173 results on '"Troillet N"'
Search Results
2. Importance of whole genome sequencing for the assessment of outbreaks in diagnostic laboratories: analysis of a case series of invasive Streptococcus pyogenes infections
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Tagini, F., Aubert, B., Troillet, N., Pillonel, T., Praz, G., Crisinel, P. A., Prod’hom, G., Asner, S., and Greub, G.
- Published
- 2017
- Full Text
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3. Hospital pharmacists' reinforcement of guidelines for switching from parenteral to oral antibiotics: a pilot study
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von Gunten, V., Amos, V., Sidler, A.‐L., Beney, J., Troillet, N., and Reymond, J.‐Ph.
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- 2003
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4. Usefulness of Procalcitonin Serum Level for the Diagnosis of Bacteremia
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Liaudat, S., Dayer, E., Praz, G., Bille, J., and Troillet, N.
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- 2001
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5. Scoring system to predict the risk of surgical-site infection after colorectal resection
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Gervaz, P., Bandiera-Clerc, C., Buchs, N. C., Eisenring, M.-C., Troillet, N., Perneger, T., and Harbarth, S.
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- 2012
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6. A score for predicting surgical site infection after colorectal surgery: F25
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Gervaz, P., Buchs, N., Morel, P., Harbarth, S., and Troillet, N.
- Published
- 2011
7. Survey of nosocomial influenza in South-western Swiss hospitals during two seasonal epidemics
- Author
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Hequet, D, primary, Qalla-Widmer, L, primary, Balmelli, C, primary, Clerc, O, primary, Fuehrer, U, primary, Iten, A, primary, Portillo, V, primary, Senn, L, primary, and Troillet, N, primary
- Published
- 2019
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8. Correlation between in vitro susceptibility ofCandida albicans and fluconazole-resistant oropharyngeal candidiasis in HIV-infected patients
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Troillet, N., Durussel, C., Bille, J., Glauser, M. P., and Chave, J. P.
- Published
- 1993
- Full Text
- View/download PDF
9. Impact of an interdisciplinary strategy on antibiotic use: a prospective controlled study in three hospitals
- Author
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von Gunten, V., Troillet, N., Beney, J., Boubaker, K., Lüthi, J.-C., Taffé, P., and Reymond, J.-P.
- Published
- 2005
10. Surveillance of surgical site infections in abdominal surgery
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Troillet, N.
- Published
- 2003
11. Disseminated histoplasmosis in an adopted infant from El Salvador
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Troillet, N., Llor, J., Kuchler, H., Delèze, G., and Praz, G.
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- 1996
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12. Impact of participation in a surgical site infection surveillance network: results from a large international cohort study
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Abbas, M., primary, de Kraker, M.E.A., additional, Aghayev, E., additional, Astagneau, P., additional, Aupee, M., additional, Behnke, M., additional, Bull, A., additional, Choi, H.J., additional, de Greeff, S.C., additional, Elgohari, S., additional, Gastmeier, P., additional, Harrison, W., additional, Koek, M.B.G., additional, Lamagni, T., additional, Limon, E., additional, Løwer, H.L., additional, Lyytikäinen, O., additional, Marimuthu, K., additional, Marquess, J., additional, McCann, R., additional, Prantner, I., additional, Presterl, E., additional, Pujol, M., additional, Reilly, J., additional, Roberts, C., additional, Segagni Lusignani, L., additional, Si, D., additional, Szilágyi, E., additional, Tanguy, J., additional, Tempone, S., additional, Troillet, N., additional, Worth, L.J., additional, Pittet, D., additional, and Harbarth, S., additional
- Published
- 2019
- Full Text
- View/download PDF
13. First Results of the Swiss National Surgical Site Infection Surveillance Program: Who Seeks Shall Find - ERRATUM
- Author
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Troillet, N, Eisenring, Marie-Christine, Widmer, A F, and University of Zurich
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10234 Clinic for Infectious Diseases ,610 Medicine & health ,2725 Infectious Diseases ,2726 Microbiology (medical) ,2713 Epidemiology - Published
- 2017
14. Accuracy of Sensititre YeastOne echinocandins epidemiological cut-off values for identification of FKS mutant Candida albicans and Candida glabrata: a ten year national survey of the Fungal Infection Network of Switzerland (FUNGINOS)
- Author
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Kritikos, A., primary, Neofytos, D., additional, Khanna, N., additional, Schreiber, P.W., additional, Boggian, K., additional, Bille, J., additional, Schrenzel, J., additional, Mühlethaler, K., additional, Zbinden, R., additional, Bruderer, T., additional, Goldenberger, D., additional, Pfyffer, G., additional, Conen, A., additional, Van Delden, C., additional, Zimmerli, S., additional, Sanglard, D., additional, Bachmann, D., additional, Marchetti, O., additional, Lamoth, F., additional, Bregenzer, T., additional, Flückiger, U., additional, Orasch, C., additional, Heininger, U., additional, Franciolli, M., additional, Damonti, L., additional, Rothen, M., additional, Zellweger, C., additional, Tarr, P., additional, Fleisch, F., additional, Chuard, C., additional, Erard, V., additional, Emonet, S., additional, Garbino, J., additional, van Delden, C., additional, Genne, D., additional, Bochud, P., additional, Calandra, T., additional, Chave, J., additional, Graber, P., additional, Monotti, R., additional, Regionale, O., additional, Bernasconi, E., additional, Civico, O., additional, Rossi, M., additional, Krause, M., additional, Piso, R., additional, Bally, F., additional, Troillet, N., additional, Eich, G., additional, Gubler, J., additional, Fehr, J., additional, Imhof, A., additional, Ruef, C., additional, Berger, C., additional, Fankhauser, H., additional, Heinzer, I., additional, Frei, R., additional, Hertel, R., additional, Dolina, M., additional, Petrini, O., additional, Dubuis, O., additional, Graf, S., additional, Risch, M., additional, Ritzler, E., additional, Fracheboud, D., additional, Rohner, P., additional, Lienhardt, R., additional, Andreutti-Zaugg, C., additional, Gallusser, A., additional, Herzog, K., additional, Schibli, U., additional, Tissière, L., additional, and Schultze, D., additional
- Published
- 2018
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15. Nosocomial influenza in south-western Swiss hospitals during two seasonal epidemics: an observational study.
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Qalla-Widmer, L., Héquet, D., Troillet, N., Petignat, C., Balmelli, C., Bassi, C., Bellini, C., Chave, J.-P., Cometta, A., Christin, L., Clerc, O., Daher, O., Fuehrer, U., Marchetti, O., Merz, L., Portillo, V., Pralong, G., Sandoz, L., Senn, L., and Tâche, F.
- Abstract
Background: In Switzerland each year, influenza leads to between 112,000 and 275,000 medical consultations. Data on nosocomial influenza infection are limited.Aim: To describe nosocomial cases of seasonal influenza in south-western Switzerland.Methods: This study was conducted during two seasonal influenza epidemics from 2016 to 2018 in 27 acute care public hospitals in south-western Switzerland. During these two time-periods, every patient hospitalized for >72 h who was positively screened by reverse transcription-polymerase chain reaction or antigen detection for influenza was included in the survey. Characteristics of patients included age, sex, and comorbidities. Included patients were followed up until discharge or death. Complications and administration of antineuraminidases and/or antibiotics were registered.Findings: The median influenza vaccine coverage of healthcare workers was 40%. In all, 836 patients were included (98% with type A influenza virus in 2016-2017; 77% with type B virus in 2017-2018). Most patients (81%) had an unknown vaccine status. Overall, the incidence of nosocomial influenza was 0.5 per 100 admissions (0.35 per 1000 patient-days). The most frequent comorbidities were diabetes (20%), chronic respiratory diseases (19%), and malnutrition (17%). Fever (77%) and cough (66%) were the most frequent symptoms. Seventy-one percent of patients received antineuraminidases, 28% received antibiotics. Infectious complications such as pneumonia were reported in 9%. Overall, the all-cause mortality was 6%.Conclusion: The occurrence of nosocomial influenza underlines the importance of vaccinating patients and healthcare workers, rapidly recognizing community- or hospital-acquired cases, and applying adequate additional measures to prevent dissemination, including the timely administration of antineuraminidases to avoid antibiotic use (and misuse). [ABSTRACT FROM AUTHOR]- Published
- 2021
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16. Temporal trends and epidemiology of Staphylococcus aureus surgical site infection in the Swiss surveillance network: a cohort study
- Author
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Abbas, M., primary, Aghayev, E., additional, Troillet, N., additional, Eisenring, M.-C., additional, Kuster, S.P., additional, Widmer, A.F., additional, Harbarth, S., additional, Balmelli, Carlo, additional, Eisenring, Marie-Christine, additional, Harbarth, Stephan, additional, Kuster, Stefan P., additional, Marschall, Jonas, additional, Spicher, Virginie Masserey, additional, Pittet, Didier, additional, Ruef, Christian, additional, Sax, Hugo, additional, Schlegel, Matthias, additional, Schweiger, Alexander, additional, Troillet, Nicolas, additional, Widmer, Andreas F., additional, and Zanetti, Giorgio, additional
- Published
- 2018
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17. Epidemiological analysis of imipenem-resistant Serratia marcescens in hospitalized patients
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Troillet, N., Carmeli, Y., Venkataraman, L., DeGirolami, P., and Samore, M.H.
