A Case of Mycotic Aneurysm Repaired by Wrapping the Pedicled Latissimus Dorsi Muscle Flap around the Artificial Graft / 日本心臓血管外科学会雑誌

A 69-year-old man with histories of cardiac and abdominal operations was hospitalized in another hospital due to brain contusion. Due to hemorrhage from the distal descending thoracic aorta, he was transferred to our hospital. After a diagnosis rupture of mycotic aneurysm an urgent operation was performed. The aneurysm was replaced by an <i>in situ </i>graft. For infection control, the graft was wrapped tightly by a pedicled latissimus dorsi muscle flap. Postoperatively, local infection of the muscle-dissected cavity continued. Although his life was ultimately not saved, he was able to live a comfortable hospital life with some activity for 8 months.

MRSA Infection in Vascular Surgical Patients: The HKL Experience

Methicillin-resistant Staphylococcus aureus (MRSA) infection is important among vas-cular surgical patients. Its effect can be devastating resulting in limb amputation and mortality. We performed a retrospective patients record analysis to determine the pat-tern of MRSA infection among vascular surgical patients in Hospital Kuala Lumpur from January 2005 to December 2007. We also attempted to identify the factors asso-ciated with poor clinical outcome after such infection. There were 999 patients who underwent vascular surgeries in HKL within the analysis period. Of these 24 patients (2.4%) were detected to have MRSA surgical site infection. The infection was commoner among cigarette smokers, patients with diabetes melitus and those who had previous vascular surgery. Most infections occurred in the emergency surgery category and manifested as wound breakdown. Fifty-four percent of the infected pa-tients ended with graft removal, amputations or death. MRSA infection complicating vascular surgery resulted in poor clinical outcome. This serious threat requires intensified preventive measures.

Infection of Methicillin-Resistant S. Aureus Nasal Carriage in the Community Pediatric Population / 한국역학회지

PURPOSE: Methcillin-resistant Staphylococcus aureus(MRSA) is known as a major cause of hospital acquired infection. The infection with MRSA bacteria is becoming frequent in the community because there are many people who have risk factors with low immunity. This study is intended to investigate the prevalence of MRSA in children and determine risk factors using genetic analysis. METHODS: Children aged between 3 and 7 years were recruited from six preschool institutions from Nov. 2004 to Feb. 2005 based in Seoul, Gyeonggi Province and Gyeongsang Province. A questionnaires was distributed to 1,000 parent of these children along with the letter of consent. A total of 242 questionnaires were collected and used for this study. Nasal secretion samples were collected using sterilized specimen containers and incubated in culture medium using mannitol salt agar to separate S. aureus. MRSA samples were identified through coagulase test and MICRO SCAN. PCR was performed on MRSA isolates to detect genetic sequence specific of MRSA. RESULTS: Of total 242 respondents, 16(6.6%) were found to be positive for MRSA. By residence area, 2(1.9%) out of 103 were positive in Seoul, 4(10.3%) out of 39 were positive in Gyeonggi Province and 10(10.0%) out of 100 were positive in Gyeongsang Province, showing a significant difference(p=0.037). A logistics regression was performed to evaluate the influences of variables that were significant. Gyeongsang Province had prevalence of MRSA(OR=5.520), and Gyeonggi Province(OR=5.710). Based on PCR, the distribution of genotypes of MRSA showed various patterns. But there was no difference between regions. CONCLUSIONS: MRSA infection was high in children when one of their parents were working in hospital or when one of their family members have underlying disease. This study provided evidence that the prevalence of MRSA is largely influenced by individual element such as family and health condition.

Epidemic MRSA Infection after Intranasal Surgery / 대한이비인후과학회지

In recent years, drug-resistant bacterial and nosocomial infections have been increased. The epidemic Methicillin Resistant Staphylococcus aureus (MRSA) infection after intranasal surgery was broken out at Wallace Memorial Baptist Hospital recently. MRSA was identified in 22 patients among 118 patients who underwent intranasal operation from January 23rd, 1996 to February 8th, 1996. Most patients represented symptoms the 7th day after the operation. Among 22 patients, 17 patients were treated with hydration, daily nasal dressing and intravenous antibiotics; Vancomycin or Ciprofloxacin was administrated in 11 patients, and primary antibiotics in five patients. Other five patients were treated with daily nasal dressing and oral antibiotics (Trimethoprim-Sulfamethoxazole or Ciprofloxacin). One of Vancomycin-treated patients developed sepsis. No further MRSA infection occurred after emphasizing thorough hand-washing, sterilization and disinfection of equipment, and control of health care providers, showing that the prevention of MRSA infection is very important.