Management of vancomycin-resistant Enterococcus faecium in Dutch healthcare institutes: a nationwide survey.

Background: Vancomycin-resistant Enterococcus faecium (VRE) is an opportunistic pathogen, which can cause outbreaks in hospitals. In the Netherlands, several national guidelines and guidance documents on different aspects of VRE management are available. Most available guidelines are written towards the hospital setting and only few on long-term care facilities (LTCFs).

Incisional Wound Irrigation for the Prevention of Surgical Site Infection: A Systematic Review and Network Meta-Analysis.

Importance: Surgical site infections (SSIs) are common postoperative complications and associated with significant morbidity, mortality, and costs. Prophylactic intraoperative incisional wound irrigation is used to reduce the risk of SSIs, and there is great variation in the type of irrigation solutions and their use.

Objective: To compare the outcomes of different types of incisional prophylactic intraoperative incisional wound irrigation for the prevention of SSIs in all types of surgery.

Evaluation of microbial occurrence in reusable robotic instruments for minimally invasive surgery: A pilot study.

In recent decades, minimally invasive surgery has become the favoured surgical technique, with increasing utilisation of robotic surgery to enhance patient outcomes. However, the design complexity of surgical robotic instruments can pose challenges in maintaining adequate cleaning, disinfection and sterilisation-particularly of the device's interior. In our hospital, robotic instruments are reused for a maximum of ten successive patients, following the manufacturer's guidelines.

Antimicrobial susceptibility profile of clinically relevant Bacteroides, Phocaeicola, Parabacteroides and Prevotella species, isolated by eight laboratories in the Netherlands.

Objectives: Recently, reports on antimicrobial-resistant Bacteroides and Prevotella isolates have increased in the Netherlands. This urged the need for a surveillance study on the antimicrobial susceptibility profile of Bacteroides, Phocaeicola, Parabacteroides and Prevotella isolates consecutively isolated from human clinical specimens at eight different Dutch laboratories.

Methods: Each laboratory collected 20-25 Bacteroides (including Phocaeicola and Parabacteroides) and 10-15 Prevotella isolates for 3 months.

Analysis of two sequential SARS-CoV-2 outbreaks on a haematology-oncology ward and the role of infection prevention.

Two SARS-CoV-2 nosocomial outbreaks occurred on the haematology ward of our hospital. Patients on the ward were at high risk for severe infection because of their immunocompromised status. Whole Genome Sequencing proved transmission of a particular SARS-CoV-2 variant in each outbreak.

Incisional negative pressure wound therapy for the prevention of surgical site infection: an up-to-date meta-analysis and trial sequential analysis.

Background: The evidence on prophylactic use of negative pressure wound therapy on primary closed incisional wounds (iNPWT) for the prevention of surgical site infections (SSI) is confusing and ambiguous. Implementation in daily practice is impaired by inconsistent recommendations in current international guidelines and published meta-analyses. More recently, multiple new randomised controlled trials (RCTs) have been published.

Efficacy of different preoperative skin antiseptics on the incidence of surgical site infections: a systematic review, GRADE assessment, and network meta-analysis.

Background: Surgical site infection (SSI) is the most common postoperative complication and substantially increases health-care costs. Published meta-analyses and international guidelines differ with regard to which preoperative skin antiseptic solution and concentration has the highest efficacy. We aimed to compare the efficacy of different skin preparation solutions and concentrations for the prevention of SSIs, and to provide an overview of current guidelines.

Role of the environment in transmission of Gram-negative bacteria in two consecutive outbreaks in a haematology-oncology department.

In 2019-2020, two subsequent outbreaks caused by phenotypically identical ESBL-producing and multi-drug-resistant (MDR) were detected in respectively 15 and 9 patients of the haematology-oncology department. Both bacterial species were resistant to piperacillin-tazobactam, used empirically in (neutropenic) sepsis in our hospital, and ciprofloxacin, used prophylactically in selective digestive decontamination for haematology patients. The was identified in clinical cultures of blood and urine.

Effects of decontamination of the oropharynx and intestinal tract on antibiotic resistance in ICUs: a randomized clinical trial.

Importance: Selective decontamination of the digestive tract (SDD) and selective oropharyngeal decontamination (SOD) are prophylactic antibiotic regimens used in intensive care units (ICUs) and associated with improved patient outcome. Controversy exists regarding the relative effects of both measures on patient outcome and antibiotic resistance.

Objective: To compare the effects of SDD and SOD, applied as unit-wide interventions, on antibiotic resistance and patient outcome.

The effects of the administration of oral nutritional supplementation with medication rounds on the achievement of nutritional goals: a randomized controlled trial.

Background & Aims: Oral nutritional supplements (ONS) are often considered for hospitalized patients with acute severe malnutrition, however the compliance to the supplements is known to be variable. The aim of our study was to investigate whether providing a lower volume of ONS at a higher frequency during medication rounds would improve the intake of the supplements.

Methods: In this randomized controlled trial, 234 malnourished inpatients (mean age 71.

The sink as a correctable source of extended-spectrum β-lactamase contamination for patients in the intensive care unit.

Between December 2010 and April 2012, intensive care unit (ICU) patients in our hospital were infrequently colonized with extended-spectrum β-lactamase-positive bacteria (ESBLs). We hypothesized that these ESBLs originated from patients' room sinks, and this was prospectively investigated by weekly culturing of patients and sinks during a 20-week period. ESBLs were isolated from all 13 sinks.

A randomised trial of honey barrier cream versus zinc oxide ointment.

