Significant Difference In Infection Rate Research Articles

Prevalence of Liver Flukes in Some Areas of Salahalddin Province

The present study aimed to diagnosis liver flukes in sheep in Tikrit and Balad districts and compare between prevalence of liver flukes that infect sheep through prevalence of infection and severity of infection. The present study included examination of 951 sheep of both sexes, and aged ranges between less than 1 year and more than 2 years through December 2017 to the end of June 2018. Flukes were isolated directly from liver of sheep. Infected sheep in Tikrit was 97 sheep with prevalence of infection 17.54% and in Balad there was 35 infected sheep with prevalence of infection 8.79%. The highest prevalence of infection in Tikrit recorded in January30.58% and the lowest prevalence of infection recorded in June10% while highest severity of infection was in December it was 2.3 and the lowest severity of infection was in January 1.07 . In Balad discrete highest prevalence of infection recorded in December 13.33% and the lowest prevalence of infection recorded in June 3.84% while highest severity of infection was in December 2.75 and the lowest severity of infection was in January 1.75. The statistical analysis shows that there is no significant difference in infection rate between Tikrit and Balad. 
 

Management of Dog Bite Injuries: Procedural Sedation, Infection, and Operative Indications at a Single-Institution Level I Pediatric Trauma Hospital.

Dog bite injuries are common within the pediatric population. Currently, there are inconclusive data on best sedation practice, antibiotic regimen, and need for plastic surgery referrals for treatment of dog bite injuries in the emergency department (ED) versus operating room (OR). This study set out to determine sedation practice, infection management, and necessity for plastic surgery referral at a level I pediatric trauma center. A retrospective review of all pediatric (0-18 years old) dog bites documented in electronic medical records from January 1, 2010, to December 31, 2019, was performed. Bitten by dog encounters were identified by International Classification of Diseases, Ninth Revision and Tenth Revision codes E906.0 and W54.0, W54.0XXA, and W54, respectively. Data gathered included age, gender, month of injury, circumstance of injury, injury characteristics, location of repair, person performing repair, sedation (if used, then length of sedation), inpatient admission, antibiotics prescribed, dog characteristics (breed, size, sex, age, relationship to patient), and complications. Summary statistics were calculated as mean ± SD. Comparisons for nominal variables were performed using the χ2 test. All analyses were performed using Stata v.16. 1. A total of 1438 pediatric patients were included in this study over a 10-year period. Of injuries requiring repair (n = 846), most repairs were performed in the ED (97.1% [822/846]), whereas 24 (2.8%) required repair in the OR. Of the bites that required repair (n = 846), 81.1% (686/846) were performed by an emergency medicine physician and 147 (17.4%) by plastic surgeons. Procedural sedation in the ED was performed in 146 repairs (17.3%). Documented sedation time ranged from 10 to 96 minutes. Most patients received a prescription for antibiotics (80.5%), usually amoxicillin/clavulanate (90.8%). Infection was the most common sequela (9.5%). There was no significant difference in infection rates between repairs performed in the ED versus those in the OR. Our study indicates that pediatric patient dog bite injuries can be successfully managed in an ED. Procedural sedation has demonstrated no increased safety risks compared with the OR. Rates of infection are also not demonstrated to be significantly higher in repairs done in the ED versus those taken to operating theater.

Role of Surgical Drains in Orthopedics

Abstract Introduction: The use of drains in orthopedic practice has been affected by the concept of evidence-based medicine, which is accepted as the standard of care for all surgical or medical practices. This concept questions all care processes that cannot be backed by evidence to be beneficial to the patient. There have been a large number of multi-center meta-analytical studies that have found drains to be of little or no benefit in trauma and orthopedic surgeries. As a result of these studies, there are few situations where drains are routinely used, such as calcaneal fractures in developed countries. Even major procedures such as total knee and arthroplasties are being performed without drains. We aim to investigate whether similar evidence can be found in our practice. Materials and Methods: This sounds like the description of a prospective randomized controlled trial studying the use of drains in certain types of surgical procedures. The study population consisted of 86 patients matched for sex and type of injury, and they were assigned to either a group that used drains or a group that did not use drains during their operations. The study aimed to observe and compare the rates of complications, such as hematoma, drain migration, infection, and inadvertent drain stitching, between the two groups. Results: Eighty-six major orthopedic operations were studied. There was no evidence of the occurrence of complication arising from nonuse of drains in the undrained group. Those patients whose wounds were drained had no need for drain change, thus making the wound care less eventful. Conclusion: Wound drains can help reduce tissue swelling in the postoperative period, but there is no significant difference in infection rates, hematoma, or seroma formation between drained and undrained wounds.