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- 1999
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18. Global outbreak of severe Mycobacterium chimaera disease after cardiac surgery: a molecular epidemiological study
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Ingen, J. van, Kohl, T.A., Kranzer, K., Hasse, B., Keller, P.M., Szafranska, A.K., Hillemann, D., Chand, M., Schreiber, P.W., Sommerstein, R., Berger, C., Genoni, M., Ruegg, C., Troillet, N., Widmer, A.F., Becker, S.L., Herrmann, M., Eckmanns, T., Haller, S., Holler, C., Debast, S.B., Wolfhagen, M.J., Hopman, J., Kluytmans, J., Langelaar, M., Notermans, D.W., Oever, J. ten, Barselaar, P. van den, Vonk, A.B., Vos, M.C., Ahmed, N., Brown, T., Crook, D., Lamagni, T., Phin, N., Smith, E.G., Zambon, M., Serr, A., Gotting, T., Ebner, W., Thurmer, A., Utpatel, C., Sproer, C., Bunk, B., Nubel, U., Bloemberg, G.V., Bottger, E.C., Niemann, S., Wagner, D., Sax, H., Ingen, J. van, Kohl, T.A., Kranzer, K., Hasse, B., Keller, P.M., Szafranska, A.K., Hillemann, D., Chand, M., Schreiber, P.W., Sommerstein, R., Berger, C., Genoni, M., Ruegg, C., Troillet, N., Widmer, A.F., Becker, S.L., Herrmann, M., Eckmanns, T., Haller, S., Holler, C., Debast, S.B., Wolfhagen, M.J., Hopman, J., Kluytmans, J., Langelaar, M., Notermans, D.W., Oever, J. ten, Barselaar, P. van den, Vonk, A.B., Vos, M.C., Ahmed, N., Brown, T., Crook, D., Lamagni, T., Phin, N., Smith, E.G., Zambon, M., Serr, A., Gotting, T., Ebner, W., Thurmer, A., Utpatel, C., Sproer, C., Bunk, B., Nubel, U., Bloemberg, G.V., Bottger, E.C., Niemann, S., Wagner, D., and Sax, H.
- Abstract
Item does not contain fulltext, BACKGROUND: Since 2013, over 100 cases of Mycobacterium chimaera prosthetic valve endocarditis and disseminated disease were notified in Europe and the USA, linked to contaminated heater-cooler units (HCUs) used during cardiac surgery. We did a molecular epidemiological investigation to establish the source of these patients' disease. METHODS: We included 24 M chimaera isolates from 21 cardiac surgery-related patients in Switzerland, Germany, the Netherlands, and the UK, 218 M chimaera isolates from various types of HCUs in hospitals, from LivaNova (formerly Sorin; London, UK) and Maquet (Rastatt, Germany) brand HCU production sites, and unrelated environmental sources and patients, as well as eight Mycobacterium intracellulare isolates. Isolates were analysed by next-generation whole-genome sequencing using Illumina and Pacific Biosciences technologies, and compared with published M chimaera genomes. FINDINGS: Phylogenetic analysis based on whole-genome sequencing of 250 isolates revealed two major M chimaera groups. Cardiac surgery-related patient isolates were all classified into group 1, in which all, except one, formed a distinct subgroup. This subgroup also comprised isolates from 11 cardiac surgery-related patients reported from the USA, most isolates from LivaNova HCUs, and one from their production site. Isolates from other HCUs and unrelated patients were more widely distributed in the phylogenetic tree. INTERPRETATION: HCU contamination with M chimaera at the LivaNova factory seems a likely source for cardiothoracic surgery-related severe M chimaera infections diagnosed in Switzerland, Germany, the Netherlands, the UK, the USA, and Australia. Protective measures and heightened clinician awareness are essential to guarantee patient safety. FUNDING: Partly funded by the EU Horizon 2020 programme, its FP7 programme, the German Center for Infection Research (DZIF), the Swiss National Science Foundation, the Swiss Federal Office of Public Health, and National
- Published
- 2017
19. Impact of an interdisciplinary strategy on antibiotic use: a prospective controlled study in three hospitals
- Author
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von Gunten, V., Troillet, N., Beney, J., Boubaker, K., Lüthi, J.-C, Taffé, P., Reymond, J.-P, von Gunten, V., Troillet, N., Beney, J., Boubaker, K., Lüthi, J.-C, Taffé, P., and Reymond, J.-P
- Abstract
Objectives: Evaluation of the impact of the implementation of practice guidelines, with or without their reinforcement by a pharmacist, on the intra-hospital use of antibiotics. Materials and methods: The duration of antibiotic treatment, their cost, and the length of patient stay were compared in three secondary-care hospitals, before and after interventions that were designed to promote rational antibiotic use. After randomization, hospital A received no intervention (control), local practice guidelines were implemented in hospital B (low grade intervention), and these guidelines were reinforced by a clinical pharmacist in hospital C (high grade intervention). Adherence to the guidelines was measured in hospitals B and C. Multivariable statistical analyses were carried out to adjust for confounding factors. Results: None of the outcomes measured in the 1200 included patients decreased between the two study periods in any hospital. Hospital A was significantly and independently associated with an increase in the duration of antibiotic treatments, the cost of antibiotics (acquisition and global costs), and the length of stay. Although these differences were not statistically significant, increases in hospital B were higher than in hospital C. Adherence to guidelines was significantly higher in hospital C. Conclusions: Even though interdisciplinary interventions aiming at rationalizing antibiotic use could not diminish the duration of treatments, their costs or the length of stay, they proved useful to control the progression of these parameters
- Published
- 2017
20. Unusual Spread of a Penicillin-Susceptible Methicillin-Resistant Staphylococcus aureus Clone in a Geographic Area of Low Incidence
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Blanc, D. S., Petignat, C., Moreillon, P., Entenza, J. M., Eisenring, M.-C, Kleiber, H., Wenger, A., Troillet, N., Blanc, C.-H, Francioli, P., Blanc, D. S., Petignat, C., Moreillon, P., Entenza, J. M., Eisenring, M.-C, Kleiber, H., Wenger, A., Troillet, N., Blanc, C.-H, and Francioli, P.
- Abstract
We describe the unusual spread of a penicillin-susceptible methicillin-resistant Staphylococcus aureus (MRSA) clone in hospitals in western Switzerland, where the incidence of MRSA is usually low. During a 2-year period, this clone had been responsible for several outbreaks and had been isolated from >156 persons in 21 institutions. Molecular typing by pulsed-field gel electrophoresis (PFGE) demonstrated that all of these isolates belonged to the same clone. In 1 of the outbreaks, involving 30 cases, the clone was responsible for at least 17 secondary cases. In contrast, during the period of the latter outbreak, 9 other patients harboring different MRSA strains, as assessed by PFGE, were hospitalized in the same wards, but no secondary cases occurred. These observations suggest that this clone, compared with other MRSA strains, had some intrinsic factor(s) that contributed to its ability to disseminate and could thus be considered epidemic
- Published
- 2017
21. [Leptospirosis in a family after whitewater rafting in Thailand]
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Gallardo C, Williams-Smith J, Katia Jaton, Asner S, Jj, Cheseaux, Troillet N, Manuel O, and Berthod D
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Adult ,Male ,Travel ,Adolescent ,Thailand ,beta-Lactams ,Anti-Bacterial Agents ,Rivers ,Doxycycline ,Zoonoses ,Animals ,Humans ,Recreation ,Female ,Leptospirosis - Abstract
Leptospirosis is a zoonosis found worldwide, with an incidence that is approximately 10 times higher in the tropics than in temperate regions. The main reservoir of leptospirosis is the rat and human infection usually results from exposure to infected animal urine or tissues. Only 10% of cases are symptomatic. We present here two confirmed and two probable cases of leptospirosis in a family returning from whitewater rafting in Thailand, illustrating the wide variety of the clinical manifestations of this infection. Two of the patients were hospitalized and presented a probable Jarisch-Herxheimer reaction after initiation of beta-lactam therapy. The two others patients were treated empirically with doxycycline. We discuss here some relevant aspects of the epidemiology, clinical manifestations, therapy and the challenge of an early diagnosis of leptospirosis.
