Abstract:
BACKGROUND:Multi-drug resistant (MDR) organisms in intensive care units (ICUs) are a growing concern. The emergence of several infections with MDR Acinetobacter baumannii prompted a review of cases and evaluation of the efficacy of intervention. OBJECTIVE:To determine the rate of clinical cure, the incidence of drug resistance, and the mortality rate associated with A. baumannii infection. METHOD:Retrospective review of A. baumannii infections in three surgical ICUs between January, 2004 and November, 2005. Infection was identified in 291 patients, 20 of whom were excluded because of incomplete documentation. Of the remaining 271 patients, 71% were male, and the mean age was 47 +/- 18 years (range 13-90 years). RESULTS:Patients had a mean length of stay in the ICU of 14 days (range 0-136 days) before infection. The initial positive cultures were from bronchoalveolar lavage fluid (BAL) in 72.3%, blood in 16.2%, a catheter tip in 6.3%, urine in 1.8%, wound in 2.2%, and abscess in 1.1%. In 46.9% of patients, the first culture was polymicrobial. The Acinetobacter isolates were resistant or intermediate-resistant to imipenem-cilastatin in 81.2% of cases; 19.9% were resistant to all drugs except colistin, and two were resistant to all tested drugs. Colistin was used in 75.6% of patients (intravenous 61.5%, nebulized 38.5%). The mean duration of treatment was 13 +/- 8.9 days (range 0-56 days), and clinical cure was achieved in 73.8% of patients. Recurrent infection after initial cure was found in 19.2% of patients. There was no significant difference in clinical cure rates between patients treated with colistin and those treated with other culture-directed drugs (75.1% vs. 69.7%), or between patients treated with intravenous vs. nebulized colistin (72.4% vs. 79.5%). The mortality rate was 26.2% for the entire group and was significantly higher in the subgroup of transplant patients (n = 31) (64.5% vs. 21.4%; p < 0.001). CONCLUSION:The majority of A. baumannii isolates were MDR, and a significant proportion were sensitive only to colistin. Treatment of A. baumannii infection with colistin is effective by both intravenous and nebulized routes of administration. However, infection with A. baumannii in critically ill surgical patients is associated with a high mortality rate, particularly in transplant patients.
journal_name
Surg Infect (Larchmt)journal_title
Surgical infectionsauthors
Trottier V,Namias N,Pust DG,Nuwayhid Z,Manning R,Marttos AC Jr,Dunham MB,Schulman CI,McKenney MGdoi
10.1089/sur.2006.029subject
Has Abstractpub_date
2007-08-01 00:00:00pages
437-43issue
4eissn
1096-2964issn
1557-8674journal_volume
8pub_type
杂志文章abstract:BACKGROUND:Colorectal surgical procedures have a high rate of surgical site infection (SSI), and obesity has been implicated as a predictor of such infection. We hypothesized that abdominal wall thickness (AWT), as a metric of obesity, would predict postoperative superficial and deep incisional SSI after colorectal sur...
journal_title:Surgical infections
pub_type: 杂志文章
doi:10.1089/sur.2012.109
更新日期:2013-08-01 00:00:00
abstract:: Background: Within the United States, surgical site infections (SSIs) have now become the most common hospital-acquired infection and impact 2%-5% of all surgical patients. It is estimated that approximately 60% of SSIs could be prevented through improved adherence to pre-...
journal_title:Surgical infections
pub_type: 杂志文章
doi:10.1089/sur.2019.135
更新日期:2019-10-01 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: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: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: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:Prosthetic mesh is employed routinely in the treatment of ventral and parastomal hernias, but its use can lead to major complications, including infection, extrusion, and fistula. Bacterial biofilms have been posited to play a role in mesh-related infection, but although bacteria have been noted to form biof...
journal_title:Surgical infections
pub_type: 杂志文章
doi:10.1089/sur.2014.026
更新日期:2015-02-01 00:00:00
abstract:BACKGROUND:This report is a review of the published literature for studies of triclosan that address mechanism of action, efficacy on skin and in the oral cavity, and the potential for development of resistance. METHODS:Triclosan citations from the past three decades were searched using Medline and other search engine...
journal_title:Surgical infections
pub_type: 杂志文章,评审
doi:10.1089/sur.2002.3.s1-55
更新日期:2002-01-01 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:PURPOSE:To discover the incidence of postoperative surgical site infections in non-immunocompromised pediatric patients with an absolute neutrophil count (ANC) < or = 1,000 preoperatively. METHODS:Office and hospital charts of consecutive patients with preoperative ANC < or = 1,000 undergoing elective surgery over a t...
journal_title:Surgical infections
pub_type: 杂志文章
doi:10.1089/sur.2006.085
更新日期:2008-04-01 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:Ventilator-associated pneumonia (VAP) is a common complication of critical illness among surgical and trauma patients. Inappropriate empiric treatment of VAP increases the mortality rate. The rates of Pseudomonas aeruginosa (PA) VAP susceptibility to doripenem (DOR) are higher than those to imipenem-cilastat...
journal_title:Surgical infections
pub_type: 杂志文章
doi:10.1089/sur.2009.076
更新日期:2010-10-01 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:The incidence and consequences of post-operative infections in patients undergoing major elective surgery is not well understood. METHODS:Using a large U.S. healthcare claims database, we identified all patients who underwent major elective surgery between January 1, 2007, and December 31, 2009. For each su...
journal_title:Surgical infections
pub_type: 杂志文章
doi:10.1089/sur.2012.200
更新日期:2014-06-01 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:Superficial surgical site infection (SSI) can be caused by bacterial invasion during surgery. We investigated whether bacteria are found at the wound margin during surgery and whether a wound protector (WP; Alexis® Wound Retractor; Applied Medical, Rancho Santa Margarita, CA) contributes to preventing invasi...
journal_title:Surgical infections
pub_type: 杂志文章
doi:10.1089/sur.2009.072
更新日期:2010-12-01 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 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: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:Appendectomy for acute appendicitis is an effective, universally accepted procedure performed more than 300,000 times annually in the United States. It is generally believed that appendicitis progresses invariably from early inflammation to later gangrene and perforation, and that appendectomy is required fo...
journal_title:Surgical infections
pub_type: 杂志文章,评审
doi:10.1089/sur.2007.079
更新日期:2008-08-01 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: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: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: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: Operating room (OR) traffic and door openings have emerged as potential modifiable risk factors for the development of surgical site infections. Methods: This study compared the microbial load of a Control OR withou...
journal_title:Surgical infections
pub_type: 杂志文章
doi:10.1089/sur.2020.361
更新日期:2020-12-23 00:00:00
abstract:OBJECTIVE:This report presents a case of femoral osteomyelitis secondary to urinary tract infection in a female neonate with bilateral urinary duplication and right ectopic ureterocele. METHODS:A female neonate with a history of late perinatal sepsis presented to the emergency department and was found to have left dis...
journal_title:Surgical infections
pub_type: 杂志文章
doi:10.1089/sur.2009.075
更新日期:2011-02-01 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:Although there are some commonalities between pediatric and adult sepsis, there are important differences in pathophysiology, clinical presentation, and therapeutic approaches. The recognition and diagnosis of sepsis is a significant challenge in pediatric patients as vital sign aberrations and examination f...
journal_title:Surgical infections
pub_type: 杂志文章,评审
doi:10.1089/sur.2017.316
更新日期:2018-02-01 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:: 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