Surgical infections最新文献

{"title":"<i>Letter to the Editor:</i> Physics-Biology-Chemistry Model: A New Clinical Proposal for Intra-Abdominal Infections.","authors":"Fengping Zhang, Xurui Zhang, Chang Liu, Jingyao Zhang","doi":"10.1089/sur.2024.305","DOIUrl":"https://doi.org/10.1089/sur.2024.305","url":null,"abstract":"","PeriodicalId":22109,"journal":{"name":"Surgical infections","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-01-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143059420","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Patient and Health Professional's Perspectives of Periprosthetic Joint Infection: A Systematic Review and Meta-Ethnography.","authors":"Toby O Smith, Hugh Gorick, Susanne Arnold, Phil Hopgood","doi":"10.1089/sur.2024.253","DOIUrl":"https://doi.org/10.1089/sur.2024.253","url":null,"abstract":"<p><p><b><i>Background:</i></b> Periprosthetic joint infection (PJI) is a major challenge for surgical teams and patients following an orthopedic surgical procedure. There is limited understanding on patient and health professional's perception of PJI. The aim of this study was to examine the literature to better understand the perspectives of patients, and those who manage PJI. <b><i>Methods:</i></b> Published and unpublished literature databases were systematically searched from inception to June 21, 2024. Qualitative studies reporting the perspectives of living with and managing PJI were included. Data were synthesized using a meta-ethnography approach and the GRADE-CERQual tool. <b><i>Results:</i></b> Of the 584 citations identified, 10 studies (n = 91 patients; n = 70 health professionals) met the eligibility criteria and were included. Three themes, all moderate-certainty evidence, were identified from the health professional data, including the following: (1) importance of PJI; (2) impact on health professionals; and (3) support for change. From the patient data, six themes on the basis of moderate-certainty evidence were identified: (1) psychological and social impact; (2) physical impacts; (3) relationship with health professionals; (4) relationship with others; (5) uncertainty over the future; and (6) support for change. A novel line of argument was developed offering third-order constructs, on the basis of first- and second-order themes. <b><i>Conclusion:</i></b> PJIs are perceived as devastating by both patients and health professionals. They impact on all aspects of a patient's physical, social and psychological health, each interacting on one another over the course of infection and management. Strategies to improve communication, multidisciplinary management, and personalization of care are advocated by both patients and health professionals to promote better outcomes.</p>","PeriodicalId":22109,"journal":{"name":"Surgical infections","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-01-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143047955","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparing Outcomes and Infection Risk in Medical, Surgical, and Trauma Intensive Care Patients with Alcohol Use Disorder.","authors":"Kristin P Colling, Alexandra K Kraft, Melissa L Harry","doi":"10.1089/sur.2024.044","DOIUrl":"https://doi.org/10.1089/sur.2024.044","url":null,"abstract":"<p><p><b><i>Introduction:</i></b> Alcohol is the most frequently abused drug in the United States, and alcohol use disorder (AUD) is a common comorbidity in intensive care units (ICUs). <b><i>Patients and Methods:</i></b> We performed a retrospective chart review of patients admitted to an ICU between January 2017 and March 2019 at a tertiary hospital serving a large rural population. Patients with diagnoses of AUDs were included. Patients were excluded if they did not require ICU care. Patient demographics, hospital course, infection type, culture results, and mortality were evaluated. We compared medical, surgical, and trauma ICU patient outcomes and infections. <b><i>Results:</i></b> In total, 527 patients met inclusion and exclusion criteria. Trauma ICU patients had the least pre-existing comorbidities, and surgical ICU patients had the longest lengths of stay. There was no difference in in-hospital mortality between ICU groups; however, surgical and medical ICU patients had significantly greater rates of in-hospital mortality compared with trauma ICU patients. Infections were common across all ICU types, occurring in 40% of patients. There was no difference in infection rate between ICU types. In multi-variable analysis controlling for age, gender, liver failure, chronic kidney disease, thrombocytopenia, complications, and blood transfusions, infection remained an independent predictor of in-hospital mortality (adjusted odds ratio 3.3, 95% confidence interval 1.7-6.4). Septic shock occurred in 57% of infections and was associated with an increased risk of mortality (38% vs. 2%, p < 0.001). Pneumonia was the most common infection occurring in 28% of the cohort, followed by bacteremia (7%), skin/soft tissue infections (6%), urinary tract infection (5%), intra-abdominal infections (4%), and <i>C. difficile</i> (2%). <b><i>Conclusions:</i></b> AUDs in all types of ICU patients are associated with high rates of infections and high morbidity and mortality.