Surgical infections最新文献

{"title":"U-Type-Shaped Curves Across Economics, Biology, and Infection.","authors":"John C Alverdy","doi":"10.1089/sur.2024.211","DOIUrl":"10.1089/sur.2024.211","url":null,"abstract":"<p><p>Major threats to the economic future of several nations include climate change, infectious pandemics, and drug-resistant bacteria. The rise and fall of each of these behaviors seems to conform to a U-shaped or inverted U-shaped curve. In academic medicine, stakeholders in the field (infection control personnel, epidemiologists, and vaccinologists) will argue that infectious outbreaks can be prevented by surveillance programs and the development of new drugs (antibiotics, vaccines, etc.). The promise of vaccines, antibiotics, genetic manipulations, air filtration, agriculture control measures, etc., is that with next-generation technology, effective countermeasures can be rapidly deployed to combat any emerging threat to our ecosystem and hence our economy. In this piece, we advance the idea that Laffer curves and their U-type-shaped ancestors share interconnectedness across multiple domains of science including biology, economics, infectious disease, and ecology. U-type-shaped curves and their sibling, the inverted U-curve, conform to the general principle of hormesis, a biphasic response where there is a measured benefit at lower exposures to a phenomenon yet harm when exposure is excessive (i.e., low-dose stimulation and high-dose inhibition).</p>","PeriodicalId":22109,"journal":{"name":"Surgical infections","volume":" ","pages":"267-271"},"PeriodicalIF":1.4,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142932419","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":"In Vitro Assessment of the Extended 21-Day Microbial Barrier Provided by the Exofin Fusion Surgical Incision Closure System.","authors":"Chaitanya Dev Pannu","doi":"10.1089/sur.2024.207","DOIUrl":"10.1089/sur.2024.207","url":null,"abstract":"<p><p><b><i>Background:</i></b> Tissue adhesives are increasingly being used as alternatives to traditional sutures and staples in surgical incision closure applications. Exofin Fusion, a novel cyanoacrylate-based adhesive with a mesh, has been developed to enhance surgical incision closure. This study investigates the microbial barrier effectiveness of Exofin Fusion. <b><i>Methods:</i></b> An in vitro assessment of 35 plates, including challenge organisms, negative controls, and positive controls, was conducted by an independent research organization, North American Science Associates, Inc (NAMSA), USA. Exofin Fusion was applied to the plates aseptically. Each plate was then inoculated with specific challenge organisms. Observations for visible growth or color changes in the media were made over a 21-day period. <b><i>Results:</i></b> The results demonstrated no growth or color changes on test plates for common pathogens such as <i>Staphylococcus aureus</i>, <i>Staphylococcus epidermidis</i>, Methicillin-resistant <i>Staphylococcus aureus</i>, <i>Pseudomonas aeruginosa</i>, <i>Escherichia coli</i>, and <i>Aspergillus brasiliensis</i> throughout the 21-day period. <i>Candida albicans</i> showed no growth or color changes up to day 20; however, two out of five replicates exhibited growth on day 21. <b><i>Conclusions:</i></b> The study confirms the microbial barrier properties of Exofin Fusion, as it effectively prevents the penetration of challenge organisms for the entire test period. Despite the growth of <i>C. albicans</i> in two replicates on day 21, the adhesive demonstrates remarkable efficacy in protecting against microbial infiltration. These findings suggest the potential clinical utility of Exofin Fusion in surgical incision closure applications, highlighting its significance in healthcare settings.</p>","PeriodicalId":22109,"journal":{"name":"Surgical infections","volume":" ","pages":"232-238"},"PeriodicalIF":1.4,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142855411","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 Validation of a Nomogram for Predicting Systemic Inflammatory Response Syndrome Following Percutaneous Nephrolithotomy.","authors":"Chi Feng, QiHua Jiang, JunTao Tan, ZhongJun Wang","doi":"10.1089/sur.2024.202","DOIUrl":"10.1089/sur.2024.202","url":null,"abstract":"<p><p><b><i>Objective:</i></b> To develop and validate a nomogram for predicting the occurrence of systemic inflammatory response syndrome (SIRS) following percutaneous nephrolithotomy (PCNL), aiming to enhance clinical decision-making and treatment planning. <b><i>Methods:</i></b> Clinical data of 1,047 patients undergoing PCNL at a single-center hospital between 2017 and 2023 were retrospectively analyzed. Independent risk factors influencing SIRS occurrence were identified through multi-variable logistic regression analysis, and a predictive