Background: Surgical site infection (SSI) poses a serious threat in Neurosurgery. The mere presence of SSI would warrant a prompt medical and/ or surgical intervention for the outcome is very poor. This study aims to establish whether a pre-operative hospital stay of >7 days & other risk factors predisposes to surgical site infections. Methods: Retrospective, cross-sectional study of all pediatric patients who underwent clean neurosurgical procedures for the first time from January 1, 2011- June 30, 2014, in the Philippine General Hospital. The primary outcome was the development of a surgical site infection within 30 days from spine surgery or 90 days from intracranial surgery. Univariate and multivariate logistic regression analyses were performed to show the association of demographic and clinical factors with the development of SSI. Results: 279 medical charts were available for review. Median age was 1 year(5 days to 18 years old). The overall prevalence rate of SSI was 11.26%. Patients with >7 days pre-operative hospital stay had an incidence rate for SSI of 76.47% compared to 23.53% in patients with <7 days pre-operative hospital stay (OR 1.61, CI 0.68-3.84, p=0.280). Conclusions The incidence of SSI is high compared to other centers. There was no association of preoperative hospital stay with SSI. The association was significant only for the history of nosocomial infection. Early pre-operative clearance and surgery are recommended. Further prospective studies and surveillance are warranted
Surgical Wound Infection ; Cross Infection

OBJECTIVE: Chlamydia trachomatis is one of the most common causative microorganism in pelvic inflammatory disease (PID). In this infection tubal obstruction, infertility, tubal pregnancy and recurrent pelvic infection has involved. Also, perinatal infection, spontaneous abortion and preterm labor of pregnant women increased in chlamydia infection. This study was performed to investigate the prevalence rate and clinical characteristics of Chlamydia trachomatis in symptomatic women. METHODS: From March, 2003 to March, 2004, in OB-Gyn development, endocervical swab were obtained in 218 patients (137 impatients of PID and 81 outpatients) by Amplicor Chlamydia Transfer Kits and Human papilloma virus kit. They were studied on history taking, physical examination, laboratory test, and polymerase chain reaction for the detection of Chlamydia trachomatis. Also, in this study we investigated the prevalence of human papilloma virus and N. gonorrhea in the Chlamydia infection group. RESULTS: The prevalence rate of Chlamydia trachomatis was 27.5% (61/218) in pelvic inflammatory disease. As regarding the age distribution of Chlamydia trachomatis positive group was the high prevalence rate in twenties (52.8%). Chlamydia infection was related to the history of artificial abortion, oral contraception, occupation status, history of gynecologic disease (PID, Ectopic pregnancy). Women with chlamydial infection were 2.5 times greater risk of coincidal HPV infection and 2 times greater risk of coincidal N. gonorrhea infection and both were statistically significant. CONCLUSION: The prevalence rate of Chlamydia infection is higher than any other sexually transmitted disease and Chlamydia infection has serious complication on reproduction. It appears weak symptom and detection is difficult. Therefore the screening and treatment of Chlamydia trachomatis are necessary to decrease the prevalence and prevention of complication.
Abortion, Spontaneous ; Age Distribution ; Chlamydia Infections ; Chlamydia trachomatis* ; Chlamydia* ; Contraception ; Fallopian Tube Diseases ; Female ; Genital Diseases, Female ; Gonorrhea ; Humans ; Infertility ; Mass Screening ; Obstetric Labor, Premature ; Occupations ; Papilloma ; Pelvic Infection ; Pelvic Inflammatory Disease* ; Physical Examination ; Polymerase Chain Reaction ; Pregnancy ; Pregnancy, Tubal ; Pregnant Women ; Prevalence ; Reproduction ; Sexually Transmitted Diseases

