Costs and resource utilization patterns in surgical site infections: a pre-COVID-19 perspective from France, Germany, Spain, and the UK.

BACKGROUND: Surgical site infections (SSIs), mainly caused by Staphylococcus aureus, pose a significant economic burden in Europe, leading to increased hospitalization duration, mortality, and treatment costs, particularly with drug-resistant strains such as meticillin-resistant S. aureus. AIM: To conduct a case-control study on the economic impact of S. aureus SSI in adult surgical patients across high-volume centres in France, Germany, Spain, and the UK, aiming to assess the overall and procedure-specific burden across Europe. METHODS: The SALT study is a multinational, retrospective cohort study with a nested case-control analysis focused on S. aureus SSI in Europe. The study included participants from France, Germany, Italy, Spain, and the UK who underwent invasive surgery in 2016 and employed a micro-costing approach to evaluate health economic factors, matching S. aureus SSI cases with controls. FINDINGS: In 2016, among 178,904 surgical patients in five European countries, 764 developed S. aureus SSI. Matching 744 cases to controls, the study revealed that S. aureus SSI cases incurred higher immediate hospitalization costs (€8,810), compared to controls (€6,032). Additionally, S. aureus SSI cases exhibited increased costs for readmissions within the first year post surgery (€7,961.6 versus €5,298.6), with significant differences observed. Factors associated with increased surgery-related costs included the cost of hospitalization immediately after surgery, first intensive care unit (ICU) admission within 12 months, and hospital readmission within 12 months, as identified through multivariable analysis. CONCLUSION: The higher rates of hospitalization, ICU admissions, and readmissions among S. aureus SSI cases highlight the severity of these infections and their impact on healthcare costs, emphasizing the potential benefits of evidence-based infection control measures and improved patient care to mitigate the economic burden.

[Serologic diagnosis of Helicobacter pylori in endoscopy personnel. Serology in endoscopists]. / Diagnóstico serológico de Helicobacter pylori en endoscopistas. Serología en endoscopistas.

OBJECTIVE: the Helicobacter pylori entered into the medical world, particularly in the field of the Gastroenterology, revolutionizing it, and changing partially our physiopathological concepts and treatment of the gastroduodenal ulcer. This infestation results in an immune response, that is measured by means of serologic tests, which are very useful in the massive screening studies, mainly in population at risk like those who are institutionalized and the personnel of health, particularly workers of the departments of Gastroenterology. METHOD: motivated for this, we carry out a prospective study in 38 endoscopists using as controls 38 workers not related with a Gastroenterology department. Thus, we analyzed the presence of antibodies against Helicobacter pylori among the personnel of the departments of Gastroenterology of three hospitals of Havana City. These personnel filled a form designed for this purpose containing following data: age, sex, time of work as endoscopist, use of protection means, and history of gastroduodenal pathology. RESULTS: there were 24 women in each group (63,2%). Whereas the seroprevalence among endoscopists was 39,47%, in the control group, only three people were seropositives (7,89%). We found a positive correlation between the time working as endoscopists and the rate of seropositivity. CONCLUSIONS: our study demonstrated that endoscopists have a significantly higher risk than the controls of contracting the infection by the Helicobacter pylori, and that the seropositive endoscopists have sintomatology more frequently than the seronegative endoscopists, although these differences were not statistically significant.

Diagnóstico serológico de Helicobacter pylori en endoscopistas. Serología en endoscopistas / Serologic diagnosis of Helicobacter pylori in endoscopy personnel. Serology in endoscopists

Objetivo: el Helicobacter pylori irrumpió en el ámbito médicogastroenterológico, revolucionándo la fisiopatología y el tratamiento de la Ulcera Gastroduodenal. Esta infestación trae consigo una respuesta inmune, que se puede reconocer con las pruebas serológicas, las cuales son muy útiles en el reconocimiento de la infección, sobre todo entre los grupos de riesgo, tales como son las personas institucionalizados y el personal sanitario y, entre estos, principalmente los trabajadores de los Departamentos de Gastroenterología. Método: en el presente artículo realizamos un estudio prospectivo longitudinal en 38 trabajadores de los Departamentos de Gastroenterología de tres hospitales de Ciudad de La Habana, tomando como controles a 38 trabajadores de un hospital que no desempeñan actividad endoscópica digestiva. Pretendemos investigar la presencia entre ellos de anticuerpos contra el H. pylori. El personal analizado completó una encuesta diseñada al efecto y se consideraron los siguientes parámetros: edad, sexo, tiempo de trabajo como endoscopista, uso de medios de protección y antecedentes de patología gastroduodenal. Resultados: nuestro grupo de investigación constaba de 38 endoscopistas y 38 trabajadores de un centro asistencial, ajenos a esta actividad laboral, que presentaba las mismas características socioeconómicas que el grupo investigado. Veinticuatro en ambos grupos eran mujeres, (63,16%) y 14 eran hombres (36,84%). El 39,47% de los endoscopistas fueron seropositivos mientras que esto ocurrió sólo en el 7,89% de los controles. Se analizó el tiempo que los endoscopistas llevaban en el trabajo y encontramos que los seropositivos llevaban más tiempo trabajando como endoscopistas que los seronegativos. Conclusiones: se demostró que los endoscopistas tienen un riesgo significativamente superior a los controles de infestarse por el Helicobacter pylori, y que los endoscopistas seropositivos presentaron sintomatología más frecuentemente que los seronegativos, aunque las diferencias no fueron estadísticamente significativas

Objective: the Helicobacter pylori entered into the medical world, particularly in the field of the Gastroenterology, revolutionizing it, and changing partially our physiopathological concepts and treatment of the gastroduodenal ulcer. This infestation results in an immune response, that is measured by means of serologic tests, which are very useful in the massive screening studies, mainly in population at risk like those who are institutionalized and the personnel of health, particularly workers of the departments of Gastroenterology. Method: motivated for this, we carry out a prospective study in 38 endoscopists using as controls 38 workers not related with a Gastroenterology department. Thus, we analyzed the presence of antibodies against Helicobacter pylori among the personnel of the departments of Gastroenterology of three hospitals of Havana City. These personnel filled a form designed for this purpose containing following data: age, sex, time of work as endoscopist, use of protection means, and history of gastroduodenal pathology. Results: there were 24 women in each group (63,2%). Whereas the seroprevalence among endoscopists was 39,47%, in the control group, only three people were seropositives (7,89%). We found a positive correlation between the time working as endoscopists and the rate of seropositivity. Conclusions: our study demonstrated that endoscopists have a significantly higher risk than the controls of contracting the infection by the Helicobacter pylori, and that the seropositive endoscopists have sintomatology more frequently than the seronegative endoscopists, although these differences were not statistically significant

[Patterns of drug resistance in Staphylococcus aureus from human clinical isolates]. / Patrones de drogorresistencia de cepas de Staphylococcus aureus de origen clínico humano.

Fifty circulating strains of Staphylococcus aureus of clinical origin were characterized by their drug susceptibility to 15 antimicrobials through the method of radial diffusion in Mueller Hinton medium. Also, beta-lactam production was determined by acidimetric and chromogenic methods as well as the presence of methicillin-resistant strains. It was confirmed that 32% of strain was susceptible to tested antimicrobials, the most effective of which were imipenem, norfloxacyn, and amikacyn for 98, 96 and 92% susceptibility respectively. Twenty-seven different drug resistance patterns were found in the studied strains. 22% of the total strains was beta-lactam producers whereas 27% of the latter turned out to be methicilline-resistant.