6; 95% CI 1.0-5.7), duration of hospitalization (OR 1.04 per additional day; 95% CI 1.0-1.1), and antibiotic use (OR 12.5; 95% CI 3.2-48.1). Of BI 2536 clinical trial the antibiotics used, cephalosporins and fluoroquinolones were identified as the major risk factors for development of CDI. The risk of developing CDI was
particularly high in people receiving a combination of a cephalosporin and a fluoroquinolone (OR 57.5; 95% CI 6.8-483.6). The main factors affecting the risk of non-CDI diarrhoea were proton-pump inhibitors, immunosuppressive drugs, underlying digestive system disease, previous surgery, and gastric tube feeding. The outbreak ended only after implementation of restricted use of cephalosporins and a complete ban on fluoroquinolones, in addition to general hygienic measures, cohorting of patients selleck products in a separate ward, education of staff, and intensified environmental cleaning. The results of this study support the importance of appropriate antimicrobial stewardship in the control of hospital outbreaks with C. difficile
PCR ribotype 027.”
“Background: The diagnosis of periprosthetic knee infections can present a challenge to surgeons, especially in the case of chronic presentation. Gram stains are regularly performed as part of the microbiological evaluation of suspected infected total knee arthroplasties. Recently, the utility of this test in diagnosing infections has been questioned. The purpose of this study was to assess the effectiveness of Gram stains performed from surgical site samples by comparing their results to the final diagnosis of infection.
Methods: The results of 347 Gram stains performed at a single center check details at the time of revision total knee arthroplasty for both septic and aseptic
reasons were compared to the final diagnosis based on intraoperative findings and histological evaluation.
Results: Gram staining demonstrated a low sensitivity of 7% (95% confidence interval 4-12%), a specificity of 99% (95% confidence interval 97-100%), and positive and negative predictive values of 92% and 57%, respectively.
Conclusions: This study confirmed previous findings of the poor utility of this test for the diagnosis of periprosthetic knee infections. The authors recommend that Gram staining no longer be performed at the time of suspected periprosthetic knee arthroplasty infection. (C) 2011 International Society for Infectious Diseases. Published by Elsevier Ltd. All rights reserved.”
“The aims of this study were, firstly, to determine the diagnostic accuracy of an anal incontinence score, clinical examination and anal manometry in identifying anal sphincter defects and, secondly, to establish manometric cut-off values associated with sphincter defects.
One hundred fifty-nine women were evaluated by clinical examination, anal manometry and endoanal ultrasound (EAU). Accuracy measures were calculated, using EAU as the gold standard.
Perineal body length (p = 0.