ORCID Profile
0000-0002-9646-2183
Current Organisation
Royal College of Surgeons in Ireland
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Publisher: Centers for Disease Control and Prevention (CDC)
Date: 03-2015
Publisher: Oxford University Press (OUP)
Date: 05-11-2013
DOI: 10.1093/JAC/DKT453
Publisher: Springer Science and Business Media LLC
Date: 08-04-2017
Publisher: Informa UK Limited
Date: 03-02-2012
DOI: 10.3109/02688697.2011.651514
Abstract: The insertion of medical devices, such as intraventricular shunts, is often complicated by infection leading to ventriculitis. Frequently, such infections result from colonisation and subsequent biofilm formation on the surfaces of the shunts by Staphylococcus epidermidis. The pathogenesis of neurosurgical shunt-related infection is complex with interactions between the pathogen, the device and the unique local immunological environment of the central nervous system (CNS). An ability to form biofilm, the main virulence determinant of Staphylococcus epidermidis, facilitates protection of the organism from the host defences while still initiating an immunological response. The presence of the blood brain barrier (BBB) and the biofilm itself also complicates treatment, which presents many challenges when managing shunt infections. A greater understanding of the interplay between S. epidermidis and the CNS could potentially improve the diagnosis, treatment and management of such infections. This review describes the pathogenesis, treatment and implications of S. epidermidis ventriculoperitoneal shunt-related infections, concentrating on recent research and the implications for treatment.
Publisher: Oxford University Press (OUP)
Date: 27-03-2018
DOI: 10.1093/JAC/DKY097
Abstract: Surgical site infection (SSI) is one of the most common causes of healthcare-associated infection. Although the use of topical antibiotics to prevent SSI is not recommended by current guidelines, published studies document conflicting results and conclusions. The objectives of this survey were to: (i) determine the extent of the use of topical antibiotics to prevent SSI in clinical practice and (ii) gather the opinions of healthcare professionals most likely to be involved in their use. A questionnaire was circulated to members of BSAC and the European Wound Management Association (EWMA). The questionnaire received 160 responses from a variety of healthcare professionals around the world. Most respondents (70%) did not have guidelines for the use of topical antibiotics for the prevention of SSI in their institution if present, local guidance was based on national guidelines (20/31, 65%). Most respondents did not use or recommend topical antibiotics to prevent SSI of those that did, gentamicin collagen sponges were most commonly used (24/96 responses, 25%). Over half of the surgeons (18/33, 55%) who responded to the survey did not use topical antibiotics for the prevention of SSI but, when used, contaminated surgery (8/33, 24%) was the most commonly stated indication. There are erse opinions and practices among healthcare professionals about the use of topical antibiotics for the prevention of SSI. This considerable, and possibly inappropriate, variation in clinical practice needs to be addressed as part of antibiotic stewardship.
Publisher: Microbiology Society
Date: 09-01-2023
DOI: 10.1099/JMM.0.001636
Abstract: Introduction . Environmental surveillance for Clostridioides difficile is challenging. There are no internationally agreed recommendations on which method should be used when environmental surveillance is undertaken. Aim . To compare the detection of C. difficile by RT-PCR to culture-based methods and to determine which is more sensitive and specific in the clinical environment. Methods . Forty-four near-patient areas of C. difficile -positive patients were s led using contact plates and moistened flocked swabs. Results . Detection using moistened flocked swabs followed by RT-PCR or culture detected more C. difficile than contact plates. The sensitivity and specificity of a RT-PCR assay for tcdB compared to the culture methods was 76 and 91 %, respectively. Conclusion . Despite the lower sensitivity and specificity, RT-PCR could potentially offer a more rapid and practical alternative.
Publisher: Springer Science and Business Media LLC
Date: 23-09-2021
DOI: 10.1007/S11845-021-02774-1
Abstract: Pathology is important in training to become a medical doctor but as curricula become more integrated, there is a risk that key aspects of pathology may be excluded. Following a survey of the current delivery of teaching in Ireland under the auspices of the Faculty of Pathology at the Royal College of Physicians of Ireland, suggested components of a core curriculum in pathology have been developed to be delivered at some stage during the medical course. These have been based on key principles and themes required by the Medical Council in Ireland. Professionalism is one of the core principles emphasised by the Medical Council. It includes the role of the pathologist in patient care and other professional values such as patient-centred care, clinical competencies and skills, e.g. explaining results, and knowledge under the various sub-disciplines, i.e. histopathology (including neuropathology), clinical microbiology, haematology, chemical pathology and immunology. In each of these, we suggest key aspects and activities that the medical graduate should be comfortable in carrying out. The methods of delivery of teaching and assessment across pathology disciplines have evolved and adapted to recent circumstances. Lessons have been learned and insights gained during the COVID-19 pandemic as educators have risen to the challenge of continuing to educate medical students. Integrated and multi-disciplinary teaching is recommended to reflect best the professional environment of the medical graduate who works as an integral part of a multi-disciplinary team, with the minimum dependence on the traditional lecture, where at all possible. Finally, options on assessment are discussed, e.g. multiple-choice questions, including their respective advantages and disadvantages.
