Presence Of Bacterial Contamination Research Articles

Suture Contamination During Arthroscopic Rotator Cuff Repair Is Associated With Significantly Higher Retear Rates in Magnetic Resonance Imaging: A Matched-Pair Analysis

PurposeTo evaluate the correlation between suture contamination and rotator cuff tendon retear after arthroscopic rotator cuff repair. MethodsPatients undergoing primary arthroscopic rotator cuff repair from April 1st, 2020 to September 30th, 2022 were enrolled. Those younger than 18 years, with a history of prior shoulder surgeries or shoulder infection episodes, or who declined participation, were excluded. A 5 cm section of the first-cut suture, originating from the anchor eyelet ends, in each rotator cuff repair surgery was subjected to bacteria culture and polymerase chain reaction (PCR) analysis. Patients with positive culture findings were matched 1:1 to those with negative culture reports based on age, sex, tear size as well as involved tendons, preoperative fatty infiltration grade (Goutallier grade) and preoperative muscle atrophy grade (Warner score). Postoperative rotator cuff tendon retear assessments were conducted at the 6-month mark using the Sugaya classification via magnetic resonance imaging. The Wilcoxon signed-rank test was used for matched-pair comparisons between the groups. ResultsA total of 141 patients (60 males and 81 females) with a mean age of 61.0 ± 8 years were finally enrolled. Twenty-six patients (18 males and 8 females) had a positive culture, while 115 patients (42 males and 73 females) had a negative culture. After the propensity score matching process, 24 culture-negative patients (16 males and 8 females) were selected as the culture-negative group. Age, fatty infiltration grade, and muscle atrophy grade were not significantly different between matched groups. The retear grade in the culture-positive group was found to be significantly higher than that in the culture-negative group (P = 0.020) under the matched-pair comparison. C. acnes. was the most prevalent bacterial species responsible for suture contamination. ConclusionsThe matched-pair analysis revealed that the presence of bacterial contamination on sutures was associated with a higher risk of retear in MRI following arthroscopic rotator cuff repair.

Softened Water and Steam Boiler Water Condensate Quality used in the Milk Production Line of a Private Dairy Unit Located in Bechar Province (South-West of Algeria): Physicochemical and Bacteriological Analysis

Background: This study aimed at assessing the physicochemical and bacteriological parameters of the water at the softener outlet and the steam boiler water condensate of a dairy unit located in Bechar province (South-West of Algeria). Methods: Some physicochemical and bacteriological parameters were analyzed based on standard methods given by the American Public Health Association (APHA). Result: The obtained results showed that the parameters: pH, EC, salinity, TA, TAC, sulfate, nitrate, and fluoride ions of most analyzed water samples at the softener outlet (SW) were in agreement with national regulations. However, the steam boiler water condensate samples (BW) were out of specification except for TA, TAC, nitrate, and fluoride ions. The SW and BW samples were qualified as very hard exceeding the standard set at 15°f and 10,5 to 11,5°f, respectively, with high salinity and TDS values. The bacteriological analysis showed that most of the steam boiler water condensate samples complied with national regulations with the absence of fecal coliforms, knowing that the BW5 and BW8 samples were contaminated with spores of sulfite-reducing Clostridia at a load of 3 and 1 spore/50 mL, respectively. However, an average of 6/10 (i.e. 60%) of the softened water samples were contaminated with the opportunistic species ‘Pseudomonas aeruginosa’, while the SW5, SW8 and SW10 samples were contaminated with spores of sulfite-reducing Clostridia (1 to 11 spores/50 mL). All samples were free from Salmonella spp. A high TH of the water at the softener outlet reveals a malfunction of the external treatment (softening). On the one hand, boiler scaling that may occur can reduce the steam flow (low efficiency of the heat treatment), which contributes to poor pasteurization of the milk, especially in the presence of bacterial contaminants, and on the other hand, increase the energy expenditure.

