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Surgical Infections

Edward K Len, Ritesh Akkisetty, Sandia Royal, Maryanne Brooks, Susette Coyle, Rajan Gupta, Matthew Lissauer
BACKGROUND: Hospital over-capacity often forces boarding patients outside of their designated intensive care unit (ICU). Anecdotal evidence suggested medical intensive care unit (MICU) patients boarding in the surgical intensive care unit (SICU) were responsible for increases in healthcare-associated infection (HAI) rates. We studied the effect of ICU boarding on rates of SICU HAIs. METHODS: This single-center, retrospective two-year database study compared primary SICU patients (Home) to MICU patients boarding in the SICU (Boarders)...
February 15, 2019: Surgical Infections
Radoslaw Jaworski, Andrzej Kansy, Katarzyna Dzierzanowska-Fangrat, Bohdan Maruszewski
BACKGROUND: Prophylactic antibiotic therapy is given routinely in the peri-operative period to prevent surgical site infection. However, in pediatric cardiac surgery, an optimal schedule has not been defined. Pediatric recommendations follow the guidelines for adults, which might be improper because of the inherent challenges in pediatric research and the heterogeneity of the population. Implementation of an effective prophylaxis protocol is needed for children undergoing cardiac surgery, especially in view of worldwide antibiotic overuse and the development of drug resistance...
February 14, 2019: Surgical Infections
Fabian Grass, David Martin, Estelle Moulin, Dieter Hahnloser, Nicolas Demartines, Martin Hübner
BACKGROUND: The present study aimed to analyze risk factors and management strategies for organ space infections (OSI) specifically after colonic resections. METHODS: This was a retrospective analysis of all consecutive colonic resections performed between February 2012 and October 2017 in a single-center quality-improvement project. All OSIs were assessed prospectively by an independent national surveillance program ( ) and classified according to the U...
February 11, 2019: Surgical Infections
Selma Sayın, Emel Yılmaz, Hakan Baydur
BACKGROUND: Glove perforation is common during surgery. Surgical gloves are used as personal protective equipment to reduce infection risks from bloodborne pathogens for both the surgical team and patients. This research was conducted to determine the perforation rates of gloves worn in open abdominal surgery performed in a general surgery department and the risk factors affecting perforation. METHODS: This research was designed as an observational prospective cohort study including 70 open abdominal operations...
February 8, 2019: Surgical Infections
Oktay Aydin, Faruk Pehlivanli
BACKGROUND: Despite surgical treatment of peptic ulcer perforation (PUP), the high rates of morbidity and mortality have motivated researchers to search for new laboratory markers to predict morbidity and mortality. The aim of this study was to investigate the relation between pre-operative laboratory values and demographic factors and post-operative mortality in patients undergoing surgery for PUP. PATIENTS AND METHODS: A retrospective study was made of the clinical findings and laboratory data of patients operated on for a diagnosis of PUP in the general surgery clinic between 2014 and 2018...
February 8, 2019: Surgical Infections
Qinjie Liu, Jie Wu, Zhiwei Wang, Xiuwen Wu, Gefei Wang, Jianan Ren
BACKGROUND: Klebsiella pneumoniae has gained notoriety because of its high antibiotic resistance and mortality. We compared the clinical features and outcomes of polymicrobial bacteremia involving K. pneumoniae (PBKP). PATIENTS AND METHODS: A retrospective observational study of patients with polymicrobial and monomicrobial bacteremia involving K. pneumoniae from January 2012 to December 2016 was performed. The expression of resistance and virulence genes of 27 strains was also compared by polymerase chain reaction (PCR)...
February 8, 2019: Surgical Infections
Sydne Muratore, Alexandria Coughlan, James K Glover, Catherine L Statz, Craig Weinert, Susan E Kline, Gregory J Beilman
BACKGROUND: Our center initiated an electronic Sepsis Best Practice Alert (sBPA) protocol to aid in early sepsis detection and treatment. However, surgery alters peri-operative physiology, which may trigger an sBPA for noninfectious causes. This study aimed to provide early evaluation of automated sBPA utility in surgical patients. METHODS: This study was a retrospective review of the outcomes of patients admitted to the University of Minnesota Medical Center (but not to the intensive care unit) from August 2015-March 2016 and compared how the sBPA performed in those having and not having surgery...