- Published
- 2015
22. Accuracy of Sensititre YeastOne echinocandins epidemiological cut-off values for identification of FKS mutant Candida albicans and Candida glabrata: a ten year national survey of the Fungal Infection Network of Switzerland (FUNGINOS)
- Author
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Bregenzer, T., Conen, A., Flückiger, U., Khanna, N., Orasch, C., Heininger, U., Franciolli, M., Damonti, L., Zimmerli, S., Rothen, M., Zellweger, C., Tarr, P., Fleisch, F., Chuard, C., Erard, V., Emonet, S., Garbino, J., van Delden, C., Genne, D., Bochud, P., Calandra, T., Lamoth, F., Marchetti, O., Chave, J., Graber, P., Monotti, R., Regionale, O., Bernasconi, E., Civico, O., Rossi, M., Krause, M., Piso, R., Bally, F., Troillet, N., Boggian, K., Eich, G., Gubler, J., Fehr, J., Imhof, A., Ruef, C., Berger, C., Fankhauser, H., Heinzer, I., Frei, R., Hertel, R., Dolina, M., Petrini, O., Dubuis, O., Mühlethaler, K., Graf, S., Risch, M., Ritzler, E., Fracheboud, D., Schrenzel, J., Rohner, P., Lienhardt, R., Bille, J., Andreutti-Zaugg, C., Gallusser, A., Pfyffer, G., Herzog, K., Schibli, U., Tissière, L., Bruderer, T., Schultze, D., Zbinden, R., Kritikos, A., Neofytos, D., Schreiber, P.W., Goldenberger, D., Van Delden, C., Sanglard, D., and Bachmann, D.
- Published
- 2018
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23. Prévention des infections en hémodialyse. Partie II : Précautions standards au centre d'hémodialyse
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Bernasconi, E., Cereghetti, C., Petignat, C., Federli, I., Ruef, C., Francioli, P., Troillet, N., and Balmelli, C.
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surveillance ,hémodialyse ,infections ,vaccination - Published
- 2008
24. Thirteen years of surgical site infection surveillance in Swiss hospitals
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Staszewicz, W., primary, Eisenring, M.-C., additional, Bettschart, V., additional, Harbarth, S., additional, and Troillet, N., additional
- Published
- 2014
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25. [Methicillin resistant staphylococcus aureus (MRSA): incidence is growing in French-speaking Switzerland]
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Dominique Blanc, Troillet N, Hh, Siegrist, Fracheboud D, Petignat C, and Francioli P
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Patient Transfer ,Cross Infection ,Infection Control ,Molecular Epidemiology ,Staphylococcus aureus ,Incidence ,Microbial Sensitivity Tests ,Staphylococcal Infections ,Population Surveillance ,Humans ,Methicillin Resistance ,Seasons ,Serotyping ,Switzerland - Published
- 2001
26. Treatment of hepatitis C in HCV mono-infected and in HIV-HCV co-infected patients: an open-labelled comparison study
- Author
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Gonvers, JJ, primary, Heim, MH, additional, Cavassini, M, additional, Müllhaupt, B, additional, Genné, D, additional, Bernasconi, E, additional, Borovicka, J, additional, Cerny, A, additional, Chave, JP, additional, Chuard, C, additional, Dufour, JF, additional, Dutoit, V, additional, Malinverni, R, additional, Monnat, M, additional, Negro, F, additional, Troillet, N, additional, and Oneta, C, additional
- Published
- 2010
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27. Antibiotic use: is appropriateness expensive?
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von Gunten, V., primary, Reymond, J.-P., additional, Boubaker, K., additional, Gerstel, E., additional, Eckert, P., additional, Lüthi, J.-C., additional, and Troillet, N., additional
- Published
- 2009
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28. Changing Molecular Epidemiology of Methicillin-Resistant Staphylococcus aureus in a Small Geographic Area over an Eight-Year Period
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Blanc, D. S., primary, Petignat, C., additional, Wenger, A., additional, Kuhn, G., additional, Vallet, Y., additional, Fracheboud, D., additional, Trachsel, S., additional, Reymond, M., additional, Troillet, N., additional, Siegrist, H. H., additional, Oeuvray, S., additional, Bes, M., additional, Etienne, J., additional, Bille, J., additional, Francioli, P., additional, and Zanetti, G., additional
- Published
- 2007
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29. Unusual Spread of a Penicillin-Susceptible Methicillin-Resistant Staphylococcus aureus Clone in a Geographic Area of Low Incidence
- Author
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Blanc, D. S., primary, Petignat, C., additional, Moreillon, P., additional, Entenza, J. M., additional, Eisenring, M.- C., additional, Kleiber, H., additional, Wenger, A., additional, Troillet, N., additional, Blanc, C.- H., additional, and Francioli, P., additional
- Published
- 1999
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30. Prospective Randomized Comparison of Imipenem-Cilastatin and Piperacillin-Tazobactam in Nosocomial Pneumonia or Peritonitis
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Jaccard, C., primary, Troillet, N., additional, Harbarth, S., additional, Zanetti, G., additional, Aymon, D., additional, Schneider, R., additional, Chiolero, R., additional, Ricou, B., additional, Romand, J., additional, Huber, O., additional, Ambrosetti, P., additional, Praz, G., additional, Lew, D., additional, Bille, J., additional, Glauser, M. P., additional, and Comett, A., additional
- Published
- 1999
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31. Prospective Randomized Comparison of Imipenem-Cilastatin and Piperacillin-Tazobactam in Nosocomial Pneumonia or Peritonitis
- Author
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Jaccard, C., primary, Troillet, N., additional, Harbarth, S., additional, Zanetti, G., additional, Aymon, D., additional, Schneider, R., additional, Chiolero, R., additional, Ricou, B., additional, Romand, J., additional, Huber, O., additional, Ambrosetti, P., additional, Praz, G., additional, Lew, D., additional, Bille, J., additional, Glauser, M. P., additional, and Cometta, A., additional
- Published
- 1998
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32. Correlation between in vitro susceptibility of Candida albicans and fluconazole-resistant oropharyngeal candidiasis in HIV-infected patients.
- Author
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Troillet, N., Durussel, C., Bille, J., Glauser, M., and Chave, J.
- Abstract
Twenty-five patients seen consecutively at an HIV outpatient clinic who had clinical evidence of oropharyngeal candidiasis and two or more oral swabs positive for yeasts on culture were studied retrospectively. For each of the 65 isolates susceptibility to fluconazole was evaluated by the disk diffusion test and determination of the minimal inhibitory concentration (MIC). A correlation was sought between clinical resistance and in vitro susceptibility data. Seven patients were non-responders and 19 were responders (one patient figuring in both groups). Significant differences were observed between the two groups with respect to the median interval after the diagnosis of AIDS (27 months in non-responders and 2 months in responders; p=0.001), the median CD4+ cell count (6 and 21 cells/mm respectively; p=0.005) and the median number of previous episodes of oropharyngeal candidiasis treated with fluconazole (13 and 2 episodes respectively; p=0.001). Candida albicans was identified in 64 of 65 cultures. The correlation between MIC values and diameters of inhibition was good (r=0.85; p<0.001). The degree of in vitro susceptibility of the isolates to fluconazole showed a significant difference between non-responders and responders (mean inhibition diameters 13 and 36 mm respectively; p<0.001) with a tentative cut-off value of 25 mm. An advanced stage of HIV infection and previous exposure to fluconazole could be risk factors for the development of fluconazole-resistant oropharyngeal candidiasis. Candida albicans strains with decreased in vitro susceptibility to fluconazole were responsible for the clinical resistance which could be predicted by a simple disk diffusion test. [ABSTRACT FROM AUTHOR]
- Published
- 1993
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33. Changing Molecular Epidemiology of Methicillin-Resistant Staphylococcus aureusin a Small Geographic Area over an Eight-Year Period
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Blanc, D. S., Petignat, C., Wenger, A., Kuhn, G., Vallet, Y., Fracheboud, D., Trachsel, S., Reymond, M., Troillet, N., Siegrist, H. H., Oeuvray, S., Bes, M., Etienne, J., Bille, J., Francioli, P., and Zanetti, G.
- Abstract
ABSTRACTThe epidemiology of methicillin-resistant Staphylococcus aureus(MRSA) at an international level shows that most MRSA strains belong to a few pandemic clones. At the local level, a predominance of one or two clones was generally reported. However, the situation is evolving and new clones are emerging worldwide, some of them with specific biological characteristics, such as the presence of Panton-Valentine leucocidin (PVL). Understanding these changes at the local and international levels is of great importance. Our objective was to analyze the evolution of MRSA epidemiology at multiple sites on a local level (Western Switzerland) over a period of 8 years. Data were based on MRSA reports from seven sentinel laboratories and infection control programs covering different areas. Pulsed-field gel electrophoresis was used to type MRSA isolates. From 1997 to 2004, a total of 2,256 patients with MRSA were reported. Results showed the presence of four predominant clones (accounting for 86% of patients), which could be related to known international clones (Berlin, New York/Japan, Southern Germany, and Iberian clones). Within the small geographic region, the 8-year follow-up period in the different areas showed spacio-temporal differences in the relative proportions of the four clones. Other international MRSA clones, as well as clones showing genetic characteristics identical to those of community-acquired MRSA (SCCmectype IV and the presence of PVL genes), were also identified but presumably did not disseminate. Despite the worldwide predominance of a few MRSA clones, our data showed that at a local level, the epidemiology of MRSA might be different from one hospital to another. Moreover, MRSA clones were replaced by other emerging clones, suggesting a rapid change.
