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Asia-Pacific Journal of Ophthalmology... 2017Endophthalmitis after cataract surgery is a rare but potentially devastating complication. There is great variability in endophthalmitis prophylaxis practice patterns... (Review)
Review
Endophthalmitis after cataract surgery is a rare but potentially devastating complication. There is great variability in endophthalmitis prophylaxis practice patterns worldwide. Treatment varies globally and is based on the microbiological profile and availability of formulations. Periocular povidone-iodine antisepsis is universally adopted and considered the standard of care in most practices. Perioperative topical antibiotics are also very popular despite the lack of level 1 evidence confirming efficacy. Based on growing observational evidence, routine intracameral antibiotic prophylaxis is increasing, especially where approved commercial intraocular preparations are available. This review updates recent trends and evidence regarding endophthalmitis prophylaxis and the preferred choice of intracameral antibiotics.
Topics: Antibiotic Prophylaxis; Cataract Extraction; Endophthalmitis; Eye Infections, Bacterial; Humans; Surgical Wound Infection
PubMed: 28780782
DOI: 10.22608/APO.2017200 -
Asia-Pacific Journal of Ophthalmology... 2018Increasing bacterial resistance to antibiotics has recently become an important medical challenge. In ophthalmology antibiotics are widely used for treatment and... (Review)
Review
Increasing bacterial resistance to antibiotics has recently become an important medical challenge. In ophthalmology antibiotics are widely used for treatment and prophylaxis of ocular infections. In many cases antiseptics may be a valuable adjunct and sometimes even an alternative to antibiotics for the prevention and treatment of infections, reducing the overuse of antibiotics. This review aims to highlight the available literature on the subject of antibiotic resistance in ophthalmology. Full understanding of this growing problem is necessary for tailoring effective pre-, intra-, and postoperative management to improve antibiotic stewardship programs.
Topics: Anti-Bacterial Agents; Anti-Infective Agents, Local; Antimicrobial Stewardship; Antisepsis; Drug Resistance, Bacterial; Humans; Ophthalmology
PubMed: 29280365
DOI: 10.22608/APO.2017343 -
Polimery W Medycynie 2021Wound infection may occur in acute and chronic wounds, wounds resulting from surgery or traffic accidents, and burns. Regardless of the extent and cause of the wound,... (Review)
Review
Wound infection may occur in acute and chronic wounds, wounds resulting from surgery or traffic accidents, and burns. Regardless of the extent and cause of the wound, prompt treatment is essential in reducing the patient's pain and limiting the spread of contamination. Improper wound care and associated chronic diseases may hinder the therapeutic success. Bacterial cellulose (BC) is highly biocompatible and has no cytotoxic effect on cells engaged in wound healing, such as fibroblasts and keratinocytes. Its high hydration level guarantees the maintenance of a moist wound environment. High mechanical strength, flexibility and resistance to damage make BC a promising material for dressings. Unfortunately, it does not display an inhibitory effect on bacterial growth. Introducing antimicrobial agents into the structure of BC has been a subject of many studies. This paper aims to present the latest reports on the possibility of the absorption of bacteriostatic and bactericidal agents in BC, such as metal particles, essential oils, antibiotics, antiseptics, and wound irrigation solutions. Moreover, the modifications in BC culture and post-production treatments in order to improve its physical properties are discussed.
Topics: Anti-Bacterial Agents; Anti-Infective Agents; Bandages; Burns; Cellulose; Humans
PubMed: 34766741
DOI: 10.17219/pim/143330 -
Journal of Visceral Surgery Jun 2018Surgical site infections (SSI) are a public health issue. The purpose of this review is to review the literature on methods of pre-operative skin preparation for the... (Review)
Review
INTRODUCTION
Surgical site infections (SSI) are a public health issue. The purpose of this review is to review the literature on methods of pre-operative skin preparation for the prevention of SSI in abdominal surgery.
METHODS
In order to obtain the best level of evidence, only meta-analyses and randomized controlled clinical trials were selected from the Cochrane Library and PubMed databases. High-powered non-randomized studies were included when results were not available for the questions asked. The primary endpoint was the rate of SSI within 30 days.
RESULTS
Analysis of the 20 selected studies suggested that hair removal in the operative field is not recommended except when it interferes with surgery; in this case, hair clipping or chemical depilation is recommended and shaving should be banned. For the pre-operative shower, the choice of a detergent product with or without antiseptic does not seem to matter, and there were no published data on the required number of showers or the interval before surgery. Application of an alcohol-based solution to the operative field for cutaneous disinfection is recommended; the products used seem to be equivalent, and there is no need for pre-operative detergent scrubbing. There is no strong evidence to recommend adhesive plastic drapes for clean or contaminated surgery.
