Skin Antiseptics Research Articles

Impact of a Polyhexanide-based Antiseptic Skin Solution on Candida auris Colonization and Invasive Fungemia.

Impact of a Polyhexanide-based Antiseptic Skin Solution on Candida auris Colonization and Invasive Fungemia.

Antibiofilm and Antimicrobial Potentials of Novel Synthesized Sulfur Camphor Derivatives.

The question being posed by scientists around the world is how different chemical modifications of naturally occurring compounds will affect their antimicrobial properties. In the current study, sulfur derivatives of camphor containing a sulfur atom were tested to detect their antimicrobial and antibiofilm potentials. The new compounds were tested on eight Gram-positive strains (S. aureus (3 isolates), S. epidermidis (4 isolates), and E. faecalis (1 isolate)) and eight Gram-negative strains (E. coli (6 isolates), A. baumannii (1 isolate), and P. aeruginosa (1 isolate)). The ability of the strains to eradicate a biofilm was evaluated under standard stationary and flow-through conditions using the Bioflux system. Two synthesized compounds, namely rac-thiocamphor (1a) and (S, S)-(+)-thiocamphor (2a), exhibited an effect on the 24 h biofilm formed by the Gram-positive strains. Our results are an important contribution to the science of natural compounds and allow us to classify our sulfur derivatives of camphor as potential prophylactic agents in treating skin infections, antiseptics, and disinfectants. The Gram-negative strains were excluded from further stages of the tests due to their high activity (MIC ≥ 512 µg/mL). On the other hand, the compound with the strongest antimicrobial activity against the Gram-positive strains was 2a, as it led led to a reductions in cell viability of 17-52% (for MIC), 37-66% (for 2MIC), and 40-94% (for 4MIC). In addition, the experimental retention index of thiocamphor was calculated for the first time.

No significant difference in skin contamination during anterior cruciate ligament reconstruction with and without preoperative skin cleaning.

This prospective study aimed to assess whether preoperative antiseptic skin cleansing reduces bacterial contamination and surgical site infections (SSI) following anterior cruciate ligament reconstruction (ACLR). We hypothesized that antiseptic cleaning would lower bacterial load, reducing contamination and early infections. One hundred and nineteen patients scheduled for ACLR were included in this prospective, nonrandomized study. Individuals were divided into two groups. Patients in the intervention group applied octenisan® wash lotion daily for three days before surgery and used the wash solution instead of their usual shower gel. Additionally, they swiped their leg with octenisan® soaked gloves on the morning of the operation. The control group followed their usual wash routine with no specific instructions. Fluid samples were taken before surgery from the irrigation bag and at 15-min intervals from the reservoir of the sterile surgical drape during the procedure. Suture material used for the ACL graft and meniscus repair were also collected for testing. The samples were subjected to a 14-day incubation period. Follow-up included outpatient visits at 6 weeks, 12 weeks and 6 months with a final evaluation at 12 months. Contamination rates showed no significant difference between the control and intervention groups. The mean contamination rate in the control group was 6.4% (n = 22) and 6.6% (n = 24) in the intervention group (p = 0.28). At 12-month follow-up, 110 out of 119 participants were included (52 control, 58 intervention). T tests for age (p = 0.19), BMI (p = 0.66), and surgery duration (p = 0.38) showed no significant differences. No early SSI were observed in either group postoperatively. Our results indicate that the use of antiseptic wash lotion and gloves does not influence the risk of bacterial contamination during surgery. Level III.

Assessment of the Level of Awareness and Degree of Implementation of Central Line Bundles for Prevention of Central Line-associated Blood Stream Infection: A Questionnaire-based Observational Study.

