Surgical infections最新文献

{"title":"Genetically Predicted Body Composition and Risk of Surgical Site Infection: A Mendelian Randomization Study.","authors":"Jinru Yang, Fen Zhang, Hui Xue, Nuo Chen, Yonghua Yao, Kun Li, Ying Wang","doi":"10.1089/sur.2024.133","DOIUrl":"10.1089/sur.2024.133","url":null,"abstract":"<p><p><b><i>Objective:</i></b> This study employed uni-variable and multi-variable Mendelian randomization (MVMR) analyses, utilizing publicly available genome-wide association study (GWAS) data, to assess the causal relationship between body composition measures such as body mass index (BMI), waist circumference (WC), and the occurrence of surgical site infection (SSI). <b><i>Patients and Methods:</i></b> GWAS summary statistical data were obtained for BMI, WC, and SSI from the MRC Integrated Epidemiology Unit (MRC-IEU) database, inverse variance weighted (IVW) method was used as the main analysis, and supplement sensitivity analysis (including heterogeneity test, pleiotropy analysis, leave-one-out analysis, and Mendelian Randomization Pleiotropy RESidual Sum and Outlier (MR-PRESSO)) was used to check the robustness of the results. <b><i>Results:</i></b> The MR analysis showed that the increase in BMI and WC predicted by genes had a substantial causal effect on the incidence of SSI (IVW: odds ratio [OR] = 1.003, 95% confidence interval [CI] = 1.002-1.004, p < 0.001; IVW: OR = 1.003, 95% CI = 1.002-1.005, p < 0.001), respectively, and the MVMR analysis showed that after jointly incorporating smoking and alcohol parameters, the impact of BMI and WC on SSI remained substantial (OR = 1.003, 95% CI = 1.002-1.004, p < 0.001; OR = 1.004, 95% CI = 1.002-1.005, p < 0.001). <b><i>Conclusion:</i></b> We further support the causal relationship between increased body composition including BMI and WC and the occurrence of SSI, highlighting the importance of SSI prevention in patients with obesity. Further research is required to mitigate the occurrence of surgical incisions in patients with obesity in the future.</p>","PeriodicalId":22109,"journal":{"name":"Surgical infections","volume":" ","pages":"95-103"},"PeriodicalIF":1.4,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142628687","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 Factors for Fertility of Daughter Cysts in Hepatic Cystic Echinococcosis and Insights into the Origin of Daughter Cysts.","authors":"Aymen Trigui, Nahed Khemakhem, Sami Fendri, Mohammad Saad Saumtally, Rahma Daoud, Amira Akrout, Jihen Trabelsi, Rafik Mzali, Fatma Cheikhrouhou, Salma Ketata, Chadli Dziri, Ali Ayadi, Foued Frikha, Nizar Kardoun, Salah Boujelbene","doi":"10.1089/sur.2024.007","DOIUrl":"10.1089/sur.2024.007","url":null,"abstract":"<p><p><b><i>Introduction:</i></b> The cycle of <i>Echinococcus granulosus</i> and its developmental potential has always been a subject of debate. While the origin of protoscoleces was well defined, the origin of daughter cysts (DC) was still a contentious topic, and several hypotheses have been proposed. The aim of this work was to study the fertility of DC and its predictive factors in order to determine its origin. <b><i>Patients and Methods:</i></b> This was a prospective pilot study including hepatic echinococcal cysts containing DC operated in the Department of General and Visceral Surgery of Habib Bourguiba University Hospital, Sfax, during a 22-month period. A parasitological study of the DC including the determination of their fertility was done. <b><i>Results:</i></b> A total of 248 DC collected from 27 multi-vesicular cysts from 21 patients were included in our study. The fertility rate of the DC was 64.5%. Free hooks were present in 130 DC (52.4%) and in only 11(12%) of infertile DC. In a multi-variable analysis, only World Health Organization-Informal Working Groups on Echinococcosis classification type CE2, bilious cyst fluid, number of DC per cyst, cyst size, and DC diameter were factors associated with DC fertility (p < 0.05). Out of 88 infertile DC, 77 (87.5%) were devoid of any hooks. <b><i>Conclusion:</i></b> Our findings suggest that most of the analyzed DC were fertile, with fertility associated with factors such as cyst size, DC size, CE2 type, and number of DC/cysts. The absence of hooks in infertile DC questions prevailing theories of their origin.