In this single-blind multicentre, intervention study, 31 patients with symmetrical intertrigo in large skin folds were included to study the clinical effect of two topical treatments, i.e. standard therapy with zinc oxide ointment versus honey barrier cream.

Hyoscine N-butylbromide does not improve polyp detection during colonoscopy: a double-blind, randomized, placebo-controlled, clinical trial.

Background: Colonoscopy is used for the detection of neoplastic polyps, although a significant miss rate has been reported. Limited data suggest that the administration of the antispasmodic hyoscine N-butylbromide during colonoscopy improves polyp detection.

Objective: To investigate whether the use of 20 mg hyoscine N-butylbromide intravenously during colonoscopy improves polyp detection or removal.

Comparison of Doppler-guided haemorrhoidal artery ligation without mucopexy and rubber band ligation for haemorrhoids.

Background And Study Aims: Recurrences after Doppler-guided haemorrhoidal artery ligation (DG-HAL) tend to occur in patients with concurrent mucosal prolapse. We retrospectively compared the results of DG-HAL and rubber band ligation (RBL) for the treatment of haemorrhoidal disease.

Patients And Methods: From 2005 to 2009, all patients who underwent either a DG-HAL procedure or RBL were selected.

Location in the right hemi-colon is an independent risk factor for delayed post-polypectomy hemorrhage: a multi-center case-control study.

Objectives: Delayed hemorrhage is an infrequent, but serious complication of colonoscopic polypectomy. Large size is the only polyp-related factor that has been unequivocally proven to increase the risk of delayed bleeding. It has been suggested that location in the right hemi-colon is also a risk factor.

Evaluation of the Sysmex UF-1000i® urine flow cytometer in the diagnostic work-up of suspected urinary tract infection in a Dutch general hospital.

Background: Automation and standardization of sediment analysis of urine samples by flow cytometry might serve as an alternative to labor-intensive laboratory methods, such as microscopic examination and culture. The Sysmex UF-1000i is a urine flow cytometer that uses two separate channels for counting blood cells and bacteria.

Methods: In this study, 358 urine samples were analyzed with the Sysmex UF-1000i in parallel with manual microscopy, Gram stain and bacterial culture, the latter considered the gold standard.

Results of 244 consecutive patients with hemorrhoids treated with Doppler-guided hemorrhoidal artery ligation.

Aim: This study was designed to determine the effect of treating hemorrhoids with the Doppler-guided hemorrhoidal artery ligation (DG-HAL) procedure.

Methods: From June 2005 to March 2008, 244 consecutive hemorrhoidal patients underwent hemorroidal artery ligation performed with the DG-HAL system from AMI. All patients were evaluated postoperatively with a proctologic examination and interview.

[Fewer blood transfusions after introduction of auto-transfusion system as part of hip- and knee-replacement surgery].

Objective: To establish the effect of the introduction of an auto-transfusion system on the number of homologous blood transfusions required as part of total hip- and knee-replacement surgery.

Design: Prospective observational study.

Methods: The number of homologous blood transfusions required after total hip or knee replacement was compared between a group of 195 patients before and a group of 176 patients after introduction of an auto-transfusion system.

An Unexpected Detrimental Effect on the Incidence of Heel Pressure Ulcers After Local 5% DMSO Cream Application: A Randomized, Double-blind Study in Patients at Risk for Pressure Ulcers.

Unlabelled: Background. Ischemia-reperfusion injury and reactive oxygen species (ROS) are considered to play an important role in the pathogenesis of pressure ulcers (PU). Antioxidants may diminish the inflammation and damage of these ROS in pressure ulcer formation.

Application of the forensic Luminol for blood in infection control.

Transmission of hepatitis C virus occurs frequently in haemodialysis units. A possible route of transmission is indirectly via the hospital environment although this has never been recorded. We investigated the haemodialysis unit in Deventer Hospital, Deventer, The Netherlands, with the forensic Luminol test.

Mannose-binding lectin (MBL) genotype in relation to risk of nosocomial infection in pre-term neonates in the neonatal intensive care unit.

Mannose-binding lectin (MBL) plays an important role in the innate immune response. Three alleles in the MBL gene, and one allele of the promoter, independently cause low serum MBL levels as compared with the wild-type. This study investigated the relationship between MBL genotype and the occurrence of nosocomial infection among neonates in a neonatal intensive care unit (NICU).

Treatment of grade 2 and 3 hemorrhoids with Doppler-guided hemorrhoidal artery ligation.

Aim: We evaluated the results of the Doppler-guided hemorrhoidal arterial ligation (DG-HAL) method in the management of symptomatic grade 2 and 3 hemorrhoids.

Patients And Methods: Between June 2005 and March 2006, 110 consecutive patients with symptomatic grade 2 and 3 hemorrhoids according to the DG-HAL method were treated. All procedures were performed in daycare under spinal anesthesia.

Analysis of multiple single nucleotide polymorphisms (SNP) on DNA traces from plasma and dried blood samples.

Reliable analysis of single nucleotide polymorphisms (SNPs) in DNA derived from samples containing low numbers of cells or from suboptimal sources can be difficult. A new procedure to characterize multiple SNPs in traces of DNA from plasma and old dried blood samples was developed. Six SNPs in the Mannose Binding Lectin 2 (MBL2) gene were chosen as targets for analysis.

Rectal carcinoma treated with short-term preoperative radiotherapy followed by abdominoperineal resection. Significantly more presacral abscesses with absence of local recurrence.

Background: Treatment of choice for rectal carcinoma is short-term preoperative radiotherapy (5 x 5 Gy) followed by a total mesorectal excision (TME) of the rectum. This treatment has led to a reduction in local recurrence 2 years after surgery from 8.2 to 2.