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https://www.readbyqxmd.com/read/28441674/the-development-of-an-indigenous-health-curriculum-for-medical-students
#1
Melissa Lewis, Amy Prunuske
Indigenous populations experience dramatic health disparities; yet, few medical schools equip students with the skills to address these inequities. At the University of Minnesota Medical School, Duluth campus, a project to develop an Indigenous health curriculum began in September 2013. This project used collaborative and decolonizing methods to gather ideas and opinions from multiple stakeholders, including students, community members, faculty, and administration, to guide the process of adding Indigenous health content to the curriculum to prepare students to work effectively with Indigenous populations...
May 2017: Academic Medicine: Journal of the Association of American Medical Colleges
https://www.readbyqxmd.com/read/28412954/does-a-quality-improvement-campaign-accelerate-take-up-of-new-evidence-a-ten-state-cluster-randomized-controlled-trial-of-the-institute-for-health-improvement-s-project-joints
#2
Eric C Schneider, Melony E Sorbero, Ann Haas, M Susan Ridgely, Dmitry Khodyakov, Claude M Setodji, Gareth Parry, Susan S Huang, Deborah S Yokoe, Don Goldmann
BACKGROUND: A decade ago, the Institute for Healthcare Improvement pioneered a quality improvement (QI) campaign, leveraging organizational and personal social networks to disseminate new practices. There have been few rigorous studies of the QI campaign approach. METHODS: Project JOINTS (Joining Organizations IN Tackling SSIs) engaged a network of state-based organizations and professionals in a 6-month QI campaign promoting adherence to three new evidence-based practices known to reduce the risk of infection after joint replacement...
April 17, 2017: Implementation Science: IS
https://www.readbyqxmd.com/read/28412178/universal-screening-and-decolonization-for-control-of-mrsa-in-nursing-homes-follow-up-of-a-cluster-randomized-controlled-trial
#3
D Héquet, V Rousson, D S Blanc, C Büla, L Qalla-Widmer, E Masserey, G Zanetti, C Petignat
In 2010-11, a trial conducted in nursing homes showed no benefit of meticillin-resistant Staphylococcus aureus (MRSA) universal screening and decolonization over standard precautions to reduce the prevalence of MRSA carriage. Accordingly, no routine screening was performed from 2012. A five-year follow-up shows no new evidence supporting the intervention. Recommendations issued after trial (no screening and decolonization of MRSA residents) were retained.
March 20, 2017: Journal of Hospital Infection
https://www.readbyqxmd.com/read/28396072/methicillin-resistant-staphylococcus-aureus-and-antibiotic-use-in-septorhinoplasty-case-report-and-review-of-literature
#4
Gregory D Lohr, Brian Hollabaugh, Patrick Waters, Paul S Tiwana
Septorhinoplasty is a commonly performed procedure for facial aesthetics and obstructed nasal breathing. There have been only 4 reported cases of methicillin-resistant Staphylococcus aureus (MRSA)-associated postoperative complications following septorhinoplasty reported in the literature across all specialties. In this article, we report a case of MRSA-associated infection after an uncomplicated septorhinoplasty. Risk stratification and outcome of treatment are described, followed by a review of the current literature...
January 24, 2017: Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology
https://www.readbyqxmd.com/read/28381601/a-novel-multiplex-pcr-assay-for-the-detection-of-chlorhexidine-quaternary-ammonium-mupirocin-and-methicillin-resistance-genes-with-simultaneous-discrimination-of-staphylococcus-aureus-from-coagulase-negative-staphylococci
#5
Jo-Ann McClure, Johanna Zaal DeLongchamp, John M Conly, Kunyan Zhang
Methicillin-resistant Staphylococcus aureus (MRSA) is a clinically significant pathogen resistant to a wide variety of antibiotics and responsible for a large number of nosocomial infections worldwide. The Agency for Healthcare Research and Quality and the Centers for Disease Control and Prevention recently recommended to adopt universal mupirocin/chlorhexidine decolonization of all admitted intensive care unit patients, rather than MRSA screening with targeted treatments, which raises the serious concern about the selection of resistance to mupirocin and chlorhexidine in strains of staphylococci...
