Abstract:
BACKGROUND:The pathogenicity of Enterococcus in polymicrobial surgical infections is controversial. The objective of this analysis was two-fold. The impact of Enterococcus on clinical outcome was assessed in adults with complicated intra-abdominal (IAI), complicated skin and skin structure (CSSSI), or acute pelvic (PI) infection treated with ertapenem or piperacillin-tazobactam, which is more active in vitro against enterococci than ertapenem. Baseline characteristics were identified that were associated with Enterococcus infection and with treatment failure. METHODS:This analysis included 1,558 patients treated in three randomized, triple-blind studies. Of these patients, 223 had Enterococcus in initial cultures: 125 of 623 (20%) with IAI, 28 of 529 (5%) with CSSSI, and 70 of 406 (17%) with PI. Logistic regression models were fit to assess each objective. RESULTS:The cure rates for the two treatment groups were similar in each of the three studies, regardless of the presence or absence of Enterococcus. Cure rates for both treatment groups combined were significantly lower in patients with Enterococcus than without Enterococcus for IAI (76% [69/91] versus 87% [264/305], OR 2.3 [95% CI, 1.2-4.1], P = 0.009) and CSSSI (58% [11/19] versus 84% [241/287], OR 3.8 [95% CI, 1.5-10.0], P = 0.010); but for PI, rates were similar (96% [50/52] versus 92% [188/205], OR 0.4 [95% CI, 0.1-1.9], P = 0.220). Characteristics predictive of the presence of Enterococcus were Pseudomonas aeruginosa as a baseline pathogen for IAI, older age, and the presence of a complicating underlying disease for CSSSI, and infection severity rated moderate rather than severe for PI. The strongest predictors of treatment failure were >2 days postoperative infection at study entry for patients with IAI and older age for patients with CSSSI. CONCLUSION:Choice of antimicrobial therapy did not affect cure rates in patients with or without Enterococcus. The strongest predictors of failure were postoperative infection at study entry in patients with IAI and older age in patients with CSSSI.
journal_name
Surg Infect (Larchmt)journal_title
Surgical infectionsauthors
Teppler H,McCarroll K,Gesser RM,Woods GLdoi
10.1089/109629602762539553subject
Has Abstractpub_date
2002-01-01 00:00:00pages
337-49issue
4eissn
1096-2964issn
1557-8674journal_volume
3pub_type
临床试验,杂志文章,多中心研究,随机对照试验abstract:BACKGROUND:Over the last half-decade, substantial breakthroughs have taken place in terms of routine therapy of critically ill patients. The combination of these strategies has the potential to result in improvement in the overall outcomes for patients in intensive care units. METHODS:A focused review was undertaken o...
journal_title:Surgical infections
pub_type: 杂志文章,评审
doi:10.1089/sur.2004.5.289
更新日期:2004-10-01 00:00:00
abstract:BACKGROUND:The prevalence of human immunodeficiency virus (HIV) is disproportionately elevated in trauma patients. Although HIV traditionally has been associated with poorer outcomes among the critically ill, recent evidence suggests that the outcomes of surgical patients have improved with the greater use of antiretro...
journal_title:Surgical infections
pub_type: 杂志文章
doi:10.1089/sur.2008.050
更新日期:2010-02-01 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:The Gatti score is a weighted scoring system based on risk factors for deep sternal wound infection (DSWI) that was created in an Italian center to predict DSWI risk after bilateral internal thoracic artery (BITA) grafting. No external evaluation based on validation samples derived from other surgical center...
journal_title:Surgical infections
pub_type: 杂志文章
doi:10.1089/sur.2016.150
更新日期:2017-02-01 00:00:00
abstract:: Background: In past decades, surgical site infections (SSIs) were neglected and not given much global attention in low- and middle-income countries (LMICs). The risk and incidence of SSIs in LMICs continue to increase. Methods: ...