The objective of this study was to assess the extent of knowledge and application of central line bundles in the intensive care unit (ICU) of a tertiary care hospital for the purpose of avoiding central line-associated bloodstream infections (CLABSI). This assessment was conducted through the use of a questionnaire. A cross-sectional study was conducted in the ICU, involving doctors and nurses. The study was observational in nature. The study employed a methodical validated questionnaire to evaluate the level of knowledge, attitude, and practice of central line bundles for the prevention of central line-associated bloodstream infections (CLABSI). The questionnaire was designed using preexisting awareness surveillance systems, infection control measures, and patient care practices that were specifically relevant to CLABSIs in the ICU. The data were analyzed utilizing SPSS. The research involved a total of 93 healthcare professionals, consisting of 67 physicians and 26 nurses. The mean knowledge score among participants was 82%, with higher scores reported in individuals who had training in central line bundles. Healthcare professionals exhibited robust compliance with hand cleanliness, antiseptic skin preparation prior to insertion, aseptic draping of the patient, utilization of utmost sterile barriers, verification of central venous catheter (CVC) tip placement using chest X-ray or fluoroscopy, and preservation of a sterile environment. The study emphasized the significance of training in enhancing understanding and adherence to central line bundling protocols in ICUs. Participants exhibited a high level of knowledge and commitment to recommended practices, indicating that this training can have a favorable effect on CLABSI rates. Singh S, Sharma A, Dhawan M, Sharma SP. Assessment of the Level of Awareness and Degree of Implementation of Central Line bundles for Prevention of Central Line-associated Blood Stream Infection: A Questionnaire-based Observational Study. Indian J Crit Care Med 2024;28(9):847-853.

Antiseptic skin preparation and surgical site infection: time to re-evaluate surveillance and the evidence?

Antiseptic skin preparation and surgical site infection: time to re-evaluate surveillance and the evidence?

Antimicrobial Strategies Proposed for the Treatment of S. pseudintermedius and Other Dermato-Pathogenic Staphylococcus spp. in Companion Animals: A Narrative Review.

The treatment of dermato-pathogenic Staphylococcus spp., particularly Staphylococcus pseudintermedius, in companion animals presents significant challenges due to rising antimicrobial resistance. This review explores innovative strategies to combat these infections. We examined novel antimicrobials and the repurposing of existing drugs to enhance their efficacy against resistant strains. Additionally, we evaluate the potential of natural products, nanomaterials, and skin antiseptics as alternative treatments. The review also investigates the use of antimicrobial peptides and bacteriophages, highlighting their targeted action against staphylococcal pathogens. Furthermore, the role of adjuvants in antibiotic treatments, such as antimicrobial resistance breakers, is discussed, emphasizing their ability to enhance therapeutic outcomes. Our analysis underscores the importance of a multifaceted approach in developing effective antimicrobial strategies for companion animals, aiming to mitigate resistance and improve clinical management of staphylococcal skin infections.

Risk of COVID­-19 Infection among Employees of a Large Anti­tuberculosis Institution in Moscow: Survey Results

Relevance. Studying the experience of working under the conditions of COVID-19 allows us to more effectively assess the functioning of anti-epidemic measures in the event of the occurrence or threat of new pandemics, including those caused by new pathogens. The risk of contracting COVID-19 among employees of medical organizations is higher compared to the rest of the population of the metropolis, which determines the need to develop additional measures in medical organizations to protect workers. Timely assessment of risks and preventive measures during a pandemic allow building a system to protect medical institutions from various biological threats when providing medical care. Aim. Assessment of the risks of contracting COVID-19 among employees of a large anti-tuberculosis medical organization in a metropolis. Materials & Methods. A survey of employees of a large anti-tuberculosis medical organization in Moscow was conducted. The survey was conducted on 46 key questions of epidemiological history, compliance with the requirements of the sanitary and anti-epidemic regime, alleged sources of infection, prognostic risks of the occurrence and course of COVID-19. During the period from August 1 to October 1, 2022, 1225 employees of the institution were surveyed (43.8% of the total number). The survey was conducted on a voluntary basis and was anonymous. When answering questions, participants provided information about demographic factors (age, gender), place of actual residence, the fact of contracting a new coronavirus infection, frequency of laboratory testing for SARS-CoV-2, immunization against COVID-19, possible places of contact with patients with COVID-19, the use of personal protective equipment (PPE) at home and at work, the regular use of skin antiseptics, as well as other information that allowed us to establish the risks of infection of workers at home and at work. To assess the risks of infection, respondents were divided into two groups depending on the presence of a positive test for SARS-CoV-2 (group I) or its absence (group II) as of October 1, 2022. The material for testing was nasal/oropharyngeal swabs. The research of employees was carried out on the basis of the laboratory of the anti-tuberculosis medical organization, as well as in other accredited laboratories of the metropolis using the molecular genetic method, and since February 2022 also using the express method that determines the SARS-CoV-2 antigen. Results. Among the survey participants and according to the questionnaire data, 797 employees suffered from the new coronavirus infection COVID-19, and 138 (17.3%) of them had repeated cases of the disease. Factors that increase the risk of COVID-19 among personnel of anti-tuberculosis medical organizations directly involved in the fight against the new coronavirus infection have been identified. The results of the study demonstrated that important factors influencing the incidence of workers were the frequency of examination for COVID-19, the regular use of skin antiseptics, contact with sources of infection, the use of glasses for vision correction, the use of public transport and eating at work. Conclusion. The need to study the risks of contracting COVID-19 among employees of medical organization and, based on them, develop a set of additional anti-epidemic protection measures was confirmed.

