Surgical infections最新文献

{"title":"Urine Culture before Radical Prostatectomy: Mitigating the Risk of Post-Operative Urinary Tract Infections.","authors":"Ali Bourgi, Maurice Tanguy, Antoine Vincentelli, Stessy Kutchukian, Robin Humphrey, Marc Françot, Jérôme Rigaud, Omar Karray, Maxime Vallée, Franck Bruyère","doi":"10.1089/sur.2024.318","DOIUrl":"https://doi.org/10.1089/sur.2024.318","url":null,"abstract":"<p><p><b><i>Background:</i></b> Post-operative urinary tract infections (UTIs) are a notable complication of radical prostatectomy, contributing to prolonged hospital stays, increased healthcare costs, and diminished patient quality of life. Despite international guideline recommendations of European Association of Urology and the French Society of Anesthesia and Intensive Care Medicine regarding the use of pre-operative urine cultures and antibiotic prophylaxis (AP) before radical prostatectomy, the role of pre-operative urine cultures in mitigating UTI risk remains uncertain. <b><i>Methods:</i></b> This multi-center prospective cohort study analyzed data from six French urology departments. Patients who underwent radical prostatectomy between January 2019 and June 2023, with variable inclusion periods across centers, were included if pre-operative urine cultures were performed. Patients were stratified into subgroups based on the occurrence of post-operative UTIs. Uni-variable and multi-variable logistic regressions, as well as receiver-operating characteristic (ROC) curve analysis, were used. <b><i>Results:</i></b> A total of 467 patients were analyzed, among whom post-operative UTIs developed in 30 patients. Among peri-operative factors, only the ASA (American Society of Anesthesiologists) score (p = 0.014) and the duration of post-operative catheterization (p = 0.001) were significantly associated with UTI occurrence in uni-variable analyses. Multi-variable logistic regression confirmed both factors as independent predictors of post-operative infections, with a model area under the ROC curve for catheterization duration of 0.789. A seven-day threshold for catheterization duration was identified as the optimal cutoff for predicting infection risk. Notably, neither pre-operative urine bacterial cultures nor AP reduced the incidence of post-operative UTIs. <b><i>Conclusion:</i></b> This study demonstrates that pre-operative urine cultures and prophylactic antibiotic agents do not mitigate UTI risk following radical prostatectomy, underscoring the need for optimized infection prevention tactics. The findings challenge the clinical utility of routine pre-operative urine cultures and highlight the critical roles of ASA score and post-operative catheterization duration in predicting infections.</p>","PeriodicalId":22109,"journal":{"name":"Surgical infections","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144508377","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":"Prevalence, Diagnosis, and Microbiology of Ventilator-Associated Pneumonia in Traumatically Injured Patients.","authors":"Christopher B Horn, Qiao Zhang, Daniel M Kaufman, Dajun Tian, Sara A Buckman, Grant V Bochicchio, Isaiah R Turnbull","doi":"10.1089/sur.2024.301","DOIUrl":"https://doi.org/10.1089/sur.2024.301","url":null,"abstract":"<p><p><b><i>Background:</i></b> Hospital-acquired infections (HAIs) are important risk factors for mortality in trauma patients and are increasingly under scrutiny as markers of healthcare quality. We sought to define the effect of trauma on the prevalence, diagnosis, microbiology, and outcomes of ventilator-associated pneumonia (VAP). <b><i>Patients and Methods:</i></b> We performed retrospective national case-control and single-center cohort studies. Injured and non-injured patients from a representative cohort of inpatient hospital visits in the United States from 2010 to 2014 were case-matched, and the prevalence and outcomes of patients with VAP were compared. Patients with a diagnosis of VAP at our institution from 2002 to 2015 were then identified. We compared the effect of trauma on the prevalence, demographics, microbiologic testing, and recovered microorganisms of patients. <b><i>Results:</i></b> Overall, 1.7 million trauma visits were identified in the 2010-2014 National Inpatient Sample. In total, 94% of these visits were case-matched with non-injured controls. Trauma visits had a three-fold increased prevalence of a diagnosis of VAP. Cases of VAP (n = 635) were then extracted from our institutional database. We found an increased prevalence of VAP in injured inpatients. Microbiologic cultures were more frequently assessed in injured patients. Injury was associated with an increased frequency of gram-positive VAP and a decreased frequency of gram-negative pneumonia. <b><i>Discussion:</i></b> Injured inpatients are three-fold more likely to receive a diagnosis of VAP as compared with uninjured inpatient controls and are more likely to have a microbiologic diagnosis.