Surgical infections最新文献

{"title":"Unveiling Therapeutic Challenges: A Unique Case of Intracranial <i>Myroides odoratimimus</i> Infection Following Hemorrhagic Stroke.","authors":"Yosr Kadri, Oumayma Belhouane, Ons Haddad, Yassmine Maatouk, Ahmed Daoued, Kais Maamri, Mehdi Darmoul, Maha Mastouri","doi":"10.1089/sur.2024.215","DOIUrl":"10.1089/sur.2024.215","url":null,"abstract":"<p><p>Intracranial infections post-neurosurgical procedure pose substantial morbidity and mortality risks. <i>Myroides odoratimimus</i>, an opportunistic gram-negative pathogen, represents a real challenge because of limited clinical experience. This article details the second reported case of intracranial <i>M. odoratimimus</i> infection associated with external ventricular drains in an immunocompetent adult. Treatment involved a 21-day course of intravenous antibiotherapy using meropenem and vancomycin. This case underscores the complexity of managing rare complications, providing insights into therapeutic strategies for this challenging condition.</p>","PeriodicalId":22109,"journal":{"name":"Surgical infections","volume":" ","pages":"51-54"},"PeriodicalIF":1.4,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142508401","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":"Predictive Value of Red Blood Cell Distribution Width-to-Platelet Ratio for Severity in Pyogenic Liver Abscess: A Retrospective Observational Study.","authors":"Yunxiao Lyu, Hao Wang, Zhuojun Zhong, Bin Wang","doi":"10.1089/sur.2024.068","DOIUrl":"10.1089/sur.2024.068","url":null,"abstract":"<p><p><b><i>Background:</i></b> The ratio of red blood cell distribution width (RDW) to platelet ratio (RPR) may have prognostic value in several inflammation-related diseases. However, few studies have been conducted on the value of RPR for predicting the severity of pyogenic liver abscess (PLA). <b><i>Methods:</i></b> Patients receiving the diagnosis of PLA from February 2013 to December 2022 were enrolled in this retrospective study. We collected data related to baseline characteristics and laboratory results within the first 24 hours the  of admission. The receiver operating characteristic curve and the area under the curve (AUC) were used to evaluate the predictive ability of different indicators for severity in PLA. <b><i>Results:</i></b> A total of 278 patients were enrolled. For the prediction of sepsis in PLA, RPR had the highest AUC (0.83; 95% confidence interval [CI], 0.78-0.89) with a sensitivity of 0.78 and specificity of 0.82. For the prediction of septic shock, RPR also had the highest AUC (0.74; 95% CI, 0.60-0.88) with a sensitivity of 0.67 and specificity of 0.79. The best cutoff value for RPR to predict sepsis was 0.08 and to predict septic shock was 0.11. <b><i>Conclusions:</i></b> An increase in RPR level serves as a useful indicator with a predictive capacity for severity in PLA.</p>","PeriodicalId":22109,"journal":{"name":"Surgical infections","volume":" ","pages":"33-38"},"PeriodicalIF":1.4,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142508398","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> The Great Masquerader: Pulmonary Paragonimiasis.","authors":"Bo Sun, Jiaqi Deng, Rong Kuang, Jing Zhou","doi":"10.1089/sur.2024.191","DOIUrl":"10.1089/sur.2024.191","url":null,"abstract":"","PeriodicalId":22109,"journal":{"name":"Surgical infections","volume":" ","pages":"49-50"},"PeriodicalIF":1.4,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142508400","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":"Impact of an Acute Care Surgery Clinical Pathway on Patient Outcomes in Acute Appendicitis.","authors":"Naima Islam, Garima Thakkar, Celeste Ferguson, Kevin Kennedy, Nicholas Bennett, Tolulope Oyetunji, Alyssa Fesmire, Josh Gazzetta, Dennis Arce, Tammy Neblock-Beirne, Sean Nix, Leo Andrew O Benedict","doi":"10.1089/sur.2024.100","DOIUrl":"10.1089/sur.2024.100","url":null,"abstract":"<p><p><b><i>Objectives:</i></b> Acute care surgery (ACS) encompasses surgical critical care, emergency general surgery, and the surgical management of trauma. Following ACS implementation at our institution, we developed a perioperative clinical pathway for acute appendicitis (AA) to improve efficiency and standardize post-operative care. The purpose of our study is to