Surgical infections最新文献

{"title":"Empiric Antifungal Therapy Is Not Associated with Improved Infectious Outcomes in Penetrating Upper Gastrointestinal Injuries: A Subgroup Analysis of the Surgical Infection Society Multi-Center Observational Study.","authors":"Vahe S Panossian, Yasmin Arda, Wardah Rafaqat, Andrea M Gochi, Mira Ghneim, Seema Anandalwar, Dias Argandykov, Cynthia Susai, Nathan Alcasid, Geoffrey A Anderson, Alexander J Ordoobadi, Erik J Teicher, David P Blake, Brendin R Beaulieu-Jones, Sabrina E Sanchez, Christopher A Guidry, Pedro Teixeira, Jonathan Meizoso, Brianna L Collie, Sarah McWilliam, Patrick McGonagill, Nicole Nitschke, Colete Galet, Lillian Nefcy, Jeffrey L Johnson, Michael P DeWane, Joseph Cuschieri, Amber Himmler, Jennifer Rickard, Jonathan Gipson, April E Mendoza","doi":"10.1177/10962964251412214","DOIUrl":"10.1177/10962964251412214","url":null,"abstract":"<p><strong>Background: </strong>The role of empiric antifungal therapy in patients with gastrointestinal (GI) perforations because of penetrating trauma remains unclear. Existing literature suggests minimal benefit in non-traumatic GI perforations. This study aimed to evaluate the association between empiric antifungal use and post-operative infectious complications in patients with upper GI perforations because of penetrating trauma.</p><p><strong>Methods: </strong>This was a prospective, multi-center cohort study conducted across 15 institutions between August 2021 and January 2024. We included adult patients with upper GI perforations because of penetrating trauma. The primary outcome was organ/space surgical site infection (SSI) within 30 days. Secondary outcomes included superficial and deep SSI, any SSI (superficial, deep, or organ/space), sepsis, pneumonia, return to the operating room, acute kidney injury (AKI), and in-hospital mortality. Multi-variable logistic regression was used to adjust for confounders.</p><p><strong>Results: </strong>A total of 173 patients were included, of whom 23.1% (n = 40) received empiric antifungals. There was no significant difference in the rate of organ/space SSI between patients who received antifungals and those who did not (17.5% vs. 9.8%, p = 0.180). Antifungal use was also not associated with any significant difference in superficial, deep, or any SSI rates. On multi-variable analysis, antifungal therapy was not independently associated with reduced risk of organ/space SSI (odds ratio 1.72, 95% confidence interval 0.58-5.07). Patients who received antifungals had higher rates of sepsis, pneumonia, AKI, return to the operating room, and in-hospital mortality.</p><p><strong>Conclusions: </strong>Empiric antifungal therapy was not associated with a reduction in organ/space SSI or any SSI, among patients with penetrating upper GI injuries. Trauma patients with upper GI injuries do not appear to benefit from empiric antifungal coverage.</p>","PeriodicalId":22109,"journal":{"name":"Surgical infections","volume":"27 4","pages":"304-310"},"PeriodicalIF":1.7,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147975544","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 Drains After Trauma Splenectomy Associated with Organ Space Surgical Site Infections?","authors":"Stephanie Martinez Ugarte, Mokunfayo O Fajemisin, Seokhun Kim, William D Rieger, Renee W Green, Gabrielle E Hatton, Lillian S Kao","doi":"10.1177/10962964251405078","DOIUrl":"10.1177/10962964251405078","url":null,"abstract":"<p><strong>Introduction: </strong>Left upper quadrant (LUQ) drain use after trauma splenectomy varies, with minimal existing data to guide practice. We aimed to investigate the association of LUQ drains with organ space surgical site infection (OS-SSI) after splenectomy. We hypothesized that LUQ drains after trauma splenectomy are associated with increased odds of OS-SSI.