Axel Kramer

Axel Kramer
University of Greifswald · Institute of Hygiene and Environmental Medicine

About

383
Publications
75,467
Reads
How we measure 'reads'
A 'read' is counted each time someone views a publication summary (such as the title, abstract, and list of authors), clicks on a figure, or views or downloads the full-text. Learn more
6,292
Citations

Publications

Publications (383)
Book
Full-text available
Today surgical debridement and antibiotic therapy are the foundations of anti-infectious strategies which treat acute and chronic infections in soft tissue and orthopedic wounds. But it must be considered that antiseptics, mostly antiseptic solutions, can be used as an additional or alternative anti-infectious therapy to prevent infections or to tr...
Article
Full-text available
Purpose Data from recent adult studies suggest a decline of median urinary iodine concentrations (UIC) in Germany, but since 1996 no German study investigated UIC in neonates. The aim of our study was to investigate UIC and serum thyroid-stimulating hormone (TSH) levels in neonates from Germany. Methods We used data from 399 neonates, which were b...
Chapter
Drug delivery through the skin barrier is a topic of high interest in cosmetology and dermatology. The disruption of the skin barrier is a common method to stimulate skin penetration. In the present chapter tissue tolerable plasma is used to damage the skin barrier, enabling topically applied substances to effectively pass the stratum corneum. Subs...
Article
Background Prevention of surgical‐site infection (SSI) has received increasing attention. Clinical trials have focused on the role of skin antisepsis in preventing SSI. The benefit of combining antiseptic chlorhexidine with alcohol has not been compared with alcohol‐based skin preparation alone in a prospective controlled clinical trial. Methods B...
Article
Full-text available
Wound antisepsis has undergone a renaissance due to the introduction of highly effective wound-compatible antimicrobial agents and the spread of multidrug-resistant organisms (MDROs). However, a strict indication must be set for the application of these agents. An infected or critically colonized wound must be treated antiseptically. In addition, s...
Article
In Germany alcohol-based skin antiseptics are standard for the preoperative treatment of skin. In the meantime, sterile preparations are offered. The review aims to assess, if the use of sterile skin antiseptics has an additional benefit. The European Pharmacopoeia does not require sterility for pharmaceutical preparations used on intact skin but a...
Article
In Germany alcohol-based skin antiseptics are standard for the preoperative treatment of skin. In the meantime, sterile preparations are offered. The review aims to assess, if the use of sterile skin antiseptics has an additional benefit. The European Pharmacopoeia does not require sterility for pharmaceutical preparations used on intact skin but a...
Article
Objective: The use of cold atmospheric pressure plasma (CAPP) as a new therapeutic option to aid the healing of chronic wounds appears promising. Currently, uncertainty exists regarding their classification as medical device or medical drug. Because the classification of CAPP has medical, legal, and economic consequences as well as implications for...
Article
Full-text available
Background: Much of the existing literature on the epidemiology of multidrug resistant bacterial organisms (MDROs) and infection control measures still concentrates on hospital care settings. Aim: We piloted a cross-sectional survey in long-term care facilities (LTCFs), rehabilitation clinics and home care services (HCSs) to assess the prevalenc...
Article
Introduction Despite the use of modern antibiotics as well as complex perioperative, intraoperative and postoperative prophylactic measures, the rate of surgical site infections (SSI) could not be significantly reduced. The introduction of biocompatible antiseptic drugs with a high microbiocidal effect provided a successful alternative for infectio...
Article
Wound antiseptics are indispensable for both the prophylaxis and treatment of wound infections. As long as an infeaion only affects the vea of the wound and has not been disseminated either haematogenously or lymphogenous, there is an indication for the sole application of wound antiseptics. In cases of systemic involvement, an antimicrobial chemot...
Poster
Full-text available
Zielsetzung Mit dem Ende des HICARE-Projektes stellte sich die Frage, wie das MRE-Netzwerk zu einer zukunftsfähigen Struktur weiterentwickelt werden kann. Die Autoren beschreiben die Gründung des KOMPASS e. V. als Beispiel für die erfolgreiche Überführung eines drittmittel-finanzierten Forschungsprojektes in eine mitgliedergetragene Netzwerkstruktu...
