Surgical infections最新文献

{"title":"Competing Interests: Vancomycin Use in Trauma Patients is Similar During Methicillin-Resistant <i>Staphylococcus aureus</i> Nasal Swab Based De-Escalation and Universal Mupirocin Decolonization Protocols.","authors":"Elizabeth D Krebs, Shayan Rakhit, Jennifer R Beavers, Leanne Atchison, Robel T Beyene","doi":"10.1089/sur.2024.280","DOIUrl":"https://doi.org/10.1089/sur.2024.280","url":null,"abstract":"<p><p><b><i>Introduction:</i></b> Protocols for vancomycin de-escalation often rely on nasal swab testing for methicillin-resistant <i>Staphylococcus aureus</i> (MRSA). However, in settings of hospital-wide universal MRSA decolonization with nasal mupirocin, these swabs may be unreliable, hindering de-escalation protocols. This study investigated vancomycin use and MRSA infection in trauma patients managed under each of these separate protocols. <b><i>Methods:</i></b> This retrospective review compared patients admitted to a Level 1 trauma center during a time-period of MRSA swab-based vancomycin de-escalation (\"de-esc\") with those admitted during a subsequent period of universal decolonization (and thus \"no de-esc\"). The primary outcome was total days of vancomycin per patient receiving vancomycin. Additional outcomes included a proportion of patients receiving a short course of vancomycin (<3 d), overall vancomycin rates, and in-hospital MRSA infections. <b><i>Results:</i></b> A total of 5,678 patients were evaluated, with 2,891 admitted during the \"de-esc\" period and 2,787 admitted during universal decolonization (\"no de-esc\"). There was no difference in the proportion of patients receiving vancomycin during the \"de-esc\" versus \"no de-esc\" protocols (7.2% [n = 208] vs. 6.5% [n = 181], p = 0.3). Among these patients, there was also no difference in either total days of vancomycin (5.3 d vs. 5.9 d, p = 0.3) or proportion receiving a short vancomycin course (33% vs. 29%, p = 0.5). There were 56 total patients with MRSA infections, with no difference between the two time periods (1.1% vs. 0.7%, p = 0.07). <b><i>Conclusion:</i></b> Despite concerns that a hospital-wide MRSA universal decolonization policy would hinder nasal swab-based vancomycin de-escalation, both vancomycin use and MRSA infection rates remained the same during the two time periods.</p>","PeriodicalId":22109,"journal":{"name":"Surgical infections","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-04-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143784445","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":"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":"164-174"},"PeriodicalIF":1.4,"publicationDate":"2025-04-01","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":"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":"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":"123-128"},"PeriodicalIF":1.4,"publicationDate":"2025-04-01","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> Retroperitoneal Paraganglioma with Infection.","authors":"Bo Sun, Jiaqi Deng, Rong Kuang, Jing Zhou","doi":"10.1089/sur.2024.292","DOIUrl":"10.1089/sur.2024.292","url":null,"abstract":"","PeriodicalId":22109,"journal":{"name":"Surgical infections","volume":" ","pages":"204-205"},"PeriodicalIF":1.4,"publicationDate":"2025-04-01","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":"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":"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":"195-203"},"PeriodicalIF":1.4,"publicationDate":"2025-04-01","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":"Comparison of the Effects of <i>Mycobacterium tuberculosis</i> H37Rv and <i>Brucella ovis</i> Infiltration on Tumor Necrosis Factor-Alpha and Interleukin-1 Beta Expression in Osteoblasts.","authors":"Le Fei, Minyu Li, Jiandang Shi, Zhangui Gu, Zongqiang Yang, Yu Li","doi":"10.1089/sur.2024.221","DOIUrl":"https://doi.org/10.1089/sur.2024.221","url":null,"abstract":"<p><p><b><i>Objective:</i></b> This study aims to compare the expression levels of tumor necrosis factor-alpha (TNF-α) and interleukin-1 beta (IL-1β) in osteoblasts infiltrated with <i>Mycobacterium tuberculosis</i> H37Rv (H37Rv) and <i>Brucella ovis</i> to understand the differential bone destruction in spinal tuberculosis (STB) versus <i>Brucella</i> spondylitis (BS). <b><i>Methods:</i></b> Primary osteoblasts were isolated and cultured from the cranial bones of 2-5 days old mice and characterized by alkaline phosphatase (ALP) staining and alizarin red staining (ARS). H37Rv