- Published
- 2007
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34. Epidemiological analysis of imipenem-resistant Serratia marcescensin hospitalized patients
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Troillet, N., Carmeli, Y., Venkataraman, L., DeGirolami, P., and Samore, M.H.
- Abstract
Our objective was to examine epidemiological characteristics of hospitalized patients with imipenem-resistant Serratia marcescens. We performed a case-control study using data collected from computerized databases and chart review. Molecular typing by pulsed field gel electrophoresis of available isolates was performed. One hundred and ten patients had Serratiaspp isolated during the 23-month study period. Twelve were infected or colonized with S. marcescensresistant or of intermediate susceptibility to imipenem. Eleven of the 12 patients were detected during a seven-month period between August 1994 and February 1995, suggesting the possible occurrence of an outbreak. However, the patients were admitted to different wards and services and, in eight patients, imipenem- resistant S. marcescenswere isolated within 48 h of admission. None of the patients had epidemiological links within other institutions. The 12 cases were not more likely to have been exposed to β-lactam antibiotics, including imipenem, than patients with imipenem-susceptible isolates. Six isolates were available for typing by PFGE; three were indistinguishable or closely related whereas each of the other three isolates were unique. In conclusion both the prevalence of imipenem-resistant S. marcescensand its unusual epidemiologic characteristics warrant further study.
- Published
- 1999
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35. [Surgical site infection surveillance: an effective preventive measure]
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Troillet N, Petignat C, Maurice MATTER, Mc, Eisenring, Mosimann F, and Francioli P
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Primary Prevention ,Cross Infection ,Infection Control ,Health Priorities ,Incidence ,Population Surveillance ,Prevalence ,Humans ,Surgical Wound Infection ,Switzerland - Abstract
Surgical site infection (SSI) is a feared complication of any surgical procedure. Despite clear progresses during the last decades, recent studies (some from Switzerland) show that many patients still suffer from SSIs and that SSIs have a huge impact for patients and public health. Thus, the prevention of SSIs must constitute a priority of nosocomial infections control in hospitals. In addition to classical approaches focusing on skin preparation, antibiotic prophylaxis, asepsis, and operative environment, surveillance has proved effective in decreasing the incidence of SSIs. The present paper reviews the principles and the main components of an SSI surveillance program.
36. Impact of an interdisciplinary strategy on antibiotic use: a prospective controlled study in three hospitals
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von Gunten, V., Troillet, N., Beney, J., Boubaker, K., Lüthi, J.-C, Taffé, P., Reymond, J.-P, von Gunten, V., Troillet, N., Beney, J., Boubaker, K., Lüthi, J.-C, Taffé, P., and Reymond, J.-P
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Objectives: Evaluation of the impact of the implementation of practice guidelines, with or without their reinforcement by a pharmacist, on the intra-hospital use of antibiotics. Materials and methods: The duration of antibiotic treatment, their cost, and the length of patient stay were compared in three secondary-care hospitals, before and after interventions that were designed to promote rational antibiotic use. After randomization, hospital A received no intervention (control), local practice guidelines were implemented in hospital B (low grade intervention), and these guidelines were reinforced by a clinical pharmacist in hospital C (high grade intervention). Adherence to the guidelines was measured in hospitals B and C. Multivariable statistical analyses were carried out to adjust for confounding factors. Results: None of the outcomes measured in the 1200 included patients decreased between the two study periods in any hospital. Hospital A was significantly and independently associated with an increase in the duration of antibiotic treatments, the cost of antibiotics (acquisition and global costs), and the length of stay. Although these differences were not statistically significant, increases in hospital B were higher than in hospital C. Adherence to guidelines was significantly higher in hospital C. Conclusions: Even though interdisciplinary interventions aiming at rationalizing antibiotic use could not diminish the duration of treatments, their costs or the length of stay, they proved useful to control the progression of these parameters
37. Unusual Spread of a Penicillin-Susceptible Methicillin-Resistant Staphylococcus aureus Clone in a Geographic Area of Low Incidence
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Blanc, D. S., Petignat, C., Moreillon, P., Entenza, J. M., Eisenring, M.-C, Kleiber, H., Wenger, A., Troillet, N., Blanc, C.-H, Francioli, P., Blanc, D. S., Petignat, C., Moreillon, P., Entenza, J. M., Eisenring, M.-C, Kleiber, H., Wenger, A., Troillet, N., Blanc, C.-H, and Francioli, P.
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We describe the unusual spread of a penicillin-susceptible methicillin-resistant Staphylococcus aureus (MRSA) clone in hospitals in western Switzerland, where the incidence of MRSA is usually low. During a 2-year period, this clone had been responsible for several outbreaks and had been isolated from >156 persons in 21 institutions. Molecular typing by pulsed-field gel electrophoresis (PFGE) demonstrated that all of these isolates belonged to the same clone. In 1 of the outbreaks, involving 30 cases, the clone was responsible for at least 17 secondary cases. In contrast, during the period of the latter outbreak, 9 other patients harboring different MRSA strains, as assessed by PFGE, were hospitalized in the same wards, but no secondary cases occurred. These observations suggest that this clone, compared with other MRSA strains, had some intrinsic factor(s) that contributed to its ability to disseminate and could thus be considered epidemic
38. Trends of the Epidemiology of Candidemia in Switzerland: A 15-Year FUNGINOS Survey
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Kai-Manuel, Adam, Michael, Osthoff, Frédéric, Lamoth, Anna, Conen, Véronique, Erard, Katia, Boggian, Peter W, Schreiber, Stefan, Zimmerli, Pierre-Yves, Bochud, Dionysios, Neofytos, Mapi, Fleury, Hans, Fankhauser, Daniel, Goldenberger, Konrad, Mühlethaler, Arnaud, Riat, Reinhard, Zbinden, Andreas, Kronenberg, Chantal, Quiblier, Oscar, Marchetti, Nina, Khanna, University of Zurich, Khanna, Nina, Fungal Infection Network of Switzerland (FUNGINOS), Bregenzer, T., Conen, A., Adam, K.M., Flückiger, U., Khanna, N., Orasch, C., Heininger, U., Franciolli, M., San Giovanni, O., Damonti, L., Zimmerli, S., Rothen, M., Zellweger, C., Tarr, P., Fleisch, F., Chuard, C., Erard, V., Emonet, S., Garbino, J., Neofytos, D., van Delden, C., Genne, D., Bochud, P.Y., Calandra, T., Lamoth, F., Marchetti, O., Chave, J.P., Bois-Cerf, C., Cécil, C., La Source, C., Graber, P., Monotti, R., Regionale, O., Bernasconi, E., Civico, O., Rossi, M., Krause, M., Piso, R.J., Bally, F., Troillet, N., Boggian, K., Eich, G., Gubler, J., Fehr, J., Imhof, A., Ruef, C., Werner Schreiber, P., Berger, C., Fankhauser, H., Heinzer, I., Goldenberger, D., Frei, R., Hertel, R., Dolina, M., Petrini, O., Dubuis, O., Mühlethaler, K., Graf, S., Risch, M., Ritzler, E., Fracheboud, D., Riat, A., Rohner, P., Schrenzel, J., Lienhardt, R., Bille, J., Andreutti-Zaugg, C., Gallusser, A., Pfyffer, G., Herzog, K., Schibli, U., Tissière, L., Bruderer, T., and Zbinden, R.
