liu.seSearch for publications in DiVA
Change search
CiteExportLink to record
Permanent link

Direct link
Cite
Citation style
  • apa
  • harvard1
  • ieee
  • modern-language-association-8th-edition
  • vancouver
  • oxford
  • Other style
More styles
Language
  • de-DE
  • en-GB
  • en-US
  • fi-FI
  • nn-NO
  • nn-NB
  • sv-SE
  • Other locale
More languages
Output format
  • html
  • text
  • asciidoc
  • rtf
Study of developed resistance due to antibiotic treatment of coagulase-negative staphylococci
The Swedish Institute of Infectious Disease Control, Solna, Sweden.
The Swedish Institute of Infectious Disease Control, Solna, Sweden.
Department of Mathematical Statistics, Stockholm University, Stockholm, Sweden.
Department of Mathematical Statistics, Stockholm University, Stockholm, Sweden.
Show others and affiliations
2003 (English)In: Microbial Drug Resistance, ISSN 1076-6294, E-ISSN 1931-8448, Vol. 9, no 1, 1-6 p.Article in journal (Refereed) Published
Abstract [en]

Coagulase-negative Staphylococci (CoNS) are a major cause of postoperative infections. These infections are often associated with foreign material implants and/or a compromised immune system in the patient. Multiresistant strains are increasingly common in the hospital environment and there is concern that the infections will become difficult or impossible to treat. This report is based on a study of 75 patients, with postoperative infections caused by CoNS after thoracic surgery. All patients were treated with surgical revision and antibiotic therapy. One or more bacterial cultures were made in each case, and the resistance pattern of the CoNS found was determined. The goal of the study was to evaluate possible relationships between antibiotic therapy and the appearance of resistance to antibiotics in CoNS found. To describe this relationship, three models were constructed and analyzed by multiple logistic regression. The results indicate an increased resistance to β-lactam antibiotics and clindamycin after the use of cephalosporins. Also, the use of vancomycin or vancomycin combination with rifampicin or fusidic acid increases the risk for development of resistance to β-lactam antibiotics, ciprofloxacin, fusidic acid, clindamycin, netilmycin, and rifampicin. The hypothesis that a combination of antibiotics will curtail the development of resistance was not supported in this study.

Place, publisher, year, edition, pages
2003. Vol. 9, no 1, 1-6 p.
National Category
Medical and Health Sciences
Identifiers
URN: urn:nbn:se:liu:diva-48659DOI: 10.1089/107662903764736283OAI: oai:DiVA.org:liu-48659DiVA: diva2:269555
Available from: 2009-10-11 Created: 2009-10-11 Last updated: 2012-09-19Bibliographically approved
In thesis
1. The epidemiology and consequences of wound infections caused by coagulase negative staphylococci after thoracic surgery
Open this publication in new window or tab >>The epidemiology and consequences of wound infections caused by coagulase negative staphylococci after thoracic surgery
2002 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

Background

Nosocomial infections in general and postoperative infections in pmticular are important aspects of modern health care. They are important factors to be taken into account when planning and organizing any kind of surgery. Thoracic surgery has become a common and important form of surgery involving significant amounts of patients and resources. Different kinds of infectious complications are not uncommon and cause considerable problems. Many microbes have been implicated in post-operative infections, but one of the most important ones in activities such as thoracic surgety is Coagulase Negative Staphylococci (CoNS). They exist in our environment and produce infections that are difficult to diagnose and complicated to treat. The source of the infections and the transmission routes remain to a great extent unclear.

Aims

To describe the basic epidemiology of sterna! infections after cardiac surgery and to find early indications of infections.To investigate the epidemiology of Coagulase Negative Staphylococci causing sternal infections and to describe the development of antibiotic resistance.

Methods and results

To describe and evaluate the impact of infections after thoracic surgety in our hospital we followed different patient populations. When examining the patients being infected we could show that risk factors mostly involved surgery and hospital related variables. The diagnosis of the infections was often late and the treatment is difficult and consuming major resomces. The late diagnosis could be explained by the discrete symptoms and that a marker for infection like CRP are difficult to evaluate in the post-operative patient. With increased surveillance of the wounds an earlier diagnosis would be possible. Following the development of the management of the infections in our hospital during the 90's we could also show that the time to diagnosis and the treatment periods became shorter.

CoNS caused the majority of the infections in our patients with little change during the 10-year petiod. Preliminary results indicate that the source of the CoNS is the hospital environment in a majority of the serious infections. The place and route of transmission is unclear but the operating theatre remains a possible place of transmissions. Even if the resistance patterns of the CoNS are quite diverse they are often multi resistant and to a substantial degree vancomycin remains the only antibiotic that can be used for the treatment.

Conclusions

Wound infections after cardiac surgery are an important cause of morbidity and mortality, and CoNS play a major role in these infections. Risk factors that contribute to the infections are often associated with complicated surgery. Symptoms of the infections are often discrete and the diagnosis and treatment of the infections often stmt late. Intensified surveillance of the wounds could improve management of infections. We found a clone of CoNS causing a majority of the infections indicating that the source of the bacteria is often the hospital environment. CoNS as a major pathogen makes antibiotic treatment difficult, and there is a high risk of extensive antibiotic resistance.

Place, publisher, year, edition, pages
Linköping: Linköpings universitet, 2002. 35 p.
Series
Linköping University Medical Dissertations, ISSN 0345-0082 ; 742
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:liu:diva-26672 (URN)11239 (Local ID)91-7373-186-2 (ISBN)11239 (Archive number)11239 (OAI)
Public defence
2002-09-27, Elsa Brändsströmsalen, Universitetssjukhuset, Linköping, 13:00 (Swedish)
Opponent
Available from: 2009-10-08 Created: 2009-10-08 Last updated: 2012-09-19Bibliographically approved

Open Access in DiVA

No full text

Other links

Publisher's full text

Authority records BETA

Tegnell, AndersÖhman, Lena

Search in DiVA

By author/editor
Tegnell, AndersÖhman, Lena
By organisation
Infectious DiseasesFaculty of Health Sciences
In the same journal
Microbial Drug Resistance
Medical and Health Sciences

Search outside of DiVA

GoogleGoogle Scholar

doi
urn-nbn

Altmetric score

doi
urn-nbn
Total: 42 hits
CiteExportLink to record
Permanent link

Direct link
Cite
Citation style
  • apa
  • harvard1
  • ieee
  • modern-language-association-8th-edition
  • vancouver
  • oxford
  • Other style
More styles
Language
  • de-DE
  • en-GB
  • en-US
  • fi-FI
  • nn-NO
  • nn-NB
  • sv-SE
  • Other locale
More languages
Output format
  • html
  • text
  • asciidoc
  • rtf