Association of cephalosporin resistance in intraoperative biliary cultures with surgical site infections in patients undergoing pancreaticoduodenectomy. A retrospective cohort study.

Background: The aim of this study was to assess the incidence of bacterobilia at the time of a pancreaticoduodenectomy (PD) and the association of resistant bacteria in bile to surgical site infections (SSI).

Methods: This was a retrospective cohort study including patients undergoing PD in a single center between May 2016 and October 2020. Data of preoperative biliary drainage (PBD), intraoperative biliary cultures (IBC) and postoperative complications were analysed to assess the risk factors for resistant bacteria in IBC and SSIs.

Clinical and microbiological factors associated with mortality in candidemia in adult patients 2007-2016.

Candidemia is a life-threatening infection with high mortality. Our aim was to evaluate the species distribution, antifungal susceptibilities and risk factors associated with 30-day mortality in candidemia in Southern Finland. We present a retrospective analysis of candidemia cases from the hospital district of Helsinki and Uusimaa during 2007-2016.

Capnocytophaga canimorsus bacteremia: clinical features and outcomes from a Helsinki ICU cohort.

Background: Capnocytophaga canimorsus is a gram-negative rod capable of causing severe sepsis or septic shock. We studied the characteristics of patients with C. canimorsus bacteremia treated in intensive care unit (ICU).

Targeting matrix metalloproteinases with intravenous doxycycline in severe sepsis--A randomised placebo-controlled pilot trial.

An overwhelming inflammatory process is the hallmark of severe sepsis and septic shock. Matrix metalloproteinases (MMPs)-8 and -9 are released from neutrophils and activated in sepsis to participate in inflammation in several ways. High levels of MMP-8 may associate with increased ICU mortality.

[Botulism].

Botulism is a rare but potentially life-threatening disease caused by Clostridium botulinum neurotoxin. In Finland only a few cases have been diagnosed during the past ten years but mild cases may be underdiagnosed. The diagnosis of botulism is clinical.

Difficulties in diagnosing food-borne botulism.

Botulism is a muscle-paralyzing disease caused by neurotoxins (types A-G) produced by the bacteria Clostridium botulinum. Symptoms of food-borne botulism most commonly appear 12-36 h after eating contaminated food, but the earliest neurological symptoms may in some cases start abruptly. Here, we report the cases of two patients with food-borne botulism who were admitted to the neurological emergency room as candidates for intravenous thrombolysis for acute stroke.

Two cases of food-borne botulism in Finland caused by conserved olives, October 2011.

In October 2011 in Finland, two persons fell ill with symptoms compatible with botulism after having eaten conserved olives stuffed with almonds. One of these two died. Clostridium botulinum type B and its neurotoxin were detected in the implicated olives by PCR and mouse bioassay, respectively.

Serum matrix metalloproteinases in patients resuscitated from cardiac arrest. The association with therapeutic hypothermia.

Aim: To study the systemic levels of matrix metalloproteinases (MMP) -7, -8 and -9 and their inhibitor TIMP-1 in cardiac arrest patients and the association with mild therapeutic hypothermia treatment on the serum concentration of these enzymes.

Methods: MMP-7, -8 and -9 and tissue inhibitor of metalloproteinases-1 (TIMP-1) were analysed in blood samples obtained from 51 patients resuscitated from cardiac arrest. The samples were taken at 24 and 48 h from restoration of spontaneous circulation (ROSC).

Serum MMP-8, -9 and TIMP-1 in sepsis: high serum levels of MMP-8 and TIMP-1 are associated with fatal outcome in a multicentre, prospective cohort study. Hypothetical impact of tetracyclines.

Recent evidence suggests that matrix metalloproteinases (MMPs) and their endogenous inhibitors are involved in the pathogenesis of sepsis. We studied serum levels of MMP-8, MMP-9 and TIMP-1 (tissue inhibitor of matrix metalloproteinase-1) in a multicentre, prospective cohort study of patients with sepsis treated in Intensive Care Units (ICUs). We analyzed serum samples taken on ICU admission from 248 critically ill sepsis patients.

Predictive value of procalcitonin decrease in patients with severe sepsis: a prospective observational study.

Introduction: This prospective study investigated the predictive value of procalcitonin (PCT) for survival in 242 adult patients with severe sepsis and septic shock treated in intensive care.

Methods: PCT was analyzed from blood samples of all patients at baseline, and 155 patients 72 hours later.

Results: The median PCT serum concentration on day 0 was 5.

Emergence of extended-spectrum beta-lactamase-producing Escherichia coli and Klebsiella pneumoniae during the years 2000 and 2004 in Helsinki, Finland.

The molecular epidemiology of 33 Escherichia coli and 81 Klebsiella pneumoniae extended-spectrum beta-lactamase-producing healthcare-associated and community-acquired isolates collected in the Helsinki district during 2000-2004 was investigated. Clonality studies, antimicrobial susceptibility and genotyping of the isolates were performed. Newly emerging CTX-M-producing E.

[Rabies].

Rabies is a mammalian zoonosis caused by a virus belonging to the family of rhabdoviruses. In Finland, the risk of rabies is associated with imported animals and traveling. We describe the second case of human rabies diagnosed in Finland.

Viral encephalitis associated with pandemic 2009 (H1N1) influenza A.

