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Surgical Infections

Faruk Pehlivanlı, Oktay Aydin
BACKGROUND: The objective of this study was to determine the clinical and laboratory features affecting mortality in Fournier gangrene. PATIENTS AND METHODS: This retrospective case control study was designed to evaluate patients treated for Fournier gangrene in our center between 2010 and 2018. Those patients were divided into two groups: discharged patients (group 1) and deceased patients (group 2). Comparisons were made regarding clinical and demographic features; leukocyte, neutrophil and lymphocyte count results; neutrophil to lymphocyte ratio (NLR); Fournier's Gangrene Severity Index (FGSI) scores; number of debridements; complications; and mortality rates...
November 7, 2018: Surgical Infections
Ragavan Siddharthan, Michael Chapek, Malissa Warren, Robert Martindale
Despite significant improvements in peri-operative care, surgical site infections (SSIs) remain an important contributor to morbidity, cost, and death. The human gastrointestinal tract is a complex microenvironment linking host cells and the indigenous microflora or "microbiome," creating a "super-organism" that engages in macro-nutrient and micro-nutrient extraction for the host while serving as a barrier to toxins and other detrimental bacterial end-products. Maintaining a healthy microbiome in the peri-operative period may enable control of multi-drug resistance (MDR) organisms, whereas use of antibiotics simply resets the dysbiotic relation by eliminating multiple strains of bacteria...
November 3, 2018: Surgical Infections
Christina Merakou, Matthew M Schaefers, Gregory P Priebe
BACKGROUND: The gram-negative bacterial pathogen Pseudomonas aeruginosa causes a wide range of infections, mostly in hospitalized and immunocompromised patients, those with burns, surgical wounds, or combat-related wounds, and in people with cystic fibrosis. The increasing antibiotic resistance of P. aeruginosa confers a pressing need for vaccines, yet there are no P. aeruginosa vaccines approved for human use, and recent promising candidates have failed in large clinical trials. DISCUSSION: In this review, we summarize recent clinical trials and pre-clinical studies of P...
November 2, 2018: Surgical Infections
Teshager Woldegioris, Getachew Bantie, Habtamu Getachew
BACKGROUND: Surgical site infections (SSIs), a type of nosocomial infection, are a leading cause of morbidity and death and increase the overall cost of care. The processes and procedures involved in the operations can endanger the life of the patient significantly. Knowledge of, and nurse practice focused on, the prevention of SSIs have not been studied well in Ethiopia, especially in our area. Therefore, we decided to establish the extent of knowledge and actual practice of SSI prevention among nurses empirically in the Bahir Dar city administration region...
November 1, 2018: Surgical Infections
Donald E Fry
No abstract text is available yet for this article.
October 30, 2018: Surgical Infections
James T Lee
No abstract text is available yet for this article.
October 26, 2018: Surgical Infections
Peter I Cha, Brooke Gurland, Joseph D Forrester
BACKGROUND: Intussusception is the process by which one segment of intestine "telescopes" into another segment. Escherichia coli O157:H7 is a rare cause of intussusception that uncommonly requires a surgical procedure. METHODS: Case report and literature review. RESULTS: We reviewed 25 cases of infection with E. coli O157:H7 that resulted in intussusception, all of which involved minors. Our case identifies the first reported adult with intussusception secondary to E...
October 25, 2018: Surgical Infections
John C Alverdy
BACKGROUND: Bacterial virulence is a dynamic property of pathogens that is expressed in a context-dependent manner. For a bacterial pathogen, the expression of virulence is a tradeoff, as there is an energy cost that can disturb other functions. As a result, virulence is activated only when bacteria sense the need for it. METHODS: Recent work from our laboratory has identified many of the local cues in the environmental context that activate bacterial virulence during surgical injury, resulting in bacterial invasion, tissue inflammation, and, in some cases, lethal sepsis...