Introduction: Unstable posterior pelvic ring injuries are best treated with operative methods due to better post-op functional score. Our patient cohort was involved in heavy manual laboring frequently required ground level work in their activities of daily living. There are very few outcome studies dealing exclusively with such patients. Materials & Methods: Forty one patients who were treated with percutaneous sacroiliac screw fixation under fluoroscopic guidance and were followed-up for at least one year were analyzed retrospectively for functional outcome using the Majeed score. Results: Twenty one (51.22%) and thirteen (31.70%) patients were found to be in excellent and good categories respectively and majority of the patients (thirty/73.17%) were able to return to their original occupation with or without minor adjustments. Conclusion: Percutaneous ilio-sacral screw fixation for posterior pelvic unstable injuries is an acceptable mode of treatment in patients involved in heavy manual laboring. laboring
Pelvic Infection

The study retrospectively reviewed 1,029 general surgery operations performed from September 1, 1991 to May 31, 1993 to find out the association between the occurrence of surgical site infection (SSI) and the Centers for Disease Control-National Nosocomial Infection Surveillance (CDC-AWS) surgical patient risk index scores. The index assigned 1 point for each of 3 risk factors: 1) American Society of Anesthesiologists (ASA) preoperative assessment class 3, 4 or 5; 2) an operational classified as either contaminated or dirty-infected; 3) an operation with a duration longer than a specified increased with increasing contamination (p=0.000) as well as increasing index scores (p=0.000). Looking at operations within the same category of contamination, SSI rates also increased with increasing scores among clean operations (p=0.944), clean-contaminated operations (p=0.000), contaminated operations (p=0.559), and dirty operations. SSI rates in this hospital series were compared to the 44-hospital CDC-NNIS report.

Background: Healthcare-associated infections (HAIs) among patients in surgical wards are serious complications that do not only affect surgical outcomes, but also increase medical care costs. Objective: To determine the proportion of patients with HAIs in surgery wards and identify factors associated with HAIs. Design: Cross-sectional study. Setting: Department of Surgery, Southern Philippines Medical Center, from January 2016 to December 2016. Participants: 182 patients from different surgical wards. Main outcome measures: Presence of HAI; prevalence odds ratios (POR) of having an HAI for selected factors. Main results: There were 182 patients (122 males and 62 females; mean age 34.89 ± 20.56 years) included in this report. Seventeen patients (9.34%) developed HAI during admission. Among patients who underwent surgery (n=126), having an HAI was significantly associated with: operation time >180 minutes (adjusted POR=15.18; 95% CI 3.92 to 58.69; p=0.0001), >4 surgical team members (adjusted POR=5.42; 95% CI 1.37 to 21.41; p=0.0158), general anesthesia (adjusted POR=10.46; 95% CI 1.29 to 84.63; p=0.0278), and use of inhalational anesthesia (adjusted POR=11.81; 95% CI 1.45 to 96.08; p=0.0210). Conclusion In this study, 9.34% of patients had an HAI during admission. Long hospital stay, use of indwelling medical devices, long surgical procedures, high number of surgical team members during surgery, general anesthesia, and use of inhalational anesthesia are all associated with having an HAI.
Surgical Wound Infection ; Cross Infection ; Pneumonia ; Anesthesia, General

In search of the best preventive measures against postoperative wound infections, the author has conducted a series of studies which preliminary results are as follows. (1) There were no postoperative secondary infections in 50 surgical cases except in one, which had undergone dacryocystorhinostomy. (2) More than one strain of microorganism were isolated from all of 20 operator's nostril, throat, and peritonsillar region. It is strongly suggested that operators and hospital workers play an important role in the cause of hospital infection. (3) Some difference in the strain of organisms isolated were noted between the countrymen and townsmen. (4) It is urged to pay particular attention to sterilization for lowere abdominal surgery. (5) Chloramphenicol exerted an sustained and excellent broadspectrum antimicrobial activity to various microorganisms.
Chloramphenicol ; Coinfection ; Cross Infection ; Dacryocystorhinostomy ; Pharynx ; Sterilization ; Surgical Wound Infection ; Wound Infection* ; Wounds and Injuries*

