Surgical infections最新文献

{"title":"Is Full Scrubbing Necessary Before Short Endourological Procedures to Reduce the Risk of Post-Operative Infection? A Retrospective Cross-Sectional Study.","authors":"Mohammad Al-Zubi, Omar Halalsheh, Rami Al Azab, Reem Omar Alqudah, Nedalaldeen Alnajadat, Sara I J Muhanna, Khayry Al-Shami, Manar Al-Shami, Mohammad Alqasem Aladaileh, Morad Bani-Hani","doi":"10.1089/sur.2024.045","DOIUrl":"10.1089/sur.2024.045","url":null,"abstract":"<p><p><b><i>Background:</i></b> Endoscopic surgery is now increasingly taking the place of open surgery in urology. Traditionally, endourological procedures are classified as clean-contaminated because the genitourinary tract is colonized by micro-flora, even in the case of sterile urine. The aim of this study was to determine whether a difference occurs in the infection rate after short endourological procedures using standard scrubbing and partial scrubbing techniques before the operations. <b><i>Patients and Methods:</i></b> This was a retrospective analysis of 397 patients who underwent a short endourological procedure, with all procedure durations lasting <30 min. Patients were divided into a first group who underwent operations using a full-scrub technique and a second group who underwent operations using a partial-scrub technique. All patients were followed up for the occurrence of urinary tract infections (UTIs). Both groups were compared for age, gender, and post-operative development of UTIs. Values of p < 0.05 were considered statistically significant. <b><i>Results:</i></b> Of the 397 patients, 200 and 197 underwent their procedures using the full-scrub and partial-scrub techniques, respectively. Females and males accounted for 142 (35.8%) and 255 (64.2%) patients, respectively. Only 18 (4.5%) patients developed documented UTIs and antibiotics were prescribed. Of the 18 patients diagnosed with post-operative UTIs, 10 (55.5%) had undergone partial-scrub operations and 8 (45.5%) had undergone full-scrub operations (p = 0.638). <b><i>Conclusion:</i></b> Our findings did not indicate any significant relationship between the risk of developing UTI after a short endourological procedure and the scrub technique used before the operation (partial or full scrub).</p>","PeriodicalId":22109,"journal":{"name":"Surgical infections","volume":" ","pages":"593-597"},"PeriodicalIF":1.4,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141499078","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"<i>Letter To The Editor:</i>Undifferentiated Carcinoma with Osteoclast-Like Giant Cells of the Pancreas with Concurrent Infection.","authors":"Ying Si Ke Xiao, Yongmao Huang","doi":"10.1089/sur.2024.162","DOIUrl":"10.1089/sur.2024.162","url":null,"abstract":"","PeriodicalId":22109,"journal":{"name":"Surgical infections","volume":" ","pages":"636-637"},"PeriodicalIF":1.4,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141580839","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":"Classification and Risk Factors for Surgical Site Infections in Radical Cystectomy: A 16-Year Analysis.","authors":"Soum D Lokeshwar, Ankur U Choksi, Shayan Smani, Kevan L Ip, Juan F Javier-DesLoges, Syed N Rahman, Michael S Leapman, Thomas V Martin, David G Hesse","doi":"10.1089/sur.2024.107","DOIUrl":"10.1089/sur.2024.107","url":null,"abstract":"<p><p><b><i>Introduction:</i></b> Surgical site infection (SSI) is a substantial cause of peri-operative morbidity among patients undergoing radical cystectomy (RC). The purpose of this study was to identify the risk factors of SSI after RC and to classify and characterize treatment of SSIs. <b><i>Methods:</i></b> We retrospectively analyzed peri-operative characteristics and SSI, for patients undergoing RC from 2007 to 2022. Patients were stratified by SSI versus no SSI and differences were assessed. Uni-variable/multi-variable logistic regression analyses were performed to identify factors associated with SSI. SSIs were categorized by the Centers for Disease Control and Prevention (CDC) type: Superficial incisional, deep incisional, and organ/space confined. <b><i>Results:</i></b> Three hundred and ninety-eight patients had RC, 279 open, and 119 robotic; 78 (19.6%) developed SSI. Cohorts were similar demographically. Length of stay (LOS) was longer in the SSI cohort (8.8 d versus 12.4 d, p < 0.001), and body mass index (BMI) was greater in patients with SSI (24.34 vs. 25.39, p = 0.0003). On uni-variable analysis, age, gender, Charlson Comorbidity Index, diabetes mellitus, diversion, odds