Surgical infections最新文献

{"title":"A Systematic Review and Meta-Analysis of <i>Aeromonas</i>-Associated Diarrhea Among Children in Asia.","authors":"Hamid Sadeghi, Masoumeh Aslanimehr, Farhad Nikkhahi, Roya Safari, Majid Vafaie, Saeideh Gholamzadeh Khoei","doi":"10.1089/sur.2024.090","DOIUrl":"10.1089/sur.2024.090","url":null,"abstract":"<p><p><b><i>Background:</i></b> Diarrheal illness is a prominent public health worry in developing countries, resulting in high mortality among children. Sociodemographic characteristics and geographic settings are the main effective factors for the increased incidence of childhood diarrhea. <i>Aeromonas</i> is a neglected organism capable of causing dysentery and diarrhea. The aim of this systematic review and meta-analysis was to determine the prevalence of <i>Aeromonas</i> as an agent in the causation of diarrhea in Asian children. <b><i>Methods:</i></b> We conducted a systematic review using Web of Science, PubMed, Wiley Online Library, Science Direct, and Google Scholar for peer-reviewed articles published between January 2000 and February 2023. We considered studies that found <i>Aeromonas</i> in diarrheal stool. A random-effects model was used to determine the pooled prevalence of <i>Aeromonas</i>. <b><i>Results:</i></b> Our search returned 2,057 articles, with 17 articles from seven Asian nations being included in the systematic review. The pooled prevalence of <i>Aeromonas</i> was 4.5% (95% confidence interval [CI]: 2.9%-6.8%), with heterogeneity (<i>I</i>² = 96.85; p < 0.001). There was a greater prevalence in areas with high population living in poverty (12.2%; 95% CI: 5.8%-24%) and lower-middle-income countries (5.0%; 95% CI: 2.7%-9.0%). In addition, the prevalence of <i>Aeromonas</i> was greater in South Asia (10.0%; 95% CI: 5.6%-17.2%), in India (12.9%; 95% CI: 6.8%-23%), and in countries with open defecation rate of 5%-25% (11.3%; 95% CI: 6.3%-19.2%). <b><i>Conclusion:</i></b> The prevalence of <i>Aeromonas</i>-associated diarrhea in children in Asia estimated in the present study highlighted the high burden of <i>Aeromonas</i> in some parts of Asia.</p>","PeriodicalId":22109,"journal":{"name":"Surgical infections","volume":" ","pages":"538-545"},"PeriodicalIF":1.4,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141917465","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> Diagnostic Accuracy of Alvarado Score, Laboratory Data, and CT Findings for Acute Appendicitis in Children with a Non-Diagnostic Ultrasound.","authors":"Mohamed Jallouli, Ahmed Elsharkawy, Ahmed Bahgat Soliman, Mohamed Zouari","doi":"10.1089/sur.2024.052","DOIUrl":"10.1089/sur.2024.052","url":null,"abstract":"","PeriodicalId":22109,"journal":{"name":"Surgical infections","volume":" ","pages":"546-547"},"PeriodicalIF":1.4,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141917464","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":"Feasibility of Narrow-Spectrum Antimicrobial Agents for Post-Operative Intra-Abdominal Infections After Gastrectomy.","authors":"Kentaro Goto, Hiroaki Hata, Kanako Degawa, Yasutaka Nakanishi, Kazutaka Obama","doi":"10.1089/sur.2024.020","DOIUrl":"10.1089/sur.2024.020","url":null,"abstract":"<p><p><b><i>Introduction:</i></b> Recently, antimicrobial resistance has received considerable attention. Broad-spectrum antimicrobial agents are recommended as the initial therapy for post-operative intra-abdominal infections. However, at our institution, we have adopted a tactic of initially treating post-operative intra-abdominal complications with relatively narrow-spectrum antimicrobial agents, such as second-generation cephalosporins. In the present study, we aimed to retrospectively analyze the use of antimicrobial agents and the resulting treatment outcomes in patients with intra-abdominal complications after gastrectomy at our facility. <b><i>Methods:</i></b> We conducted a retrospective observational study of patients treated with antibiotic agents for intra-abdominal infectious complications after gastrectomy between 2011 and 2021. We determined the proportion of \"initial treatment failures\" associated with the initial administration of antibiotic agents for post-operative intra-abdominal complications. <b><i>Results:</i></b> Post-operative intra-abdominal infections were observed in 29 patients. Broad-spectrum antimicrobial agents were not administered. We successfully treated 19 patients. Initial treatment failure was observed in 10 patients, of whom five experienced failure due to bacterial resistance to the initial antimicrobial agent. All 10 patients who experienced initial treatment failure were discharged after drainage procedures or other treatments. There were no deaths due to post-operative complications. Cefmetazole was used as the initial antimicrobial agent in 27 of the 29 patients. <b><i>Conclusions:</i></b> Considering that all patients with post-gastrectomy intra-abdominal infections were successfully treated using relatively narrow-spectrum antimicrobial agents, and initial treatment failure due to antimicrobial-resistant pathogens was 17.2%, the use of narrow-range antimicrobial agents for intra-abdominal infections after gastrectomy can be deemed appropriate.