</p>","PeriodicalId":22109,"journal":{"name":"Surgical infections","volume":" ","pages":"71-78"},"PeriodicalIF":1.4,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142740146","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>Clostridium difficile</i> Bacteremia in an Elderly Patient with Multiple Comorbidities: A Case Report.","authors":"Binwei Wu, Xiaoying Song, Yu Liu, Xu Zheng","doi":"10.1089/sur.2024.223","DOIUrl":"10.1089/sur.2024.223","url":null,"abstract":"<p><p><i>Clostridium difficile</i> (<i>C. difficile</i>) stands as a primary cause of health-care-associated colitis in adults; however, extraintestinal manifestations of <i>C. difficile</i>, particularly bacteremia, are exceptionally rare. In this report, we document a case of an elderly male with multiple comorbidities who presented with an acute onset of fever. Diagnostic testing revealed the presence of concurrent bacteremia involving <i>C. difficile</i> and <i>Klebsiella pneumonia</i>. The multilocus sequence typing analysis identified this <i>C. difficile</i> strain as ST81. After receiving a combination treatment of vancomycin and biapenem, the patient successfully recovered and was subsequently discharged. This case report elucidates the clinical presentation and treatment strategies for <i>C. difficile</i> ST81 bacteremia, underscoring the critical need for heightened monitoring of extraintestinal infections in high-risk patients.</p>","PeriodicalId":22109,"journal":{"name":"Surgical infections","volume":" ","pages":"112-115"},"PeriodicalIF":1.4,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142740524","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":"Outcomes of the Subsequent Periprosthetic Joint Infection Revisions after a Failed Debridement, Antibiotics and Implant Retention: A Multicentric Study of 197 Patients.","authors":"Álvaro Auñón, Martí Bernaus, Margarita Veloso, Lluis Font-Vizcarra, Jaime Esteban, Monica Mijangos, Nerea Hernández, Ainara Achaerandio, José Baeza, Francisco Argüelles, Roger Rojas, Joel Sánchez, Alejandra Martínez-Roselló, Montserrat Monfort, Javier Martínez, Alejandro Corredor, José María Lamo de Espinosa, Juan Castellanos, Juan Carlos Martínez Pastor, Alfonso Alías, Laia Boadas, Ernesto Muñoz-Mahamud, Marta Sabater","doi":"10.1089/sur.2024.047","DOIUrl":"10.1089/sur.2024.047","url":null,"abstract":"<p><p><b><i>Background:</i></b> The impact of prior unsuccessful debridement, antibiotics, and implant retention (DAIR) procedures on subsequent revisions is uncertain, with conflicting evidence. Despite 85% consensus against the second DAIR procedure following the 2018 International Consensus Meeting, a 2020 study reported high success rates for the aforementioned second DAIR procedure. <b><i>Methods:</i></b> We conducted a multicenter observational study reviewing data from patients with failed DAIR procedures between 2005 and 2021. Patients diagnosed with acute periprosthetic joint infection of the hip or knee were included, following ICM criteria. Failure was defined as uncontrolled infection leading to additional surgeries, prosthesis removal, infection-related mortality, or suppressive antibiotic therapy. Demographic, surgical, and microbiological variables were recorded. <b><i>Results:</i></b> Among 197 patients from 10 institutions with failed DAIR procedures were included: 88 (44.7%) received a second DAIR, 21 (10.7%) underwent one-stage revision, and 77 (39.1%) underwent two-stage revision. One-stage revision success rate was 76.2%, with no identified predictors of failure. Two-stage revision success rate was 79.3%; factors associated with failure included polymicrobial infections (p = 0.025) and revision procedures (p = 0.049). Second DAIR success rate was 54.5%; factors associated with failure included non-specialized surgical teams in the first DAIR (p = 0.034), non-exchange of mobile components (p = 0.0038), polymicrobial infections (p = 0.043), and antibiotic resistance (p = 0.035). Excluding patients with these risk factors increased the success rate to 83.3%. <b><i>Conclusions:</i></b> Second DAIR's overall success rate was 54.5%, significantly increasing to 83.3% when excluding patients with identified risk factors. These findings suggest considering second DAIR in carefully selected patients without these risk factors. Our study found success rates of 76.2% and 79.3% for one- and two-stage revisions, respectively, aligning closely with published data.