</p><p><strong>Patients and methods: </strong>A retrospective study of adult blunt trauma patients who underwent splenectomy from 7/2018 to 6/2024 was performed. We excluded patients who survived <5 days after operation, and those with an intraoperatively identified pancreatic injury. Demographics, surgical details, and drain information were abstracted from the medical record. Inverse probability of treatment weighting (IPTW) was used to balance variables between patients who did and did not receive an LUQ drain after splenectomy. Multivariable logistic regression with IPTW was performed to estimate the association of LUQ drains with OS-SSI.</p><p><strong>Results: </strong>Of 179 patients, 68% (n = 121) were male, the median age was 38 years (interquartile range 28, 55), and 27% (n = 48) received an LUQ drain. Patients with a drain were more likely to be male and overweight. Age, injury severity, use of damage control, and bowel injuries and resections were similar in patients with and without drains. LUQ drains were associated with increased adjusted odds of OS-SSIs (aOR 5.6, 95% confidence interval 1.7-18.3, p ≤ 0.01). Seven patients, all with drains, had a pancreatic fistula (7/48 vs. 0/131).</p><p><strong>Conclusion: </strong>LUQ drains after splenectomy for blunt trauma were associated with increased odds of OS-SSIs. Given the high likelihood of unmeasured confounders and the inability to capture surgeons' complex decision-making in this study, randomized controlled trials are needed to assess the risks and benefits of LUQ drains after splenectomy.</p>","PeriodicalId":22109,"journal":{"name":"Surgical infections","volume":" ","pages":"253-259"},"PeriodicalIF":1.7,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13035279/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145744664","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":"Two-Year Burden of Antibiotic Use for Prosthetic Joint Infection Following Total Knee Arthroplasty.","authors":"Yu-Tung Lan, Ya-Wen Chen, Ruijia Niu, David C Chang, Carl T Talmo, David Mattingly, Eric L Smith, Brian L Hollenbeck","doi":"10.1177/10962964251412709","DOIUrl":"10.1177/10962964251412709","url":null,"abstract":"<p><strong>Introduction: </strong>Prosthetic joint infection (PJI) after total knee arthroplasty (TKA) poses an economic burden on patients and the healthcare system. Our study aims to estimate the total days and cost of therapeutic antibiotic use among patients with PJI after TKA.</p><p><strong>Patients and methods: </strong>A nationwide claims database study was conducted. Primary exposure was the diagnosis of PJI within 90 days post-TKA. Outcomes were days of antibiotic use and costs associated with antibiotics over the 2-year period post-TKA. Propensity score matching analysis was performed to adjust for patient and provider characteristics.</p><p><strong>Results: </strong>A total of 13,201 patients (female 59.0%, age 59.4 ± 8.4, PJI 1.0%) were included in the study. Patients with PJI had 135.8 more days of antibiotic use than patients without PJI (p < 0.001). PJI patients spent $2138.9 more on antibiotics than those without PJI (p < 0.001). The attributable cost of antibiotics use for PJI patients is estimated to be $12 million over two years following acute PJI diagnosis and reflects 814,000 antibiotic-days of therapy.</p><p><strong>Discussion and conclusion: </strong>Patients with early PJI receive a large quantity of antibiotics and contribute to overall antibiotic use and cost. Reducing early PJI after TKA would be expected to have considerable antimicrobial stewardship benefits.</p>","PeriodicalId":22109,"journal":{"name":"Surgical infections","volume":"27 4","pages":"266-271"},"PeriodicalIF":1.7,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147975564","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":"Age Is Not an Indication: Antibiotic Agents for Urinary Tract Infections in Patients with Geriatric Trauma.","authors":"John R Austin, Michelle Lippincott, Jessica L Weaver","doi":"10.1177/10962964251413393","DOIUrl":"10.1177/10962964251413393","url":null,"abstract":"<p><strong>Background: </strong>Geriatric patients injured in traumatic falls may present with either baseline or acquired cognitive impairment, preventing them from describing genitourinary symptoms. Thus, they are frequently given a screening urinalysis (UA) for possible urinary tract infection (UTI). However, according to the Infectious Diseases Society of America (IDSA), patients without systemic signs of infection should be assessed for other causes of falls and instead closely monitored. We conducted a study in our trauma system to assess UTI screening and treatment. We hypothesized that geriatric falls are likely to receive unnecessary urinalyses (UAs) and antibiotic agent treatment.