Surgical infections最新文献

{"title":"Surgical Management of Necrotizing Pneumonia in Pediatric Patients. A Retrospective Analysis in a Third-Level Center.","authors":"Mónica Martínez-Ferman, Amelia Fernández-Avendaño, Pablo Gomes-da Silva de Rosenzweig, Luis Fernando Arana-Bolaños, Xcaret Luna-Vargas, Johana Ramírez-Cruz, Christian Elena Archivaldo-García, Francina Valezka Bolaños-Morales","doi":"10.1177/10962964261436961","DOIUrl":"10.1177/10962964261436961","url":null,"abstract":"<p><strong>Introduction: </strong>Necrotizing pneumonia (NP) is a rare entity seen to occur in 0.9%-7% of cases of community-acquired pneumonia in the pediatric population. Medical management remains the cornerstone of treatment. However, the destruction of both parenchyma and blood vessels impairs blood flow, limiting antibiotic concentrations and allowing the infection to persist. Although surgical management remains debated, some authors advocate for it in cases of medical treatment failure or extensive disease. The objective of this study was to present the surgical outcomes of our experience in treating NP in the pediatric population.</p><p><strong>Methods: </strong>A retrospective and observational study was conducted on all cases of NP in children who required surgical management between January 2022 and June 2024.</p><p><strong>Results: </strong>During the study period, a total of 142 pediatric thoracic surgeries were performed, of which 25 involved patients with NP, who were included in our analysis. The median age was 3 years (2-4), with a nearly equal gender distribution (52% female, n = 13). The median duration of symptoms prior to the surgical procedure was 27 days (22-36), antibiotic therapy duration ranged from 5 to 18 days. On the basis of computed tomography findings regarding the extent of parenchymal involvement, 17 patients underwent sublobar resections, while 8 required lobar resections. While no statistically significant differences were observed in post-operative outcomes between groups, it is noteworthy that patients who underwent lobectomy experienced a higher frequency of complications.</p><p><strong>Conclusion: </strong>Surgical intervention, typically involving resection of necrotic lung tissue, may be considered in carefully selected pediatric patients who demonstrate persistent clinical deterioration despite optimized medical therapy and exhibit extensive parenchymal destruction on imaging. It is critical to tailor the treatment plan to the patient's clinical status and disease progression.</p>","PeriodicalId":22109,"journal":{"name":"Surgical infections","volume":" ","pages":"489-494"},"PeriodicalIF":1.7,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147594967","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":"Multi-Disciplinary and Protocol-Driven Post-Operative Care Reduces Incidence of Post-Sternotomy Mediastinitis.","authors":"David Fernández-de-Velasco, Manuel Carnero-Alcázar, Fernando-Jose Reguillo-Lacruz, Juan-Miguel Miranda Torrón, Cristina Villamor-Jiménez, Jorge Calleja-Sanz, Pilar Ruiz-Álvarez, Luis Maroto-Castellanos, Sally Moores, Maria Arantzazu Álvarez-de-Arcaya","doi":"10.1177/10962964261428654","DOIUrl":"10.1177/10962964261428654","url":null,"abstract":"<p><strong>Background: </strong>Post-sternotomy mediastinitis (PSM) is a rare but life-threatening complication of cardiac surgical procedures. This study evaluated the impact of a structured multi-disciplinary post-discharge care bundle on PSM incidence.</p><p><strong>Methods: </strong>A single-center, retrospective cohort study compared the incidence of PSM two years before and after implementation of a care bundle led by a multi-disciplinary team. The intervention included telephonic monitoring, a specialized wound-care clinic, and a standardized two-phase wound management protocol incorporating single-use negative pressure wound therapy. Outcomes were assessed using chi-square tests and logistic regression adjusted with propensity scores and inverse probability weighting. To rule out a temporal trend in newly identified wound infections, we performed a linear regression using bimonthly incident counts as the outcome.</p><p><strong>Results: </strong>A total of 1,197 patients underwent median sternotomy between May 1, 2018, and April 30, 2022. The crude incidence of PSM was 3.32% in the pre-implementation group and 1.56% in the post-implementation group (p = 0.058). After adjustment with inverse probability of treatment weighting, the care bundle was associated with a significant reduction in PSM rate (absolute risk difference 1.96%, 95% confidence interval [CI]: 0.54-3.87; p = 0.044; relative reduction 59%, 95% CI: 16.3%-116%), despite a higher baseline surgical risk in the post-implementation cohort (higher EuroSCORE II, more urgent procedures, greater need for vasoactive support). The rate of newly identified wound infections did not exhibit a significant time trend (β = -0.43; p = 0.299).</p><p><strong>Conclusion: </strong>Implementation of a multi-disciplinary care bundle is significantly associated with a reduction in PSM incidence in cardiac sternotomy patients, underscoring the importance of structured outpatient wound surveillance.</p>","PeriodicalId":22109,"journal":{"name":"Surgical infections","volume":" ","pages":"510-516"},"PeriodicalIF":1.7,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147356694","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":"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 (MIC₅₀) values for both antiseptics. <i>qac</i>-positive strains exhibited significantly increased BAC MIC₅₀ (1 vs. 0.25 µg/mL; p < 0.001). Biofilm-forming isolates (16.4%) had three-fold higher BAC MIC₅₀ (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}

{"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 mm²; 55.5 mm²/sec; p < 0.05), compared with Brand B (61 mm²; 6.2 mm²/sec) and Brand C (115 mm²; 11.7 mm²/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 mm²; p < 0.05), compared with Brands B (124 mm²) and C (314 mm²), 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}

{"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}

{"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}

{"title":"<i>Letter:</i> Syphilitic Granuloma: A Case Report.","authors":"Bo Sun, Jiaqi Deng, Rong Kuang, Jing Zhou","doi":"10.1177/10962964261430415","DOIUrl":"10.1177/10962964261430415","url":null,"abstract":"","PeriodicalId":22109,"journal":{"name":"Surgical infections","volume":" ","pages":"522"},"PeriodicalIF":1.7,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147349289","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> 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}

{"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":"<i>Letter:</i> Abdominal Wall Aspergillosis.","authors":"Bo Sun, Jiaqi Deng, Rong Kuang, Jing Zhou","doi":"10.1177/10962964261425161","DOIUrl":"10.1177/10962964261425161","url":null,"abstract":"","PeriodicalId":22109,"journal":{"name":"Surgical infections","volume":" ","pages":"520-521"},"PeriodicalIF":1.7,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146182415","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}