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  #31  
Old 03-23-2007, 11:00 AM
David David is offline
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Yup. I concur 100%.

I got the same 'song and dance' from a couple of U.S. surgeons before I decided on Dr. B (and I wish I would have made that decision two years earlier!)

David
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  #32  
Old 03-25-2007, 10:26 PM
RhondaDanielle RhondaDanielle is offline
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This staph infection topic caught my eye due to the fact I have had very rare and serious diseases since I had my discectomy Oct. '05. I never thought they could be related until now. After my surgery, I acquired pseudonomis, MRSA, and a unexplainable fungus infection on my left breast.
~Commit Random Acts Of Kindness~
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  #33  
Old 07-23-2007, 07:28 AM
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Harrison Harrison is offline
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As I was reading the WSJ today, I saw an interesting ad in the Op-Ed section:

http://www.hospitalinfection.org/protectyourself.shtml
STEPS YOU CAN TAKE TO REDUCE YOUR RISK OF A HOSPITAL INFECTION

The RID organization is a non-profit focused on reducing infant deaths. It looks like by carrying out their mission, they figured out how to help out a much larger audience of patients!

Way to go, Betsy.
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Fell on my ***winter 2003, Canceled fusion April 6 2004
Reborn June 25th, 2004, L5-S1 ADR Charite in Boston
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  #34  
Old 11-08-2007, 02:17 PM
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Harrison Harrison is offline
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It is interesting to see some spine centers (perhaps a minority) perform MRSA testing pre-operatively. Perhaps this is evolving for the better. In the meantime, some places see it as a no-brainer...see below.
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Preop nasal screening for S. aureus significantly lowered postop spine infection rates

Spinal patients who underwent screening had a 0.7% surgical Staph infection rate vs. 1.5% of the unscreened group

By Gina Brockenbrough
1st on the web (October 29, 2007)
October 2007

AUSTIN, Texas — Using a novel preoperative nasal screening protocol may significantly decrease the rate of postoperative Staphylococcus aureus infections in patients undergoing spinal procedures, according to a study presented here.

David Shapiro, MD, and colleagues at Northwestern University Feinberg School of Medicine, Chicago, compared rates of postoperative surgical Staphylococcus aureus infections between two patient groups who underwent major spinal surgery. The study included 673 patients who received preoperative nasal screening using real-time polymerase chain reaction (PCR) testing and 699 patients who received surgery before the screening protocol was implemented.

Of the PCR-tested group, 29% were positive for S. aureus and subsequently were treated with mupirocin for 5 days before surgery.

Postoperatively, investigators found an overall surgical S. aureus infection rate of 0.7% among patients screened preoperatively compared to 1.5% for the non-screened group.

"PCR is a cost-effective way and [an] easy way to decrease the rate of postoperative Staph infections," said Shapiro, in a presentation at the North American Spine Society 22nd Annual Meeting. "Real-time PCR allows for prompt initiation of therapy and demonstrates a statistically significant improvement in the rate of postoperative Staph infections."

Investigators obtained two preoperative nasal swabs from patients in the PCR group. "One swab was placed into a bacterial lysis solution containing achromopeptidase, while the other was saved for culture and sensitivity testing, and strain testing," Shapiro said.

"The DNA liberated from the swab was used as a template for real-time PCR with primers to detect [S. aureus]," he said.

PCR testing magnifies the DNA for bacterial identification without waiting several days for culture incubation, Shapiro noted.

"This is the first time, to our knowledge, that this test has been put to the use for preoperative nasal screening for [S. aureus]," he said. "It was developed at our hospital and it is not FDA approved."

For more information:

Shapiro D, Peterson L, Shapiro G. Use of a real-time PCR assay to detect Staphylococcus Aureus as part of a successful nasal screening program for major spine surgery. Paper #60. Presented at the North American Spine Society 22nd Annual Meeting. Oct. 23-27, 2007. Austin, Texas.

Courtesy: OrthoSupersite (Slack, Inc.)
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Fell on my ***winter 2003, Canceled fusion April 6 2004
Reborn June 25th, 2004, L5-S1 ADR Charite in Boston
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  #35  
Old 06-10-2010, 07:45 PM
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Harrison Harrison is offline
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Just adding a recent article to this old topic. I think this is a terribly important topic, especially since we know several patients that had severe staph infections, a few requiring revision surgery!
_____________________________________________

Risk Of Staph Infection After Surgery Linked To Type Of Procedure

10 Jun 2010

A new US study suggests that post-surgery infection by the bacterium Staphylococcus aureus (Staph), a type commonly acquired in hospital settings, is more likely to occur after operations to the chest and head than other major procedures.

