Surgical infections最新文献

{"title":"Aortic Infections-A Narrative Review.","authors":"Manuel J D R Silva, Andrew H Stephen, Emanuel Dias, Nelson G Oliveira, Carla C Moreira, Peter A Soden, Jeffrey M Slaiby, Katherine P MacCallum, Richard A Meena, Daithi S Heffernan","doi":"10.1177/10962964251414374","DOIUrl":"https://doi.org/10.1177/10962964251414374","url":null,"abstract":"<p><strong>Background: </strong>Infections involving the aorta are particularly complex, posing unique diagnostic and therapeutic challenges. Aortic infections (AIs) are associated with considerable morbidity and mortality and incur significant healthcare costs. This narrative review examines the current literature and offers guidance on primary and post-operative AIs.</p><p><strong>Methods: </strong>We conducted a search using electronic databases (PubMed, Medline, Scopus, and Cochrane) with a Boolean approach using selected keywords of aorta and infection, aortitis, aortic graft infection, infected aortic aneurysm, and mycotic aneurysm.</p><p><strong>Results: </strong>AIs are among the most feared complications in vascular surgery. Gram-positive bacteria, such as <i>Staphylococcus aureus</i>, are responsible for about 80% of AIs. These microorganisms produce toxins capable of leading to anastomotic disruption. The common use of broad-spectrum antibiotic agents has resulted in an increasing prevalence of multi-drug-resistant organisms, making the management of AIs even more complex. Clinical presentation is often non-specific, ranging from mild symptoms, such as abdominal pain, malaise, and fever, to sepsis and hemorrhagic shock due to anastomotic rupture. Management of patients with an infected aorta includes antimicrobial therapy and surgical source control, which may include washout and aneurysm repair if a primary aortic infection or graft removal if a post-operative infection. Collaboration with intensive care unit and ID consultation improved long-term outcomes.</p><p><strong>Conclusions: </strong>AIs are among the most complicated and challenging surgical problems and are potentially life-threatening and require a multi-disciplinary approach to reduce its prevalence and improve clinical outcomes.</p>","PeriodicalId":22109,"journal":{"name":"Surgical infections","volume":"27 6","pages":"439-448"},"PeriodicalIF":1.7,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148412910","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> Perforated Meckel's Diverticulitis: An Uncommon Cause of Severe Sepsis in a 6-Year-Old Boy.","authors":"Mohamed Zouari, Manel Belhajmansour, Manar Hbaieb, Wiem Rhaiem, Hamdi Louati, Najoua Ben Kraiem, Mahdi Ben Dhaou, Riadh Mhiri","doi":"10.1177/10962964251370278","DOIUrl":"10.1177/10962964251370278","url":null,"abstract":"","PeriodicalId":22109,"journal":{"name":"Surgical infections","volume":" ","pages":"453-454"},"PeriodicalIF":1.7,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145811467","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> All-Round Impostor: Hepatic Capsular Tuberculosis Mimicking Ovarian Cancer Liver Metastasis.","authors":"Rong Kuang, Bo Sun, Jiaqi Deng, Jing Zhou","doi":"10.1177/10962964251415297","DOIUrl":"10.1177/10962964251415297","url":null,"abstract":"","PeriodicalId":22109,"journal":{"name":"Surgical infections","volume":" ","pages":"459-460"},"PeriodicalIF":1.7,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146067096","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":"Are Fewer Damage Control Laparotomies Associated with a Decrease in the Rate and Severity of Surgical Site Infections?","authors":"Stephanie Martinez Ugarte, Mokunfayo O Fajemisin, Chelsea J Guy-Frank, William D Rieger, Renee W Green, John A Harvin, Lillian S Kao","doi":"10.1177/10962964261419732","DOIUrl":"10.1177/10962964261419732","url":null,"abstract":"<p><strong>Background: </strong>Damage control laparotomy (DCL) rates have declined and remained low. Given DCL's association with surgical site infections (SSIs), we hypothesize that SSI rates and severity, as per Clavien-Dindo (CD) classification, have decreased concurrently.