Abstract:
BACKGROUND:Patients with serious intraabdominal infections (IAI) who subsequently acquire nosocomial infections (NI) have been shown to have adverse outcomes. We evaluated factors that put patients at risk for developing NI and examined the effect of the NI on outcomes. METHODS:This study was a retrospective review of NI among 168 patients diagnosed with IAI over a seven-year period. RESULTS:Sixty-six patients (39.3%) developed 98 NI (23 urinary tract, 20 surgical site, 19 pneumonia, 14 bloodstream, 12 recurrent peritonitis, seven intravascular catheter-related, and three enteric). There were 35 males and 31 females. Patients with NI were older (56.0 +/- 18.3 vs. 47.0 +/- 15.6 years, p = 0.001), had a higher admission APACHE II score (10.7 +/- 6.1 vs. 7.5 +/- 5.1 points, p = 0.001), and more often had concomitant medical diagnoses (27.3% vs. 12.7%, OR = 2.57, 95% CI: 1.159-5.69, p = 0.018) than those who did not develop infection. Antimicrobial resistance among the IAI was higher in the NI group (19.7 vs. 5.9%, OR = 3.93, 95% CI: 1.41-10.93, p = 0.006). Patients who developed NI had an increased mortality rate (27.0% vs. 4.0%, OR = 8.87, 95% CI: 2.82-27.86, p < or = 0.0001), longer hospital stay (24.7 +/- 19.5 vs. 11.7 +/- 8.1 days, p < or = 0.0001), required more days of intravenous antibiotics (11.5 +/- 8.0 vs. 7.6 +/- 4.4 days, p < or = 0.0001), and were more likely to be admitted to an intensive care unit (54.5% vs. 25.5%, OR = 3.51, 95% CI: 1.82-6.77, p < or = 0.0001). Multivariate analysis demonstrated that antimicrobial resistance and an APACHE II score of > or = 10 independently predicted the development of a nosocomial infection. Age >/= 50 years, APACHE II score > or = 10, or the presence of a NI independently predicted death. CONCLUSIONS:The development of NI following treatment of an IAI significantly affects mortality, hospital length of stay, and treatment. Early recognition and treatment of these infections, combined with strategies to prevent NI, may be important to improve outcomes in this patient population.
journal_name
Surg Infect (Larchmt)journal_title
Surgical infectionsauthors
Merlino JI,Yowler CJ,Malangoni MAdoi
10.1089/109629604773860273subject
Has Abstractpub_date
2004-04-01 00:00:00pages
21-7issue
1eissn
1096-2964issn
1557-8674journal_volume
5pub_type
杂志文章abstract:BACKGROUND:A substantial proportion of operative procedures are complicated by infections, either remote from or related to the surgical site. These infections account for substantive morbidity and health care costs. With limited research funds available to study interventions designed to either prevent or reduce the m...
journal_title:Surgical infections
pub_type: 杂志文章
doi:10.1089/sur.2006.7.101
更新日期:2006-04-01 00:00:00
abstract:BACKGROUND:The optimal duration of antimicrobial therapy for treatment of complicated intra-abdominal infections (cIAI) in critically ill surgical patients is unknown. Recent evidence suggests that a short (four-day) course of therapy may be effective, however data in severely critically ill patients are limited. PATI...
journal_title:Surgical infections
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abstract:: Background: This study was performed to investigate the combination of admission serum procalcitonin (PCT) and albumin (alb) concentrations as a diagnostic predictor for discriminating patients with nosocomial blood stream infection (BSI) among those with spontaneous intra...