NARINGENIN, CURCUMIN AND ISOQUERCITRIN MITIGATE DAMAGES IN SPERMATOZOA CAUSED BY STAPHYLOCOCCUS AUREUS DURING BACTERIOSPERMIA IN VITRO

The presence of bacterial contamination in bovine insemination doses may lead to unexpected economic loss. Currently used antimicrobial supplements are often ineffective due to antibiotic resistance of the common bacterial contaminants. Staphylococcus aureus belongs to the frequent inhabitant of bovine semen with a deleterious effect on spermatozoa quality. Bioactive substances including naringenin, curcumin and isoquercitrin were previously studied with various beneficial effects on spermatozoa. Therefore, the study aimed to simulate bacteriospermia in vitro using S. aureus, which was previously isolated from the bovine ejaculate, and to test if the bioactive substances mentioned above would bring some protective properties against the bacterial damage. Density gradient centrifugation was used to avoid contamination by naturally present bacteria. S. aureus was inoculated in BGM-3 medium, and co-incubated with pre-washed spermatozoa and bioactive substances. At times of 0, 2, and 4 h, progressive motility, the membrane potential of mitochondria, reactive oxygen species (ROS) formation, and sperm DNA damage were evaluated. The results showed that S. aureus significantly increased ROS production, sperm cells with damaged mitochondrial membrane potential, and sperm DNA integrity which led to a decrease in the progressive movement of spermatozoa. On the other hand, all three bioactive substances significantly scavenged elevated ROS. Especially, the groups treated with naringenin and isoquercitrin showed preserved mitochondrial membrane, DNA integrity inside the sperm head, and improved sperm progressive movement under bacteriospermia in vitro.

Salmonella sp. and Escherichia coli Contamination on Beef from Slaughterhouse and Traditional Markets in Medan City

Salmonella sp and Escherichia coli are zoonotic pathogenic bacteria that can be found on beef. The presence of bacterial contamination on meat will impact the meat quality physical and in microbiological. The environment of the slaughter area is one of the factors causing Salmonella sp and Escherichia coli contamination in beef. The study aimed to determine the presence of Salmonella sp. and Escherichia coli contamination on meat from Slaughterhouses (RPH) and Medan Traditional Markets. Sampling was taken in 4 locations; RPH, and three traditional markets: Brayan, MMTC, and Central Market. Meat samples researched from October to December 2021 at Laboratorium Balai Penguji Penyidik Penyakit Balai Veteriner Regional Wilayah I. Data analysis used Paired Sample T-Test. The positive result of Salmonella spp contamination was found one a meat samples from Brayan Market. Meanwhile, Negative results of Salmonella spp contamination were found on meat samples from Slaughterhouse, MMTC Market, and Central Market. Furthermore, Escherichia coli is also found on almost all meat samples from RPH, and traditional markets.

Capsular contracture around silicone miniimplants following bacterial contamination: an in vivo comparative experimental study between textured and polyurethane implants

Capsular contracture remains a problem following breast implant surgery. Although impact of biofilm and implant surface on capsule formation has been demonstrated, interaction of microorganisms with different surface types has not been clarified yet. We aimed to compare the ability of biofilm formation of implants with different surfaces, under standard conditions and to demonstrate its impact on capsular contracture. Twenty-four rats were divided into four groups. Mini-implants with three different surfaces (fine-textured, rough-textured and polyurethane) were placed on the dorsum of each rat. In Group-1, sterile implants were placed in submuscular pockets. In Group-2, implants were incubated in Staphylococcus epidermidis medium before implantation. In Group-3, before implantation, implants were immersed in Rifamycin solution following bacterial contamination. In Group-4, sterile implants were immersed in Rifamycin solution before implantation, and served as the control group. Rats were sacrificed at three months. Clinical, microbiological, histological and immunohistochemical evaluations were performed. Capsule contracture developed only on infected rough-textured implants. Rough-textured and polyurethane implants showed more biofilm formation than fine-textured implants. Capsule thickness and inflammatory cell density were higher on rough-textured implants compared to fine-textured implants (p = 0.004). Actin sequence was parallel and concentric on fine-textured and rough-textured implants; but was in irregular array on polyurethane implants. In presence of bacterial contamination, rough-textured implants have the most propensity of developing capsular contracture comparing to fine-textured and polyurethane implants at three months after implantation. Despite high bacterial load and biofilm formation, polyurethane implants are resistant to capsule contracture due to surface characteristics.