Article
Full-text available
Cold atmospheric plasma (CAP) has been repeatedly identified to bear powerful microbicidal efficacy on bacteria including multidrug resistant organisms and fungi on non-living surfaces, in biofilms as well as on contaminated and infected tissues. CAP furthermore was found to stimulate wound healing in chronic wounds and exerted anti-neoplastic effe...
Article
Objective: Acute traumatic wounds are contaminated with bacteria and therefore an infection risk. Antiseptic wound irrigation before surgical intervention is routinely performed for contaminated wounds. However, a broad variety of different irrigation solutions are in use. The aim of this retrospective, non-randomised, controlled longitudinal cohor...
Article
Full-text available
Background/aim: To evaluate the potential involvement of redox-specific signalling pathways in cold atmospheric plasma (CAP)-induced apoptosis on human osteosarcoma cells. Materials and methods: Osteosarcoma cell lines were treated with CAP with or without antioxidative agents and seeded in cell culture plates. Cell proliferation was determined...
Article
Background: The role of enterococci in the context of peritonitis and surgical site infections (SSI) has not yet been definitively clarified but enterococci are being detected more frequently. Numerous resistances reduce the available antibiotic options. Objective: This article gives an overview of the pathogenic importance of enterococci and of...
Article
In general surgery the etiology of surgical site infections has not significantly changed over the last 30 years. Gram-positive bacteria, e.g. coagulase negative staphylococci (CNS), Staphylococcus aureus and Enterococcus spp. as well as Gram-negative bacteria, e.g. Escherichia coli, Enterobacter spp., Klebsiella spp. and Pseudomonas aeruginosa, ar...
Article
WHO recommends the use of hand rubs with “sustained activity” for surgical hand preparation. This structured narrative review aims to verify if any of the alcohol-based hand rubs containing non-volatile “active ingredients” such as chlorhexidine digluconate (CHG), mecetronium etilsulfate (MES) or ortho-phenylphenol (OPP) provide such sustained effi...
Article
Full-text available
Objective: The objective of this standardised experimental study was to investigate the antimicrobial efficacy of the combination of chlorhexidine digluconate (CHX) and the anti-inflammatory pro-vitamin dexpanthenol, which stimulates wound-healing, in the form of Bepanthen® Antiseptic Wound Cream, in order to rule out possible antagonistic combinat...
Article
Ende 2015 lief die Förderung für das vorrangig forschungsorientierte HICARE-Netzwerk aus. Damit stellte sich die Frage, wie das MRENetzwerk zu einer zukunftsfähigen Struktur weiterentwickelt werden kann. Ausgehend von einer Situationsanalyse beschreibt der Beitrag die Gründung des KOMPASS e. V. als Beispiel dafür, wie aus einem Drittmittel-finanzie...
Article
Die Bilanz ist erschreckend: In Deutschland sterben jährlich rund 15.000 Menschen an Infektionen mit gefährlichen Krankenhauskeimen. Dabei sind Patienten nicht nur potenzielle Opfer einer Infektion, sondern ebenso wie ihre Angehörigen Überträger der Erreger. Das „AHOI“-Projekt der Uniklinik Greifswald will daher Patienten stärker für das Thema Infe...
Article
Chlorhexidine gluconate is used to prevent the accumulation of dental plaque and gingivitis, infection of the surgical site, and ventilator-associated pneumonia in maxillofacial surgery, but it is not clear whether the metabolites of chlorhexidine are detectable in the patient’s saliva at clinically relevant concentrations. Forty-three patients who...
Article
Background: Few studies have explored the microbial contamination of glove boxes in clinical settings. The objective of this observational study was to investigate whether a new glove packaging system in which single gloves are dispensed vertically, cuff end first, has lower levels of contamination on the gloves and on the surface around the box a...
