Surgical infections最新文献

{"title":"Optimizing Antibiotic Management for Adult Patients Presenting with Acute Perforated Appendicitis: A Quality Improvement Study.","authors":"Carlos Gallego-Navarro, Jason Beckermann, Maria E Linnaus, Hayden J Swartz, Shelby Stewart, Justin M York, Ryan R Gassner, Christopher A Kasal, Annaliese G Seidel, Corey J Wachter, Kirstin J Kooda, Jennifer R Rich, Mark D Sawyer","doi":"10.1089/sur.2024.179","DOIUrl":"https://doi.org/10.1089/sur.2024.179","url":null,"abstract":"<p><p><b><i>Introduction:</i></b> Acute appendicitis (AA) is one of the most common surgically treated diseases, and perforation is a complication that increases morbidity and mortality. At our institution, providers frequently prescribe broad-spectrum antibiotics for patients with appendicitis. <b><i>Methods:</i></b> We performed a subset analysis of patients with perforated appendicitis in a multisite quality improvement project to decrease broad-spectrum antibiotic utilization for AA. Surgeons and emergency department providers were educated on antibiotic therapy for AAs. Electronic medical record (EMR) orders were optimized to encourage ceftriaxone plus metronidazole preoperatively and discourage piperacillin/tazobactam. <b><i>Results:</i></b> During the study periods, a total of 116 patients had perforated appendicitis and underwent laparoscopic appendectomy, 45 in the 6-month pre-protocol group (pre-AB) and 71 in the 6-month post-protocol group (post-AB). The groups were similar regarding baseline demographics, vital signs, and hematological workup. Preoperative piperacillin/tazobactam utilization rates were 62.2% in the pre-AB group and 25.4% in the post-AB group (p < 0.0001), and the utilization rates of ceftriaxone plus metronidazole were 8.9% and 53.5%, respectively. Thirty-day readmission rates were similar: 15.6% in the pre-AB group versus 5.6% in the post-AB group (p = 0.104). Surgical site infections (SSIs) were comparable among groups: superficial SSI 0.0% versus 2.8% (p = 0.521), deep SSI 4.4% versus 0.0% (p = 0.148), and organ space SSI 17.8% versus 8.5% (p = 0.152). No patient had a <i>Clostridium difficile</i> infection postoperatively. <b><i>Conclusion:</i></b> Education regarding antibiotic therapy and optimization of orders in the EMR can decrease the utilization of broad-spectrum antibiotics for acute perforated appendicitis without increasing SSIs.</p>","PeriodicalId":22109,"journal":{"name":"Surgical infections","volume":"26 3","pages":"143-149"},"PeriodicalIF":1.4,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143781070","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":"Beyond CDC-Defined Surgical Site Infection: Factors Associated with Antibiotic Prescription After Breast Operation.","authors":"Corey K Gentle, Moustafa Moussally, Jenny H Chang, Hanna Hong, Kelly Walker, Kelly Nimylowycz, Sayf Al-Deen Said, Zahraa Al-Hilli","doi":"10.1089/sur.2024.145","DOIUrl":"10.1089/sur.2024.145","url":null,"abstract":"<p><p><b><i>Background:</i></b> Most studies on surgical site infections (SSIs) use the US Centers for Disease Control and Prevention (CDC) guidelines, which excludes inflammation or cellulitis without fever. The aim of this study was to evaluate antibiotic prescription trends in the post-operative period among patients undergoing breast operation. We explore the outcomes of patients receiving antibiotic agents outside of the CDC-defined SSI. <b><i>Patients and Methods:</i></b> A retrospective review of patients undergoing breast operation from January 2021 to May 2021 was conducted. Solely reconstructive and cosmetic cases were excluded. The primary outcome was the prevalence of antibiotic prescription in the absence of CDC-defined SSI, excluding routine prophylactic antibiotic agents, with analysis of associated factors. <b><i>Results:</i></b> A total of 754 breast surgical procedures were included. Seventy-seven patients (10.2%) were prescribed outpatient antibiotic agents. CDC-defined SSI occurred in 5.3% (n = 40), mostly involving tissue expander/implant-based reconstruction (47.5%, n = 19). However, 37 (4.9%) did not progress to meet the CDC criteria for SSI. Patients prescribed outpatient antibiotic agents without CDC-defined SSI did not have increased rates of diabetes mellitus, obesity, or current smoking. These patients were more likely to have a surgical drain (48.6% vs. 28.4%, p = 0.02), plastic surgery involvement (32.4% vs. 18.0%, p = 0.048), and a post-operative seroma (32.4% vs. 8.1%, p < 0.001) and or or cellulitis (18.9% vs. 0%, p < 0.001). <b><i>Conclusion:</i></b> Patients are prescribed antibiotic agents after breast operation based on clinical judgment for indications other than CDC-defined SSI. Post-operative wound morbidity including seroma and cellulitis could be contributing to these antibiotic prescriptions. Further study is needed to determine whether providers are preemptively treating SSIs appropriately or over-treating non-infectious wound complications.