Hand infection patients presenting to an orthopaedic unit: An audit of incidence and demographics at a rural hospital

Turow, Arthur; Palapitige, Bandulasena; Kim, Susan W.; Jaarsma, Ruurd L.; Bramwell, Donald; Krishnan, Jeganath

doi:10.1111/ajr.12197

Cited by 7 publications

(10 citation statements)

References 16 publications

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“…Infection is one of the most common causes for emergency admissions in orthopaedic surgery along with trauma. S. aureus was the most commonly cultured organism in this study and is consistent with reports from all over the world (Table ). Only one adult in the series had Haemophilus influenzae infection.…”

Section: Discussionsupporting

confidence: 91%

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Bacteriological profile of community‐acquired musculoskeletal infections: a study from Queensland

Matthews

Bamal

McLean

et al. 2018

ANZ Journal of Surgery

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Section: Discussionsupporting

confidence: 91%

“…[18][19][20][21] In contrast, the incidence of MRSA among hand infections appears to be universally high. The incidence of hand infections from MRSA in this series was 50%, higher than that reported from Alice Springs (25%) and similar to a report from Pittsburgh where 53% of hand infections were due to MRSA 10,11 (Table 1).…”

Section: Discussionsupporting

confidence: 88%

Bacteriological profile of community‐acquired musculoskeletal infections: a study from Queensland

Matthews

Bamal

McLean

et al. 2018

ANZ Journal of Surgery

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“…18 In the present study, most of the affected patients were males, which is consistent with earlier studies. 19 The right hand showed preponderance over the left hand in terms of dominance, although no association was found between hand dominance and the pattern of injury. Manual labourers were found to be more prone to risk of injury, exposing them to microbial infections.…”

Section: Discussionmentioning

confidence: 88%

Factors affecting bacteriology of hand sepsis in South Africa

Vyver¹,

Madaree²

2021

S. Afr. j. surg.

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BACKGROUND: Hand sepsis is a common cause of morbidity. The study was conducted in the KwaZulu-Natal province of South Africa, investigating the bacteriological profile and aetiology of hand sepsis, aiming at optimising empiric antibiotic therapy METHODS: This is a descriptive study of 120 patients who presented to the plastic surgery department of Inkosi Albert Luthuli Central Hospital with hand sepsis, from January 2017 to April 2019, that required surgical drainage. Data recorded included: aetiology of sepsis, underlying comorbidities, length of hospital stay, and outcome. A pus swab was taken during surgical drainage for microscopy, culture and sensitivity (MCS) analysis. The relationship between clinical factors and microbiological findings was analysed RESULTS: The predominant bacterial strains cultured from infected patients, excluding methicillin-resistant Staphylococcus aureus, were Staphylococcus aureus (80.8%) and Streptococcus spp. (20.0%), mostly due to spontaneous onset infection (58.3%). Cultures of the more problematic Streptococcus spp. were more frequently associated in patients with diabetes mellitus (60.0%), penetrating trauma (41.9%), or blunt trauma (31.3%). The diabetes group in isolation had the longest median hospital stay of 8 (5-15) days, the most need for multiple procedures (60.0%), amputations (30.0%), and skin grafts (20.0%). The most effective antimicrobial drug particularly in mixed cultures was amoxicillin-clavulanic acid CONCLUSION: Staphylococcus aureus infection was the most common. Streptococcus spp. occurred more frequently in patients with traumatic injury and diabetes mellitus. The latter required further surgical procedures and an increased hospital stay. Amoxicillin-clavulanic acid is the preferred empiric antimicrobial agent Keywords: hand sepsis, bacteriology, optimising empiric antibiotic therapy

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“…9,10 Aboriginal populations in Australia also experience inequitable outcomes from treatable infections and the reasons for this are not yet completely understood. 19 Early operative input for this population group may prevent long-term neurologic damage. 20 In 2008, a retrospective study of 42 patients characterized the presentation and referral process for SEA in New Zealand.…”

Section: Discussionmentioning

confidence: 99%

“…9,10 Aboriginal populations in Australia also experience inequitable outcomes from treatable infections and the reasons for this are not yet completely understood. 19…”

Section: Discussionmentioning

confidence: 99%

Predictors of Failure for Nonoperative Management of Spinal Epidural Abscess

Hunter

Cussen

Baker

2019

Global Spine Journal

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Study Design: Retrospective cohort study. Objectives: The aim of this study is to identify predictive factors associated with failure of nonoperative management of spinal epidural abscess (SEA). Methods: Between January 2007 and January 2017, there were 97 patients 18 years or older treated for SEA at a tertiary referral center. Of these, 58 were initially managed nonoperatively. Details on presenting complaint, laboratory parameters, radiographic evaluation, demographics, comorbidities, and neurologic status (Frankel grades A-E) were collected. Success of treatment was defined as eradication of infection with no requirement for further antimicrobial therapy. Diagnosis of SEA was made via evaluation of imaging and intraoperative findings. Patients with repeat presentation of SEA, children, and those who were transferred for immediate surgical decompression were excluded. Results: Fifty-eight patients initially treated nonoperatively were included. Of these, 21 failed nonoperative management and required surgical intervention. The mean age was 60 years, 66% male, and 19% of Maori ethnicity. Abscess location was predominantly dorsal, and in the lumbar region (53%). Multivariate analysis identified Maori ethnicity, multifocal sepsis, and elevated white cell count as predictors of failure of nonoperative management. With 1 predictor the risk of failure was 44%. In the presence of 2 predictive variables, failure rate increased to 60%, and if all 3 variables were present, patients had a 75% risk of failure. Conclusion: Thirty-six percent of patients treated nonoperatively failed nonoperative management—the failure rate was significantly increased in patients with multifocal sepsis, in patients with elevated white cell count, and in patients of Maori ethnicity.

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Hand infection patients presenting to an orthopaedic unit: An audit of incidence and demographics at a rural hospital

Abstract: Hand infections are a common presentation to Alice Springs Hospital. Indigenous people are admitted 2.38 times longer after adjusting for age and alcohol abuse. They have a more than ninefold chance of being re-admitted to hospital than non-Indigenous people following a hand infection.

Cited by 7 publications

References 16 publications

Bacteriological profile of community‐acquired musculoskeletal infections: a study from Queensland

Bacteriological profile of community‐acquired musculoskeletal infections: a study from Queensland

Factors affecting bacteriology of hand sepsis in South Africa

Predictors of Failure for Nonoperative Management of Spinal Epidural Abscess

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