</p><p><strong>Methods: </strong>Our trauma registry was queried for all patients with trauma aged 65 years and older between 2020 and 2023 for a ground-level fall with an initial Glasgow Coma Score (GCS) <15. Individual charts were reviewed for UTI testing and treatment data.</p><p><strong>Results: </strong>Two hundred and sixty-eight out of 489 patients with geriatric falls (54.8%) had a screening UA performed. One hundred and fifteen (42.9%) patients had positive UAs. Of those with positive UAs, 69/115 (60%) patients were initially given antibiotic agent therapy for UTI treatment. There was no correlation between UTI treatment and either sepsis on presentation (p = 0.65), change in GCS (p = 0.21), or mortality rate (p = 0.16). Of all UAs done, 263/268 (98.1%) were given to patients without a systemic sign of infection.</p><p><strong>Conclusion: </strong>Geriatric patients with cognitive impairment that were injured in falls were consistently over-tested and overtreated for UTIs. Application of IDSA guidelines can potentially reduce unnecessary antibiotic agent use in these patients.</p>","PeriodicalId":22109,"journal":{"name":"Surgical infections","volume":" ","pages":"289-294"},"PeriodicalIF":1.7,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147628791","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 Pre-Operative Occult Bacteremia on Post-Operative Infectious Complications in Patients Undergoing Esophagectomy for Esophageal Cancer.","authors":"Kosuke Inada, Yukihiro Yokoyama, Kazushi Miyata, Shizuki Sugita, Shuta Yamamoto, Masaki Sunagawa, Atsushi Ogura, Takashi Asahara, Tomoki Ebata","doi":"10.1177/10962964251401456","DOIUrl":"10.1177/10962964251401456","url":null,"abstract":"<p><strong>Purpose: </strong>Occult bacteremia (OB), defined as blood stream micro-organisms confirmed by reverse transcriptase-quantitative polymerase chain reaction that target 16S or 23S ribosomal RNA, has been shown to increase the incidence of post-operative infections during pancreaticoduodenectomy. However, its impact on other surgical procedures remains unclear. This study aimed to evaluate the effect of pre-operative OB on post-operative surgical site infection (SSI) during esophageal cancer surgery.</p><p><strong>Methods: </strong>In this prospective observational study, 56 patients scheduled for esophagectomy were included. Pre-operative blood samples were tested for OB, and fecal samples were analyzed for microbiota.</p><p><strong>Results: </strong>Ten patients (18%) exhibited pre-operative OB. These patients had more frequent SSIs than did those without OB (40% vs. 10.9%, p = 0.044). Other complications or clinical factors did not substantially differ between the OB-positive and OB-negative groups. Fecal samples from OB-positive patients presented a greater prevalence of <i>Atopobium</i> clusters. In addition, the same bacterial species were detected in both the blood and feces of five OB-positive patients, with <i>Collinsella aerofaciens</i> being the most commonly shared species among <i>Atopobium</i> clusters.</p><p><strong>Conclusions: </strong>Pre-operative OB increased the risk of SSI following esophagectomy. These findings emphasize the potential role of the gut microbiota, particularly <i>Collinsella aerofaciens</i>, in OB and subsequent infections.