Surgical infections最新文献

{"title":"Factors Affecting Readmission in Patients with Surgical Site Infection: A Graphical and Prediction Model-Based Approach.","authors":"Shwetha Somakumar, Fathima Thashreefa Basheer, Vijayanarayana K, Vani Lakshmi R, Shyamasunder N Bhat, Gabriel Sunil Rodrigues, Girish Menon R, Elstin Anbu Raj S, Rajesh V","doi":"10.1089/sur.2024.087","DOIUrl":"10.1089/sur.2024.087","url":null,"abstract":"<p><p><b><i>Background:</i></b> Antimicrobial therapy is becoming less effective because of the rising microbial resistance. Surgical site infections (SSI) are one of the major complications that require modifications in the infection control policy for effective management. <b><i>Objective/Aim:</i></b> To develop a model for predicting the readmission rates post-SSI treatment and to identify prevalent microbial isolates and the respective trends in resistance patterns. <b><i>Methodology:</i></b> A retrospective study was carried out in a tertiary care setting in India. A total of 549 patients were diagnosed with SSI from January 1, 2016, to August 25, 2021, visiting orthopedics (n = 373), general surgery (n = 135), and neurosurgery (n = 41) departments were included in the study. Patient data and microbial isolate data were collected. Logistic regression with purposeful selection of covariates (p ≤ 0.25) was used to identify the predictors. The model fit was validated using the omnibus test. The area under the curve (AUC) was considered for the model discrimination. The resistance trend of microbial isolates was graphically represented. <b><i>Results:</i></b> One hundred thirty-seven (24.9%) were readmitted because of repeated infections. Readmission happened with a mean of 152 ± 32 days post-surgery was estimated. Uni-variable logistic regression showed 40 significant variables. The multi-variable logistic regression eliminated three variables because of insufficient comparator levels. Collinearity statistics further excluded two variables, i.e., reconstruction type of surgery and peripheral surgical area (variance inflation factor >10). The model showed an AUC of 0.77 and an accurate prediction of 77.8% (Akaike Information Criterion [AIC]: 568; Bayesian Information Criterion [BIC]: 722). Fifteen types of micro-organisms were isolated from 75.4% of readmitted patients. Methicillin-resistant <i>Staphylococcus aureus</i> (23.8%) was the primary isolate showing a resistance trend toward cloxacillin, ciprofloxacin, and ofloxacin (25.69%) equally, followed by erythromycin (18.4%) and gentamycin (6.25%). <b><i>Conclusion:</i></b> The current study predicted the post-SSI readmission rate and the microbial isolates along with their resistance patterns. The results of the study could serve as a tool for assessing and managing the factors leading to readmissions.</p>","PeriodicalId":22109,"journal":{"name":"Surgical infections","volume":" ","pages":"63-70"},"PeriodicalIF":1.4,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142883011","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}

{"title":"Transcriptomics in Human Septic Shock: State of the Art.","authors":"Fabiano Pinheiro da Silva","doi":"10.1089/sur.2024.161","DOIUrl":"10.1089/sur.2024.161","url":null,"abstract":"<p><p><b><i>Background:</i></b> Septic shock is a complex syndrome characterized by signs of intense systemic inflammation and a profound dysregulation of the immune response. Large-scale gene expression analysis is a valuable tool in this scenario because sepsis affects various cellular components and signaling pathways. <b><i>Results:</i></b> In this article, we provide an overview of the transcriptomic studies that investigated human sepsis from 2007 to 2024, highlighting their major contributions. <b><i>Conclusions:</i></b> The field, however, still faces substantial limitations and several challenges. To advance further, we believe that standardization of sample collection and data analysis, preservation of cell and tissue architecture, and integration with other omics techniques are crucial for a broader understanding of this lethal disease.</p>","PeriodicalId":22109,"journal":{"name":"Surgical infections","volume":" ","pages":"104-111"},"PeriodicalIF":1.4,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142886021","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":"Prevention of Early Ventriculoperitoneal Shunt Infection: A Long-Term Experience from Peking Union Medical College Hospital.","authors":"Xiao Zhang, Yihao Chen, Rui Yin, Jianbo Chang, Xiying Dong, Houshi Xu, Pengtao Li, Lang Yang, Xiaoyu Liu, Junji Wei, Renzhi Wang","doi":"10.1089/sur.2024.125","DOIUrl":"10.1089/sur.2024.125","url":null,"abstract":"<p><p><b><i>Background:</i></b> Preventing the early shunt infection is critical for the success of ventriculoperitoneal shunt (VPS) operation. Our goal was to establish a standardized protocol to prevent early shunt infection. <b><i>Patients and Methods:</i></b> This was a single-center retrospective study. Patients who received the VPS in Peking Union Medical College Hospital (PUMCH) between August 2012 and June 2022 were enrolled. Data of patients were extracted from the PUMCH hydrocephalus database. An evidence-based protocol to prevent early shunt infection was established, implemented, and supervised strictly throughout the study period. A central nervous system (CNS) infection presented within 30 days after VPS was defined as early VPS infection. <b><i>Results:</i></b> A total of 311 patients who received VPS were enrolled in this study. Under the strict execution of a standardized protocol including scalp pre-disinfection, \"no touch\" shunt technique, and an amikacin-soaked catheter, only 2 patients had early shunt infection. <b><i>Conclusion:</i></b> We established a standardized shunt infection prevention protocol and reported a low early infection rate. Our experience may be a clinical pearl for the surgical treatment of patients with hydrocephalus.