Chapter
Die Verabreichung von Medikamenten in die lebende Epidermis der Haut ist weit verbreitet in der Dermatologie. Leider erreichen tatsächlich jedoch nur geringe Mengen dieser Medikamente die lebende Epidermis. Daher ist die Entwicklung und Anwendung neuer so genannter Drug-Delivery-Methoden von sehr großer Bedeutung. Während die Plasmabehandlung die H...
Chapter
Kalte Plasmen zeigen eine hohe Wirksamkeit gegen Mikroorganismen und Viren sowie gegen bakterielle und fungielle Biofilme bei gleichzeitiger Verträglichkeit für die Körperoberfläche sowie für unbelebte Materialien. Darüber hinaus besteht die Möglichkeit der gezielten Modifikation der Eigenschaften von Mikroorganismen. Polymere und metallische Oberf...
Article
Die Vermeidung postoperativer Wundinfektionen ist ethische Verantwortung und zugleich gesetzliche Verpflichtung. Sie stellt eine permanente Herausforderung fur alle an der chirurgischen Versorgung beteiligten Arzte und Pflegekrafte dar. Die Etablierung und Umsetzung einer interdisziplinaren Multibarrierenstrategie ist fur den Arzt eine Fuhrungsaufg...
Article
Background: Medical examination gloves and surgical gloves protect the wearer directly and the patient indirectly from the risk of contamination. Because of concerns related to latex allergy, an increasing trend toward the use of synthetic gloves made of materials other than latex is observable. However, currently it is unknown if the physical pro...
Article
The quality of the primary care of Gustilo–Anderson (GA) type IIIB and IIIC extremity injuries is crucial to the success of the limb salvage procedure. This article provides a compilation of consistent, but often controversially discussed aspects of initial debridement, modern techniques of lavage and wound closure, in addition to current issues on...
Article
Full-text available
Since the publication of the first "Hospital Hygiene Guideline for the implementation and operation of air conditioning systems (HVAC systems) in hospitals" (http://www.krankenhaushygiene.de/informationen/fachinformationen/leitlinien/12) in 2002, it was necessary due to the increase in knowledge, new regulations, improved air-conditioning systems a...
Article
There were 256 health care workers in 39 facilities who were interviewed about their perceptions of the quality of care of patients with and without multidrug-resistant organisms based on a standardized questionnaire. There are remarkable differences in the responses between facility types (acute care hospitals, long-term care hospitals, rehabilita...
Article
Full-text available
Aim: While the requirements for single-use gloves for staff protection are clearly defined, the conventional medical differentiation between "sterile surgical gloves" used during surgical procedures and "single-use medical gloves" used in non-sterile medical areas does not adequately define the different requirements in these two areas of use. Ste...
Article
Full-text available
Background : The aim of this questionnaire-based study conducted by the Austrian Society for Infection Control was to evaluate the current situation of waste disposal and the amount of medical non-hazardous waste in Austrian medical and dental surgeries in cities larger than 20,000 inhabitants. Based on the collected data, it was expected to identi...
Article
Full-text available
In recent years, extended-spectrum β-lactamases (ESBL) producing bacteria have been found in livestock, mainly as asymptomatic colonizers. The zoonotic risk for people working in close contact to animal husbandry has still not been completely assessed. Therefore, we investigated the prevalence of ESBL-producing Escherichia spp. in livestock animals...
Article
Full-text available
Objectives The purpose of this clinical study was to determine the antibacterial and antiplaque efficacy of a recently introduced octenidine-containing mouthrinse (Octenidol®) in comparison with established antiseptic mouthrinses. Materials and methods In a 4-day plaque-regrowth study employing a four-replicate cross-over design, a 0.1 % octenidine...
Chapter
Das wichtigste Ziel des Hygienekonzepts in der Ästhetischen Medizin mit Skalpell oder Laser ist die Vermeidung einer Wundinfektion, einer Surgical Site Infection (SSI). Die dominierende Infektionsquelle entstammt zumeist der residenten Flora. Das Infektionsrisiko erhöht sich mit dem Einsatz aggressiver Techniken. Gerade wegen des im Vergleich zum k...