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medicine.medical_specialty ,Population ,610 Medicine & health ,resistance ,10234 Clinic for Infectious Diseases ,Internal medicine ,Intensive care ,medicine ,Major Article ,education ,Candida albicans ,education.field_of_study ,biology ,Candida glabrata ,business.industry ,10179 Institute of Medical Microbiology ,Incidence (epidemiology) ,candidemia ,Micafungin ,biology.organism_classification ,bacterial infections and mycoses ,Infectious Diseases ,AcademicSubjects/MED00290 ,2728 Neurology (clinical) ,Oncology ,antifungals ,candida ,epidemiology ,Anidulafungin ,570 Life sciences ,2730 Oncology ,business ,Fluconazole ,medicine.drug - Abstract
Background The increasing incidence of candidemia and emergence of drug-resistant Candida species are major concerns worldwide. Long-term surveillance studies are needed. Methods The Fungal Infection Network of Switzerland (FUNGINOS) conducted a 15-year (2004–2018), nationwide, epidemiological study of candidemia. Hospital-based incidence of candidemia, Candida species distribution, antifungal susceptibility, and consumption were stratified in 3 periods (2004–2008, 2009–2013, 2014–2018). Population-based incidence over the period 2009–2018 derived from the Swiss Antibiotic Resistance Surveillance System (ANRESIS). Results A total of 2273 Candida blood isolates were studied. Population and hospital-based annual incidence of candidemia increased from 2.96 to 4.20/100 000 inhabitants (P = .022) and 0.86 to 0.99/10 000 patient-days (P = .124), respectively. The proportion of Candida albicans decreased significantly from 60% to 53% (P = .0023), whereas Candida glabrata increased from 18% to 27% (P < .0001). Other non-albicans Candida species remained stable. Candida glabrata bloodstream infections occurred predominantly in the age group 18–40 and above 65 years. A higher proportional increase of C glabrata was recorded in wards (18% to 29%, P < .0001) versus intensive care units (19% to 24%, P = .22). According to Clinical and Laboratory Standards Institute, nonsusceptibility to fluconazole in C albicans was observed in 1% of isolates, and anidulafungin and micafungin nonsusceptibility was observed in 2% of C albicans and C glabrata. Fluconazole consumption, the most frequently used antifungal, remained stable, whereas use of mold-active triazoles and echinocandins increased significantly in the last decade (P < .0001). Conclusions Over the 15-year period, the incidence of candidemia increased. A species shift toward C glabrata was recently observed, concurring with increased consumption of mold-active triazoles., The incidence of candidemia increased in Switzerland from 2004 to 2018. A species shift toward C glabrata was observed after 2013, now accounting for one fourth of all candidemia, concurring with increased consumption of mold-active triazoles.
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- 2021
39. Corona Immunitas: study protocol of a nationwide program of SARS-CoV-2 seroprevalence and seroepidemiologic studies in Switzerland
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Erin A. West, Anja Frei, Idris Guessous, Thomas Vermes, Silvia Stringhini, Daniel H. Paris, Daniela Anker, Adina Mihaela Epure, Ania Wisniak, Rebecca Amati, Luca Crivelli, Nicolas Rodondi, Jan Fehr, Milo A. Puhan, Audrey Butty, Medea Imboden, Laurent Kaufmann, Emiliano Albanese, Arnaud Chiolero, Gisela Michel, Valérie D'Acremont, Nicole Probst-Hensch, Christian R Kahlert, Murielle Bochud, Irène Frank, Nicolai Mösli, Stéphane Cullati, Fabian Vollrath, Philipp Kohler, Aude Richard, Semira Gonseth, Antoine Flahault, Luc Fornerod, Azman, Andrew, Baysson, Hélène, Collombet, Prune, Dibner, Yaron, Kaiser, Laurent, Petrovic, Dusan, Picazio, Attilio, Portier, Jane, Pugin, Caroline, University of Zurich, Puhan, Milo A, Corona Immunitas Research Group, Albanese, E., Amati, R., Amendola, A., Anker, D., Annoni, A.M., Azman, A., Bally, F., Balmer, B., Baysson, H., Berthod, D., Blankenberger, J., Bochud, M., Bodenmann, P., Bopp, M., Butty, A., Camerini, A.L., Cappeli, C., Carmelli, C., Chiolero, A., Collombet, P., Corna, L., Crawford, J., Crivelli, L., Cullati, S., Cusini, A., D'Acremont, V., De Pietro, C., Deschamps, A., Droz, S., Dumoulin, A., Duperrex, O., Dupraz, J., Egger, M., Engler, N., Epure, A.M., Estoppey, S., Fadda, M., Faivre, V., Fehr, J., Felappi, A., Fiordelli, M., Flahault, A., Fornerod, L., Fragoso Corti, C., Frangville, M., Frank, I., Franscella, G., Frei, A., Gille, D., Michel, G., Gonseth Nusslé, S., Gouzowski, A., Guessous, I., Guggisberg, J., Günthard, H., Gutzwiller, F., Incici, L., Jendly, E., Jung, R., Kahlert, C., Kaiser, L., Kaufmann, L., Kaufmann, M., Kessler, S., Kohler, P., Kriemler, S., Lenoir, L., Levati, S., Maeschli, B., Magnin, J.L., Masserey, E., Morese, R., Mösli, N., Noël, N., Orhant, M., Pasquier, J., Pennacchio, F., Petrovic, D., Pfister, S., Picazio, A., Prandi, C., Piumatti, G., Portier, J., Probst-Hensch, N., Pugin, C., Puhan, M., Radtke, T., Richard, A., Robert, C.F., Rodondi, P.Y., Rodondi, N., Salberg, E., Sanchis Zozaya, J., Schlüter, V., Schneider, V., Steiner-Dubuis, A., Stringhini, S., Sumer, J., Tall, I., Thabard, J., Tonolla, M., Troillet, N., Ulyte, A., Vassaux, S., Vermes, T., Vollrath, F., von Wyl, V., West, E., Wisniak, A., Zaballa, M.E., and Zuppinger, C.
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Research design ,Health (social science) ,Ethnic group ,030204 cardiovascular system & hematology ,Socioeconomic differences ,Antibodies, Viral ,Viral/blood ,ddc:616.89 ,0302 clinical medicine ,Seroepidemiologic Studies ,Pandemic ,Epidemiology ,Prevalence ,Ethnicity ,030212 general & internal medicine ,Serosurvey ,Child ,610 Medicine & health ,COVID-19/epidemiology ,education.field_of_study ,SARS-CoV-2/isolation & purification ,Middle Aged ,Viral/epidemiology ,Geography ,Research Design ,Original Article ,Switzerland ,360 Social problems & social services ,Adolescent ,Adult ,Aged ,Antibodies, Viral/blood ,Betacoronavirus/immunology ,Ethnic Groups ,Humans ,Pandemics ,Pneumonia, Viral/epidemiology ,Young Adult ,Hygiene practices ,Longitudinal ,SARS-CoV-2 ,medicine.medical_specialty ,Population ,Pneumonia, Viral ,Antibodies ,Health(social science) ,03 medical and health sciences ,Betacoronavirus ,Environmental health ,medicine ,Seroprevalence ,education ,ddc:613 ,Public health ,Public Health, Environmental and Occupational Health ,COVID-19 ,10060 Epidemiology, Biostatistics and Prevention Institute (EBPI) ,2739 Public Health, Environmental and Occupational Health ,Pneumonia ,ddc:618.97 - Abstract
Objectives: Seroprevalence studies to assess the spread of SARS-CoV-2 infection in the general population and subgroups are key for evaluating mitigation and vaccination policies and for understanding the spread of the disease both on the national level and for comparison with the international community. Methods: Corona Immunitas is a research program of coordinated, population-based, seroprevalence studies implemented by Swiss School of Public Health (SSPH+). Over 28,340 participants, randomly selected and age-stratified, with some regional specificities will be included. Additional studies in vulnerable and highly exposed subpopulations are also planned. The studies will assess population immunological status during the pandemic. Results: Phase one (first wave of pandemic) estimates from Geneva showed a steady increase in seroprevalence up to 10.8% (95% CI 8.2-13.9, n = 775) by May 9, 2020. Since June, Zurich, Lausanne, Basel City/Land, Ticino, and Fribourg recruited a total of 5973 participants for phase two thus far. Conclusions: Corona Immunitas will generate reliable, comparable, and high-quality serological and epidemiological data with extensive coverage of Switzerland and of several subpopulations, informing health policies and decision making in both economic and societal sectors. ISRCTN Registry: https://www.isrctn.com/ISRCTN18181860 ., + ID der Publikation: unilu_50428 + Sprache: Englisch + Letzte Aktualisierung: 2020-11-02 15:42:18
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- 2020
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40. Emergence of vancomycin-resistant enterococci in Switzerland: a nation-wide survey
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Nasstasja Wassilew, Andreas F. Widmer, Jonas Marschall, Viktorija Rion, Laurence Senn, Niccolò Buetti, Céline Gardiol, for Swissnoso, Balmelli, C., Eisenring, M.C., Harbarth, S., Kuster, S.P., Spicher, V.M., Pittet, D., Ruef, C., Sax, H., Schlegel, M., Schweiger, A., Troillet, N., and Zanetti, G.
