AI Article Synopsis
- - Recent infection outbreaks in outpatient care, including a 2009 case where three patients developed severe MSSA infections after epidural injections, highlighted unsafe infection control practices as key risk factors.
- - A study of 110 patients revealed that 8 (7%) had infections, predominantly among those who received epidural injections, with poor adherence to infection control protocols observed during procedures, such as inadequate use of face masks and reusing syringes.
- - Genetic testing showed that MSSA strains from patients matched those of clinic staff, indicating that infection control failures likely contributed to the spread of the bacteria, underscoring the importance of strict infection control measures in outpatient settings.
Article Abstract
Background: Recent outbreaks in ambulatory care settings have highlighted infection control breaches as risk factors for disease transmission. In May 2009, 3 patients were hospitalized with severe methicillin-susceptible Staphylococcus aureus (MSSA) infections after receiving epidural injections at a West Virginia outpatient pain clinic.
Methods: We conducted a retrospective cohort study evaluating clinic patients who received injections during a 3-week period. A case was defined as laboratory-confirmed infection or clinical evidence of infection ≤ 14 days after a patient received an injection. Infection control procedures were assessed. MSSA isolates from patient infections and clinic staff nasal swabs were genotyped by using pulsed-field gel electrophoresis.
Results: Eight (7%) of 110 cohort patients met the case definition; 6 (75%) cases were laboratory confirmed. Eight (12%) of 69 patients who received epidural injections were case patients compared with none of the other 41 patients (P = .02). During procedures, staff use of face masks and preparation of patient skin were suboptimal; epidural injection syringes were reused to access shared medication vials. MSSA isolates from 2 patients and 1 staff member were indistinguishable by pulsed-field gel electrophoresis.
Conclusion: Infection control breaches likely facilitated MSSA transmission to patients receiving epidural injections. Adhering to correct infection control practices in ambulatory care settings is critical to prevent disease transmission.
Download full-text PDF |
Source |
|---|---|
| http://dx.doi.org/10.1016/j.ajic.2011.03.007 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Comparing the clinical efficacy of preganglionic and preganglionic plus ganglionic transforaminal epidural steroid injections for lumbosacral radicular pain.
Neurosciences (Riyadh)
January 2025
From the Department of Algology (Göksu), Ankara Dr. Abdurrahman Yurtaslan Oncology Training and Research Hospital, Ankara Dr. Abdurrahman Yurtaslan Oncology Training and Research Hospital, from the Department of Algology (Celik, Akcaboy, Şahin), University of Health Sciences Ankara City Hospital, Ankara, from Ankara Gaziler PMR Training and Research Hospital (Baran), University of Health Sciences, Ağrı, from the Department of Algology (Yıldız), University of Health Sciences Ankara Etlik City Hospital, Ankara, from the Department of Algology (Kaya), Adıyaman University Training and Research Hospital, Adıyaman, and from the Department of Algology (Ayhan), Dumlupinar University Kutahya Evliya Celebi Training and Research Hospital, Kütahya, Turkey.
Objectives: To compare the effectiveness of preganglionic transforaminal epidural steroid injection (TFESI) with preganglionic plus postganglionic TFESI.
Methods: Patients with unilateral radicular pain and disc pathology were randomly assigned to either the preganglionic group or the preganglionic plus postganglionic group. All patients were evaluated using a numeric rating scale (NRS) and a patient satisfaction scale (PSS) at the third week and the third month after treatment.
Is there a relationship between lumbosacral epidural spinal injections and lumbosacral epidural lipomatosis? A retrospective study.
Neurochirurgie
January 2025
Department of Diagnostic Radiology and Nuclear Medicine, Faculty of Medicine, Jordan University of Science and Technology, P.O. Box 3030, Irbid 22110, Jordan.
Background: We aim to investigate the potential association between the administration of Lumbosacral epidural steroid injections (LESIs) and the subsequent onset or progression of Lumbosacral epidural lipomatosis (LEL) in patients devoid of established risk factors for LEL.
Methods: We carried out a single-center retrospective study on patients who underwent LESI. We collected demographics including age and gender as well as clinical and radiological characteristics including the type of corticosteroids utilized, the number of LESIs administered, the use of epidural guidance during LESI procedures, and LEL grading.
Comparison of Unilateral and Bilateral Transforaminal Epidural Steroid Injections in Unilateral Lumbar Disc Herniation: A Randomized Controlled Trial.
J Clin Med
December 2024
Department of Anesthesiology and Reanimation, School of Medicine, Ankara University, 06100 Ankara, Turkey.
To compare the efficiency of unilateral and bilateral transforaminal epidural steroid injections (TFESI) in patients with unilateral lumbar disc herniation (LDH). In this prospective randomized single-blinded study, patients with unilateral LDH were randomly divided into two groups: A unilateral TFESI group; and a bilateral TFESI group. The severity of pain and disability were assessed with the Numeric Rating Scale (NRS-11) and Oswestry Disability Index (ODI) at baseline, 1 week, 1 month, and 3 months after interventions.
View Article and Find Full Text PDFRecent Advances in Perioperative Analgesia in Thoracic Surgery: A Narrative Review.
J Clin Med
December 2024
Aberdeen Centre for Arthritis and Musculoskeletal Health (Epidemiology Group), Institute of Applied Health Sciences, School of Medicine, Medical Sciences and Nutrition, Aberdeen AB24 3UE, UK.
Thoracic surgery is associated with significant postoperative pain, which can hinder recovery and elevate morbidity risks. Traditionally, epidural anesthesia has been the cornerstone for pain management, but its drawbacks including technical challenges, side effects, and complications necessitate exploring alternative methods. This narrative review examined recent advances in perioperative analgesic strategies in thoracic surgery, focusing on regional anesthetic techniques like paravertebral blocks (PVBs), erector spinae plane blocks (ESPBs), intercostal blocks, and serratus anterior blocks.
View Article and Find Full Text PDFAre Stabilisation Exercises Effective After Epidural Steroid Injection in Patients With Cervical Radiculopathy? A Prospective Randomised Controlled Trial.
Eur J Pain
February 2025
Division of Pain Medicine, Department of Physical Medicine and Rehabilitation, Marmara University Faculty of Medicine, Istanbul, Turkey.
Background: Cervical radiculopathy is caused by dysfunction of nerve roots in the cervical spine. While many studies have assessed the effectiveness of interlaminar epidural steroid injection (ILESI) and stabilisation exercises separately for this condition, our study aims to evaluate the impact of different stabilisation exercise programmes following ILESI on treatment outcomes in radiculopathy patients.
Methods: Sixty-two patients with cervical radiculopathy were randomised into three groups: cervical ILESI-only (CO), neck stabilisation group (NSG) and scapular stabilisation group (SSG).
Want AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!