A novel method of surgical site infection surveillance after cardiac surgery by active participation of stake holders.

We describe a comprehensive surveillance system involving infection control practitioners, surgeons, administrative staff, and patients aimed at improving the postdischarge surveillance of surgical site infections. The system was able to detect 22 infections out of 538 procedures, 95% of which were detected during the postdischarge period.

Primary amebic meningoencephalitis caused by Naegleria fowleri, Karachi, Pakistan.

We report 13 cases of Naegleria fowleri primary amebic meningoencephalitis in persons in Karachi, Pakistan, who had no history of aquatic activities. Infection likely occurred through ablution with tap water. An increase in primary amebic meningoencephalitis cases may be attributed to rising temperatures, reduced levels of chlorine in potable water, or deteriorating water distribution systems.

Range for normal body temperature in hemodialysis patients and its comparison with that of healthy individuals.

BACKGROUND/AIMS: Patients with chronic kidney disease undergoing hemodialysis have an altered homeostasis leading to altered body temperatures. We aimed to determine the range for normal body temperature in hemodialysis patients and compared it to healthy individuals. Also, we determined how much axillary temperatures differed from oral temperatures in both groups and whether axillary temperature is affected by the presence of an arteriovenous fistula (AVF) in hemodialysis patients. METHODS: Oral and axillary (left & right) temperatures were recorded using an ordinary mercury-in-glass thermometer in 400 subjects (200 hemodialysis patients, 200 healthy individuals) at the Sindh Institute of Urology and Transplantation from mid-May to mid-June 2006. Comparisons were made between the temperatures of both groups. RESULTS: Mean oral temperature in hemodialysis patients was higher than in healthy individuals [98.7 degrees F (37 degrees C) vs. 98.4 degrees F (36.8 degrees C); p < 0.001], as was the mean average axillary temperature [97.7 degrees F (36.5 degrees C) vs. 97.5 degrees F (36.3 degrees C); p = 0.02] and mean left axillary temperature [97.9 degrees F (36.6 degrees C) vs. 97.6 degrees F (36.4 degrees C); p < 0.001]. The fistula arm had higher axillary temperature in 77 (44%) hemodialysis patients. The difference between oral and axillary temperatures varied widely, making it impossible to obtain an accurate correction factor in both groups. CONCLUSION: Hemodialysis patients have higher normal body temperatures than healthy individuals. Axillary temperatures require cautious interpretation. In hemodialysis patients, the non-fistula arm should be preferred for recording axillary temperatures, as the presence of AVF may cause discrepancies in temperature measurements.

"Moraxella lacunata" endocarditis treated with penicillin.

The case report of a young male with Endocarditis caused by Moraxella lacunata is presented. Although a well recognized cause of keratitis, conjunctivitis, and sinusitis; very few cases of endocarditis by this rare pathogen are reported in literature. Patient showed a prompt response when empirical therapy was de-escalated to penicillin, after receiving culture and sensitivity report from Microbiology department.

Range for normal body temperature in the general population of Pakistan.

OBJECTIVES: To determine the range for normal body temperature in the general population of Pakistan and to determine if any age, sex and ambient temperature related variations exist in body temperature. Moreover, to compare how much axillary temperature differs from oral temperature measurements. METHODS: Oral as well as left and right axillary temperature recordings were made using an ordinary mercury-in-glass thermometer in 200 healthy individuals accompanying patients at various clinics at the Sindh Institute of Urology and Transplantation (SIUT) between mid-May to mid-June 2006. Data analysis was done using Epi Info version 3.3. RESULTS: The range for Normal Oral Temperatures fell between 97 degrees F to 99.8 degrees F (mean 98.4 degrees F). There were no significant age related (p=0.68) and ambient temperature related variations (p=0.51) in body temperature, but women had slightly higher normal temperatures than men (mean 98.5 degrees F vs. 98.3 degrees F; p=0.01). A wide variation existed in the difference between oral and axillary temperatures, with axillary temperatures ranging up to 2.6 degrees F lower or up to 1.1 degrees F higher than the oral temperatures (mean difference = 0.85 degrees F). The correlation between oral and axillary temperatures increased at higher oral temperatures (p=0.009). CONCLUSION: There is a range for Normal Body Temperature and any temperature above 98.6 degrees F/37 degrees C is not necessarily pathological. Women appear to have higher body temperatures. As there is no uniform oral equivalent of axillary temperature, the latter should be interpreted with caution.