</p>","PeriodicalId":22109,"journal":{"name":"Surgical infections","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-01-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143047954","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Povidone-Iodine Versus Saline Irrigation on Reduction of Surgical Site Infections in Total Hip and Knee Arthroplasty: A Retrospective, Propensity-Matched Cohort.","authors":"Samantha J Simon, Andrew R Grant, Hannah I Travers, Eric L Smith, Brian L Hollenbeck","doi":"10.1089/sur.2024.250","DOIUrl":"https://doi.org/10.1089/sur.2024.250","url":null,"abstract":"<p><p><b><i>Introduction:</i></b> Surgical site infection (SSI) after total hip and knee arthroplasty (THA/TKA) is a major complication leading to morbidity and mortality. Perioperative irrigation, frequently with antiseptic compounds including povidone-iodine (PI), is the standard of care in reducing SSI. Evidence supporting the value of PI versus nonantiseptic substances varies. This study aims to identify whether PI irrigation in THA/TKA reduces the rate of SSI versus normal saline irrigation. <b><i>Patients and Methods:</i></b> A retrospective, propensity-matched cohort study of patients who underwent TKA or THA was conducted using data from patient charts, hospital infection control surveillance software, and operative reports. SSI rates of patients who had received PI versus saline irrigation were compared. Patient medical status, demographics, and procedure details were considered for propensity score determination and matching. <b><i>Results:</i></b> The study encompassed 21,482 patients. The unadjusted univariate analysis demonstrated no statistically significant difference in SSI rate between PI and saline (p = 0.759). Multivariate analysis showed that men, patients with diabetes, and those with a 2-3 h procedure time had increased risk of SSI, but differences were not observed between irrigation groups. Propensity score matching yielded 21 (0.25%) SSI in the matched PI group and 19 (0.23%) in the saline group (odds ratio: 1.10; confidence interval: 0.59-2.06). <b><i>Conclusions:</i></b> This investigation proposes that PI irrigation is not significantly different to saline in reducing SSI in this population. When cost is of concern, saline irrigation is equally effective and therefore a sensible option.</p>","PeriodicalId":22109,"journal":{"name":"Surgical infections","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-01-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143011943","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"<i>Letter to the Editor:</i> Mesentery Lymphangioma with Infection in Children.","authors":"Ying Si, Yongmao Huang","doi":"10.1089/sur.2024.295","DOIUrl":"https://doi.org/10.1089/sur.2024.295","url":null,"abstract":"","PeriodicalId":22109,"journal":{"name":"Surgical infections","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-01-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143011932","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Development and Prospective Validation of a Novel Risk Score for Predicting the Risk of Poor Surgical Site Healing in Patients Following Surgical Procedure for Spinal Tuberculosis: A Multi-Center Cohort Study.","authors":"Jinglian Wen, Qing Ye, Haiyi Wu, Yi Zhang, Sisi Ai, Run Li, Qian Xu, Qin Zhou, Yingjie Fu, Guoxuan Peng, Wei Tang","doi":"10.1089/sur.2024.255","DOIUrl":"https://doi.org/10.1089/sur.2024.255","url":null,"abstract":"<p><p><b><i>Background:</i></b> The risk of poor surgical site healing in patients with spinal tuberculosis due to <i>M. tuberculosis</i> infection is known to be higher than in other surgical patients. Early identification and diagnosis are critical if we are to reduce the disability and mortality associated with spinal tuberculosis. We aimed to develop and validate a novel predictive score for predicting the risk of poor surgical site healing in patients following surgical procedure for spinal tuberculosis. <b><i>Patients and Methods:</i></b> We retrospectively analyzed the clinical data of patients with spinal tuberculosis who