Surgical infections最新文献

{"title":"Deep Surgical Site Infection with Epidural Abscess Following Anterior Cervical Discectomy and Fusion: A Case Report and Incidence Analysis in Sweden.","authors":"Ryo Fujita, Ioannis Georgopoulos, Pavlos Vlachogiannis, Katrin Ivars, Paul Gerdhem, Anna MacDowall","doi":"10.1089/sur.2025.013","DOIUrl":"https://doi.org/10.1089/sur.2025.013","url":null,"abstract":"<p><p><b><i>Background:</i></b> Anterior cervical discectomy and fusion (ACDF) is a common spinal procedure with a low complication rate. Although dysphagia and recurrent laryngeal nerve paralysis are well-documented, deep surgical site infections (SSIs) are rare (0.03%-0.3%). This report presents a rare case of deep SSI with an epidural abscess post-ACDF and analyzes the incidence of SSI in Sweden using Swespine data. <b><i>Case Presentation:</i></b> A 55-year-old female developed cervicothoracic pain and bilateral arm pain three weeks after C6/7 ACDF. Imaging confirmed deep SSI with an epidural abscess. Despite antibiotic agents, reoperation was required 37 days post-operatively, involving C7 corpectomy and titanium reconstruction. Cultures identified oral flora, suggesting hematogenous spread from untreated dental caries. Swespine data showed a 0.05% incidence of deep SSI among 9,382 cases. <b><i>Conclusions:</i></b> Deep SSI following ACDF is an exceptionally rare but serious complication. Cervicothoracic pain may indicate SSI, and pre-operative dental care is advisable to reduce infection risk.</p>","PeriodicalId":22109,"journal":{"name":"Surgical infections","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143658267","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":"Ceftaroline + Rifampin Versus Vancomycin + Rifampin in the Treatment of Methicillin-Resistant <i>Staphylococcus aureus</i> Meningitis in an Experimental Rabbit Model.","authors":"Damla Akdag, Tuncer Turhan, Elif Bolat, Gamze Sanlıdag-Isbilen, Canberk Tomruk, Furkan Isbilen, Yigit Uyanikgil, Sohret Aydemir, Tansu Yamazhan, Husnu Pullukcu, Bilgin Arda, Meltem Tasbakan, Berke Gokkilic, Ekin Kartal, Dilsah Baskol Elik, Hilal Sipahi, Sercan Ulusoy, Oguz Resat Sipahi","doi":"10.1089/sur.2024.069","DOIUrl":"https://doi.org/10.1089/sur.2024.069","url":null,"abstract":"<p><p><b><i>Background/Aim:</i></b> To compare the effectiveness ceftaroline-rifampicin (CR) and vancomycin-rifampicin (VR), against methicillin-resistant <i>Staphylococcus aureus</i> (MRSA) in a rabbit meningitis model, to compare the effects on brain tissues in terms of inflammation and apoptosis and to test the antibiotics via in vitro time-kill and synergy tests. <b><i>Method:</i></b> Meningitis was induced using MRSA strain ATCC 43300. After 28 hours, the rabbits were split into three groups: control, VR, and CR. A CSF culture was taken at the start (<i>T</i>₀) and end of treatment (EOT)-the 24th hour of treatment. At EOT, the animals' brain tissues were examined for inflammation and apoptosis. The study strain was tested for a 24-hour time kill assay. <b><i>Results:</i></b> At the EOT, statistically significant differences were observed between the treatment groups in terms of reducing the cerebrospinal fluid (CSF) bacterial count, achieving partial or complete treatment response, and exhibiting lower levels of neuronal apoptosis compared with the control group. However, there was no significant difference in all three parameters and in survival between the two treatment groups. The CR group exhibited a noticeable decrease in inflammation than the control group, but no significant difference was found between the control group versus VR and VR versus CR group. Rifampicin did not improve antibacterial efficacy in the in vitro time-kill assay. <b><i>Conclusion:</i></b> The CR arm showed better complete response and inflammation, but both treatments were similar in other parameters. CR combination was found as effective as VR combination for treating MRSA meningitis.