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0301 basic medicine ,Microbiology (medical) ,medicine.medical_specialty ,VRE ,030106 microbiology ,Short Report ,Clone (cell biology) ,610 Medicine & health ,Drug resistance ,ST796 ,Communicable Diseases, Emerging ,lcsh:Infectious and parasitic diseases ,03 medical and health sciences ,0302 clinical medicine ,Medical microbiology ,Vancomycin ,Anti-Bacterial Agents/pharmacology ,Communicable Diseases, Emerging/epidemiology ,Communicable Diseases, Emerging/microbiology ,Gram-Positive Bacterial Infections/epidemiology ,Gram-Positive Bacterial Infections/microbiology ,Humans ,Switzerland/epidemiology ,Vancomycin/pharmacology ,Vancomycin Resistance ,Vancomycin-Resistant Enterococci/classification ,Vancomycin-Resistant Enterococci/drug effects ,Vancomycin-Resistant Enterococci/genetics ,Vancomycin-Resistant Enterococci/isolation & purification ,Hospital-acquired ,Nosocomial ,Outbreak ,Vancomycin-resistant enterococci ,Epidemiology ,Medicine ,Pharmacology (medical) ,lcsh:RC109-216 ,030212 general & internal medicine ,Gram-Positive Bacterial Infections ,business.industry ,Public Health, Environmental and Occupational Health ,Vancomycin-Resistant Enterococci ,biochemical phenomena, metabolism, and nutrition ,bacterial infections and mycoses ,Virology ,Anti-Bacterial Agents ,3. Good health ,Infectious Diseases ,business ,Switzerland - Abstract
This nation-wide survey on the epidemiology of vancomycin-resistant enterococci (VRE) included 142 healthcare institutions and showed an increasing number of VRE colonizations and infections in Switzerland, probably for the most part due to nosocomial dissemination. The introduction and spread of a new clone, gaps in VRE screening policies as well as heterogeneity regarding the management of VRE clusters may be possible explanations. Electronic supplementary material The online version of this article (10.1186/s13756-019-0466-x) contains supplementary material, which is available to authorized users.
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- 2019
41. Association of institutional masking policies with healthcare-associated SARS-CoV-2 infections in Swiss acute care hospitals during the BA.4/5 wave (CH-SUR study): a retrospective observational study.
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Dörr T, Güsewell S, Flury D, Süveges M, Gaza Valera CB, Botero-Mesa S, Zanella MC, Iten A, Balmelli C, Troillet N, Tschudin-Sutter S, W Schreiber P, Jent P, Damonti L, Sommerstein R, Portmann L, Vuichard-Gysin D, Cusini A, Nussbaumer-Ochsner Y, Heininger U, Berger C, Zimmermann P, Gardiol C, Keiser O, Schlegel M, Kohler P, and P Kuster S
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- Humans, Switzerland epidemiology, Retrospective Studies, Female, Male, Middle Aged, Adult, Hospitals, Aged, Health Personnel, Infection Control methods, Organizational Policy, Aged, 80 and over, COVID-19 epidemiology, COVID-19 prevention & control, Masks, Cross Infection prevention & control, Cross Infection epidemiology, SARS-CoV-2
- Abstract
Background: In the initial phase of the SARS-CoV-2 pandemic, masking has been widely accepted in healthcare institutions to mitigate the risk of healthcare-associated infection. Evidence, however, is still scant and the role of masks in preventing healthcare-associated SARS-CoV-2 acquisition remains unclear.We investigated the association of variation in institutional mask policies with healthcare-associated SARS-CoV-2 infections in acute care hospitals in Switzerland during the BA.4/5 2022 wave., Methods: SARS-CoV-2 infections in hospitalized patients between June 1 and September 5, 2022, were obtained from the "Hospital-based surveillance of COVID-19 in Switzerland"-database and classified as healthcare- or community-associated based on time of disease onset. Institutions provided information regarding institutional masking policies for healthcare workers and other prevention policies. The percentage of healthcare-associated SARS-CoV-2 infections was calculated per institution and per type of mask policy. The association of healthcare-associated SARS-CoV-2 infections with mask policies was tested using a negative binominal mixed-effect model., Results: We included 2'980 SARS-CoV-2 infections from 13 institutions, 444 (15%) were classified as healthcare-associated. Between June 20 and June 30, 2022, six (46%) institutions switched to a more stringent mask policy. The percentage of healthcare-associated infections subsequently declined in institutions with policy switch but not in the others. In particular, the switch from situative masking (standard precautions) to general masking of HCW in contact with patients was followed by a strong reduction of healthcare-associated infections (rate ratio 0.39, 95% CI 0.30-0.49). In contrast, when compared across hospitals, the percentage of health-care associated infections was not related to mask policies., Conclusions: Our findings suggest switching to a more stringent mask policy may be beneficial during increases of healthcare-associated SARS-CoV-2 infections at an institutional level., (© 2024. The Author(s).)
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- 2024
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42. Surgical Antimicrobial Prophylaxis in Low-Risk Cholecystectomies is Associated with Fewer Surgical Site Infections: Nationwide Cohort Study in Switzerland.
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Florinett L, Widmer A, Troillet N, Beldi G, Von Flüe M, Harbarth S, and Sommerstein R
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Objective: To assess whether administration of surgical antimicrobial prophylaxis (SAP) versus absence of SAP is associated with a decreased risk of surgical site infections (SSI) after low-risk cholecystectomies (LR-CCE)., Summary Background Data: Current guidelines do not recommend routine SAP administration prior to LR-CCE., Methods: This cohort study included adult patients who underwent LR-CCE and were documented by the Swissnoso SSI surveillance system between 1/2009-12/2020 at 66 Swiss hospitals. LR-CCE was specified as elective endoscopic surgery, age <70, no active cholecystitis, ASA score <3, operating time <120 minutes without implantation of foreign material. Exposure was defined as the administration of cefuroxime or cefazoline ± metronidazole within 120 minutes prior to incision versus no SAP administration. Our main outcome was occurrence of SSI until day 30. Logistic regression models were used to adjust for institutional, patient, and perioperative variables., Results: Of 44 682 surveilled adult cholecystectomy patients, 12 521 (8 726 women [69.7%]; median [IQR] age, 49.0 [38.1-58.2] years), fulfilled inclusion criteria. SSI was identified in 143 patients (1.1%). SAP was administered in 9 269 patients (74.0%) and was associated with a lower SSI rate (adjusted odds ratio [aOR], 0.50; 95% CI, 0.35-0.70; P < 0.001). The number needed to treat to prevent one SSI episode is 100., Conclusions: The overall LR-CCE SSI rate was 1.1%. SAP was associated with a 50% lower overall SSI rate. Patients undergoing LR-CCE may benefit from routine surgical antimicrobial prophylaxis., Competing Interests: Conflict of interest statement: RS received an unrestricted research grant from BBraun, Sempach, Switzerland., (Copyright © 2024 Wolters Kluwer Health, Inc. All rights reserved.)
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- 2024
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43. Association between the introduction of a national targeted intervention program and the incidence of surgical site infections in Swiss acute care hospitals.
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Eder M, Sommerstein R, Szelecsenyi A, Schweiger A, Schlegel M, Atkinson A, Kuster SP, Vuichard-Gysin D, Troillet N, and Widmer AF
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- Female, Humans, Incidence, Prospective Studies, Switzerland epidemiology, Adult, Aged, Middle Aged, Hospitals, Surgical Wound Infection epidemiology, Surgical Wound Infection prevention & control, Surgical Wound Infection drug therapy
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Background: In Switzerland, the national surgical site infection (SSI) surveillance program showed a modest decrease in SSI rates for different procedures over the last decade. The study aimed to determine whether a multimodal, targeted intervention program in addition to existing SSI surveillance is associated with decreased SSI rates in the participating hospitals., Methods: Prospective multicenter pre- and postintervention study conducted in eight Swiss acute care hospitals between 2013 and 2020. All consecutive patients > 18 years undergoing cardiac, colon, or hip/knee replacement surgery were included. The follow-up period was 30 days and one year for implant-related surgery. Patients with at least one follow-up were included. The intervention was to optimize three elements of preoperative management: (i) hair removal; (ii) skin disinfection; and (iii) perioperative antimicrobial prophylaxis. We compared SSI incidence rates (main outcome measure) pre- and postintervention (three years each) adjusted for potential confounders. Poisson generalized linear mixed models fitted to quarter-yearly confirmed SSIs and adjusted for baseline differences between hospitals and procedures. Adherence was routinely monitored through on-site visits., Results: A total of 10 151 patients were included, with a similar median age pre- and postintervention (69.6 and IQR 60.9, 76.8 years, vs 69.5 and IQR 60.4, 76.8 years, respectively; P = 0.55) and similar proportions of females (44.8% vs. 46.1%, respectively; P = 0.227). Preintervention, 309 SSIs occurred in 5 489 patients (5.6%), compared to 226 infections in 4 662 cases (4.8%, P = 0.09) postintervention. The adjusted incidence rate ratio (aIRR) for overall SSI after intervention implementation was 0.81 (95% CI, 0.68 to 0.96, P = 0.02). For cardiac surgery (n = 2 927), the aIRR of SSI was 0.48 (95% CI, 0.32 to 0.72, P < 0.001). For hip/knee replacement surgery (n = 4 522), the aIRR was 0.88 (95% CI, 0.52 to 1.48, P = 0.63), and for colon surgery (n = 2 702), the aIRR was 0.92 (95% CI, 0.75 to 1.14, P = 0.49)., Conclusions: The SSI intervention bundle was associated with a statistically significant decrease in SSI cases. A significant association was observed for cardiac surgery. Adding a specific intervention program can add value compared to routine surveillance only. Further prevention modules might be necessary for colon and orthopedic surgery., (© 2023. The Author(s).)
