Abstract:
BACKGROUND:Antimicrobial resistance is a growing problem in the intensive care setting. This study was designed to evaluate the trends in bacterial prevalence and changes in antibiotic resistance at a large university hospital over the past decade. Antimicrobial resistance data were compared among the surgical intensive care unit (SICU), medical intensive care unit (MICU), and burn unit (BNU). MATERIALS AND METHODS:A large database was created using hospital-wide data from 1989 to 2000. A retrospective analysis of the evolution of organism prevalence, antibiotic resistance, and response to study protocols was evaluated. The formulary was relatively unrestricted. All positive cultures were examined, focusing on wound, blood, and sputum cultures. Six primary antibiotics were targeted specifically to follow resistance patterns. RESULTS:There were 847 identified positive wound cultures, 2,862 positive sputum cultures, and 2,252 positive blood cultures. The incidence of gram-positive and gram-negative organisms changed little in the SICU and BNU; however, there was a large increase in gram-positive organisms and yeast in the MICU over the past 5 years. Anaerobic bacteria and yeast were nearly nonexistent pathogens in the SICU and BNU. The resistance pattern of most organisms changed little following the introduction of a new antibiotic. However, the effectiveness of study antibiotics after formal clinical study periods decreased dramatically, albeit transiently. CONCLUSION:Hospital-wide antibiotic resistance data may be misleading and may not reflect individual critical care units throughout the hospital. Bacterial flora, including resistant organisms, changed little over 10 years, despite an unrestricted formulary. The emergence of resistant and opportunistic organisms is related to antibiotic usage and can vary significantly over time. This suggests that a policy of administering limited duration, narrow spectrum antibiotics may reduce drug resistance.
journal_name
Surg Infect (Larchmt)journal_title
Surgical infectionsauthors
Franklin GA,Moore KB,Snyder JW,Polk HC Jr,Cheadle WGdoi
10.1089/109629602760105808subject
Has Abstractpub_date
2002-07-01 00:00:00pages
135-44issue
2eissn
1096-2964issn
1557-8674journal_volume
3pub_type
杂志文章abstract:BACKGROUND:Ventilator-associated pneumonia (VAP) is a common healthcare-associated infection affecting as many as 27% of mechanically ventilated patients. Ventilator-associated pneumonia is an important source of morbidity and mortality in the surgical intensive care unit (SICU). The optimal diagnostic method for VAP h...
journal_title:Surgical infections
pub_type: 杂志文章
doi:10.1089/sur.2013.142
更新日期:2014-10-01 00:00:00
abstract:BACKGROUND:Ceftaroline fosamil is a novel cephalosporin approved by the United States Food and Drug Administration (US FDA) for treatment of acute bacterial skin and skin structure infection, including those caused by methicillin-resistant Staphylococcus aureus (MRSA). We evaluated the activity of ceftaroline and compa...
journal_title:Surgical infections
pub_type: 杂志文章,多中心研究
doi:10.1089/sur.2015.209
更新日期:2016-08-01 00:00:00
abstract:BACKGROUND:Surgical infections, and sepsis in particular, are characterized by extensive release of mediators. Our laboratories have been interested in understanding how these substances contribute to morbidity and mortality during various stages of surgical infections in order to develop new and more effective therape...
journal_title:Surgical infections
pub_type: 杂志文章,评审
doi:10.1089/sur.2006.7.s2-3
更新日期:2006-01-01 00:00:00
abstract::Multiple organ dysfunction syndrome (MODS) is caused by an overwhelming, uncontrolled systemic inflammatory response that is activated by a number of hostile stimuli including sepsis, hypovolemic shock, and severe trauma resulting in massive tissue injury. The indiscriminate activation of the inflammatory response due...
journal_title:Surgical infections
pub_type: 杂志文章,评审
doi:10.1089/109629600750018123
更新日期:2000-10-01 00:00:00
abstract:BACKGROUND:Clostridium perfringens myonecrosis following an elective surgical procedure in a previously healthy child is a rare incident. METHODS:Case report and literature review. RESULTS:A two-year old boy admitted for elective bilateral osteotomies of tibiae was detected to be febrile at day one post-operatively w...
journal_title:Surgical infections
pub_type: 杂志文章
doi:10.1089/sur.2012.192
更新日期:2014-10-01 00:00:00
abstract:BACKGROUND:Mycobacterium tuberculosis infection rarely penetrates both skull and dura with temporalis muscle abscess formation. METHODS:Case report and review of the literature. RESULTS:A non-immunocompromised female patient with a right temporal mass underwent surgical resection. The tubercular abscess extended from...
journal_title:Surgical infections
pub_type: 杂志文章,评审
doi:10.1089/sur.2012.106
更新日期:2013-10-01 00:00:00
abstract:BACKGROUND:Surgical care is delivered 24 h a day at most institutions. Alarmingly, some authors have found that certain operative start times are associated with greater morbidity and mortality rates. This effect has been noted in both the public and private sector. Although some of these differences may be related to ...