Cross-Sectional Study to Evaluate Infection in Operation Theater and Difference in Infection Pattern Between Laminar Air Flow and Non-Laminar Air Flow Operation Theaters

This was a cross-sectional study to compare the infection rate between laminar air flow and non-laminar air flow operation theater (OT). This was bi-center study and study places were the OT complexes of Sylhet Women’s Medical College Hospital (SWMCH) and Al Haramain Hospital Pvt. Ltd. of Sylhet. A Total 24 samples were collected from 12 OTs. Air and wall swab both types of samples were collected from each OT. Out of these 12 OTs 4 had laminar air flow system. Half of the air samples (50%) and 8.3% of wall samples were infected, whereas overall organism isolation rate was 29.17%. Among all the infected samples 25% were from laminar air flow OTs and the rest 75% were from non-laminar air flow OTs. Commonest isolated bacteria was staphylococcus epidermidis (62.5%) followed by bacillusspp (25%) and staphylococcus aureus (12.5%). staphylococcus epidermidis was predominantly found in General Surgery, Obstetrics and septic OTs. Distance from entry or toilet did not show any significant difference in infection rate in operation theaters.

Epidemiological Profile and Spatial Patterns of Enterobiasis in Children Aged 3-9 Years in China from 2016 to 2020.

(1) Background: Enterobius vermicularis infection causes a significant health burden in children. The infection occurs throughout the country and remains a serious public concern in China. Therefore, it is necessary to know the situation of E. vermicularis infection, to provide a scientific basis for the disease control and the optimum conditions for children's growth. (2) Methods: Descriptive epidemiological analysis was implemented to demonstrate the status and changing trend of E. vermicularis infection from 2016 to 2020, while the spatial distribution characteristics and spatial-temporal clustering were illuminated by spatial autocorrelation analysis and spatio-temporal scanning analysis. (3) Results: The infection of E. vermicularis showed a fluctuating downward trend with a decline of 32.00% in 2020 compared to that in 2016 and was concentrated in central and southern China. There was no significant difference in infection rate between boys and girls, while the high infection rate was presented in 4-, 5- and 6- year-old children. The hotspots and spatial clustering areas were mainly concentrated in southern China. (4) Conclusions: From 2016 to 2020, the infection rate of E. vermicularis in children aged 3 to 9 years in China demonstrated a declining trend, and its distribution showed spatial clustering, mainly in southern China. Therefore, it is necessary to strengthen surveillance and implement control measures in combination with health education and environmental improvement.

Predicting Risk of Infection Based on Immunoglobulin Nadirs after CD38 Monoclonal Antibody Treatment in Multiple Myeloma