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- 2023
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44. Association between perioperative prophylaxis with cefuroxime plus metronidazole or amoxicillin/clavulanic acid and surgical site infections in paediatric uncomplicated appendectomy: a Swiss retrospective cohort study.
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Bielicki I, Schmid H, Atkinson A, Kahlert CR, Berger C, Troillet N, Marschall J, and Bielicki JA
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- Child, Male, Humans, Female, Cefuroxime therapeutic use, Appendectomy adverse effects, Retrospective Studies, Switzerland epidemiology, Amoxicillin-Potassium Clavulanate Combination therapeutic use, Surgical Wound Infection epidemiology, Surgical Wound Infection prevention & control, Metronidazole therapeutic use
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Objective: We aimed to evaluate the association between post-appendectomy SSI rates and the two most commonly used regimens for perioperative antimicrobial prophylaxis in Swiss children., Methods: We conducted a retrospective cohort study, analysing data from the Swiss national SSI surveillance database with a study period from 2014 to 2018. All hospitals undertaking paediatric appendectomies in Switzerland participate in the surveillance. We compared the cumulative incidence and odds of post-appendectomy SSI within 30 days of surgery in children ≤ 16 years of age undergoing appendectomy for uncomplicated appendicitis and receiving perioperative antimicrobial prophylaxis with cefuroxime plus metronidazole or with amoxicillin/clavulanic acid using multivariable adjusted logistic regression and propensity-score matching., Results: A total of 6207 cases were recorded in the study time frame. Overall SSI cumulative incidence was 1.9% (n = 119). 4256 children (54.9% male, median (IQR) age 12 [10, 14] years) received either cefuroxime plus metronidazole (n = 2348, 53.8% male) or amoxicillin/clavulanic acid (n = 1491, 57.0% male). SSI cumulative incidence was 1.1% (25/2348) among children receiving cefuroxime plus metronidazole and 2.8% (42/1491, p < 0.001) when receiving amoxicillin/clavulanic acid. The administration of cefuroxime plus metronidazole was associated with statistically significantly lower SSI odds compared to amoxicillin/clavulanic acid (aOR 0.35, 95%CI [0.20, 0.61], p < 0.001), and this was confirmed upon propensity-score matching., Conclusion: We found lower odds of post-appendectomy SSI in children receiving cefuroxime plus metronidazole compared to amoxicillin/clavulanic acid. Treating amoxicillin/clavulanic acid as the baseline, only 55 children need to receive cefuroxime plus metronidazole perioperative prophylaxis to avert one SSI. Existing guidelines recommending amoxicillin/clavulanic acid may need to be revised. Trial registration ISRCTN47727811, registered retrospectively., (© 2023. BioMed Central Ltd., part of Springer Nature.)
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- 2023
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45. Association of antimicrobial perioperative prophylaxis with cefuroxime plus metronidazole or amoxicillin/clavulanic acid and surgical site infections in colorectal surgery.
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Stavropoulou E, Atkinson A, Eisenring MC, Fux CA, Marschall J, Senn L, and Troillet N
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- Humans, Female, Male, Metronidazole therapeutic use, Surgical Wound Infection prevention & control, Cefuroxime therapeutic use, Amoxicillin-Potassium Clavulanate Combination therapeutic use, Colorectal Surgery adverse effects, Anti-Infective Agents, Gammaproteobacteria
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Objective: To compare intravenous (IV) amoxicillin/clavulanic acid (A/CA) to IV cefuroxime plus metronidazole (C + M) for preventing surgical site infections (SSI) in colorectal surgery., Background: Given their spectra that include most Enterobacterales and anaerobes, C + M is commonly recommended as prophylaxis of SSI in colorectal surgery. A/CA offers good coverage of Enterobacterales and anaerobes as well, but, in contrast to C + M, it also includes Enterococcus faecalis which is also isolated from patients with SSI and could trigger anastomotic leakage., Methods: Data from a Swiss SSI surveillance program were used to compare SSI rates after class II (clean contaminated) colorectal surgery between patients who received C + M and those who received A/CA. We employed multivariable logistic regression to adjust for potential confounders, along with propensity score matching to adjust for group imbalance., Results: From 2009 to 2018, 27,922 patients from 127 hospitals were included. SSI was diagnosed in 3132 (11.2%): 278/1835 (15.1%) in those who received A/CA and 2854/26,087 (10.9%) in those who received C + M (p < 0.001). The crude OR for SSI in the A/CA group as compared to C + M was 1.45 [CI 95% 1.21-1.75]. The adjusted OR was 1.49 [1.24-1.78]. This finding persisted in a 1:1 propensity score matched cohort of 1835 patients pairs with an OR of 1.60 [1.28-2.00]. Other factors independently associated with SSI were an ASA score > 2, a longer duration of operation, and a reoperation for a non-infectious complication. Protective factors were female sex, older age, antibiotic prophylaxis received 60 to 30 min before surgery, elective operation, and endoscopic approach., Conclusions: Despite its activity against enterococci, A/CA was less effective than C + M for preventing SSI, suggesting that it should not be a first choice antibiotic prophylaxis for colorectal surgery., (© 2023. BioMed Central Ltd., part of Springer Nature.)
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- 2023
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46. Treatment effect of remdesivir on the mortality of hospitalised COVID-19 patients in Switzerland across different patient groups: a tree-based model analysis.
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Estill J, Venkova-Marchevska P, Günthard HF, Botero-Mesa S, Thiabaud A, Roelens M, Vancauwenberghe L, Damonti L, Heininger U, Iten A, Schreiber PW, Sommerstein R, Tschudin-Sutter S, Troillet N, Vuichard-Gysin D, Widmer A, Hothorn T, and Keiser O
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- Aged, Male, Humans, Switzerland epidemiology, COVID-19 Drug Treatment, Hospitals, Antiviral Agents therapeutic use, COVID-19
- Abstract
Aims of the Study: Remdesivir has shown benefits against COVID-19. However, it remains unclear whether, to what extent, and among whom remdesivir can reduce COVID-19-related mortality. We explored whether the treatment response to remdesivir differed by patient characteristics., Methods: We analysed data collected from a hospital surveillance study conducted in 21 referral hospitals in Switzerland between 2020 and 2022. We applied model-based recursive partitioning to group patients by the association between treatment levels and mortality. We included either treatment (levels: none, remdesivir within 7 days of symptom onset, remdesivir after 7 days, or another treatment), age and sex, or treatment only as regression variables. Candidate partitioning variables included a range of risk factors and comorbidities (and age and sex unless included in regression). We repeated the analyses using local centring to correct the results for the propensity to receive treatment., Results: Overall (n = 21,790 patients), remdesivir within 7 days was associated with increased mortality (adjusted hazard ratios 1.28-1.54 versus no treatment). The CURB-65 score caused the most instability in the regression parameters of the model. When adjusted for age and sex, patients receiving remdesivir within 7 days of onset had higher mortality than those not treated in all identified eight patient groups. When age and sex were included as partitioning variables instead, the number of groups increased to 19-20; in five to six of those branches, mortality was lower among patients who received early remdesivir. Factors determining the groups where remdesivir was potentially beneficial included the presence of oncological comorbidities, male sex, and high age., Conclusions: Some subgroups of patients, such as individuals with oncological comorbidities or elderly males, may benefit from remdesivir.
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- 2023
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47. Timing of Cefuroxime Surgical Antimicrobial Prophylaxis and Its Association With Surgical Site Infections.
