Surgical infections最新文献

{"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":"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":"520-529"},"PeriodicalIF":1.4,"publicationDate":"2025-09-01","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":"Triple Versus Double Antibiotic Therapy in Children Undergoing Laparoscopic Appendicectomy for Complicated Appendicitis: A Case-Control Study.","authors":"Kai-Zheong Lim, Ramesh M Nataraja, Maurizio Pacilli","doi":"10.1089/sur.2024.322","DOIUrl":"10.1089/sur.2024.322","url":null,"abstract":"<p><p><b><i>Background and Objectives:</i></b> Historically, a triple-antibiotic (TA) regimen (ampicillin, gentamicin, metronidazole) has been used for children with complicated appendicitis (CA) at our institution. We implemented a double-antibiotic (DA) regimen (ceftriaxone, metronidazole) in November 2018. The aim of this study was to compare the post-operative outcomes between the two groups. <b><i>Patients and Methods:</i></b> Clinical and laboratory data were collected from the medical records of children who underwent laparoscopic appendicectomy (LA) for CA between November 2017 and 2019. Data, reported as number of cases (%) and median with interquartile range or 95% confidence interval (CI), were analyzed with Fisher exact test and Mann-Whitney U test; p values <0.05 were considered significant. <b><i>Results:</i></b> One hundred and ninety-seven patients were identified; 99 treated with the TA regimen and 98 with the DA regimen. The groups had similar demographics. Post-operative complications were similar between the two groups: intra-abdominal abscess (IAA) 12 (12.1%) in TA versus 10 (10.2%) in DA (p = 0.82); surgical site infections 1 (1.0%) in TA versus 2 (2.2%) in DA (p = 0.62). Time to defervescence in the first 5 post-operative days was substantially longer in the TA group: 72 (95% CI 72-96) versus 48 (95% CI 48-72) hours (p = 0.003). Among patients without post-operative IAA, the DA group had a shorter post-operative hospital stay (5 [5-6] vs. 5.5 [5-6] days; p = 0.04). The cost of DA regimen was substantially lower (p < 0.0001). <b><i>Conclusions:</i></b> The DA regimen provided better post-operative temperature control and a quicker overall recovery, without increasing the incidence of IAA and surgical site infection in children following LA for CA.</p>","PeriodicalId":22109,"journal":{"name":"Surgical infections","volume":" ","pages":"496-500"},"PeriodicalIF":1.4,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144015256","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> <i>Streptococcus constellatus</i> Causing Temporal Muscle Abscess, Subdural Empyema, and Superior Sagittal Sinus Thrombosis.","authors":"Hiroshi Yokota, Takahiro Masutani, Hidetsugu Maekawa, Kenta Kounushi, Kenta Fujimoto","doi":"10.1177/10962964251371493","DOIUrl":"https://doi.org/10.1177/10962964251371493","url":null,"abstract":"","PeriodicalId":22109,"journal":{"name":"Surgical infections","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-08-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144969793","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":"Incisional Negative Pressure Wound Therapy in Trauma Laparotomies and Rates of Superficial Surgical Site Infections.","authors":"Miles W Reese, Raymond Hogge, Brendan Roess, John Hepner, Robert Luke, Ishraq Kabir, Tuan Nguyen, Kristen Snyder, Julia Heaton, Ricardo Rendel, Michael Martyak","doi":"10.1177/10962964251370931","DOIUrl":"https://doi.org/10.1177/10962964251370931","url":null,"abstract":"<p><p><b><i>Objectives:</i></b> Investigate the relationship between incisional negative pressure wound therapy (iNPWT) and the development of superficial surgical site infections (SSIs) and wound dehiscence. <b><i>Methods:</i></b> A retrospective chart analysis was performed. Trauma patients between the ages of 18 and 89 years receiving an emergent exploratory laparotomy on admission between January 1, 2015, and March 31, 2022, were included. A multivariable analysis was performed. The primary and secondary outcomes were the development of superficial SSI and wound dehiscence, respectively, on the basis of the type of incision closure. <b><i>Results:</i></b> Two hundred forty-seven patients who met our criteria were analyzed. Of these, 135 patients were closed with staples plus iNPWT, and 112 patients were closed with only staples. The multivariable analysis found decreased odds of superficial SSI in patients who received staples plus iNPWT versus staples alone (odds ratio [OR] = 0.28, p = 0.019). The multivariable analysis found decreased odds of wound dehiscence in patients who received staples plus iNPWT versus staples alone (OR = 0.24, p = 0.001). <b><i>Conclusion:</i></b> Our study revealed a statistically significant decreased odds of superficial SSI and wound dehiscence in patients who received staples plus iNPWT when compared with staples alone.