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The Bacteriological Profile of Surgical Site Infections in Orthopaedic Implant Surgeries in South-East Nigeria

Journal of Biosciences and Medicines 2019年第9期7卷 19-27页

作者： Kelechukwu A. okoro Osita Ede Emmanuel C. Iyidobi ugochukwu u. Enweani Cajetan u. Nwadinigwe Gabriel O. Eyichukwu udo E. Anyaehie Francis N. Ahaotu Richard C. Ezeh Department of Orthopaedics and Trauma National Orthopaedic Hospital Enugu Nigeria City Clinics Enugu Nigeria

Background: Knowledge of the common bacteria that cause surgical site infection (SSI) and their antibiotic sensitivity is mandatory if treatment of surgical infection is to be successful. The threat of the emergence of resistant strains of bacteria is ever-present. Hence, a sensitivity directed therapy is paramount for the successful eradication of organisms with minimal risk of development of antibiotic resistance. Aim: The aim is to identify the common bacteria that cause SSI in orthopaedic implant surgeries in our hospital. Method: This is a prospective longitudinal study that includes all orthopaedic surgeries involving the use of implants within one year. Patients that had major orthopaedic surgeries involving implant were followed up and their wounds inspected for signs of SSI on postoperative days 3, 7, 14, 42 and 90. Wound swab was taken for microscopy, culture and sensitivity analysis from those who had wound infection, based on the CDC guidelines. Results: One-hundred and sixteen patients met our inclusion criteria and were included in the analysis. There were 62 males and 54 females. The mean age of the participant was 39.62 years (SD = 15.02 years). Fracture fixation with plates and screws was the most common implant surgery done. The incidence of SSI was 2.6%, and Escherichia coli was the most common isolated pathogen. All the SSIs were superficial incisional type, and the infection was monomicrobial in 67% of cases and polymicrobial in 33%. All of the isolated pathogens were sensitive to Imipenem and Gentamycin. Conclusion: Superficial incisional SSI is the most common type of SSI in this study. Escherichia coli is the most frequent pathogen in SSI affecting implant surgeries in our hospital. Gentamycin and Imipenem should be used for the prophylaxis of SSI in our environment.

关键词： SSI Bacteriology Orthopaedic Implant Nigeria

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Implementing TB Surveillance in Nigeria: Best Practices, Challenges and Lessons Learnt

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Journal of Tuberculosis Research 2020年第4期8卷 199-208页

作者： Oluremilekun Comfort Kusimo Chukwuebuka Immanuel ugwu ufuoma Aduh Chika Augustus okoro World Health Organization Lagos Nigeria

Introduction: TB Surveillance is a critical component of the global TB response. Comprehensive, accurate and timely information on TB is crucial for an effective TB control program hence the need for a robust tuberculosis surveillance system in all countries that contribute to the global burden of TB including Nigeria. Against this backdrop, an intervention was set in motion to triangulate the information from the health data reporting systems towards improving the overall surveillance system for TB in the country. Objectives: This article highlights the best practices, lessons learnt and challenges associated with the implementation of TB surveillance in Nigeria. In resource-limited settings such as Nigeria where health systems including health information management are sub-optimal, there is a heavy reliance on national and sub-national TB surveillance systems. TB data is mainly reported through the National Tuberculosis Control, however the integrated disease surveillance and response (IDSR) system also provides a platform for TB data collation through the LGA and State disease surveillance and notification officers. Conclusion: Implementing TB surveillance in Nigeria brought to fore the need for a wider engagement of all health facilities in TB control. As a dividend of the TB surveillance intervention, quality of care was improved in the private health sector through effective linkages to the commodity management system of

关键词： Tuberculosis Surveillance IDSR Health Information TB Data

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The Antiseptic Efficacy of Povidone-Iodine in Reducing Early Surgical Site Infections in Orthopaedic Implant Surgeries

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Journal of Biosciences and Medicines 2019年第9期7卷 9-18页

作者： Kelechukwu A. okoro Osita Ede ugochukwu u. Enweani Emmanuel C. Iyidobi Cajetan u. Nwadinigwe Gabriel O. Eyichukwu udo E. Anyaehie Francis N. Ahaotu Richard C. Ezeh Department of Orthopaedics and Trauma National Orthopaedic Hospital Enugu Nigeria City Clinics Enugu Nigeria