and <i>B. ovis</i> were cultured to the logarithmic phase, and transfection solutions were prepared. Osteoblasts were infiltrated with these bacteria at various multiplicities of infection (MOI) and time points. Cell survival post-infiltration was assessed using CCK-8 to determine optimal infection conditions. Osteoblasts were divided into three groups: the H37Rv group (infiltrated with optimal MOI H37Rv), the <i>B. ovis</i> group (infiltrated with optimal MOI <i>B. ovis</i>), and a negative control group. TNF-α and IL-1β expression in the cytoplasm was observed using immunohistochemical staining, whereas their levels in cell supernatants were measured using enzyme-linked immunosorbent assay. Protein expression was analyzed by Western blot. Differences between groups were compared with using one-way analysis of variance and t-tests, with p < 0.05 indicating statistical significance. <b><i>Results:</i></b> Both H37Rv and <i>B. ovis</i> infiltrated osteoblasts, substantially increasing TNF-α and IL-1β expression. The H37Rv group showed substantially higher levels of TNF-α and IL-1β compared with the <i>B. ovis</i> group (p < 0.05). <b><i>Conclusion:</i></b> Infiltration of osteoblasts with H37Rv and <i>B. ovis</i> substantially increases TNF-α and IL-1β expression, with higher levels observed in H37Rv-infected osteoblasts. This overexpression may contribute to the more severe vertebral bone destruction seen in STB compared with BS.</p>","PeriodicalId":22109,"journal":{"name":"Surgical infections","volume":"26 3","pages":"175-182"},"PeriodicalIF":1.4,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143781083","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":"Association Between Systemic Immune-Inflammation Index and Outcomes of Acute Myocardial Infarction: A Systemic Review and Meta-Analysis.","authors":"Wen Sun, Zheye Chen, Yi Luo","doi":"10.1089/sur.2024.172","DOIUrl":"10.1089/sur.2024.172","url":null,"abstract":"<p><p><b><i>Objective:</i></b> To assess the link between systemic immune-inflammation index (SII) and risk of major adverse cardiovascular events (MACE), contrast-induced nephropathy (CIN), and overall mortality in patients with acute myocardial infarction (AMI). <b><i>Patients and Methods:</i></b> Electronic search of PubMed, EMBASE, Web of Science, and Scopus databases was done for observational studies with the data on the association of SII and outcomes, such as MACE, and CIN in adult (≥18 y) patients with AMI. A random-effects model was used, and the pooled effect sizes were expressed as relative risk (RR) with corresponding 95% confidence intervals (CI). Subgroup analysis was conducted on the basis of the type of AMI (ST elevation myocardial infarction and non-ST elevation myocardial infarction), sample size (≥500 and <500), and study design. GRADE assessment was used to evaluate the certainty of the evidence. <b><i>Results:</i></b> The analysis included 23 studies. Most studies were conducted in China (n = 13), followed by Turkey (n = 10). Majority of the studies (n = 20) had a retrospective cohort design. Patients with high SII had increased risk of MACE (RR 2.95, 95% CI: 1.25, 6.99; n = 5, I² = 97.5%), overall mortality (RR 2.59, 95% CI: 1.64, 4.07; n = 6, I² = 58.0%), and CIN (RR 4.58, 95% CI: 3.44, 6.10; n = 4, I² = 0.0%), compared with patients with lower SII. Egger's test detected publication bias for MACE (p = 0.047) and overall mortality (p = 0.012) but not for CIN. These associations remained valid in subgroup analysis. <b><i>Conclusion:</i></b> Findings suggest that higher SII in patients with AMI is associated with increased risks of MACE, CIN, and overall mortality. This underscores SII's potential as a prognostic marker in AMI.</p>","PeriodicalId":22109,"journal":{"name":"Surgical infections","volume":" ","pages":"183-194"},"PeriodicalIF":1.4,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142855382","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":"Molecular Identification of OXA Carbapenemase-Encoding Genes in <i>Acinetobacter baumannii</i> Isolated from Patients in Critical Care in Egypt.","authors":"Nahla Y Sahlol, Nermin M K Mohamed, Khaled Z El-Baghdady, Iman M A El-Kholy, Gihan M Fahmy, Mai A Sahbal, Hagar L Mowafy","doi":"10.1089/sur.2024.210","DOIUrl":"10.1089/sur.2024.210","url":null,"abstract":"<p><p><b><i>Background:</i></b> The emergence of carbapenem-resistant <i>Acinetobacter baumannii</i> (CRAB) in hospitals, particularly within critical care units, has garnered substantial global concern. CRAB