Publisher: Elsevier BV
Date: 2012
Publisher: Cambridge University Press (CUP)
Date: 10-08-2017
DOI: 10.1017/ICE.2017.168
Abstract: To evaluate the efficacy of a multijet cold-plasma system and its efficacy in decontaminating 2 surfaces commonly found in hospitals An in vitro study of common causes of healthcare-acquired infection Log 10 9 cultures of methicillin-resistant Staphylococcus aureus , vancomycin-resistant enterococci, extended spectrum β-lactamase–producing Escherichia coli , and Acinetobacter baumannii were applied to 5-cm 2 sections of stainless steel and mattress. Human serum albumin (HSA) was used as a proxy marker for organic material, and atomic force microscopy (AFM) was used to study the impact on bacterial cell structure. The inoculated surfaces were exposed to a cold-air-plasma–generating multijet prototype for 15, 20, 30, and 45 seconds. After 45 seconds, at least 3 to 4 log reductions were achieved for all bacteria on the mattress, while 3 to 6 log reductions were observed on stainless steel. The presence of HSA had no appreciable effect on bacterial eradication. The surfaces with bacteria exposed to AFM showed significant morphological changes indicative of “etching” due to the action of highly charged ions produced by the plasma. This multijet cold-plasma prototype has the potential to augment current environmental decontamination approaches but needs further evaluation in a clinical setting to confirm its effectiveness. Infect Control Hosp Epidemiol 2017 :1182–1187
Publisher: Elsevier BV
Date: 06-2017
DOI: 10.1016/J.JHIN.2017.02.008
Abstract: Staphylococcus aureus is a leading cause of healthcare-associated infections. The ability of S. aureus to attach and subsequently accumulate on the surfaces of implanted medical devices and in host tissues makes infections caused by this pathogen difficult to treat. Current treatments have been shown to have limited effect on surface-associated S. aureus, and may be enhanced by the addition of a dispersal agent. This study assessed the enzymatic agents dispersin B, lysostaphin, alpha amylase, V8 protease and serrapeptase, alone and in combination with vancomycin and rif icin, against biofilms formed by meticillin-resistant and -susceptible strains of S. aureus. The efficacy of both antibiotics was enhanced when combined with any of the dispersal agents. Lysostaphin and serrapeptase were the most effective dispersal agents against all strains tested. These data indicate that combinations of biofilm dispersal agents and antibiotics may extend the therapeutic options for the treatment of S. aureus biofilm-associated infections.
Publisher: Springer Science and Business Media LLC
Date: 23-03-2011
DOI: 10.1007/S00701-011-0990-9
Abstract: Candida infection of the central nervous system (CNS) following neurosurgery is relatively unusual but is associated with significant morbidity and mortality. We present our experience with this infection in adults and discuss clinical characteristics, treatment options, and outcome. All episodes of Candida isolated from the central nervous system were identified by searching our laboratory database. Review of the cases was performed by means of a retrospective chart review. Eleven episodes of Candida CSF infection following neurosurgery were identified over a 12-year period. Candida albicans was the predominant species isolated (n = 8, 73%). All infections were associated with foreign intracranial material, nine with external ventricular drains (82%), one with a ventriculoperitoneal shunt, one with a lumbar drain, and one with Gliadel wafers (1,3-bis [2-chloroethyl]-1-nitrosurea). Fluconazole or liposomal hotericin B were the most common anti-fungal agents used. The mortality rate identified in our series was 27%. Candida infection following neurosurgery remains a relatively rare occurrence but one that causes significant mortality. These are complex infections, the management of which benefits from a close liaison between the clinical microbiologist and neurosurgeon. Prompt initiation of antifungal agents and removal of infected devices offers the best hope of a cure.
Location: United Kingdom of Great Britain and Northern Ireland
No related grants have been discovered for Hilary Humphreys.