ratio (OR) time, blood loss, and open versus robotic technique were not substantial SSI predictors. BMI was an independent risk factor for SSI on both uni-variable (OR: 1.07, 95% confidence interval [CI]: 1.018-1.115, p = 0.0061) and multi-variable analysis (OR: 1.06, 95% CI: 1.009-1.109, p = 0.02) for 10 (12.8%) and 24 (30.8%) superficial and deep-incisional SSIs, respectively. Superficial wound SSI was treated conservatively with 60% receiving antibiotic agents and no procedural intervention. Deep SSIs received antibiotic agents and 50% required surgical intervention. There were 44 (56.4%) organ/space SSIs, and the most common treatment was antibiotic agents (100%) and IR drain placement (30, 68.2%). <b><i>Conclusion:</i></b> In patients undergoing RC, BMI was an independent risk factor for SSI. Type of the surgical procedure, robotic versus open, was not predictive of SSI. LOS was longer for patients with SSI. SSI was managed differently depending on CDC classification.</p>","PeriodicalId":22109,"journal":{"name":"Surgical infections","volume":" ","pages":"580-585"},"PeriodicalIF":1.4,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141499077","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":"Secondary Pituitary Abscess: A Rare Complication of Transsphenoidal Surgery for Pituitary Adenoma - Description of Two New Cases and Review of the Literature.","authors":"Ozan Baskurt, Benan Baysoy Avinçsal, Furkan Diren, Serdar Kabatas, Hulya Kusoglu, Simay Kara, Nurperi Gazioglu","doi":"10.1089/sur.2024.077","DOIUrl":"10.1089/sur.2024.077","url":null,"abstract":"<p><p><b><i>Background:</i></b> Pituitary abscess (PA), a rare complication following transsphenoidal (TS) surgery for pituitary adenoma with an incidence of 0.2%, poses a significant risk; carrying potential morbidity, recurrence, and the necessity for reoperation. Timely suspicion, diagnosis, and treatment are imperative. <b><i>Patients and Methods:</i></b> We present two cases and provide a literature review on the symptoms, risk factors, diagnosis, treatment, and outcomes associated with secondary PAs following TS surgery for adenoma. <b><i>Results:</i></b> We identified 12 articles reporting a total of 45 cases, in addition to our 2 cases. The primary symptoms were headache and visual impairment, with no fever or specific infectious parameters observed. Predominant risk factors identified included cerebrospinal fluid (CSF) leakage and prior radiotherapy (RT). Our first patient, a 45-year-old male, presented 10 weeks after TS surgery with sudden-onset symptoms, whereas our second patient, a 64-year-old female, presented 22 years postoperatively. In the first case, intraoperative CSF leakage, with the patient's history of allergic rhinitis and frequent nasal irrigation possibly contributed to the development of abscess. In the second case, RT was considered a potential risk factor. Severe headache and subclinical signs of infection associated with a cystic lesion of the pituitary gland were common findings. Both patients underwent endoscopic TS drainage and received appropriate antibiotic therapy, resulting in complete recovery without recurrence. <b><i>Conclusions:</i></b> When faced with severe headaches in a patient with a history of TS surgery for a pituitary adenoma, coupled with radiological evidence showing a cystic appearance with peripheral enhancement, taking a proactive approach to promptly identify and intervene in secondary PAs is essential for mitigating potential complications and optimizing patient outcomes.</p>","PeriodicalId":22109,"journal":{"name":"Surgical infections","volume":" ","pages":"612-623"},"PeriodicalIF":1.4,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141767508","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":"Intrathecal Tigecycline in the Treatment of Hospital-Acquired Meningitis: A Review of Four Cases.","authors":"Gamze Sanlıdağ Işbilen, Deniz Akyol, Taşkın Yurtseven, Erkin Ozgiray, Mehmet Sedat Cağlı, Söhret Aydemir, Bilgin Arda, Oğuz Reşat Sipahi","doi":"10.1089/sur.2024.063","DOIUrl":"10.1089/sur.2024.063","url":null,"abstract":"<p><p><b><i>Objectives:</i></b> Carbapenem-resistant <i>A. baumannii</i> is a common cause of nosocomial meningitis, and it presents a challenge in terms of treatment because of limited therapeutic options. Intravenous tigecycline has been considered a potential salvage therapy against multi-drug-resistant <i>Acinetobacter baumannii</i>. However, its effectiveness is limited by its poor ability to cross the