</p>","PeriodicalId":22109,"journal":{"name":"Surgical infections","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-06-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144476782","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":"https://doi.org/10.1089/sur.2025.073","url":null,"abstract":"","PeriodicalId":22109,"journal":{"name":"Surgical infections","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-06-17","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":"The Unhoused State, Not Area Deprivation Index, Is an Independent Risk Factor for Resistant Infections in Burn Patients.","authors":"Stephen Stopenski, Louis Perkins, Jarrett E Santorelli, Laura N Haines, Jeanne G Lee, Eli Strait, Todd W Costantini, Jay J Doucet, Allison E Berndtson","doi":"10.1089/sur.2024.273","DOIUrl":"https://doi.org/10.1089/sur.2024.273","url":null,"abstract":"<p><p><b><i>Background:</i></b> Patients with burn injuries are especially prone to infections; however, the influence of socioeconomic status on infection following burn injury remains poorly understood. This study aimed to evaluate the association between socioeconomic disadvantage and risk of infection among burn patients. We hypothesize that burn patients with more socioeconomic disadvantage have an increased risk of infections. <b><i>Patients and Methods:</i></b> The burn registry of an American Burn Association-verified burn center was queried for all admissions from 2015 to 2019. Patients admitted for <7 days or with a home address outside California were excluded. Collected data included demographics, burn characteristics, and culture results. Patient home addresses were geocoded, and correlated Area Deprivation Index (ADI) scores were classified into quintiles. Unhoused patients were classified as a separate category. Groups were then compared using univariate and multivariate analysis. The primary outcome was any infection. Resistant infections were analyzed as a secondary outcome. <b><i>Results:</i></b> Overall, 788 patients were included for analysis. The median ADI state decile was 6 (interquartile range = 5-8); 4.6% (n = 36) of patients were unhoused. 16.6% (n = 131) of patients had an infection during admission, whereas 6.3% (n = 50) had an infection with a resistant organism. Risk factors for having an infection included age (p < 0.001), percent total body surface area burned (p < 0.001), and diabetes mellitus (0.004). ADI quintile was not associated with infection. The unhoused state was an independent risk factor for resistant infection (odds ratio = 3.37, 95% confidence interval = 1.05-9.31, p = 0.027). <b><i>Conclusions:</i></b> ADI was not associated with an increased risk of infection, but unhoused patients are at increased risk of developing an infection with a resistant organism during admission for a burn injury.</p>","PeriodicalId":22109,"journal":{"name":"Surgical infections","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-06-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144317886","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":"Bromelain as a Source of Debridement for Infected Orthopedic Implants.","authors":"Matthew B Bratton, Jaclyn P Murphy, Jessica C Rivera","doi":"10.1089/sur.2025.009","DOIUrl":"https://doi.org/10.1089/sur.2025.009","url":null,"abstract":"<p><p><b><i>Introduction:</i></b> Enzymatic debridement has emerged as an alternative method to combat biofilms. Bromelain is an enzyme derived from pineapple stems that has been used in several studies as a method of biofilm dissolution (BD). As a result, researchers hypothesized that bromelain could be used to debride contaminated orthopedic implants. <b><i>Methods:</i></b> In this study, cortical bone screws were incubated in methicillin-resistant <i>Staphylococcus aureus</i> inoculated broth. Treatment groups were exposed to low-dose bromelain solution, high-dose bromelain solution, or bromelain powder with or without manual scrubbing of the implant. The screws were then stained with crystal violet dye and analyzed using optical density (OD). OD means were compared between each treatment group and their respective control group using analysis of variance. <b><i>Results:</i></b> Six screws were used for each group. The average OD of the low-dose bromelain solution group (0.104 ± 0.047) was no different compared with the control group (p = 0.345). The average ODs of the low-dose + scrub bromelain solution (0.068 ± 0.020) and high-dose + scrub solution (0.045 ± 0.014) were significantly different from their respective control group (p = 0.012; p = 0.001). The average ODs of screws in the high-dose (0.056 ± 0.012), powder (0.041 ± 0.010), and powder + scrub (0.032 ± 0.005) groups were also significantly different from their respective control group (p = 0.003; p = 0.001; p < 0.0001). <b><i>Discussion:</i></b> On the basis of these outcomes, bromelain is a promising alternative for the debridement of biofilm-contaminated orthopedic implants. Further investigation is required to assess how different concentrations and exposure times may affect the percentage of BD.