Surgical infections最新文献

{"title":"Transcriptomics in Human Septic Shock: State of the Art.","authors":"Fabiano Pinheiro da Silva","doi":"10.1089/sur.2024.161","DOIUrl":"https://doi.org/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":""},"PeriodicalIF":1.4,"publicationDate":"2024-12-26","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":"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":"https://doi.org/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":""},"PeriodicalIF":1.4,"publicationDate":"2024-12-23","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":"Urinary Catheter Utility in Laparoscopic Appendectomy: Risk Benefit Analysis of Post-Operative Urinary Tract Complications.","authors":"Charoo Piplani, Jennifer E Geller, Sorasicha Nithikasem, George A Hung, Amanda L Teichman, Philip S Barie, Mayur Narayan, Rachel L Choron","doi":"10.1089/sur.2024.196","DOIUrl":"https://doi.org/10.1089/sur.2024.196","url":null,"abstract":"<p><p><b><i>Background:</i></b> Catheter-associated urinary tract infections (CAUTIs) account for 1 million nosocomial infections annually and 75% of all hospital-acquired UTIs. A risk factor for CAUTI is prolonged urinary catheterization (UC); therefore, transitory UC during laparoscopic appendectomy (LA), a common practice justified to avoid iatrogenic bladder injury, is believed to be safe. However, data on the incidence of post-operative UC-related complications, including CAUTI, following LA or their avoidance are limited. <b><i>Hypothesis:</i></b> Patients who underwent UC for LA developed more post-operative UTIs than patients without UC (noUC), without effect on the incidence of bladder injury. <b><i>Patients and Methods:</i></b> Retrospective analysis of patients ≥21 years who underwent LA (2016-2023) at an academic hospital. The primary outcome was post-operative UTI in UC versus noUC patients, defined as symptoms or urinalysis findings compatible with UTI within 21 days from LA. Secondary outcomes included bladder injury, catheter-related complications, time until UTI diagnosis, and antibiotic exposure. Statistics: Mann-Whitney U and Fisher exact tests; p < 0.05. <b><i>Results:</i></b> Among 981 LA, there were 678 UC and 303 noUC. A majority was male (56%) and young [38 years, inter-quartile range (IQR) 28-50]. Duration of catheterization was 102 min (IQR 85-123), whereas duration of the procedure was 58 min (IQR 44-80). There were more catheter-related complications in the UC versus noUC group (10 [1.5%] vs. 0; p = 0.04). The incidence of UTI was 0.5%, with five cases (0.7%) after UC and zero for noUC (p = 0.34). UTIs were detected at 11 post-operative days (IQR 6-17) and treated with antibiotic agents for 5 days (IQR 5-13). Four UC patients had urinary retention (two required re-catheterization and discharge with an indwelling catheter). One UC urinary \"retainer\" developed a post-operative UTI and required hospital re-admission. There was no urinary retention in the noUC group. There were no bladder injuries. <b><i>Conclusions:</i></b> The incidence of UTI was low following LA; bladder injuries were non-existent. UC-related complications were greater among UC patients, but there was neither urinary retention and post-operative catheterization nor bladder injury in the noUC group; we suggest the omission of UC for LA.</p>","PeriodicalId":22109,"journal":{"name":"Surgical infections","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2024-12-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142883024","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":"Association Between Systemic Immune-Inflammation Index and Outcomes of Acute Myocardial Infarction: A Systemic Review and Meta-Analysis.","authors":"Wen Sun, Zheye Chen, Yi Luo","doi":"10.1089/sur.2024.172","DOIUrl":"https://doi.org/10.1089/sur.2024.172","url":null,"abstract":"<p><p><b><i>Objective:</i></b> To assess the link between systemic immune-inflammation index (SII) and risk of major adverse cardiovascular events (MACE), contrast-induced nephropathy (CIN), and overall mortality in patients with acute myocardial infarction (AMI). <b><i>Patients and Methods:</i></b> Electronic search of PubMed, EMBASE, Web of Science, and Scopus databases was done for observational studies with the data on the association of SII and outcomes, such as MACE, and CIN in adult (≥18 y) patients with AMI. A random-effects model was used, and the pooled effect sizes were expressed as relative risk (RR) with corresponding 95% confidence intervals (CI). Subgroup analysis