Background: Anti-CD38 monoclonal antibodies are used to treat newly diagnosed and relapsed or refractory multiple myeloma. Previous studies have shown an increased risk of infection while on daratumumab due to the immunosuppressive effect on malignant and normal plasma cells. We sought to retrospectively analyze and further understand the correlation of immunoglobin levels and risk of infection during treatment with anti-CD38 monoclonal antibodies in Multiple Myeloma. Methods: Analysis was performed on data from 261 patients who had received anti-CD38 monoclonal antibody therapy as part of treatment for multiple myeloma between November 11, 2016, and May 11, 2022. 51.7% were male and 48.3% were female. 47.1% of the patients identified as Black, 46% as White, and 6.9% as other races. 14.9% of the patients had Stage I, 41.8% had Stage II and 17.2% had Stage III disease, based on the Revised International Staging System (RISS). Baseline renal disease was present in 35.6% of patients. Median number of anti-CD38 Monoclonal antibody infusions was 16. We examined rates of specific infections (determined by ICD-10 codes), including pneumonia, urinary tract infection, bacteremia, and sepsis, as well as emergency room visits, hospitalizations including ICU stays for up to a year after completing treatment. These rates were correlated with immunoglobulin levels, absolute lymphocyte count, and the presence of concomitant treatment with a proteasome inhibitor or immunomodulator. Results: The overall infection rate among patients receiving anti-CD 38 monoclonal antibody treatment was 32.6%. Bacterial infection developed in 22.2%, viral infections in 17.6%, and fungal infections in 3.4% of patients. SARS-CoV-2 infection rate was 13.4%. The median number of infusions was 15 in those without an infection and 20 in those who developed an infection (p<0.001).19.2% of patients who began anti-CD38 monoclonal antibody treatment during the study period have expired, of whom 56.0 % had an infection. Higher rates of infection were noted with lower IgA levels (p=0.007). There was no significant difference in infection rate with lower IgG and IgA levels or lower absolute lymphocyte levels (p=0.054). However, in patients with an infection there was a longer duration of sub-normal IgG days (114 vs 287 days, p=<0.001), IgA (119.5 vs 215, p=0.006), and IgM (161 vs 274.5, p=0.011). 44.4% of patients had an emergency room visit of whom 40.0% were due to infections (p=0.113). 66.9% of patents required hospital admissions of whom 43.2% had an infection) p<0.001). 18.5% of treated patients required ICU stays of whom 63.9% had an infection) p<0.001). Discussion:Conclusions: A longer duration of subnormal Immunoglobulin levels correlated with higher risk of infection in Multiple Myeloma patients treated with anti-CD 38 monoclonal antibodies. Lowest Ig A levels during treatment correlated with a higher rate of infection while lowest IgG levels did not. Patients who developed infectious complications while on treatment with anti-CD 38 monoclonal antibodies had a significantly higher risk of hospitalization, ICU stays, and death. Prophylactic intravenous immunoglobulin can be studied to evaluate mitigation of infection in the highest risk subpopulation identified in this analysis such as those with prolonged subnormal Immunoglobulin levels. Figure 1View largeDownload PPTFigure 1View largeDownload PPT Close modal

First Experience With Postoperative Transcranial Ultrasound Through Sonolucent Burr Hole Covers in Adult Hydrocephalus Patients.

Managing patients with hydrocephalus and cerebrospinal fluid (CSF) disorders requires repeated head imaging. In adults, it is typically computed tomography (CT) or less commonly magnetic resonance imaging (MRI). However, CT poses cumulative radiation risks and MRI is costly. Ultrasound is a radiation-free, relatively inexpensive, and optionally point-of-care alternative, but is prohibited by very limited windows through an intact skull. To describe our initial experience with transcutaneous transcranial ultrasound through sonolucent burr hole covers in postoperative hydrocephalus and CSF disorder patients. Using cohort study design, infection and revision rates were compared between patients who underwent sonolucent burr hole cover placement during new ventriculoperitoneal shunt placement and endoscopic third ventriculostomy over the 1-year study time period and controls from the period 1 year before. Postoperatively, trans-burr hole ultrasound was performed in the clinic, at bedside inpatient, and in the radiology suite to assess ventricular anatomy. Thirty-seven patients with sonolucent burr hole cover were compared with 57 historical control patients. There was no statistically significant difference in infection rates between the sonolucent burr hole cover group (1/37, 2.7%) and the control group (0/57, P = .394). Revision rates were 13.5% vs 15.8% (P = 1.000), but no revisions were related to the burr hole or cranial hardware. Trans-burr hole ultrasound is feasible for gross evaluation of ventricular caliber postoperatively in patients with sonolucent burr hole covers. There was no increase in infection rate or revision rate. This imaging technique may serve as an alternative to CT and MRI in the management of select patients with hydrocephalus and CSF disorders.

Prevalence of Toxoplasmosis in Sheep and Goats in Pakistan: A Systematic Review and Meta-Analysis.