</p>","PeriodicalId":22109,"journal":{"name":"Surgical infections","volume":" ","pages":"295-303"},"PeriodicalIF":1.4,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145669878","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":"Ertapenem as an Antibiotic Prophylaxis for Colectomies and Laparotomies: A Systematic Review.","authors":"Stephanie Martinez Ugarte, Mokunfayo O Fajemisin, Beatriz Varman, Parker C Towns, Elias A Chamely, Renee W Green, William D Rieger, Susan H Wootton, Lillian S Kao","doi":"10.1177/10962964251396052","DOIUrl":"10.1177/10962964251396052","url":null,"abstract":"<p><strong>Introduction: </strong>Given concerns for antibiotic resistance, broader spectrum antibiotic agents such as ertapenem are being used for pre-operative prophylaxis. We hypothesize that pre-operative ertapenem prior to laparotomies and colectomies is superior at decreasing surgical site infections (SSIs) compared with other widely used antibiotic agents.</p><p><strong>Methods: </strong>Medline, Embase, the Cochrane Library, and Web of Science were queried for studies until February 02, 2025. Studies were excluded if they did not evaluate ertapenem as a pre-operative antibiotic prophylaxis in patients undergoing laparotomy or colectomy, the outcome was not SSIs, or it represented a review of prior publications. Three reviewers independently extracted relevant articles, and two performed risk-of-bias analyses.</p><p><strong>Results: </strong>Of 6,389 abstracts identified, 9 studies remained after full-text review. Seven of the included studies were observational (78%), and two (22%) were randomized controlled trials (RCTs). The median number of patients enrolled was 499 (inter-quartile range 253, 5192). Study populations included colorectal surgery (n = 8) and trauma patients undergoing laparotomy (n = 1). Ertapenem was compared with single-agent second-generation cephalosporins such as cefotetan, cefuroxime, and cefoxitin and to a single-agent penicillin with or without a combined β-lactamase inhibitor (i.e., ampicillin-sulbactam). In total, five (56%) studies showed that ertapenem was superior in preventing SSIs, decreasing SSI rates by as much as 59% (adjusted odds ratio = 0.41 [0.28-0.61]; p < 0.001).</p><p><strong>Conclusion: </strong>Approximately half of the studies (56%) demonstrated that ertapenem was superior to other commonly used antibiotic prophylaxis regimens in decreasing SSI after laparotomies and colectomies. However, most studies were observational. Therefore, RCTs, especially in trauma, are needed.</p>","PeriodicalId":22109,"journal":{"name":"Surgical infections","volume":" ","pages":"311-322"},"PeriodicalIF":1.7,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13035282/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145551110","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":"Predictors for Positive Repeated Urine Culture in Patients with Negative Initial Urine Culture before Endoscopic Lithotripsy.","authors":"Fenglian Liu, Jun Zhang, Minghui Liu, Zhi Liu, Jin Long","doi":"10.1177/10962964251413994","DOIUrl":"10.1177/10962964251413994","url":null,"abstract":"<p><strong>Background: </strong>Few studies investigated whether a pre-operative repeated urine culture (RUC) was needed to reduce the risk of post-operative infection in patients with negative initial urine culture (UC). Our objective was to identify predictors for positive RUC in patients with negative initial UC before endoscopic lithotripsy.</p><p><strong>Methods: </strong>We retrospectively included 358 patients with urinary stone and negative initial UC who received RUC prior to endoscopic lithotripsy between November 2020 and October 2022. Uni-variable analysis and multi-variable logistic regression analysis were performed to identify risk factors of pre-operative positive RUC. A nomogram was further established as a predicted model to comprehensively evaluate the risk of positive RUC.</p><p><strong>Results: </strong>RUC was found to be positive in 9.8% of patients (35/358). Gram-negative bacteria were the predominant pathogens. The incidence of systemic inflammatory response syndrome (SIRS) was significantly higher in patients with positive RUC (3/35, 8.6%) than that of patients with negative RUC (6/323, 1.9%, p = 0.048), and there was a trend that patients with positive RUC had a higher incidence of urosepsis (2/35, 5.7% vs. 3/323, 0.9%; p = 0.077). Multi-variable logistic regression analysis showed that female (odds ratio [OR] = 2.71, 95% confidence interval [CI]: 1.21-6.09, p = 0.016), age >65 years (OR = 2.69, 95% CI: 1.15-6.33, p = 0.006), positive urine leukocyte esterase (ULE) (OR = 4.88, 95% CI: 2.04-11.63, p < 0.001), and positive nitrite (OR = 11.21, 95% CI: 3.10-40.51, p < 0.001) were independent risk factors for positive RUC.