</p>","PeriodicalId":22109,"journal":{"name":"Surgical infections","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143658321","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":"Hyperbaric Oxygen Therapy for Necrotizing Soft Tissue Infections: A Retrospective Cohort Analysis of Clinical Outcomes.","authors":"Akira Shishido, Gregory Schrank, Alexander Vostal, Megan Uehling, Ravi Tripathi, Sai Chintalapati, Lauren Conway, Nikki Kus, Laura DiChiacchio, Marc Kai, Joseph A Kufera, Ronald Rabinowitz","doi":"10.1089/sur.2024.285","DOIUrl":"https://doi.org/10.1089/sur.2024.285","url":null,"abstract":"<p><p><b><i>Background:</i></b> Hyperbaric oxygen therapy (HBOT) is an adjunctive therapy for necrotizing soft tissue infections (NSTIs) that remains controversial due to lack of quality clinical evidence. This retrospective cohort examines the impact of HBOT on clinical outcomes from NSTI at a single center where evaluation for HBOT is standard of care. <b><i>Methods:</i></b> The COVID-19 pandemic disrupted HBOT service and NSTI cases went without HBOT treatment, allowing for a comparison of treatment groups. The clinical outcomes of 253 patients with NSTI that were evaluated for HBOT were compared; 143 (56.3%) received HBOT and 110 (43.3%) did not. <b><i>Results:</i></b> Baseline characteristics were similar except for surface area of the wounds and distribution on the extremities. More patients in the non-HBOT group died within 90 days of admission than those in the HBOT group (5.8% vs. 15.4%, p = 0.015). Further, patients with large wounds (≥450 cm²) and those with high APACHE II scores (≥18) who underwent HBOT had significantly lower risk of death than patients who did not (odds ratio [OR] 0.12, 95% confidence interval [CI] 0.02-0.72). <b><i>Conclusion:</i></b> Our study shows that there was a mortality benefit in patients with NSTI that was more significant in patients with large wounds and higher APACHE II scores.</p>","PeriodicalId":22109,"journal":{"name":"Surgical infections","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143650889","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> Outcomes of the Subsequent Periprosthetic Joint Infection Revisions after a Failed Debridement, Antibiotics, and Implant Retention: A Multicentric Study of 197 Patients.","authors":"Xiangji Liu, Hao Wu","doi":"10.1089/sur.2025.004","DOIUrl":"https://doi.org/10.1089/sur.2025.004","url":null,"abstract":"","PeriodicalId":22109,"journal":{"name":"Surgical infections","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143650886","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":"Impact of a Multiplex PCR Assay for Rapid Diagnosis and Antibiotic Utilization in Trauma Intensive Care Unit Patients with Ventilator-Acquired Pneumonia.","authors":"Gregory R Stettler, Danielle M Detelich, Joshua S Chait, Alexandra R Monetti, Elizabeth L Palavecino, James R Beardsley, Preston R Miller, Andrew M Nunn","doi":"10.1089/sur.2024.290","DOIUrl":"https://doi.org/10.1089/sur.2024.290","url":null,"abstract":"<p><p><b><i>Background:</i></b> Ventilator-associated pneumonia (VAP) is a frequent complication in injured patients. Multiplex polymerase chain reaction (PCR) facilitates rapid identification of many respiratory pathogens prior to formal culture results. Our objective was to evaluate the effect of multiplex PCR implementation in a trauma intensive care unit (TICU) on antibiotic utilization and de-escalation. <b><i>Patients and Methods:</i></b> Injured adult patients admitted to the TICU with quantitative respiratory cultures were included. Patients were dichotomized into two groups, before (PRE) or after (POST) implementation of the pneumonia (PNA) panel. The PRE cohort included all patients meeting study criteria from January to June 2021, and the POST cohort included all patients meeting study criteria from January to June 2022, Patients were excluded if there was any documented infection requiring antibiotics other than a respiratory source. <b><i>Results:</i></b> During the study period, 60 patients met criteria for inclusion, 30 PRE and 30 POST. Diagnosis of VAP was confirmed in 43.3% PRE and 50% POST patients. The time to antibiotic change was substantially shorter in the POST group (23 h vs. 61 h, p < 0.001). In the POST cohort, 83% of initial antibiotic regimens were eligible for change on the basis of PNA panel. Of these, 88% were changed in a median time of 15.4 h. In all patients, total days of antibiotic therapy (DOT) were not different (9 vs. 10, p = 0.207); however, vancomycin DOT was less in the POST group (2 d vs. 3 d, p ≤ 0.001). In those patients diagnosed with VAP, the total antibiotic (10 vs. 12 d p = 0.008), vancomycin (2 vs. 3 d p = 0.003), and cefepime DOT (3 vs. 4 d 0.029) were substantially less in the POST group. <b><i>Conclusions:</i></b> Utilization of multiplex PCR in addition to bacterial culture substantially reduced time to achieve targeted antibiotic therapy in suspected pneumonia. Furthermore, it reduced the number of days of vancomycin therapy.