Effect of Skin Antiseptics Used in Peripheral Intravenous Catheter Application on Phlebitis Development: A Double- Blind Randomized Controlled Trial

Objective: This study aimed to examine the effect of antiseptics used in peripheral intravenous catheter (PIVC) application on phlebitis development. Methods: This is a double-blind randomized controlled trial that is suitable for the Consolidated Standards of Reporting Trials (CONSORT) statement. The study was carried out at a University Hospital in Turkey. The study participants were 60 patients (experiments 30 and control 30). 2% chlorhexidine was used as a skin antiseptic in the intervention group and 70% alcohol was used in the control group. In both groups, the catheter insertion site was observed every 8 hours for 72 hour. Data were obtained using the “Personal Information Form” and “Phlebit Scale”. Independent samples t-test (t-table value), Mann–Whitney U test (Z-table value) and Fisher’s exact test, continuity correction, or Pearson’s χ2 cross tables were used for data analysis. Results: No statistically significant difference was found between 2% chlorhexidine and 70% alcohol in preventing the development of phlebitis after PIVC application (p > 0.05). No statistically significant relationship was found between the intervention and control groups in terms of sex, BMI, substance abuse, alcohol use, smoking, chronic disease, or PIVC application area (p>0.05). The highest degree of phlebitis that developed in the intervention and control groups was 1st degree. There was also no statistically significant difference between the groups in terms of degree of phlebitis and phlebitis development time (p > 0.05). Conclusions: In line with the findings obtained from this study, it is thought that both skin antiseptics used when inserting a peripheral intravenous catheter are effective in preventing the development of phlebitis and will guide healthcare personnel in the selection of antiseptics.

Effects of Phyllanthus niruri antiseptic skin cream on surgical wounds in Felis catus after ovariosalpingohysterectomy

Studies highlight the cost-effectiveness and lower adverse effects of herbal remedies than allopathic medicines, making them attractive amidst growing microbial resistance concerns. This investigation explored the in vitro antiseptic properties of Phyllanthus niruri alcoholic extract (EA) against Escherichia coli, Staphylococcus aureus, Streptococcus spp., and Candida albicans. Various in vitro methods were employed, including disk diffusion, Minimum Inhibitory Concentration (MIC), and Bactericidal/Fungicidal Concentration (MBC/MFC). A skin cream formulation using P. niruri was developed, undergoing in vivo trials on ten feline subjects post-ovariosalpingohysterectomy (OSH). Felines were treated with P. niruri skin cream (100mg/ml), with 0.1% aqueous chlorhexidine as the positive control. Skin assessments included hyperemia, crust, edema, and exudation. Inhibition was observed in vitro at various EA concentrations, and cytotoxicity analysis showed no harm. The P. niruri skin cream at 100mg/ml exhibited consistent outcomes, with a minor deviation from the fifth day onwards, without compromising therapeutic efficacy (Tukey test, p < 0.05). The formulation demonstrated stable physical-chemical properties with no adverse feline reactions. These findings suggest the skin cream's in vivo antimicrobial potential as a future antiseptic alternative.