journal_title:Surgical infections
pub_type: 杂志文章
doi:10.1089/sur.2015.150
更新日期:2016-10-01 00:00:00
abstract:BACKGROUND:Vancomycin is used widely as empiric therapy for gram-positive organisms in patients with an intra-abdominal infection (IAI), even in those with no history of methicillin-resistant Staphylococcus aureus (MRSA) infection or colonization. Potential adverse effects of vancomycin include nephrotoxicity, increase...
journal_title:Surgical infections
pub_type: 杂志文章
doi:10.1089/sur.2014.211
更新日期:2015-08-01 00:00:00
abstract:BACKGROUND:The lack of uniformity of criteria for defining recipient-site infection after oral oncologic surgery with simultaneous reconstruction is problematic despite numerous studies on this issue. This study aimed to investigate the difference in the criteria for defining recipient-site infection after oral oncolog...
journal_title:Surgical infections
pub_type: 杂志文章,评审
doi:10.1089/sur.2017.101
更新日期:2017-10-01 00:00:00
abstract:: Background: We aimed to assess independent risk factors for inadequate initial antimicrobial treatment (IAT) in critically ill patients with ventilator-associated pneumonia (VAP) treated in intensive care units (ICU) and to determine whether IAT is associated with adverse ...
journal_title:Surgical infections
pub_type: 杂志文章
doi:10.1089/sur.2020.306
更新日期:2021-01-13 00:00:00
abstract:: Background: Faulty cleaning of surgical instruments may lead to corrosion damage and a higher risk of surgical site infection. We have developed a method in which each instrument has an attached radiofrequency identification (RFID) tag for individual management. However, b...
journal_title:Surgical infections
pub_type: 杂志文章
doi:10.1089/sur.2019.034
更新日期:2019-12-01 00:00:00
abstract::Broad-spectrum beta-lactam antibiotics have several advantages in the treatment of intra-abdominal infections. These agents are effective against gram-negative rods and anaerobes, reach therapeutic levels rapidly after parenteral administration, and, in the absence of penicillin allergy, generally exhibit low toxicity...
journal_title:Surgical infections
pub_type: 杂志文章,评审
doi:10.1089/109629600321308
更新日期:2000-01-01 00:00:00
abstract:BACKGROUND:The utility of tigecycline as compared with other antibiotic therapies in the treatment of patients with complicated intra-abdominal infection (cIAI) and the short- and long-term outcomes of a large cohort of severely ill patients were examined. We provide the first published data on post-discharge events fo...
journal_title:Surgical infections
pub_type: 杂志文章,多中心研究
doi:10.1089/sur.2015.075
更新日期:2016-08-01 00:00:00
abstract:BACKGROUND:Neutrophil dysfunction has been documented after injury in animals and human beings. This review evaluates the relative effects of the hormonal and endotoxin response to injury on immune resistance. METHOD:Review of the pertinent English-language literature. RESULTS:In volunteers given total parenteral nut...
journal_title:Surgical infections
pub_type: 杂志文章,评审
doi:10.1089/sur.2012.161
更新日期:2012-10-01 00:00:00
abstract:BACKGROUND:Skin and soft tissue infections are common problems dealt with in emergency departments and medical offices. It is routine practice to prescribe antibiotic agents after incision and drainage of cutaneous abscesses. However, current evidence does not support prescribing oral antibiotic agents after surgical d...
journal_title:Surgical infections
pub_type: 杂志文章
doi:10.1089/sur.2017.225
更新日期:2018-04-01 00:00:00
abstract:BACKGROUND:Portal hypertension in the mucosa of the intestine and the presence of granulomas in the wall of this organ can alter digestive function in patients with schistosomiasis. Citrulline is a potential marker of intestinal function in some diseases that affect the morphometry of the mucosa because of its close as...
journal_title:Surgical infections
pub_type: 杂志文章
doi:10.1089/sur.2009.066
更新日期:2010-10-01 00:00:00
abstract:BACKGROUND:Fungal sinusitis has been reported increasingly in immunocompetent patients. However, the most effective, appropriate mode of therapy has not been determined. MATERIALS AND METHODS:In this retrospective study, we examined the records of 110 immunocompetent patients with chronic sinusitis who had undergone s...
journal_title:Surgical infections
pub_type: 杂志文章
doi:10.1089/109629603766956997
更新日期:2003-07-01 00:00:00
abstract:: Background: Catheter-associated urinary tract infections (CAUTIs) are associated with urinary catheterization. Up to 25% of hospitalized patients may be catheterized during their stay. Urethral catheters are necessary as part of many urologic procedures, but the removal of...
journal_title:Surgical infections
pub_type: 杂志文章
doi:10.1089/sur.2020.223
更新日期:2020-10-22 00:00:00
abstract:BACKGROUND AND AIM:Infection or bleeding after transrectal prostate biopsy remains a concern of both patients and urologists. We explored the risk of association of certain co-morbidities with both complications. PATIENTS AND METHODS:Using the Taiwan National Health Insurance Research Database, we identified patients ...
