Surgical infections最新文献

{"title":"<i>Letter:</i> Can We Predict Nosocomial Infections Following Neonatal Repair of Digestive System Atresias?","authors":"Mohamed Zouari, Manel Belhajmansour, Manar Hbaieb, Wiem Rhaiem, Hamdi Louati, Najoua Ben Kraiem, Mahdi Ben Dhaou, Riadh Mhiri","doi":"10.1177/10962964251381641","DOIUrl":"https://doi.org/10.1177/10962964251381641","url":null,"abstract":"","PeriodicalId":22109,"journal":{"name":"Surgical infections","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145065541","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":"Clinical Implications of Systemic Corticosteroid Treatment on Mortality and Surgical Outcomes in Patients with Gastrointestinal Perforation: A Retrospective Cohort Study.","authors":"Chulhyo Jeon, Kiyoung Sung, Jinbeom Cho","doi":"10.1177/10962964251376959","DOIUrl":"https://doi.org/10.1177/10962964251376959","url":null,"abstract":"<p><p><b><i>Background:</i></b> Systemic corticosteroids are commonly used in critically ill patients. Although steroids may reduce the duration of shock and mechanical ventilation (MV), their use in postoperative surgical patients raises concerns regarding complications such as anastomotic leakage, impaired wound healing, and infection. This study aimed to evaluate the impact of postoperative corticosteroid therapy on clinical outcomes in patients undergoing surgery for gastrointestinal perforation and receiving intensive care. <b><i>Methods:</i></b> We conducted a single-center retrospective cohort study of 354 patients treated between January 2013 and March 2023. Postoperative corticosteroid use was identified, and clinical outcomes were compared between treated and untreated patients. To reduce confounding, propensity score matching was performed based on initial and postoperative sequential organ failure assessment scores and the Acute Physiology and Chronic Health Evaluation II score. A generalized linear model and a random forest (RF) regression model were applied to explore associations between steroid-related variables and the duration of MV. <b><i>Results:</i></b> Of the 354 patients, 37 (10.5%) received corticosteroids. In the unmatched cohort, the steroid group had higher mortality and complication rates. These differences were not significant after matching. In the matched cohort, the steroid group showed longer MV duration. No steroid-related variable was significantly associated with ventilation duration in regression analysis. Total hydrocortisone-equivalent dose emerged as the strongest predictor of prolonged MV duration in the RF model. <b><i>Conclusion:</i></b> Postoperative systemic corticosteroid therapy was independently associated with prolonged MV without adversely affecting mortality or overall morbidity. Although parametric analyses did not confirm a clear dose-response relationship, cumulative steroid dose demonstrated the highest predictive importance for ventilator dependence in machine learning modeling.</p>","PeriodicalId":22109,"journal":{"name":"Surgical infections","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145055631","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":"High Dose of Antithrombin Suppresses Neutrophil Extracellular Trap Formation in Human Neutrophils In Vitro Following Lipopolysaccharide- and Platelet-Induced Stimulation.","authors":"Michiko Aoyama-Ishikawa, Hideki Higashi, Hiromoto Murakami, Taketo Inoue, Noritomo Fujisaki, Keisuke Kohama","doi":"10.1177/10962964251376946","DOIUrl":"https://doi.org/10.1177/10962964251376946","url":null,"abstract":"<p><p><b><i>Objective:</i></b> During sepsis, blood antithrombin (AT) concentrations decrease; administering AT to patients with sepsis-associated intravascular coagulation has been shown to improve their prognosis. Neutrophil extracellular traps (NETs) are closely related to immunothrombosis; however, the relation between AT and NETs remains nebulous. This study examined the effects of AT on NETs of human neutrophils in vitro. <b><i>Methods:</i></b> Blood samples were collected from healthy volunteers, and the isolated neutrophils were seeded onto collagen-coated cell culture plates. The cells were then stimulated by lipopolysaccharide (LPS) with platelets. Human serum albumin (hAlb) was used as a control for AT. AT (0.01-10 U/mL) or hAlb was added 30 minutes after LPS and platelet treatment. The timing of AT addition was determined by the results of a single cell NETs assay. NET formation was assessed using enzyme-linked immunosorbent assay and immunostaining. Peptidyl arginine deiminase 4 (PAD4) nuclear transfer was detected by Western blotting. <b><i>Results:</i></b> Lipopolysaccharide-induced deoxyribonucleic acid (DNA)-binding neutrophil elastase substantially. NET formation over time was 3%, 15%, 50%, and 70% of the total neutrophils at 30, 60, 100, and 120 minutes after LPS stimulation, respectively. NETs evaluation in addition to AT at 15, 30, or 60 minutes after LPS stimulation showed that AT inhibited NET formation only at 30 minutes. High AT concentrations (i.e., 2-10 U/mL) substantially decreased NET formation and decreased nuclear expression of PAD4. <b><i>Conclusion:</i></b> The high concentrations of AT decrease NETs in human neutrophils induced by LPS and platelets via PAD4 pathway.