{"title":"Antiseptic Susceptibility and Sub-Inhibitory Concentration-Induced Biofilm Response in <i>Staphylococcus epidermidis</i> from Abdominal Surgical Site Skin.","authors":"Pinjia Wang, Ruomei Wang, Ruolan Guo, Zhe Su, Yulu Wu, Chengbin Xie","doi":"10.1177/10962964261425154","DOIUrl":"10.1177/10962964261425154","url":null,"abstract":"<p><strong>Background: </strong><i>Staphylococcus epidermidis</i>, a commensal skin pathogen, is a key pathogen in surgical site infections (SSIs). This study characterized clinical isolates obtained from an abdominal operation to guide decolonization therapy.</p><p><strong>Methods: </strong>In total, 146 <i>S. epidermidis</i> isolates obtained from pre-operative skin swabs of patients undergoing gynecological procedures were analyzed. PCR was performed to detect <i>mecA</i>, efflux pump genes (<i>qacA/B</i>, <i>smr</i>, etc.), and biofilm-associated genes (<i>icaA-D</i>, <i>aap</i>). Methicillin-resistant <i>S. epidermidis</i> (MRSE) isolates were typed by multi-locus sequence typing. Broth microdilution was used to assess susceptibility to benzalkonium chloride (BAC) and chlorhexidine digluconate (CHG). Biofilm formation was measured in the presence or absence of sub-inhibitory antiseptic exposure.</p><p><strong>Results: </strong>Of the isolates, 49.3% were MRSE, and 63.0% and 29.5% carried <i>qacA/B</i> and <i>smr</i>, respectively. MRSE showed higher minimum inhibitory concentration (MIC<sub>50</sub>) values for both antiseptics. <i>qac</i>-positive strains exhibited significantly increased BAC MIC<sub>50</sub> (1 vs. 0.25 µg/mL; p < 0.001). Biofilm-forming isolates (16.4%) had three-fold higher BAC MIC<sub>50</sub> (p < 0.01). Sub-MIC exposure to BAC/CHG induced biofilm formation in prior non-producers (p < 0.05); among these, 81.3% were <i>qac</i>-positive, and 62.5% were MRSE.</p><p><strong>Conclusions: </strong>The high prevalence of MRSE and efflux genes contributed to antiseptic tolerance. Sub-inhibitory antiseptic concentrations may enhance biofilm formation in resistant strains, underscoring the need for optimized decolonization tactics to prevent SSI.</p>","PeriodicalId":22109,"journal":{"name":"Surgical infections","volume":" ","pages":"465-473"},"PeriodicalIF":1.7,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146182393","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}
Surgical infectionsPub Date : 2026-09-01Epub Date: 2026-04-01DOI: 10.1177/10962964261430395
Katherine Dziak
{"title":"Detecting Surgical Glove Breaches: Evaluation of Double Glove Indicator System Performance Using an In Vitro Glove Perforation Method.","authors":"Katherine Dziak","doi":"10.1177/10962964261430395","DOIUrl":"10.1177/10962964261430395","url":null,"abstract":"<p><strong>Background: </strong>Surgical glove breaches may compromise the aseptic barrier and pose risks to surgical staff. Double gloving with an indicator system improves breach detection compared with similar colored double gloves or single gloving. This study evaluates the performance of market-leading indicator gloves for breach detection.</p><p><strong>Methods: </strong>Liquid was introduced between layers of breach indicating polyisoprene double gloves (Brands A [six styles], B [three styles], and C [two styles]). Indication area was measured using a calibrated camera at two time points (immediate = 9.8 sec; final = 49 sec). Performance differences between styles and brands were analyzed using Games-Howell and Mood's tests (95% confidence interval).</p><p><strong>Results: </strong>Brand A had a larger and faster immediate median indication area (544 mm<sup>2</sup>; 55.5 mm<sup>2</sup>/sec; p < 0.05), compared with Brand B (61 mm<sup>2</sup>; 6.2 mm<sup>2</sup>/sec) and Brand C (115 mm<sup>2</sup>; 11.7 mm<sup>2</sup>/sec); this was 9.0 and 4.7 times faster than Brands B and C, respectively. Brand A also displayed a larger final median indication area (597 mm<sup>2</sup>; p < 0.05), compared with Brands B (124 mm<sup>2</sup>) and C (314 mm<sup>2</sup>), with a 4.8 and 1.9 times larger area, respectively. Brand A immediately reached 91% of its final indication area compared with only 49% and 37% for Brands B and C, respectively.</p><p><strong>Conclusions: </strong>Indicator glove performance influences breach visualization. Brand A gloves, which have unique surface characteristics, displayed the fastest and largest breach indication among the brands tested. Faster and larger breach indication enables rapid detection and response, protecting the aseptic barrier between the wearer and patient.</p>","PeriodicalId":22109,"journal":{"name":"Surgical infections","volume":" ","pages":"483-488"},"PeriodicalIF":1.7,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147594944","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}
Surgical infectionsPub Date : 2026-09-01Epub Date: 2026-02-03DOI: 10.1177/10962964261421063
Colin Rivet, Yamuna Carey, Tovy Kamine
