Causes And Treatment Of Biofilm Formation

My practical competencies have been obtained through working with a general and orthopaedic surgeon. Whilst working with my clinical supervisor, (a consultant orthopaedic surgeon) we decided it would be beneficial to review orthopaedic wound infections. I chose to concentrate on wound infections during a Total Hip Replacement (THR). Wound infections is a massive subject so I have selected specific areas to look at, which are:

Sterile Processing compromises a service of which the medical and surgical supplies of any medical facility’s equipment and instrumentation- sterile or non-sterile are cleaned, prepared, processed, stored, and distributed throughout the healthcare facility. There are several functions of this highly skilled team perform on a daily basis from decontamination to the sterilization of high risk medical implant devices. They are the first line of defense in infection prevention for any patient receiving medical treatment in healthcare facilities. Japp (2014) affirmed the importance of properly processing medical devices performed by Sterile Processing technicians for patient safety by stating a critical point “Not following the correct process can be detrimental to the patient as the device that we are assuming is safe for the patient may all actually cause severe illness or death” (p.

Catheter-Associated Urinary Tract Infection (UTI) 8.Vascular Catheter-Associated Infection 9. Deep vein thrombosis or pulmonary embolism following total knee replacement and hip replacement procedures 10. Certain Surgical Site Infections, including Mediastinitis after Coronary Artery Bypass Graft (CABG), following certain orthopedic procedures, and following bariatric surgery for obesity.

Conduct a literature search to locate research articles focused on a practice problem of interest. This literature search should include both quantitative and qualitative peer research articles to support your practice problem or issue of interest in 350-750 words.

During this talk, Dr. Shah discussed his experience identifying and diagnosing prosthetic infections. Then he starts pointing out the current challenges he has been able to identify and presented a thoughtful literature review about common practices during the identification of join infections. The overall conclusion was that there is no test that allow to accurate identify join infection and this also affects treating the patient. Patients that undergo join surgery and get back with swelling, change in color in join area, and pain are part of the group easy to diagnose yet with a significant infection difficult to treat. However, when patients get back to the doctor early on during the infection when the signs are not that obvious, all comes down to clinical judgement.

Lens case contamination is a well-documented occurrence for contact lens wearers despite the efficacy of contact lens disinfectants. Several microorganisms have a propensity to attach to surfaces and may become more tolerant of disinfection upon attachment. Contact lens case is one of the accessories which become contaminated easily and more prone to biofilm formation. Since last few decades the modification of the biomedical devices has attracted attention and the application of the antimicrobial surface is one of them to eliminate microbial contamination. Silver is an established and proven antimicrobial with efficacy against both Gram positive and Gram negative bacteria. In vitro studies evaluating the antimicrobial efficacy of silver-impregnated

It is very crucial for surgical site infection (SSI) be prevented since they are associated with increased antibiotics use, high healthcare costs, prolonged hospital stay, increased patient discomfort and they may also result to patient’s death. Completing a full clinical assessment is very important in identification of risk factors for developing SSI such as patient-related (endogenous) and the environment (exogenous) factors. Some of the risk factors are modifiable such as obesity, malnutrition, and tobacco use (Harrington, 2014).

A study from Costa et al. pointed out that over a 5-year period, 0 to 14.4% of the dental implants demonstrated peri-implant inflammatory reactions which were associated with bone loss that may eventually lead to the implant failure. Besides, Peri-implantitis has been divided into three categories according to the pocket depth and bone loss (table 3).

Bacterial biofilms are a major barrier in terms of wound healing. During cell to cell

Surgical site infections (SSIs) are the most common nosocomial infections among surgical patients and the second or third most frequent hospital acquired infections in general hospitals (1). SSIs cause destruction of tissue, pain, scars, and fail in wound healing and increasing risk of morbidity in surgical patients(2). The susceptibility data collected in some study suggested that some antibiotic agents can be ineffective against the common bacterial pathogens isolated from SSIs. However the inappropriate administration of antimicrobials in preoperative prophylaxis is still a problem(3). Among antibiotic resistance organisms MRSA, is an increasing important nosocomial pathogen that causes SSIs and complicates treatment for these infections(4).

Biofilms are hard to treat for many reasons. The main reason is because they are highly resistant to antibiotics. This is because the outer cells protect the inner cells from the antibiotic. Therefore, a long-term treatment of antibiotics is required to help the biofilm related infection. Living in groups, give bacteria properties they didn't have when living alone. Another reason they're hard to treat is because they are undefeatable by the body's natural immune defense system. Biofilms avoid chemical disinfection in two different ways. The first is that a gel-like polysaccharide layer provides a physical barrier against any outside agent, biological or chemical. The second is that even if a biocidal agent is introduced in a large enough quantity to eliminate the living bacteria, then

Infection is the most dreaded complication in orthopedic surgery. It causes increased morbidity and mortality and is a source of great harassment not only for the patient but the doctor as well. Incidence of Surgical site infection in USA is more than 2% [1]. Whereas in India the infection ranges from 2.5 – 41% [2]. This causes an increase in the mortality rate by 2-3 times. The rate of postoperative infection in procedures like total hip replacement (THR) and total knee replacement (TKR) is 1 – 5%. [3]

Pseudarthrosis was the most common diagnosis overall (49.1%) in which intra-operative cultures were obtained, followed by recurrent index disease (17.0%). Pseudarthrosis was also the most common revision surgical diagnosis where cultures were positive (55.6%). Including all patients who had revision surgery for the diagnosis of pseudoarthrosis (both cultured and not cultured), 18.9%(24/127) had positive cultures. When pseudarthrosis was the primary diagnosis at revision surgery and cultures were taken, Propionobacterium acnes was cultured in 54.2% of cases; though, this was not stastistically more common than other organisms (p = 0.6381). Overall, staphylococcal species were found most commonly (57.8% of cases), but Propionobacterium acnes was at least one of the isolates in 48.9% of cases and was the most common organism isolated. Polymicrobial cultures were obtained in 22.2% of cases. MRSA infections were found in only 6.7% of cases. Non-instrumented cases were significantly more likely to develop an infection (p = 0.0253) than instrumented cases. Positive cultures were seen more commonly in non-fusion cases than fusion cases (p = 0.027). Those fused to the sacrum were less likely to have positive cultures than those who did not have fusion to the sacrum (p = 0.032).

Despite the ubiquitous presence of P. acnes on human tissues, information about its role in human diseases still remains debated (Portillo et al. 2013). Several studies have reported the ability of this organism to act as an opportunistic pathogen, with suggested pathological roles in a variety of inflammatory diseases such as acne vulgaris and discitis (Achermann et al. 2014, Rollason et al. 2013). Studies have revealed that this organism comprises of several distinct evolutionary clades which have been further discriminated based on Multilocus sequence typing into phylogenetically distinct clusters (type IA, IB, IC, II, and III) (Kilian et al. 2012). These clades differ in their production of virulence factors which can

Several factors determine whether a percutaneous device might get infected. These include improper surgical technique, an existing infection at the implantation site, the introduction of microorganism during the surgical procedure, patients with conditions that compromise healing, improper cleaning of the device after implantation, or misuse of the device.