</p>","PeriodicalId":22109,"journal":{"name":"Surgical infections","volume":" ","pages":"492-498"},"PeriodicalIF":1.4,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141555473","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":"Diagnostic Value of Neutrophil-Lymphocyte Ratio in Predicting Post-Operative Infection after Orthopedic Surgery: A Systematic Review and Meta-Analysis.","authors":"Zhan Peng, Yukun Jia, Jin Li, Guangye Wang","doi":"10.1089/sur.2024.002","DOIUrl":"10.1089/sur.2024.002","url":null,"abstract":"<p><p><b><i>Objective:</i></b> This study aims to evaluate the predictive value of neutrophil-lymphocyte ratio (NLR) in determining infection after orthopedic surgery. <b><i>Methods:</i></b> A comprehensive search was conducted in PubMed, EBASE, CNKI, and Wanfang databases to identify relevant studies. The quality of the included studies was assessed using QUADAS-2. Data extraction was performed to calculate sensitivity, specificity, and other indicators. Bivariate mixed-effects meta-analysis was conducted using Stata software. The sources of heterogeneity were evaluated, and a summary receiver operating characteristic curve was generated. <b><i>Results:</i></b> A total of 16 literatures comprising 18 studies involving 3737 patients were included in this analysis. NLR demonstrated moderate sensitivity (0.77) and specificity (0.69) in diagnosing orthopedic post-operative infection, with an area under the curve of 0.80 and diagnostic odds ratio of 7.76. Significant heterogeneity was observed among the studies, primarily due to variations in surgical type, infection type, blood test timing, and NLR cutoff value. Fagan nomogram indicated that NLR could increase the positive posterior probability to 72% and decrease the negative posterior probability to 25%. The pooled effect of the likelihood ratio dot plot for diagnosis fell in the lower right quadrant. Deek funnel plot suggested no publication bias in this study. <b><i>Conclusion:</i></b> NLR holds certain value in diagnosing infection after orthopedic surgery and can provide additional information to assess the risk of infection. However, its predictive performance is influenced by various factors, and it cannot be used as a sole criterion for confirming the diagnosis. Prospective studies should be conducted in the future to optimize the diagnostic threshold and explore its combination with other indicators.</p>","PeriodicalId":22109,"journal":{"name":"Surgical infections","volume":" ","pages":"527-537"},"PeriodicalIF":1.4,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141760910","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":"Rosalind Franklin Society Proudly Announces the 2023 Award Recipient for Surgical Infections.","authors":"Catherine J Hunter","doi":"10.1089/sur.2024.54642.rfs2023","DOIUrl":"https://doi.org/10.1089/sur.2024.54642.rfs2023","url":null,"abstract":"","PeriodicalId":22109,"journal":{"name":"Surgical infections","volume":"64 1","pages":"477"},"PeriodicalIF":2.0,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142264983","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 Retrospective Exploration of Pre-operative Antibiotic Prophylaxis with Cefazolin in Cesarean Sections: Implications for Obstetrics and Gynecologic Surgery.","authors":"Alyaa S Abdel Halim, Mohamed A M Ali, Ruqiya Al Mamari, Fatma Al Raisi, Fehmi Boufahja, Anis Ahmad Chaudhary, Wael A H Hegazy","doi":"10.1089/sur.2024.048","DOIUrl":"10.1089/sur.2024.048","url":null,"abstract":"<p><p><b><i>Background:</i></b> Post-partum infection is a major contributor to maternal mortality and is responsible for approximately 10% of maternal fatalities worldwide. The risk of infection is substantially higher in cesarean section procedures. Approximately 8% of women who undergo cesarean sections are susceptible to infection. Although the body of evidence supporting the regular pre-operative utilization of prophylactic antibiotic treatment is steadily expanding, its usefulness in cesarean sections has not yet been standardized, and post-partum infection is still a serious medical challenge. We aimed to retrospectively assess the prophylactic effectiveness of cefazolin in combination with other antibiotic agents in cesarean sections. <b><i>Materials and Methods:</i></b> Both uni-variable and multi-variable analyses were conducted to identify factors that may affect cefazolin pre-operative antibiotic prophylaxis in elective cesarean section operations. The uni-variable analysis included timing of administration, operation duration, body mass index (BMI), and wound type. A multi-variable logistic regression model was then created to determine which variables provide independent information in the context of other variables. <b><i>Results:</i></b> Time of administration did not affect prophylactic cefazolin efficacy. However, prophylactic cefazolin