - Samuel N Forjuoh
- Department of Family and Community Medicine, Baylor Scott & White Health, and College of Medicine, Texas A&M Health Science Center, Temple, Texas
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