Combination of natural antimicrobials for contamination control in ethanol production.

Presence of bacterial contaminants at levels > 107 colony forming units per milliliter (CFU/mL) during ethanol production processes reduces the alcoholic fermentation yield by 30%. Antibiotics are currently used to control contamination, but their residues may be detected in yeast extract, restricting this by-product trade to several countries. Thus, the objective of this study was to assess antimicrobial activity of the natural compounds hops extract, 4-hydroxybenzoic acid, nisin Z, and lysozyme against Lactobacillus fermentum, Leuconostoc mesenteroides, and Saccharomyces cerevisiae, aiming development of a formula. Minimum Inhibitory Concentration of each antimicrobial was determined for bacteria and subsequently, nisin (30mg/L) and hops extract (5mg/L) were tested together, showing inhibitory effects combining doses of each antimicrobial that were equivalent to an eightfold reduction of their original Minimum Inhibitory Concentrations (3.75 and 0.625mg/L, respectively), resulting in a FICIndex of 0.25. Thereon, a formula containing both compounds was developed and tested in fermentation assays, promoting reductions on bacterial population and no severe interferences in yeast viability or population even at extreme doses. Therefore, these compounds have great potential to successfully substitute conventional antibiotics in the ethanol industry.

Determination of leucocyte extracellular traps (ETs) in seminal fluid (ex vivo) in infertile patients-A pilot study.

Leucocytospermia has been associated with loss of sperm function. Extracellular traps (ETs) of leucocytes are produced during innate immune response. ETs can be activated by spermatozoa in contact with polymorphonuclear (in vitro), inducing sperm entrapment and decrease motility. In this pilot study, we describe the results of ETosis ex vivo, in seminal fluid (SF) smear of infertile patients, associating ETs with leucocytospermia and bacteriospermia. In 21 infertile patients, semen parameters (WHO, 2010), microbiological study, leucocytospermia and presence of ETs in SF were determined. Leucocytes (CD45, CD15 and CD68) were evaluated by immunostaining in SF smears. Indirect immunofluorescence (global histone and H4-citrullinated 3) and scanning electron microscopy (SEM) were used to determine ETs morphology. In 28.6% of patients presented leucocytospermia without bacteriospermia, all of them presented a large number of ETs in the SF smears examined. About 76.6% of the patients without leucocytospermia were positive for ETs. Samples with leucocytospermia have a higher number of ETs and would be related to the amount of leucocytes in the SF. The morphological predominant ETs were diffuse (diffETs) and spread (sprETs). The formation of ETs indicates leucocyte activation in semen, and it was observed that ETosis does not depend exclusively on the presence of bacterial contamination.

Karakterisasi dan Identifikasi Bakteri Enterobacteriaceae pada Telur Penyu Lekang (Lepidochelys olivacea) asal Lhok Pante Tibang, Banda Aceh

The population of olive ridley turtle (Lepidochelys olivacea) are currently thretened with extinction, among the contributing factors is the failure of turtle eggs to hatch. The condition can be caused by the presence of bacterial contamination, especially group Enterobacteriaceae. The purpose of this research was to isolate the group of Enterobacteriaceae bacteria from olive ridley turtle. The sample used were shells from olive ridley turtle eggs comes from natural captivity in Lhok Pante Tibang Beach, Banda Aceh. The research parameters included the number of isolates, macroscopic morphology (shape, edge, elevation, and color of isolates), cell morphology (Gram staining and cell shape), and biochemical tests. Isolation method using spread plate and quadrant method. The isolation results obtained five isolates which had varying macroscopic morphology. The five isolates were Gram negative and formed such as trunk. Identification results found that there were three genus from Enterobacteriaceae videlicet two isolates were Enterobacter, two isolates as Shigella and the other were Klebsiella.