April 5, 2017: Journal of Clinical Microbiology
https://www.readbyqxmd.com/read/28369341/fecal-microbiota-transplantation-in-patients-with-blood-disorders-inhibits-gut-colonization-with-antibiotic-resistant-bacteria-results-of-a-prospective-single-center-study
#6
Jaroslaw Bilinski, Pawel Grzesiowski, Nikolaj Sorensen, Krzysztof Madry, Jacek Muszynski, Katarzyna Robak, Marta Wroblewska, Tomasz Dzieciatkowski, Grazyna Dulny, Jadwiga Dwilewicz-Trojaczek, Wieslaw Wiktor-Jedrzejczak, Grzegorz W Basak
BACKGROUND: Patients with blood disorders colonized with antibiotic-resistant bacteria (ARB) are prone to systemic infections that are difficult to treat. Reintroduction of commensal bacteria in a murine model of enterococcal colonization of the gut can lead to eradication of enterococci. We hypothesized that fecal microbiota transplantation (FMT) could be used to eradicate ARB in humans. METHODS: Participants colonized with ARB were treated with intraduodenal FMT according to a prospective protocol (NCT02461199)...
March 24, 2017: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
https://www.readbyqxmd.com/read/28360994/mrsa-decolonization-failure-are-biofilms-the-missing-link
#7
Frank Günther, Brigitte Blessing, Evelina Tacconelli, Nico T Mutters
BACKGROUND: Device-associated infections due to biofilm-producing methicillin-resistant Staphylococcus aureus (MRSA) have been recently associated with the failure of antibiotic treatment and decolonization measures. The goal of our study was to evaluate the extent to which the formation of biofilms influenced the efficacy of topical decolonization agents or disinfectants such as mupirocin (MUP), octenidine (OCT), chlorhexidine (CHG), polyhexanide (POL), and chloroxylenol (CLO). METHODS: Bacterial killing in biofilms by the disinfectants and MUP was determined as the reduction [%] in metabolic activity determined by a biofilm viability assay that uses kinetic analysis of metabolic activity...
2017: Antimicrobial Resistance and Infection Control
https://www.readbyqxmd.com/read/28350942/prevention-of-surgical-site-infection-in-spine-surgery
#8
Paul A Anderson, Jason W Savage, Alexander R Vaccaro, Kristen Radcliff, Paul M Arnold, Brandon D Lawrence, Mohammed F Shamji
BACKGROUND: Spine surgery is complicated by an incidence of 1% to 9% of surgical site infection (SSI). The most common organisms are gram-positive bacteria and are endogenous, that is are brought to the hospital by the patient. Efforts to improve safety have been focused on reducing SSI using a bundle approach. The bundle approach applies many quality improvement efforts and has been shown to reduce SSI in other surgical procedures. OBJECTIVE: To provide a narrative review of practical solutions to reduce SSI in spine surgery...
March 1, 2017: Neurosurgery
https://www.readbyqxmd.com/read/28344704/decolonization-in-health-professions-education-reflections-on-teaching-through-a-transgressive-pedagogy
#9
Ruth Rodney
BACKGROUND: Canadian health educators travel to the global south to provide expertise in health education. Considering the history of relations between the north and south, educators and healthcare providers from Canada should critically examine their practices and consider non-colonizing ways to relate to their Southern colleagues. METHODS: Using her experience as a teacher with the Toronto Addis Ababa Academic Collaboration in Nursing, the author explored issues of identity and representation as a registered nurse and PhD candidate teaching in Ethiopia...
December 2016: Canadian Medical Education Journal
https://www.readbyqxmd.com/read/28343857/staphylococcus-aureus-nasal-carriage-in-health-care-workers-first-report-from-a-major-public-hospital-in-argentina
#10
Carina Andrea Boncompain, Cristian Alejandro Suárez, Héctor Ricardo Morbidoni
Staphylococcus aureus causes numerous mild to severe infections in humans, both in health facilities and in the community. Patients and health care workers (HCWs) may disseminate strains during regular medical examinations or hospitalization. The aim of this study was to determine the nasal carriage rate of methicillin-susceptible and methicillin-resistant S. aureus among health care workers at Hospital Provincial del Centenario, a public general hospital in Rosario, Argentina. A transversal study was conducted on 320 health care workers...
March 24, 2017: Revista Argentina de Microbiología
https://www.readbyqxmd.com/read/28341280/cost-effectiveness-of-staphylococcus-aureus-decolonization-strategies-in-high-risk-total-joint-arthroplasty-patients
#11
Devin M Williams, Andy O Miller, Michael W Henry, Geoffrey H Westrich, Hassan M K Ghomrawi
BACKGROUND: The risk of prosthetic joint infection increases with Staphylococcus aureus colonization. The cost-effectiveness of decolonization is controversial. We evaluated cost-effectiveness decolonization protocols in high-risk arthroplasty patients. METHODS: An analytical model evaluated risk under 3 protocols: 4 swabs, 2 swabs, and nasal swab alone. These were compared to no-screening and universal decolonization strategies. Cost-effectiveness was evaluated from the hospital, patient, and societal perspective...