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Sommerstein R, Troillet N, Harbarth S, de Kraker MEA, Vuichard-Gysin D, Kuster SP, and Widmer AF
- Subjects
- United States, Male, Adult, Humans, Aged, Surgical Wound Infection epidemiology, Surgical Wound Infection prevention & control, Surgical Wound Infection drug therapy, Anti-Bacterial Agents therapeutic use, Cohort Studies, Antibiotic Prophylaxis methods, Risk Factors, Time Factors, Cefuroxime therapeutic use, Anti-Infective Agents therapeutic use
- Abstract
Importance: World Health Organization guidelines recommend administering surgical antimicrobial prophylaxis (SAP), including cefuroxime, within 120 minutes prior to incision. However, data from clinical settings supporting this long interval is limited., Objective: To assess whether earlier vs later timing of administration of cefuroxime SAP is associated with the occurrence of surgical site infections (SSI)., Design, Setting, and Participants: This cohort study included adult patients who underwent 1 of 11 major surgical procedures with cefuroxime SAP, documented by the Swissnoso SSI surveillance system between January 2009 and December 2020 at 158 Swiss hospitals. Data were analyzed from January 2021 to April 2023., Exposures: Timing of cefuroxime SAP administration before incision was divided into 3 groups: 61 to 120 minutes before incision, 31 to 60 minutes before incision, and 0 to 30 minutes before incision. In addition, a subgroup analysis was performed with time windows of 30 to 55 minutes and 10 to 25 minutes as a surrogate marker for administration in the preoperating room vs in the operating room, respectively. The timing of SAP administration was defined as the start of the infusion obtained from the anesthesia protocol., Main Outcomes and Measures: Occurrence of SSI according to Centers for Disease Control and Prevention definitions. Mixed-effects logistic regression models adjusted for institutional, patient, and perioperative variables were applied., Results: Of 538 967 surveilled patients, 222 439 (104 047 men [46.8%]; median [IQR] age, 65.7 [53.9-74.2] years), fulfilled inclusion criteria. SSI was identified in 5355 patients (2.4%). Cefuroxime SAP was administered 61 to 120 minutes prior to incision in 27 207 patients (12.2%), 31 to 60 minutes prior to incision in 118 004 patients (53.1%), and 0 to 30 minutes prior to incision in 77 228 patients (34.7%). SAP administration at 0 to 30 minutes was significantly associated with a lower SSI rate (adjusted odds ratio [aOR], 0.85; 95% CI, 0.78-0.93; P < .001), as was SAP administration 31 to 60 minutes prior to incision (aOR, 0.91; 95% CI, 0.84-0.98; P = .01) compared with administration 61 to 120 minutes prior to incision. Administration 10 to 25 minutes prior to incision in 45 448 patients (20.4%) was significantly associated with a lower SSI rate (aOR, 0.89; 95% CI, 0.82-0.97; P = .009) vs administration within 30 to 55 minutes prior to incision in 117 348 patients (52.8%)., Conclusions and Relevance: In this cohort study, administration of cefuroxime SAP closer to the incision time was associated with significantly lower odds of SSI, suggesting that cefuroxime SAP should be administrated within 60 minutes prior to incision, and ideally within 10 to 25 minutes.
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- 2023
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48. Hospital Outcomes of Community-Acquired SARS-CoV-2 Omicron Variant Infection Compared With Influenza Infection in Switzerland.
- Author
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Portmann L, de Kraker MEA, Fröhlich G, Thiabaud A, Roelens M, Schreiber PW, Troillet N, Iten A, Widmer A, Harbarth S, and Sommerstein R
- Subjects
- Humans, Female, Aged, Male, Cohort Studies, Hospital Mortality, Pandemics, Prospective Studies, SARS-CoV-2, Switzerland epidemiology, Hospitals, Influenza, Human epidemiology, COVID-19 epidemiology, Community-Acquired Infections epidemiology
- Abstract
Importance: With the ongoing COVID-19 pandemic, it is crucial to assess the current burden of disease of community-acquired SARS-CoV-2 Omicron variant in hospitalized patients to tailor appropriate public health policies. Comparisons with better-known seasonal influenza infections may facilitate such decisions., Objective: To compare the in-hospital outcomes of patients hospitalized with the SARS-CoV-2 Omicron variant with patients with influenza., Design, Setting, and Participants: This cohort study was based on a national COVID-19 and influenza registry. Hospitalized patients aged 18 years and older with community-acquired SARS-CoV-2 Omicron variant infection who were admitted between January 15 and March 15, 2022 (when B.1.1.529 Omicron predominance was >95%), and hospitalized patients with influenza A or B infection from January 1, 2018, to March 15, 2022, where included. Patients without a study outcome by August 30, 2022, were censored. The study was conducted at 15 hospitals in Switzerland., Exposures: Community-acquired SARS-CoV-2 Omicron variant vs community-acquired seasonal influenza A or B., Main Outcomes and Measures: Primary and secondary outcomes were defined as in-hospital mortality and admission to the intensive care unit (ICU) for patients with the SARS-CoV-2 Omicron variant or influenza. Cox regression (cause-specific and Fine-Gray subdistribution hazard models) was used to account for time-dependency and competing events, with inverse probability weighting to adjust for confounders with right-censoring at day 30., Results: Of 5212 patients included from 15 hospitals, 3066 (58.8%) had SARS-CoV-2 Omicron variant infection in 14 centers and 2146 patients (41.2%) had influenza A or B in 14 centers. Of patients with the SARS-CoV-2 Omicron variant, 1485 (48.4%) were female, while 1113 patients with influenza (51.9%) were female (P = .02). Patients with the SARS-CoV-2 Omicron variant were younger (median [IQR] age, 71 [53-82] years) than those with influenza (median [IQR] age, 74 [59-83] years; P < .001). Overall, 214 patients with the SARS-CoV-2 Omicron variant (7.0%) died during hospitalization vs 95 patients with influenza (4.4%; P < .001). The final adjusted subdistribution hazard ratio (sdHR) for in-hospital death for SARS-CoV-2 Omicron variant vs influenza was 1.54 (95% CI, 1.18-2.01; P = .002). Overall, 250 patients with the SARS-CoV-2 Omicron variant (8.6%) vs 169 patients with influenza (8.3%) were admitted to the ICU (P = .79). After adjustment, the SARS-CoV-2 Omicron variant was not significantly associated with increased ICU admission vs influenza (sdHR, 1.08; 95% CI, 0.88-1.32; P = .50)., Conclusions and Relevance: The data from this prospective, multicenter cohort study suggest a significantly increased risk of in-hospital mortality for patients with the SARS-CoV-2 Omicron variant vs those with influenza, while ICU admission rates were similar.
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- 2023
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49. Focusing on the follow-up for detecting surgical site infections after total joint arthroplasty and cardiac surgery: A cohort study from the Swiss national surveillance system, 2009-2018.
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Piezzi V, Atkinson A, Jent P, Troillet N, Zwahlen M, Widmer A, and Marschall J
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- Humans, Surgical Wound Infection epidemiology, Surgical Wound Infection diagnosis, Cohort Studies, Follow-Up Studies, Switzerland epidemiology, Retrospective Studies, Arthroplasty, Replacement, Knee, Arthroplasty, Replacement, Hip, Cardiac Surgical Procedures adverse effects, Prosthesis-Related Infections
- Published
- 2022
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50. Better Operating Room Ventilation as Determined by a Novel Ventilation Index is Associated With Lower Rates of Surgical Site Infections.
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Surial B, Atkinson A, Külpmann R, Brunner A, Hildebrand K, Sicre B, Troillet N, Widmer A, Rolli E, Maag J, and Marschall J
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- Humans, Cohort Studies, Electrolytes, Operating Rooms, Risk Factors, Surgical Wound Infection epidemiology, Surgical Wound Infection prevention & control, Arthroplasty, Replacement, Hip, Arthroplasty, Replacement, Knee
- Abstract
Objective: The aim was to assess the impact of operating room (OR) ventilation quality on surgical site infections (SSIs) using a novel ventilation index., Background: Previous studies compared laminar air flow with conventional ventilation, thereby ignoring many parameters that influence air flow properties., Methods: In this cohort study, we surveyed hospitals participating in the Swiss SSI surveillance and calculated a ventilation index for their ORs, with higher values reflecting less turbulent air displacement. For procedures captured between January 2017 and December 2019, we studied the association between ventilation index and SSI rates using linear regression (hospital-level analysis) and with the individual SSI risk using generalized linear mixed-effects models (patient-level analysis)., Results: We included 47 hospitals (182 ORs). Among the 163,740 included procedures, 6791 SSIs were identified. In hospital-level analyses, a 5-unit increase in the ventilation index was associated with lower SSI rates for knee and hip arthroplasty (-0.41 infections per 100 procedures, 95% confidence interval: -0.69 to -0.13), cardiac (-0.89, -1.91 to 0.12), and spine surgeries (-1.15, -2.56 to 0.26). Similarly, patient-level analyses showed a lower SSI risk with each 5-unit increase in ventilation index (adjusted odds ratio 0.71, confidence interval: 0.58-0.87 for knee and hip; 0.72, 0.49-1.06 for spine; 0.82, 0.69-0.98 for cardiac surgery). Higher index values were mainly associated with a lower risk for superficial and deep incisional SSIs., Conclusions: Better ventilation properties, assessed with our ventilation index, are associated with lower rates of superficial and deep incisional SSIs in orthopedic and cardiac procedures. OR ventilation quality appeared to be less relevant for other surgery types., Competing Interests: The authors report no conflicts of interest., (Copyright © 2022 The Author(s). Published by Wolters Kluwer Health, Inc.)
- Published
- 2022
- Full Text
- View/download PDF
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