Lessons Learned from the Implementation of the Wake County, North Carolina EMS Medication for Opioid Use Disorder Program.

Objectives: Buprenorphine has recently emerged as a prehospital treatment for opioid use disorder. Limited data exist regarding the implementation of prehospital buprenorphine programs. Our objective was to describe the development, deployment, lessons learned, and ongoing evolution of the Wake County EMS buprenorphine program using data from the first year following implementation.

The effects of chlorhexidine, povidone-iodine and vancomycin on growth and biofilms of pathogens that cause prosthetic joint infections: an in-vitro model.

Background: Chlorhexidine gluconate (CHG) and povidone-iodine (PI) are commonly used to prevent prosthetic joint infection (PJI) during total joint replacement; however, their effective concentrations and impact on biofilms are not well defined.

Aim: To determine: (1) the in-vitro minimum inhibitory concentration of CHG and PI against model PJI-causing organisms and clinical isolates; (2) their impact on biofilm formation; (3) whether there is a synergistic benefit to combining the two solutions; and (4) whether adding the antibiotic vancomycin impacts antiseptic activity.

Methods: We measured in-vitro growth and biofilm formation of Staphylococcus epidermidis, meticillin-sensitive and meticillin-resistant Staphylococcus aureus, Escherichia coli, Pseudomonas aeruginosa and Candida albicans, as well as recent clinical isolates, in the presence of increasing concentrations of CHG and/or PI.

Standardising the elusive diagnosis of NEC in the premature infant - A practical score.

Objective: The perceived risk of necrotising enterocolitis (NEC) can result in overtreatment of the otherwise adapting preterm neonate. We aim to develop an assessment tool to aid the decision making in the management of preterm neonates at risk of NEC.

Method: An evidence-based assessment tool was designed bringing together clinical, laboratory and radiological signs commonly associated with NEC.

Stoma recycling in a surgical neonatal unit: Prevalence, challenges, and review of nursing attitudes.

Aim: Recycling has been shown to improve growth, nutrition and facilitate early stoma closure. We aim to review current practice and nursing experience at a tertiary paediatric surgical unit and to evaluate possible areas for improvement.

Method: Retrospective study of all neonates who underwent a stoma closure between January 2018 and October 2020, alongside a nursing staff survey on experience and barriers to effective recycling.

Exploration of BAY 11-7082 as a Potential Antibiotic.

Exposure of the Gram-negative pathogen to subinhibitory concentrations of antibiotics increases the formation of biofilms. We exploited this phenotype to identify molecules with potential antimicrobial activity in a biofilm-based high-throughput screen. The anti-inflammatory compound BAY 11-7082 induced dose-dependent biofilm stimulation, indicative of antibacterial activity.