February 6, 2019: Surgical Infections
Daithi S Heffernan
BACKGROUND: The influenza virus is a pathogenic virus responsible for large numbers of deaths and long-term disabilities worldwide. Although the very young, the very old, and immunocompromised individuals are most susceptible, the effects of the influenza virus can be observed across the entire spectrum of individuals. DISCUSSION: Infection with the influenza virus induces a substantial inflammatory and immunologic response and induces marked pulmonary inflammation...
February 6, 2019: Surgical Infections
Ru-Hong Tu, Jian-Xian Lin, Jacopo Desiderio, Ping Li, Jian-Wei Xie, Jia-Bin Wang, Jun Lu, Qi-Yue Chen, Long-Long Cao, Mi Lin, Chao-Hui Zheng, Amilcare Parisi, Chang-Ming Huang
BACKGROUND: The objective of the study was to investigate the effects of intra-abdominal infection after curative gastrectomy on the prognosis of patients. PATIENTS AND METHODS: Data were collected for enrolled patients who underwent curative gastrectomy in two centers; the relationship between intra-abdominal infection and prognosis was analyzed. RESULTS: Of the 5,721 patients in the entire group, intra-abdominal infection occurred in 202 (3...
February 5, 2019: Surgical Infections
Jason Fawley, Lena M Napolitano
BACKGROUND: Current guidelines for the treatment of Clostridium difficile infections (CDIs) recommend vancomycin enemas for patients with adynamic ileus. There is significant variability in guideline recommendations for vancomycin dose and enema volume and whether a retention enema should be used. The most recent (2017) guidelines from the Infectious Diseases Society of America/Society for Healthcare Epidemiology of America recommend rectal instillation of 500 mg of vancomycin in 100 mL of physiologic saline every 6 hours as a retention enema...
February 4, 2019: Surgical Infections
Lauren C Beauchamp, Lisa G Mostafavifar, David C Evans, Anthony T Gerlach
BACKGROUND: Necrotizing soft-tissue infection (NSTI) is a devastating disease associated with high rates of morbidity and mortality. Hyperglycemia is associated with poor wound healing; however, there are no studies evaluating glycemic control outcomes in patients with NSTI. The objective of this study was to examine disease progression and death in patients with NSTI who achieved early glycemic control (EGC) compared with patients that did not. METHODS: A retrospective chart review of patients with NSTI was conducted between November 2011 and August 2017...
February 4, 2019: Surgical Infections
Sadullah Turhan
BACKGROUND: Total knee arthroplasty (TKA) is performed to improve the quality of life by reducing knee arthralgia. One of the most destructive and expensive complications of TKA is deep infection. The primary purpose of this study was to evaluate the effect of using antibiotic-loaded bone cement (ALBC) on the incidence of deep infection after primary TKA. PATIENTS AND METHODS: A total of 506 patients who underwent primary knee arthroplasty at the Antalya Training and Research Hospital between February 2009 and January 2016 were investigated retrospectively...
February 1, 2019: Surgical Infections
Yu Fan, Hongwei Bai, Yeyong Qian, Zhongwei Sun, Bingyi Shi
OBJECTIVE: To investigate the characteristics of BK virus (BKV) specific cellular immune response in the recipients who have early infection with BKV after renal transplantation. METHODS: The recipients of renal allografts (n = 30) were divided into groups of BK virus nephropathy (BKVN), viruria, and viremia. The BKV load was observed with real-time fluorescence quantitative polymerase chain reaction in urine and blood every three months. The values of serum creatinine (SCr) were detected...