October 25, 2018: Surgical Infections
Julius Pochhammer, Joachim Köhler, Michael Schäffer
BACKGROUND: Surgical site infections (SSIs), after colorectal resection, pose a significant burden. Recognition of the spectrum of potentially involved pathogens is crucial for determining correct antibiotic prophylaxis. This study aimed to determine whether the distribution of SSI-associated pathogens depends on the location of the colorectal resection. METHODS: We retrospectively categorized 2713 consecutive colon resections as left- or right-side operations, identified patients having concurrent peritonitis or development of postoperative SSIs and peritonitis, and assigned all subcutaneously and intra-abdominally isolated pathogens according to the location of the resection...
October 24, 2018: Surgical Infections
Zhoujia Yao, Jun Zheng, Youguang Si, Xudong Xu, Tingting Li
BACKGROUND: Emphysematous cholecystitis and spontaneous hepatic hemorrhage are uncommon and serious conditions with non-specific presentations that can lead to a poor clinical outcome. We report a case of spontaneous hepatic hemorrhage of emphysematous cholecystitis. A 49-year-old male presented to the emergency department with fever, chills, right upper quadrant pain, vomiting, and diarrhea of four days' duration. He had a history of diabetes mellitus, hypertension, and uarthritis. Computed tomography (CT) revealed an enlarged gallbladder with intra-luminal, intra-mural, and peri-cholecystic air; subcapsular high-density fluid collection; and an intra-hepatic mass with gas and liquid in the right lobe of the liver...
October 23, 2018: Surgical Infections
Gary E Stein, Curtis L Smith, Amy Scharmen, James M Kidd, Christopher Cooper, Joseph Kuti, Subhashis Mitra, David P Nicolau, Daniel H Havlichek
BACKGROUND: The pharmacokinetics, especially the volume of distribution (Vd), of ß-lactam antibiotics can be altered in critically ill patients. This can lead to decreased serum concentrations and a reduction in clinical cures. Ceftazidime/avibactam (CZA) is a new antimicrobial agent utilized in critically ill patients although its pharmacokinetics has not been well defined in these patients. PATIENTS AND METHODS: In this study, the serum concentrations of CZA from adult patients treated in an intensive care unit (ICU) with standard dosing regimens were measured and both pharmacokinetic and pharmacodynamic parameters were computed...
October 23, 2018: Surgical Infections
Ioannis D Kostakis, Nikolaos Machairas, Anastasia Prodromidou, Zoe Garoufalia, Petros Charalampoudis, Georgios C Sotiropoulos
BACKGROUND: Our goal was to evaluate the microbe species responsible for bacteremia or infections related to central venous catheter (CVC) or fluid collections after liver resection. PATIENTS AND METHODS: Data from 112 patients (68 males, 44 females) who underwent liver resection over a period of 63 months were reviewed. Patient and tumor characteristics, intra-operative and post-operative data, and the results from cultures of peripheral blood, CVC tips and drained intra-abdominal or intra-throracic fluid collections were collected...
October 9, 2018: Surgical Infections
Charles E Edmiston, Maureen Spencer, David Leaper
A surgical site infection (SSI) can occur at several anatomic sites related to a surgical procedure: Superficial or deep incisional or organ/space. The SSIs are the leading cause of health-care-associated infection (HAI) in industrialized Western nations. Patients in whom an SSI develops require longer hospitalization, incur significantly greater treatment costs and reduction in quality of life, and after selective surgical procedures experience higher mortality rates. Effective infection prevention and control requires the concept of the SSI care bundle, which is composed of a defined number of evidence-based interventional strategies, because of the many risk factors that can contribute to the development of an SSI...
October 9, 2018: Surgical Infections
Raghavendra Paknikar, Joel Pekow
The clinical burden of Clostridium difficile infection (CDI) continues to grow. Despite the multitude of treatment options that have been developed and tested to combat the morbidity and death associated with CDI, recurrence remains common. As such, treatment modalities such as fecal microbiota transplantation (FMT) have become studied increasingly; FMT serves to transplant stool from carefully selected healthy subjects into C. difficile positive patients through a variety of delivery routes. In doing so, FMT is hypothesized to correct dysbiosis of the recipient gut microbiome addressing the root cause of the pathogenesis of C...