</p>","PeriodicalId":22109,"journal":{"name":"Surgical infections","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143617335","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":"Time to Percutaneous Drain Placement and Impact on Patient Outcomes.","authors":"Tien Pham, Jacob C O'Dell, Jocelyn E Hunter Rose, Aaron Rohr, Matthew Johnson, Andrew Dulek, Robert D Winfield, Stepheny D Berry, Jennifer L Hartwell, Scott A Turner, Erich Wessel, Stephen R Eaton, C Cameron McCoy, Christopher A Guidry","doi":"10.1089/sur.2024.231","DOIUrl":"https://doi.org/10.1089/sur.2024.231","url":null,"abstract":"<p><p><b><i>Background:</i></b> Percutaneous drains are a commonly used method of source control for intra-abdominal infections. Increased time to source control has been shown to predict worse outcomes in patients with intra-abdominal infections, but it is unclear whether this relationship is valid when the source control method is percutaneous drainage. <b><i>Hypothesis:</i></b> We hypothesized that increased time from diagnostic imaging to drain placement would be associated with higher complication rates in a population of patients requiring percutaneous drainage for intra-abdominal, retroperitoneal, or pelvic infectious processes. <b><i>Methods:</i></b> We identified all adult patients who received a percutaneous drain placed by interventional radiology that had positive microbial drain culture results in the abdomen, retroperitoneum, or pelvis from 2020 to 2021 at the University of Kansas Medical Center. Demographics, comorbidities, and Sequential Organ Failure Assessment (SOFA) scores were collected. Multiple organ failure was defined as derangement of two or more organ systems with an SOFA ≥ 3. Standard univariate and logistic regression analyses were performed. <b><i>Results:</i></b> One hundred seventy patients were included, 94 of whom developed a complication (52%). Drain placement occurred at a median of 20.6 hours (inter-quartile range or IQR: 11.3-31.0 h) overall. Both uni-variable and logistic regression analyses demonstrate that time from imaging read to drain placement did not differ between the complication and non-complication groups. <b><i>Conclusion:</i></b> In this observational study, the time from diagnosis of intra-abdominal infection to percutaneous drain placement was not associated with increased complication rates even in the sickest patients.</p>","PeriodicalId":22109,"journal":{"name":"Surgical infections","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-03-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143597100","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> Rectal Adenocarcinoma in Children: An Uncommon Cause of Perforation and Sepsis.","authors":"Mohamed Zouari, Manel Be Lhajmansour, Rami Zouari, Wiem Rhaiem, Najoua Ben Kraiem, Mahdi Ben Dhaou, Riadh Mhiri","doi":"10.1089/sur.2025.005","DOIUrl":"https://doi.org/10.1089/sur.2025.005","url":null,"abstract":"","PeriodicalId":22109,"journal":{"name":"Surgical infections","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-03-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143587127","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":"Pneumonia and Dysphagia after Cervical Spine Trauma.","authors":"Andrew H Tran, Kaitlin A Ritter, Vanessa P Ho, Christopher W Towe, Jeffrey A Claridge, Laura Kreiner","doi":"10.1089/sur.2024.150","DOIUrl":"https://doi.org/10.1089/sur.2024.150","url":null,"abstract":"<p><p><b><i>Introduction:</i></b> In patients with cervical spine trauma (CST) or cervical spinal cord injury (C-SCI), literature reports the incidence of dysphagia at 17% and 30%, respectively. It remains unclear whether diagnosing dysphagia during an index admission (IA) would help prevent subsequent pneumonia or whether it would simply reflect a risk for future pneumonia. We hypothesized that IA dysphagia would be associated with greater future pneumonia-related