Surgical infections最新文献

{"title":"Pneumonia and Dysphagia after Cervical Spine Trauma.","authors":"Andrew H Tran, Kaitlin A Ritter, Vanessa P Ho, Christopher W Towe, Jeffrey A Claridge, Laura Kreiner","doi":"10.1089/sur.2024.150","DOIUrl":"https://doi.org/10.1089/sur.2024.150","url":null,"abstract":"<p><p><b><i>Introduction:</i></b> In patients with cervical spine trauma (CST) or cervical spinal cord injury (C-SCI), literature reports the incidence of dysphagia at 17% and 30%, respectively. It remains unclear whether diagnosing dysphagia during an index admission (IA) would help prevent subsequent pneumonia or whether it would simply reflect a risk for future pneumonia. We hypothesized that IA dysphagia would be associated with greater future pneumonia-related readmission. <b><i>Methods:</i></b> We identified patients with CST or C-SCI from the Nationwide Readmissions Database. Readmissions within 90 days of discharge were identified, and logistic regression identified factors associated with 90-day readmission and pneumonia. Factors included age, C-SCI, pneumonia at IA, dysphagia at IA, comorbidity count, ISS, index discharge destination, and payer type. <b><i>Results:</i></b> Of 27,752 patients with CST, 23.6% had C-SCI (median age 58; median ISS 16). A total of 9% of all patients with CST had dysphagia (13% for C-SCI). In total, 11.9% of IA survivors were readmitted within 90 days and 16.8% had a diagnosis of pneumonia. In adjusted logistic regression, dysphagia at IA was not associated with readmission or pneumonia. Pneumonia, C-SCI, and tracheostomy at IA were associated with pneumonia at readmission. <b><i>Conclusion:</i></b> The incidence of IA dysphagia for patients with CST in this study was low, suggesting under-diagnosis. Pneumonia was common at both IA and readmission for patients with CST and C-SCI. Pneumonia at IA, tracheostomy, and C-SCI were strong predictors of pneumonia at readmission. Due to the discordant dysphagia rates, protocolized screening for dysphagia during IA may be key to understanding pneumonia-related readmission.</p>","PeriodicalId":22109,"journal":{"name":"Surgical infections","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-03-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143587129","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":"Microbial Pathogen Spectrum in Anastomotic Leaks after Ivor-Lewis Esophagectomy.","authors":"Andreas Schneider, Seung-Hun Chon, Philipp Kasper, Wolfgang A Wetsch, Christiane J Bruns, Andreas Hohn","doi":"10.1089/sur.2024.300","DOIUrl":"https://doi.org/10.1089/sur.2024.300","url":null,"abstract":"<p><p><b><i>Background:</i></b> Anastomotic leaks after esophagectomy cause significant morbidity and mortality. In addition to their early detection and prompt endoscopic or surgical management, providing adequate antimicrobial agents is a fundamental aspect of therapy. In this study, different types of microbiological samples were analyzed to provide insight into the microbial pathogen spectrum of anastomotic leaks after esophagectomy. <b><i>Methods:</i></b> We retrospectively reviewed patients who developed anastomotic leak after Ivor-Lewis esophagectomy at a German high-volume center between 2016 and 2018. Results of microbiological cultures from surgical samples, chest tube fluid, endoscopic aspirates, and blood cultures were analyzed to determine species and antimicrobial susceptibility. <b><i>Results:</i></b> Out of 513 consecutive patients undergoing esophagectomy, 74 developed an anastomotic leak. About 88%-100% of positive samples showed growth of gram-positive bacteria, mainly viridians streptococci but also enterococci. Gram-negative bacteria were found in 48%-82% of positive samples, mainly enterobacterales. Yeasts were found in 43%-64%. The prevalance of multidrug-resistant bacteria was low in our patient population. Expected failure of empiric antibiotic treatment was <10% for piperacillin-tazobactam, meropenem, and tigecycline (each combined with an echinocandin) but not for ampicillin-sulbactam, ceftriaxone plus metronidazole, moxifloxacin, or gentamicine plus clindamycin. <b><i>Conclusions:</i></b> There is a broad microbial pathogen spectrum in anastomotic leaks after esophagectomy. Implications for empiric antimicrobial treatment arise from enterobacterales, enterococci, and yeasts.</p>","PeriodicalId":22109,"journal":{"name":"Surgical infections","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-03-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143587128","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":"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":"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}