Abstract:
BACKGROUND:Conceptually, appropriateness of antibiotic therapy includes choice of agent relative to susceptibility of pathogens as well as dosing, timing of onset, and duration of therapy, but is most commonly considered in terms of choice of antibiotic. It has been suggested that inappropriate antibiotic selection can result in increased mortality. This study was performed to elucidate the role of scheduled, rotating antibiotic therapy in defining mortality among febrile, infected surgical ICU patients. METHODS:Prospective inception-cohort study of 356 patients during their initial episode of fever (temperature > 38.2 degrees C), caused by infection diagnosed by positive cultures or direct inspection (some cases of peritonitis). Collected data included age, gender, admission APACHE III score, peak temperature, microbial isolates and susceptibility, source of infection, multiple organ dysfunction score, mortality, and several time intervals (time that cultures were collected, time from collection to antibiotic prescription, time from collection to antibiotic administration, duration of therapy). RESULTS:The mean age was 63 +/- 1 years, the mean APACHE III score was 74 +/- 2 points, the mean multiple organ dysfunction score was 8 +/- 1 points, and overall mortality was 31%. Neither the source of infection nor the specific isolate influenced mortality. Antibiotic therapy was appropriate (covered the isolates) in 94% of cases, and did not influence mortality. Duration of therapy was identical between groups (5.1 +/- 0.3 vs. 5.4 +/- 0.3 days, p = 0.61). By logistic regression (dependent variable = mortality), APACHE III score OR 1.025, 95% C.I. 1.021-1.04) and delayed antibiotic administration (30-min intervals, OR 1.021, 95% C.I. 1.003-1.038) were independent predictors of mortality. CONCLUSIONS:The use of scheduled monthly antibiotic cycling in the surgical ICU is associated with a high rate of "appropriate" antibiotic therapy, and appears to maintain or improve resistance patterns. Because antibiotic therapy was mostly appropriate for isolates, initial inappropriate therapy could not be identified as a risk factor for mortality. However, in the setting of appropriate antibiotic choice, the prompt initial administration of antibiotics appears to be crucial for survival, but neither site of infection nor specific pathogen are influential.
journal_name
Surg Infect (Larchmt)journal_title
Surgical infectionsauthors
Barie PS,Hydo LJ,Shou J,Larone DH,Eachempati SRdoi
10.1089/sur.2005.6.41subject
Has Abstractpub_date
2005-04-01 00:00:00pages
41-54issue
1eissn
1096-2964issn
1557-8674journal_volume
6pub_type
杂志文章abstract:BACKGROUND:Implant-related infections in hand surgery are dreaded complications, potentially leading to loss of finger joint function or amputation. Knowledge about the clinical presentation and treatment concepts of these infections is limited. The aim of this study is to present a consecutive series of patients with ...
journal_title:Surgical infections
pub_type: 杂志文章
doi:10.1089/sur.2018.133
更新日期:2018-10-01 00:00:00
abstract:BACKGROUND:Nutritional status has major impacts on the outcome of surgery, in particular in patients with cancer. The aim of this review was to assess the merit of oral pre-operative nutritional support as a part of prehabilitation in patients undergoing surgery for colorectal cancer. METHODS:A systematic literature s...
journal_title:Surgical infections
pub_type: 杂志文章,meta分析,评审
doi:10.1089/sur.2017.143
更新日期:2018-01-01 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
doi:10.1089/sur.2009.019
更新日期:2010-08-01 00:00:00
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...
journal_title:Surgical infections
pub_type: 杂志文章
doi:10.1089/109629604773860273
更新日期:2004-04-01 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
doi:10.1089/sur.2008.085
更新日期:2010-02-01 00:00:00
abstract:BACKGROUND:An appendectomy is a contaminated or potentially dirty surgical procedure that can be associated with surgical site infection (SSI). METHODS:A single-center unblinded prospective cohort study examined the role of antimicrobial incise film drapes in lowering the rate of SSI after appendectomy. Any patient ag...