readmission. <b><i>Methods:</i></b> We identified patients with CST or C-SCI from the Nationwide Readmissions Database. Readmissions within 90 days of discharge were identified, and logistic regression identified factors associated with 90-day readmission and pneumonia. Factors included age, C-SCI, pneumonia at IA, dysphagia at IA, comorbidity count, ISS, index discharge destination, and payer type. <b><i>Results:</i></b> Of 27,752 patients with CST, 23.6% had C-SCI (median age 58; median ISS 16). A total of 9% of all patients with CST had dysphagia (13% for C-SCI). In total, 11.9% of IA survivors were readmitted within 90 days and 16.8% had a diagnosis of pneumonia. In adjusted logistic regression, dysphagia at IA was not associated with readmission or pneumonia. Pneumonia, C-SCI, and tracheostomy at IA were associated with pneumonia at readmission. <b><i>Conclusion:</i></b> The incidence of IA dysphagia for patients with CST in this study was low, suggesting under-diagnosis. Pneumonia was common at both IA and readmission for patients with CST and C-SCI. Pneumonia at IA, tracheostomy, and C-SCI were strong predictors of pneumonia at readmission. Due to the discordant dysphagia rates, protocolized screening for dysphagia during IA may be key to understanding pneumonia-related readmission.</p>","PeriodicalId":22109,"journal":{"name":"Surgical infections","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-03-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143587129","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":"Microbial Pathogen Spectrum in Anastomotic Leaks after Ivor-Lewis Esophagectomy.","authors":"Andreas Schneider, Seung-Hun Chon, Philipp Kasper, Wolfgang A Wetsch, Christiane J Bruns, Andreas Hohn","doi":"10.1089/sur.2024.300","DOIUrl":"https://doi.org/10.1089/sur.2024.300","url":null,"abstract":"<p><p><b><i>Background:</i></b> Anastomotic leaks after esophagectomy cause significant morbidity and mortality. In addition to their early detection and prompt endoscopic or surgical management, providing adequate antimicrobial agents is a fundamental aspect of therapy. In this study, different types of microbiological samples were analyzed to provide insight into the microbial pathogen spectrum of anastomotic leaks after esophagectomy. <b><i>Methods:</i></b> We retrospectively reviewed patients who developed anastomotic leak after Ivor-Lewis esophagectomy at a German high-volume center between 2016 and 2018. Results of microbiological cultures from surgical samples, chest tube fluid, endoscopic aspirates, and blood cultures were analyzed to determine species and antimicrobial susceptibility. <b><i>Results:</i></b> Out of 513 consecutive patients undergoing esophagectomy, 74 developed an anastomotic leak. About 88%-100% of positive samples showed growth of gram-positive bacteria, mainly viridians streptococci but also enterococci. Gram-negative bacteria were found in 48%-82% of positive samples, mainly enterobacterales. Yeasts were found in 43%-64%. The prevalance of multidrug-resistant bacteria was low in our patient population. Expected failure of empiric antibiotic treatment was <10% for piperacillin-tazobactam, meropenem, and tigecycline (each combined with an echinocandin) but not for ampicillin-sulbactam, ceftriaxone plus metronidazole, moxifloxacin, or gentamicine plus clindamycin. <b><i>Conclusions:</i></b> There is a broad microbial pathogen spectrum in anastomotic leaks after esophagectomy. Implications for empiric antimicrobial treatment arise from enterobacterales, enterococci, and yeasts.</p>","PeriodicalId":22109,"journal":{"name":"Surgical infections","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-03-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143587128","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":"Can We Predict Post-operative Sepsis after Neonatal Abdominal Surgery?","authors":"Mohamed Zouari, Manel Belhajmansour, Asma Issaoui, Oumaima Jarboui, Najoua Ben Kraiem, Mahdi Ben Dhaou, Riadh Mhiri","doi":"10.1089/sur.2024.283","DOIUrl":"10.1089/sur.2024.283","url":null,"abstract":"","PeriodicalId":22109,"journal":{"name":"Surgical infections","volume":" ","pages":"120-121"},"PeriodicalIF":1.4,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142575680","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}