Hygienic characteristics of ethanol for preventive use in skin antiseptics

Aim – to study the ethyl alcohol 70% of the Lux brand in respect to its chemical and analytical quality, toxicological safety, microbial effectiveness and to assess its use in skin antiseptics. Material and methods. The studies were performed using organoleptic, physical, chemical, toxicological and microbial analysis in accordance with standard modern methods. Results. Ethyl alcohol 70% has chemical, analytical and microbial quality indicators that meet the requirements of the State Pharmacopeia of the Republic of Belarus. According to toxicological indicators, it belongs to class IV – lowhazard substances, with no irritating effect, which corresponds to the regulatory toxicological indicators of the safety of skin antiseptics. During the primary epicutaneous application on volunteers, it does not cause subjective and objective symptoms of sensitization; it belongs to substances that do not have an irritating effect and sensitizing ability. Standard test cultures and clinical strains of microorganisms are highly sensitive to ethyl alcohol 70% in a qualitative suspension test tube and micromethod without protein load and moderately sensitive in the diskdiffusion method with an exposure of 1 min. In relation to these microorganisms, the antimicrobial activity of ethyl alcohol 70% is above 99.999% and a reduction factor above 5 lg at exposure of 1 min in a quantitative suspension method without a protein load. Ethyl alcohol 70% is also characterized by a high efficiency of normal skin disinfection and E.coli contaminated skin of volunteers over 99% and a reduction factor above 2 lg and 4 lg, respectively. Conclusion. Ethyl alcohol 70% of the brand "Lux" is a highquality, toxicologically safe and microbial effective drug. It can be recommended for skin antisepsis of the injection field (class A), as well as hygienic hand antisepsis (class B) and antiseptic sanitization of the skin in the Republic of Belarus and Russian Federation.

Анализ закупок дезинфицирующих средств в медицинских организациях. Часть 2. 2020–2022?гг.

The COVID-19 pandemic had an impact on all spheres of public health. The multiplied load on medical organizations, forced use of unsuitable premises for treatment of people could not but affect disinfection activities. In addition, given the closed borders in 2020, there was a shortage of both raw materials and ready disinfectants on the market. On the one hand, this situation has led to an explosive interest of the business community in the disinfectants market. This is evidenced by the increased number of disinfectants registered in the Russian Federation from 164 in 2019 to 467 and 471 in 2020 and 2021, respectively. In this study, we analyzed technical specifications for the procurement of disinfectants by medical organizations posted on www.zakupki.gov.ru. Despite the fact that during the period there were relaxations in the procurement legislation that allowed medical organizations to directly purchase disinfectants from suppliers, the analysis revealed significant deviations in 2020 and 2021 in the consumption of disinfectants compared to 2017–2019 and 2022. For example, the consumption of disinfectants based on sodium hypochlorite increased significantly. Also, with the shortage and increased cost of alcohol-based skin antiseptics, purchases of soaps with antibacterial properties have increased, which is especially noticeable in 2021. However, the 2022 purchases indicate that healthcare organizations are returning to normal operations and their consumption of disinfectants is becoming similar to that seen in 2017–2019. Keywords: disinfectants, auctions, hospital-acquired infection.

Optimal antiseptic skin preparation agents for minimizing surgical site infection following surgery: cost and cost-effectiveness analysis.

The application of antiseptic skin agents prior to incision minimizes the rate of surgical site infection. Despite their ubiquity, the optimal skin preparation agent remains uncertain. A retrospective economic analysis was conducted to complement the results from the NEWSkin Prep trial which prospectively compared three preparation agents. A cost and cost-effectiveness analysis was performed from a healthcare service perspective to compare chlorhexidine with 70% ethanol, and aqueous povidone-iodine, against povidone-iodine with 70% ethanol. Resource use estimates accounted for hospital admissions, readmissions associated with surgical site infection, outpatient and general practitioner attendances, visits from community nurses and therapeutic consumables. The measure of effectiveness comprised the net difference in number of patients with surgical site infections per 1000 patients. Costs were compared using a two-sample Welch's t-test. Deterministic and probabilistic sensitivity analyses were performed to evaluate the incremental cost-effectiveness ratio. The null hypothesis that the mean costs for the trial arms were significantly different was not rejected (Welch's t-test P value: 0.771 for chlorhexidine with 70% ethanol against povidone-iodine with 70% ethanol; and 0.955 for aqueous povidone-iodine against povidone-iodine with 70% ethanol). Based on bootstrap averages, the chlorhexidine with 70% ethanol intervention generated 8.0 fewer surgical site infections per 1000 patients and net cost savings of €151,698 (Euros) per 1000 patients compared with povidone-iodine with 70% ethanol, and aqueous povidone-iodine produced a net cost saving of €37,494 per 1000 patients but generated an additional 11.6 surgical site infections per 1000 patients compared with povidone-iodine with 70% ethanol. The comparison of chlorhexidine with 70% ethanol to povidone-iodine with 70% ethanol was sensitive to the inclusion of cost outliers, while the comparison of aqueous povidone-iodine to povidone-iodine with 70% ethanol was sensitive to the estimated cost per surgical site infection. Based on the outcomes from the NEWSkin Prep study, this economic analysis found no definitive evidence in favour of any one of the study comparators. Future model-based economic analyses of alternative skin preparations should critically address the quality of evidence and integrate the results from the NEWSkin Prep study.