</p>","PeriodicalId":22109,"journal":{"name":"Surgical infections","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145065490","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":"Short-Course Antibiotic Agent Therapy for Early Ventilator-Associated Pneumonia in Patients with Trauma.","authors":"Bethany R Shoulders, Anne-Marie Fassler, Kelly L Maguigan, Tyler J Loftus, Philip A Efron, Alicia M Mohr, Erin Vanzant","doi":"10.1177/10962964251376956","DOIUrl":"https://doi.org/10.1177/10962964251376956","url":null,"abstract":"<p><p><b><i>Background:</i></b> Patients with traumatic injuries who develop ventilator-associated pneumonia (VAP) incur a higher risk of developing multi-drug resistance. Shorter duration of antibiotic agents for early VAP at five days may reduce antibiotic agent exposure without worsening patient outcomes. <b><i>Methods:</i></b> This retrospective cohort study performed at a Level I Trauma Center included adult (≥16 years old) patients with trauma diagnosed with bronchoalveolar lavage (BAL)-proven early (within four days of intubation) bacterial VAP. Groups were stratified by treatment duration. The primary outcome was the rate of recurrent pneumonia. Secondary outcomes included total antibiotic agent duration, time to recurrent pneumonia, ventilator days, ventilator-free days, intensive care unit and hospital length of stay, re-admission within 30 days, and mortality at discharge and at one year. <b><i>Results:</i></b> Of the 73 included patients in the analysis, 38 underwent a shortened course (4-5 d) of systemic antibiotic agents, while 35 patients had a standard course (7-8 d). Patients in the short-duration cohort were significantly older with a lower injury severity score (ISS) and were more likely to be extubated at the time of antibiotic agent discontinuation (61% vs. 37%, p = 0.045). There was no difference in the primary outcome; 10 patients had recurrence in the short-duration cohort, while 7 patients had recurrence in the standard cohort (26% vs. 20%, p = 0.522). There were no significant differences in secondary outcomes. <b><i>Conclusion:</i></b> This study suggests that in patients with trauma diagnosed with early VAP on BAL, five days of antibiotic agent therapy can reduce antibiotic agent use with no adverse impact on pneumonia recurrence rates or other salient outcomes.</p>","PeriodicalId":22109,"journal":{"name":"Surgical infections","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145034213","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":"Skin Closure Using Surgical Skin Staples May Have Increased Risk for Deep Surgical Site Infection Compared to Running Subcuticular Stitch Using Absorbable Suture in Posterior Lumbar Spine Surgery: A Single-Surgeon Experience.","authors":"Saechin Kim, John G Massoud, Philip Hanna, Serafina F Zotter, Amanda Schillinger, Valerie Kiers, Christopher M Bono","doi":"10.1177/10962964251372841","DOIUrl":"https://doi.org/10.1177/10962964251372841","url":null,"abstract":"<p><p><b><i>Background:</i></b> Most systemic analyses of optimum wound closure have not found significant differences in the surgical site infection (SSI) rates between the different methods of skin closure. A recent international survey reported that spine surgeons used continuous sutures, interrupted sutures, and surgical skin staples (SS) frequently for skin closure. We found that SS and running subcuticular stitch using absorbable suture (RSAS) were the two most common methods of skin closure in our spine division, and one surgeon had routinely used SS for skin closure until early 2020, at which time the surgeon switched to RSAS. Our hypothesis was that the infection rate would not be different whether the skin is closed with SS or RSAS. <b><i>Methods:</i></b> After IRB approval, a retrospective review of billing and hospital records at a tertiary referral academic medical center was used to identify all open posterior lumbar spine surgeries (OPLS) by a single surgeon in 2018-22 and obtain demographics, clinical history, and surgical characteristics. The inclusion criterion was OPLS closed with the RSAS or SS. Exclusion criteria were oncologic condition and previous infection