Toxoplasmosis, a parasitic disease caused by Toxoplasma gondii, results in congenital disorders and miscarriages among livestock and humans worldwide. This systematic review and meta-analysis were conducted to determine the prevalence of T. gondii infection in sheep and goats in Pakistan from 2000 to 2020. We searched the PubMed, Scopus, EMBASE, and Google Scholar databases and selected 17 publications that fulfilled our inclusion criteria. Eight studies were conducted in Southern Punjab, six in Khyber Pakhtunkhwa, two in Northern Punjab, and one in Central Punjab. The diagnostic tests used in the included articles to confirm toxoplasmosis were the latex agglutination test in 56% of the studies, the enzyme-linked immunosorbent assay in 38%, and the indirect hemagglutination assay in 6%. The infection rates were substantially higher among sheep &gt; 1 year of age (37%) than among sheep ≤ 1 year old (19%). Statistically significant differences in infection rates were found between male and female sheep and goats. The overall infection rate by age was also significant among sheep and goats. Sex and age variability between sheep investigations were significant, and sex heterogeneity and age homogeneity were significant among goats. Hence, robust infection control protocols should be implemented to prevent infection in animals and humans.

Preoperative epidural steroid injections do not increase the risk of postoperative infection in patients undergoing lumbar decompression or fusion: a systematic review and meta-analysis.

Epidural corticosteroid injections (ESI) are a mainstay of nonoperative treatment for patients with lumbar spine pathology. Recent literature evaluating infection risk following ESI after elective orthopedic surgery has produced conflicting evidence. Our primary objective was to review the literature and provide a larger meta-analysis analyzing the temporal effects of steroid injections on the risk of infection following lumbar spine surgery. We conducted a query of the PubMed, Embase, and Scopus databases from inception until April 1, 2022 for studies evaluating the risk of infection in the setting of prior spinal steroid injections in patients undergoing lumbar spine decompression or fusion. Three meta-analyses were conducted, (1) comparing ESI within 30-days of surgery to control, (2) comparing ESI within 30-days to ESI between 1 and 3months preoperatively, and (3) comparing any history of ESI prior to surgery to control. Tests of proportions were utilized for all comparisons between groups. Study heterogeneity was assessed via forest plots, and publication bias was assessedquantiatively via funnel plots and qualitatively with the Newcastle-Ottawa Scale. Nine total studies were included, five of which demonstrated an association between ESI and postoperative infection, while four found no association. Comparison of weighted means demonstrated no significant difference in infection rates between the 30-days ESI group and control group (2.67% vs. 1.69%, p = 0.144), 30-days ESI group and the > 30-days ESI group (2.34% vs. 1.66%, p = 0.1655), or total ESI group and the control group (1.99% vs. 1.70%, p = 0.544). Heterogeneity was low for all comparisons following sensitivity analyses. Current evidence does not implicate preoperative ESI in postoperative infection rates following lumbar fusion or decompression. Operative treatment should not be delayed due to preoperative steroid injections based on current evidence. There remains a paucity of high-quality data in the literature evaluating the impact of preoperative ESI on postoperative infection rates. II.

Effect of malnutrition and nutritional support to reduce infections in elderly hospitalized patients with cancer: A multicenter survey in China

ObjectivesMalnutrition is common among elderly patients with cancer, and greatly affects patients’ quality of life. Malnutrition is a key factor in the development of systemic, chronic, low-grade inflammation that can exacerbate. MethodsA total of 633 elderly patients with cancer from 29 tertiary public hospitals in 14 cities in China were selected as the research subjects. Physical examination, questionnaire survey, medical history collection, and blood index detection were performed on the research subjects to analyze the relationship between malnutrition, nutritional support, and infection status. ResultsThere was no significant difference in infection rate among elderly hospitalized patients with cancer and different cancer types, cancer stages, or therapy methods (P > 0.05). The proportion of vomiting, loss of appetite, depression, and physical fatigue in patients with good nutritional status were lower than in patients with moderate or severe malnutrition (P < 0.05). Nutritional support is crucial for the nutritional status of elderly patients with cancer, and patients without special nutritional guidance are more likely to develop infection (P < 0.05). After adjusting for confounding variables, the results of the logistic regression analysis showed that oral nutritional supplements (odds ratio [OR]: 0.088; 95% confidence interval [CI], 0.015–0.514), parenteral nutrition (OR: 0.091; 95% CI, 0.011–0.758), and individualized nutritional guidance (OR: 0.026; 95% CI, 0.003–0.202) were all protective factors associated with cancer infection. ConclusionsMany elderly hospitalized patients with cancer have local or systemic infections, and good nutrition is associated with lower rates of infection. Receiving nutritional guidance or support is associated with lower infection rates in elderly patients with cancer.