{"title":"Rapidly Progressive Necrotizing Soft Tissue Infection of the Chest Wall After Skeletal Muscle Injury in a Healthy Young Adult Leading to Death: A Case Report.","authors":"Colin Rivet, Yamuna Carey, Tovy Kamine","doi":"10.1177/10962964261421063","DOIUrl":"10.1177/10962964261421063","url":null,"abstract":"<p><strong>Background: </strong>Necrotizing soft tissue infections (NSTIs) are life-threatening surgical emergencies characterized by rapid tissue destruction, systemic toxicity, and high mortality. Early recognition and aggressive treatment are critical.</p><p><strong>Case presentation: </strong>A previously healthy 28-year-old male presented with one week of right shoulder and chest wall pain. Initially diagnosed with muscle strains via MRI, he re-presented to the emergency department five days later with hypotension. Blood cultures grew <i>Streptococcus pyogenes</i>, and imaging revealed extensive soft tissue involvement. Emergent fasciotomy and serial debridement revealed NSTI extending from the right shoulder to the scrotum and contralateral shoulder. Despite broad-spectrum antibiotics, debridements, continuous renal replacement therapy, and vasopressors, the patient developed multi-organ failure and died within 24 h of ICU admission.</p><p><strong>Conclusion: </strong>This case highlights the aggressive nature of NSTIs, the importance of early diagnosis, a non-classical presentation, and the potential for rapid progression to multi-organ failure and death even in young, previously healthy individuals.</p>","PeriodicalId":22109,"journal":{"name":"Surgical infections","volume":" ","pages":"517-519"},"PeriodicalIF":1.7,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146114294","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}
Surgical infectionsPub Date : 2026-09-01Epub Date: 2026-04-10DOI: 10.1177/10962964261437620
Yasmin Arda, Josip Plascevic, John F Jachimiak, Jack H A Miller, Riley B Brackin, Charudutt N Paranjape, John O Hwabejire, Haytham M A Kaafarani, George C Velmahos, Michael P DeWane
{"title":"Predictors of Infectious Complications Following Emergency Colectomy: A Nationwide Analysis.","authors":"Yasmin Arda, Josip Plascevic, John F Jachimiak, Jack H A Miller, Riley B Brackin, Charudutt N Paranjape, John O Hwabejire, Haytham M A Kaafarani, George C Velmahos, Michael P DeWane","doi":"10.1177/10962964261437620","DOIUrl":"10.1177/10962964261437620","url":null,"abstract":"<p><strong>Background: </strong>Infectious complications following emergency colectomy are a significant cause of morbidity and mortality. We aimed to identify predictors of infection after emergency colectomy.</p><p><strong>Patients and methods: </strong>We analyzed the 2013-2017 American College of Surgeons National Surgical Quality Improvement Program database to identify patients ≥ 18 years undergoing emergency colectomy. The primary outcome was post-operative infectious complication rate, defined as the presence of sepsis, septic shock, surgical site infection, pneumonia, or urinary tract infection. Multivariable logistic regression was used to investigate the effect of pre-operative/operative factors on infection risk.</p><p><strong>Results: </strong>Of 40,913 included patients, 17,481 (42.7%) developed infectious complications. On multivariable analyses, pre-operative factors associated with increased odds of infectious complications were body mass index ≥30, chronic obstructive pulmonary disease, bleeding disorder, ascites, smoking, dependent functional status, American Society of Anesthesiologists ≥3, blood urea nitrogen ≥ 20 mg/dL, and albumin ≤ 3 g/dL. Additionally, dirty wound class and open, delayed, or prolonged surgical procedure were associated with increased infection risk.</p><p><strong>Conclusions: </strong>Identifying predictors of infection following emergency colectomy may inform perioperative decision-making and guide strategies to reduce infection-related morbidity.</p>","PeriodicalId":22109,"journal":{"name":"Surgical infections","volume":" ","pages":"495-502"},"PeriodicalIF":1.7,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147654913","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}
Laura Hobbs, Hugo Bonatti, Stephen Kavic, Christina Paluskievicz
{"title":"<i>Letter:</i> Recurrent Breast Abscess Caused by <i>Facklamia hominis</i> Requiring Definitive Surgical Excision.","authors":"Laura Hobbs, Hugo Bonatti, Stephen Kavic, Christina Paluskievicz","doi":"10.1177/10962964261485012","DOIUrl":"https://doi.org/10.1177/10962964261485012","url":null,"abstract":"","PeriodicalId":22109,"journal":{"name":"Surgical infections","volume":" ","pages":"10962964261485012"},"PeriodicalIF":1.7,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148875908","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}
Surgical infectionsPub Date : 2026-09-01Epub Date: 2026-02-25DOI: 10.1177/10962964261427350
Korry T Wirth, Abigail F Loszko, Matthew M Byrne, Derek S Wakeman, Martin S Pavelka, Timothy M Baran, Nicole A Wilson