</p><p><strong>Patients and methods: </strong>A retrospective study was performed on patients (≥16 y) who underwent trauma laparotomy from January 2011 to December 2020. Patients who survived ≤48 hours were excluded. Data were divided into period 1 (January 2011-December 2015, DCL rates declined) and period 2 (January 2016-December 2020, low DCL rates were sustained). SSIs were defined as per the Centers for Disease Control and Prevention, and severity was graded by the CD scale (I-V). SSIs were classified as minor (CD grade I-II) and major (CD grade III-V). Uni-variable and multi-variable analyses were performed (p < 0.05).</p><p><strong>Results: </strong>In total 1,975 patients met the inclusion criteria. Between periods 1 and 2, there was an increase in injury severity score (ISS); (19 [IQR: 10, 29] vs. 21 [IQR: 12, 34], <i>p</i> ≤ 0.001) and penetrating injuries (426 [44%] vs. 513 [51%], <i>p</i> = 0.002), with a decrease in DCL (283 [29%] vs. 153 [15%], <i>p</i> ≤ 0.001). A total of 355 (18%) patients developed an SSI, 18.5% (179) in period 1 and 17.5% (176) in period 2 (<i>p</i> = 0.5). On multi-variable analysis, after controlling for mechanism of injury, emergency room systolic blood pressure, wound classification, large bowel resection, ISS, splenectomy, and operating-room time at index laparotomy, DCL was associated with major SSIs.</p><p><strong>Conclusions: </strong>Despite decreases in DCL, SSI rates and severity after trauma laparotomy remain stable, potentially because of increased injury severity and penetrating trauma. Identification of other potential modifiable risk factors is needed to decrease SSI incidence and severity.</p>","PeriodicalId":22109,"journal":{"name":"Surgical infections","volume":" ","pages":"430-438"},"PeriodicalIF":1.7,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13035280/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146100789","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> The Acute Care Surgery Evidence Vacuum in Surgical Site Infection Research.","authors":"Divya Kewalramani, W Evan Johnson, Keith Kaye, Philip S Barie, Mayur Narayan","doi":"10.1177/10962964251414597","DOIUrl":"https://doi.org/10.1177/10962964251414597","url":null,"abstract":"","PeriodicalId":22109,"journal":{"name":"Surgical infections","volume":"27 6","pages":"457-458"},"PeriodicalIF":1.7,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148412859","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":"A Model for Intracranial Bacterial Infection After Neurosurgery Integrating Bacterial Culture and Genetic Testing.","authors":"Baoli Lin, Xianbing Meng, Ke Pu, Tao Fu, Nanyue Peng, Qingguo Li","doi":"10.1177/10962964261417294","DOIUrl":"10.1177/10962964261417294","url":null,"abstract":"<p><strong>Background: </strong>Early diagnosis of intracranial bacterial infections following neurosurgical procedures remains challenging because of delayed or inconclusive pathogen identification. This study aimed to develop and validate a predictive model for early detection of post-neurosurgical procedure bacterial infections by integrating clinical features and cerebrospinal fluid (CSF) biomarkers.</p><p><strong>Methods: </strong>We conducted a retrospective study including 429 patients who underwent neurosurgery at Tianjin Huanhu Hospital between November 2018 and December 2024. Patients were randomly divided into training (n = 300) and validation (n = 129) cohorts. Predictive parameters were selected via uni-variable analysis and LASSO regression, followed by multi-variable logistic regression to construct a nomogram. Model performance was evaluated using receiver operating characteristic curves, calibration plots, and decision curve analysis (DCA).</p><p><strong>Results: </strong>Among 429 patients, 147 (34.3%) had confirmed CSF bacterial infections. Seven independent predictors were identified: CSF time to operation, CSF color, CSF white blood cell count ≥ 2000 × 10⁶/L, CSF glucose < 1.89 mmol/L, CSF lactate concentration, hyperpyrexia, and slower reaction time. The model achieved an area under the ROC curve of 0.822 (95% confidence interval [CI]: 0.771-0.873) in the training cohort and 0.715 (95% CI: 0.604-0.827) in the validation cohort. DCA demonstrated substantial clinical net benefit across a threshold probability range of 0.1-0.25.