The retrospective cohort study is available to read online and is due to appear in the July print issue of the journal Infection Control and Hospital Epidemiology.

Lead author Dr Deverick Anderson, an infectious diseases specialist at Duke University Medical Center in Durham, North Carolina, told the media that:

"We found that chest and head procedures accounted for the majority of staph infections after major surgery."

Anderson and colleagues analyzed data on 96,455 orthopaedic, neurosurgical, cardiothoracic, and plastic surgery procedures performed between 2003 and 2006 on 81,267 patients at 11 centers (9 community hospitals and 2 tertiary care hospitals in North Carolina and Virginia).

They found that:
  • 454 patients had S. aureus infections: 317 had surgical site infection, 188 had bloodstream infection, and 51 had both.
  • The overall incidence of infection was 0.47 per 100 procedures.
  • Around half of infections (51 per cent) were due to methicillin-resistant S. aureus (MRSA).
  • S. aureus infection was more common after cardiothoracic procedures (0.79 infections per 100 procedures) than after orthopedic, neurosurgical or plastic surgical procedures (0.37, 0.62 and 0.32 per 100 respectively).
  • The highest rate of bloodstream infection was after cardiothoracic procedures ( 0.57 infections per 100 procedures), comprising almost 75 per cent of infections.
  • The highest rate of surgical site infection was after neurosurgical procedures (0.50 infections per 100 procedures), comprising 80 per cent of infections.
The authors concluded that:
  • "The frequency and type of postoperative invasive S. aureus infection varied significantly across procedure types."
  • They recommended that the "highest risk procedures, such as cardiothoracic procedures, should be targeted for ongoing preventative interventions".
Anderson, who also works with the Duke Infection Control Outreach Network (DICON), said a key message of the study was that "one prevention strategy does not fit all" and there may be a need to have strategies for cardiovascular and neurosurgical procedures that are not necessary for plastic or orthopaedic surgery.

He also said strategies that focus exclusively on MRSA will not necessarily prevent all infections:"On average MRSA was only present in half of the infections that we identified," he added.

The study was funded by Merck & Co, and two of its authors work at their labs in North Wales, Pennsylvania, but according to a statement they were not involved in the analysis of the data.

"Variation in the Type and Frequency of Postoperative Invasive Staphylococcus aureus Infections According to Type of Surgical Procedure."
Deverick J. Anderson, Jean Marie Arduino, Shelby D. Reed, Daniel J. Sexton, Keith S. Kaye, Chelsea A. Grussemeyer, Senaka A. Peter, Chantelle Hardy, Yong Il Choi, Joelle Y. Friedman, Vance G. Fowler, Jr.
Infection Control and Hospital Epidemiology Vol 31, No 7, 701-709, July 2010
DOI: 10.1086/653205

Source: http://www.medicalnewstoday.com/articles/191520.php
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"Harrison" - info (at) adrsupport.org
Fell on my ***winter 2003, Canceled fusion April 6 2004
Reborn June 25th, 2004, L5-S1 ADR Charite in Boston
Founder & moderator of ADRSupport - 2004
Founder Arthroplasty Patient Foundation a 501(c)(3) - 2006
Creator & producer, Why Am I Still Sick? - 2012
Donate www.arthropatient.org/about/donate
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  #36  
Old 06-16-2010, 07:19 PM
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Harrison Harrison is offline
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Default New Video Interview Excerpt

Last year, I interviewed one of the top scientists at NIAID whose expertise involves staph infections, particularly MRSA. You can read an interview excerpt and see the 10 minute video here.

I hope this interests some of you, while also educating others who do not appreciate the myriad chronic conditions associated with bacterial biofilm infections.

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"Harrison" - info (at) adrsupport.org
Fell on my ***winter 2003, Canceled fusion April 6 2004
Reborn June 25th, 2004, L5-S1 ADR Charite in Boston
Founder & moderator of ADRSupport - 2004
Founder Arthroplasty Patient Foundation a 501(c)(3) - 2006
Creator & producer, Why Am I Still Sick? - 2012
Donate www.arthropatient.org/about/donate
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