commonly arises from the degradation by various ß-lactamases. <b><i>Objective</i></b>: We aimed to assess OXA-type carbapenemases in clinical isolates of <i>A. baumannii</i> obtained from an Egyptian tertiary care facility. <b><i>Patients and Methods:</i></b> This study examined 25 distinct <i>A. baumannii</i> strains collected from various clinical samples of patients in intensive care unit. Bacterial identification was conducted utilizing both traditional methods and the Vitek2 system. Antibiotic resistance profiles were assessed according to the European Committee on Antimicrobial Susceptibility Testing standards using the Vitek2 Compact automated system. Additionally, multiplex real-time polymerase chain reaction was used to identify the presence of blaOXA23, blaOXA24, blaOXA51, and blaOXA58 carbapenemase genes. Colistin susceptibility was assessed utilizing the broth microdilution method. <b><i>Results:</i></b> Carbapenem resistance was identified in 100% of the studied isolates. The blaOXA51 gene was detected in all <i>A. baumannii</i> strains. The gene blaOXA23 was identified in 22 strains (88%), whereas blaOXA24 and blaOXA58 were present in 15 strains (60%). All isolates, except one, co-harbored two or more OXA encoding genes. Colistin resistance was detected in 4 of 25 strains (16%). <b><i>Conclusion:</i></b> Our findings demonstrate the widespread distribution of CRAB isolates that co-harbor multiple carbapenemase-encoding genes. Molecular epidemiological studies and the surveillance of antibiotic resistance profiles may aid in identifying and tracing the origins of resistant bacteria, thereby limiting their spread.</p>","PeriodicalId":22109,"journal":{"name":"Surgical infections","volume":" ","pages":"158-163"},"PeriodicalIF":1.4,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142739651","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":"A Mendelian Randomization Study of the Connection Between Exogenous Hormones and Perianal Abscess in Pediatric Patients.","authors":"Hai Zhou, Chunli Bao, Yao Li, Guoyong Wang, Wei Zhou, Chunbao Guo","doi":"10.1089/sur.2024.229","DOIUrl":"10.1089/sur.2024.229","url":null,"abstract":"<p><p><b><i>Background:</i></b> Recent years have witnessed the hypothesis that bioavailable testosterone (BT) might be closely related to the development of inflammatory diseases, especially anal abscess (AA), a common inflammatory ailment with unclear pathogenesis. Given that AA is more prevalent among males, this study investigates the causal relationship between BT and AA. <b><i>Objective:</i></b> To explore the causal link between BT and AA, a Mendelian randomization (MR) study was conducted using large-scale genomic data. <b><i>Materials and Methods:</i></b> Utilizing genomic data from the UK Biobank and IEU OpenGWAS databases, a two-sample MR analysis was executed. Twenty-six genetic variants strongly associated with BT were selected as instrumental variables (IVs) to assess their link with AA risk. Various MR methods were employed for consistency checks, including sensitivity analyses for heterogeneity and horizontal pleiotropy. <b><i>Results:</i></b> Using a combination of MR methods, we identified a significant causal relationship between BT and the risk of AA. Specifically, the MR analysis revealed that higher levels of BT were associated with an increased risk of AA. Sensitivity analyses, including heterogeneity tests and assessments for horizontal pleiotropy, confirmed the robustness of these findings. The IVs used in the analysis demonstrated a strong association with BT and showed no evidence of significant heterogeneity or horizontal pleiotropy, indicating the validity of the causal inference. <b><i>Conclusion:</i></b> This study, employing two-sample MR for the first time, confirms a causal relationship between BT levels and the risk of AA. These findings provide preliminary evidence of the causal relationship between BT and AA and may offer new insights into the pathophysiological mechanism of AA and future therapeutic strategies.</p>","PeriodicalId":22109,"journal":{"name":"Surgical infections","volume":" ","pages":"150-157"},"PeriodicalIF":1.4,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142508395","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":"10.1089/sur.2024.295","url":null,"abstract":"","PeriodicalId":22109,"journal":{"name":"Surgical infections","volume":" ","pages":"206-207"},"PeriodicalIF":1.4,"publicationDate":"2025-04-01","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}