PURPOSE: This study was undertaken to find two things. One was to reveal the infection route of methicillin resistant Staphylococcus aureus(MRSA) that causes serious nosocomial infection through epidemic study, and the other was to seek preventative methods through blocking the dispersion. MATERIALS AND METHODS: We cultured MRSA obtained by nasal cavity swabbing, from 82 doctors and 219 personnel in our hospital, between September 1997 and August 1999. In addition, swabs were taken from the nasal cavities and surgical sites of 57 orthopaedic surgery patients, who were free of wound infection. In this practice, we use the disc test for drug sensitivity, and pulse-field gel electrophoresis (PFGE) to separate colonies. RESULTS: MRSA was discovered in 8 doctors (10%) and in 13 personnels (6%) by nasal cavity sabbing, and these included 3 orthopaedic surgeons. MRSA was also found in the patients' group, there were 23 (40%) from nasal cavities and 14 ones (25%) from surgical sites. Their PFGE types of MRSA were of A type, which were also identified in two orthopaedic surgeons. SUMMARY: We noticed that nasal cavitiy infection could occur by cross infection between doctors and patients. Surgical wound infection may occur by infection from the nasal cavity. This study underlines the importance of MRSA infection and management.
Cross Infection ; Electrophoresis ; Humans ; Methicillin Resistance* ; Methicillin* ; Methicillin-Resistant Staphylococcus aureus ; Nasal Cavity ; Staphylococcus* ; Surgical Wound Infection ; Wound Infection

Hansenula anomala is a normal or transient flora of the throat and alimentary tract, and has been reported as an organism causing opportunistic or nosocomial infections in immunocompromised patients, but rarely in immunocompetent hosts. From the review of the literatures, there is no published report on arthritis caused by H. anomala. We experienced a case of H. anomala arthritis in a 59-year old man who had diabetes mellitus and right knee joint swelling with deformity. The findings of magnetic resonance image were consistent with septic arthritis which had bony destruction in distal femur and proximal tibia, abscess formation in joint space, and joint effusion with synovial hypertrophy. A fungus was isolated from a couple of blood cultures and knee joint aspiration fluid, and later identified as H. anomala by yeast biochemical cards. He was successfully treated with extensive debridement and fluconazole for 8 weeks.
Abscess ; Arthritis* ; Arthritis, Infectious ; Congenital Abnormalities ; Cross Infection ; Debridement ; Diabetes Mellitus ; Femur ; Fluconazole ; Fungi ; Humans ; Hypertrophy ; Immunocompromised Host ; Joints ; Knee Joint ; Middle Aged ; Pharynx ; Pichia* ; Tibia ; Yeasts

Actinomycosis of cerivcofacial region is an uncommon disease and presents as an abscess or chronic lesion mimicking malignancy, tuberculosis, or fungal lesion. Actinomycosis is difficult to diagnose because of fastidious nature of the organism in culture and general lack of familiarity with the disease. So, a high index of suspicion is required to make an accurate and timely diagnosis. We present a case of male patient with actinomycosis of submandibular triangle complaining of neck mass.
Abscess ; Actinomycosis* ; Actinomycosis, Cervicofacial ; Diagnosis ; Humans ; Male ; Neck* ; Recognition (Psychology) ; Tuberculosis

Actinomycosis is a disease caused by an anaerobic bacteria called Actinomyces species (predominantly Actinomyces israelii), which is a common and normally nonpathogenic organism found in the nose and throat. The four major clinical presentations of actinomycosis include the cervicofacial, thoracic, abdominal, and pelvic region. Actinomycosis is difficult to diagnose because of variable presentation and fastidious nature of the organism in culture. A high index of suspicion and biopsy are often necessary to make the diagnosis, because the disease can mimic neoplasm or a chronic granulomatous infection. We present, with the appropriate review, a case of actinomycosis in the mandibular angle area which was mistaken for a parotid abscess.
Abscess* ; Actinomyces ; Actinomycosis ; Actinomycosis, Cervicofacial ; Bacteria, Anaerobic ; Biopsy ; Diagnosis ; Nose ; Pelvis ; Pharynx