</p><p><strong>Conclusions: </strong>Positive RUC was associated with an increased risk of post-operative infectious complications in patients with urinary stones and negative initial UC. Female, age over 65 years, positive ULE, and positive nitrite were independent risk factors for positive RUC. We first developed the nomogram to identify those patients with positive RUC, which may assist clinicians to provide individualized recommendations for RUC prior to endoscopic lithotripsy.</p>","PeriodicalId":22109,"journal":{"name":"Surgical infections","volume":"27 4","pages":"260-265"},"PeriodicalIF":1.7,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147975502","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":"The Cytotoxicity Profile of Silver Carboxylate in a TiO₂/Polydimethylsiloxane Matrix in Osteoblasts, Keratinocytes, Endothelial Cells, and Skeletal Muscle Cells.","authors":"Dioscaris R Garcia, Jose Navarro, Benjamin Stone, Colin Whitaker, Neel Vishwanath, Olive Cooper, Drew Clippert, James Hong, Nathaniel Kim, Valentin Antoci, Christopher T Born","doi":"10.1177/10962964251409563","DOIUrl":"10.1177/10962964251409563","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Introduction: &lt;/strong&gt;Surgical site infections continue to pose a major challenge in healthcare, contributing to prolonged hospitalizations and increased morbidity and mortality. Despite advancements in antimicrobial agent treatments, bacterial resistance remains an important obstacle. Among various antimicrobial agents, silver compounds have been re-evaluated for their broad-spectrum efficacy. Previous studies, have demonstrated the potential of silver carboxylate embedded in a titanium dioxide/polydimethylsiloxane (TiO&lt;sub&gt;2&lt;/sub&gt;/PDMS) matrix as a material of biomedical relevance. This study aims to expand upon these findings by examining the cytotoxicity profile of silver carboxylate in four human cell lines that play a crucial role in wound healing.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Hypothesis: &lt;/strong&gt;Controlled silver elution from the TiO&lt;sub&gt;2&lt;/sub&gt;/PDMS matrix produces a cytotoxicity profile comparable with commonly used antibiotic agents at clinically relevant exposures.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;In this study, silver carboxylate beads were prepared using a modified method, whereby silver neodecanoate was incorporated into a TiO&lt;sub&gt;2&lt;/sub&gt;/PDMS matrix. The modification involved adjusting the concentration ratios to optimize the release profile for controlled silver elution. Primary human osteoblasts (OBs), keratinocytes (KTs), skeletal muscle cells (SkMs), and endothelial cells (ETs) were cultured under standard conditions and, after 24 h, were exposed to specific silver carboxylate concentrations (1×, 10×, and 100%) without additional washing steps before exposure. In addition, we included a comparative analysis with newly developed silver formulations (silver nanoparticles at 10 and 30 nM, and colloidal silver at 100 and 300 nM) and a panel of conventional antibiotic agents, including vancomycin (5 and 50 µg/mL), tobramycin (5 and 50 µg/mL), linezolid (2 and 20 µg/mL), and polymyxin E (2 µg/mL). Cell viability following exposure was measured using the MTT assay, and the results were analyzed statistically using analysis of variance followed by post hoc Tukey tests.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;OBs exhibited marked cytotoxicity at higher silver carboxylate concentrations, particularly at the 10× condition, with viability comparable with that observed with higher dose antibiotic agents such as vancomycin 50 µg/mL and tobramycin 50 µg/mL. SkMs and ETs demonstrated limited sensitivity at 1× exposure but showed substantial loss of viability at 10×, consistent with dose-dependent toxicity. KTs were the most sensitive cell type, displaying decreased viability even at 1× exposure. The modified TiO&lt;sub&gt;2&lt;/sub&gt;/PDMS matrix demonstrated an enhanced controlled release mechanism, resulting in lower cytotoxicity compared with both early silver formulations and conventional antibiotic agents.