ABSTRACT
Objective: To evaluate the rate and causes of cancellation of elective procedures
Design: A Retrospective Study
Setting: Salmaniya Medical Complex, Bahrain
Method: Data were collected for four months from the operation theatre register and were analyzed
Result: Day of surgery [DOS] cancellation rate in our study was found to be 7.3%. The causes of cancellation were lack of time, high blood pressure, cardiology consultation, chest infection and upper respiratory tract infection. Most cancellations in the OT were because of high blood pressure. These causes can be avoided if proper preoperative assessment and control were applied
Conclusion: DOS cancellation is a universal problem. Several common factors that play a role in increasing cancellation rate and these should be considered individually for a better outcome. A general understanding and cooperation between the caring firm, anesthesia department, nursing team and other medical departments is paramount in reducing the incidence to a minimum and to increase the efficacy of the hospital
ABSTRACT
To investigate the prevalence and antibiotic susceptibility pattern of extended-spectrum beta-lactamases [ESBL]-producing Enterobacteriaecae among patients in the United Arab Emirates. A total of 130 Enterobacteriaceae comprising of Escherichia coli [n = 83], Klebsiella pneumoniae [n = 45] and Klebsiella oxytoca [n = 2] was studied. Of these 130 isolates, 64 were from urine. ESBL screening was by disc diffusion and confirmatory tests for ESBL phenotype were conducted using BD Phoenix[TM] ESBL System and cephalosporin/clavulanate combination discs. Susceptibility to a panel of antibiotics was evaluated. Of the 130 isolates, 53 [41%] were identified as having ESBL phenotype; of these, 32 [60%] were E. coli, 20 [36%] K. pneumoniae and 2 [4%] K. oxytoca. ESBL phenotype was seen in 100% of endotracheal tubes isolates, 20 [31%] from urine, 7 [58%] from blood and 4 [80%] from catheter tips. Amikacin susceptibility was 100%. Over 90% of ESBL isolates showed resistance to aztreonam and cephalosporins. All Klebsiella isolates were carbapenem sensitive. One ESBL isolate showed intermediate resistance to imipenem and meropenem [both MIC 8 micro g/ml], cefotetan [MIC 32 micro g/ml] and piperacillin/ tazobactam [MIC 32 micro g/ml]. MIC for the carbapenems was lower in non-ESBL isolates [0.034 micro g/ml] than ESBL isolates [0.071 micro g/ml]. Resistance to gentamicin, ciprofloxacin and piperacillin/tazobactam was higher in ESBL than non-ESBL isolates [p < 0.05]. A high prevalence of ESBL-producing bacteria exists among in-patients in the United Arab Emirates. Amikacin and carbapenems remain the most effective drugs, but the presence of carbapenem-resistant ESBL-producing E. coli and occurrence of multidrug resistance are of concern. Continued surveillance and judicious antibiotic usage are recommended