Prevalence of Coccidiosis among local and exotic breeds of reared chickens in Azare Metropolis, Bauchi State Nigeria

Coccidiosis is a deadly disease that hampers chickens’ productivity and welfare. The disease is a major menace to the global poultry industry. Coccidiosis is caused by the apicomplexan parasite of the genus Eimeria. This study investigated the prevalence of Coccidiasis amongst the chickens reared in Azare metropolis. A total number of four hundred 400 feacal samples of live and slaughtered chickens were collected and examined using standard parasitological methods between March and June, 2022. The samples comprised of 246 female and 154 male; 300 exotic species and 100 local species. Chi-square test and simple percentage were used to analyze the generated data and p&lt;0.05 was adopted to determine the level of significance. An overall prevalence rate of 173 (43.3%) was recorded. The prevalence rate was higher in female 138 (56.1%) than male with 35 (22.7%). There was statistically significant difference in infection rate between the sexes of the Chickens. The lower age (1-4weeks) had the highest rate of prevalence rate of 64(59.8%) followed by age (5-16weeks) with 97(38.1%) and Adult (16weeks&gt;above) with lowest infection rate of 12(17.6%). Similarly, high infection rates were observed among local breed 64(64%) than exotic breed 109(36.3%). The difference between the age groups and the two breeds in prevalence rate was statistically significant (p&lt;0.05).Coccidiosis is endemic in both local and exotic chickens in the study area due to poor management system. It is therefore, recommended that good management system of rearing the chickens, regular vaccination against Coccidiosis, maintaining good hygienic practice as well as creating awareness among farmers on effect of this disease on their productivity and welfare should be ensured.

The spread of the parasite Giardia lamblia in the city of Samarra and its effect on some biochemical variables

The current study was conducted on patients infected with Giardia lamblia, who were admitted to Samarra General Hospital and some private laboratories in the city of Samarra / belonging to Salah al-Din Governorate, the age groups ranged from (1-40) years, the work was completed during the period from 10/2/2021 to 1/5/2022. The cases of parasite infestation were diagnosed by examining faeces samples by direct swab method using light microscope to detect the trophic and cystic phases. The current study examined 585 stool samples, the number of infections was 76, and the study includes several criteria (sex, age of residence), lipid profile and blood sugar. The results of the study recorded a significant difference in infection rate at the sex level, and the percentage of males (56.58%) was higher than females (43.42%). While the highest percentage of infection was recorded in the age groups aged (1-10) years in both males and females (38.16%)) and a lower percentage in the age groups ≥40 years (11.84%). The results of the study showed that there was a difference in the rate of infection in the months of the year, if the highest infection rate was in October, November and April, 30.29%, 17.12%, and 25.49%, respectively, and the lowest infection rate was in January, if the infection rate was 5.26%. The study showed that the highest percentage of parasite infection was among the people living in rural areas, and the percentage was 61.71% out of a total of 76, while the percentage of infection among city patients was 38.92%. The results indicated that there was a significant decrease in the level of cholesterol concentrations 162.7 ± 23.1, triglycerides 111.9 ± 26.5 and high-density lipids in the group infected with the parasite compared with the control group. .1 ± 18.8 but a significant increase.

Are Infection Rates Increased After Sterilization of the External Fixator During Staged Internal Fixation of High-Energy Tibial Plateau Fractures?

