Neulanpistotapaturmat

English summar

Pamoja tulinde maisha - yhdessä säästämme elämää

Kansainvälinen yhteistyö erittäin tarttuviin infektioihin varautumisessa on tiivistynyt

Erikoissairaanhoidon henkilökunta ja COVID-19-infektiot

Vertaisarvioitu. English summary.Tiedot koronaviruspotilaita hoitavan henkilökunnan sairastumisriskistä ovat erikoissairaanhoidon näkökulmasta kiinnostavia. Kävin läpi 85 Helsingin ja Uudenmaan sairaanhoitopiirissä (HUS) tapahtunutta työntekijöiden ja potilaiden altistustilannetta. Yli 600 altistuneesta työntekijästä vain kymmenen (1,6 %) sairastui koronavirusinfektioon karanteeniaikana, altistuneista potilaista sairastui kaksi (2/81, 2,5 %). Lisäksi selvitin erikseen koronaviruspotilaita hoitavien kohorttiosastojen työntekijöiden sairastumiset. Näillä osastoilla sairastui 37 työntekijää, joista 31 oli sairaanhoitajia. Kukaan ei sairastunut vakavasti. Noin kolmessa neljästä tapauksesta altistumisen lähde oli toinen työntekijä ja vain neljäsosassa tapauksista potilas. Selvityksen perusteella erikoissairaanhoidon työntekijöiden määrääminen rutiinimaisesti THL:n nykykriteerien mukaiseen karanteeniin ei ole mielekästä eikä tarpeellista erikoissairaanhoidon epidemioiden torjunnassa.Peer reviewe

Persistent vs non-persistent candidaemia in adult patients in 2007-2016 : A retrospective cohort study

Abstract Objectives Persistent candidaemia (PC) is a recognized complication of candidaemia. Our objective was to evaluate risk factors and clinical significance of PC in adult patients. Methods This is a retrospective, cohort study. We compared PC with non-PC. All patients with blood cultures positive for Candida species were identified from a microbiological database in the hospital district of Helsinki and Uusimaa from 2007 to 2016. PC was defined as an isolation of the same Candida species from positive blood culture for ≥ 5 days. Results PC criteria were fulfilled by 75/350 patients (21.4%). No significant difference emerged between persistent and non-persistent cases caused by non-albicans Candida species (37.3% vs. 35.1%, P = 0.742). The length of hospital stay before onset of candidaemia was longer before PC (hospital stay > 7 days; 73.3% vs. 59.6%, P = 0.043). No significant impact on 30-day mortality was observed (20.0% vs. 15.5%, P = 0.422). Using multivariable regression analysis, we found the presence of central venous catheter (CVC) (OR = 2.71, 95% CI 1.31-5.59), metastatic infection foci (OR 3.60, 95% CI 1.66-7.79) and ineffective empirical treatment (OR = 3.31, 95% CI 1.43-7.65) to be independent risk factors for PC. In subgroup analysis, early source control was identified as a protective factor against PC (30.5% vs. 57.7%, P = 0.002). Conclusion Presence of CVC, metastatic infection foci and ineffective empirical treatment were independently associated with PC in adult patients. Active search for and treatment of metastatic infection foci and removal of CVC are key elements for preventing PC.Peer reviewe

Disseminated Scedosporium apiospermum central nervous system infection after lung transplantation : A case report with successful recovery

Scedosporium species are fungal opportunistic pathogens frequently seen in chronic lung diseases such as in cystic fibrosis (CF). They can cause a wide spectrum of diseases mainly in immunodeficient patients. Invasive, disseminated infections with poor prognosis have been described after lung transplantation. We present a CF-patient with disseminated Scedosporium apiospermum infection after lung transplantation. The patient had skin, surgical wound, spinal cord, and brain involvements. She recovered fully after prolonged course of voriconazole treatment.Peer reviewe