</p>","PeriodicalId":22109,"journal":{"name":"Surgical infections","volume":" ","pages":"129-134"},"PeriodicalIF":1.4,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142590608","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 Predictive Value of Heparin-Binding Protein in Total Joint Arthroplasty Prosthesis Infections.","authors":"Dongsheng Guo, Dahui Shen, Yuefu Dong","doi":"10.1089/sur.2024.122","DOIUrl":"10.1089/sur.2024.122","url":null,"abstract":"<p><p><b><i>Objective:</i></b> This study aims to explore the predictive value of heparin-binding protein (HBP) in diagnosing prosthesis infections after total joint arthroplasty (TJA), in order to provide a new biomarker for early identification and management of prosthetic joint infections (PJI) post-TJA. <b><i>Methods:</i></b> A retrospective analysis of data from 168 patients who underwent TJA revision at Lianyungang First People's Hospital from October 2020 to March 2024 was conducted. The participants were divided into an infection group (38 cases) and a non-infection group (94 cases). Inclusion criteria included all patients undergoing joint prosthesis revision who had preoperative HBP levels measured. Primary assessment parameters included HBP, C-reactive protein (CRP), white blood cell (WBC) count, and erythrocyte sedimentation rate (ESR). Univariate analysis and multivariate regression analysis were used to evaluate the correlation of these factors with PJI, and the performance of HBP in predicting PJI was analyzed using the receiver operating characteristic (ROC) curve. <b><i>Results:</i></b> There were significant statistical differences in HBP, CRP, WBC, and ESR between the infection and non-infection groups (p < 0.05). Multivariate regression analysis showed that HBP is an independent predictive factor for the risk of PJI. The area under the ROC curve was 0.856, indicating that HBP has good predictive performance. The optimal cutoff value for HBP was 51.3, with a sensitivity of 69.2% and a specificity of 89.5%. <b><i>Conclusion:</i></b> The study found that HBP levels are significantly associated with the occurrence of PJI following TJA, serving as an effective independent predictive factor for PJI risk. HBP has high predictive value and can be considered an important biomarker for predicting PJI post-TJA in clinical settings, aiding in the early identification and management of PJI, thereby improving patient treatment outcomes and quality of life.</p>","PeriodicalId":22109,"journal":{"name":"Surgical infections","volume":" ","pages":"135-142"},"PeriodicalIF":1.4,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142740255","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":"Development and Evaluation of Machine Learning Models for the Identification of Surgical Site Infection in Electronic Health Records.","authors":"Arjun Chakraborty, Kevin Lybarger, Jorge A Olivas Estebane, Judy Y Chen, Mahul Patel, Vikas O'Reilly-Shah, Peter Tarczy-Hornoch, Meliha Yetisgen, Dustin R Long","doi":"10.1089/sur.2024.266","DOIUrl":"https://doi.org/10.1089/sur.2024.266","url":null,"abstract":"<p><p><b><i>Background:</i></b> Surgical site infection (SSI) affects 160,000-300,000 patients per year in the United States, adversely impacting a wide range of patient- and health-system outcomes. Surveillance programs for SSI are essential to quality improvement and public health systems. However, the scope of SSI surveillance is currently limited by the resource-intensive nature of these activities, which are largely based on manual chart review. Recent advances in natural language processing and machine learning could potentially augment the scope and quality of routine SSI surveillance. <b><i>Patients and Methods:</i></b> Electronic health records (EHRs) for 28,864 surgical procedures (representing 25% of all surgical cases) linked to either National Healthcare Safety Network (NHSN) data from Harborview Medical Center or National Surgical Quality Improvement Program (NSQIP) data from the University of Washington Montlake Medical Center were included. Cases comprised five different surgical procedure types performed between 2010 and 2020 (general surgery, gynecological surgery, spine surgery, non-spine orthopedic surgery, and non-spine neurological surgery). Using all clinical notes and structured data elements, we trained random forest and neural network models to identify SSI cases. We conducted