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Biomedical subjects

O B Jepsen

Publications and source records attributed to O B Jepsen.

At least 37 records · Page 2Linked to original sources
PubMed1993

Nosocomial epidemic of Serratia marcescens septicemia ascribed to contaminated blood transfusion bags.

Two cases of transfusion-related Serratia marcescens bacteremia prompted extensive epidemiologic investigations in three independent hospitals. Test tubes and plasma from donors whose blood was drawn into bags from a single production batch were cultured. Analysis of the ribotype of S. marcescens isolates was performed. For comparison, a strain from the production plant and eight other, unrelated bacteremia isolates were examined. In addition, a retrospective national survey was carried out. S. marcescens was cultured from 11 (0.73%) of 1515 blood units, and an additional (third) bacteremic patient was identified. The clinical isolates from three patients, the three units of blood transfused, and the plant-derived strain shared a unique ribotype. The incident is interpreted as a sporadic, bacterial contamination of blood bags with the S. marcescens epidemic strain, occurring during the manufacturing or packaging. A similar incident has not previously been reported. Attention is drawn to the possibility of significant contamination during the complex production of multiple-bag blood collection systems. Guidelines for improved registration and handling of transfusion complications in wards are suggested. Manufacturers should be encouraged to provide blood packs with sterile exteriors, in appropriate, single, outer packages.

Aged↗
PubMed1992

[Removal and storage of human bone for transplantation. Directives for infection control].

When bone is transplanted from one person to another, a risk of simultaneous transfer of infectious material is present. Transfer of bacteria is commonest but transmission of Hepatitis virus and HIV have been described. In order to reduce this risk as much as possible, medical and social screening of the donors are recommended together with hepatitis B antigen test (HBsAg), hepatitis C antibody test (anti-HCV) and HIV antibody test. In addition, living donors are preferable on account of the better possibilities for screening. The risk of transfer of HIV is limited at present, if male donors are aged over 60 years and female donors are over 40 years. Removal of the tissue should always be undertaken under sterile conditions. Aerobic and anaerobic culture of multiple bone biopsies from the transplant on removal of the tissue are recommended. Neither freezing nor freeze-drying result in decontamination of the bone. Chemical methods and also irradiation are considered inadequate or injurious to the quality of the bone.

Adult↗
PubMed1992

Recording of postoperative wound infections in Denmark. Implementation, surgeons attitude, status and recommendations.

PURPOSE: To evaluate the state of the surveillance of surgical infections in Denmark. To investigate whether a negative attitude to infection registration on the part of the chief surgeon is correlated to departments with no plans of recording their infections. DESIGN: Questionnaire sent to all surgical and gynaecological departments in Denmark. PLACE: The National Centre for Hospital Hygiene, Statens Seruminstitut, Copenhagen, Spring 1991. MATERIAL: 73 general, 34 orthopaedic, eight thoracic and vascular surgical departments, seven reconstructive, five neurosurgical, and 31 gynaecological departments. VARIABLES: Kind of specialty, attitudes to infection registration, do register, plan to register, no plans to register, type of program, year of start of registration, satisfaction, problems and suggestive improvements. RESULTS: Out of 170 possible units, 65 were already recording their infection rates, 59 had plans to start registration, 34 had no plans to start, five did not state whether they had any plans to start, and seven units did not respond. The units which were recording their infections had a more positive attitude towards surveillance systems. CONCLUSIONS: We found that the Danish public health service had a high degree of concern about infection surveillance without any legislative or other regulative pressures, and the process of implementing surveillance is still ongoing. The adoption of a common minimal data set is recommended in order to make a national and international comparison of infection surveillance data possible. Enlarging the infection control team may result in a better wound infection surveillance in hospitalised patients. More intensive studies are needed to examine how effectively surveillance prevents postoperative infections.

Attitude of Health Personnel↗
PubMed1991

[Registration of postoperative wound complications at a department of vascular surgery].

During the period 1 March 1987 to 31 December 1988, current registration of all vascular surgical operations in the Department of Vascular Surgery RK, Rigshospitalet, was undertaken employing a PC-based programme (DANOP-DATA). A total of 1,898 primary vascular surgical operations were performed on 1,335 patients. During the entire period, 48 (2.5%) patients with wound infection were registered. In half of these, the infection was superficial and in the remainder the infection was deep. Comparison between 1987 and 1988 revealed a non-significant tendency towards a lower incidence of infection in 1988. Significantly more wound infections were found after non-sterile operations (p = 0.005). Significantly more deep infections were found on employing synthetic vascular prostheses (p less than 0.00001) and with inguinal incisions (less than 0.05). No significant connection could be found with age, duration of preoperative hospitalization, duration of operation and the degree of planning of the operation. The authors find that computer-based monitoring of the surgical activity is a good which renders current assessment and analysis of the pattern of complications possible. The authors did not find that DANOP-DATA was sufficient for registration in a special department for vascular surgery and a programmel (KARBASE) has been developed which is more suitable for this purpose.