PEMERIKSAAN BAKTERIOLOGI ES BATU BALOK DI KOTA KLATEN

Ice cubes beams is that cooled water then molded into beams large extremely known to the public and is considered safe to eat. Storage of ice cubes beams that only in put it on the roadside with closed using plastic or sacks and plastic sheeting allow the presence of bacterial contamination. The purpose of this research is analyzing and knows the value of the ALT and MPN Coliform on ice cubes beams that sold in the city of Klaten. The research is observational. A sample of ice cubes beam used is 3 samples to be taken from the seller in in Klaten north, in Klaten central and southern district Klaten. Samples of ice cubes beam were tested ALT and MPN Coliform to determine the value of bacterial contamination. The result of the research using ALT method, shows 2 samples to meet the standard of contamination of samples A and B, while for sample C exceeds the standard of contamination determined by BPOM RI No. HK.00.06.1.52.4011 that is 1x104 UK / ml. For the results of the research using MPN Coliform method, showed that the three samples exceeded the standard of the contamination that has been determined by BPOM RI No. HK.00.06.1.52.4011 ie <3 cells/ ml. The conclusion of this research is that all three samples ice cubes beams unfit for consumed.

Knowledge, Attitude and Practice of Food Utensils Hygiene amongst Food Handlers in Kuala Pilah, Negeri Sembilan, Malaysia

This study aimed to evaluate the level of knowledge, attitude and practice (KAP) amongst food handlers in food utensils hygiene and presence of bacterial contamination on food utensils. There were two approaches used in this study. In the first approach, 134 of food handlers from 75 food premises were interviewed via questionnaires to assess their knowledge, attitude and practice. In the second approach, the presence of Staphylococcus aureus, Escherichia coli and total coliform of 225 utensils (knives (75), chopping boards (75) and dish plates (75)) was examined. The result showed that the food handlers had sufficient level of knowledge (80.5%), attitude (87.4%) and practice (90.1%). Highest contamination was found on the chopping boards for the presence of S. aureus (82.8%), E. coli (9.7%) and total coliform (73.9%). Logistic regression analysis showed that knowledge contributes to the presence of E. coli on the dish plates; and total coliform on the knives. Thus, ongoing training that focused on food utensils hygiene must be emphasized to improve knowledge, attitude and practice amongst the food handlers.

Local application of a gentamicin-loaded thermo-responsive hydrogel allows for fracture healing upon clearance of a high Staphylococcus aureus load in a rabbit model.

Antibiotic-loaded biomaterials (ALBs) have emerged as a potential useful adjunctive antimicrobial measure for the prevention of infection in open fracture care. A biodegradable thermo-responsive poly(N-isopropylacrylamide) grafted hyaluronic acid (HApN) hydrogel loaded with gentamicin has recently been shown to prevent implant-related infection in a rabbit osteosynthesis model. The primary aim of this study was to determine the influence of this HApN hydrogel on bone healing at an early stage (4 weeks). A rabbit humeral osteotomy model with plating osteosynthesis was used to compare fracture healing in rabbits receiving the hydrogel as compared with control animals. The secondary aim was to observe fracture healing in groups treated with and without antibiotic-loaded hydrogel in the presence of bacterial contamination. In all groups, outcome measures were mechanical stability and histological score, with additional quantitative bacteriology in the inoculated groups. Application of the HApN hydrogel in non-inoculated rabbits did not significantly influence humeral stiffness or histological scores for fracture healing in comparison to controls. In the inoculated groups, animals receiving the bacterial inoculum without hydrogel were culture-positive at euthanasia and found to display lower humeral stiffness values and higher histopathological scores for bacterial presence in comparison with equivalents receiving the gentamicin-loaded HApN hydrogel, which were also infection-free. In summary, our data showed that HApN was an effective antibiotic carrier that did not affect fracture healing. This data supported its suitability for application in fracture care. Addition of osteopromotive compounds could provide further support for accelerating fracture healing in addition to successful infection prophylaxis.