experiments to evaluate the impact of clinical notes on the task of retrospective SSI identification and to study domain adaptation across different procedure types and registries. <b><i>Results:</i></b> The best performing model utilized a neural network with input derived from both structured data and unstructured text notes, trained on all surgery types (F1 score: NHSN 0.77, NSQIP 0.58; area under the receiver operating characteristic curve: NHSN 0.98, NSQIP 0.92; recall: NHSN 0.85, NSQIP 0.61). Jointly training one model on all domains (both registries, all surgery types) yielded better performance than training procedure- or registry-specific models. <b><i>Conclusion:</i></b> Automated systems for retrospective identification of SSI in EHRs have the potential to improve the efficiency and reliability of chart reviews for national surveillance and quality improvement programs.</p>","PeriodicalId":22109,"journal":{"name":"Surgical infections","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143754540","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":"Assessment of Therapeutic Approaches: Necrotizing Soft Tissue Infections and the Choice Between Vancomycin + Clindamycin and Linezolid.","authors":"Joanna Nixon, Sara E Parli, Jacqueline M Bishop, Katie B Olney, Jeremy VanHoose, Alexandra Wiegand, Dina Ali, Courtney Bradley, Zachary D Warriner, Abigail Leonhard, Aric Schadler, William J Olney","doi":"10.1089/sur.2024.281","DOIUrl":"https://doi.org/10.1089/sur.2024.281","url":null,"abstract":"<p><p><b><i>Background:</i></b> Necrotizing skin and soft tissue infections (NSTIs) are life threatening, requiring antibiotic agents and surgical intervention. Clindamycin or linezolid is recommended as an adjunct therapy for toxin mediation; however, limited data are comparing clindamycin-based to linezolid-based regimens in NSTI. <b><i>Methods:</i></b> This single-center retrospective study included adults with NSTI admitted to the intensive care unit (ICU) at the University of Kentucky HealthCare for surgical debridement between January 2017 and June 2023. Patients were excluded if they received antibiotic agents for <24 hours, underwent surgical debridement at an outside hospital, or were readmitted within the study period. The primary outcome was the number of debridements before source control. Secondary outcomes included time to source control, acute kidney injury (AKI) rates, ICU length of stay, and antibiotic duration. <b><i>Results:</i></b> A total of 242 patients were included with 199 receiving clindamycin and 43 receiving linezolid. There was no difference observed in the number of surgical debridements between the clindamycin and linezolid cohorts ([2.0 (2, 4) vs. 3.0 (2, 4)]; p = 0.219). The multi-variable regression identified independent parameters that predicted a significant increase in number of debridements included sequential organ failure assessment score (1.03 [1.003, 1.047]; p = 0.028), culture(s) positive for <i>Streptococcus anginosus, Streptococcus constellatus</i>, or <i>Streptococcus intermedius</i> (1.309 [1.042, 1.629]; p = 0.018), and <i>Bacteroides</i> spp. (1.301 [1.048, 1.602]; p = 0.015). No differences were observed in AKI ([53.8% vs. 60.8%], p = 0.424), ICU stay ([5.3 vs. 6.1 d]; p = 0.399), or antibiotic duration between vancomycin, clindamycin, and linezolid ([5.6 vs. 5.6 vs. 6.7 d]; p = 0.683), respectively. <b><i>Conclusions:</i></b> Linezolid resulted in a similar number of surgical debridements compared with clindamycin in NSTI patients.</p>","PeriodicalId":22109,"journal":{"name":"Surgical infections","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143711112","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":"Risk Factors of Post-Craniotomy Surgical Site Infection: A Retrospective Study.","authors":"Entisar M Alotaibi, Tala Abedalqader, Abderrahman Ouban, Abdulaziz Barakat, Atef M Shibl","doi":"10.1089/sur.2024.177","DOIUrl":"https://doi.org/10.1089/sur.2024.177","url":null,"abstract":"<p><p><b><i>Background:</i></b> Although surgical site infection following craniotomy (SSI-CRAN) is uncommon, it is a significant complication of surgical procedures. In addition, it imposes a considerable disease burden on patients and healthcare systems regarding morbidity, mortality, and economic costs. Despite that, the risk factors for its development are unknown. Therefore, identifying the risk factors for SSI-CRAN enables the determination and implementation of preventative measures to lower the infection rate. <b><i>Methods:</i></b> This retrospective cohort research was conducted on patients who underwent craniotomy operation for any indication from January 01, 2011 to December 31, 2020 