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 differentiate without genetic testing. METHODS:We present a patient with necrotizing fasciitis and a review of the literature to exemplify and assess the scope of this diagnostic conundrum. Cultures taken intra-operatively during surgical debridement grew Morganella morganii and "diphtheroids." Given the low virulence of both organisms, the diphtheroids were reexamined microscopically and assayed for enzymatic activity. Genetic sequence analysis of 16S ribosomal ribonucleic acid (rRNA) was required for species identification. RESULTS:Microscopic inspection identified small, non-spore-forming, gram-positive rods, arranged in clusters, that formed circular, smooth colonies. These were facultatively anaerobic, catalase-negative, non-hemolytic, and unable to reduce nitrates. Standard techniques and assays were unable to identify our organism to species. Ultimately, 16S rRNA gene sequencing of 833 base pairs achieved a 99.04% species match to Arcanobacterium bernardiae. CONCLUSION:At our facility, diphtheroids are generally considered non-pathogenic contaminants in skin and soft tissue infections. The finding of A. bernardiae in necrotizing fasciitis is unusual and clinically important but would have been missed using conventional methods. As the "gram-positive bacillus" comes to include an ever-increasing number of organisms, genetic sequencing will probably be required more regularly for species identification. Furthermore, given that these genera are similar, often mistaken as contaminants, and difficult to differentiate using standard assays, they may often be missed and are possibly a more-frequent cause of complicated skin and soft tissue infections than the literature would suggest.
journal_name
Surg Infect (Larchmt)journal_title
Surgical infectionsauthors
Clarke TM,Citron DM,Towfigh Sdoi
10.1089/sur.2008.085subject
Has Abstractpub_date
2010-02-01 00:00:00pages
65-72issue
1eissn
1096-2964issn
1557-8674journal_volume
11pub_type
杂志文章,评审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: Fungal isolates from peritoneal fluid sampling in patients with perforated peptic ulcer (PPU) is not uncommon and its management unclear. This study aims to evaluate whether the presence of fungus in peritoneal fluid cultures is a predictor of morbidity and mor...
journal_title:Surgical infections
pub_type: 杂志文章
doi:10.1089/sur.2019.024
更新日期:2019-12-01 00:00:00
abstract:: Background: Gallstones and cholecystitis are common clinical problems. There is a wide spectrum of disease severity, from rare symptoms of biliary colic to severe cholecystitis with marked gallbladder infection and inflammation that can cause life-threatening sepsis. The c...
journal_title:Surgical infections
pub_type: 杂志文章
doi:10.1089/sur.2020.110
更新日期:2020-05-29 00:00:00
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: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: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: 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: Rates of infections with multi-drug-resistant organisms (MDROs) are increasing among critically ill patients. Among non-surgical patients, MDROs increase directly the risk of adverse secondary events including death. However, similar effects do not appear to oc...
journal_title:Surgical infections
pub_type: 杂志文章
doi:10.1089/sur.2019.240
更新日期:2020-06-01 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:Suppurative kidney infections (SKIs) have potentially lethal implications and a high incidence of treatment-related morbidity and death. Until this point, there has been no study that has derived a prognostic model for adverse early outcomes in SKI. Therefore, our aim was to derive and validate a simple scor...
journal_title:Surgical infections
pub_type: 杂志文章
doi:10.1089/sur.2010.057
更新日期:2011-04-01 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: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:Tracheostomy is one of the most common procedures performed in trauma patients in the intensive care unit (ICU). Few studies have evaluated the incidence of surgical site infections (SSIs) specifically in a trauma population. Our objective was to compare the incidence of SSI after open versus percutaneous tr...
journal_title:Surgical infections
pub_type: 杂志文章
doi:10.1089/sur.2011.059
更新日期:2013-02-01 00:00:00
abstract:BACKGROUND:It has been suggested that the damage observed in invasive amebiasis is related to interactions between polymorphonuclear leukocytes (PMN) and Entamoeba histolytica trophozoites. We analyzed the relation between infiltrating inflammatory cell populations and E. histolytica density in intestinal amebic lesion...
journal_title:Surgical infections
pub_type: 杂志文章
doi:10.1089/sur.2008.011
更新日期:2009-04-01 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:Surgical site infection (SSI), the third most common type of nosocomial infection in Sweden, is a patient injury that should be prevented. Methods of reducing SSIs include, for instance, disinfecting the skin, maintaining body temperature, and ensuring an aseptic environment. Guidelines for most of these int...
journal_title:Surgical infections
pub_type: 杂志文章
doi:10.1089/sur.2017.286
更新日期:2018-05-01 00:00:00
abstract:BACKGROUND:Vancomycin is the mainstay of treatment for methicillin-resistant Staphylococcus aureus (MRSA) meningitis. However, successful outcomes with linezolid have not been reported in a large series of patients. We conducted a single-center retrospective cohort study to compare vancomycin with linezolid in the trea...
journal_title:Surgical infections
pub_type: 杂志文章
doi:10.1089/sur.2012.091
更新日期:2013-08-01 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
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: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: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: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: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: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: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:The third most common healthcare-associated infection is surgical site infection (SSI), accounting for 14%-16% of infections. These SSIs are associated with high morbidity, numerous deaths, and greater cost. METHODS:A prospective study was conducted to assess the incidence of SSI in a single university hosp...
journal_title:Surgical infections
pub_type: 杂志文章
doi:10.1089/sur.2012.096
更新日期:2013-06-01 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: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: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: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