was 1.43 and 1.77 times more effective when the operation lasted for 45 minutes or more, compared with operations that were shorter than 45 minutes. Patients with a BMI ranging from 18 to 29 kg/m² showed increased efficacy of prophylactic cefazolin compared with obese patients with a BMI exceeding 30 kg/m². The effectiveness of prophylactic cefazolin decreased by 95% in patients with clean-contaminated surgical incisions compared with those with clean surgical incisions. <b><i>Conclusions:</i></b> Our findings demonstrate that administering pre-operative prophylactic antibiotic agents to women undergoing cesarean section resulted in a reduction in post-partum infections, thereby reducing maternal mortality. Furthermore, optimal timing of administration, re-dosing if necessary, length of prophylactic medication, and dosing adjustments for obese patients are crucial factors in preventing surgical site infections and promoting antimicrobial stewardship.</p>","PeriodicalId":22109,"journal":{"name":"Surgical infections","volume":" ","pages":"513-520"},"PeriodicalIF":1.4,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141493457","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":"Ampicillin-Sulbactam for Carbapenem-Susceptible <i>Acinetobacter baumannii</i> Pneumonia: A Case for High-Dose, Continuous Infusion Dosing Strategy in the Trauma ICU.","authors":"Bethany R Shoulders, Barbara A Santevecchi, Veena Venugopalan, Kaitlin M Alexander","doi":"10.1089/sur.2024.135","DOIUrl":"10.1089/sur.2024.135","url":null,"abstract":"<p><p><b><i>Background</i></b>: The optimal ampicillin-sulbactam dosing regimen for carbapenem-susceptible <i>Acinetobacter baumannii</i> isolates in critically ill trauma patients has not been clearly defined. One strategy to provide the adequate sulbactam dose includes high-dose continuous infusion. <b><i>Case(s) Description:</i></b> We present three cases of critically ill trauma patients with augmented renal clearance treated with high-dose ampicillin-sulbactam through an intravenous continuous infusion for ventilator-associated pneumonia. All <i>A. baumannii</i> isolates were susceptible to sulbactam with low minimum inhibitory concentrations. All achieved clinical cure at the end of therapy and no recurrent pneumonia was noted. No clinically substantial adverse effect attributable to ampicillin-sulbactam therapy occurred. <b><i>Discussion:</i></b> There is limited evidence to endorse high-dose, continuous infusion ampicillin-sulbactam for treatment of infections caused by carbapenem-susceptible <i>A. baumannii</i>. This report presents three critically ill trauma patients with augmented renal clearance that achieved positive clinical outcomes with higher doses of ampicillin-sulbactam administered through a continuous infusion.</p>","PeriodicalId":22109,"journal":{"name":"Surgical infections","volume":" ","pages":"553-557"},"PeriodicalIF":1.4,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141493459","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":"Sex Differences of Neutrophil Extracellular Traps on Lipopolysaccharide-Stimulated Human Neutrophils.","authors":"Michiko Ishikawa, Hiromoto Murakami, Hideki Higashi, Taketo Inoue, Noritomo Fujisaki, Keisuke Kohama","doi":"10.1089/sur.2024.016","DOIUrl":"10.1089/sur.2024.016","url":null,"abstract":"<p><p><b><i>Objective:</i></b> Sex differences exist in sepsis, but the commitment of neutrophils to these differences remains unclear. Neutrophil extracellular traps (NETs) function to remove pathogens, yet excessive NETs release can contribute to organ damage. This study explores effects of the gender hormones on endotoxin-induced NETs using neutrophils from both male and female sources. <b><i>Methods:</i></b> Blood samples were collected from healthy volunteers. Isolated neutrophils were seeded in collagen-coated cell culture plates, and NETs were induced by lipopolysaccharide (LPS) treatment. After 15 minutes of LPS treatment, 17β-estradiol (0.03-272.4 ng/mL), testosterone enanthate (0.01-10 ng/mL), dimethyl sulfoxide, or ethanol (vehicle control) was added to the plates. These were incubated for three hours at 37°C with 5% CO₂. Neutrophil extracellular traps formation was assessed using immunofluorescence staining. <b><i>Results:</i></b> Lipopolysaccharide-induced NETs formation was significantly greater in females than in males. In male-derived neutrophils, 17β-estradiol at above the blood concentrations significantly suppressed LPS-induced NETs. No effect was seen while using testosterone enanthate to NETs at any concentration. In female-derived neutrophils, 17β-estradiol, which was near to the highest concentration of non-pregnant women's blood, tended to increase NETs. Testosterone enanthate, which was near to female blood concentration, significantly promoted NETs. <b><i>Conclusions:</i></b> Sex differences existed in LPS-induced NETs of human neutrophil. In males, high concentrations of 17β-estradiol administration may have a suppressive effect on excessive NETs during infection. In females, endogenous gender hormones may promote NETs during infection. Sex differences in neutrophils may need to be considered in organ damage owing to NETs excess such as sepsis.