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Prévention de la transmission des micro-organismes en réanimation. Indicateurs et modalités de surveillance

Infective Endocarditis of Intracardiac Devices

This chapter discusses infections related to pacemakers (PMs) or implantable cardioverter defibrillators (ICDs) are major complications and are difficult to manage; complete removal of the device is required in a majority of cases. Many factors such as diabetes, underlying malignancy, corticosteroids, anticoagulation, and advanced age have been suspected as potential predisposing factors for developing a device-related infection, but only some of them can nowadays be considered as well characterized independent risk factors. The diagnosis of a device-related infection can be difficult to establish. The clinical presentation depends on many variables, including the site of infection (the pulse-generator pocket and/or the conducting system), the type of electrode implanted (epicardial or intraventricular transvenous), the route of contamination (erosion, wound or pocket infection, secondary to a bacteremia, or contiguous spread from an adjacent infectious focus), and the microorganism involved. In summary, the diagnosis of an implanted device-related infection must be suspected in the presence of any erosion of an implanted device, chronic fever without documented infectious foci, multiple pulmonary infiltrates or emboli, and/or persistent or relapsing evidence of infection at the insertion site. Despite strong microbiological and epidemiological data suggesting that local contamination with the flora present in the skin appendages might contaminate the wound margin during the surgical procedure and be responsible for a majority of device-related infections, systemic antibiotic prophylaxis has remained controversial. Almost all authors report the necessity for assiduous skin disinfection before surgery, and others employ intrapocket antibiotic spray or instillation before insertion.

Pacemaker and Defibrillator Infections

Efficacy of antiseptic-impregnated central venous catheters in preventing catheter-related bloodstream infection. A Meta-analysis

<title>Abstract</title> Urosepsis, is a severe systemic infection resulting from a urinary tract infection (UTI) that has spread to the bloodstream. Urosepsis management is challenging, especially in immunocompromised oncology patients. In this retrospective study, we characterized the urosepsis cases in oncology patients between 2019 and 2023. Of the 337 cases, males were the most affected group (p = 0.039). Similar to other studies <italic>Escherichia coli</italic> was the most common cause of urosepsis in our oncology patients. None of the analyzed variables showed any statistical significance associated with urosepsis. These include type of tumor (liquid or solid), nephrostomy, double J stent, Diabetes Mellitus, length of stay, and presence of a central line. Our study was the first study from Palestine that looked at urosepsis in oncology patients. The overall challenge in urosepsis in our oncology patients remains to be the emergence of antimicrobial resistance in the isolated urosepsis pathogens. 

Prevalence of Certain Microorganisms in Cancer Patients with Urosepsis and Literature Review

Central line sepsis in intensive care units: overview and update

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Central line sepsis in intensive care units: overview and update