</p><p><strong>Conclusion: </strong>This nomogram-based model provides a practical and reliable tool for early risk stratification of post-neurosurgical procedure intracranial bacterial infections, supporting timely diagnostic and therapeutic decision-making in clinical practice.</p>","PeriodicalId":22109,"journal":{"name":"Surgical infections","volume":" ","pages":"408-421"},"PeriodicalIF":1.7,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146067126","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":"Assessing the Gap: Surgical Infection Society Guidelines Versus Real-World Antibiotic Agent Use in Facial Fractures.","authors":"Ahmad El Nouiri, Hadi Hamdan, Camden Gardner, Fateh Ahmad, Jeffrey L Johnson","doi":"10.1177/10962964261421857","DOIUrl":"10.1177/10962964261421857","url":null,"abstract":"<p><strong>Introduction: </strong>Facial fractures account for over 400,000 emergency department visits annually in the United States. They are managed operatively, non-operatively, or via observation with diet and activity modification. Regardless of management, antibiotic agents are commonly prescribed. The Surgical Infection Society (SIS) published the 2020 guidelines limiting antibiotic agent use to the peri-operative period.</p><p><strong>Methodology: </strong>We performed a retrospective chart review to evaluate antibiotic agent prescribing practices for patients with isolated facial fractures at an academic level-one trauma center. We assessed potential antibiotic agent days saved by adhering to SIS guidelines. Patients 18 and older presenting to the trauma service with a facial fracture from January 2019 to August 2024 were identified from the trauma registry. Patients with clear antibiotic agent indications (e.g., open fractures) were excluded. Descriptive and chi-square analyses were used.</p><p><strong>Results: </strong>The number of potentially saved antibiotic agent days was 495. Of 119 patients, 89.1% received antibiotic agents, 57.6% at least twice. A total of 80.2% of antibiotic agents given were against SIS recommendations. The antibiotic agent administration rate for mandibular fractures was 97%. Operative management accounted for 93.2% of cases. Antibiotic agent use did not significantly differ between operative and non-operative management (p = 0.18) or between open and closed operative cases (p = 0.99). In operative cases, appropriate peri-operative antibiotic agents were used 89.9% of the time, with 47.5% pre-operative and 63.6% post-operative non-guideline use. Segmented logistic regression showed no statistically significant reduction in non-guideline antibiotic agent use after the guidelines were published. The 30-day post-operative surgical site infection rate was 3.4%, with no significant difference between guideline and non-guideline use.</p><p><strong>Conclusion: </strong>There is substantial discordance between real-world antibiotic agent prescribing practices and SIS guideline recommendations for facial fractures. Quantifying excess non-guideline antibiotic agent use highlights an important opportunity for antimicrobial agent stewardship and provides a foundation for future quality improvement initiatives.</p>","PeriodicalId":22109,"journal":{"name":"Surgical infections","volume":" ","pages":"401-407"},"PeriodicalIF":1.7,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146120374","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":"Surgeon-Led Antibiotic Time-Outs After Emergency Abdominal Surgery.","authors":"Takahiro Suenaga, Hiroaki Hata, Yoshihito Goto, Yutaro Hori, Daiju Yokoyama, Yasutaka Nakanishi, Gen Nishikawa, Rei Mizuno, Kojiro Nakamura, Maki Murata, Akihiro Yasoda, Takashi Kawamura","doi":"10.1177/10962964261469315","DOIUrl":"https://doi.org/10.1177/10962964261469315","url":null,"abstract":"<p><strong>Introduction: </strong>Antimicrobial agent resistance caused by excessive antibiotic agent use is a critical global concern. Antibiotic agent time-outs (ATO) are recommended stewardship tools; however, their benefits after emergency abdominal operations are unproven. We evaluated whether incorporating an ATO in routine post-operative rounds could shorten the antibiotic treatment course without compromising patient outcomes.