</p>","PeriodicalId":22109,"journal":{"name":"Surgical infections","volume":" ","pages":"505-512"},"PeriodicalIF":1.4,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141493495","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":"Adherence to Antimicrobial Prophylaxis Guidelines in Endourologic Procedures: Frequency and Related Outcomes.","authors":"Sondos Abdaljaleel, Mariam Abdeljalil, Oriana Awwad, Ghazi Al Edwan, Mohammad Amaireh, Manar Hamdan, Ahmad Khattab, Tasneem Al-Hourani","doi":"10.1089/sur.2024.008","DOIUrl":"10.1089/sur.2024.008","url":null,"abstract":"<p><p><b><i>Background:</i></b> Surgical antimicrobial prophylaxis (SAP), when used appropriately based on evidence-based guidelines, can reduce the rate of infectious complications following endourologic procedures without compromising patient outcomes. <b><i>Objectives:</i></b> To investigate the appropriateness of the current SAP used in endourologic surgeries based on international guidelines and report their associated outcomes (urinary tract infection [UTI] and blood stream infection [BSI]). <b><i>Design:</i></b> Prospective cross-sectional study. <b><i>Methodology:</i></b> The medical records of patients undergoing endourologic procedures were reviewed to assess healthcare providers' adherence to international guideline recommendations. Assessed parameters included indication, duration, choice, and dose of the antibiotics used in endourologic procedures in two medical centers in Amman/Jordan. Furthermore, patients were asked to conduct laboratory urine tests to determine the rate of infectious complications within one month post-procedure. <b><i>Results:</i></b> Three hundred and sixty-one patients were recruited for the study. The adherence rates to guidelines regarding indication, choice, and dose of pre-operative antibiotics were 90.3%, 2.8%, and 77.8%, respectively. The duration was concordant with guidelines in only 3.4% of participants. A total of 41.8% of patients completed follow-up. Among those, 4.6% developed bacterial UTIs, and 0.7% developed BSI. <b><i>Conclusion:</i></b> Adherence to SAP guidelines in endourologic procedures was far from optimal. Primary deviations in the implementation of guidelines' recommendations were pinpointed. These results are crucial for planning interventions that optimize SAP utilization.</p>","PeriodicalId":22109,"journal":{"name":"Surgical infections","volume":" ","pages":"484-491"},"PeriodicalIF":1.4,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141493458","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":"Modernizing Surgical Quality: A Novel Approach to Improving Detection of Surgical Site Infections in the Veteran Population.","authors":"Louis Perkins, Thomas O'Keefe, William Ardill, Bruce Potenza","doi":"10.1089/sur.2024.013","DOIUrl":"10.1089/sur.2024.013","url":null,"abstract":"<p><p><b><i>Introduction:</i></b> Surgical site infections (SSIs) are an important quality measure. Identifying SSIs often relies upon a time-intensive manual review of a sample of common surgical cases. In this study, we sought to develop a predictive model for SSI identification using antibiotic pharmacy data extracted from the electronic medical record (EMR). <b><i>Methods:</i></b> A retrospective analysis was performed on all surgeries at a Veteran Affair's Medical Center between January 9, 2020 and January 9, 2022. Patients receiving outpatient antibiotics within 30 days of their surgery were identified, and chart review was performed to detect instances of SSI as defined by VA Surgery Quality Improvement Program criteria. Binomial logistic regression was used to select variables to include in the model, which was trained using k-fold cross validation. <b><i>Results:</i></b> Of the 8,253 surgeries performed during the study period, patients in 793 (9.6%) cases were prescribed outpatient antibiotics within 30 days of their procedure; SSI was diagnosed in 128 (1.6%) patients. Logistic regression identified time from surgery to antibiotic prescription, ordering location of the prescription, length of prescription, type of antibiotic, and operating service as important variables to include in the model. On testing, the final model demonstrated good predictive value with c-statistic of 0.81 (confidence interval: 0.71-0.90). Hosmer-Lemeshow testing demonstrated good fit of the model with p value of 0.97. <b><i>Conclusion:</i></b> We propose a model that uses readily attainable data from the EMR to identify SSI occurrences. In conjunction with local case-by-case reporting, this tool can improve the accuracy and efficiency of SSI identification.</p>","PeriodicalId":22109,"journal":{"name":"Surgical infections","volume":" ","pages":"499-504"},"PeriodicalIF":1.4,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141555474","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}