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Liu S, Huang X, Fu C, Dou Q, Li J, Feng X, Mo Y, Meng X, Zeng C, Wu A, Li C. Is It an Outbreak of Health Care-Associated Infection? An Investigation of Binocular Conjunctival Congestion After Laparoscopic Cholecystectomy Was Traced to Chitosan Derivatives. Front Med (Lausanne) 2022; 9:759945. [PMID: 35321463 PMCID: PMC8936390 DOI: 10.3389/fmed.2022.759945] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2021] [Accepted: 01/24/2022] [Indexed: 11/13/2022] Open
Abstract
Background From May 6 to May 23, 2019, 24 (80.00%) patients who underwent laparoscopic cholecystectomy (LC) developed binocular conjunctival congestion within 4–8 h after their operation in the day ward of a teaching hospital. Methods Nosocomial infection prevention and control staff undertook procedural and environmental investigations, performed a case-control retrospective study (including 24 cases and 48 controls), and reviewed all lot numbers of biological material products to investigate the suspected outbreak of health care-associated infection. Findings Initially, an outbreak of health care-associated infection caused by bacteria was hypothesized. We first suspected the membranes that covered patients' eyes were cut using non-sterile scissors and thus contaminated, but they failed to yield bacteria. In addition, both corneal and conjunctival fluorescein staining results were negative in case-patients and isolated bacteria were ubiquitous in the environment or common skin commensals or normal flora of conjunctiva from 218 samples from day surgery and the day ward. Hence, we considered a non-infectious factor as the most likely cause of the binocular conjunctival congestion. Then, we found that case-patients were more likely than LC surgery patients without binocular conjunctival congestion to be exposed to biological materials in a retrospective case-control study. When we reviewed lot numbers, duration of use, and the number of patients who received four biological material products during LC in the day ward, we found that the BLK1821 lot of a modified chitosan medical membrance (the main ingredient is chitosan, a linear cationic polysaccharide) was used concurrently to when the case aggregation appeared. Finally, we surmised there was a correlation between this product and the outbreak of binocular conjunctival congestion. Relapse of the pseudo-outbreak has not been observed since stopping usage of the product for 6 months. Conclusion A cluster of binocular non-infectious conjunctival congestion diagnosed after LC proved to be a pseudo-outbreak. We should pay more attention to adverse events caused by biomaterials in hospitals.
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Affiliation(s)
- Sidi Liu
- Infection Control Center, Xiangya Hospital of Central South University, Changsha, China
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital of Central South University, Changsha, China
| | - Xun Huang
- Infection Control Center, Xiangya Hospital of Central South University, Changsha, China
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital of Central South University, Changsha, China
| | - Chenchao Fu
- Infection Control Center, Xiangya Hospital of Central South University, Changsha, China
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital of Central South University, Changsha, China
| | - Qingya Dou
- Infection Control Center, Xiangya Hospital of Central South University, Changsha, China
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital of Central South University, Changsha, China
| | - Jie Li
- Infection Control Center, Xiangya Hospital of Central South University, Changsha, China
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital of Central South University, Changsha, China
| | - Xuelian Feng
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital of Central South University, Changsha, China
- Operating Room Department, Xiangya Hospital of Central South University, Changsha, China
| | - Yang Mo
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital of Central South University, Changsha, China
- Day Ward Unit, Xiangya Hospital of Central South University, Changsha, China
| | - Xiujuan Meng
- Infection Control Center, Xiangya Hospital of Central South University, Changsha, China
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital of Central South University, Changsha, China
| | - Cui Zeng
- Infection Control Center, Xiangya Hospital of Central South University, Changsha, China
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital of Central South University, Changsha, China
| | - Anhua Wu
- Infection Control Center, Xiangya Hospital of Central South University, Changsha, China
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital of Central South University, Changsha, China
- *Correspondence: Anhua Wu
| | - Chunhui Li
- Infection Control Center, Xiangya Hospital of Central South University, Changsha, China
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital of Central South University, Changsha, China
- Chunhui Li
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Guo S, Shi Y, Liang Y, Liu L, Sun K, Li Y. Relationship and improvement strategies between drug nanocarrier characteristics and hemocompatibility: What can we learn from the literature. Asian J Pharm Sci 2021; 16:551-576. [PMID: 34849162 PMCID: PMC8609445 DOI: 10.1016/j.ajps.2020.12.002] [Citation(s) in RCA: 26] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2020] [Revised: 12/01/2020] [Accepted: 12/21/2020] [Indexed: 01/30/2023] Open
Abstract
This article discusses the various blood interactions that may occur with various types of nano drug-loading systems. Nanoparticles enter the blood circulation as foreign objects. On the one hand, they may cause a series of inflammatory reactions and immune reactions, resulting in the rapid elimination of immune cells and the reticuloendothelial system, affecting their durability in the blood circulation. On the other hand, the premise of the drug-carrying system to play a therapeutic role depends on whether they cause coagulation and platelet activation, the absence of hemolysis and the elimination of immune cells. For different forms of nano drug-carrying systems, we can find the characteristics, elements and coping strategies of adverse blood reactions that we can find in previous researches. These adverse reactions may include destruction of blood cells, abnormal coagulation system, abnormal effects of plasma proteins, abnormal blood cell behavior, adverse immune and inflammatory reactions, and excessive vascular stimulation. In order to provide help for future research and formulation work on the blood compatibility of nano drug carriers.