To compare infection rates after second-stage definitive surgery for high-energy tibial plateau fractures between groups of patients who had the external fixator prepped into the surgical field and those who did not. Retrospective cohort study. Two academic Level 1 trauma centers. Two hundred forty-four patients met inclusion and exclusion criteria between the 2 institutions. Prepping of the external fixator into the surgical field during second-stage definitive open reduction and internal fixation. 162 patients were in the prepped group, and 82 patients were in the nonprepped group. The primary outcome was the rate of deep infection after definitive fixation. Secondary outcome was operative time. There were no significant differences in infection rates between prepped (11.7%) and nonprepped (18.3%) groups ( P = 0.162). Patients in the prepped groups had significantly decreased operative time (168.2 minutes vs. 221.9 minutes, P &lt; 0.001) even after controlling for confounders in regression analysis. There is no increased risk of infection associated with prepping and maintenance of the external fixator during definitive internal fixation for high-energy tibial plateau fractures. These data suggest that this practice may lead to shorter operative times as well. Therapeutic Level III. See Instructions for Authors for a complete description of levels of evidence.

Application-Based Early Interventions of Hardware-Related Infection After Invasive Neuromodulation Prevent Implant Removal

This study aimed to establish a mobile health application to diagnose and treat postdischarge hardware-related infections in a timely manner and prevent the complete removal of hardware or an implantable pulse generator (IPG). We conducted a retrospective and historical controlled study of all patients who had undergone initial hardware implantation at a single center. All participants were aggregated into 2 groups, A (between June 2005 and June 2014) and B (between July 2014 and May 2020). In group B, the Postdischarge Patient Aide was used for wound monitoring. Both groups received regular clinical follow-up. Cases and the range of hardware-related infections were compared. There was no significant difference in infection rate between the groups (1.8% vs. 1.4%, P= 0.413). After application of the Postdischarge Patient Aide, the proportion of patients with early interventions had increased significantly in group B compared with group A (83.3% vs. 20.0%, P < 0.001). The percentage of patients with IPG infection at the time of interventions in group B was significantly lower than that in group A (8.3% vs. 60.0%, P < 0.001). The IPG preservation rate in group B was significantly higher than that in group A (75% vs. 16%, P < 0.001). A mobile health application provides an efficient way to make an early diagnosis, treat a hardware-related infection, and prevent hardware removal. Information on wound healing should be transmitted to the surgery team in a convenient and fast way to prevent infection spreading, which helps to prevent the IPG from being abandoned.

Molecular detection of norovirus and TNF-α polymorphism in children with acute gastroenteritis infection in Samawa, Iraq

Human Norovirus is the leading cause of non-bacterial gastroenteritis in children worldwide, and research into it is critical for outbreak prevention and infection control. The multiplex real time PCR technique was evaluated in this study using 100 specimens (stool and blood) collected from children in Al-Muthanna province. RT-Qpcr for NVGI and NVGII was used to test all samples for Norovirus. The overall incidence rate of human Norovirus infection was 26%, with the first genogroup G1 accounting for only one case (2%) and the second genogroup accounting for 12 cases (24%). The findings revealed a high prevalence of previous virus infection in the age group (1-10) months. Infections occurred equally among males and females, with no significant difference in infection rates; females were infected at a rate of 42%, while males were infected at a rate of 58%. Males were infected at a higher rate (53.8%) than females (46.2%). The results of Tetra ARMS -PCR after DNA extraction for patients and amplification using the previous method show that there are three genotypes for G/G among patients compared to two results for A/A in the control groups. As a result, association and both homozygous as risk factors for HNV infection development.

294 Stem Cell Enriched Fat Grafts Versus Autologous Fat Grafts for Facial Reconstruction: A Systematic Review and Meta-Analysis

Abstract Aim To compare the results of stem cell-enhanced fat grafting to autologous fat grafting for face reconstruction. Method A systematic review and meta-analysis were carried out in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) Guidelines, and an electronic search was carried out to identify all Randomised Controlled Trials (RCTs), case control studies, and cohort studies comparing the outcomes of stem cell-enrichment fat grafting versus routine fat grafting for facial reconstruction. The primary outcome measures were volume retention and infection rate. Secondary outcome measures included post-surgery patient satisfaction, redness and swelling, fat necrosis, cysts, and operation time. For the analysis, fixed and random effects modelling were utilised. Results Eight studies with a total of 275 participants were assessed. In terms of mean volume retention, there was a significant difference between the stem cell-enrichment fat grafting and routine grafting groups (standardised Mean Difference [MD] = 2.49, P 0.00001). However, there was no significant difference in infection rates between the two groups (OR = 0.36, P = 0.30). Except for the operation duration, which was shorter in the latter, the intervention group had similar results to the control group for all secondary outcomes. Conclusions When compared to conventional fat grafting, stem cell-enriched fat grafting is a better alternative for facial reconstruction surgery since it enhances mean volume retention and does not worsen patient satisfaction or surgical complications.

