Background: The objectives of our study were to study the stethoscope cleaning practices of medical personnel and to assess the microbial load on stethoscopes and efficacy of cleaning stethoscopes with alcohol-based disinfectant. Methodology: A questionnaire-based cross-sectional study was conducted among medical personnel at a tertiary care hospital in India to assess their knowledge and cleaning practices regarding stethoscope disinfection. Samples from the stethoscopes were collected before and after cleaning with alcohol-based disinfectant. Results: Out of 62 participants, 53.22% individuals had never cleaned their stethoscope. All the initial swab samples showed bacterial growth. There was mixed growth in the samples taken from 35 stethoscope bells and 31 diaphragms. Bacteria included coagulase negative staphylococci, bacillus species, diptheroids, S. aureus, Acinetobacter and Klebsiella pneumoniae. After cleaning with an alcohol-based disinfectant, there was a significant decrease in the average number of bacterial colony-forming units. Conclusions: Regular cleaning practices should be followed to prevent growth and transmission of potentially pathogenic organisms.
We assessed the incidence of aortic valve surgery intervention in the treatment of infective endocarditis (IE) after transcatheter aortic valve replacement (TAVR) and compared the characteristics and outcomes of surgical intervention versus medical management alone in this cohort using a nationwide data set. We identified all the hospitalizations in patients undergoing TAVR who developed IE within 1‐year (i.e., early IE) of the procedure from 2014 to 2017 using the Nationwide Readmission Database (NRD). The primary outcomes of the study were in‐hospital mortality. A total of 906 hospitalizations were identified for IE amongst the TAVR patients from 2014 to 2017 of which 20 (2.21%) underwent aortic valve surgery during the hospitalization. Patients undergoing surgery were younger, more likely to have Staphylococcus aureus endocarditis, cardiogenic shock, and acute kidney injury (AKI) during the hospitalization. There were no significant differences in in‐hospital mortality (9.9% vs. 12.4%, p = 0.824; adjusted odds ratio (aOR): 0.26 (0.01–1.58), p = 0.223) and 30‐day readmissions. However, the length of stay and hospitalization costs were higher in surgical intervention group. The important predictors of in‐hospital mortality in TAVR‐related IE patients were dialysis during IE hospitalization, AKI, cardiogenic shock, Staphylococcus aureus endocarditis, stroke, and female sex. The utilization of surgical management for IE post‐TAVR during the index hospitalization is low, and there is no significant mortality benefit with surgical intervention as compared with the medical management.
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