</p>","PeriodicalId":22109,"journal":{"name":"Surgical infections","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-06-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144235306","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":"Ventilator-Associated Pneumonia Predicts Severe Cognitive Disability in Severe Traumatic Brain Injury.","authors":"Shruthi Srinivas, Kelly Nahum, Christopher Gilliam, William Brigode, Stephanie Doris, Tanya Egodage, Michelle Kincaid, Anna Liveris, Katherine McBride, Kaushik Mukherjee, Philip Edmundson, Liz Penaloza-Villalobos, Jacob W Roden-Foreman, Joy Song, Johanna Stecher, Anthony Tigano, Brett Tracy","doi":"10.1089/sur.2024.208","DOIUrl":"10.1089/sur.2024.208","url":null,"abstract":"<p><p><b><i>Background:</i></b> Ventilator-associated pneumonia (VAP) is linked to poor outcomes in patients with severe traumatic brain injury (TBI), yet its effect on cognitive disability is unknown. We hypothesized that there would be an association between severe cognitive disability and VAP in this patient population. <b><i>Methods:</i></b> We performed a post hoc analysis of a prospective, multi-center, observational study of adults with a severe, blunt TBI from 2020 to 2023. Patients were grouped by whether they developed VAP. Our primary outcome was severe cognitive disability, defined as a disability rating scale (DRS) score >13 at discharge (or 28 days post-injury if not discharged). <b><i>Results:</i></b> There were 309 patients in the cohort; 31.7% (<i>n</i> = 98) developed VAP. The VAP group had greater incidences of diffuse axonal injury (37.3% vs. 22.3%, p = 0.004), neurosurgical interventions (63.3 vs. 38.4%, p < 0.001), and tracheostomies (72.5% vs. 28.9%, p < 0.001). Patients with VAP had a longer duration of mechanical ventilation (13 d vs. 3 d, p < 0.001). Among patients with VAP, median time to diagnosis was 7 days (4-12), time to tracheostomy was 10 days (7-16), and time between the two events was 4 days (2-11). Greater proportions of cognitive disability (64.3% vs. 19.9%, p < 0.001) and worse median DRS scores (8 vs. 2, p < 0.001) occurred in the VAP group. On multi-variable regression analysis, VAP was an independent risk factor for severe cognitive disability (adjusted odds ratio [aOR]: 4.2, 95% CI: 2.2-7.8). <b><i>Conclusion:</i></b> Ventilator-associated pneumonia is common among patients with a severe TBI and is a risk factor for severe cognitive disability. Adherence to VAP prevention techniques may help mitigate cognitive impairment in this population.</p>","PeriodicalId":22109,"journal":{"name":"Surgical infections","volume":" ","pages":"279-285"},"PeriodicalIF":1.4,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143080995","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":"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":"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":"359-363"},"PeriodicalIF":1.4,"publicationDate":"2025-06-01","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":"<i>Letter:</i> Physics-Biology-Chemistry Model: A New Clinical Proposal for Intra-Abdominal Infections.","authors":"Fengping Zhang, Xurui Zhang, Chang Liu, Jingyao Zhang","doi":"10.1089/sur.2024.305","DOIUrl":"10.1089/sur.2024.305","url":null,"abstract":"","PeriodicalId":22109,"journal":{"name":"Surgical infections","volume":" ","pages":"355-356"},"PeriodicalIF":1.4,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143059420","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":"Extended Post-Operative Antibiotic Usage Does Not Reduce Surgical Site Infections after Spinal Surgery.","authors":"Sade Olatunbosun, Brian L Hollenbeck","doi":"10.1089/sur.2024.258","DOIUrl":"10.1089/sur.2024.258","url":null,"abstract":"<p><p><b><i>Background:</i></b> Currently there is not a clear basis of evidence for post-operative antibiotic duration in spine surgery. A better understanding of risk factors and proper dosing for antibiotics will help improve outcomes and further define appropriate antibiotic use. <b><i>Patients and Methods:</i></b> A single-center retrospective cohort study of all patients undergoing spinal fusions and/or decompressions between January 1, 2018, and July 1, 2023 was performed. Patient demographic data and surgical information were collected. The exposure variable assessed was the duration of post-operative antibiotic administration. The primary outcome was incidence of surgical site infections (SSI). Uni-variable and multi-variable analysis were used to determine risk factors for infection. <b><i>Results:</i></b> A total of 5,656 procedures were performed by 25 different orthopedic spine- or neurosurgery-trained surgeons. The incidence of SSI was similar between the ≤24 h of antibiotic group and the >24 h antibiotic group, 0.50% and 0.45%, respectively (p = 0.769). In multi-variable analysis, only a body mass index (BMI) over 30 was associated with increased risk for SSI (odds ratio 2.54 [1.12, 5.74]). <b><i>Conclusion:</i></b> We observed no significant difference in the incidence of SSI among patients who were administered ≤24 h of post-operative antibiotics compared with those who we administered >24 h post-operative antibiotics. A BMI ≥30 was a risk factor for SSI in both uni-variable and multi-variable analysis.</p>","PeriodicalId":22109,"journal":{"name":"Surgical infections","volume":" ","pages":"331-335"},"PeriodicalIF":1.4,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143011939","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> Rectal Adenocarcinoma in Children: An Uncommon Cause of Perforation and Sepsis.","authors":"Mohamed Zouari, Manel Belhajmansour, Rami Zouari, Wiem Rhaiem, Najoua Ben Kraiem, Mahdi Ben Dhaou, Riadh Mhiri","doi":"10.1089/sur.2025.005","DOIUrl":"10.1089/sur.2025.005","url":null,"abstract":"","PeriodicalId":22109,"journal":{"name":"Surgical infections","volume":" ","pages":"357-358"},"PeriodicalIF":1.4,"publicationDate":"2025-06-01","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}