Deutsche medizinische Wochenschrift
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Dtsch. Med. Wochenschr. · Sep 2024
Review[Multi-resistant pathogens - are they also resistant to disinfectants?].
Epidemiological studies show that the care of patients in rooms with a previous stay by a person with evidence of multi-resistant pathogens (MRP) is associated with an increased risk of these pathogens occurring. The question therefore regularly arises as to whether MRP also exhibit resistance to the disinfectants used. To date, there are no standardised definitions for "resistance" to disinfectants. ⋯ A reduced sensitivity to disinfectants can occur in individual isolates due to selection under sub-inhibitory concentrations of disinfectants. Resistance mechanisms to antibiotics do not mediate cross-resistance to disinfectants, but a change in the permeability of bacterial cells can influence sensitivity to disinfectants and antibiotics. In general, the success of routine disinfection can be improved by suitable process controls and contribute to reducing the transmission of MRP.
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Dtsch. Med. Wochenschr. · Sep 2024
[Importance and prevalence of multidrug-resistant gram-negative bacteria in Germany].
Infections with multidrug-resistant gram-negative bacterial species are a great concern in clinics in Germany. By limiting therapeutic options dramatically, these bacteria pose a significant threat to patient health and cause extensive pressure on hygiene systems and patient management. ⋯ According to established surveillance systems like national reporting systems, KISS or the National Reference Centre, multidrug-resistant bacteria are constantly on the rise in Germany. Although several novel therapeutic options have been approved recently, these bacteria represent a constant challenge and it may be necessary to discuss if the present hygiene recommendations need an update for an efficient and targeted prevention of transmission.
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Dtsch. Med. Wochenschr. · Sep 2024
[IT Failures in Hospitals - Structures and Processes in Hospitals for Coping Cyber Attacks].
Clinics are, by definition, part of a country's critical infrastructure. In recent years, hospitals have increasingly become the target of cyber attacks, resulting in disruptions to their functionality lasting weeks to even months. According to the "National Strategy for the Protection of Critical Infrastructures (CRITIS Strategy)", clinics are legally obligated to take preventive measures against such incidents. ⋯ Additionally, paper-based alternative solutions, such as request forms for diagnostic or consultation services, department-specific emergency documents, and patient documentation charts, should be kept in a readily accessible location known to staff in the respective areas. The complete restoration of a clinic's network after a cyber attack often requires extensive recovery of numerous IT systems, which may take weeks to months in some cases. If the hospital has robust plans for cyber emergency preparedness, including regular scans and real-time backups, stabilization and a quicker resumption of operations may be possible.
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Dtsch. Med. Wochenschr. · Sep 2024
[Skin changes around wounds: A position paper from the professional society Initiative Chronische Wunden (ICW) e.V.].
Many patients with chronic wounds have skin changes that can provide important clues as to the etiology of the wound and/or inappropriate treatment. As the largest human organ, the skin is easily accessible for clinical inspection. ⋯ One focus here is on the definition and differentiated description of the wound edge and wound surrounding skin. Atrophies, blisters, eczema, erythema, hemorrhages, hyperpigmentation, hypopigmentation, hyperkeratosis, maceration, necrosis, oedema, pustules, sclerosis and scales are then described in more detail and placed in a clinical context.
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Dtsch. Med. Wochenschr. · Sep 2024
[Shortfalls of new data 2017-2020 in the German transplant registry].
Recently, considerable deficiencies of legacy data (2006–2016) of the newly established German Transplant Registry were described. Current data (2017–2020) of the registry are subject to the present assessment. ⋯ The German Transplant Registry needs to be fundamentally reorganized. Above all, the mandatory consent to data storage and the uncritical inclusion of data provided by various institutions render the current registry useless.