blood-brain barrier. As an alternative treatment option, intrathecal tigecycline has shown promise with its minimal side effects and high concentration in cerebrospinal fluid. <b><i>Methods:</i></b> In this report, we present a series of four cases infected with multi-drug-resistant A. baumannii following neurosurgery and treated with intrathecal tigecycline, including antimicrobial therapy. <b><i>Results:</i></b> The rate of successful microbiological response was 2 out of 3 cases (66%) in whom microbiological response could be tested anytime during the intrathecal therapy, whereas the 30-day survival rate after treatment completion was ¼ (25%). <b><i>Conclusion:</i></b> Although intrathecal tigecycline treatment has shown relative efficacy in achieving microbiological response, its impact on overall survival is still uncertain. Further studies involving larger groups of patients are necessary to evaluate the outcomes of intrathecal tigecycline therapy.</p>","PeriodicalId":22109,"journal":{"name":"Surgical infections","volume":" ","pages":"627-631"},"PeriodicalIF":1.4,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141760911","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":"Short Report: Is There a Good Prognostic Score to Detect Risk of Sternal Wound Infection after Coronary Artery Bypass Surgery?","authors":"Chloé Bernard, Ludwig Serge Aho Glele","doi":"10.1089/sur.2024.206","DOIUrl":"https://doi.org/10.1089/sur.2024.206","url":null,"abstract":"","PeriodicalId":22109,"journal":{"name":"Surgical infections","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2024-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142354248","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Spectrum of Pathogens in Surgical Site Infections after Sarcoma Resection in the Peri-Pelvic and Pelvic Region. Distinct Location, Distinct Infection?","authors":"Alexander Klein,Chataut Chudamani,Andreas Wieser,Annika Bilgeri,Annabelle Weigert,Jörg Arnholdt,Boris Michael Holzapfel,Hans Roland Dürr","doi":"10.1089/sur.2024.093","DOIUrl":"https://doi.org/10.1089/sur.2024.093","url":null,"abstract":"Background: Soft tissue sarcomas (STS) often occur in the peri-pelvic region (proximal thigh, groin, gluteal region). A common complication following resection of STS is surgical site infection (SSI). The peri-pelvic site appears to be particularly problematic. Surgical site infections are associated with a high proportion of gram-negative and anaerobic micro-organisms. To date, there are no published recommendations for peri-operative antibiotic prophylaxis in pelvic STS resection. Therefore, the aim of this study was to determine the rate of SSI and the spectrum of micro-organisms detected in this region. Methods: In this monocentric study, 366 patients were retrospectively evaluated. All of these patients had undergone surgery for STS in the peri-pelvic and pelvic regions. Surgical site infections were recorded, and the microbial spectrum was analyzed. Results: There were 85 (23.2%) patients with SSI, and 188 revisions were required in these patients (2.21 per case). Swabs were sterile in 20% of clinically infected cases. In total, 36.5% of infections were polymicrobial. The most common bacteria were coagulase-negative staphylococci in 31.5%, followed by Enterococcus species in 13.3% and Escherichia coli in 7.7%. In total, 30.8% of the bacteria were gram-negative and 25.9% were anaerobic. Conclusions: Our results demonstrate the uniqueness of the bacterial spectrum of SSI after STS resection in the peri-pelvic region. In the authors' opinion, recommendations regarding the peri-operative antibiotic prophylaxis need to be adapted for the typical microbial spectrum at this site.","PeriodicalId":22109,"journal":{"name":"Surgical infections","volume":"51 1","pages":""},"PeriodicalIF":2.0,"publicationDate":"2024-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142264979","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":"Misdiagnosed as Fungal Keratitis: Herpes Simplex Virus-1 Keratitis Confirmed by Next-Generation Sequencing.","authors":"Hui-Zhong Zhou, Xiu-Fen Liu, Cheng-Wei Lu, Ji-Long Hao","doi":"10.1089/sur.2024.001","DOIUrl":"10.1089/sur.2024.001","url":null,"abstract":"<p><p><b><i>Objective:</i></b> The purpose of this study was to report a case of herpes simplex virus-1 (HSV-1) keratitis misdiagnosed as fungal keratitis due to its clinical presentation being similar to that of fungal keratitis, ultimately diagnosed by NGS. <b><i>Patients and Methods:</i></b> A 59-year-old