The stability and microbial contamination of bupivacaine, lidocaine and mepivacaine used for lameness diagnostics in horses

Local anaesthetics (LAs) are frequently used for diagnostic procedures in equine veterinary practice. The objective of this study was to investigate the physico-chemical stability and bacterial contamination of bupivacaine, lidocaine and mepivacaine used for lameness examinations in horses. The LAs were stored in 12 different groups at different temperatures (−18 °C to 70 °C), light intensities and in common veterinary field conditions for up to 16 months. The pH, presence of bacterial contamination and concentrations of LAs and methylparaben (a preservative present in lidocaine) were determined serially in both new and repeatedly punctured (RP) vials.Mepivacaine remained chemically stable. A 1.9% increase in bupivacaine concentration was evident in one group, whereas a 1.9–3.7% decrease was noted in six groups. Risk factors associated with a change in concentration were light and RP vials. Lidocaine concentration decreased 6.3% in one group and increased 5.3–7.2% in two groups. Risk factors for degradation were heat and RP vials whereas storage in practice vehicles was a risk factor for increased concentrations. Methylparaben decreased 8.3–75.0% in seven groups, and RP vials, heat and storage in practice vehicles were risk factors for degradation. No contamination was present in any of the LAs and pH remained stable. Commercially available solutions of lidocaine, mepivacaine and bupivacaine stored under common veterinary field conditions are extremely stable and sterile for extended periods. The minor changes in concentration documented in this study are unlikely to affect anaesthetic efficacy during equine lameness examinations. When using products containing methylparaben, degradation of the preservative over time is to be expected.

English

Patients and professionals involved in dentistry are constantly exposed to potentially pathogenic microorganisms, which may be present in agents such as instruments and equipment, among others. The production of orthodontic appliances, as well as other dentistry work, is carried out in a dental laboratory where there is potential for cross-infection. Nevertheless, studies which evaluate the presence of bacterial contamination of orthodontic appliances after routine procedures in the dental laboratory are not enough. Also, there is no established clinical protocol for infection control of orthodontic appliances before they are installed in the patient. This study aimed at evaluating bacterial contamination of orthodontic appliances and the effectiveness of disinfection with 2% chlorhexidine and 0.12% chlorhexidine. Two microbiological collections were done from 60 orthodontic appliances made of chemically active acrylic resin. The first collection was made before disinfection and the second was done after, in order to evaluate bacterial growth. After analysis, it was found that 85% of sampled devices introduced were contaminated and that disinfection protocol performed with 2% chlorhexidine was effective. Furthermore, the adopted disinfection protocol should have the device soaked in 2% chlorhexidine for 10 min to prevent patient contamination from contaminated orthodontic appliances. Key words: Orthodontic appliances, chlorhexidine, disinfection.

Polylactic acid nanosheets in prevention of postoperative intestinal adhesion and their effects on bacterial propagation in an experimental model.

Ultrathin films (nanosheets) adhere tightly to organ surfaces but prevent adhesion to other organs. The antiadhesive effect of nanosheets and their effect on bacterial propagation were investigated in a murine intestinal adhesion model. Polylactic acid nanosheets (approximately 80 nm thick) were produced. Serosal defects were created by peeling off the intestinal serosa; these were left open or covered with nanosheets or Seprafilm® and the formation of intestinal adhesions was analysed. To examine bacterial propagation, a nanosheet or Seprafilm® was placed on intact murine jejunum followed by Escherichia coli inoculation at the site. Treatment both with nanosheets and with Seprafilm® reduced postoperative intestinal adhesion (mean adhesion score 0·67 for nanosheets, 0·43 for Seprafilm® and 2·87 for no antiadhesive treatment; P < 0·001 for nanosheets or Seprafilm® versus no adhesive treatment). Nanosheet treatment did not affect bacterial propagation in the peritoneal cavity, whereas Seprafilm®-treated mice showed bacterial propagation, leading to increased mortality. Nanosheets may be effective novel antiadhesive agents even in the presence of bacterial contamination. Surgical relevance Intra-abdominal adhesions following surgical contamination can trigger postoperative complications and lead to deterioration in long-term quality of life. However, currently there are no effective antiadhesion materials to prevent the formation of adhesions. Treatment with ultrathin nanosheets effectively reduced postoperative intestinal adhesion in an experimental mouse model, and did not affect bacterial propagation in the peritoneal cavity. These nanosheets are potent novel antiadhesive materials that potentially can be applied even in contaminated conditions.

