MRSA screening for surgical site infection prevention prior to hysterectomy at a cancer center
Poster May 09, 2018
Kuznicki M, Mallen A, Robertson S, Todd S, Boulware D, Martin S, McClung EC, Apte SM
Objectives: Screening and decolonization for methicillin resistant staphylococcus aureus (MRSA) is routinely performed prior to surgery in many centers, however limited data describe the contribution of MRSA to surgical site infections (SSIs) in gynecologic oncology patients. We present the outcome of a MRSA screening and decolonization program implemented as part of a bundled
intervention to prevent SSIs after hysterectomy at a cancer center.
Methods: Patients were screened for MRSA colonization by polymerase chain reaction nasal swab during their preoperative surgical consultation. Decolonization of MRSA carriers included oral doxycycline 100 mg twice daily for 7 days, and mupirocin 2% ointment to both nares for 5 days. For all MRSA carriers, vancomycin was added to routine preoperative antibiotics. We implemented a perioperative SSI prevention bundle on July 19, 2016 which included a renewed in-service teaching for clinic staff to increase performance of MRSA screening. Additional interventions included preoperative 4% chlorhexidine gluconate (CHG) showers, the use of 4% CHG topical wipes on day of surgery, revised and standardized preoperative antibiotics, a 4% CHG soap vaginal prep, and post-op 4% CHG showers. Consecutive patients undergoing hysterectomy by the gynecologic oncology division 6 months PRE and POST implementation of the bundled intervention were retrospectively reviewed. Statistical analysis included Fishers exact test and the Kruskal-Wallis test.
Results: From 1/18/2016 to 1/18/2017 we identified 358 women undergoing hysterectomy (178 PRE-intervention and 180 POST-intervention). MRSA screening was completed in 129/178 (72.5%) PRE, and 159/180(88.3%) POST (p<0.001). MRSA colonization was detected in 10/298 (3.4%), with 4/129 (3.1%) PRE and 6/159 (3.8%) POST intervention (p=1.0). Decolonization was completed in 2/4 PRE and 5/6 POST patients. The SSI rate was 14/178 (7.9%) PRE and 6/180 (3.3%) POST. Cultures were collected for 13/14 PRE and 6/6 POST SSIs. At least one organism was identified in 5/6 PRE and 10/13 POST. No SSIs involved MRSA.
Conclusions: Preoperative MRSA screening is feasible for the gynecologic oncology population. Screening rates can be improved with in-service teaching. MRSA is an uncommon cause of SSI after hysterectomy. Cost effectiveness of MRSA screening prior to hysterectomy should be evaluated
Characterization of a Type 2 diabetes-associated islet-specific enhancer cluster in STARD10 by genome editing of EndoC-βH1 cellsPoster
Genome-wide association studies (GWAS) have identified more than 100 genetic loci associated with type 2 diabetes. The majority of these are located in the intergenic or intragenic regions suggesting that the implicated variants may alter chromatin conformation. This, in turn, is likely to influence the expression of nearby or more remotely located genes to alter beta cell function. At present, however, detailed molecular and functional analyses are still lacking for most of these variants. We recently analysed one of these loci and mapped five causal variants in an islet-specific enhancer cluster within the STARD10 gene locus. Here, we aimed to understand how these causal variants influence b-cell function by alteration of the chromatin structure of enhancer clusterREAD MORE
Young Adult Women’s Relationship Status and HPV Risk Perceptions: A Barrier to HPV Vaccination?Poster
Human papillomavirus (HPV) vaccine rates continue to be low in the United States. Young women ages 18-26 years are eligible for catch-up vaccination but previous research shows that relationships status and percieved risk may be barriers to HPV vaccination. The purpose of this quantitative study was to assess the association between relationship status and perceived risk for HPV among young adult women.READ MORE
Treatment Options for Chronic Parvovirus Viremia in Pediatric Heart Transplant Patients in a Tertiary Care CenterPoster
This abstract discusses three cases of pediatric heart transplant patients who suffered from parvovirus (B19) infection. Of these patients, two ( B & C) responded well to standard intravenous Ig therapy. Patient A however, did not respond to standard treatment and was begun on subcutaneous Ig, which effectively diminished his viral load. Thus, subcutaneous Ig infusions might serve as a second line treatment for transplant patients with parvovirus who do not respond well to the standard approach.READ MORE
3rd International Conference on Diagnostic Microbiology and Infectious Diseases
Sep 24 - Sep 25, 2018