Влияние реологических свойств на антимикробную активность изопропилового спирта

Gels are one of the most comprehensive forms of hand hygiene antiseptics. Alcohol-based gels are used in many hospitals around the world for hand antisepsis. The main reason for using antiseptics in gel form is the reduction of skin irritation and dryness and the ease of use (no spillage as quickly as liquid antiseptics when tilting or tipping the bottle). However, gels take longer to dry than other forms, depending on the consistency of the gel. The change in consistency (rheology) has a significant effect on the rate of alcohol evaporation and therefore determines the contact time of the active ingredient with the skin. Since it is believed that the main contribution to antimicrobial activity is made by the active ingredient, and the other components are considered inert, in this work we tested model skin antiseptics based on isopropyl alcohol with different viscosity to evaluate the effectiveness of antiseptics in hand hygiene treatment was carried out in vivo on volunteers. The results obtained do not allow us to unambiguously interpret the effect of viscosity on antimicrobial activity, since up to a gel-former concentration of 1.5?% we observed a decrease in efficacy, and at a concentration of 2?% we observed a concentration higher than that for the aqueous solution of isopropyl alcohol. It follows from our findings that the issue of the influence of viscosity on the antimicrobial activity of skin antiseptics should be studied during disinfectological examination. Keywords: skin antiseptics, gels, rheological properties, hospital-acquired infection.

EFEKTIFITAS PREPARASI KULIT MENGGUNAKAN KLORHEXIDIN 7,5% SETRIMID 15%-POVIDON IODIN 10% DAN POVIDON IODIN 10%-ALKOHOL 70% TERHADAP INFEKSI LUKA OPERASI SEKSIO SESAREA DI RSUD DR. HARYOTO LUMAJANG

Surgical wound infections are the second most common cause of nosocomial infections and have high morbidity and mortality rates. The use of antiseptic skin preparations is effective in preventing surgical wound infections. There is still insufficient evidence to evaluate the type, concentration and method of use of antiseptic agents for skin preparation in cesarean section. The aim of the study was to determine the effectiveness of skin preparation using chlorhexidine 7.5%, cetrimide 15%-povidone iodine 10% and povidone iodine 10%-alcohol 70% against Wound Infections for Caesarean Section Operations in RSUD Dr. Haryoto Lumajang.
 The research design used is quantitative research with a quasi-experimental approach, post test only-control group design. The population in this study were patients who underwent cesarean section at RSUD Dr. Haryoto Lumajangl. The sample was selected by accidental sampling from 27 February 2023 to 25 March 2023, and 66 respondents were found who met the inclusion and exclusion criteria. The samples were divided into 2 groups: the test group (33 samples) received a combination skin preparation of 7.5% chlorhexidine, setrimide 15% - 10% povidone iodine and the control group (33 samples) received a skin preparation combination of 10% povidone iodine - 70% alcohol . Observation of the surgical wound was carried out on day 3 and day 10.
 The results of this study indicated that there was no incidence of surgical wound infection on the third day. Surgical wound infections on the 10th day in the 7.5% chlorhexidine skin preparation group, setrimide 15% - 10% povidone iodine by 2 respondents and in the 10% povidone iodine skin preparation group - alcohol by 4 respondents. But statistically it was not significantly different from the value of p = 0.395, meaning that Ho was accepted and Ha was rejected, so there was no significant difference between skin preparation using chlorhexidine 7.5% setrimide 15% - 10% povidone iodine and 10% povidone iodine - 70% alcohol on the Incidence of Wound Infection by Caesarean Section at RSUD Dr. Haryoto Lumajang.
 With the difference in the incidence of surgical wound infection, it can be considered and an alternative for Dr. Haryoto Lumajang to use skin preparation using 7.5% chlorhexidine, 15% setrimide-10% povidone iodine
 Keywords: Surgical wound infection, skin preparation, chlorhexidine, povidone iodine, alcohol, cesarean section.