assess patient outcomes utilizing our ACS clinical pathway for patients with AA. <b><i>Methods:</i></b> This is a retrospective cohort study involving patients admitted to our tertiary care facility with AA who underwent appendectomy. Patients were classified by pre-implementation (January 1, 2016-July 31, 2018) and post-implementation (August 1, 2018-December 31, 2020) of our ACS clinical pathway. The primary outcome was hospital length of stay (LOS). Statistical analysis was performed using SAS with a p-value <0.05 determined as significant. <b><i>Results:</i></b> Of the 492 patients included, 225 were in the pre- and 267 were in the post-implementation cohorts. Hospital LOS was substantially decreased in the post-implementation cohort (31.2 vs. 50.4 h, p < 0.001). The post-implementation group had a substantial decrease in computed tomography (CT) to operating room (OR) start time (6.81 vs. 11.4 h, p < 0.001), CT to antibiotic agents' administration (2.20 vs. 3.37 h, p < 0.001), inpatient opioid utilization (125 morphine equivalents [ME] vs. 172 ME, p < 0.001), and discharge antibiotic agents' prescription rates (23.6% vs. 30.7%, p = 0.077). Recovery unit discharges (20 vs. 9%, p < 0.001) were increased in the post-implementation cohort. <b><i>Conclusion:</i></b> Our ACS clinical pathway for AA resulted in earlier surgical intervention, enhanced opioid and antimicrobial stewardship, and gains in surgical care efficiencies.</p>","PeriodicalId":22109,"journal":{"name":"Surgical infections","volume":" ","pages":"11-16"},"PeriodicalIF":1.4,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142590670","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":"Different Clinical Characteristics of Right-Sided Versus Left-Sided Colonic Diverticular Complications: A Four-Year Retrospective Study in a Chinese Population.","authors":"Qi Gao, Jia-Yuan Peng, Yue-Qing Bai, Xiao-Er Wei, Zhong-Nan Li","doi":"10.1089/sur.2024.132","DOIUrl":"10.1089/sur.2024.132","url":null,"abstract":"<p><p><b><i>Aim:</i></b> To determine whether right-sided and left-sided colonic diverticular complications have different clinical manifestations and treatment outcomes. <b><i>Methods:</i></b> Patients diagnosed with diverticulitis or diverticular hemorrhage from January 2019 to December 2023 were retrieved. Patients were assigned into the right-sided group and the left-sided group according to the colon affected by diverticular complications. For each patient, age, gender, body mass index (BMI), lifestyle, clinical presentation, and concomitant medication were recorded. Clinical characteristics and treatment outcomes were compared with between the two groups. <b><i>Results:</i></b> A total of 123 patients were included in this study, 89 in the right-sided group and 34 in the left-sided group. Patients in the right-sided group presented a significantly lower mean age (43.33 vs. 66.35 yrs old, p < 0.0001) and a smaller proportion of patients with BMI above 25 (10.11% vs. 24.76%, p = 0.02). Left-sided group diverticulitis had a significantly higher proportion of Hinchey III to IV (29.41% vs. 1.12%, p = 0.0001) and rate of intensified conservative treatment (30.77% vs. 2.38%, p = 0.0003). Patients in the left-sided group had a higher rate of crowding of diverticula (diverticular number counted >20) (35.29% vs. 1.12%, p < 0.01). Two patients in the right-sided group and eight in the left received laparotomy because of diverticulitis. All three cases of hemorrhage were in the right-sided group. <b><i>Conclusion:</i></b> Compared with the left, right-sided diverticulosis is characterized by a younger age, less-virulent diverticulitis, and potentially higher hemorrhagic propensity. Different mechanisms between the groups may exist to mediate the onset and development of diverticulosis and its complications.