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Affiliation(s)
- Shiqi Guo
- School of Pharmacy, Key Laboratory of Molecular Pharmacology and Drug Evaluation (Yantai University), Ministry of Education, Collaborative Innovation Center of Advanced Drug Delivery System and Biotech Drugs in Universities of Shandong, Yantai University, Yantai 264005, China
| | - Yanan Shi
- College of Life Science, Yantai University, Yantai 264005, China
| | - Yanzi Liang
- School of Pharmacy, Key Laboratory of Molecular Pharmacology and Drug Evaluation (Yantai University), Ministry of Education, Collaborative Innovation Center of Advanced Drug Delivery System and Biotech Drugs in Universities of Shandong, Yantai University, Yantai 264005, China
| | - Lanze Liu
- College of Life Science, Yantai University, Yantai 264005, China
| | - Kaoxiang Sun
- School of Pharmacy, Key Laboratory of Molecular Pharmacology and Drug Evaluation (Yantai University), Ministry of Education, Collaborative Innovation Center of Advanced Drug Delivery System and Biotech Drugs in Universities of Shandong, Yantai University, Yantai 264005, China
- State Key Laboratory of Long-acting and Targeting Drug Delivery System, Luye Pharmaceutical Co., Ltd., Yantai 264003, China
| | - Youxin Li
- School of Pharmacy, Key Laboratory of Molecular Pharmacology and Drug Evaluation (Yantai University), Ministry of Education, Collaborative Innovation Center of Advanced Drug Delivery System and Biotech Drugs in Universities of Shandong, Yantai University, Yantai 264005, China
- State Key Laboratory of Long-acting and Targeting Drug Delivery System, Luye Pharmaceutical Co., Ltd., Yantai 264003, China
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Denzinger M, Held M, Scheffler H, Haag H, Nussler AK, Wendel HP, Schlensak C, Daigeler A, Krajewski S. Hemocompatibility of different burn wound dressings. Wound Repair Regen 2019; 27:470-476. [DOI: 10.1111/wrr.12739] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2019] [Accepted: 05/20/2019] [Indexed: 01/24/2023]
Affiliation(s)
- Markus Denzinger
- Department of Plastic, Reconstructive, Hand and Burn Surgery, BG‐Trauma CenterEberhard Karls University Tuebingen Tuebingen Germany
| | - Manuel Held
- Department of Plastic, Reconstructive, Hand and Burn Surgery, BG‐Trauma CenterEberhard Karls University Tuebingen Tuebingen Germany
| | - Hanna Scheffler
- Department of Plastic, Reconstructive, Hand and Burn Surgery, BG‐Trauma CenterEberhard Karls University Tuebingen Tuebingen Germany
- Siegfried Weller Institute, BG Trauma CenterEberhard Karls University Tuebingen Tuebingen Germany
| | - Hanna Haag
- Department of Thoracic, Cardiac and Vascular Surgery, Clinical Research LaboratoryEberhard Karls University Tuebingen Tuebingen Germany
| | - Andreas K. Nussler
- Siegfried Weller Institute, BG Trauma CenterEberhard Karls University Tuebingen Tuebingen Germany
| | - Hans Peter Wendel
- Department of Thoracic, Cardiac and Vascular Surgery, Clinical Research LaboratoryEberhard Karls University Tuebingen Tuebingen Germany
| | - Christian Schlensak
- Department of Thoracic, Cardiac and Vascular Surgery, Clinical Research LaboratoryEberhard Karls University Tuebingen Tuebingen Germany
| | - Adrien Daigeler
- Department of Plastic, Reconstructive, Hand and Burn Surgery, BG‐Trauma CenterEberhard Karls University Tuebingen Tuebingen Germany
| | - Stefanie Krajewski
- Department of Thoracic, Cardiac and Vascular Surgery, Clinical Research LaboratoryEberhard Karls University Tuebingen Tuebingen Germany
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