Effects of Fibronectin Coating on Bacterial and Osteoblast Progenitor Cells Adherence in a Co-culture Assay.

Bacterial adherence to the surface of implants functionalized with cell-adhesive biomolecules is a critical first step of infection development. This study was designed to determine how the immobilization of human plasmatic fibronectin (pFN) could impact bacterial and osteoblast cells interaction with the surface during concomitant exposition to the two cell-types. Calibrated suspensions of P. aeruginosa PAOI or S. aureus CIP4.83 bacteria and STRO-1+A osteoblast progenitor cells were mixed, co-seeded on glass coverslips coated or not with pFN and incubated at 37 °C. After 3 h of co-culture, the presence of bacteria did not modify the STRO-1+A cells adherence to glass. pFN coating significantly enhanced STRO-1+A cells, CIP4.83 and PAOI adherence to glass and bacterial interaction with STRO-1+A cells. Confocal laser scanning microscopy observations revealed that cells on the pFN-coated substrate exhibited a greater spreading, better organized network of cytoskeletal filaments, and an increased cellular FN expression than cells on the uncoated substrate. The use of fluorescently labeled pFN showed that adherent STRO-1+A cells were able to remodel and to concentrate coated pFN at the cells surface. Thus, the use of FN coating could increase the risk of bacterial adherence to the material surface, acting either directly onto the coating layer or indirectly on adherent osteoblastic cells. This may increase the infection risk in the presence of bacterial contamination.

Evaluation of bacterial contamination in raw milk, ultra-high temperature milk and infant formula using single molecule, real-time sequencing technology

The Pacific Biosciences (Menlo Park, CA) single molecule, real-time sequencing technology (SMRT) was reported to have some advantages in analyzing the bacterial profile of environmental samples. In this study, the presence of bacterial contaminants in raw milk, UHT milk, and infant formula was determined by SMRT sequencing of the full length 16S rRNA gene. The bacterial profiles obtained at different taxonomic levels revealed clear differences in bacterial community structure across the 16 analyzed dairy samples. No indicative pathogenic bacteria were found in any of these tested samples. However, some of the detected bacterial species (e.g., Bacillus cereus, Enterococcus casseliflavus, and Enterococcus gallinarum) might potentially relate with product quality defects and bacterial antibiotic gene transfer. Although only a limited number of dairy samples were analyzed here, our data have demonstrated for the first time the feasibility of using the SMRT sequencing platform in detecting bacterial contamination. Our paper also provides interesting reference information for future development of new precautionary strategies for controlling the dairy safety in large-scale industrialized production lines.

Glove Changing When Handling Money: Observational and Microbiological Analysis

The purpose of this study was to determine the rate of glove changing by mobile food vendors after monetary transactions, and the presence of bacterial contamination on a sample of dollar bills obtained from 25 food vendors near five hospitals in Manhattan, New York City. During 495 monetary transactions observed there were only seven glove changes performed by the workers. Eleven of 34 food workers wore no gloves at all while handling money and food. Nineteen of 25 one-dollar bills collected (76 %) had 400 to 42,000 total bacterial colony-forming units. Colonies were of varied morphology and size. Of these 19 samples, 13 were selected (based on level of growth), and tested for the presence of coliform bacteria, which was found in 10 of the 13 samples. Effective strategies to monitor and increase glove wearing and changing habits of mobile food vendors are needed to reduce risk of foodborne illness.