</p>","PeriodicalId":22109,"journal":{"name":"Surgical infections","volume":" ","pages":"57-62"},"PeriodicalIF":1.4,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142751702","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":"Too Hot to Handle: Investigating Seasonal Variations in Surgical Site Infections after Colorectal Surgery.","authors":"Chen Chia Wang, Kevin Sun, Hanjoo Lee, Shannon McChesney, Timothy Geiger, Joel Bradley, Aimal Khan","doi":"10.1089/sur.2024.298","DOIUrl":"https://doi.org/10.1089/sur.2024.298","url":null,"abstract":"<p><p><b><i>Background:</i></b> Surgical site infections (SSIs) increase morbidity and cost following colorectal surgery. Seasonal variabilities in SSI were shown in orthopedic and neurological operations but not yet investigated in colorectal surgery. <b><i>Objective:</i></b> We studied the seasonal trends of SSI in colorectal operations and hypothesized that warmer weather increases the risk of SSI. <b><i>Design:</i></b> This was a retrospective cohort study. <b><i>Settings:</i></b> Patients were identified from the National Surgical Quality Improvement Program and assigned to the warm (April to September) or cold cohort (October to March). <b><i>Patients:</i></b> All patients undergoing colorectal surgery between 2006 and 2021 without significant additional procedures were included. <b><i>Main Outcome Measures:</i></b> Our primary aim was to identify the difference in SSI rates between cohorts, whereas secondary aims included further characterization of the onset and type of SSI, as well as identifying the incidence of reoperation because of SSI. <b><i>Results:</i></b> The final study population included 306,984 patients, with 155,137 (50.5%) in the cold cohort and 151,847 (49.5%) in the warm cohort. The warm cohort had higher odds of overall SSI (odds ratio [OR]: 1.04, 95% confidence interval [CI]: 1.02-1.07), with higher rates of superficial SSIs (OR: 1.08, 95% CI: 1.04-1.12) and comparable rates of deep incisional (OR: 1.02, 95% CI: 0.93-1.11) and organ space SSI (OR: 1.01, 95% CI: 0.97-1.05). SSIs occurred post-discharge more often in the warm cohort (57.1% vs. 55.9%, p = 0.048). Patients in the warm cohort also had higher odds of reoperation (OR: 1.39, 95% CI: 1.15-1.67). <b><i>Limitations:</i></b> This study has limitations inherent in retrospective research and the use of a national-level database, such as missing data and differences in reporting standards from each participating center. <b><i>Conclusions:</i></b> Our study showed that patients undergoing colorectal surgery during warm weather months were at higher risk of superficial SSI and reoperation because of infection than those in colder weather.</p>","PeriodicalId":22109,"journal":{"name":"Surgical infections","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-02-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143504337","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":"Antibiogram Surveillance to Determine Appropriate Initial Empiric Antibiotic Therapy for Ventilator-Associated Pneumonia.","authors":"Andrew J Kerwin, G Christopher Wood, Saskya Byerly, Dina M Filiberto, Julie E Farrar, Joseph M Swanson, Maegan L Rogers, Martin A Croce","doi":"10.1089/sur.2024.256","DOIUrl":"https://doi.org/10.1089/sur.2024.256","url":null,"abstract":"<p><p><b><i>Background:</i></b> Our protocolized empiric antibiotic therapy for early (≤7 d) ventilator-associated pneumonia (VAP) and late (>7 d) VAP based on our local