caa a22 4500 388035315 CHVBK 20180307125002.0 cr unu---uuuuu 161130e199807 xx s 000 0 eng 10.1086/647865 doi S0195941700088202 pii (NATIONALLICENCE)cambridge-10.1086/647865 High Rates of Discitis Following Surgery for Prolapsed Intervertebral Discs at a Hospital in Pakistan [Elektronische Daten] Abstract OBJECTIVES: To confirm the presence of an outbreak of postoperative infections following laminectomy and to determine the infection rate after interventions were instituted. DESIGN: Retrospective cohort study. Medical records were reviewed, personnel interviewed, and premises examined. SETTING: Surgical unit of hospital A in Pakistan. SUBJECTS: Patients who had surgical laminectomy between January 1993 and July 1994. INTERVENTION: Instructive program for nursing and medical staff in December 1993. RESULTS: From January to December 1993, 6 (15%) of 41 laminectomy patients developed postoperative discitis. The risk of discitis varied significantly by surgeon (P=.016); patients who had one particular surgeon, surgeon A, were nine times more likely to develop postoperative infections than patients who did not have surgeon A. Patients were not consistently cleaned or shaved before coming to the operating room, and personnel moved back and forth between the operation theater and other parts of the hospital without changing their gowns or slippers. After the instructional intervention, between January and July 1994, 2 (6%) of 31 laminectomy patients developed postoperative discitis, a rate not significantly lower than in the preceding 12 months (P=.45). Overall, from January 1993 through July 1994, female patients were more likely to develop discitis than males (31% vs 7%; relative risk, 4.4; 95% confidence interval, 1.3-15.6; P<.032). CONCLUSION: Endemic conditions require that laminectomy at hospital A be limited to those situations where the benefits of the surgery exceed the considerable risk of postoperative discitis. Copyright © The Society for Healthcare Epidemiology of America 1998 Siddiqui Amna R. Department of Community Health Sciences, The Aga Khan University Hospital, Karachi, Pakistan Luby Stephen P. Department of Community Health Sciences, The Aga Khan University Hospital, Karachi, Pakistan Infection Control & Hospital Epidemiology Cambridge University Press 19/7(1998-07), 526-529 0899-823X 19:7<526 1998 19 ICE https://doi.org/10.1086/647865 text/html Onlinezugriff via DOI 1 research-article jats NATIONALLICENCE 856 40 https://doi.org/10.1086/647865 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Siddiqui Amna R. Department of Community Health Sciences, The Aga Khan University Hospital, Karachi, Pakistan NATIONALLICENCE 700 1- Luby Stephen P. Department of Community Health Sciences, The Aga Khan University Hospital, Karachi, Pakistan NATIONALLICENCE 773 0- Infection Control & Hospital Epidemiology Cambridge University Press 19/7(1998-07), 526-529 0899-823X 19:7<526 1998 19 ICE CC0 http://creativecommons.org/publicdomain/zero/1.0 nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-cambridge