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abstract:BACKGROUND:Intestinal fatty acid binding protein (iFABP) is elevated in plasma by intestinal injury. We investigated the influence of surgical trauma and severe sepsis caused by abdominal and pulmonary infection on plasma iFABP concentrations. METHODS:Seventy-nine patients were included in this prospective observation...
journal_title:Surgical infections
pub_type: 杂志文章
doi:10.1089/sur.2014.073
更新日期:2015-06-01 00:00:00
abstract:BACKGROUND:We investigated the clinical effectiveness of antimicrobial prophylaxis in lower-extremity open fractures following the Eastern Association for the Surgery of Trauma Guidelines. METHODS:This observational, retrospective, single-center study included adults with lower-extremity open fractures of the ankle, t...
journal_title:Surgical infections
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更新日期:2017-04-01 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
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更新日期:2014-12-01 00:00:00
abstract:BACKGROUND:Surgical site infection (SSI) surveillance has become increasingly important during the peri-operative period of esophagectomy with cervical anastomosis (McKeown esophagectomy). This study sought to clarify the risk factors for SSI and to develop a stratification scoring system to predict SSI after esophagec...
journal_title:Surgical infections
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更新日期:2018-10-01 00:00:00
abstract:BACKGROUND:There has not been an appraisal of outcomes of appendectomy for more than 10 years. More reliable diagnostic techniques and minimally invasive surgery are now in widespread use, yet the impact of these advances remains unknown. METHODS:A retrospective review was performed of 453 patients who underwent appen...
journal_title:Surgical infections
pub_type: 杂志文章
doi:10.1089/sur.2011.104
更新日期:2012-06-01 00:00:00
abstract:BACKGROUND:The designation "gram-positive bacillus" includes a variety of pleomorphic microorganisms, including diphtheroids, coryneform species, coccobacilli, and other small rods. Despite differing greatly in their virulence, sources, and even genus, these microscopically similar organisms are often difficult to diff...
journal_title:Surgical infections
pub_type: 杂志文章,评审
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更新日期:2010-02-01 00:00:00
abstract:BACKGROUND:Orbital hydatidosis is rare, accounting for only 1% of all hydatid cysts. Herein we report a case and review the sparse literature. METHODS:Case report and review of pertinent literature. RESULTS:A 74-year-old farmer presented with progressive proptosis and loss of vision of the left eye. Evaluation reveal...
journal_title:Surgical infections
pub_type: 杂志文章,评审
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journal_title:Surgical infections
pub_type: 杂志文章
doi:10.1089/sur.2015.266
更新日期:2017-02-01 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: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:Deep sternal incisional surgical site infection is a serious and potentially life-threatening complication after open heart surgery. Although a rare post-operative complication, the rates of post-operative morbidity and mortality are greater in patients who develop a deep sternal incisional surgical site inf...
journal_title:Surgical infections
pub_type: 杂志文章
doi:10.1089/sur.2013.245
更新日期:2014-12-01 00:00:00
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:Pre-existing humoral barriers challenge the transplantation of living donor kidneys (LDK) into highly sensitized ABO- and human leukocyte antigen (HLA)-incompatible recipients. Conditioning these LDK recipients' immune systems is required before they undergo transplantation. We hypothesized that medical dese...
journal_title:Surgical infections
pub_type: 杂志文章
doi:10.1089/sur.2012.231
更新日期:2014-06-01 00:00:00
abstract:BACKGROUND:The Donor Risk Index (DRI) is used to predict graft survival following liver transplantation, but has not been used to predict post-operative infections in graft recipients. We hypothesized that lower-quality grafts would result in more frequent infectious complications. METHODS:Using a prospectively collec...
journal_title:Surgical infections
pub_type: 杂志文章
doi:10.1089/sur.2013.035
更新日期:2014-04-01 00:00:00
abstract:: Background: The greatest burden of sepsis- and septic shock-related morbidity and mortality is in low- and middle-income countries (LMICs). Accurate tracking of incidence and outcomes of patients in LMICs with sepsis has been limited by changing definitions, lack of diagno...
journal_title:Surgical infections
pub_type: 杂志文章
doi:10.1089/sur.2020.047
更新日期:2020-09-01 00:00:00
abstract:BACKGROUND:An untreated hand infection can lead rapidly to tissue destruction and permanent disability. METHODS:Review of the pertinent English literature. RESULTS:Early diagnosis and timely, effective intervention is crucial to treatment. Anatomically, the hand consists of multiple potential spaces and tissue planes...