journal_title:Surgical infections
pub_type: 杂志文章
doi:10.1089/sur.2020.006
更新日期:2020-08-01 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:Invasive mucormycosis or aspergillosis is a life-threatening infection. The disease typically occurs in immunocompromised patients (e.g., those with diabetes mellitus or burns) but is rarely serious in otherwise-healthy young trauma patients. METHODS:Case report and literature review. RESULTS:A previously-...
journal_title:Surgical infections
pub_type: 杂志文章
doi:10.1089/sur.2010.065
更新日期:2011-10-01 00:00:00
abstract:: Background: Skin and soft tissue infection (SSTI) after hernia surgery is infrequent yet catastrophic and is associated with mesh infection, interventions, and hernia recurrence. Although hernia repair is one of the most common general surgery procedures, uncertainty persi...
journal_title:Surgical infections
pub_type: 杂志文章
doi:10.1089/sur.2020.354
更新日期:2020-12-01 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 approach to perioperative antibiotic prophylaxis, bowel preparation, and postoperative routines in elective colorectal resections has changed over the last two decades. The aim of this national survey was to document the current methods of perioperative management of those patients scheduled for elective...
journal_title:Surgical infections
pub_type: 杂志文章
doi:10.1089/sur.2005.6.305
更新日期:2005-10-01 00:00:00
abstract:BACKGROUND:Temporary intra-operative portocaval shunts (TPCS) are believed to improve outcomes after cava-sparing liver transplantation. We hypothesize that decompression of the portal venous system via a TPCS reduces gut congestion, thereby decreasing bacterial translocation. Thus, we sought to clarify whether transpl...
journal_title:Surgical infections
pub_type: 杂志文章
doi:10.1089/sur.2017.036
更新日期:2017-10-01 00:00:00
abstract:BACKGROUND:Controversy continues to exist regarding the immunomodulatory effects of cellular blood transfusions in the fields of oncology, transplantation, and infectious diseases. Numerous studies have correlated transfusion with hospital-acquired infection, but the impact of transfusion on infection-related mortality...
journal_title:Surgical infections
pub_type: 杂志文章
doi:10.1089/109629603322761391
更新日期:2003-01-01 00:00:00
abstract:BACKGROUND AND PURPOSE:The exact mechanism of fever and urosepsis after percutaneous procedures has not been established. This research studied the frequency of fever after percutaneous nephrolithotomy (PCNL) and the contributing factors. METHODS:In a cross-sectional study, from September 2003 to March 2004, all 217 p...
journal_title:Surgical infections
pub_type: 杂志文章
doi:10.1089/sur.2006.7.367
更新日期:2006-08-01 00:00:00
abstract:BACKGROUND:Negative-pressure wound therapy (NPWT) has been suggetsed to have a positive impact on the healing of sternal or extremity wounds. However, few data deriving from breast surgery have been published. We evaluated the available literature regarding the effectiveness of NPWT systems in the healing of breast tis...
journal_title:Surgical infections
pub_type: 杂志文章,评审
doi:10.1089/sur.2013.165
更新日期:2014-12-01 00:00:00
abstract:BACKGROUND:The Surviving Sepsis Campaign (SSC) was launched in 2002 as a collaborative initiative of the European Society of Intensive Care Medicine (ESICM), the International Sepsis Forum (ISF), and the Society of Critical Care Medicine (SCCM). Its objective was, through the development and promulgation of evidence-ba...
journal_title:Surgical infections
pub_type: 杂志文章,评审
doi:10.1089/sur.2010.024
更新日期:2010-06-01 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:Intra-abdominal infection may lead to adhesion and abscess formation. An adhesion barrier can reduce these complications but also aggravate intra-peritoneal infection, causing the opposite effects. The fear of infection propagation has limited clinical adhesion barrier use in a contaminated or infected abdom...