male presented with reduced vision in the right eye, combined with a history of trauma with vegetative matter. The corneal ulcer was accompanied with feathery infiltration, satellite lesion, and endothelial plaques. In vivo confocal microscopy (IVCM) showed hyper-reflective linear, thin, and branching interlocking structures. Fungal keratitis was diagnosed. Voriconazole 100 mg orally daily, topical tobramycin and 1% voriconazole were initiated empirically right away. The condition was aggravated and penetrating keratoplasty was performed. Anterior segment optical coherence tomography (AS-OCT) demonstrated the presence of plaques with a clear boundary between plaques and endothelium, resembling the AS-OCT images observed in cases of viral keratitis. Next-generation sequencing (NGS) further detected HSV-1 deoxyribonucleic acid, and no fungal component was found. Antifungal agents were discontinued and antiviral treatments were added. <b><i>Results:</i></b> We successfully treated a patient with HSV-1 keratitis who was misdiagnosed due to clinical features and IVCM findings similar to fungal keratitis. The patient's infection was controlled. At 2 years after surgery, the cornea recovered well. <b><i>Conclusions:</i></b> HSV-1 keratitis with atypical clinical presentation can be easily misdiagnosed. This case report emphasizes the importance of NGS in diagnosing the pathogens of keratitis.</p>","PeriodicalId":22109,"journal":{"name":"Surgical infections","volume":" ","pages":"550-552"},"PeriodicalIF":1.4,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141493494","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"<i>Letter to the Editor:</i> Regarding \"Real-World Evidence of the Impact of a Novel Surgical Irrigant on Surgical Site Infections in Primary Total Knee Arthroplasty Performed at an Ambulatory Surgery Center\".","authors":"Xinjie Wang","doi":"10.1089/sur.2024.159","DOIUrl":"10.1089/sur.2024.159","url":null,"abstract":"","PeriodicalId":22109,"journal":{"name":"Surgical infections","volume":" ","pages":"548-549"},"PeriodicalIF":1.4,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141601834","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":"Effectiveness of Treatment with Antibiotics Alone in Patients with Acute Diverticulitis and Pelvic Abscesses.","authors":"María Carmona Agúndez, Isabel María Gallarín Salamanca, Jesús Salas Martínez","doi":"10.1089/sur.2024.021","DOIUrl":"10.1089/sur.2024.021","url":null,"abstract":"<p><p><b><i>Introduction:</i></b> The available evidence regarding the treatment of acute diverticulitis (AD) with pelvic abscess using antibiotics alone is very limited. The objective of this study was to determine whether the short- and long-term outcomes of AD with pelvic abscesses treated exclusively with antibiotics are comparable to those of pericolic abscesses. <b><i>Methods:</i></b> A retrospective study was conducted on patients diagnosed with AD and either pelvic or pericolic abscesses, as confirmed by computed tomography, who were treated solely with antibiotic therapy between 2011 and 2021. Cases involving percutaneous drainage as part of conservative treatment were excluded. <b><i>Results:</i></b> Fifty-eight patients met the inclusion criteria, comprising 12 with pelvic abscesses and 46 with pericolic abscesses. Both groups exhibited similar baseline characteristics and radiological findings, except for a more frequent presence of free fluid in pelvic abscesses. The success rate of antibiotic therapy was 91.7% for pelvic abscess cases and 96.7% for pericolic cases (p = 0.508). No significant differences were observed in recurrence or elective surgery. In the subgroup of abscesses with a diameter ≥4 cm, the evolution was similar in both locations (treatment success rate of 87.5% in pelvic and 94.4% in pericolic; p = 0.529), although recurrence was slightly higher for pericolic abscesses (38.4% vs. 14.3%; p = 0.362). <b><i>Conclusions:</i></b> Antibiotic therapy alone proves to be effective and safe for pelvic abscesses, demonstrating a course similar to pericolic abscesses, even in the case of large abscesses. Although the analyzed patient cohort is small, this study provides additional evidence that percutaneous drainage is not always essential for treating this complication.</p>","PeriodicalId":22109,"journal":{"name":"Surgical infections","volume":" ","pages":"478-483"},"PeriodicalIF":1.4,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141767507","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}