February 7, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28292539/prevention-of-infection-in-orthopedic-prosthetic-surgery
#12
REVIEW
Ioana Chirca, Camelia Marculescu
Total joint arthroplasty is a generally safe orthopedic procedure; however, infection is a potentially devastating complication. Multiple risk factors have been identified for development of prosthetic joint infections. Identification of patients at risk and preoperative correction of known risk factors, such as smoking, diabetes mellitus, anemia, malnutrition, and decolonization of Staphylococcus carriers, represent well-established actions to decrease the infection risk. Careful operative technique, proper draping and skin preparation, and appropriate selection and dosing of antimicrobials for perioperative prophylaxis are also very important in prevention of infection...
March 11, 2017: Infectious Disease Clinics of North America
https://www.readbyqxmd.com/read/28246002/multi-site-and-nasal-swabbing-for-carriage-of-staphylococcus-aureus-what-does-a-single-nose-swab-predict
#13
B C Young, A A Votintseva, D Foster, H Godwin, R R Miller, L W Anson, A S Walker, T E A Peto, D W Crook, K Knox
BACKGROUND: Carriage of Staphylococcus aureus is a risk for infections. Targeted decolonization reduces postoperative infections but depends on accurate screening. AIM: To compare detection of S. aureus carriage in healthy individuals between anatomical sites and nurse- versus self-swabbing; also to determine whether a single nasal swab predicted carriage over four weeks. METHODS: Healthy individuals were recruited via general practices. After consent, nurses performed multi-site swabbing (nose, throat, and axilla)...
January 30, 2017: Journal of Hospital Infection
https://www.readbyqxmd.com/read/28237504/is-faecal-microbiota-transplantation-an-option-to-eradicate-highly-drug-resistant-enteric-bacteria-carriage
#14
B Davido, R Batista, H Michelon, M Lepainteur, F Bouchand, R Lepeule, J Salomon, D Vittecoq, C Duran, L Escaut, I Sobhani, M Paul, C Lawrence, C Perronne, F Chast, A Dinh
Carbapenem-resistant Enterobacteriaceae (CRE) or vancomycin-resistant enterococci (VRE) carriage present a major public health challenge. Decolonization strategies are lacking. We aimed to evaluate the impact of faecal microbiota transplantation (FMT) on a cohort of patients with digestive tract colonization by CRE or VRE. Eight patients were included: six carrying CRE and two colonized by VRE. One month after FMT, two patients were free from CRE carriage, and another patient was free from VRE after three months...
April 2017: Journal of Hospital Infection
https://www.readbyqxmd.com/read/28229205/-spectrum-of-pathogens-in-postoperative-complications-of-visceral-surgery-the-problem-of-multidrug-resistance
#15
A Kramer, J Pochhammer, P Walger, U Seifert, M Ruhnke, J C Harnoss
In general surgery the etiology of surgical site infections has not significantly changed over the last 30 years. Gram-positive bacteria, e.g. coagulase negative staphylococci (CNS), Staphylococcus aureus and Enterococcus spp. as well as Gram-negative bacteria, e.g. Escherichia coli, Enterobacter spp., Klebsiella spp. and Pseudomonas aeruginosa, are the most common findings. Although in general surgery 10% of the S. aureus causing postoperative wound infections were methicillin resistant (MRSA), no cases of multidrug-resistant Gram-negative (MRGN) bacteria were reported...
February 22, 2017: Der Chirurg; Zeitschrift Für Alle Gebiete der Operativen Medizen
https://www.readbyqxmd.com/read/28215714/microbiological-effect-of-mupirocin-and-chlorhexidine-for-staphylococcus-aureus-decolonization-in-community-and-nursing-home-based-adults
#16
Mary-Claire Roghmann, Alison D Lydecker, Patricia Langenberg, Emmanuel F Mongodin, J Kristie Johnson
OBJECTIVE: To compare the presence of Staphylococcus aureus and pathogenic Gram-negative rods (GNR) in the anterior nares, posterior pharynx and three skin sites in community-based adults and nursing home-based adults before and after treatment with nasal mupirocin and topical chlorhexidine. METHODS: S. aureus-colonized adults were recruited from the community (n=26) and from nursing homes (n=8). Eligible participants were cultured for S. aureus and GNR during two study visits and then received intranasal mupirocin and topical chlorhexidine for 5days, with a 2-month follow-up period...