was conducted on the basis of the type of AMI (ST elevation myocardial infarction and non-ST elevation myocardial infarction), sample size (≥500 and <500), and study design. GRADE assessment was used to evaluate the certainty of the evidence. <b><i>Results:</i></b> The analysis included 23 studies. Most studies were conducted in China (n = 13), followed by Turkey (n = 10). Majority of the studies (n = 20) had a retrospective cohort design. Patients with high SII had increased risk of MACE (RR 2.95, 95% CI: 1.25, 6.99; n = 5, I² = 97.5%), overall mortality (RR 2.59, 95% CI: 1.64, 4.07; n = 6, I² = 58.0%), and CIN (RR 4.58, 95% CI: 3.44, 6.10; n = 4, I² = 0.0%), compared with patients with lower SII. Egger's test detected publication bias for MACE (p = 0.047) and overall mortality (p = 0.012) but not for CIN. These associations remained valid in subgroup analysis. <b><i>Conclusion:</i></b> Findings suggest that higher SII in patients with AMI is associated with increased risks of MACE, CIN, and overall mortality. This underscores SII's potential as a prognostic marker in AMI.</p>","PeriodicalId":22109,"journal":{"name":"Surgical infections","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2024-12-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142855382","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":"https://doi.org/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":""},"PeriodicalIF":1.4,"publicationDate":"2024-12-18","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":"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":"https://doi.org/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":""},"PeriodicalIF":1.4,"publicationDate":"2024-12-18","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}

{"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":"https://doi.org/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":""},"PeriodicalIF":1.4,"publicationDate":"2024-12-10","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":"<i>Letter to the Editor:</i>Emerging Global Threat of Monkeypox: Urgent Call for Action and Awareness for Anesthesiologists.","authors":"Burhan Dost, Sezgin Bilgin, Ersin Koksal, Yasemin Burcu Ustun","doi":"10.1089/sur.2024.249","DOIUrl":"10.1089/sur.2024.249","url":null,"abstract":"","PeriodicalId":22109,"journal":{"name":"Surgical infections","volume":" ","pages":"773-774"},"PeriodicalIF":1.4,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142354244","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":"Surgical Management of Complicated Thoracic Fungal Infections: A Case Series from a Tertiary Referral Center.","authors":"Josephine Guitton, Jonathan Livezey, Andrew Anklowitz, Caitlin Jones-Sayyid, Melissa Shafer, Daniel Miller","doi":"10.1089/sur.2024.091","DOIUrl":"10.1089/sur.2024.091","url":null,"abstract":"<p><p>Although rare in the general population, pulmonary fungal infections usually occur in immunocompromised patients. The mainstay of pulmonary fungal infection treatment is prolonged intravenous antifungal therapy. However, surgical management may be required in cases of complex disease, resistance to medical therapy or percutaneous procedures, or associated complications such as fungal empyema and massive hemoptysis. In this series, we present three patients with complicated thoracic fungal infections who underwent individualized surgical management over a 3-month period in 2022 at our institution. Complicated pulmonary fungal infections require surgical intervention to ensure complete resolution. The choice of operation is dependent on several factors, and surgeons operating on these patients must be privy to the various surgical modalities that may be required to successfully treat these patients.</p>","PeriodicalId":22109,"journal":{"name":"Surgical infections","volume":" ","pages":"777-779"},"PeriodicalIF":1.4,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142133828","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>Low Birth Weight is Independently Associated with Surgical Site Infections Following Neonatal Abdominal Surgery.","authors":"Mohamed Zouari, Manel Belhajmansour, Emna Krichen, Mariem Boukattaya, Najoua Ben Kraiem, Mahdi Ben Dhaou, Riadh Mhiri","doi":"10.1089/sur.2024.224","DOIUrl":"10.1089/sur.2024.224","url":null,"abstract":"","PeriodicalId":22109,"journal":{"name":"Surgical infections","volume":" ","pages":"775-776"},"PeriodicalIF":1.4,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142354245","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}