</p>","PeriodicalId":22109,"journal":{"name":"Surgical infections","volume":" ","pages":"6-10"},"PeriodicalIF":1.4,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142590669","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> Is There a Good Prognostic Score to Detect Risk of Sternal Wound Infection after Coronary Artery Bypass Surgery?","authors":"Chloé Bernard, Ludwig Serge Aho Glele","doi":"10.1089/sur.2024.206","DOIUrl":"10.1089/sur.2024.206","url":null,"abstract":"","PeriodicalId":22109,"journal":{"name":"Surgical infections","volume":" ","pages":"47-48"},"PeriodicalIF":1.4,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142354248","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":"Antibiotic Stewardship through Use of a Preferred Antibiotic Regimen is Associated with Decreased Organ Space Surgical Site Infections in Uncomplicated and Complicated Pediatric Appendicitis.","authors":"Ursula Adams, Nicholas Kane, William Wilson, Zachary Willis, Ali M Eakes, Marcia Dillon, Adesola C Akinkuotu, Sean E McLean, Anthony G Charles, Michael R Phillips","doi":"10.1089/sur.2024.138","DOIUrl":"10.1089/sur.2024.138","url":null,"abstract":"<p><p><b><i>Background:</i></b> There is a lack of consensus on the optimal antibiotic regimen for pediatric appendicitis, and conflicting data exist regarding the need for extended-spectrum use in this population. We implemented an antibiotic stewardship program with a standard, preferred antibiotic regimen for both uncomplicated and complicated appendicitis and hypothesized that clinical outcomes would be equivalent. <b><i>Methods:</i></b> This is a single-institution, retrospective study of pediatric patients (≤18 y) who underwent appendectomy for acute appendicitis between October 2015 and May 2022. We used institutional data from our stewardship program supplemented by manual chart review. Patients were assigned to pre- and post-pathway cohorts on the basis of appendectomy date. Patients were further stratified on the basis of whether they met criteria for complicated appendicitis on the basis of intra-operative findings. <b><i>Results:</i></b> There were 752 patients that were included: 346 (46.0%) in the pre-pathway cohort and 406 (54.0%) in the post-pathway cohort. The pre-pathway cohort had a higher rate of complicated appendicitis (40.2 vs. 25.6%). However, pre- and post-pathway cohorts had similar rates of post-operative infections, readmissions, and reoperations. When separated by complicated operative findings, patients with uncomplicated appendicitis had a shorter length of stay post-pathway implementation (p < 0.001). After controlling for complicated operative findings and pertinent covariates, the preferred antibiotic regimen was independently associated with decreased odds of post-operative organ space surgical site infections (SSI) (adjusted odds ratio 0.22, 95% CI: 0.05-0.99). <b><i>Discussion:</i></b> Antibiotic stewardship to increase the use of a standardized, preferred antibiotic regimen did not result in worse clinical outcomes. The preferred regimen was significantly associated with a decreased rate of organ space SSI, even when controlling for complicated operative findings. The mechanism of this finding requires additional study.</p>","PeriodicalId":22109,"journal":{"name":"Surgical infections","volume":" ","pages":"17-23"},"PeriodicalIF":1.4,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142575220","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> Migration of Fish Bone Foreign Bodies into Thyroid and Common Carotid Artery.","authors":"Rong Kuang, Bo Sun, Qiaohong Wei, Jiaqi Deng, Xiaomei Chen","doi":"10.1089/sur.2024.168","DOIUrl":"10.1089/sur.2024.168","url":null,"abstract":"","PeriodicalId":22109,"journal":{"name":"Surgical infections","volume":" ","pages":"45-46"},"PeriodicalIF":1.4,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142575782","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 of Infective Endocarditis in Patients with Spinal Surgical Site Infection and <i>Staphylococcus aureus</i> Bacteremia.","authors":"Sébastien Rodrigues, Olivier Gille, Camille Collinet, Vianney Jouhet, Romain Griffier, Camille Damade, Julie Bride, Alice Boishardy, Julien Ternacle, Nahema Issa, Aymeric Amelot, Benjamin Bouyer","doi":"10.1089/sur.2024.123","DOIUrl":"10.1089/sur.2024.123","url":null,"abstract":"<p><p><b><i>Context:</i></b> Surgical site infection (SSI) is responsible for significant morbidity, prolonged hospital stays, and increased costs. Infectious endocarditis (IE) is a rare but serious complication of bacteremia, particularly that resulting from <i>Staphylococcus aureus</i> SSI. The VIRSTA score predicts the risk of IE and determines the priority of transthoracic echocardiography (TTE) in