Background: Surgical site infection (SSI) is a dreaded nightmare for the Orthopaedic surgeon. Preoperative skin cleaning with antiseptics has been shown to reduce the microbial burden of the skin and results in reduced incidence of SSI. However, the ideal skin cleaning agent remains to be established. Aim: To compare the efficacy of Povidone-Iodine/Povidone-Iodine (PI-PI) combination with that of Chlorhexidine-Gluconate/Alcohol (CG-A) combination in re-ducing SSI in Orthopaedic surgeries. Methods: This was a prospective, randomized, double-blinded, controlled study. Subjects that met the selection criteria and gave consent were randomized into PI-PI group (test group) and the CG-A group (control group). Both the patients and the assessors for SSI were blinded to the group a participant belongs. Blocking was done on the type of surgery to cancel the confounding effect of surgery type on SSI. Standard perioperative protocols were applied to both groups. Assessment for features of SSI was done on the 3rd day, 7th day, 14th day, 6th week and 12th-week postoperative period. The diagnosis of SSI was made based on the Centers for Disease and Control (CDC) guidelines. Results: We recruited 124 patients for this study, 62 males and 54 females. The mean age of the subjects was 37.5 years (SD = 14.7 years). Sixty-two subjects were randomized into each group. There was no significant difference in the distribution of the genders in the study arms. Other possible confounders such as duration of hospital stay, use of drains, the surgeon involved and age were evenly distributed in the two groups. Eight patients did not complete the study. The overall incidence of SSI in the study was 2.6%. Subjects in the control group had an SSI of 3.4% while those in the PI-PI group had a rate of 1.8%;however, this was not significant, p = 0.579. Conclusion: Both CG-A and PI-PI combinations are equally efficacious as preoperative skin antiseptic in Orthopaedic implant surgeries.

关键词： SSI Orthopaedic Implant Surgeries Chlorhexidine Gluconate-Alcohol Povidone Iodine

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产业周期对中国造纸工业的影响

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中华纸业 2014年第7期35卷 22-28页

作者： Stanley okoro 美国费雪国际公司

造纸企业的发展方向包括扩大产能、兼并及专注于成本结构的优化．但这三者并不是只能选择其一的，可以并驾齐驱进行发展。未来中国造纸企业应该关注的是提高生产效率，目前中国造纸企业的纸机生产效率差距比较大，因此对于大多数造纸企... 详细信息

造纸企业的发展方向包括扩大产能、兼并及专注于成本结构的优化．但这三者并不是只能选择其一的，可以并驾齐驱进行发展。未来中国造纸企业应该关注的是提高生产效率，目前中国造纸企业的纸机生产效率差距比较大，因此对于大多数造纸企业来说，提高纸机的生产效率有很大的发展空间。通过提高企业的运行效率来提高企业的利润率，是将来中国造纸行业发展的主流。

关键词：中国造纸工业造纸企业周期产业生产效率成本结构运行效率

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中国造纸工业整合的理性分析

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中华纸业 2015年第13期36卷 51-57页

作者： Stanley okoro 美国费雪国际公司

该板块将主要针对目前国内制浆造纸行业、造纸装备行业的发展现状、特点以及新趋势，探讨制浆造纸和装备企业的应对策略，国际国内三大咨询公司的专家就整合、运营优化、走出去等问题提出了独道见解，造纸和装备企业的企业家和技术专家... 详细信息

该板块将主要针对目前国内制浆造纸行业、造纸装备行业的发展现状、特点以及新趋势，探讨制浆造纸和装备企业的应对策略，国际国内三大咨询公司的专家就整合、运营优化、走出去等问题提出了独道见解，造纸和装备企业的企业家和技术专家分享了各自企业的新举措和新思路。

关键词：造纸工业整合制浆造纸行业理性中国技术专家企业家咨询公司

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中国投资者,转向海外发展?

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中华纸业 2017年第13期38卷 71-75页

作者： Stanley okoro 美国费雪国际公司

"中国造纸行业的新增产能投资逐年放缓,潜在的产能过剩风险会导致投资进一步减少。将来对中国造纸工业的投资会集中在效率提升方面。北美造纸行业具有吸引力的市场规模,丰富且低廉的纤维成本以及较高的行业集中度。……北美造纸业该是... 详细信息

"中国造纸行业的新增产能投资逐年放缓,潜在的产能过剩风险会导致投资进一步减少。将来对中国造纸工业的投资会集中在效率提升方面。北美造纸行业具有吸引力的市场规模,丰富且低廉的纤维成本以及较高的行业集中度。……北美造纸业该是中国投资者的合适目标。"过去30年内,中国的造纸产能经历了从20世纪90年代初期的不到1500万吨,到2016年末

关键词：造纸业造纸工业造纸企业中华人民共和国轻工业投资者产能过剩中国造纸行业文化用纸生活用纸北美地区包装用纸投资方向

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市场分析:成品纸价格波动机制探讨

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造纸信息 2017年第12期 25-26页

作者： Stanley okoro 美国费雪国际公司

2016年以来,造纸产业上下游的价格上涨成为业界关注的热点话题,特别是现在纸价仍然处于高位,并开始出现波动式的调整。价格主要受哪些因素影响,如何综合考虑各种不确定性因素对价格走势进行预测?在2017中国国际造纸创新发展论坛上,国际... 详细信息

2016年以来,造纸产业上下游的价格上涨成为业界关注的热点话题,特别是现在纸价仍然处于高位,并开始出现波动式的调整。价格主要受哪些因素影响,如何综合考虑各种不确定性因素对价格走势进行预测?在2017中国国际造纸创新发展论坛上,国际咨询机构美国费雪国际公司全球总经理Stanley okoro先生探讨了成品纸价格波动的机制。

关键词：市场分析成品纸价格波动机制

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