model was constructed. The model's accuracy and reliability were evaluated through internal training and validation set. <b><i>Results:</i></b> Multi-variable regression analysis identified six key predictive factors: gender, diabetes, urine culture results, stone surface, staghorn stones, and operative time, leading to the establishment of a nomogram predictive model. Internal validation and validation set data demonstrated the model's high predictive accuracy and reliability, with areas under the receiver operating characteristic curve of 0.718 and 0.723, respectively. <b><i>Conclusions:</i></b> A nomogram predictive model for assessing SIRS following PCNL was successfully developed and validated. This model provides clinicians with a valuable tool for personalized treatment planning and implementing preventive measures.</p>","PeriodicalId":22109,"journal":{"name":"Surgical infections","volume":" ","pages":"217-223"},"PeriodicalIF":1.4,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142801600","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":"Fever in the Trauma Bay: A Marker for Greater Risk of Adverse Outcomes.","authors":"Samir M Fakhry, Yan Shen, Gina M Berg, James R Dunne, Parker Hu, Darrell L Hunt, Mark G McKenney, Nicholas W Sheets, R Joseph Sliter, Matthew M Carrick, Jeneva M Garland, Alessandro Orlando","doi":"10.1089/sur.2024.184","DOIUrl":"10.1089/sur.2024.184","url":null,"abstract":"<p><p><b><i>Purpose:</i></b> Previous work identified a sub-group of trauma patients at risk for bacteremia who presented with signs of infection, including fever. A majority were older adult falls who had early onset bacteremia. <b><i>Hypothesis:</i></b> Fever in the trauma bay is associated with a greater risk of adverse outcomes and identifies patients who might benefit from early initiation of interventions for sepsis. <b><i>Methods:</i></b> Trauma patients ≥18 years, drawn from a system-wide electronic medical record (EMR) (2017-2020), were included. Fever+ patients (temperature >38°C) were compared with Fever- patients (36°C-38°C). Multi-variable logistic regressions assessed the association of fever status with outcomes. The interaction between fever, age, and outcomes was assessed. <b><i>Results:</i></b> A total of 140,647 patients were included from 89 centers. Eight hundred ninety (0.6%) were Fever+ and had worse unadjusted outcomes. After adjustment, Fever+ patients had significantly greater mortality (adjusted odds ratios [aOR], 95% confidence interval: 1.05 [1.04-1.07]), intensive care unit use (1.08 [1.04-1.11]), and ventilator use (1.11 [1.09-1.13]). Fever+ status was associated with a significantly larger aOR of severe sepsis in older versus younger patients (≥65 y: 1.12 [1.11-1.13]; <65 y: 1.04 [1.03-1.05]). Fever+ status was also associated with a significantly larger aOR of bacteremia in older versus younger patients (≥65 y: 1.09 [1.08-1.10]; <65 y: 1.04 [1.03-1.05]). <b><i>Implications:</i></b> Although uncommon, fever at presentation is an ominous sign for trauma patients and portends significantly greater risks for bacteremia, sepsis, and mortality. These risks increase with age. These findings suggest older adults who present with fever warrant early aggressive intervention and may sustain injury as a consequence of debility from systemic infection.</p>","PeriodicalId":22109,"journal":{"name":"Surgical infections","volume":" ","pages":"255-262"},"PeriodicalIF":1.4,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142979953","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> Hydatid Cyst of the Liver Mimicking Cutaneous Abscess in a 5-Year-Old Child.","authors":"Mohamed Zouari, Manel Belhajmansour, Emna Krichen, Asma Issaoui, Najoua Ben Kraiem, Mahdi Ben Dhaou, Riadh Mhiri","doi":"10.1089/sur.2024.293","DOIUrl":"10.1089/sur.2024.293","url":null,"abstract":"","PeriodicalId":22109,"journal":{"name":"Surgical infections","volume":" ","pages":"274-275"},"PeriodicalIF":1.4,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142955585","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":"Influencing Factors of Urinary Tract Stones Complicated by Urinary Tract Infections and the Construction of a Column Chart Prediction Model.","authors":"Li Cai, Xiaofen Wu, Xin Lian, Qing Zhou","doi":"10.1089/sur.2024.212","DOIUrl":"10.1089/sur.2024.212","url":null,"abstract":"<p><p><b><i>Objective:</i></b> To analyze the influencing factors of urinary tract stones complicated by urinary tract infections and construct a column chart prediction model. <b><i>Patients and Methods:</i></b> From July 2020 to October 2023, 345 patients with urinary tract stones admitted to our hospital were collected as the training set, they were separated into an infection group of 51 cases and a non-infection group of 294 cases on the basis of the presence or absence of