antibiogram leads to inappropriate empiric antibiotic therapy (IEAT) approximately 15% of the time. We reviewed our trauma intensive care unit (TICU) antibiogram to determine if sensitivity patterns were changing and warranted protocol adjustments. We hypothesized there would be no change in IEAT over time. <b><i>Patients and Methods:</i></b> TICU patients with VAP (bronchoalveolar lavage culture ≥100,000 CFU/mL) between 2017 and 2022 were reviewed. We reviewed the pathogens and sensitivity patterns to identify the IEAT percentage, and we reviewed changes in the rate of antimicrobial days per 1,000 days present for 2018-2022. <b><i>Results:</i></b> We noted an increase in IEAT beginning in 2017. In early VAP, the increase in IEAT was because of an increase in identification of gram-negative bacteria isolates (7%-24%), specifically an increase in <i>Pseudomonas</i> (3%-10%) and a decrease in <i>Streptococcus sp.</i> (32%-23%) and <i>Haemophilus influenzae</i> (20%-17%). In late VAP, the increase in IEAT was largely because of an increase in identification of <i>Stenotrophomonas</i> (3%-5%) and <i>Acinetobacter</i> (4%-10%). Antimicrobial use changed as pathogens and sensitivity changed. There were increases in rates per 1,000 days for cefazolin (11.9%), vancomycin (22.8%), cefepime (33.1%), and meropenem (424.7%), whereas there were decreases in rates per 1,000 days for ampicillin/sulbactam (-4.5%) and piperacillin/tazobactam (-9.5%). <b><i>Conclusions:</i></b> The change in organisms identified and the increase in IEAT highlight the importance of continuous antibiogram monitoring.</p>","PeriodicalId":22109,"journal":{"name":"Surgical infections","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-02-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143484054","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 Drain Removal Timing and Prophylactic Antibiotic Agents on Surgical Site Infections in Head and Neck Reconstruction.","authors":"Haruyuki Hirayama, Katsuhiro Ishida, Keita Kishi, Hiroki Kodama, Masaki Nukami, Taisuke Akutsu, Soichiro Fukuzato, Takeshi Miyawaki","doi":"10.1089/sur.2024.214","DOIUrl":"https://doi.org/10.1089/sur.2024.214","url":null,"abstract":"<p><p><b><i>Background:</i></b> Regarding drain removal timing in head and neck reconstruction, each institution applies its criteria, and a clear consensus has not been established. This pre-post study aims to identify risk factors for surgical site infection (SSI) after reconstructive surgical procedure for head and neck cancer, specifically examining the influence of drain removal timing. <b><i>Patients and Methods:</i></b> A cohort of 220 patients undergoing reconstructive surgical procedure was analyzed. Patients had closed suction drains removed on post-operative day (POD) 2 or POD3. The primary endpoint was SSI incidence within 30 days after operation. Secondary endpoints included the incidence of hematoma and lymphorrhea within 30 days after operation and drain tip culture results. Statistical analyses were performed using Fisher exact test and logistic regression models. <b><i>Results:</i></b> SSIs occurred in 14.5% of patients, with no significant difference between the POD2 (14.6%) and POD3 (14.5%) groups. No substantial differences were found for hematoma and lymphorrhea. The positive rate of drain tip cultures was significantly greater in the POD3 group (38.2%) compared with the POD2 group (18.0%). Multi-variable analysis showed no correlation between SSI and POD3 drain removal (odds ratio [OR], 0.728; p = 0.471). However, significant SSI risk factors included oral cavity lesions (OR, 3.510; p = 0.003) and ampicillin prophylaxis (OR, 5.266; p < 0.001). <b><i>Conclusions:</i></b> Oral cavity lesions and ampicillin prophylaxis were substantial SSI risk factors in reconstructive surgical procedure for head and neck cancer. However, drain removal timing did not significantly affect SSI incidence or other complications. Considering benefits such as shorter hospital stays and less chance of retrograde bacterial invasion, removing drains on POD2 is preferable compared with removal on POD3. Further research is needed to refine prophylactic protocols and enhance patient outcomes.