Study Identifies Risk Factors for Serious Knee Replacement Infection

A study has identified the most important risk factors for developing severe infection following knee replacement surgery.

The research, which was published in The Lancet Infectious Diseases, involved analysis of more than 679,000 primary knee replacements, of which nearly 3,700 were revised for an indication of prosthetic joint infection. Researchers from the Musculoskeletal Research Unit at the University of Bristol determined that the following were the notable risk factors:

• patients under 60 years of age;

• males;

• those with a pre-existing history of chronic pulmonary disease, diabetes, liver disease, connective tissue or rheumatic disease, or peripheral vascular disease; and

• those with a higher body mass index.

The researchers conclude, "Some of these factors are modifiable, and the use of targeted interventions or strategies could lead to a reduced risk of revision for prosthetic joint infection. Non-modifiable factors and the time-specific nature of the effects we have observed will allow clinicians to appropriately counsel patients preoperatively and tailor follow-up regimens."

Study: Reprocessing, Infection Prevention Challenges Tied to Endoscopist Off-Label Use of Products

The results of a new study show that the off-label use of a variety of products by endoscopists contribute to reprocessing failures, raising the risk of infection.

The study, published in the American Journal of Infection Control, examined reprocessed endoscopes from several hospitals. Visual inspections detected different types of residue on and in the scopes. Researchers found that microbial cultures were positive for at least half of the endoscopes. Hospital personnel reported the off-label use of simethicone, cooking spray, silicone spray and tissue glue during endoscopy.

As the researchers note, these products are insoluble and cannot be removed by reprocessing technicians, thus potentially affecting reprocessing effectiveness.

The researchers conclude: "Infection preventionists should determine whether these products are used in their institutions and evaluate methods for removing them. New policies may be needed to support procedural success and effective endoscope reprocessing."

Healthcare Worker Surveys Reveal Significant Rise in Sharps Injuries

Surveys of healthcare workers indicate a troubling trend: The number of sharps injuries is increasing.

The EXPO-S.T.O.P. (EXPOsure Survey of Trends in Occupational Practice) 2016 and 2017 surveys were conducted by the Association of Occupational Health Professionals in Healthcare (AOHP), with their results published in the AOHP Journal.

An Infection Control Today report covering the surveys and their results noted that "EXPO-S.T.O.P. is an electronic survey designed to ascertain the incidence of sharps injuries and mucocutaneous blood exposures among healthcare workers in U.S. healthcare facilities." The 2016 survey included facilities in 37 states, while the 2017 survey — AOHP's largest to date — included 224 hospital participants.

The 2016 and 2017 surveys' results point to a significant increase in blood exposure incidence over the 2011 results and continue this trend, which was witnessed in the 2015 survey. Furthermore, the 2017 sharps injuries rate is almost back to the 2001 rate. That was the year that the Needlestick Safety and Prevention Act was enacted, which contributed to a substantial decrease in sharps injuries in the years that followed, according to the report.