Adult ; Aged ; Female ; Foot Injuries ; microbiology ; Hand Injuries ; microbiology ; Humans ; Male ; Middle Aged ; Surgical Wound Infection ; epidemiology ; etiology ; microbiology ; Suture Techniques ; adverse effects ; Wound Healing ; physiology

BACKGROUND/AIMS: Peristomal infection is the most common complication of percutaneous endoscopic gastrostomy (PEG) insertion. Methicillin-resistant Staphylococcus aureus (MRSA) is the most commonly implicated organism of peristomal infection. The aims of this study were to determine the contribution of nasal MRSA to wound infection in PEG and the predictors of wound infection. METHODS: A prospective study was conducted on patients undergoing PEG between September 2003 and July 2005. All patients received antibiotics prior to PEG insertion. Nasal swabs were taken from a consecutive series of patients prior to PEG insertion. Wound status of the peristomal site were prospectively evaluated at day 1, 3, and 7 following the insertion of PEG. RESULTS: Thirty-one patients underwent PEG insertion (mean age, 66+/-16 years). Ten patients (32.3%) had MRSA-positive nasal swabs. Peristomal infection did not have any relationship with nasal MRSA colonization (p>0.05). Peristomal infection occurred in 4 (12.9%) cases. The rate of peristomal infections was significantly higher in patients with diabetes mellitus (p<0.05). CONCLUSIONS: Nasal MRSA colonization is not associated with the risk of peristomal infections in patients receiving antibiotics prior to PEG insertion. Diabetes mellitus might be the risk factor for peristomal infection after PEG insertion.
Aged ; Aged, 80 and over ; Anti-Bacterial Agents/pharmacology ; Diabetes Complications/epidemiology ; Female ; Gastroscopy ; *Gastrostomy ; Humans ; Male ; Methicillin/pharmacology ; *Methicillin Resistance ; Middle Aged ; Nose/microbiology ; Risk Factors ; Staphylococcal Infections/epidemiology/etiology/*microbiology ; Staphylococcus aureus/drug effects/*isolation & purification ; Surgical Wound Infection/epidemiology/etiology/*microbiology

The major aims of this study were to estimate the infection rate and recognize the risk factor for ventriculoperitoneal (VP) shunt infections in children. To analyze shunt infection rate and identify risk factors, a retrospective cohort analysis of 333 consecutive VP shunt series was performed at Seoul National University Children's Hospital in Korea between January 2005 and February 2011. Overall, 35 shunts (10.5%) were infected, which represented an infection rate of 0.075 infection cases per shunt per year. VP shunt infection occurred at a median of 1 month (range, 6 days to 8 months) after insertion. An independent risk factor for shunt infection was undergoing an operation before the first year of life (relative risk 2.31; 95% confidence interval, 1.19-4.48). The most common causative microorganism was coagulase-negative staphylococci in 16 (45.7%) followed by Staphylococcus aureus in 8 (22.9%). Methicillin resistance rate was 83.3% among coagulase-negative staphylococci and S. aureus. In this study, cerebrospinal fluid shunt infection rate was 10.5%. Infection was frequently caused by methicillin-resistant coagulase-negative staphylococci and S. aureus within two months after shunt surgery. Vancomycin may be considered as the preoperative prophylaxis for shunt surgery in a situation where methicillin resistance rate is very high.
Anti-Bacterial Agents/therapeutic use ; Bacterial Infections/drug therapy/*epidemiology/microbiology ; Child ; Child, Preschool ; Cohort Studies ; Humans ; Hydrocephalus/surgery ; Incidence ; Infant ; Infant, Newborn ; Male ; Methicillin-Resistant Staphylococcus aureus/isolation & purification ; Retrospective Studies ; Risk Factors ; Staphylococcus/isolation & purification ; Surgical Wound Infection/drug therapy/*epidemiology/etiology ; Vancomycin/therapeutic use ; Ventriculoperitoneal Shunt/*adverse effects