CONCLUSION
Some recommendations on skin preparation before abdominal surgery to reduce the rate of SSI are based on a high level of evidence. Other recommendations such as the number and duration of pre-operative showers or use of adhesive plastic skin drapes are less well supported.
Topics: Abdomen; Humans; Infection Control; Preoperative Care; Skin; Surgical Wound Infection
PubMed: 29631947
DOI: 10.1016/j.jviscsurg.2018.03.004 -
Scientific Reports Jul 2018Escherichia coli and Staphylococcus aureus bacterial retention on mirror-polished and ultrashort pulse laser-textured surfaces is quantified with a new approach based on...
Escherichia coli and Staphylococcus aureus bacterial retention on mirror-polished and ultrashort pulse laser-textured surfaces is quantified with a new approach based on ISO standards for measurement of antibacterial performance. It is shown that both wettability and surface morphology influence antibacterial behavior, with neither superhydrophobicity nor low surface roughness alone sufficient for reducing initial retention of either tested cell type. Surface structures comprising spikes, laser-induced periodic surface structures (LIPSS) and nano-pillars are produced with 1030 nm wavelength 350 fs laser pulses of energy 19.1 μJ, 1.01 μJ and 1.46 μJ, respectively. SEM analysis, optical profilometry, shear force microscopy and wettability analysis reveal surface structures with peak separations of 20-40 μm, 0.5-0.9 μm and 0.8-1.3 μm, average areal surface roughness of 8.6 μm, 90 nm and 60 nm and static water contact angles of 160°, 119° and 140°, respectively. E. coli retention is highest for mirror-polished specimens and spikes whose characteristic dimensions are much larger than the cell size. S. aureus retention is instead found to be inhibited under the same conditions due to low surface roughness for mirror-polished samples (S: 30 nm) and low wettability for spikes. LIPSS and nano-pillars are found to reduce E. coli retention by 99.8% and 99.2%, respectively, and S. aureus retention by 84.7% and 79.9% in terms of viable colony forming units after two hours of immersion in bacterial broth due to both low wettability and fine surface features that limit the number of available attachment points. The ability to tailor both wettability and surface morphology via ultrashort pulsed laser processing confirms this approach as an important tool for producing the next generation of antibacterial surfaces.
Topics: Asepsis; Bacterial Adhesion; Escherichia coli; Lasers; Staphylococcus aureus; Steel; Wettability
PubMed: 29973628
DOI: 10.1038/s41598-018-28454-2 -
Clinical and Experimental Emergency... Sep 2014Increased awareness of the signs and symptoms of sepsis and an emphasis on the importance of early treatment have helped to improve survival rates from this serious and... (Review)
Review
Increased awareness of the signs and symptoms of sepsis and an emphasis on the importance of early treatment have helped to improve survival rates from this serious and frequent condition in recent years. With no specific, effective anti-sepsis therapies available, management focuses on early source control with adequate and appropriate antibiotics and removal of any source of infection, rapid resuscitation, hemodynamic stabilization and organ support. Use of dedicated teams to care for patients with sepsis can help optimize early management.
PubMed: 27752546
DOI: 10.15441/ceem.14.005 -
Romanian Journal of Ophthalmology 2021Endophthalmitis remains a serious complication following intraocular procedures. Preoperative prophylactic measures for endophthalmitis decrease the morbidity associated... (Review)
Review
Endophthalmitis remains a serious complication following intraocular procedures. Preoperative prophylactic measures for endophthalmitis decrease the morbidity associated with this disease and represent a standard of care prior to ophthalmic surgery. The literature supports as measures for ocular antisepsis: povidone-iodine solution for ocular surface preparation, chlorhexidine in patients with iodine allergy and application of topical antibiotics. Povidone-iodine is regarded as the most effective antiseptic associated with significant reduction in ocular surface bacterial counts. Currently, the recommended preoperative management is the application of 5% povidone-iodine solution in the conjunctival fornix, prior to surgery. This paper reviews the preoperative measures for ocular antisepsis, used in order to decrease the risk of culture-proven endophthalmitis.