Encephalitis has been described as a rare complication of pandemic 2009 (H1N1) influenza A infection in children and adolescents. This report is on two adult patients who presented with encephalitis in relation to acute H1N1 influenza. Encephalitis is therefore also a potential complication of pandemic 2009 (H1N1) influenza infection in adults.

[Surgical site infections at Töölö hospital and the dog days myth].

Introduction: In the Finnish folklore, the time from June 23 to August 23 has been called "rotten month" (dog days), whereupon wound healing is delayed due to infections.

Patients And Methods: A retrospective comparison was made of surgical infections entered in the infections register at Töölö hospital over the dog days of 2002 to 2005.

Results: Of 49517 surgical operations, 8 % were performed during dog days, during which the number of contaminated and infected surgeries was higher.

The consequences of an outbreak of multidrug-resistant Pseudomonas aeruginosa among patients treated for critical leg ischemia.

Objective: This retrospective matched case-control study evaluated the consequences of multidrug-resistant Pseudomonas aeruginosa (MDR Pa) in critical leg ischemia (CLI) patients treated with infrainguinal bypass surgery (IBS).

Methods: An outbreak of MDR Pa occurred on our vascular surgical ward during a 13-month period. Bacteria cultures positive for MDR Pa were obtained from 129 patients, and 64 CLI patients treated with IBS formed the study group.

Costs of an outbreak of meticillin-resistant Staphylococcus aureus.

An outbreak of meticillin-resistant Staphylococcus aureus (MRSA) occurred in surgical and internal medicine units of a 1752-bed Finnish tertiary care hospital during 2003-2004. In order to analyse the costs of this 14-month outbreak, patients were categorized as follows: patients with MRSA infections; patients with MRSA colonization; patients exposed to MRSA but whose MRSA status remained inconclusive; and exposed patients who were negative for MRSA. We reviewed a sample of patients' charts to determine the types of clinical infections and interviewed staff about the practical implementation of control measures.

Universal leukocyte reduction of transfused red cells does not provide benefit to patients undergoing cardiac surgery.

Objective: A policy of universal leukocyte reduction of the blood supply in Finland was implemented at the beginning of 2003. The aim of the present evaluation was to determine the potential role of leukocyte-reduced red blood cells in decreasing postoperative infections.

Design: A retrospective cohort study.

Incidence, treatment, and outcome of severe sepsis in ICU-treated adults in Finland: the Finnsepsis study.

Objective: To determine the incidence and outcome of severe sepsis in the adult Finnish population and to evaluate how treatment guidelines in severe sepsis are applied in clinical practice.

Study Design: A prospective study in 24 closed multidisciplinary ICUs in 21 hospitals (4 university and 17 tertiary hospitals) in Finland.

Patients: All 4,500 consecutive ICU admission episodes were screened for severe sepsis during a 4-month period (1 November 2004 - 28 February 2005).

Collagenase 2/matrix metalloproteinase 8 in critically ill patients with secondary peritonitis.

Secondary peritonitis is an important indication for surgical intensive care admissions, and it is associated with high morbidity and mortality. Collagenase 2/matrix metalloproteinase (MMP) 8 is a tissue matrix-degrading enzyme that is released from leukocytes upon inflammatory stimuli and may thus contribute to peritonitis-associated organ damage. We studied the levels and activity of MMP-8 in the peritoneal fluid of 15 critically ill patients with secondary peritonitis.

Corticosteroids combined with continuous veno-venous hemodiafiltration for treatment of hantavirus pulmonary syndrome caused by Puumala virus infection.

Reported here are two cases of hantavirus pulmonary syndrome caused by Puumala virus infection, which rapidly resolved after initiation of corticosteroid treatment combined with continuous veno-venous hemodiafiltration. These cases emphasize the role of the inflammatory response in the pathogenesis of hantavirus pulmonary syndrome.

Incidence and risk factors for nosocomial infections caused by fluoroquinolone-resistant Escherichia coli.

The aim of the retrospective case-control study presented here was to elucidate the incidence, risk factors, and outcomes of nosocomial infections caused by quinolone-resistant Escherichia coli (QREC). During the 3-year period studied, 51 nosocomial QREC infections were found, and the characteristics of these cases were compared with those of 102 control patients with quinolone-susceptible nosocomial infections. In the multivariate analysis, risk factors were identified as prior quinolone therapy (odds ratio [OR], 18.

Increase of the number of vancomycin resistant enterococci (VRE) isolated in Helsinki, Finland.

The emergence of hospital acquired infections with bacteria resistant to antimicrobials such as vancomycin resistant enterococci (VRE) has become a worldwide concern. In hospitals in the United States, VRE have spread quickly and currently account for eve

Characteristics of discrepancies between clinical and autopsy diagnoses in the intensive care unit: a 5-year review.

Objectives: To characterise discrepancies between clinical and autopsy diagnoses in patients who die in the intensive care unit.

Design: Retrospective chart review.

Setting: Ten-bed closed mixed adult intensive care unit in a tertiary referral teaching hospital.

Purulent pneumococcal pericarditis: a rarity in the antibiotic era.

Purpose: The purpose of this report is to show that even while properly treated, pneumococcal disease may proceed to a life-threatening condition including purulent pericarditis and multiple organ failure.

Patients And Methods: This is a case-report describing one patient treated in the intensive care unit (ICU) of Helsinki University Central Hospital in March 2001.

Conclusions: In the antibiotic era, purulent pericarditis is an extremely rare yet possible condition complicating pneumococcal disease.