{"title":"Linking Antimicrobial Agent Resistance Profiles to Clinical Outcomes in Pediatric Perforated Appendicitis.","authors":"Korry T Wirth, Abigail F Loszko, Matthew M Byrne, Derek S Wakeman, Martin S Pavelka, Timothy M Baran, Nicole A Wilson","doi":"10.1177/10962964261427350","DOIUrl":"10.1177/10962964261427350","url":null,"abstract":"<p><strong>Background: </strong>Complicated appendicitis remains a leading cause of post-operative morbidity in children, but the relationship between specific microbial resistance profiles and clinical outcomes is poorly defined.</p><p><strong>Methods: </strong>We conducted a retrospective cohort study of pediatric patients (<18 y) who underwent appendectomy for complicated appendicitis at a tertiary children's hospital (2019-2024). Demographic, operative, and outcome data were abstracted from the National Surgical Quality Improvement Program Pediatric database and electronic health records. Intra-operative cultures were analyzed for bacterial species, gram stain morphology, and antibiotic agent resistance. Hierarchical clustering of weighted resistance scores identified resistance-based microbial groupings. The primary outcome was post-operative organ-space infection (OSI), and secondary outcomes included length of stay (LOS) and 30-day re-admission.</p><p><strong>Results: </strong>Among 194 children (median age = 10.2 y; 56.2% male), 26 (13.4%) developed OSI. Culture analysis (n = 176 with samples) demonstrated that polymicrobial infections with ≥3 bacterial species isolated and the presence of <i>Bacteroides fragilis</i> increased the odds of OSI by 3.04× (95% confidence interval [CI] = 1.18-7.80, p = 0.010) and 2.40× (95% CI = 1.01-5.35; p = 0.021), respectively. Cluster analysis revealed three groups reflecting resistance burden and clinical phenotype. The Enterobacteriaceae group and a hard-to-treat cluster were associated with longer hospital stays (both p < 0.02), and the hard-to-treat cluster with increased 30-day re-admissions (5.6% vs. 1.5%; p = 0.040).</p><p><strong>Conclusions: </strong>Children with OSI exhibited distinct microbiologic features, including polymicrobial cultures and <i>B. fragilis</i>. Resistance-weighted clusters were linked to longer LOS and re-admission, highlighting that intra-operative cultures, traditionally considered low yield, may provide prognostic information with implications for post-operative management and antibiotic agent stewardship in pediatric complicated appendicitis.</p>","PeriodicalId":22109,"journal":{"name":"Surgical infections","volume":" ","pages":"474-482"},"PeriodicalIF":1.7,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13158973/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147310529","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Surgical Site Infections in Indigenous Populations of the United States and Canada: A Scoping Review.","authors":"Fabrizio Darby, Shaan Bhandarkar, Kamryn Butler, Arusha Basani, Alexandria Brackett, Vanita Ahuja, Margarita Elloso","doi":"10.1177/10962964261427348","DOIUrl":"10.1177/10962964261427348","url":null,"abstract":"<p><strong>Background: </strong>Several studies have highlighted higher rates of adverse outcomes such as superficial surgical site infection (SSI) in Indigenous populations. However, there is a paucity of literature amalgamating reports of SSI in these populations compared with other ethnic and racial groups. The aim of this review is to highlight the incidence of SSI in Indigenous populations in the United States and Canada compared with non-Indigenous patients.</p><p><strong>Methods: </strong>Based upon systematic assessment of relevant articles found in Scopus, PubMed, and PubMed Central, a state-of-the-art review was conducted. Studies in English that were cohort, cross-sectional, case-control, or randomized controlled studies on human beings of all ages and genders were included. Studies that were reviews, case series, case reports, editorials, letters to editors, animal studies, or studies that did not examine SSI as a direct outcome of surgical procedure were excluded.</p><p><strong>Results: </strong>We retrieved 1,718 articles, 9 of which were included for review. The most reported adverse surgical infection was superficial SSI. Five studies reported statistically significant increased risk of superficial SSI in Indigenous populations compared with White patients. Increased rates of deep incisional SSI for Indigenous populations compared with White patients were statistically significant in two of three studies looking at this outcome. As it relates to organ-space SSI, two studies reported statistically significant increases for Indigenous patients of the three studies reporting this parameter.</p><p><strong>Conclusion: </strong>There are statistically significant differences in the incidence of SSI for Indigenous patients, particularly when compared with their White counterparts.</p>","PeriodicalId":22109,"journal":{"name":"Surgical infections","volume":" ","pages":"503-509"},"PeriodicalIF":1.7,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147310538","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":"WITHDRAWAL-Administrative Duplicate Publication: Surgery Wards Health Caregivers' Knowledge, Attitude, and Practices Regarding the Pre-Operative Shower: A French Multi-Center Descriptive Survey.","authors":"","doi":"10.1177/10962964261474468","DOIUrl":"10.1177/10962964261474468","url":null,"abstract":"","PeriodicalId":22109,"journal":{"name":"Surgical infections","volume":" ","pages":"10962964261474468"},"PeriodicalIF":1.7,"publicationDate":"2026-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148866849","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}