patients with <i>S. aureus</i> bacteremia. The aim of the study was to (1) assess the performance of the VIRSTA score and (2) determine the usefulness of TTE in <i>S. aureus</i> bacteremia related to spinal SSI. <b><i>Materials and Methods:</i></b> We carried out a retrospective study of consecutive patients with spinal SSI and <i>S. aureus</i> bacteremia at two university hospitals in France (Bordeaux and Tours) from January 2009 to January 2023. We collected the patients' clinical and surgical characteristics at baseline, VIRSTA score items, TTE results, and medicosurgical management. The associations of these parameters with IE were assessed using the chi-square test and logistic regression models. <b><i>Results:</i></b> Of 82 patients with spinal SSI and <i>S. aureus</i> bacteremia, only 1 (1.21%) developed IE. Thirteen patients did not benefit from TTE during hospitalization and were considered free of IE after clinical follow-up. Diabetes mellitus (p < 0.04) and the presence of severe sepsis or septic shock (p < 0.03) were significantly associated with the presence of IE in this population. <b><i>Conclusions:</i></b> Incidence of IE in patients with spinal SSI and <i>S. aureus</i> bacteremia is low. The VIRSTA score has high sensitivity but is not accurate for identifying patients at high risk for IE and systematic performance of TTE is complex and not useful in this setting. <b><i>Level of Evidence:</i></b> IV.</p>","PeriodicalId":22109,"journal":{"name":"Surgical infections","volume":" ","pages":"39-44"},"PeriodicalIF":1.4,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142576018","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":"Antimicrobial Resistance Trends and Epidemiological Characteristics of Isolates from Intra-Abdominal Infections in China: A 6-Year Retrospective Study (2017-2022).","authors":"Meilin Wu, Yong Chen, Jiayang Li, Zhitao Zhou, Lei Wu, Wenqi Wu, Jiajie Wang, Sai Tian, Xiuwen Wu, Tao Zheng, Jianan Ren","doi":"10.1089/sur.2024.140","DOIUrl":"10.1089/sur.2024.140","url":null,"abstract":"<p><p><b><i>Background:</i></b> Antimicrobial resistance represents a continuing threat to the health of patients with intra-abdominal infections (IAIs). This study aimed to provide clinicians with guidance to optimize antibiotic therapy. <b><i>Methods:</i></b> The clinical data and antibiotic susceptibility results of pathogens from patients with IAIs from 2017 to 2022 were retrospectively collected. The 6-year period was segmented into two stages, namely, the early (2017-2020) and recent stages (2021-2022). The distribution and antibiotic resistance of pathogens were compared between the stages. <b><i>Results:</i></b> In total, 5,795 pathogens were isolated from 2,283 patients diagnosed with IAIs. Gram-negative bacteria, Gram-positive bacteria, and fungi accounted for 71.0%, 21.4%, and 7.5% of the isolates, respectively. <i>Klebsiella pneumoniae</i> (1,037, 17.9%) was the primary isolate. The proportion of extended-spectrum β-lactamase-producing <i>Enterobacteriaceae</i> was 89.8% (2,028/2,259), with extended-spectrum β-lactamase-producing <i>Escherichia coli</i> and <i>K. pneumoniae</i> accounting for 27.4% and 43.2%, respectively, of all such isolates. The carbapenem resistance rates of <i>E. coli</i> and <i>K. pneumoniae</i> were 17.1% and 75.9%, respectively. Compared with that in the early stage, the imipenem resistance rate of <i>E. coli</i> was significantly higher in the recent stage (13.8% vs. 25.1%, p < 0.001). Among Gram-positive bacteria, 88 strains of vancomycin-resistant <i>Enterococcus</i> were detected, giving a resistance rate of 10.3%, and the detection rate of methicillin-resistant <i>Staphylococcus aureus</i> was 65.7%. <b><i>Conclusions:</i></b> <i>Enterobacteriales</i> and non-fermentative bacteria from IAIs remain highly resistant to carbapenems. The epidemiological characteristics and antibiotic resistance profiles of pathogens in various regions should be closely monitored to mitigate the appearance of drug-resistant bacteria in clinical settings.</p>","PeriodicalId":22109,"journal":{"name":"Surgical infections","volume":" ","pages":"24-32"},"PeriodicalIF":1.4,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142628720","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}