Including Infection Prevention Research Articles

The business of infection control and epidemiology

The business of infection control and epidemiology

Moving from recommendation to implementation and audit: Part 1. Current recommendations and programs: a critical commentary

Growing concern over the spread of resistance to antibiotics and other antimicrobials has prompted a plethora of recommendations for its control. Strategic programs for resistance containment have been initiated in various countries, particularly in Western Europe and North America. The World Health Organization and the European Union have responded to the need for international action by publishing guidance and encouraging collaboration. These recommendations rightly focus on controlling resistance in the community. They agree on the importance of surveillance of resistance patterns and antibiotic usage and the need to encourage judicious antibiotic usage (especially through education of prescribers and the public). Yet there remains a pressing need for the implementation of effective actions to address these issues. Important considerations given less attention include infection prevention (e.g. through immunization), the use of rapid diagnostic tests to reduce antibiotic usage, audit of implemented actions, and the provision of feedback. Furthermore, research is necessary to fill the substantial gaps in our knowledge. Notably, the reversibility or containment of resistance with the optimization of antibiotic usage has yet to be definitely established. For now, antimicrobial management programs should focus on ensuring the most appropriate use of antimicrobials rather than simply on limiting choices. Finally, developed countries must recognize that a truly global approach to resistance containment will require greater support for developing countries.

Three major issues in infection control.

In considering the three major issues in infection control the author decided upon education and empowerment, community practices, and research availability and application as they span a range of infection control practices and healthcare settings. Education and empowerment of staff is needed to ensure safe practice. This requires collaboration between education providers and infection control personnel and should be available to all disciplines of staff. Infection control needs to be seamless across the primary and secondary care interface and must include infection prevention advice to the population in general. Evidence relating to infection control is either lacking or not achievable. When it is available, it is not always implemented because of lack of resources.

Amputation Stump Lengthening With the Ilizarov Technique

It is often difficult to create a functional stump from a traumatic amputation, especially in a child. A case is described of a traumatic, high, below-knee amputation in a five-year-old child. The resulting stump was too short to allow a conventional below-knee prosthesis, decreasing gait efficiency. The Ilizarov technique was used to increase tibial length. Bony lengthening was very successful, but several problems were encountered with the soft-tissue reconstruction. This technique of stump reconstruction holds promise only if the soft-tissue problems are anticipated. The suggestions for future stump-lengthening procedures are preparatory plastic surgery for skin requirements including infection prevention measures.