</p><p><strong>Methods: </strong>This single-center, retrospective study included adults (aged ≥18 y) who underwent emergency operation for intra-abdominal infection at the Kyoto Medical Center between January 2017 and December 2018. From January 1, 2018, surgeons conducted daily ATOs, reassessing the indication, spectrum, and planned duration of each antimicrobial agent regimen. Segmented regression analysis was performed to compare pre- and post-intervention trends.</p><p><strong>Results: </strong>During the 24-month study period, 226 patients were screened, and 93 met the inclusion criteria (44 pre-intervention and 49 post-intervention). The mean duration of post-operative antibiotic agent therapy decreased from 6.7 to 5.8 days, whereas that of meropenem exposure reduced from 0.7 to 0.1 days. Interrupted time-series analysis showed an immediate 3.9-day-level decrease following ATO implementation (95% confidence interval: -8.4 to 0.6; p = 0.09). Surgical site infection rate, number of overall complications, and median length of hospital stay remained unchanged.</p><p><strong>Conclusion: </strong>Surgeon-led ATOs integrated into daily rounds were associated with a shorter post-operative antimicrobial agent duration after an emergency abdominal procedure, although the reduction did not reach statistical significance. Clinical outcomes, including post-operative complications and length of stay, were not worsened. This pragmatic, low-resource intervention aligns with the goals of surgical antimicrobial agent stewardship and warrants consideration for broader implementation.</p>","PeriodicalId":22109,"journal":{"name":"Surgical infections","volume":" ","pages":"10962964261469315"},"PeriodicalIF":1.7,"publicationDate":"2026-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148449455","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":"Advancing Surgical Infection Science in the Americas: Highlights from the 2025 Panamerican Trauma Congress.","authors":"Marco Yanes Anzola, Juan Carlos Salamea, Pablo Ottolino, Manuel Lorenzo, Patricia Martinez Quinones","doi":"10.1177/10962964261420666","DOIUrl":"10.1177/10962964261420666","url":null,"abstract":"<p><p>Surgical site infections (SSIs) and other infectious complications remain a major cause of preventable morbidity across Latin America. SSI prevalence in elective clean and clean-contaminated procedures in Latin America is substantial, and rates may increase further when post-discharge surveillance is incorporated. The XXXVII Panamerican Congress of Trauma, Critical Care, and Emergency Surgery, held in Cuenca, Ecuador, convened over 800 clinicians and researchers and featured a dedicated session focused on infectious complications in trauma and burn care. We present a focused narrative synthesis of five highlighted studies addressing infection prevention, diagnosis, and management in burn care, trauma, and emergency general surgery across the Americas. Collectively, these studies reflect the continental efforts to advance surgical infection science in the Americas and reinforce priorities for standardized SSI and intra-abdominal infection surveillance, including post-discharge follow-up, consistent reporting, and multi-center collaboration to accelerate translation of evidence into practice.</p>","PeriodicalId":22109,"journal":{"name":"Surgical infections","volume":" ","pages":"329-331"},"PeriodicalIF":1.7,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146100781","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> Impact of Residual Moisture on Chemical Monitoring Results of Hollow-Process Challenge Devices in Rapid Sterilization Cycles: An Experimental Study.","authors":"Bingbing Chen, Hui Jin, Xiaoping Ni, Kunkun Leng","doi":"10.1177/10962964251370276","DOIUrl":"10.1177/10962964251370276","url":null,"abstract":"","PeriodicalId":22109,"journal":{"name":"Surgical infections","volume":" ","pages":"395-396"},"PeriodicalIF":1.4,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145834833","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}