were hospitalized in the orthopedic ward of four regional medical centers in Guizhou Province between January 2015 and October 2022. Univariate and LASSO analysis was used to identify risk factors, construct and evaluate predictive models and novel predictive score for poor surgical site healing following the surgical procedure. Subsequently, 110 patients, admitted to four regional medical centers in Guizhou Province between January 2023 and February 2024, were used as an external prospective validation cohort to test the predictive efficacy of the prediction model. <b><i>Results:</i></b> Seven predictors were identified as risk factors for poor surgical site healing in patients undergoing surgical procedure for spinal tuberculosis. The areas under the receiver operating characteristic curve for a risk prediction model constructed based on the significant risk factors were 0.753 (95% CI: 0.693-0.813) and 0.779 (95% CI: 0.696-0.863) for the training and validation sets, respectively. Decision curve analysis demonstrated that the model yielded good clinical benefit. Finally, we applied the newly developed poor surgical site healing risk assessment score for the external prospective validation set; the area under the receiver operating characteristic curve for the poor surgical site healing risk assessment score was 0.846 (95% CI: 0.769-0.923) demonstrated that the model yielded better predictive effectiveness. <b><i>Conclusion:</i></b> The novel poor surgical site healing risk assessment score exhibits good discriminatory power and represents a beneficial predictive tool for facilitating suitable postoperative clinical management.</p>","PeriodicalId":22109,"journal":{"name":"Surgical infections","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-01-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143011937","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Extended Post-Operative Antibiotic Usage Does Not Reduce Surgical Site Infections after Spinal Surgery.","authors":"Sade Olatunbosun, Brian L Hollenbeck","doi":"10.1089/sur.2024.258","DOIUrl":"https://doi.org/10.1089/sur.2024.258","url":null,"abstract":"<p><p><b><i>Background:</i></b> Currently there is not a clear basis of evidence for post-operative antibiotic duration in spine surgery. A better understanding of risk factors and proper dosing for antibiotics will help improve outcomes and further define appropriate antibiotic use. <b><i>Patients and Methods:</i></b> A single-center retrospective cohort study of all patients undergoing spinal fusions and/or decompressions between January 1, 2018, and July 1, 2023 was performed. Patient demographic data and surgical information were collected. The exposure variable assessed was the duration of post-operative antibiotic administration. The primary outcome was incidence of surgical site infections (SSI). Uni-variable and multi-variable analysis were used to determine risk factors for infection. <b><i>Results:</i></b> A total of 5,656 procedures were performed by 25 different orthopedic spine- or neurosurgery-trained surgeons. The incidence of SSI was similar between the ≤24 h of antibiotic group and the >24 h antibiotic group, 0.50% and 0.45%, respectively (p = 0.769). In multi-variable analysis, only a body mass index (BMI) over 30 was associated with increased risk for SSI (odds ratio 2.54 [1.12, 5.74]). <b><i>Conclusion:</i></b> We observed no significant difference in the incidence of SSI among patients who were administered ≤24 h of post-operative antibiotics compared with those who we administered >24 h post-operative antibiotics. A BMI ≥30 was a risk factor for SSI in both uni-variable and multi-variable analysis.</p>","PeriodicalId":22109,"journal":{"name":"Surgical infections","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-01-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143011939","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparison of Multi-Drug Resistant Organisms Causing Early Ventilator-Associated Pneumonia in Three Geographically Distinct Trauma Intensive Care Units.","authors":"Joseph M Swanson, Peyton C Cole, Julie E Farrar, Kristina L Smith, Andrew J Kerwin, G Christopher Wood, Dina M Filiberto","doi":"10.1089/sur.2024.149","DOIUrl":"https://doi.org/10.1089/sur.2024.149","url":null,"abstract":"<p><p><b><i>Introduction:</i></b> It is unclear why differences in patient location change organisms causing ventilator-associated pneumonia (VAP). We investigated VAP organisms in three geographically separate trauma intensive care units (TICUs). <b><i>Patients and Methods:</i></b> A retrospective review of organisms causing VAP (bronchoalveolar lavage [BAL] performed ≤7 d after