Article
Hintergrund Die präoperative Hautantiseptik ist ein essenzieller Bestandteil der Multibarrierenstrategie zur Prävention postoperativer Wundinfektionen (SSI). Methoden Für die Hautantiseptik sind alkoholbasierte Formulierungen aufgrund ihrer raschen Wirkung und hohen Wirksamkeit Wirkstoff der ersten Wahl. Durch Zusatz remanent wirksamer Antisepti...
Article
Full-text available
In the age of multiresistant microbes and the increasing lack of efficient antibiotics, conventional antiseptics play a critical role in the prevention and therapy of wound infections. Recent studies have demonstrated the antiseptic effects of cold atmospheric pressure plasma (APP). In this pilot, study we investigate the overall suitability of one...
Article
As a result of their mode of filter feeding, zebra mussels (Dreissena polymorpha Pall.) have been observed to purify natural water bodies and in vitro. Therefore, the possibility of using zebra mussels for water purification was investigated in a slightly brackish water body of a large lagoon. In this study, water samples were taken above, near and...
Article
This article gives a report on principles of reprocessing of rigid and flexible endoscopes used in ENT units including structural and spatial requirements based on the general and also ENT-specific risks of infection associated with diagnostic and therapeutic endoscopy. The underlying legal principles as well as recommendations from scientific soci...
Article
Full-text available
Hintergrund Das diabetische Fußsyndrom (DFS) ist ein Krankheitsbild mit wachsender Bedeutung wegen der erheblichen Beeinträchtigung der Betroffenen, der zunehmenden Häufigkeit und des immensen Ressourcenverbrauchs. Wesentliche Aspekte der Diagnostik und der Therapie werden durch tradierte Vorstellungen geprägt und sind nicht geklärt. Ziel der Arbei...
Book
In der Ästhetischen Chirurgie sind Laser nicht mehr wegzudenken: Narben, Falten und Tätowierungen, Facial Rejuvenation, Nasen- und Blepharoplastik oder zahnärztlich-ästhetische Behandlungen – vielfältig sind die Indikationen, bei denen Laser Mittel der Wahl oder eine erfolgversprechende Alternative zur klassischen Chirurgie sind. Laserbehandlungen...
Article
Full-text available
AWMF-Leitlinien-Register Nr. 029/006 Entwicklungsstufe: S1 1 Intraartikuläre Punktionen und Injektionen: Hygienemaßnahmen 1. Präambel Das Risiko punktions-und injektionsassoziierter Infektionen hängt von Ort und Art des Eingriffs ab. Die Unterscheidung zwischen Infektionen nach Punktionen oder Injektionen ist unscharf und nicht abschließend geklärt...
Chapter
Die Prävention nosokomialer Infektionen einschließlich Surgical-site-Infektionen und die Ausbreitung multiresistenter Bakterien (MRE) erfordern ein evidenzbasiertes Qualitätsmanagement der Hygiene. Dargestellt werden die Voraussetzungen der Struktur- und Prozessqualität, die Evaluierung der Ergebnisqualität durch Infektionssurveillance, die Erfassu...
Article
Einleitung: Eine Osteitis der Schädelbasis ist eine lebensbedrohliche Erkrankung. Wenn ein multi-resistenter Erreger vorliegt, verschlechtert dies die Prognose. In diesem Fallbericht, wird ein zusätzlicher therapeutischer Ansatz bei der Erradikation eines multi-resistenten Staphylococcus aureus (MRSA) vorgestellt. Methoden: Ein immunsupprimierter P...
Article
Antibiotic resistance among Escherichia coli is globally an increasing problem in public healthcare. Understanding the spread of plasmid-mediated ESBL genes is of great importance in elucidating their molecular epidemiology. However, differentiation of subtypes and alleles is frequently hampered by the lack of comprehensive diagnostic tools. We the...
