Methicillin-resistant Staphylococcus aureus in an Irish orthopaedic centre A FIVE-YEAR ANALYSIS
ABSTRACT This prospective five-year study analyses the impact of methicillin-resistant Staphylococcus aureus (MRSA) on an Irish orthopaedic unit. We identified 318 cases of MRSA, representing 0.76% of all admissions (41,971). A total of 240 (76%) cases were colonised with MRSA, while 120 (37.7%) were infected. Patients were admitted from home (218; 68.6%), nursing homes (72; 22.6%) and other hospitals (28; 8.8%). A total of 115 cases (36.6%) were colonised or infected on admission. Many patients were both colonised and infected at some stage. The length of hospital stay was almost trebled because of the presence of MRSA infection. Encouragingly, overall infection rates have not risen significantly over the five years of the study despite increased prevalence of MRSA. However, the financial burden of MRSA is increasing, highlighting the need for progress in understanding how to control this resistant pathogen more effectively.
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- "    Several studies have reported a prolonged length of stay (LOS) attributable to MRSA colonization and infections.   One study found the mean LOS for MRSAcolonized orthopedic patients to be 88 days, substantially longer than the 11-day mean LOS for patients not colonized with MRSA.  Sankar et al., reported that implementing preadmission MRSA screening in a population undergoing joint replacement surgery significantly reduced the average LOS from 10.43 to 9.47 days ( p=0.0049), and significantly reduced the incidence of nosocomial MRSA infections. "
ABSTRACT: To evaluate the potential economic value of a Staphylococcus aureus vaccine for pre-operative orthopedic surgery patients, we developed an economic computer simulation model. At MRSA colonization rates as low as 1%, a $50 vaccine was cost-effective [<or=$50,000 per quality-adjusted life year (QALY) saved] at vaccine efficacy >or=30%, and a $100 vaccine at vaccine efficacy >or=70%. High MRSA prevalence (>or=25%) could justify a vaccine price as high as $1000. Our results suggest that a S. aureus vaccine for the pre-operative orthopedic population would be very cost-effective over a wide range of MRSA prevalence and vaccine efficacies and costs.Vaccine 03/2010; 28(12):2465-71. DOI:10.1016/j.vaccine.2009.12.075 · 3.49 Impact Factor
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ABSTRACT: The paper presents an adaptive backstepping approach for systems in strict-feedback form using multilayered, nonlinear-in-the-parameters neural networks. A benefit this approach is that the construction of the controller is greatly simplified by obviating the need to construct a regressor or basis functions for the neural network. In addition the network is adapted solely online, with no off-line training. The neural network architecture is very simple, and scales easily with the number of backward steps taken in the control design.American Control Conference, 2002. Proceedings of the 2002; 02/2002
Conference Paper: Environmental significance of harvesting wind power on the Alleghenies[Show abstract] [Hide abstract]
ABSTRACT: The paper discusses the environmental and social significance of wind powered electric generation on the Allegheny Mountains. The existing power generation capacity in four states surrounding the region is first described and statistical data is given to show the history of fuel mix and emissions. Environmental effects of the existing power generation facilities are discussed in terms of greenhouse gas emissions. The wind potential available in the region is described. Recent developments and planned wind power projects are presented with a discussion of their environmental impacts. The current policies and initiatives applicable to wind power in Pennsylvania, Maryland, West Virginia, and Virginia are compared and suggestions are made to promote the use of wind energy potential in the regionPower Engineering Society General Meeting, 2004. IEEE; 07/2004