Adolescent↗
PubMed1991

Increased number of sporadic nosocomial group A streptococcal bacteraemias during a community epidemic.

An increased morbidity rate due to Lancefield group A streptococci (GAS) in the Scandinavian countries, beginning late in 1987, led to the present retrospective survey of bacteraemias with GAS in Denmark. Among 242 reported cases from January 1987-December 1989, 94 were found to have been nosocomially acquired, and their occurrence mirrored the pattern of the epidemic with T-type 1 and the seasonal variation of other serotypes in the community. The 27 nosocomial cases from 1988 were studied further. Eighty percent were associated with postoperative wound infection, erysipelas, puerperal or neonatal infection. Of the 52 community-acquired cases in 1988, 80% comprised erysipelas, respiratory tract infection, meningitis, gastrointestinal disease or arthritis. The bacteraemic patients were promptly treated with antibiotics, but the use of penicillin was in some cases delayed because the clinical signs of streptococcal infection were misinterpreted by the attending clinician. Ideally, the nosocomial infections should have been prevented by hygienic measures in the hospitals. When an epidemic situation of this type exists in the community, handwashing routines become vitally important. A warning for epidemics should be extended to the hospital.

Adult↗
PubMed1989

[Risk of occupationally acquired HIV infection among health manpower. A review of known cases].

In the world literature, 31 probable or certain cases of occupational HIV-infection among health staff have been described during a period of ten years from 1977. In 17 cases needle punctures had occurred while cuts or skin/mucosal exposure had occurred on 11 occasions. The predominant route of infection was thus percutaneous lesions most frequently in connection with giving injections or taking blood samples and the most exposed persons were nurses and laboratory staff. Cohort investigations of HIV-infection following percutaneous exposure include a total of approximately 1,500 persons and the risk of seroconversion, ie infectionsness, was, in these cases, 0.5% (0.2-1.1%), on an average. The occupational risk for HIV-infection among health staff in Denmark is low and is determined by the infectionsness, incidence of exposure (particularly needle punctures) and the prevalence of carrieres of infection. On the basis of certain assumptions about the incidence of needle punctures and the prevalence of HIV-carriers the average risk for nurses is calculated to be 1 per 100 years or 1 per 20,000 staff.

Acquired Immunodeficiency Syndrome↗
PubMed1989

[Postoperative wound infections at a mixed surgical department. 1 year's registration employing a PC-based system].

Operation wounds and surgical wound infections (S.W.I.) in the surgical department of Holbaek County Hospital were recorded over a period of one year. This registration was conducted in co-operation with the National Centre for Hospital Hygiene to test a standardised and simplified registration system and edb-programme, the Danop-Data system, developed to record S.W.I. on PC. 1.377 wounds and 45 S.W.I. were recorded. The overall infection rate was 3.3%. This compares favourably with rates reported in more extensive foreign investigations. There were significantly fewer infections during the second six months than during the first six month of the year. This was not due to changed conditions during the period of registration. The registration system and the edb-programme provide a satisfactory method of continuous surveillance of S.W.I. At the same time, the system itself proved very easy to use.

Computer Systems↗
PubMed1989

[Registration of postoperative wound infections by ADB. A trial of the Danop program].

The EDB programme, Danop, which was developed in cooperation with Statens Seruminstitut which is the central department for hospital hygeine in Denmark, was employed during the period 1.7.1987-30.6.1988 for consecutive registration of operative interventions and postoperative wound infection. During the period, 1,660 interventions were registered with a total frequency of infection of 3.5%; 2.6% of these in clean cases and 13.8% in infected cases. About one third of the infections were demonstrated by the general practitioners after discharge. In connection with introduction of registration, a considerable decrease in the number of postoperative wound infections occurred. It is decisive for the employability of the system that a reliable procedure for registration and return information is organized. The system is easy to use and functions well and does not require prior knowledge of edb and it provides excellent current control of and review of postoperative wound infections in one or more departments.

Computer Systems↗
PubMed1989

The DANOP-DATA system: a low-cost personal computer based program for monitoring of wound infections in surgical ward.