SP1.1.3 Feasibility, safety and cost effectiveness of outpatient removal of ureteric stent following kidney transplantation

Abstract Aims The aim of this study was to evaluate the feasibility, safety, and costs associated with a dedicated flexible cystoscope for the removal of ureteric stents from transplant recipients in the outpatient setting. Methods In our centre, we routinely performed post renal transplant ureteric stent removal in theatres. Recently we have switched this practice to outpatient settings. We performed retrospective analysis of prospectively collected data from two settings between Aug 2018-Dec 2021 to compare the impact on the timing of post renal transplant ureteric stent removal, associated complications, cost effectiveness and patient satisfaction. Results In total 99 ureteric stents were removed from 100 transplant recipients in theatre and 100 stents in outpatient department. 2 patients in clinic cohort did not tolerate procedure under LA. 5 patients in theatre cohort and 6 patients in clinic cohort underwent PD catheter removal in theatres along with stent removal. Earlier stent removal was achieved in clinic compared with theatre with (36 versus 55 days after transplant; p=0.001) There was no statistically significant difference in infection rates following stent removal in either groups. Outpatient stent removal proved to be very cost effective to the trust with savings of over £250 per procedure in comparison to the theatre setting. Patient satisfaction was measured by numerical rating score for pain and discomfort which showed that the patients tolerated the outpatient procedure under local anaesthesia very well,(mean score 4/10). Conclusions A dedicated outpatient ureteric stent removal service for kidney transplant recipients seems to be feasible, cost effective, and safe.

Do Post-injury Prophylactic Antibiotics Reduce Infection for Isolated Midface Fractures: A Cohort Study

Fractures of the midface are a core component to the practice of contemporary oral and maxillofacialtrainees and surgeons. As such, in an era where antibiotic resistance is increasing it is important to investigate if antibiotics are required after midface fractures to prevent infections before follow-up in an outpatient setting. The purpose of this study is to determine whether postinjury prophylactic preoperative antibiotics reduce rates of infection after midface fracture. A retrospective multicenter cohort study was conducted in Queensland, Australia. Patients who presented to Royal Brisbane Hospital and Townsville Hospital with isolated midface fractures betweenJanuary 2017 and January 2019 were included. Clinical and demographic data of patients who received postinjury prophylactic antibiotics were compared to those who did not using the χ2 test. Logistic regression was used to determine factors associated with increased odds of postinjury prophylactic antibiotic prescription. In total, 1,353 patients with midfacial fractures over the 2-year period were included. In addition, 724 (53.5%) patients received postinjury antibiotics and 629 (46.5%) patients did not. The overall rate of infection was very low: 1 patient who received postinjury prophylactic antibiotics (0.1%) developed infection compared to 2 patients (0.3%) who did not receive postinjury prophylactic antibiotics, and this difference was not significant (χ2=0.49; P=.48). Male sex (odds ratio 1.4; 95% confidence interval, 1.1 to 1.7; P=.02) and tobacco use (odds ratio 1.4; 95% confidence interval, 1.1 to 1.7; P=.008) were associated with an increased odds of postinjury prophylactic antibiotic prescription in the univariate analyses,but were no longer significant once site, age, and fracture type were adjusted for in the multivariate model. The rate of infection after midface fracture was low and there was no significant difference in infection rates for patients who received postinjury prophylactic antibiotics compared to those who did not. Use of postinjury prophylactic preoperative antibiotics for midfacial fractures should be reconsidered.

