Prevention of iatrogenic infections in interventional rheumatology: Optimal measures but adapted to each risk

Maugars, Yves; Albert, Jean-David; Bard, Hervé; Baron, D.; Bloch, Jean-Gérard; Bourgeois, Pierre; Cormier, Grégoire; D’Agostino, Maria-Antonietta; Diebolt, Vincent; Dixneuf, V.; Etchepare, Fabien; Gandjbakhch, Frédérique; Gaudin, Philippe; Lecoq, B.; Lellouche, Henri; Monod, P; Rolland, Denis; Sanchez, Jean-Philippe; Goff, Benoît Le

doi:10.1016/j.jbspin.2015.07.003

Cited by 11 publications

(7 citation statements)

References 13 publications

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“…Hand washing with soap and hydroalcoholic solution is sufficient. 11 In our study, wearing a mask was not systematic. However, several studies reported iatrogenic septic arthritis due to oral flora, especially oral streptococci.…”

Section: Discussionmentioning

confidence: 53%

“…10 The Section of the French Rheumatology Society (SIRIS) recommends the use of either Betadine or alcohol or chlorhexidine. 11 In our study, 44.2% of the participants let the disinfectant dry. It is recommended to wait 2 minutes for betadine or chlorhexidine to dry and 30 seconds for the alcohol.…”

Section: Discussionmentioning

confidence: 64%

“…15 The same recommendation was also issued by the SIRIS. 11 Wearing a mask in the recommendations of the SIRIS is compulsory for both the doctor and the patient, if he keeps talking to contain respiratory droplets. 16 Sterile towels were used by 19.2% of participants.…”

Section: Discussionmentioning

confidence: 99%

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Evaluation of aseptic technique used in interventional rheumatology: survey among Moroccan and Tunisian rheumatologists

et al. 2021

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The objective of our study was to evaluate the aseptic technique used in interventional rheumatology by Moroccan and Tunisian rheumatologists. We performed an online survey among rheumatologists from Morocco and Tunisia. The questionnaire included 15 questions with single and multiple-choice answers and three open sections for freetext comments. An online survey was prepared and sent to 380 rheumatologists. One hundred and four rheumatologists (27.36%) replied to the survey. More than half of the participants (56.7%) were from Tunisia and 43.3% were from Morocco. Interventional procedures on superficial joints were performed by all participants. Ultrasonography was used by 41.3% of respondents to guide interventional procedures. Regarding the aseptic precautions taken to avoid infection, the majority of participants used povidone iodine to clean the skin and only 8.7% wore a mask. Hand washing alone without gloves wearing was done by 19.2% of participants. 2.9% of participants reported a history of iatrogenic septic arthritis and the duration of practice was the only factor associated with its occurrence (P=0.007). Our study showed that aseptic technique used during interventional rheumatologic procedures is heterogeneous. However, the majority of participants were aware of its necessity to avoid iatrogenic septic arthritis.

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Section: Discussionmentioning

confidence: 53%

Section: Discussionmentioning

confidence: 64%

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Evaluation of aseptic technique used in interventional rheumatology: survey among Moroccan and Tunisian rheumatologists

et al. 2021

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“…Patients in close contact with certain animals or those who live in endemic areas may suffer from zoonotic infection [18] . In addition, aggressive medical examinations, especially improper medical manipulations, increase the risk of infection [19][20][21] . Accordingly, the screening list of clues to identify pathogen invasion was comprehensively developed from the four aspects of host factors, epidemiological factors, behavioral factors, and iatrogenic factors.…”

Section: Discussionmentioning

confidence: 99%

Establishment of a Predictive Model Related to Pathogen Invasion for Infectious Diseases and Its Diagnostic Value in Fever of Unknown Origin

Xing

Wei

et al. 2018

CURR MED SCI

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The present study aimed to establish a list of parameters indicative of pathogen invasion and develop a predictive model to distinguish the etiologies of fever of unknown origin (FUO) into infectious and non-infectious causes. From January 2014 to September 2017, 431 patients with FUO were prospectively enrolled in the study population. This study established a list of 26 variables from the following 4 aspects: host factors, epidemiological factors, behavioral factors, and iatrogenic factors. Predefined predicted variables were included in a multivariate logistic regression analysis to develop a predictive model. The predictive model and the corresponding scoring system were developed using data from the confirmed diagnoses and 9 variables were eventually identified. These factors were incorporated into the predictive model. This model discriminated between infectious and non-infectious causes of FUO with an AUC of 0.72, sensitivity of 0.71, and specificity of 0.63. The predictive model and corresponding scoring system based on factors concerning pathogen invasion appear to be reliable screening tools to discriminate between infectious and non-infectious causes of FUO.

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“…Thus, in most cases, the use of ultrasound or another imaging guidance technique is not recommended as the rst line approach, especially when the extra costs involved and the limited hypothetical clinical bene t are taken into account. As the contraindications to performing corticosteroid injections are not abundant and are easily identi able [1], and as the signi cant complications are unusual (notably the infectious risk which remains lower than one case per twenty thousand procedures) [1,4,6,7], corticosteroid injections as part of primary care management seems to be practical. As it has already been demonstrated in other countries such as in United Kingdom for example [8,9], this management would allow a better use of health care services from the point of view of both patients and society.…”

Section: Introductionmentioning

confidence: 99%

How to conduct post-graduate training of general practitioners in performing articular or abarticular corticosteroid injections in the knee and shoulder joints? Analysis of the current training courses, literature review and implementation of a new training program

Vrignaud

Dernis

2020

Preprint

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Background: While several studies have shown the usefulness and effectiveness of articular and abarticular corticosteroid injections performed by general practitioners, the main limitation that has been identified in expanding the use of these acts in everyday practice lies in a lack of training. Thus, this study aimed to determine the best settings for training courses concerning this subject.Methods: Our study was composed of two parts: the first one consisted in a survey concerning the improvements induced by training courses in the context of continuing medical education on the participants’ skills and degree of confidence, the second part was a review of the published literature about this topic.Results: As expected, every training program analysed through our survey generated improvements in the participants’ confidence in performing articular or abarticular injections. Furthermore, these findings are reflected in an increase in the proportion of such skills that the trainees complete by themselves. These results were reinforced by similar findings raised by the literature review. Moreover, it highlighted that hands-on training courses seemed to be the most efficient and that the use of synthetic models appeared to be a suitable alternative to human bodies or corpses, surrounded by less ethical and logistic concerns.Conclusion: This study supports the expansion of training courses for general practitioners on articular and abarticular injections. It also suggests that they should be based on a hands-on training design, possibly with the use of manikins.

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Prevention of iatrogenic infections in interventional rheumatology: Optimal measures but adapted to each risk

Cited by 11 publications

References 13 publications

Evaluation of aseptic technique used in interventional rheumatology: survey among Moroccan and Tunisian rheumatologists

Evaluation of aseptic technique used in interventional rheumatology: survey among Moroccan and Tunisian rheumatologists

Establishment of a Predictive Model Related to Pathogen Invasion for Infectious Diseases and Its Diagnostic Value in Fever of Unknown Origin

How to conduct post-graduate training of general practitioners in performing articular or abarticular corticosteroid injections in the knee and shoulder joints? Analysis of the current training courses, literature review and implementation of a new training program

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