journal_title:Surgical infections
pub_type: 杂志文章
doi:10.1089/sur.2018.174
更新日期:2019-04-01 00:00:00
abstract:BACKGROUND:In recent years, there has been a worldwide increase in infections caused by microorganisms resistant to multiple antimicrobial agents. METHODS:In the past few decades, an increased prevalence of infections caused by antibiotic-resistant pathogens, including Enterococcus spp., carbapenem-resistant Pseudomon...
journal_title:Surgical infections
pub_type: 杂志文章,评审
doi:10.1089/sur.2013.262
更新日期:2015-06-01 00:00:00
abstract:BACKGROUND:Nocardia farcinica is a gram-positive, partially acid-fast, methenamine silver-positive aerobic actinomycete. Nocardia spp. are opportunistic pathogens, and N. farcinica is the least common species of clinical importance. METHODS:Review of the recent literature and description of a immunocompetent patient w...
journal_title:Surgical infections
pub_type: 杂志文章,评审
doi:10.1089/sur.2011.012
更新日期:2012-06-01 00:00:00
abstract:BACKGROUND:Purpura fulminans (PF) is a rare but lethal complication of severe infection. Aggressive surgical debridement of irreversibly devitalized tissue improves survival frequently at the cost of disfigurement. The ethical dilemma of surrogate decision-making for these often incapacitated patients presents a unique...
journal_title:Surgical infections
pub_type: 杂志文章
doi:10.1089/sur.2013.223
更新日期:2014-12-01 00:00:00
abstract:BACKGROUND:By definition, the term "surgical infection" implies that surgery plays the major role in therapy, whereas antimicrobial chemotherapy is only supplementary. Despite this view, the efficacy of such drugs is relevant, and for this reason, drug activity surveillance is necessary, especially for opportunistic an...
journal_title:Surgical infections
pub_type: 杂志文章
doi:10.1089/sur.2006.7.269
更新日期:2006-06-01 00:00:00
abstract:BACKGROUND:Group A streptococcal necrotizing soft-tissue infection with toxic shock is a life-threatening disease. Corticosteroid use in the treatment of this process has been reported rarely. METHOD:Case reports and review of pertinent literature. RESULTS:Two infections caused by the same clonal strain of Streptococ...
journal_title:Surgical infections
pub_type: 杂志文章
doi:10.1089/sur.2010.035
更新日期:2011-02-01 00:00:00
abstract:BACKGROUND:Staphylococcus aureus nasal carriage is an independent risk factor for developing nosocomial infections and for developing surgical site infection (SSI) in particular. The number of post-operative nosocomial S. aureus infections can be reduced by screening patients and decolonizing nasal carriers. In additio...
journal_title:Surgical infections
pub_type: 杂志文章
doi:10.1089/sur.2014.022
更新日期:2015-04-01 00:00:00
abstract:: Background: Implanting hardware into surgical sites increases the rate of infection associated with these sites. Without novel efforts to reduce this rate of infection, we can expect to see an increase in the number of hardware-associated infections as more patients are im...
journal_title:Surgical infections
pub_type: 杂志文章
doi:10.1089/sur.2019.075
更新日期:2020-05-01 00:00:00
abstract:BACKGROUND:Surgical site infections are the third most common healthcare-associated infection, often leading to prolonged hospital stay and excessive expenditures. Management of these infections has become more challenging due to rising rates of multi-drug-resistant organisms and few new antibiotic options. METHODS:Th...
journal_title:Surgical infections
pub_type: 杂志文章,评审
doi:
更新日期:2005-01-01 00:00:00
abstract:BACKGROUND:Nucleated red blood cells (NRBCs) are present in certain non-oncologic disease states and are associated with a poor prognosis. The purpose of this study was to evaluate NRBCs as an early prognostic marker for death in patients with surgical sepsis. METHODS:Retrospective evaluation of data collected prospec...
journal_title:Surgical infections
pub_type: 杂志文章
doi:10.1089/sur.2011.089
更新日期:2012-12-01 00:00:00
abstract:BACKGROUND:Implant infections represent a relevant problem after immediate breast cancer reconstruction. In addition to difficulties in distinguishing early infections from other post-surgical complications (such as hematoma, seroma, and liponecrosis) late breast implant infections still represent a grey area of our kn...
journal_title:Surgical infections
pub_type: 杂志文章
doi:10.1089/sur.2014.146
更新日期:2015-10-01 00:00:00
abstract:BACKGROUND:Mycobacterium avium-intracellulare (MAI) is a well-described pathogen in patients with acquired immune deficiency syndrome (AIDS). However, peritonitis and severe sepsis as a complication of disseminated MAI is rare. We report a case that represents the first successful use of recombinant human activated pro...
journal_title:Surgical infections
pub_type: 杂志文章
doi:10.1089/sur.2007.050
更新日期:2008-06-01 00:00:00