admission and growing ≥10⁵ cfu/mL) in three geographically separate TICUs was conducted. Patients were treated by similar multidisciplinary teams and protocolized pathways. The primary outcome was the incidence of multi-drug resistant (MDR) VAP. Secondary outcomes were the incidence of inappropriate empiric antimicrobial therapy (IEAT) and the determination of risk factors for MDR VAP. Chi-squared, Kruskal-Wallis, and multi-variable logistic regression analyses were used accordingly. <b><i>Results:</i></b> In total, 271 patients were included: 142 in TICU-1, 63 in TICU-2, and 66 in TICU-3. The incidence of MDR VAP was similar across TICUs at 33.8%, 47.6%, and 39.4%, respectively (p = 0.17). Gram-negative MDRs were more prevalent in TICU-1 (70.8%) versus TICU-2 (60.0%) or TICU-3 (26.9%) (p = 0.001). Gram-positive MDRs were identified more in TICU-3 (73.1%) versus TICU-2 (43.3%) or TICU-1 (35.4%). IEAT did not differ by unit overall but was significantly greater for MDR gram-positive organisms in TICU-3 (70.4%) versus TICU-2 (44.8%) or TICU-1 (37.5%) (p = 0.02) and highest for MDR gram-negative organisms in TICU-1 (64.6%) versus TICU-2 (62.1%) or TICU-3 (55.8%) (p = 0.02). Multi-variable regression analyses revealed antibiotic days before BAL and kidney replacement therapy (KRT) as significant predictors of MDR VAP. <b><i>Conclusions:</i></b> Different TICU locations did not influence the overall incidence of MDR VAP, but differences in MDR organisms were observed. IEAT rates for both gram-positive and gram-negative organisms in different units may necessitate changes in empiric therapy. Antibiotic days prior to the BAL and KRT significantly increased the odds of early MDR VAP.</p>","PeriodicalId":22109,"journal":{"name":"Surgical infections","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-01-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143011934","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Retroperitoneal Paraganglioma with Infection.","authors":"Bo Sun, Jiaqi Deng, Rong Kuang, Jing Zhou","doi":"10.1089/sur.2024.292","DOIUrl":"https://doi.org/10.1089/sur.2024.292","url":null,"abstract":"","PeriodicalId":22109,"journal":{"name":"Surgical infections","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-01-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143011947","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Non-Operative Management of Cholecystitis in Pregnant Patients Remains Common.","authors":"Jessica L Weaver, Alan Smith, Todd W Costantini, Laura Haines","doi":"10.1089/sur.2024.209","DOIUrl":"https://doi.org/10.1089/sur.2024.209","url":null,"abstract":"<p><p><b><i>Background:</i></b> Cholecystectomy is the recommended treatment for acute cholecystitis in pregnancy, leading to fewer pregnancy-related complications than non-operative management. However, past research demonstrated high rates of non-operative management despite these recommendations. Rates of cholecystostomy tube usage and outcomes in pregnancy are not well described. We hypothesized that rates of interventions for cholecystitis have increased over time. <b><i>Patients and Methods:</i></b> The National Readmissions Database was queried for all visits in the first three quarters of each year 2016 to 2019, which included a patient with an International Classification of Diseases-10 code for cholecystitis and pregnancy. These entries were then further investigated for demographics, gestation, rates of interventions at the index admission (cholecystectomy or cholecystostomy tube), 90-day readmissions, interventions at readmission, and pregnancy-related complications. <b><i>Results:</i></b> Annual rates of interventions for cholecystitis remained low over the study period (27.0%-34.9%). Of patients treated with non-operative management, 6.0% had cholecystectomy on readmission. Compared with the first trimester, interventions were more likely in the second trimester (p < 0.001) and less likely in the third trimester (p < 0.001). Length of stay was highest for cholecystostomy tube placement and lowest for patients who received non-operative management. <b><i>Conclusions:</i></b> Cholecystectomy rates in pregnancy remain low despite evidence that cholecystectomy is safe. Cholecystostomy appears to be a safe alternative but associated with a longer length of stay. Further study is needed to determine what barriers exist to adequate treatment of cholecystitis in pregnant patients.</p>","PeriodicalId":22109,"journal":{"name":"Surgical infections","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-01-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143011941","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}