concurrent urinary tract infections; 192 patients with urinary tract stones were used as the testing set and were divided into an infection group of 26 cases and a non-infection group of 166 cases on the basis of the presence or absence of concurrent urinary tract infections. Data such as gender, age, and procalcitonin (PCT) were recorded. Multi-variable logistic regression analysis was applied to screen predictive factors, R4.0.2 software was applied to construct a column chart model, the calibration curve and Receiver Operating Characteristic (ROC) curve were applied to evaluate the discrimination and calibration of the column chart model; decision curve analysis curve was applied to evaluate the predictive performance of column chart models. <b><i>Results:</i></b> The proportions of female, diabetes mellitus, indwelling time of urinary catheter ≥7 days, the PCT, and urine pH in the infected group were greater than those in the non-infected group (p < 0.05). Female, diabetes mellitus, catheter retention time ≥7 days, high PCT, and high urine pH were independent risk factors for urinary calculi complicated with urinary tract infection (p < 0.05). Training set: C-index was 0.913, Area Under Curve (AUC) was 0.943 [95% Confidence Interval (CI) = 0.912-0.973], sensitivity was 86.36%, and specificity was 89.81%, testing set: C-index was 0.905, AUC was 0.959 (95% CI = 0.928-0.989), sensitivity was 84.65%, and specificity was 95.84%, indicating good discriminability of the line graph model; Hosmer-Lemeshow test showed <i>χ</i>² = 2.843, 2.894, p = 0.944, 0.941, the calibration curve approached the ideal curve, and the line graph model had good calibration. When the risk threshold for urinary tract stones complicated by urinary tract infections was between 0.08 and 0.86, this column chart model provided clinical net benefits. <b><i>Conclusion:</i></b> The column chart prediction model for urinary tract stones complicated by urinary tract infections constructed in this study has high predictive efficiency and clinical practical value, and can provide reference for medical staff.</p>","PeriodicalId":22109,"journal":{"name":"Surgical infections","volume":" ","pages":"209-216"},"PeriodicalIF":1.4,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142740546","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> Rare Cause of Chest Wall Abscess: <i>Salmonella</i> Enterica Infection Based on Metagenomics Next-Generation Sequencing Diagnosis.","authors":"Yueying Zeng, Xue You, Chunfang You","doi":"10.1089/sur.2024.316","DOIUrl":"10.1089/sur.2024.316","url":null,"abstract":"","PeriodicalId":22109,"journal":{"name":"Surgical infections","volume":" ","pages":"272-273"},"PeriodicalIF":1.4,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142955591","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":"Stop-It Randomized Clinical Trial (RCT) for Intra-Abdominal Infection (IAI) Revisited: Multivariate Analyses To Identify Treatment Effects 4 Days Antibiotic Agents Versus Resolution Signs/Symptoms + 2 Days and Drivers of Outcomes.","authors":"Nicholas P Zanghi, Nicole Stouffer, Gus J Slotman","doi":"10.1089/sur.2024.277","DOIUrl":"10.1089/sur.2024.277","url":null,"abstract":"<p><p><b><i>Background:</i></b> The STOP-IT randomized clinical trial (RCT) pioneered limiting antibiotic agents in intra-abdominal infection (IAI) with adequate surgical source control, but NIH funding ended before an adequate power sample size was enrolled to determine equivalence between STOP-IT study regimens: four days of antibiotic agents (4-days) after source control versus antibiotic agents until resolution of signs and symptoms of IAI plus two days (standard of care [SOC]). The objective of this investigation was to identify possible significant treatment effects 4-days versus SOC, and independent variables defining and predicting outcomes. <b><i>Methods:</i></b> De-identified data from 518 STOP-IT subjects were analyzed retrospectively in two groups: 4-days (n = 258) and SOC (n = 260), and separately as one group (n = 518). Statistics: multivariate regression analysis, chi-squared, and simple Cohen kappa coefficient. <b><i>Results:</i></b> No pre-randomization variable predicted protocol FAILURE (surgical site infection, recurrent IAI, or death at 30 d) in 4-day subjects. APACHE II predicted SOC FAILURE, but no cut point determined treatment effect (AUC = 0.608). Both observations implied that FAILURE may not reflect patient outcomes. Additionally, Cohen kappa for FAILURE and hospitalization at 7, 14, and 21 days was weak (0.1154, 0.2084, and 0.1969, respectively) with high numbers of discordant values. Pre-randomization variables associated with hospitalization/discharge at days 7, 14, and 21: extra-abdominal infection 1 (p < 0.0001), APACHE II score (p < 0.0001), age (p = 0.006), and WBC maximum (p < 0.05). However, all of these pre-randomization variables did not predict FAILURE, except APACHE II. <b><i>Conclusions:</i></b> Poor Cohen kappa coefficients indicate STOP-IT FAILURE agreed only weakly with hospital/discharge at 7, 14, or 21 days, and is not a valid reliable endpoint in IAI or for determining success or failure of any treatment. Pre-randomization extra-abdominal infection, APACHE II score, age, and WBC maximum strongly predicted hospitalization, but only APACHE II predicted failure. The study should use the appropriate sample size calculation when doing an equivalence on the basis of the Two One-Sided Test design. RCTs in IAI need prospectively validated clinically reliable endpoints that align with known patient outcomes that determine success.</p>","PeriodicalId":22109,"journal":{"name":"Surgical infections","volume":" ","pages":"239-243"},"PeriodicalIF":1.4,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142898164","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":"Ascending-to-Descending Aortic Bypass of a Thoracic Stent Graft Infection with a Rare Pathogen.","authors":"Tsung-Han Cheng, Yu-Ting Cheng, Sung-Yu Chu, Chih-Chun Lee, Shao-Wei Chen","doi":"10.1089/sur.2024.227","DOIUrl":"10.1089/sur.2024.227","url":null,"abstract":"<p><p><b><i>Background:</i></b> Stent graft infection (SGI) caused by <i>Burkholderia cepacia</i> complex is rare. The usage of ascending-to-descending aortic bypass (ADAB) in such situations has not yet been fully discussed. <b><i>Methods:</i></b> Case report and literature review. <b><i>Results:</i></b> We describe a case of SGI caused by <i>B. cepacia</i> complex after multiple surgical interventions because of an injury from a fall. The successful management encompassed thoracic endovascular aortic repair, antibiotic agents, device removal, and ADAB. <b><i>Conclusion:</i></b> Our report highlights the ADAB technique in addressing the progression of infection after multiple minimally invasive thoracic procedures for emergent thoracic trauma. The ADAB technique could be considered a viable option in certain clinical scenarios in SGI.</p>","PeriodicalId":22109,"journal":{"name":"Surgical infections","volume":" ","pages":"276-278"},"PeriodicalIF":1.4,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142971061","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 Application Study of External Fixation Treatment Using Removed Locking Plates in Patients with Failed Debridement and Antimicrobial Therapy for Infection after Internal Fixation of Fractures.","authors":"Wei Li, Lei Zhang, Yang Li, Yong Chen, Zhao Xie, Quan-Kui Zhuang","doi":"10.1089/sur.2024.261","DOIUrl":"10.1089/sur.2024.261","url":null,"abstract":"<p><p><b><i>Purpose:</i></b> The main focus of this study is to investigate the clinical efficacy of external fixation treatment using removed locking plates in patients with failed debridement and antimicrobial therapy of infection after internal fixation of fractures. <b><i>Patients and Methods:</i></b> From January 2019 to January 2023, our medical institution treated 13 patients who had failed debridement and antimicrobial therapy for infection after internal fixation of fractures. All patients had their internal fixation devices removed, underwent thorough debridement, and then the removed locking plates were repurposed for external fixation treatment. Post-operatively, we observed the infection control status, fracture healing, and complications following locking plate external fixation. <b><i>Results:</i></b> Among all patients, there were seven males and six females, with an average age of 45.92 ± 13.19 years. The time interval from fracture internal fixation surgical procedure to the onset of infection was 7.08 ± 1.89 weeks, and the average debridement frequency was 1.62 ± 0.51 times. After treatment with external fixation using a removed locking plate, infection was controlled in 12 patients, ultimately achieving clinical bone healing. These 12 patients achieved clinical bone healing at a time of 7.50 ± 1.00 months, and the locking plate external fixation time was 9.83 ± 1.11 months. <b><i>Conclusions:</i></b> External fixation using removed locking plates appears to be an effective treatment option for patients who have failed debridement and antimicrobial therapy for infection after internal fixation of fractures. This approach effectively controls infection symptoms while not interfering with the fracture healing process. Additionally, this treatment option using a removed locked plate may potentially contribute to reducing patients' medical expenses.</p>","PeriodicalId":22109,"journal":{"name":"Surgical infections","volume":" ","pages":"244-248"},"PeriodicalIF":1.4,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142855334","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}