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;This study builds upon previous investigations on silver carboxylate and provides new insights into its cytotoxic effects","PeriodicalId":22109,"journal":{"name":"Surgical infections","volume":" ","pages":"272-278"},"PeriodicalIF":1.4,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145858082","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":"Enhanced Outcomes in Bacteremia Through Rapid Phenotype Identification of Carbapenemase-Producing Organisms.","authors":"Huajian Ren, Yitian Teng, Zhihao Xu, Caiqing Yang, Jiayang Li, Jiajie Wang, Jinjian Huang, Jinpeng Zhang, Shuai Hao, Zhiwu Hong, Zherui Zhang, Jianan Ren","doi":"10.1177/10962964251403441","DOIUrl":"10.1177/10962964251403441","url":null,"abstract":"<p><strong>Objective: </strong>The treatment of carbapenemase-producing organisms (CPOs) causing bacteremia in patients with intra-abdominal infections remains challenging. The early detection of CPOs from blood specimens is critical for guaranteeing the timely selection of appropriate antibiotics and achieving favorable outcomes. Our aim was to evaluate whether the rapid identification of CPOs can improve clinical outcomes.</p><p><strong>Patients and methods: </strong>Between January 2019 and January 2024, we conducted a retrospective study of all bacteremia patients admitted to the Intestinal Fistulae and Intra-abdominal Infection Center at Jinling Hospital. A subset of patients underwent screening for CPOs using lateral flow immunoassays (LFIA) method.</p><p><strong>Results: </strong>A total of 163 patients were enrolled, with 96 in the 30-day survivors group and 67 in the 30-day non-survivors group. LFIA was performed in 76 patients, revealing the identification of 64 carbapenemases in four classes: bla Klebsiella pneumoniae carbapenemases (KPC) (45/76, 59.2%), bla NDM (11/76, 14.5%), bla oxacillinase (OXA)-48 (6/76, 7.9%), and bla imipenemase (IMP) (2/45, 2.2%). The most prevalent CPOs cultured were carbapenem-resistant <i>Klebsiella pneumoniae</i> (104/163, 63.8%), followed by carbapenem-resistant <i>Acinetobacter</i> baumannii (36/163, 22.1%), carbapenem-resistant <i>Pseudomonas aeruginosa</i> (32/163, 19.6%), carbapenem-resistant <i>Escherichia coli</i> (19/163, 11.7%), and others (28/163, 17.2%). Univariable analysis revealed that risk factors related to mortality included outbreaks in the intensive care unit or community, sources from the respiratory tract, mechanical ventilation, Pitt score of ≥4, and active therapy before blood culture collection. Multivariable logistic regression analysis indicated that outbreaks in the intensive care unit or community, sources from the respiratory tract, and mechanical ventilation were independent predictors of clinical failure. In addition, LFIA test was associated with decreased 30-day mortality.</p><p><strong>Conclusions: </strong>The LFIA method can rapidly detect the presence of CPOs in patients with bacteremia, thereby improving clinical outcomes. Future multicenter randomized controlled trial (RCT) studies are warranted to investigate the benefits of LFIA detection in bacteremia.</p>","PeriodicalId":22109,"journal":{"name":"Surgical infections","volume":" ","pages":"279-288"},"PeriodicalIF":1.4,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145669863","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> Limitations of Pre-Operative Urine Culture Alone in Predicting Post-Operative UTI after Radical Prostatectomy.","authors":"Akif Erbin, Batu Akalin","doi":"10.1177/10962964261444955","DOIUrl":"https://doi.org/10.1177/10962964261444955","url":null,"abstract":"","PeriodicalId":22109,"journal":{"name":"Surgical infections","volume":" ","pages":"10962964261444955"},"PeriodicalIF":1.4,"publicationDate":"2026-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147691988","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}