</p>","PeriodicalId":22109,"journal":{"name":"Surgical infections","volume":" ","pages":"88-94"},"PeriodicalIF":1.4,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142740233","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 Schwannoma with Infection: A Case Report.","authors":"Ying Si, Yongmao Huang","doi":"10.1089/sur.2024.270","DOIUrl":"10.1089/sur.2024.270","url":null,"abstract":"","PeriodicalId":22109,"journal":{"name":"Surgical infections","volume":" ","pages":"116-117"},"PeriodicalIF":1.4,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142575993","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> Oral Tuberculosis Masquerading as an Oral Neoplasm.","authors":"Yuyi Gu, Hualing Li, Yunjian Sheng","doi":"10.1089/sur.2024.279","DOIUrl":"https://doi.org/10.1089/sur.2024.279","url":null,"abstract":"","PeriodicalId":22109,"journal":{"name":"Surgical infections","volume":"26 2","pages":"118-119"},"PeriodicalIF":1.4,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143575987","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":"Genetically Predicted Body Composition and Risk of Surgical Site Infection: A Mendelian Randomization Study.","authors":"Jinru Yang, Fen Zhang, Hui Xue, Nuo Chen, Yonghua Yao, Kun Li, Ying Wang","doi":"10.1089/sur.2024.133","DOIUrl":"10.1089/sur.2024.133","url":null,"abstract":"<p><p><b><i>Objective:</i></b> This study employed uni-variable and multi-variable Mendelian randomization (MVMR) analyses, utilizing publicly available genome-wide association study (GWAS) data, to assess the causal relationship between body composition measures such as body mass index (BMI), waist circumference (WC), and the occurrence of surgical site infection (SSI). <b><i>Patients and Methods:</i></b> GWAS summary statistical data were obtained for BMI, WC, and SSI from the MRC Integrated Epidemiology Unit (MRC-IEU) database, inverse variance weighted (IVW) method was used as the main analysis, and supplement sensitivity analysis (including heterogeneity test, pleiotropy analysis, leave-one-out analysis, and Mendelian Randomization Pleiotropy RESidual Sum and Outlier (MR-PRESSO)) was used to check the robustness of the results. <b><i>Results:</i></b> The MR analysis showed that the increase in BMI and WC predicted by genes had a substantial causal effect on the incidence of SSI (IVW: odds ratio [OR] = 1.003, 95% confidence interval [CI] = 1.002-1.004, p < 0.001; IVW: OR = 1.003, 95% CI = 1.002-1.005, p < 0.001), respectively, and the MVMR analysis showed that after jointly incorporating smoking and alcohol parameters, the impact of BMI and WC on SSI remained substantial (OR = 1.003, 95% CI = 1.002-1.004, p < 0.001; OR = 1.004, 95% CI = 1.002-1.005, p < 0.001). <b><i>Conclusion:</i></b> We further support the causal relationship between increased body composition including BMI and WC and the occurrence of SSI, highlighting the importance of SSI prevention in patients with obesity. Further research is required to mitigate the occurrence of surgical incisions in patients with obesity in the future.</p>","PeriodicalId":22109,"journal":{"name":"Surgical infections","volume":" ","pages":"95-103"},"PeriodicalIF":1.4,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142628687","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":"Predictive Factors for Fertility of Daughter Cysts in Hepatic Cystic Echinococcosis and Insights into the Origin of Daughter Cysts.","authors":"Aymen Trigui, Nahed Khemakhem, Sami Fendri, Mohammad Saad Saumtally, Rahma Daoud, Amira Akrout, Jihen Trabelsi, Rafik Mzali, Fatma Cheikhrouhou, Salma Ketata, Chadli Dziri, Ali Ayadi, Foued Frikha, Nizar Kardoun, Salah Boujelbene","doi":"10.1089/sur.2024.007","DOIUrl":"10.1089/sur.2024.007","url":null,"abstract":"<p><p><b><i>Introduction:</i></b> The cycle of <i>Echinococcus granulosus</i> and its developmental potential has always been a subject of debate. While the origin of protoscoleces was well defined, the origin of daughter cysts (DC) was still a contentious topic, and several hypotheses have been proposed. The aim of this work was to study the fertility of DC and its predictive factors in order to determine its origin. <b><i>Patients and Methods:</i></b> This was a prospective pilot study including hepatic echinococcal cysts containing DC operated in the Department of General and Visceral Surgery of Habib Bourguiba University Hospital, Sfax, during a 22-month period. A parasitological study of the DC including the determination of their fertility was done. <b><i>Results:</i></b> A total of 248 DC collected from 27 multi-vesicular cysts from 21 patients were included in our study. The fertility rate of the DC was 64.5%. Free hooks were present in 130 DC (52.4%) and in only 11(12%) of infertile DC. In a multi-variable analysis, only World Health Organization-Informal Working Groups on Echinococcosis classification type CE2, bilious cyst fluid, number of DC per cyst, cyst size, and DC diameter were factors associated with DC fertility (p < 0.05). Out of 88 infertile DC, 77 (87.5%) were devoid of any hooks. <b><i>Conclusion:</i></b> Our findings suggest that most of the analyzed DC were fertile, with fertility associated with factors such as cyst size, DC size, CE2 type, and number of DC/cysts. The absence of hooks in infertile DC questions prevailing theories of their origin.