Efficiency of octenidine dihydrochloride alcohol combination compared to ethanol based skin antiseptics for preoperative skin preparation in dogs.

To quantify the bacterial burden after skin disinfection using an alcohol octenidine dihydrochloride combination (Octenisept®) compared to an 74.1% ethanol 10% 2-propanol combination (Softasept N®). Prospective randomized clinical trial. 61 dogs undergoing clean or clean-contaminated surgeries (excluding surgeries on the gastrointestinal tract) were randomly assigned to group O (skin disinfection with alcohol and octenidine dihydrochloride after washing with octenidine containing soap) or to control group C (skin disinfection using the ethanol-2-propanol combination after washing with a neutral soap without antiseptic ingredients). Samples were then taken from 8 different locations within the surgical field at four different stages: after clipping, after washing, after disinfection and one hour later. At each stage, two different sampling techniques (wet-dry swab technique (WDS) and contact plates (CP)) were used for quantitative analysis of bacterial counts. WDS detected about 100-fold more bacteria compared to CP sampling in cases with high bacterial burden, but was not accurate enough to detect small numbers. CP sampling was therefore used for comparison of treatment protocols. 30 dogs were assigned to group O and 31 to group C. A relative reduction of 69% in group O and 77 percent in group C was observed after the soap wash. No significant differences were detected between both groups. Washing and disinfection resulted in a reduction of bacterial counts of 99.99% in group O versus 99.7% in group C (p = 0.018). Bacterial reduction one hour after washing and disinfection was significantly higher in group O (99.9%) than in group C (98.5%, p = 0.001). Additional octenidine dihydrochloride provided a slightly better decontamination effect after disinfection, particularly one hour after, which means it may only be indicated in longer surgeries. WDS is more sensitive but less specific to detect bacteria on the skin than the CP sampling.

Effect of aqueous olanexidine versus alcohol-based chlorhexidine for surgical skin antisepsis on incidence of surgical site infections in gastrointestinal surgery: multicentre randomised controlled clinical trial (OEDO trial) protocol

IntroductionSurgical site infections (SSIs) are among the most common nosocomial infections in surgery patients. Two types of preparations, povidone-iodine and chlorhexidine-alcohol, are commonly used in preoperative antiseptic procedures worldwide. However,...

Improving Surgical Safety in Living Donor Renal Transplantation With Antiseptic Skin Preparation, Bladder Irrigation, Corner-Saving Vascular Anastomosis, DJ Stenting, and Extravesical Ureteroneocystostomy Modifications: A Comprehensive Approach.

Introduction The antiseptic skin preparation, bladder irrigation, corner-saving vascular anastomosis, DJ stenting, and extravesical ureteroneocystostomy (ABCDE) approach encompasses a range of modifications applied during different stages of the surgical procedure in renal transplantation. These modifications include the following: A, antiseptic skin preparation sequentially with cetrimide 3.35%, chlorhexidine scrub 4%, spirit, and povidone-iodine 10%; B, bladder irrigation with amikacin and betadine solution;C, corner-saving end-to-side vascular anastomosis; D, DJ stenting with early postoperative removal within three weeks; and E, extravesical ureteroneocystostomy using our institute's modified Lich-Gregoir technique. Methods This prospective observational study was conducted at our institution between March 2021 and May 2023. Data were collected from the patients' medical records and analyzed using Statistical Package for the Social Sciences (SPSS) (IBM SPSS Statistics, Armonk, NY, USA). Statistical tests, including t-test, Mann-Whitney test, chi-square test, and Fisher's exact test, were used for analysis. The study assessed various recipient, donor, intraoperative, and post-transplant factors, as well as surgical complications and stent-related factors. Results Out of 72 renal transplantations, 12 (16.6%) had the followingsurgical complications: urinary(n= 4; 5.5%), wound-related (n= 3; 4.1%), andlymphocele(n= 5; 6.9%). The most common complications werelymphocele(n= 5; 6.9%) and urinary leak (n= 4; 5.5%). Surgical complications were more common in male recipients (91.6% versus 8.3%), as well as in recipients with longer dialysis duration (24 ± 17 versus 11.0 ± 7 months) and had extended hospitalization time (16.4 ± 8.6 versus 8.0 ± 2.9 days) (p < 0.05). Wound infectioncorrelated with longer surgeries (>300 minutes) and other complications. Lymphocele patients had higher drain output (>500 mL) on day 1 and longer hospital stays (>15 days). Urinary tract infections (UTIs) were linked to dialysis duration (>24 months), diabetes, and longer indwelling times of DJ stents and urinary catheters. Early DJ stent removal (<3 weeks) reduced UTI incidence and symptoms (p < 0.05). All complications were categorized as minor (3a or less), according to the Clavien-Dindo classification. Conclusion The modified ABCDE surgical approachin renal transplantation decreased the complications, showing favorable outcomes compared to those in the literature.