Article
Introduction: Antibiotic resistance has emerged as one of the eminent public health concerns. Infections can cause prolonged illness and are related to a high mortality. Expanding tourism and global travelling is one risk factor for spreading of "superbugs" (multidrug-resistant organisms, MDRO) from endemic countries with less hygiene conditions a...
Article
Nosokomiale, d. h. durch medizinische Maßnahmen erworbene Infektionen bedeuten für den Patienten eine vermeidbare und nicht selten gravierende Komplikation seiner Grunderkrankung. Nach den postoperativen Wundinfektionen bilden Harnwegsinfektionen (HWI) mit 22,4 % die zweithäufigste Fraktion nosokomialer Infektionen. Dies entspricht etwa 155.000 nos...
Article
Full-text available
Aim: Information on the epidemiology of multiresistant bacteria (MRB) with zoonotic potential is growing but still remains quite incomplete. This narrative mini-review provides a general overview of the epidemiology of the most important zoonotic MRB in cattle, swine and poultry in Europe. Methods: A literature search was conducted mainly on the Pu...
Article
Full-text available
Background Livestock-associated methicillin-resistant Staphylococcus aureus (LA-MRSA) has a wide host range and is transmissible to humans, especially to those with close contact to colonized animals. This study presents the first data on the occurrence of MRSA in farm workers and livestock farms (pig, cattle and poultry) in the federal state of Me...
Article
Hintergrund Für Krankenhäuser und Arztpraxen besteht die gesetzliche Verpflichtung zur Qualitätssicherung. Der Aufbau eines Qualitätsmanagements zur Prävention von postoperativen Wundinfektionen [SSI („surgical site infections“)] ist eine Führungsaufgabe, die hohe Sachkenntnis und Konsequenz erfordert. Präventionsmaßnahmen/Handlungsanweisungen...
Article
Hintergrund Im Rahmen der forensischen Fahreignungsbegutachtung wird Ethylglucuronid (EtG) als Alkoholkonsummarker im Urin bestimmt. Der Einsatz von ethanolischen Händedesinfektionsmitteln in Kliniken und Laboren dient bei Teilnahme an einem Alkoholabstinenzprogramm gelegentlich als Rechtfertigung bei grenzwertüberschreitenden EtG-Werten (> 100 ng/...
Chapter
Full-text available
In healthcare settings microbial contaminated surfaces play an important role in indirect transmission of infection. Especially surfaces close to the patients’ environment may be touched at high frequencies, allowing transmission from animated sources to others via contaminated inanimate surfaces. Therefore, the knowledge on the survival of bacteri...
Conference Paper
Objective: Octenidine has been used for many years as an antiseptic in medicine. Its use in the oral cavity is more frequently discussed. The purpose of this clinical study was to determine the efficacy of antibacterial activity and ability to inhibit plaque formation of a commercial available octenidine-containing mouthrinse (Octenidol®) in compar...
Article
Objective: Undergloves are a way to reduce moisture-related skin damage. The aim of this feasibility study was to gain experience with logistics, applicability, acceptability and cost of the routine use of reusable textile undergloves in a hospital setting. Methods: Undergloves were tested with 18 health-care workers on an intensive care unit ov...
Conference Paper
Wirkung von Guanidinthiocyanat (GdSCN) auf Nickel-Titan-Wurzelkanalinstrumente hinsichtlich Torsionsfestigkeit und Biegesteifigkeit sowie mikrobiozide und viruzide Wirksamkeit von GdSCN
Article
Full-text available
Because of its antimicrobial properties, nonthermal plasma could serve as an alternative to chemical antisepsis in wound treatment. Therefore, this study investigated the inactivation of biofilm-embedded Pseudomonas aeruginosa SG81 by a surface barrier-discharged (SBD) plasma for 30, 60, 150 and 300 s. In order to optimize the efficacy of the plasm...
Article
Full-text available
Präambel Im Interesse der Patientensicherheit haben in einem Hybridoperationssaal generell dieselben hygienischen Anforderungen zu gelten wie in konventionellen Operationssälen. Damit ist ein wichtiger Teil der vorgeschriebenen Qualitätssicherung erfüllt.