journal_title:Surgical infections
pub_type: 杂志文章,评审
doi:10.1089/sur.2004.5.210
更新日期:2004-07-01 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:There is a paucity of data regarding whether sterile handling of endotracheal tubes (ETTs) impacts the incidence and prevalence of pneumonia in the emergency, urgent, or elective clinical scenarios. Intensive care units employ infection control and reduction schemes to reduce pneumonia rates. METHODS:A MEDL...
journal_title:Surgical infections
pub_type: 杂志文章,评审
doi:10.1089/sur.2006.054
更新日期:2007-10-01 00:00:00
abstract:BACKGROUND:The use of silver for the treatment of various maladies or to prevent the transmission of infection dates back to at least 4000 b.c.e. Medical applications are documented in the literature throughout the 17th and 18th centuries. The bactericidal activity of silver is well established. Silver nitrate was used...
journal_title:Surgical infections
pub_type: 杂志文章,评审
doi:10.1089/sur.2011.097
更新日期:2013-02-01 00:00:00
abstract:BACKGROUND:Chronic pancreatitis is a painful and often debilitating disease. Total pancreatectomy with intra-portal islet autotransplantation (TP-IAT) is a treatment option that allows for pain relief and preservation of beta-cell mass, thereby minimizing the complication of diabetes mellitus. Cultures of harvested isl...
journal_title:Surgical infections
pub_type: 杂志文章
doi:10.1089/sur.2013.224
更新日期:2015-04-01 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:Surgical site infection (SSI) continues to be a common if often times preventable infection. Considerable patient morbidity and economic cost are the consequences. METHODS:Review of the pertinent English-language literature. RESULTS:The National Surgical Infection Prevention (SIP) Project was an initiative...
journal_title:Surgical infections
pub_type: 杂志文章
doi:10.1089/sur.2008.9951
更新日期:2008-12-01 00:00:00
abstract:BACKGROUND:Severe trauma leads to hematopoietic failure and bone marrow (BM) dysfunction that manifests clinically as a persistent anemia and leukopenia. The impact of severe trauma and its associated hyperadrenergic state on erythropoiesis has not been described. The aim of this study was to demonstrate the effects of...
journal_title:Surgical infections
pub_type: 杂志文章
doi:10.1089/sur.2004.5.385
更新日期:2004-01-01 00:00:00
abstract:: Background: Multi-drug resistance is considered a serious health threat particularly in the intensive care unit (ICU) setting. Studies evaluating multi-drug-resistant (MDR) pathogens in critically ill trauma patients are limited. The objectives were to describe the inciden...
journal_title:Surgical infections
pub_type: 杂志文章
doi:10.1089/sur.2019.031
更新日期:2020-02-01 00:00:00
abstract:: Background: The use of mechanical bowel preparation and prophylaxis with oral antimicrobial agents can prevent surgical site infection (SSI) in colorectal surgical procedures, but routine adoption of these and other practices by surgeons has been limited. The aim of this s...
journal_title:Surgical infections
pub_type: 杂志文章
doi:10.1089/sur.2019.203
更新日期:2020-04-01 00:00:00
abstract:BACKGROUND:Selection of a pre-operative hand antisepsis agent has not been studied in relation to surgical site infection (SSI) culture data. In our hospital, we introduced an alcohol-based hand rub (ABR) in 2012 as an alternative to traditional aqueous surgical scrubs (TSS). It was the goal of this study to review any...
journal_title:Surgical infections
pub_type: 杂志文章
doi:10.1089/sur.2016.125
更新日期:2017-05-01 00:00:00
abstract:BACKGROUND:Bacterial infections are a well-known complication of traumatic amputations. In cases involving contact with soil or water contaminated with manure, one also must be aware of infections with fungi, particularly Scedosporium spp. We report on an immunocompetent trauma patient with an infection caused by a rec...
journal_title:Surgical infections
pub_type: 杂志文章
doi:10.1089/sur.2006.038
更新日期:2007-12-01 00:00:00