Screening and treatment of methicillin-resistant Staphylococcus aureus in children undergoing open airway surgery.
ABSTRACT (1) To determine the prevalence of methicillin-resistant Staphylococcus aureus (MRSA) colonization in children undergoing open airway surgery using a screening protocol; (2) to examine the rates of postoperative infection in this cohort; and (3) to determine adherence to a MRSA antibiotic protocol.
Retrospective cohort study.
Tertiary pediatric referral center.
The study population comprised 180 children undergoing 197 open airway operations from January 2007 to March 2009 at the Cincinnati Children's Hospital Medical Center.
Methicillin-resistant Staphylococcus aureus screening and treatment protocol.
Prevalence of MRSA colonization, postoperative infection rates, colonization rates by site, and adherence to antibiotic protocol.
A total of 180 patients who underwent 197 operations were included in the study. The overall prevalence of MRSA was 32.5%. There were no significant differences between MRSA-colonized and noncolonized patients regarding age at surgery, sex, gestational age at birth, or comorbidities. Postoperative infection rates were similar between the 2 groups (16% MRSA colonized; 17% MRSA noncolonized). Three patients who developed postoperative MRSA infections were MRSA negative on preoperative screening. Intraoperative adherence was high in both groups.
We describe a MRSA screening and treatment protocol for children undergoing open airway surgery. We found a high prevalence (32.5%) of MRSA colonization in these patients. Treatment of MRSA-colonized patients resulted in postoperative infection rates similar to those in MRSA-noncolonized patients. Treatment of MRSA-colonized patients resulted in no MRSA-associated postoperative infections, graft loss, or dehiscence. MRSA screening and treatment protocols may be helpful in minimizing MRSA-associated postoperative infections in these patients.
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Article: Congenital laryngeal anomalies[Show abstract] [Hide abstract]
ABSTRACT: Introdução As anomalias congênitas da laringe estão em risco de uma via aérea instável, sendo essencial que o clínico tenha uma boa compreensão dos problemas relevantes para o manuseio das vias aéreas de bebês. Objetivos (1) Familiarizar os clínicos com os problemas relevantes para o manuseio das vias aéreas de bebês e (2) apresentar uma descrição sucinta do diagnóstico e tratamento de uma série de anomalias congênitas da laringe. Métodos Artigo de revisão, no qual serão tratados os principais aspectos relacionados ao manuseio das vias aéreas de bebês. Conclusões É essencial que o clínico tenha um bom conhecimento dos problemas relevantes ao manuseio das vias aéreas de bebês.Brazilian journal of otorhinolaryngology 08/2014; 80(6). DOI:10.1016/j.bjorl.2014.08.001 · 0.62 Impact Factor
Article: Management of tracheal stenosis.[Show abstract] [Hide abstract]
ABSTRACT: PURPOSE OF REVIEW: The treatment for pediatric tracheal stenosis has evolved over the past 50 years. Open airway reconstruction has traditionally been the treatment of choice for this condition. Numerous recent publications now support the use of endoscopic techniques to both augment and sometimes replace open procedures. RECENT FINDINGS: During the past 12 months, a significant interest in expanding the role of airway dilation with balloons to manage airway stenoses has emerged. Development of novel airway stents, to include bioabsorbable products, holds promise to decrease the morbidity of stenting procedures. Continued improvement in preoperative imaging, in the form of virtual bronchoscopy, may someday replace airway endoscopy for planning purposes. Additionally, perioperative management strategies and the use of novel adjuvants have been introduced with a goal of improving outcomes in both endoscopic and open techniques through better control of granulation. Ultimately, advances in tissue engineering may provide yet another reconstructive option in the future. SUMMARY: Endoscopic techniques have an increasing role in the management of pediatric subglottic and tracheal stenosis. However, open airway reconstructive procedures are still required in cases of mature scar, high-grade stenosis, and long-segment stenosis.Current opinion in otolaryngology & head and neck surgery 08/2012; DOI:10.1097/MOO.0b013e328358566d · 1.39 Impact Factor