in the surgical site. <b><i>Results:</i></b> There were no significant differences between RSAS and SS groups in the risk factors such as age, BMI, history of diabetes or smoking, number of levels decompressed per case, number of levels fused per instrumented case, and operative time. The incidence of previous surgical procedure in the same site and the percentage of cases with instrumented fusion were both greater in the RSAS group, which should have resulted in greater risk for SSI in the RSAS group. However, the deep SSI rate in the RSAS group (1.4% = 3/216) was less than that in the SS group (5.9% = 6/101), and the difference was statistically significant (p = 0.02). <b><i>Conclusions:</i></b> SS skin closure may have a greater risk for deep SSI compared with RSAS skin closure in OPLS.</p>","PeriodicalId":22109,"journal":{"name":"Surgical infections","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144969902","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:</i> A Troublesome Beaded Chain: One End in the Stomach and the Other in the Jejunum.","authors":"Rong Kuang, Bo Sun, Jiaqi Deng, Jing Zhou","doi":"10.1177/10962964251372610","DOIUrl":"https://doi.org/10.1177/10962964251372610","url":null,"abstract":"","PeriodicalId":22109,"journal":{"name":"Surgical infections","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144969861","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:</i> Risk Factors for Nosocomial Infections after Emergency Abdominal Operation. A Prospective Pediatric Cohort.","authors":"Mohamed Zouari, Manel Belhajmansour, Manar Hbaieb, Wiem Rhaiem, Hamdi Louati, Najoua Ben Kraiem, Mahdi Ben Dhaou, Riadh Mhiri","doi":"10.1089/sur.2025.073","DOIUrl":"10.1089/sur.2025.073","url":null,"abstract":"","PeriodicalId":22109,"journal":{"name":"Surgical infections","volume":" ","pages":"548-549"},"PeriodicalIF":1.4,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144317885","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":"Persistent Post-Recovery Hyperinflammation of Necrotizing Enterocolitis Is Ameliorated by 5-ASA Treatment.","authors":"Katherine Brooke Snyder, Cody Dalton, Grant Gershner, Camille Schlegel, Aslan Massahi, Chase L Calkins, Jeffrey Eckert, William Berry, Catherine J Hunter","doi":"10.1089/sur.2024.173","DOIUrl":"10.1089/sur.2024.173","url":null,"abstract":"<p><p><b><i>Background:</i></b> Necrotizing enterocolitis (NEC) is the leading gastrointestinal cause of death of premature neonates. We have previously shown that this hyperinflammatory state persists even post-recovery. We hypothesize that recovered patients with NEC will have a decreased hyperinflammatory response when the anti-inflammatory medication mesalamine (5-ASA) is administered even when exposed to in vitro NEC induction. <b><i>Methods:</i></b> Enteroids were generated and subjected to in vitro NEC induction. One half were subjected to 5-ASA treatment. Tumor necrosis factor-alpha (TNF-α) and interleukin 8 (IL-8) were evaluated via RT-qPCR. Mice underwent in vivo NEC induction, one group was given 5-ASA 50 mg/kg 12 h before the start of NEC induction. The intestine was harvested and assessed for hyperinflammatory markers and histological grading was performed. <b><i>Results:</i></b> Recovered NEC enteroids treated with 5-ASA during NEC induction show a significant decrease in inflammatory markers compared with control (p = 0.0014 TNF-α, downtrend IL-8). Active NEC enteroids treated with 5-ASA during in vitro NEC induction show a significant decrease in TNF-α RT-qPCR (p = 0.0443) and IL-8 RT-qPCR (p = 0.0265). In mice that received 5-ASA 50 mg/kg before in vivo NEC induction, there is a significant decrease in both TNF-α (p = 0.0114) and IL-8 (p = 0.0051). <b><i>Conclusion:</i></b> Enteroids and mice exposed to 5-ASA have a significant decrease in inflammatory markers. This decrease despite NEC induction in both enteroids and mice may demonstrate the impact that anti-inflammatory agents could have on treatment for NEC. This could be important given the robust hyperinflammatory response to a second hit after recovery and may impact the trajectory of an illness post-recovery from NEC.