</p>","PeriodicalId":22109,"journal":{"name":"Surgical infections","volume":" ","pages":"71-78"},"PeriodicalIF":1.4,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142740146","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>Clostridium difficile</i> Bacteremia in an Elderly Patient with Multiple Comorbidities: A Case Report.","authors":"Binwei Wu, Xiaoying Song, Yu Liu, Xu Zheng","doi":"10.1089/sur.2024.223","DOIUrl":"10.1089/sur.2024.223","url":null,"abstract":"<p><p><i>Clostridium difficile</i> (<i>C. difficile</i>) stands as a primary cause of health-care-associated colitis in adults; however, extraintestinal manifestations of <i>C. difficile</i>, particularly bacteremia, are exceptionally rare. In this report, we document a case of an elderly male with multiple comorbidities who presented with an acute onset of fever. Diagnostic testing revealed the presence of concurrent bacteremia involving <i>C. difficile</i> and <i>Klebsiella pneumonia</i>. The multilocus sequence typing analysis identified this <i>C. difficile</i> strain as ST81. After receiving a combination treatment of vancomycin and biapenem, the patient successfully recovered and was subsequently discharged. This case report elucidates the clinical presentation and treatment strategies for <i>C. difficile</i> ST81 bacteremia, underscoring the critical need for heightened monitoring of extraintestinal infections in high-risk patients.</p>","PeriodicalId":22109,"journal":{"name":"Surgical infections","volume":" ","pages":"112-115"},"PeriodicalIF":1.4,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142740524","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":"Outcomes of the Subsequent Periprosthetic Joint Infection Revisions after a Failed Debridement, Antibiotics and Implant Retention: A Multicentric Study of 197 Patients.","authors":"Álvaro Auñón, Martí Bernaus, Margarita Veloso, Lluis Font-Vizcarra, Jaime Esteban, Monica Mijangos, Nerea Hernández, Ainara Achaerandio, José Baeza, Francisco Argüelles, Roger Rojas, Joel Sánchez, Alejandra Martínez-Roselló, Montserrat Monfort, Javier Martínez, Alejandro Corredor, José María Lamo de Espinosa, Juan Castellanos, Juan Carlos Martínez Pastor, Alfonso Alías, Laia Boadas, Ernesto Muñoz-Mahamud, Marta Sabater","doi":"10.1089/sur.2024.047","DOIUrl":"10.1089/sur.2024.047","url":null,"abstract":"<p><p><b><i>Background:</i></b> The impact of prior unsuccessful debridement, antibiotics, and implant retention (DAIR) procedures on subsequent revisions is uncertain, with conflicting evidence. Despite 85% consensus against the second DAIR procedure following the 2018 International Consensus Meeting, a 2020 study reported high success rates for the aforementioned second DAIR procedure. <b><i>Methods:</i></b> We conducted a multicenter observational study reviewing data from patients with failed DAIR procedures between 2005 and 2021. Patients diagnosed with acute periprosthetic joint infection of the hip or knee were included, following ICM criteria. Failure was defined as uncontrolled infection leading to additional surgeries, prosthesis removal, infection-related mortality, or suppressive antibiotic therapy. Demographic, surgical, and microbiological variables were recorded. <b><i>Results:</i></b> Among 197 patients from 10 institutions with failed DAIR procedures were included: 88 (44.7%) received a second DAIR, 21 (10.7%) underwent one-stage revision, and 77 (39.1%) underwent two-stage revision. One-stage revision success rate was 76.2%, with no identified predictors of failure. Two-stage revision success rate was 79.3%; factors associated with failure included polymicrobial infections (p = 0.025) and revision procedures (p = 0.049). Second DAIR success rate was 54.5%; factors associated with failure included non-specialized surgical teams in the first DAIR (p = 0.034), non-exchange of mobile components (p = 0.0038), polymicrobial infections (p = 0.043), and antibiotic resistance (p = 0.035). Excluding patients with these risk factors increased the success rate to 83.3%. <b><i>Conclusions:</i></b> Second DAIR's overall success rate was 54.5%, significantly increasing to 83.3% when excluding patients with identified risk factors. These findings suggest considering second DAIR in carefully selected patients without these risk factors. Our study found success rates of 76.2% and 79.3% for one- and two-stage revisions, respectively, aligning closely with published data.</p>","PeriodicalId":22109,"journal":{"name":"Surgical infections","volume":" ","pages":"57-62"},"PeriodicalIF":1.4,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142751702","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}