in the neuroscience center at King Fahad Medical City (Riyadh, Saudi Arabia) to determine risk factors for SSIs. Many patient-related and procedure-related factors were tested as possible risk factors for craniotomy SSI. <b><i>Results:</i></b> This 9-year retrospective study found an overall SSI-CRAN rate of 3.02%. Gram-negative bacteria were the predominant causative pathogen (75.35%). Cerebrospinal fluid leak (odds ratio [OR]: 18, 95% confidence interval [CI] 9.50-34.0), seizure (OR: 30.50, 95% CI: 16.3-57.2), history of hypertension (OR: 14.9, 95% CI: 8.2-27.1), bronchial asthma (OR: 3.80, 95% CI: 1.5-9.5), and history of epilepsy (OR: 7.20, 95% CI: 3.0-17.40) were associated with an increased risk of post-operative SSIs in the multivariable regression analysis model. No significant associations with gender, age, American Society of Anesthesiologists class, body mass index, use of pre- or post-operative antibiotic agents, duration of surgical procedure, number of operations, length of stay, or risk index have been found. <b><i>Conclusion:</i></b> The risk parameters and causal agents for SSI-CRAN found in this study should be considered when developing preventative strategies to reduce this devastating complication's incidence. Identifying risk factors for SSI should aid in improving patient treatment and declining mortality, morbidity, and the economic burden associated with healthcare costs. Post-operative surveillance is also critical for identifying reliable risk parameters for SSI.</p>","PeriodicalId":22109,"journal":{"name":"Surgical infections","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143701543","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":"Is There Always a Need to Perform Urine Culture before <i>Bacillus</i> Calmette-Guérin Instillation for Bladder Cancer?","authors":"Ali Bourgi, Omar Ghanem, Camille Brocail, Franck Bruyère","doi":"10.1089/sur.2024.119","DOIUrl":"https://doi.org/10.1089/sur.2024.119","url":null,"abstract":"<p><p><b><i>Objectives:</i></b> There are no unanimous recommendations between urology societies regarding the performance of a urine culture before <i>Bacillus</i> Calmette<b>-</b>Guérin (BCG) instillations. The management of a positive urine culture before each instillation depends on the choice of the urologist. The objective of our study was to collect urine cultures performed before instillations and to study their impact on the risk of associated urinary tract infection (UTI) and on the risk of recurrence of bladder tumors. <b><i>Patients and Methods:</i></b> A retrospective analysis of induction BCG files (six instillations per cycle) associated or not with maintenance BCG (three instillations per cycle) was performed between January 2022 and January 2023. A urine culture was systematically carried out a few days before each instillation. In the event of a positive urine culture, the choice of treatment depended on the referring urologist. Demographic data, tumor characteristics, risk factors for UTI, and bacteriological data (date of urine culture, leukocyturia, hematuria, polymicrobial, sterile, and antibiotic therapy given) were collected. <b><i>Results:</i></b> Eighty patients were included, all with non-muscle-infiltrating bladder tumors. A total of 812 urine cultures were studied, of which 88 were positive. Among all positive urine cultures, 42 did not receive antibiotics, and yet no febrile UTI was detected. A serious infectious event was reported in two patients including one death, and no risk factor for the occurrence of a positive urine culture could be identified. Bladder tumor recurrence was identified in 17 patients, 3 of whom had positive urine culture treated with antibiotics. <b><i>Conclusions:</i></b> Performing urine culture before BCG instillation does not seem necessary. Antibiotic therapy for a positive urine culture could expose to a higher risk of recurrence.</p>","PeriodicalId":22109,"journal":{"name":"Surgical infections","volume":" ","pages":"0"},"PeriodicalIF":1.4,"publicationDate":"2025-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143701494","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":"Choice of Machine Learning Models Is Important to Predict Post-Operative Infections in Surgical Patients.","authors":"Addison Heffernan, Reetam Ganguli, Isaac Sears, Andrew H Stephen, Daithi S Heffernan","doi":"10.1089/sur.2024.288","DOIUrl":"https://doi.org/10.1089/sur.2024.288","url":null,"abstract":"<p><p><b><i>Background:</i></b> Surgical quality datasets are critical to decision-making tools including surgical infection (SI). Machine learning models (MLMs), a branch of artificial intelligence (AI), are increasingly being ingrained within