</p>","PeriodicalId":22109,"journal":{"name":"Surgical infections","volume":" ","pages":"530-537"},"PeriodicalIF":1.4,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144018623","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":"Clinicopathologic and Etiologic Characteristics of Urinary Tract Infections in Patients with Cervical Cancer Undergoing Radical Operation with Indwelling Ureteral Stents.","authors":"Chengwen Jin, Hualei Bu, Jiangdong Xiang, Chengjuan Jin","doi":"10.1089/sur.2024.129","DOIUrl":"10.1089/sur.2024.129","url":null,"abstract":"<p><p><b><i>Background:</i></b> The objective of this study was to investigate the clinicopathologic and etiologic characteristics of urinary tract infections in patients with cervical cancer who had undergone radical operation with ureteral stent insertion. <b><i>Patients and Methods:</i></b> We conducted a retrospective analysis on the medical records of 24 patients who underwent radical operation for cervical cancer with indwelling ureteral stents at Shanghai General Hospital between April 2019 and December 2022. <b><i>Results:</i></b> A total of 15 patients experienced urinary tract infections, resulting in an infection rate of 62.5%. Although postoperative adjuvant chemotherapy might have been a potential risk factor for urinary tract infections, the difference was not statistically significant (p = 0.074). A total of 30 pathogen strains were isolated, with <i>Escherichia coli</i> being the most prevalent. Notably, two strains of carbapenem-resistant <i>Enterobacteriaceae</i> were identified. The majority of patients (70.83%) had ureteral stents in place for 3-12 months. As the duration of stent insertion exceeded 2 months, we noted a decrease in antibiotic sensitivity against the same pathogen. Furthermore, fungal infections became more prevalent when the stent placement duration surpassed 4 months. <b><i>Conclusions:</i></b> The incidence of urinary tract infection is exceptionally high in patients with locally advanced cervical cancer and who have undergone radical operation with ureteral stent insertion. <i>E. coli</i> strains exhibited relative resistance to penicillins and cephalosporins. With prolonged stent placement, there was a notable diminution in antibiotic sensitivity against the same pathogen, and the microbial profile shifted from bacteria to fungi. This study provides valuable insights for the determination of the optimal timing for stent removal or replacement and for the selection of effective antibiotics to treat urinary tract infections for patients with indwelling ureteral stents, so as to ultimately prevent severe infections and mitigate disease burden.</p>","PeriodicalId":22109,"journal":{"name":"Surgical infections","volume":" ","pages":"453-460"},"PeriodicalIF":1.4,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143664584","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":"Surgical Site Infections Following Pelvic Sarcoma Reconstruction with 3D-Printed Implants: Current Concepts and Future Directions.","authors":"Sadegh Saberi, Hamed Naghizadeh, Khalil Kargar Shooroki, Seyyed Saeed Khabiri","doi":"10.1089/sur.2024.319","DOIUrl":"10.1089/sur.2024.319","url":null,"abstract":"<p><p><b><i>Introduction:</i></b> Surgical site infections (SSIs) are a major complication following pelvic sarcoma reconstruction using 3D-printed implants. Despite advances in anatomical matching and biomechanics, infection rates remain significantly higher than in conventional arthroplasty.To review and synthesize current evidence (2010-2025) on the incidence, microbiological characteristics, risk factors, prevention strategies, and treatment approaches of SSIs in patients undergoing pelvic reconstruction with 3D-printed implants. <b><i>Methods:</i></b> A narrative literature review was conducted using PubMed, MEDLINE, Scopus, and Web of Science databases. Studies focusing on pelvic reconstructions with 3D-printed implants and reporting infection outcomes were included. A total of 56 studies were selected after applying inclusion and exclusion criteria. <b><i>Results:</i></b> SSIs in 3D-printed pelvic reconstructions exhibit a high incidence (5-40%) and a unique polymicrobial, gram-negative-dominated microbiological profile. Key risk factors include extensive surgical resection, prolonged operative time, prior radiotherapy, and compromised immune status. Titanium alloy (Ti6Al4V) remains the standard material, although it poses infection risks due to bioinert properties. Preventive measures such as antibacterial coatings, improved surgical techniques, and high-pressure lavage are increasingly used. Treatment involves surgical debridement, targeted antibiotics, and in some cases, implant revision or removal. <b><i>Conclusion:</i></b> SSIs represent a critical barrier in optimizing outcomes for pelvic sarcoma reconstruction with 3D-printed implants. A multidisciplinary approach integrating surgical innovation, materials science, and infection control is essential. Further research is needed on antimicrobial technologies and long-term outcomes.</p>","PeriodicalId":22109,"journal":{"name":"Surgical infections","volume":" ","pages":"541-547"},"PeriodicalIF":1.4,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144054719","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}