February 1, 2019: Surgical Infections
Joseph S Fernandez-Moure, Anna Mydlowska, Crystal Shin, Michael Vella, Lewis J Kaplan
Prosthetic contamination and biofilm formation continue to plague implanted materials. With increasing resistance to traditional antibiotic regimens, alternative approaches to preventing bacterial adhesion and biofilm formation have focused on the physiochemical properties of the prosthetics. Roughness, topography, hydrophobicity, porosity, charge, stiffness, and surface area all influence the processes of adhesion and colonization leading to biofilm formation. In this review, we discuss the physiochemical properties of solid and porous prosthetic materials that influence biofilm formation at the nanometric scale...
January 31, 2019: Surgical Infections
Jennifer Rickard
Surgical infections present a significant burden of disease globally. Management focuses on source control and appropriate antibiotic therapy. This remains a challenge in low- and middle-income settings, where access to surgical care and antibiotics is limited. This paper discusses the complex challenges facing the management of surgical infections in low- and middle-income countries.
January 30, 2019: Surgical Infections
Sergio Alejandro Gómez-Ochoa, Blanca Beatriz Espín-Chico, Nicolás Andrés García-Rueda, Agustín Vega-Vera, José Luis Osma-Rueda
BACKGROUND: Routine screening and treatment for pre-operative asymptomatic bacteriuria (ASB) before joint arthroplasty are controversial. This systematic review and meta-analysis aimed to evaluate the impact of ASB and other bacterial colonization markers (BCM) observed in abnormal urine analyses, such as positive nitrites, leukocyturia, or positive leukocyte esterase in the risk of surgical site infections (SSIs) of joint arthroplasty patients. METHODS: Studies published between 1970 and 2017 that reported data on SSI and prosthetic joint infection (PJI) in patients after joint arthroplasty of the hip, knee, or shoulder with pre-operative ASB or BCM were included...
January 28, 2019: Surgical Infections
David P Blake
BACKGROUND: Infection control is a critical aspect in the continuum of surgical care. Much of what is outlined in the literature pertains to hospital-based practice, with only recent attention paid to the more austere environments, particularly those faced during humanitarian or combat operations. OBJECTIVE: This manuscript provides a brief historical review of the development of infection control practices and further identifies and outlines several aspects necessary to successful program applications in austere environments...
January 24, 2019: Surgical Infections
Tina L Palmieri
BACKGROUND: Infection is a common complication of burn injury caused by the loss of skin (the primary defense against micro-organisms) as well as burn-induced immunosuppression. Essentially, survival after burn injury is determined by whether wound healing or infection predominates. The purpose of this article is to describe how burn unit structure and design may impact the incidence of infection after burn injury. METHODS: This article describes the special considerations for burn unit structure and design based on burn pathophysiology, including burn-related immunosuppression and wound treatment...
January 24, 2019: Surgical Infections
Sarah E Posillico, Brian T Young, Husayn A Ladhani, Brenda M Zosa, Jeffrey A Claridge
BACKGROUND: After publication of the Study to Optimize Peritoneal Infection Therapy (STOP IT) trial, we sought to determine if we were implementing study findings into practice appropriately. We had three objectives: evaluate antibiotic usage; evaluate patient outcomes; and delineate differences in antibiotic usage between general surgeons (GS) and trauma/acute care surgery trained surgeons (TACS). PATIENTS AND METHODS: This was an analysis of patients with complicated intra-abdominal infection admitted via the emergency department from February 2014 through May 2017...
January 24, 2019: Surgical Infections
Wen-Bo Pang, Ting-Chong Zhang, Ya-Jun Chen, Chun-Hui Peng, Zeng-Meng Wang, Dong-Yang Wu, Kai Wang
BACKGROUND: Cholangitis is the most common complication after the Kasai procedure. It can be life-threatening and may affect long- and short-term outcomes of children with biliary atresia. We summarize our experiences in the prevention of early-onset cholangitis. PATIENTS AND METHODS: From January 2002 to March 2013, children with biliary atresia (BA) who underwent the Kasai procedure in the General Surgical Department were included in a retrospective cohort study...
January 18, 2019: Surgical Infections
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