Prevention, diagnosis and treatment of cardiac implantable electronic device infections. Position paper of the Italian Association of Arrhythmology and Cardiac Pacing (AIAC)

The number of cardiac implantable electronic device (CIED) implantations has increased over recent years as a result of population growth, increasing life expectancy, adoption of guidelines, and better access to healthcare. Device-related infection is, however, one of the most serious complications of CIED therapy associated with significant morbidity, mortality, and financial healthcare burden. Although many preventive strategies such as administration of intravenous antibiotic therapy before implantation are well recognized, uncertainties still exist about other regimens. Uncertainties have remained about the role of various preventive, diagnostic, and treatment measures such as skin antiseptics, pocket antibiotic solutions, anti-bacterial envelopes, prolonged antibiotics post-implantation, and others. The key aspect to successful treatment of definite CIED infections is complete removal of all parts of the system and transvenous hardware, including the device and all leads. Thus, transvenous lead extraction has been increasing. Expert consensus statements on how to prevent, diagnose, and treat CIED infections and on lead extraction have been published by the European Heart Rhythm Association in 2020 and 2018, respectively. The aim of this AIAC position paper is to describe the current knowledge on the risks for device-related infections and to assist healthcare professionals in their clinical decision making regarding its prevention, diagnosis, and management by providing the latest update of the most effective strategies.

Horizontal approaches to infection prevention: daily chlorhexidine gluconate bathing.

Healthcare-associated infections (HAIs) pose a significant challenge in hospitals. Infection control strategies have been widely employed to mitigate their incidence. In hospitals, chlorhexidine gluconate (CHG) solutions are commonly used as antiseptic skin cleansers as part of comprehensive infection prevention bundles, with daily CHG bathing being highly effective in reducing HAIs and lowering skin micro-organism density. This evidence review addresses the challenges of risk stratification in implementing CHG bathing protocols in hospitals. It highlights the benefits of a horizontal approach, where CHG bathing is implemented across the entire facility rather than being limited to specific patient populations. Evidence from systematic reviews and studies suggests that CHG bathing consistently reduces HAI rates in both intensive care unit (ICU) and non-ICU settings, supporting the adoption of a hospital-wide approach. The findings emphasise the significance of incorporating CHG bathing as part of a comprehensive approach to infection prevention in hospitals and highlight the potential for cost savings.

Что остается за кадром при выборе кожного антисептика

Disinfection of the hands of medical personnel at the present stage is one of the leading measures in the prevention of infections associated with the provision of medical care (HCAI). Regulatory documents regulate the use of alcohol antiseptics. When choosing skin antiseptics, it is necessary to arm yourself with a number of criteria to minimize the risk of transmission of HCAI by contact and household contact, as well as to avoid negative effects on the skin of the hands of medical personnel. The paper presents an analysis and selection of criteria when choosing a skin antiseptic for hygienic hand treatment, based on regulatory documents and the results of randomized trials. The main selection criteria are identified: the type of alcohol and its concentration (by weight) depending on the type of pathogen, the amount of antiseptic for one treatment, the duration of exposure and the presence of additional components and substances. Keywords: hand hygiene, alcohol-based handrubs (ABHR), persistent activity, Ethanol, 1-propanol and 2-propanol, non-enveloped viruses.