A low-cost personal computer program to monitor surgical wound infections was developed in parallel to the Danish national guidelines for recording postoperative wound infections. Internationally accepted definitions were used. The program offers three fixed-data entry screens and produces user-specified variations of four standard tables, comprising most of the epidemiological data needed for surveillance and infection control. The program was tested in Danish hospitals and was found to serve well as a simple local tool for the operating staff, offering fast information on infection rates. Results from two hospitals consisting of 3904 operations are presented. Infections occurring after discharge were included. Overall infection rates for clean wounds were 2.3%, clean-contaminated wounds 4.7%, contaminated wounds 4.3% and dirty operations 8.3%. None of the hospitals had used infection surveillance systems before.

Denmark↗
PubMed1989

[The Danop Data System for decentralized postoperative surveillance of wound infections].

The Danop Data System is a microcomputer system designed for the local (ward) surveillance of postoperative surgical infections. The system is served by a simply operated microcomputer program capable of tabulating data input in four standard tables providing continuous information sufficient for surveillance purposes. The aim is that, within a five-year period, 50 per cent of all Danish hospitals will adopt this or similar systems. The system is envisaged as a preliminary to more systematic surveillance of all nosocomial infections.

Computer Systems↗
PubMed1988

Antibiotic therapy of meningitis caused by ampicillin-resistant Haemophilus influenzae in Denmark and Greenland 1981 to 1987.

A survey was performed in Denmark and Greenland in order to determine whether the current recommendation of ampicillin (400 mg/kg/day) for initial treatment of purulent meningitis is appropriate. Data obtained 1981-1987 in an ongoing nationwide programme for surveillance of ampicillin-resistant Haemophilus species was analysed, and patient records of 21 cases of meningitis caused by ampicillin-resistant Haemophilus influenzae strains (17 in Denmark, 4 in Greenland) reported in the period 1981-1987 were reviewed. In Denmark the overall rate of ampicillin-resistant Haemophilus influenzae was estimated to be approximately 2% for the study period, and the average rate of resistant isolates from spinal fluid was 5.2% (range 0-12.3%). The incidence of meningitis caused by ampicillin-resistant Haemophilus influenzae strains remained low in the Danish population (around 0.05/100,000/year) except for a peak in 1985. The overall mortality rate of Haemophilus influenzae meningitis for the study period was 2.4%, which was the same as before 1980. In Greenland the actual number of cases of meningitis caused by ampicillin-resistant Haemophilus influenzae was small, but the incidence was at least 40 to 80 times higher than in Denmark with a high mortality rate (50%). These observations prompted revision of the antibiotic regimen in Greenland, whereas the regimen was considered appropriate in Denmark.

Adult↗
PubMed1988

A comparison of the effects of preoperative whole-body bathing with detergent alone and with detergent containing chlorhexidine gluconate on the frequency of wound infections after clean surgery. The European Working Party on Control of Hospital Infections.

In a prospective, randomized, double-blind, placebo-controlled study involving 27 surgical units in six European countries, the effect of preoperative whole-body bathing on two occasions with a detergent containing chlorhexidine (CHX+) on the incidence of wound infection in elective, clean surgery was compared with two bathings with a detergent without chlorhexidine (CHX-). In the CHX+ group 2.62% of 1413 patients and in the CHX- group 2.36% of 1400 patients subsequently became infected. The infection rate in the CHX+ group was 1.11 times that in the CHX- group with 95% confidence limits ranging between 0.69 and 1.82. Consequently, bathing patients twice preoperatively with chlorhexidine-detergent did not reduce the incidence of infection of clean wounds.

Adolescent↗
PubMed1988

Seroepidemiological study of Legionella infection in Denmark. A 28-month retrospective survey.

An indirect immunofluorescence (IF) test for Legionella antibodies has been used since 1978 at Statens Seruminstitut, Copenhagen. An increasing annual number of blood specimens from all parts of the country has been tested by IF and the number of Legionella antigens in the test was increased from 4 over 10 to 13, resulting in an ever growing number of seropositive patients over the years. We investigated the occurrence of serologically diagnosed Legionella infections from November 1982 through February 1985, a period of 28 months during which the same 13 Legionella antigens were applied in the IF test. We used CDC's criteria for the serological diagnosis of a current Legionella infection: a greater than or equal to 4-fold rise in antibody titre to greater than or equal to 128 in the IF test. In a test of more than 5,000 blood specimens from 3,374 patients, 69 were found to have diagnostic titre rises. When analysed according to serological reactions with three groups of antigens, seroconversion to a L. pneumophila antigen was found to be more frequent in patients 30-59 years old than seroconversion to a non-L. pneumophila Legionella antigen, while in the age group 60-69 this relation was reversed. Thirteen of the 69 patients had acquired their infection abroad. Twelve of these were below the age of 60, and they had all seroconverted to a L. pneumophila antigen. Clinical data were in accordance with the assumption that Legionella may have been the aetiological agent of the disease in our patients selected by serological criteria.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