agar and Postoperative-Complications

We describe the microbiological profile of postoperative endophthalmitis from northern India and analyse the pattern of antibiotic sensitivity which may have changed due to development of resistance secondary to overuse of antimicrobial drugs.. This is a retrospective study of postoperative endophthalmitis from January 2011 to December 2017 in a tertiary eye hospital of northern India. Any patient developing endophthalmitis within one year of any intraocular procedure was included in the study. According to severity, treatment with a trial of intravitreal antibiotic injections or core vitrectomy was decided. Ocular samples were collected which were either anterior chamber tap or vitreous biopsy and sent for microbiological examination. The samples were stained with Gram's and KOH stain and cultured on chocolate agar, blood agar, brain heart infusion broth and Sabouraud dextrose agar.. A total of 545 patients of postoperative endophthalmitis were analysed which showed a male predilection (60.5%) with maximum patients between the age group 50-69 years. 292 patients (53.5%) were culture negative and 253 patients (46.4%) were culture positive. Most common organism identified was Staphylococcus in 73 patients followed by Pseudomonas in 48 patients. Staphylococcus species was most sensitive to vancomycin (97%) followed by amikacin (91%) followed by gentamicin and moxifloxacin (88% each). Pseudomonas was the second most common isolate which showed maximum sensitivity to imipenem (82%) followed by ciprofloxacin(60%). Polymicrobial infection was noted in 23 patients. The most common fungal isolate was aspergillus in 11 patients, followed by fusarium in 10 patients.. Our study shows that gram positive bacteria are the most common organisms in postoperative endophthalmitis and are most sensitive to vancomycin, followed by gram negative bacteria which show increased sensitivity with imipenem than commonly used antibiotic - ceftazidime.

Topics: Agar; Aged; Anti-Bacterial Agents; Endophthalmitis; Eye Infections, Bacterial; Humans; Imipenem; Male; Microbial Sensitivity Tests; Middle Aged; Postoperative Complications; Retrospective Studies; Tertiary Care Centers; Vancomycin; Vitrectomy

Surgical site infection (SSI) rate in pediatric appendicitis is a commonly used hospital quality metric. We hypothesized that surveillance of organ-space SSI (OSI) using cultures alone would fail to capture many clinically-important events.. A prospective, multidisciplinary surveillance program recorded 30-day SSI and hospital length of stay (LOS) for patients <18years undergoing appendectomy for perforated appendicitis from 2012 to 2015. Standardized treatment pathways were utilized, and OSI was identified by imaging and/or bacterial cultures.. Four hundred ten appendectomies for perforated appendicitis were performed, and a total of 84 OSIs (20.5%) were diagnosed with imaging. Positive cultures were obtained for 39 (46%) OSIs, whereas 45 (54%) had imaging only. Compared to the mean LOS for patients without OSI (5.2±2.9days), LOS for patients with OSI and positive cultures (13.7±5.4days) or with OSI without cultures (10.4±3.7days) was significantly longer (both p<0.001). The OSI rate identified by positive cultures alone was 9.5%, whereas the clinically-relevant OSI rate was 20.5%.. Using positive cultures alone to capture OSI would have identified less than half of clinically-important infections. Utilizing clinically-relevant SSI is an appropriate metric for comparing hospital quality but requires agreed upon standards for diagnosis and reporting.. II.. Diagnostic study.

Topics: Agar; Appendectomy; Appendicitis; Child; Female; Humans; Intestinal Perforation; Length of Stay; Male; Microbiological Techniques; Postoperative Complications; Prospective Studies; Surgical Wound Infection; Texas

Peritoneal adhesions cause significant long-term postoperative morbidity. This study evaluates the efficacy of agar plates as the physical barrier in reducing adhesion formation after abdominal surgery in an animal model.. Adhesions were induced, by cecum abrasion, in 20 C57/BL6 mice during a laparotomy procedure. Agar plates were used in 10 mice as the experimental group. At a second operation, 28 days later, the adhesions were graded, in two groups. Data were analyzed by using Student t test.. There was no significant difference in weight gain of the two groups during the study period. A comparison of the morphological appearances of the adhesions demonstrated that there was no evident difference between the two groups. There was also no significant difference in the incidence ratio of adhesions or postoperative adhesion scores between the two groups (p value >0.05).. Despite the hydrogel properties of agar, it was not successful in practice in the reduction of adhesion formation after peritoneal surgery. Since agar is a biological product, it may cause a hyperreactivity induced by the innate immune system in peritoneum. Therefore, agar does not appear to be useful in clinical practice for the reduction of adhesion formation after peritoneal surgery.

Topics: Agar; Animals; Disease Models, Animal; Female; Laparotomy; Mice; Mice, Inbred C57BL; Peritoneal Cavity; Postoperative Complications; Random Allocation; Reoperation; Tissue Adhesions

Both prereduced molten agar and broth and aerobic molten agar and broth were inoculated with blood samples collected from patients with periodontitis, but in otherwise good health, both before and after extraction of two or more teeth. Postoperative blood samples from 23 of 25 patients sampled yielded anaerobic and facultative species. Colony counts from nine samples yielded from less than 1 to over 100 colonies per ml of blood. Organisms detected were species belonging to the genera Bacteroides, Fusobacterium, Peptostreptococcus, Leptotrichia, Propionibacterium, Peptococcus, Veillonella, plus Streptococcus mitis, S. salivarius, vibrio forms, and strains resembling S. mutans. The data indicate that prereduced anaerobically sterilized culture medium with polyanethol sulfonate is effective for detecting anaerobic species in bacteremia and that anaerobic species can be prevalent in bacteremias immediately after tooth extraction in patients with periodontitis.

Topics: Aerobiosis; Agar; Anaerobiosis; Animals; Anticoagulants; Bacteria; Bacteriological Techniques; Culture Media; Gastric Juice; Humans; Periodontitis; Postoperative Complications; Rumen; Sepsis; Sterilization; Sulfonic Acids; Tooth Extraction

Topics: Acute Disease; Agar; Amylases; Electrophoresis; Female; Gastrointestinal Diseases; Humans; Isoenzymes; Male; Pancreas; Pancreatitis; Parotid Gland; Postoperative Complications

Topics: Agar; Anemia; Blind Loop Syndrome; Body Weight; Diet; Escherichia coli; Feces; Female; Gastrectomy; Gastroenterostomy; Hemoglobins; Humans; Indican; Intestine, Small; Iron; Lipids; Male; Peptic Ulcer; Postoperative Complications; Tryptophan; Vitamin B 12

Topics: Agar; Anti-Bacterial Agents; Bacteria; Culture Techniques; Eye Diseases; Germany, West; Hospitals, Special; Humans; Infection Control; Methods; Ophthalmology; Postoperative Complications; Preoperative Care

Topics: Adult; Agar; Aged; Animals; Cardiac Surgical Procedures; Child; Child, Preschool; Female; Humans; Immune Sera; Immunodiffusion; Male; Middle Aged; Myoglobin; Myoglobinuria; Postoperative Complications; Proteinuria; Rabbits