October 9, 2018: Surgical Infections
Adrian A Coleoglou Centeno, Christopher B Horn, Rohit K Rasane, Jose A Aldana, Qiao Zhang, Kelly M Bochicchio, Grant V Bochicchio, Obeid N Ilahi
BACKGROUND: Clostridium difficile infection (CDI) is an important surgical complication. Emergency general surgery (EGS) is a developing area of the acute care surgical practice. Few studies evaluating the incidence and risk factors of CDI in this patient population are available. PATIENTS AND METHODS: A prospectively maintained Acute and Critical Care Surgery registry spanning from 2008 to 2015 was queried for cases of operative EGS with clinical suspicion of CDI post-operatively...
October 9, 2018: Surgical Infections
Christine Rohde, Johannes Wittmann, Elizabeth Kutter
Bacteriophages (phages) are viruses that kill bacteria specifically but cannot infect other kinds of organisms. They have attracted new attention since the increasing antibiotic resistance developed into a global crisis. Phage therapy, a 100-year-old form of antibacterial treatment in medicine, is gaining momentum because phages represent a therapy concept without such negative side effects as toxicity; phages are the only therapeutic agent that regulates itself at the sites of infection and decays when the infectious bacteria have been killed...
October 9, 2018: Surgical Infections
Veikko Nikulainen, Päivi Helmiö, Saija Hurme, Harri Hakovirta
BACKGROUND: The groin surgical site is frequently infected in vascular surgical procedures. Our aim was to evaluate the relation of skin closure methods and groin incision infection after vascular operations involving femoral artery exposure. METHODS: In this retrospective patient record study, patient files of all consecutive patients admitted for a vascular procedure to the Turku University Hospital Department of Vascular Surgery during 2015-2016 were evaluated...
October 6, 2018: Surgical Infections
Jennifer E Baker, Ryan M Boudreau, Aaron P Seitz, Charles C Caldwell, Erich Gulbins, Michael J Edwards
Antibiotic resistance has been demonstrated during the entire duration of antibiotic use even before medical utilization. Increasing resistance within virtually all microbes continues to be a problem. Infection with antibiotic resistant microbes has demonstrated significantly increased morbidity, death, and health-care-associated costs. Given increasing antibiotic resistance, multiple novel agents and approaches are being investigated, including antimicrobial lipids. Sphingosine and ceramide have been demonstrated to play a pivotal role in the innate immunity of the epidermis, oral mucosa, and respiratory epithelium; their role is being investigated currently in uroepithelium...
October 2, 2018: Surgical Infections
Kelsey Han, Jae Moo Lee, Aditya Achanta, Napaporn Kongkaewpaisan, Manasnun Kongwibulwut, Ahmed I Eid, Nikolaos Kokoroskos, Suzanne van Wijck, Karien Meier, Ask Nordestgaard, Gabriel Rodriguez, Zhenyi Jia, Jarone Lee, David King, Peter Fagenholz, Noelle Saillant, April Mendoza, Martin Rosenthal, George Velmahos, Haytham M A Kaafarani
BACKGROUND: The Emergency Surgery Score (ESS) was validated recently as an accurate and user-friendly post-operative mortality risk calculator specific for Emergency General Surgery (EGS). ESS is calculated by adding one to three integer points for each of 22 pre-operative variables (demographics, co-morbidities, and pre-operative laboratory values); increasing scores accurately and gradually predict higher mortality rates. We sought to evaluate whether ESS can predict the occurrence of post-operative infectious complications in EGS patients...
September 29, 2018: Surgical Infections
Pieter R Zwanenburg, Berend T Tol, Fleur E E de Vries, Marja A Boermeester
BACKGROUND: With the prospect of antibiotic failure in the post-antibiotic era, strategies that prevent surgical site infection (SSI) are increasingly important. Current literature suggests that incisional Negative Pressure Wound Therapy (iNWPT) is a promising intervention. METHODS: Based on published literature regarding iNPWT, its mechanisms of action, and clinical results, a narrative summary was built, including both the experimental as well as the clinical literature...
September 29, 2018: Surgical Infections
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