May 2017: Diagnostic Microbiology and Infectious Disease
https://www.readbyqxmd.com/read/28194547/madness-decolonized-madness-as-transnational-identity-in-gail-hornstein-s-agnes-s-jacket
#17
Gavin Miller
The US psychologist Gail Hornstein's monograph, Agnes's Jacket: A Psychologist's Search for the Meanings of Madness (2009), is an important intervention in the identity politics of the mad movement. Hornstein offers a resignified vision of mad identity that embroiders the central trope of an "anti-colonial" struggle to reclaim the experiential world "colonized" by psychiatry. A series of literal and figurative appeals makes recourse to the inner world and (corresponding) cultural world of the mad as well as to the ethno-symbolic cultural materials of dormant nationhood...
February 13, 2017: Journal of Medical Humanities
https://www.readbyqxmd.com/read/28162098/the-effect-of-universal-decolonization-with-screening-in-critical-care-to-reduce-mrsa-across-an-entire-hospital
#18
Craig W Bradley, Martyn A C Wilkinson, Mark I Garvey
OBJECTIVE To describe the effect of universal methicillin-resistant Staphylococcus aureus (MRSA) decolonization therapy in a large intensive care unit (ICU) on the rates of MRSA cases and acquisitions in a UK hospital. DESIGN Descriptive study. SETTING University Hospitals Birmingham (UHB) NHS Foundation Trust is a tertiary referral teaching hospital in Birmingham, United Kingdom, that provides clinical services to nearly 1 million patients every year. METHODS A break-point time series analysis and kernel regression models were used to detect significant changes in the cumulative monthly numbers of MRSA bacteremia cases and acquisitions from April 2013 to August 2016 across the UHB system...
April 2017: Infection Control and Hospital Epidemiology
https://www.readbyqxmd.com/read/28116797/a-multidisciplinary-infection-control-bundle-to-reduce-the-number-of-spinal-cord-stimulator-infections
#19
Erlangga Yusuf, Sven Bamps, Bénédicte Thüer, Jan Mattheussen, Jean-Paul Ursi, Elke Del Biondo, Kris de Smedt, Raf Van Paesschen, Dirk Berghmans, Kaat Hofkens, Jef Van Schaeren, Tony van Havenbergh, Bruno Van Herendael
OBJECTIVE: To investigate the effect of a quality improvement project that resulted in an infection control bundle to reduce the number of spinal cord stimulator (SCS) infections. MATERIALS AND METHODS: The study was performed in a single center for neuromodulation from January 1, 2014, through May 31, 2016. In response to a high number of surgical site infections (SSIs) after SCS surgery, a multidisciplinary team analyzed the surgical process and developed an infection prevention bundle consisting of five items: 1) showering and decolonization for five days prior to surgery and showering in the hospital on the morning of surgery; 2) performing the SCS implantation as the first in the daily operating room (OR) program; 3) maintaining a minimal number of people in the OR; 4) providing home care nurses with a folder with SCS wound care instructions including pictures; 5) giving oral specific wound care instructions to patients...
January 24, 2017: Neuromodulation: Journal of the International Neuromodulation Society
https://www.readbyqxmd.com/read/28109620/effect-of-pre-operative-octenidine-nasal-ointment-and%C3%A2-showering-on-surgical-site-infections-in-patients-undergoing-cardiac-surgery
#20
M Reiser, A Scherag, C Forstner, F M Brunkhorst, S Harbarth, T Doenst, M W Pletz, S Hagel
OBJECTIVE: To evaluate the effect of pre-operative octenidine (OCT) decolonization on surgical site infection (SSI) rates. DESIGN: Before-and-after cohort study. PATIENTS: Patients undergoing an elective isolated coronary artery bypass graft (CABG) procedure: control group (1(st) January to 31(st) December 2013), N=475; intervention group (1(st) January to 31(st) December 2014), N=428. INTERVENTIONS: The intervention consisted of nasal application of OCT ointment three times daily, beginning on the day before surgery, and showering the night before and on the day of surgery with OCT soap...
February 2017: Journal of Hospital Infection
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