</p>","PeriodicalId":22109,"journal":{"name":"Surgical infections","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144969893","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":"Bacteriology of Anorectal Abscess and Anal Fistula: A Systematic Review of the Literature.","authors":"Edward Sanchez-Haro, Sonia Molinos, Jose Troya, Ingrid Tapiolas, Sandra Vela, Pere-Joan Cardona, David Parés","doi":"10.1177/10962964251369451","DOIUrl":"https://doi.org/10.1177/10962964251369451","url":null,"abstract":"<p><p><b><i>Aim:</i></b> A cryptoglandular anorectal abscess is a collection of purulent material around the anus, often leading to the development of an anal fistula after drainage. Although <i>Escherichia coli</i> and <i>Bacteroides fragilis</i> have been considered key bacteria in these conditions, recent evidence suggests the need to revisit this assumption. This work aimed to analyze the presence and role of bacteria in the development of anal fistulas following anorectal abscesses. <b><i>Patients and Methods:</i></b> A search was conducted using MEDLINE via PubMed, EMBASE, Cochrane Library, and Google Scholar. Articles reporting the microbiology of cryptoglandular anorectal abscesses and the resulting anal fistulas in human beings were included. The main outcome was to evaluate the presence of bacteria in cultures of anorectal abscesses or in patients who developed anal fistulas. Additional goals included identifying patient characteristics and assessing clinical outcomes on the basis of the isolated bacteria. <b><i>Results:</i></b> In total, 22 articles on anorectal abscesses and seven on anal fistulas met the inclusion criteria. Men were the most prevalent in both cases. <i>Escherichia coli</i> and the <i>Bacteroides</i> genus were the most isolated microorganisms in abscesses and fistulas, though inconsistently in the latter. <i>Bilophila wadsworthia</i> was newly isolated in abscesses, and <i>Rothia</i> sp. was notable in fistulas using new molecular techniques. <b><i>Conclusions:</i></b> <i>Escherichia coli</i> and <i>Bacteroides</i> sp. are involved in anorectal abscesses and anal fistula formation. Recently, using new technology non-well-known bacteria had been isolated involved in this clinical problem.</p>","PeriodicalId":22109,"journal":{"name":"Surgical infections","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144969895","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> Quality of Antimicrobial Therapy and Physician Compliance Are Optimized When the Principles of Antibiotic Stewardship Are Considered in Pediatric Surgery.","authors":"Sebastian Beltz, Stephanie Fischer, Andreas Leutner, Hermann Kalhoff","doi":"10.1177/10962964251370926","DOIUrl":"https://doi.org/10.1177/10962964251370926","url":null,"abstract":"","PeriodicalId":22109,"journal":{"name":"Surgical infections","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144969921","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> Addressing Persistent Challenges in Surgical Site Infection Prediction, Detection, and Management: The Need for Multimodal, Inclusive Approaches.","authors":"Divya Kewalramani, Heather L Evans, Philip S Barie, Mayur Narayan","doi":"10.1177/10962964251370283","DOIUrl":"https://doi.org/10.1177/10962964251370283","url":null,"abstract":"","PeriodicalId":22109,"journal":{"name":"Surgical infections","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144875349","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> Can We Predict Post-Operative Sepsis in Neonates Undergoing Surgery for Esophageal Atresia?","authors":"Mohamed Zouari, Manel Belhajmansour, Manar Hbaieb, Oumaima Jarboui, Hamdi Louati, Najoua Ben Kraiem, Mahdi Ben Dhaou, Riadh Mhiri","doi":"10.1177/10962964251370286","DOIUrl":"10.1177/10962964251370286","url":null,"abstract":"","PeriodicalId":22109,"journal":{"name":"Surgical infections","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-08-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144875350","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> Xanthogranuloma: Rare Breast Inflammation.","authors":"Bo Sun, Jiaqi Deng, Rong Kuang, Jing Zhou","doi":"10.1177/10962964251370285","DOIUrl":"https://doi.org/10.1177/10962964251370285","url":null,"abstract":"","PeriodicalId":22109,"journal":{"name":"Surgical infections","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-08-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144849132","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> Risk Factors for Nosocomial Infections in Neonatal Intensive Care Unit Patients Undergoing Surgery for Intestinal Obstruction.","authors":"Mohamed Zouari, Manel Belhajmansour, Manar Hbaieb, Salma Kharrat, Hamdi Louati, Najoua Ben Kraiem, Mahdi Ben Dhaou, Riadh Mhiri","doi":"10.1177/10962964251370282","DOIUrl":"https://doi.org/10.1177/10962964251370282","url":null,"abstract":"","PeriodicalId":22109,"journal":{"name":"Surgical infections","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-08-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144837777","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}