Prospective Monitoring and Adapting Strategies for Prevention of Infection Following Transrectal Prostate Procedures.
Solomon L Woldu1, Ryan C Hutchinson1, Nirmish Singla1
1Department of Urology, University of Texas Southwestern Medical Center, Dallas, Texas USA.
Urology Practice
|April 25, 2018
Summary
Minimizing infection risk after transrectal prostate procedures (TRPXs) involved enhancing prophylaxis strategies. Adding intramuscular aminoglycoside and later targeted prophylaxis with formalin needle-tip disinfection significantly reduced infection-related hospitalizations.
Area of Science:
- Urology
- Infectious Diseases
- Public Health
Background:
- Transrectal prostate procedures (TRPXs) carry an inherent risk of infection.
- Minimizing post-procedure infections is a critical clinical challenge.
- Previous prophylaxis strategies have had limited success in reducing infectious complications.
Purpose of the Study:
- To prospectively evaluate the impact of augmenting prophylaxis strategies on infection rates following TRPXs.
- To assess the effectiveness of adding intramuscular aminoglycoside to standard prophylaxis.
- To determine the benefit of implementing formalin needle-tip disinfection and targeted prophylaxis based on antibiotic resistance screening.
Main Methods:
- Prospective monitoring of post-TRPX infections from 2010-2016.
- Sequential modification of the prophylaxis regimen: addition of intramuscular aminoglycoside (2011), and later, formalin needle-tip disinfection with targeted prophylaxis (2015).
- Monitoring of infection-related hospitalizations and antibiotic resistance patterns, particularly fluoroquinolone (FQ) resistance.
Main Results:
- Overall infection-related hospitalization rate was 1.7% (41/2398 cases).
- Addition of intramuscular aminoglycoside reduced infection rates by 69% (from 3.8% to 1.1%).
- Subsequent implementation of targeted prophylaxis and formalin disinfection led to a further 53% decrease in infection rates (to 1.2%), despite a 29.8% FQ-resistance rate.
Conclusions:
- Augmenting prophylaxis with intramuscular aminoglycoside initially reduced post-TRPX infections.
- Further improvements in reducing infection-related hospitalizations were achieved through targeted prophylaxis and formalin needle-tip disinfection.
- These enhanced strategies are effective in managing infectious complications even with rising antibiotic resistance.
Related Concept Videos
01:22Healthcare Associated Infections II: Preventive Measures
4.2K
Essential infection prevention measures are based on the knowledge of the infection chain, the modes of transmission in healthcare settings, and the use of the best practices in all healthcare settings. Compulsory public reporting of healthcare-associated infection rates is needed to allow individuals and the community to make informed choices regarding selecting a healthcare facility.
The best practices for preventing healthcare-associated infections include hand hygiene, patient risk...
The best practices for preventing healthcare-associated infections include hand hygiene, patient risk...
4.2K
01:24Strategies of Self-Presentation III: Self-Monitoring
272
Self-monitoring is a central construct in understanding individual differences in self-presentation strategies across social contexts. It refers to how individuals observe, regulate, and control their expressive behavior and self-presentation following situational cues. Self-monitoring reflects a person's sensitivity to social appropriateness and willingness to adapt behavior to fit varying interpersonal demands.High vs. Low Self-Monitoring IndividualsIndividuals high in self-monitoring are...
272
02:59Cancer Prevention
8.2K
Several factors can increase the risk of cancer in an individual. About 50% of cancer cases can be prevented by adopting a healthy lifestyle, regular exercise, eating healthy, and following a modest cancer prevention diet. Epidemiological studies have consistently shown that populations with vegetable and fruit-rich diets have reduced the incidence of cancer. On the other hand, populations who have a diet rich in animal fat, red meat, junk food, or high calories are predisposed to cancer.
Some...
Some...
8.2K
01:14Prevention of Further Absorption of Poison
1.3K
In cases of acute poisoning, the primary objective is to prevent further absorption of the toxic substance into the body. Immediate interventions using various decontamination techniques targeting the gastrointestinal (GI) tract can achieve this. Decontamination is crucial to prevent poison from entering the systemic circulation, which involves washing affected areas with water and mild soap and removing contaminated clothing. Once external decontamination is done, attention must be turned to...
1.3K
01:30Preventive Healthcare Services
2.2K
Preventive healthcare services keep people healthy via frequent check-ups, screening, and counseling. They primarily aid in disease prevention rather than treating an acute or chronic illness. Preventive treatment also keeps individuals productive and energetic, allowing them to work well into their retirement years. Examples of preventive care services include:
2.2K
01:30Pneumonia V: Nursing management and Prevention
3.6K
Nursing management of pneumonia involves promoting airway patency, facilitating rest and conserving energy, encouraging fluid intake, maintaining nutrition, and educating patients.
The nurse must practice strict medical asepsis and adhere to infection control guidelines to minimize healthcare-associated infections.
Enhance airway patency
Position the patient correctly to facilitate drainage of the affected lung segments. Manual or mechanical percussion and vibration can also be employed....
The nurse must practice strict medical asepsis and adhere to infection control guidelines to minimize healthcare-associated infections.
Enhance airway patency
Position the patient correctly to facilitate drainage of the affected lung segments. Manual or mechanical percussion and vibration can also be employed....
3.6K