journal_title:Surgical infections
pub_type: 杂志文章
doi:10.1089/sur.2014.111
更新日期:2015-08-01 00:00:00
abstract:BACKGROUND:We reported similar rates of ventilator-associated pneumonia (VAP) previously in trauma patients intubated either in a pre-hospital (PH) venue or the emergency department. A subset of PH intubations with continuous quality assessment was re-examined to identify the intubation factors associated with VAP. ME...
journal_title:Surgical infections
pub_type: 杂志文章
doi:10.1089/sur.2010.074
更新日期:2011-10-01 00:00:00
abstract:BACKGROUND:Blood stream infections (BSIs) remain as a serious life-threatening condition after solid organ transplant (SOT). In recent years, a progressive growth in the incidence of bacteremia caused by non-lactose fermenting gram-negative bacilli (NLF GNB) has been observed. NLF GNB led to high mortality among SOT re...
journal_title:Surgical infections
pub_type: 杂志文章,评审
doi:10.1089/sur.2015.005
更新日期:2015-10-01 00:00:00
abstract:BACKGROUND:We defined the contemporary conversion rate from laparoscopic appendectomy (LA) to open appendectomy and identified pre-operative factors associated with conversion. METHODS:Retrospective review of 941 consecutive LAs performed for suspected acute appendicitis in a single urban university hospital between 2...
journal_title:Surgical infections
pub_type: 杂志文章
doi:10.1089/sur.2010.079
更新日期:2011-08-01 00:00:00
abstract:BACKGROUND:The utility of hyperbaric oxygen therapy (HBOT) in the treatment of necrotizing soft tissue infections (NSTIs) has not been proved. Previous studies have been subject to substantial selection bias because HBOT is not available universally at all medical centers, and there is often considerable delay associat...
journal_title:Surgical infections
pub_type: 杂志文章
doi:10.1089/sur.2012.135
更新日期:2014-06-01 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:We identified recently esophageal cancer related gene-4 (ECRG4) as a candidate cytokine that is expressed on the surface of quiescent polymorphonuclear leukocytes (PMNs) and shed in response to ex vivo treatment with lipopolysaccharide. To investigate the potential biologic relevance of changes in cell surfa...
journal_title:Surgical infections
pub_type: 杂志文章
doi:10.1089/sur.2014.209
更新日期:2015-12-01 00:00:00
abstract:BACKGROUND:We aim to assess the patient factors and concomitant infectious outcomes associated with urinary tract infection (UTI) occurrence and the impact of UTI on length of stay (LOS), re-admission, and death in a colorectal surgical population. PATIENTS AND METHODS:National Surgical Quality Improvement Program Use...
journal_title:Surgical infections
pub_type: 杂志文章
doi:10.1089/sur.2016.282
更新日期:2017-07-01 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:Computed tomography (CT) is used increasingly to evaluate suspected cases of acute appendicitis (AA) in the emergency department (ED). This prospective study was performed to test the hypothesis that the evaluation of AA by CT in the ED remains suboptimal and that erroneous interpretation diminishes its util...
journal_title:Surgical infections
pub_type: 杂志文章
doi:10.1089/109629601317202687
更新日期:2001-10-01 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:Pyomyositis (PY) is a primary infection of the skeletal muscles, leading to inflammation of the muscle fibers followed by pus formation and even necrosis in late stages. Because of overlap in presentation of intermuscular abscess (IM) and PY, the exact incidence and severity of PY is under-appreciated. PATI...
journal_title:Surgical infections
pub_type: 杂志文章
doi:10.1089/sur.2015.191
更新日期:2016-10-01 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:Implant infection is a common clinical complication of abdominal hernia repair. Our objectives were to determine if acellular dermal matrix (ADM) grafts resisted Staphylococcus aureus infection better (as measured by ability to reduce or clear bacterial counts) than synthetic (polytetrafluoroethylene [PTFE])...
journal_title:Surgical infections
pub_type: 杂志文章
doi:10.1089/sur.2007.044
更新日期:2008-08-01 00:00:00