surgical decision-making algorithms. However, given the unique and distinct functioning of individual models, not all models may be suitable for acutely ill surgical patients. <b><i>Patients and Methods:</i></b> This is a 5-year retrospective review of National Surgical Quality Improvement Program (NSQIP) patients who underwent an operation. The data were reviewed for demographics, medical comorbidities, rates, and sites of infection. To generate the MLMs, data were imported into <i>Python</i>, and four common MLMs, extreme gradient boosting, K-nearest neighbor (KNN), random forest, and logistic regression, as well as two novel models (flexible discriminant analysis and generalized additive model) and ensemble modeling, were generated to predict post-operative SIs. Outputs included area under the receiver-operating characteristic curve (AUC ROC) including recall curves. <b><i>Results:</i></b> Overall, 624,625 urgent and emergent NSQIP patients were included. The overall infection rate was 8.6%. Patients who sustained a post-operative infection were older, more likely geriatric, male, diabetic, had chronic obstructive pulmonary disease, were smokers, and were less likely White race. With respect to MLMs, all four MLMs had reasonable accuracy. However, a hierarchy of MLMs was noted with predictive abilities (XGB AUC = 0.85 and logistic regression = 0.82), wherein KNN has the lowest performance (AUC = 0.62). With respect to the ability to detect an infection, precision recall of XGB performed well (AUC = 0.73), whereas KNN performed poorly (AUC = 0.16). <b><i>Conclusions:</i></b> MLMs are not created nor function similarly. We identified differences with MLMs to predict post-operative infections in surgical patients. Before MLMs are incorporated into surgical decision making, it is critical that surgeons are at the fore of understanding the role and functioning of MLMs.</p>","PeriodicalId":22109,"journal":{"name":"Surgical infections","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143664567","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":"https://doi.org/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":""},"PeriodicalIF":1.4,"publicationDate":"2025-03-19","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":"Ceftaroline + Rifampin Versus Vancomycin + Rifampin in the Treatment of Methicillin-Resistant <i>Staphylococcus aureus</i> Meningitis in an Experimental Rabbit Model.","authors":"Damla Akdag, Tuncer Turhan, Elif Bolat, Gamze Sanlıdag-Isbilen, Canberk Tomruk, Furkan Isbilen, Yigit Uyanikgil, Sohret Aydemir, Tansu Yamazhan, Husnu Pullukcu, Bilgin Arda, Meltem Tasbakan, Berke Gokkilic, Ekin Kartal, Dilsah Baskol Elik, Hilal Sipahi, Sercan Ulusoy, Oguz Resat Sipahi","doi":"10.1089/sur.2024.069","DOIUrl":"https://doi.org/10.1089/sur.2024.069","url":null,"abstract":"<p><p><b><i>Background/Aim:</i></b> To compare the effectiveness ceftaroline-rifampicin (CR) and vancomycin-rifampicin (VR), against methicillin-resistant <i>Staphylococcus aureus</i> (MRSA) in a rabbit meningitis model, to compare the effects on brain tissues in terms of inflammation and apoptosis and to test the antibiotics via in vitro time-kill and synergy tests. <b><i>Method:</i></b> Meningitis was induced using MRSA strain ATCC 43300. After 28 hours, the rabbits were split into three groups: control, VR, and CR. A CSF culture was taken at the start (<i>T</i>₀) and end of treatment (EOT)-the 24th hour of treatment. At EOT, the animals' brain tissues were examined for inflammation and apoptosis. The study strain was tested for a 24-hour time kill assay. <b><i>Results:</i></b> At the EOT, statistically significant differences were observed between the treatment groups in terms of reducing the cerebrospinal fluid (CSF) bacterial count, achieving partial or complete treatment response, and exhibiting lower levels of neuronal apoptosis compared with the control group. However, there was no significant difference in all three parameters and in survival between the two treatment groups. The CR group exhibited a noticeable decrease in inflammation than the control group, but no significant difference was found between the control group versus VR and VR versus CR group. Rifampicin did not improve antibacterial efficacy in the in vitro time-kill assay. <b><i>Conclusion:</i></b> The CR arm showed better complete response and inflammation, but both treatments were similar in other parameters. CR combination was found as effective as VR combination for treating MRSA meningitis.</p>","PeriodicalId":22109,"journal":{"name":"Surgical infections","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143658321","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}