Prevalence and Genotype Distribution of High-Risk Human Papillomavirus Infection among Women in Beijing, China: A Two-Year Cross-Sectional Comparative Study

Objective: Our study aimed to observe the dynamic epidemiological characteristics of high-risk human papillomavirus (HR-HPV) infection among women in Beijing, China, between 2015 and 2020. Methods: A retrospective analysis was performed on all collected cervical specimens from women who underwent HR-HPV examination in the outpatient clinic, ward, and physical examination center of Beijing Chao yang Hospital, Capital Medical University, from April to December 2015, and from April to December 2020. Real-time polymerase chain reaction (PCR) was applied to detect 15 HR-HPV genotypes. Results: A total of 26003 patients were enrolled in the study. No statistical difference was detected in the HR-HPV infection rate between the two years (22.1% versus 23.1%, P&gt;0.05). The top five genotypes were HPV52/58, 16, 56 and 51, in descending order in both years. Single HR-HPV infection was the most frequent infection type in both years. The proportion of single infection in 2015 and 2020 were 73.32% (2218/3025) and 76.22% (2167/2843), respectively. There was no significant difference in infection rates across age groups in 2015, but the infection rate curve of 2020 was “bimodal”, with two peaks in young women (≤24 years-old group) group and the 60-64 years-old (y) group, with the trough in the 45-49y group. Conclusions: There was no significant change in the overall HR-HPV infection rate of women in Beijing, and the genotype distribution of HR-HPV seldom changed except for the age-related infection rate during the last 5 years. These findings may provide baseline information for local administrations topromote targeted HPV screening and HPV vaccination.

Poster 103: Incidence of postoperative infections in rheumatic disease patients undergoing arthroscopy was not affected by use of immunosuppressive medications

Objectives:Although guidelines exist for perioperative management of immunosuppressive (IS) treatment in rheumatic disease patients around the time of total joint arthroplasty, there are no such guidelines or reports in the literature for arthroscopy. The purpose of this study is to compare the incidence of infectious complications in patients with rheumatic diseases undergoing arthroscopic surgery who either 1) remained on IS perioperatively, 2) held IS perioperatively or 3) were not on IS at baseline.Methods:We conducted a retrospective review of all arthroscopic surgeries in patients with a rheumatic disease diagnosis at our institution over a 10-year period. Inclusion criteria included an underlying diagnosis of one of the following: spondyloarthritis (reactive arthritis, psoriatic arthritis, ankylosing spondylitis, enteropathic arthritis), rheumatoid arthritis, systemic lupus erythematosus, juvenile idiopathic arthritis, polymyalgia rheumatica, dermatomyositis, polymyositis, and sarcoidosis. Patients on IS at baseline (medication classes including conventional synthetic disease-modifying drugs (csDMARDs), biologics, janus kinase (JAK) inhibitors, glucocorticoids, or a combination of two or three of medications) were grouped into those who remained on IS perioperatively versus those who had IS held before the date of their surgery. These two groups were compared to patients who were not on IS at baseline. Demographic data and 90-day postoperative infections (superficial surgical site infections (SSI), deep SSI, septic arthritis, and prosthetic joint infection) were analyzed. Incidence of postoperative complications was calculated for the three cohorts and by medication class. Analysis of variance (ANOVA) was used to determine the statistical significance of between-group differences in postoperative infection incidence.Results:We identified 1,316 rheumatic disease patients undergoing arthroscopy, with 214 of them taking IS medications at baseline. Among patients on IS, patients were most frequently on glucocorticoids (5.2%, n= 69), followed by a combination of 2 or more immunosuppressive medications (3.8%, n=50), csDMARDS (3.6%, n=48), biologics (3.4%, n=45), and JAK inhibitors (0.2%, n=2). Overall, 8.4% (n=110) remained on IS perioperatively, 7.9% (n=104) held IS perioperatively, and 83.7% (n=1102) were not on IS at baseline. There were two cases (1.82%) of infections among patients remaining on IS perioperatively (one on glucocorticoids and the other taking multiple medications), zero cases (0%) of infection in patients who held IS, and four cases (0.36%) of post-operative infection in patients who were not on IS at baseline. There was no statistically significant difference in infection rates among the three cohorts – nor any stratified risk between the various medication classes.Conclusions:This study is the first to suggest that patients with rheumatic diseases undergoing arthroscopy may remain on immunosuppression perioperatively without significant risk for infection.