Do collagen meshes offer any benefits over preclude® ePTFE implants in contaminated surgical fields? A comparative in vitro and in vivo study

The surgical repair of an abdominal wall defect may be complicated by infection. We examined the in vitro and in vivo behavior of Staphylococcus aureus (Sa) and Staphylococcus epidermidis (Se) when placed in contact with three collagen bioprostheses. For the in vitro study, 1 cm(2) fragments of the collagen meshes (Collamend®, Surgisis®, and Permacol®) and a control polytetrafluoroethylene mesh, Preclude®(ePTFE) were incubated on blood agar plates inoculated with Sa or Se. In the in vivo study, 2 partial 3 × 3 cm defects were created in the abdominal wall of 72 rabbits and infected with a suspension-containing 10(6) Colony-forming unit (CFU) of Sa or Se. The defects were then repaired using the above materials. At 14 and 30 days postimplant, mesh specimens were obtained for histological, morphometric, and biomechanical analysis. The incubated collagen meshes showed significantly greater bacterial loads than the ePTFE. In vivo, large abscesses comprised of bacteria (Sa/Se), detritus and white cells could be seen 14 days post-implant. At 30 days, the bacterial infiltrate was reduced in the Se group. In conclusion, in presence of bacterial contamination, no benefits were observed of the use of the collagen bioprostheses tested over the use of a non porous ePTFE mesh (Preclude®).

Environmental surveillance and molecular investigation of Legionella spp. in Apulia, in the years 2008-2011.

Legionella spp. is considered an emerging microorganism involved in aquatic environments contamination and cause of Legionnaires' disease. The aims of the study are to evaluate the level of contamination of Legionella spp. in the water system of the largest Hospital of Apulia region during a 4-year surveillance and to establish, by molecular method, the presence of a predominant genotype of L. pn. sg 1. The results showed that Legionella spp. was present in 36% of water samples with Legionella pneumophila serogroup 1 (L. pn. sg 1) the most prevalent species and serogroup and the wards most contaminated are the high risk units. In addition, despite four main clones of L. pn. sg 1 were identified, a predominant genotype existed. In conclusion the study demonstrates the necessity for periodic evaluation on hospitals water system to assess the potential contamination of Legionella spp., performing decontamination in the presence of bacterial contamination, even low, in particular in high risk wards. Moreover, the switching of the disinfection methods may be suggested in order to prevent resistance phenomenon by some L. pn. sg 1 clones.

Negative Pressure Therapy for High-Risk Abdominal Wall Reconstruction Incisions

A high rate of surgical site infection (SSI) accompanies the repair of large ventral hernias in the presence of bacterial contamination. Recent clinical and laboratory studies suggest that negative-pressure therapy (NPT) applied to closed surgical incisions may reduce the risk of SSI in high-risk populations. We hypothesized that NPT would reduce the risk of SSI in patients undergoing the repair of contaminated ventral hernias. We reviewed retrospectively our prospectively collected database for patients undergoing repair of potentially contaminated and infected ventral hernias with or without NPT. All of the patients had primary wound closure. In the NPT group, a vacuum dressing was applied over the closed midline wound. The primary outcome measure was SSI at 30 d post-operatively. We evaluated 119 patients (70 with a standard wound dressing (SWD) and 49 with NPT). The groups were similar in age, gender, body mass index (BMI), the prevalence of chronic obstructive pulmonary disease (COPD), diabetes mellitus (DM), and smoking; and the number of prior abdominal operations. The SWD group had a higher American Society of Anesthesiologists (ASA) score than did the NPT group (3.0 vs. 2.8; p=0.01). The two groups were similar in the sizes of their hernia defects and duration of surgery, and did not differ in their 30-d rates of SSI (25.8% SWD vs. 20.4% NPT; p=0.50) or in the distribution of major and minor SSIs (SWD: 6 major, 12 minor vs. NPT: 2 major, 8 minor; p=0.56). Factors associated with an increased risk of SSI included ASA score (p=0.02), BMI (p=0.05), defect area (p<0.01), DM (p=0.01), and duration of surgery, (p<0.01). This retrospective, non-randomized study found that NPT in the setting of a closed surgical incision after potentially contaminated or infected ventral hernia repair (VHR) did not reduce the incidence of SSI. Although prophylactic NPT has reduced wound morbidity in some surgical populations, it does not appear to offer the same reduction in wound morbidity in high-risk, contaminated, and potentially contaminated open VHR.