</p>","PeriodicalId":22109,"journal":{"name":"Surgical infections","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-02-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143484056","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":"Antibiotics and Surgically Treated Acute Appendicitis, When, Where, and Why?","authors":"Andrew Hendrix, Alexander Kammien, Adrian A Maung, Bishwajit Battacharya, Kimberly A Davis, Kevin M Schuster","doi":"10.1089/sur.2024.264","DOIUrl":"https://doi.org/10.1089/sur.2024.264","url":null,"abstract":"<p><p><b><i>Background:</i></b> Antibiotics within an hour of incision reduce the incidence of surgical site infection (SSI) in clean-contaminated abdominal surgery. However, patients undergoing emergency surgery for an intra-abdominal infectious process often receive treatment antibiotics and may not benefit from additional pre-incisional antibiotics (POA). We hypothesized that POA would not lead to a reduction in the occurrence of SSIs following emergency appendectomy. <b><i>Patients and Methods:</i></b> All patients at a single institution undergoing emergency appendectomies for acute appendicitis from 2013 to 2020 were included. Age, gender, perforation, body mass index (BMI), Elixhauser comorbidity index (ECI), surgical approach, emergency department antibiotics (EDA), EDA administration time, and pre-operative antibiotics were abstracted. Primary outcomes were superficial/deep and organ-space SSIs. Bi-variable logistic regression models assessed the independent impact of each tactic. Multi-variable models compared those receiving pre-incisional cefazolin with those receiving no POA. <b><i>Results:</i></b> Patients (n = 1380) had a mean age (standard deviation) of 39.5 (17.0) years, and 48.6% were female. Age, gender, perforated appendicitis, EDA, ECI, and BMI all were predictive of infection. POA were not predictive of SSI (p = 0.632). After adjustment for age, gender, perforation, EDA, EDA administration timing, ECI, and BMI, only perforation (odds ratio [OR]: 17.08, 95% confidence interval [CI] = 6.97-51.43) and male gender (OR: 2.75, 95% CI = 1.29-6.43) were associated with organ-space infection, whereas pre-incisional cefazolin was not (OR: 0.83, 95% CI = 0.38-1.97). Emergency department broad-spectrum antibiotics were associated with a lower incidence of superficial/deep infection (OR: 0.06, 95% CI = 0.00-0.68); however, pre-incisional cefazolin was not (OR: 0.71, 95% CI = 0.08-15.34). <b><i>Conclusion:</i></b> For patients undergoing emergency appendectomies who have received broad-spectrum antibiotic treatment, additional pre-incisional cefazolin does not reduce the incidence of superficial/deep or organ-space SSI.</p>","PeriodicalId":22109,"journal":{"name":"Surgical infections","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-02-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143459506","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 Study of Risk Factors for Surgical Site Infections and Direct Economic Losses in Clean Orthopedic Surgery.","authors":"Qiuxia Zuo, Hua Li, Baoji Dong, Yuan Zhou, Kexin Zhao, Ping Tian","doi":"10.1089/sur.2024.257","DOIUrl":"https://doi.org/10.1089/sur.2024.257","url":null,"abstract":"<p><p><b><i>Background:</i></b> Surgical site infection (SSI) is a serious complication after clean orthopedic surgery. <b><i>Patients and Methods:</i></b> We retrospectively gathered data on 18,140 patients who underwent clean incision orthopedic operations at two institutions between January 2023 and April 2024. The study included 87 patients with SSIs in the case group and 80 matched controls without SSIs. Age, diabetes mellitus, and intra-operative blood transfusions were all examined using uni-variable and conditional multi-variable logistic regression to detect risk and independent risk factors for SSI. Differences in hospital charges and length of stay were also investigated. <b><i>Results:</i></b> Among