journal_title:Surgical infections
pub_type: 杂志文章
doi:10.1089/sur.2013.188
更新日期:2015-04-01 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:Musculoskeletal trauma represents a large source of morbidity in low and middle human development index countries (LMHDICs). Open reduction and internal fixation (ORIF) of traumatic long bone fractures definitively manages these injuries and restores function when conducted safely and effectively. Surgical s...
journal_title:Surgical infections
pub_type: 杂志文章,meta分析,评审
doi:10.1089/sur.2017.273
更新日期:2018-04-01 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: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: Post-operative central nervous system infections (PCNSIs) caused by extensively drug-resistant (XDR) or pan-drug-resistant (PDR) Acinetobacter baumannii are rare but intractable problems. To investigate a potential combined strategy to treat Acinetobacter bauma...
journal_title:Surgical infections
pub_type: 杂志文章
doi:10.1089/sur.2019.341
更新日期:2020-12-01 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: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: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: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: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: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:The pathophysiologic features of acute respiratory distress syndrome (ARDS) are attributed to neutrophil accumulation and over-activation. Low blood immunoglobulin G concentrations in septic shock patients are associated with higher risk of developing ARDS. This study showed the effects of intravenous immuno...
journal_title:Surgical infections
pub_type: 杂志文章
doi:10.1089/sur.2012.227
更新日期:2014-02-01 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 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: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 intensiv...
journal_title:Surgical infections
pub_type: 杂志文章
doi:10.1089/109629602760105808
更新日期:2002-07-01 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: 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: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 emergence of multi-drug resistant microorganisms presents a critical problem for patients undergoing surgery. Acidic pH, which is produced by oxidized regenerated cellulose (ORC), is a broad-spectrum physiological detriment to survival of microorganisms known to cause surgical infections. The purpose of ...
journal_title:Surgical infections
pub_type: 杂志文章
doi:10.1089/109629603322419599
更新日期:2003-10-01 00:00:00
abstract:BACKGROUND:Surgical site infections are reduced by appropriate and timely antimicrobial prophylaxis. Consensus guidelines recommend that antimicrobial infusion begin within 60 min prior to creation of the incision. An internal audit of our institution suggested poor guideline compliance. We hypothesized that the additi...
journal_title:Surgical infections
pub_type: 杂志文章
doi:10.1089/sur.2008.054
更新日期:2010-08-01 00:00:00
abstract:: Background: Hand infections can spread quickly and destroy functional structures. Early diagnosis and adequate therapy can prevent severe morbidities. The aim of this study was to evaluate systematically the spread of hand infections according to injury mechanism, pathogen...
journal_title:Surgical infections
pub_type: 杂志文章
doi:10.1089/sur.2020.035
更新日期:2020-07-28 00:00:00
abstract:: Background: Sarcopenia is a syndrome that can have negative consequences after gastric cancer (GC) surgery. This study aims to determine the effect of sarcopenia on surgical site infection (SSI) that develops after open GC surgery. Patients and Met...
journal_title:Surgical infections
pub_type: 杂志文章
doi:10.1089/sur.2020.211
更新日期:2020-11-11 00:00:00
abstract:BACKGROUND:Six hours from injury to washout is considered the gold standard in the treatment of open traumatic fractures. Despite this being our hospital policy, the rural nature of our Level I trauma center causes delays in discovery and transport, creating a unique randomization of time to washout. We hypothesized th...
journal_title:Surgical infections
pub_type: 杂志文章
doi:10.1089/sur.2010.075
更新日期:2011-10-01 00:00:00
abstract:BACKGROUND:To determine the effects of hypertonic saline (HS) as fluid resuscitation during or after major spinal surgery. We hypothesized that the administration of HS perioperatively would decrease morbidity and mortality rates. METHODS:A two-year retrospective, pair-matched, case-control study of adult patients (57...
journal_title:Surgical infections
pub_type: 杂志文章
doi:10.1089/sur.2005.069
更新日期:2008-02-01 00:00:00