Topics: Anti-Infective Agents, Local; Antisepsis; Conjunctiva; Endophthalmitis; Humans; Povidone-Iodine
PubMed: 34179575
DOI: 10.22336/rjo.2021.25 -
Dermatology Practical & Conceptual Jan 2021Dermatologic procedures are performed under varying degrees of antisepsis, and no clear guidelines exist regarding the role of the aseptic technique in dermatology. This... (Review)
Review
Dermatologic procedures are performed under varying degrees of antisepsis, and no clear guidelines exist regarding the role of the aseptic technique in dermatology. This review aims to clarify the terminology surrounding surgical asepsis and examines the importance of various components of the aseptic technique in cutaneous surgery. Included are studies examining optimal glove type, surgical instruments, skin antisepsis, and cost-reducing protocols. Our review highlights that most dermatology procedures are not performed under completely sterile conditions due to the lack of environmental and foot traffic controls in dermatology offices. In addition, for some outpatient procedures, such as for minor excisions and Mohs surgery before reconstruction, elements of the clean technique can be used without increasing infection rates. However, data on the feasibility of a clean protocol for Mohs reconstruction is conflicting. Future prospective, randomized trials analyzing various components of the aseptic technique in dermatology are greatly needed so that guidelines can be established for practicing dermatologists.
PubMed: 33614211
DOI: 10.5826/dpc.1101a126 -
International Journal of Nanomedicine 2020Nanoparticle solutions have been studied to improve antimicrobial effect. The aim of this study was to develop, characterize, and evaluate the in vitro and in vivo...
INTRODUCTION
Nanoparticle solutions have been studied to improve antimicrobial effect. The aim of this study was to develop, characterize, and evaluate the in vitro and in vivo antiseptic efficacy of 0.25% aqueous-based chlorhexidine nanoemulsion (NM-Cl 0.25% w/v).
METHODS
The NM-Cl 0.25% w/v (2.5mg/mL) and free chlorhexidine nanoemulsion (FCN; same composition of NM-Cl without the molecule of chlorhexidine) were synthetized by the spontaneous emulsification method. Characterization analyses of physical and chemical properties were performed. The NM-Cl 0.25% w/v was compared with chlorhexidine 0.5% alcohol base (CS-Cl 0.5%) in vitro studies (microdilution study and kill curve study), and in vivo study (antisepsis of rats dorsum). Kruskal-Wallis test was used between groups and inside the same group, at different sample times and the Mann-Whitney test was performed when difference was detected.
RESULTS
The NM-Cl 0.25% w/v presented adequate physicochemical characteristics for a nanoemulsion, revealing a more basic pH than FCN and difference between zeta potential of NM-Cl 0.25% w/v and FCN. The NM-Cl 0.25% w/v and CS-Cl 0.5% solutions were more effective on Gram-positive than on Gram-negative bacteria (≤0.05). NM-Cl 0.25% w/v presented upper antiseptic effect in the microdilution study and residual antiseptic effect was maintained for a longer time when compared to CS-Cl 0.5% (kill curve study). The four-fold (minimal inhibitory concentration) of NM-Cl 0.25% were the formulations with most durable effect within those tested, presenting residual effect until T6 for both bacteria. In the in vivo study, both formulations (NM-Cl 0.25% w/v and CS-Cl 0.5%) had a reduction of the microorganisms in the skin of the rats (<0.0001) not revealing any difference between the formulations at different times, showing the antiseptic effect of NM-Cl (≤0.05).
CONCLUSION
Both in vitro and in vivo experiments demonstrated that NM-Cl showed promising future as an antiseptic for cutaneous microbiota.
Topics: Animals; Anti-Infective Agents, Local; Chlorhexidine; Emulsions; Ethanol; Gram-Negative Bacteria; Gram-Positive Bacteria; Male; Microbial Sensitivity Tests; Nanostructures; Rats, Wistar; Skin
PubMed: 33061360
DOI: 10.2147/IJN.S228280 -
Cell Reports Mar 2023It is generally believed that environmental or cutaneous bacteria are the main origin of surgical infections. Therefore, measures to prevent postoperative infections...
It is generally believed that environmental or cutaneous bacteria are the main origin of surgical infections. Therefore, measures to prevent postoperative infections focus on optimizing hygiene and improving asepsis and antisepsis. In a large cohort of patients with infections following major surgery, we identified that the causative bacteria are mainly of intestinal origin. Postoperative infections of intestinal origin were also found in mice undergoing partial hepatectomy. CCR6 group 3 innate lymphoid cells (ILC3s) limited systemic bacterial spread. Such bulwark function against host invasion required the production of interleukin-22 (IL-22), which controlled the expression of antimicrobial peptides in hepatocytes, thereby limiting bacterial spread. Using genetic loss-of-function experiments and punctual depletion of ILCs, we demonstrate that the failure to restrict intestinal commensals by ILC3s results in impaired liver regeneration. Our data emphasize the importance of endogenous intestinal bacteria as a source for postoperative infection and indicate ILC3s as potential new targets.
Topics: Mice; Animals; Lymphocytes; Immunity, Innate; Liver Regeneration; Interleukins; Skin
PubMed: 36933213
DOI: 10.1016/j.celrep.2023.112269