the 18,140 surveyed patients, 87 developed SSIs, yielding an infection rate of 0.48%. Significant risk factors for SSI included hypertension (31.3% vs. 15.0%, p = 0.015), more than two surgical procedures (28.8% vs. 8.8%, p = 0.001), and durations of indwelling urinary catheters (p ＜ 0.001) and drains (p = 0.003). Independent risk factors included age ≥60 years [odds ratio (OR): 36.011, p = 0.025], more than two surgical procedures (OR: 7.001, p = 0.034), and durations of indwelling urinary catheters (OR: 2.164, p = 0.033) and drains (OR: 1.426, p = 0.004). The median hospitalization cost was $5,289.3 for patients with SSIs compared with $3,653.9 for those without infections. The cost difference was statistically significant (Z = -3.409, p = 0.001), with an additional median expense of $1,366.5 attributed to SSIs. Patients in the infection group were hospitalized for a median of 30 days, compared with 15 days in the non-infected group, a statistically significant difference (Z = -7.32, p < 0.001), resulting in 17 additional days of hospitalization. The total direct economic loss attributed to 80 SSI cases across both hospitals amounted to $162,415.8. <b><i>Conclusion:</i></b> The study identifies multiple risk factors for SSIs following orthopedic clean surgical procedures. Hospital-related departments should aim to mitigate these risks to decrease the incidence of SSIs and reduce the financial burden on patients.</p>","PeriodicalId":22109,"journal":{"name":"Surgical infections","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-02-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143399857","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":"Direct Peritoneal Resuscitation in Critically Ill Patients with an Open Abdomen is Associated with Increased Risk of Intraperitoneal Fungal Infections.","authors":"Cassandra A Cairns, James Martinson, Lindsay O'Meara, Roumen M Vesselinov, Jose J Diaz, Mira Ghneim","doi":"10.1089/sur.2024.128","DOIUrl":"https://doi.org/10.1089/sur.2024.128","url":null,"abstract":"<p><p><b><i>Background:</i></b> Damage control laparotomy (DCL) is a well-established tool to stabilize critically ill surgical patients. Direct peritoneal resuscitation (DPR), whereby the open abdomen is continuously irrigated with glucose-based hypertonic dialysate, is a valuable adjunct that improves abdominal closure rates and decreases wound complications. Infectious implications of its use remain underexplored. <b><i>Objective:</i></b> To assess the impact of DPR on the incidence intra-abdominal fungal infections (AFIs) in critically ill surgical patients. <b><i>Methods:</i></b> A retrospective chart review was performed of trauma and emergency general surgery patients undergoing DCL with and without DPR at our level 1 trauma center. The effect of DPR on the primary outcomes was assessed using two-stage logistic regression models. Classification and Regression Tree (CART) models were used to evaluate the leading factors contributing to the primary outcome. <b><i>Results:</i></b> A total of 169 patients were included in the study, 44% of which underwent DPR. Overall, patients who underwent DPR received a more frequent diagnosis of AFIs (28% vs. 13%, p = 0.012). After multi-variable adjustment, patients undergoing post-operative DPR had significantly higher odds of developing AFI (odds ratio [OR] = 5.0, 95% confidence interval [CI]: 1.3-18.5). In hybrid-logit CART models, DPR was again identified as being associated with an increased likelihood of developing AFI (OR = 2.4, 95% CI: 1.0-6.0). <b><i>Conclusion:</i></b> In this cohort, DPR patients had significantly higher chances of developing AFIs. This supports the need for further investigation into the clinical implications of AFIs in critically ill surgical patients and the need to develop risk mitigating strategies.</p>","PeriodicalId":22109,"journal":{"name":"Surgical infections","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-02-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143392113","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}