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, increased cost, and bacterial resistance. We hypothesized that MRSA nasal screening could be used to predict patients with a MRSA IAI and used to avoid unnecessary empiric vancomycin use. METHODS:A surgical infections database collected prospectively from a single institution was reviewed for all IAIs between January 1, 2000-December 31, 2011. Patients with and without MRSA obtained from abdominal cultures as either a monomicrobial or polymicrobial isolate were compared by univariate analysis. A multivariable logistic regression was performed to identify independent predictors of MRSA IAI. RESULTS:Of 2,591 patients with an IAI, 240 patients had a nasal MRSA screen within 30 d prior to infection and abdominal culture data, with an incidence of 23% for MRSA IAI. Patients with MRSA IAI (n=45) had more healthcare associated infections, lower white blood cell counts and greater rates of positive nasal MRSA screenings compared with those with non-MRSA IAI. By multivariable analysis (C statistic=0.908), the strongest independent predictor of an MRSA IAI was a positive MRSA screen (odds ratio [OR] 40.9, confidence interval [CI] 14.2-118.1). The positive predictive value for a MRSA screen was 53% whereas the negative predictive value of a MRSA screen was 97%. CONCLUSION:A negative MRSA nasal screen indicates with near certainty the absence of MRSA as part of an IAI. In the setting of a recent screen, empiric vancomycin can be withheld. Further, rapid MRSA nasal screening could be used to forego or to discontinue vancomycin therapy rapidly in the setting of IAI. This change in empiric antibiotic management of IAI may lead to decreased morbidity, reduction in cost, and a decrease in bacterial resistance.
journal_name
Surg Infect (Larchmt)journal_title
Surgical infectionsauthors
Hennessy SA,Shah PM,Guidry CA,Davies SW,Hranjec T,Sawyer RGdoi
10.1089/sur.2014.211subject
Has Abstractpub_date
2015-08-01 00:00:00pages
396-400issue
4eissn
1096-2964issn
1557-8674journal_volume
16pub_type
杂志文章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
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: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:With high morbidity and potentially devastating consequences, surgical site infections (SSIs) after cardiac surgery add substantially to the healthcare burden. Inhibiting migration of skin microbes is likely to reduce contamination of the surgical incision by endogenous potential pathogens. We studied the ef...
journal_title:Surgical infections
pub_type: 杂志文章
doi:10.1089/sur.2011.050
更新日期:2011-12-01 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: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: 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 aim of this study was to review the post-operative and infectious complications and determine the risk factors associated with infections in cytoreductive surgery (CRS) and hyperthermic intra-peritoneal chemotherapy (HIPEC). PATIENTS AND METHODS:Between October 2007 and December 2013, patients who under...
journal_title:Surgical infections
pub_type: 杂志文章
doi:10.1089/sur.2016.102
更新日期:2017-02-01 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: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: 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: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: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: 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...
journal_title:Surgical infections
pub_type: 杂志文章
doi:10.1089/sur.2018.260
更新日期:2019-12-01 00:00:00
abstract:BACKGROUND:Primary echinococcosis, and especially primary alveolar echinococcosis (AE) is rare among adrenal lesions. METHODS:We report a case of primary AE in a 28-year-old male with low backache and occasional upper limb pain lasting for six months, and review the pertinent but sparse literature on this disorder. R...
journal_title:Surgical infections
pub_type: 杂志文章,评审
doi:10.1089/sur.2012.037
更新日期:2013-08-01 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: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:Solid organ transplantation (SOT) frequently is complicated by cytomegalovirus (CMV) infections. Cidofovir (CDV) is active against CMV, including many ganciclovir (GCV)-resistant mutants, but often is considered to be too nephrotoxic for use after organ transplantation. PATIENTS AND METHODS:Seven males and ...
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: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:To determine if there is a difference in periocular post-operative infection rates when utilizing new versus re-processed monopolar electrocautery tips. METHODS:Retrospective cohort study of 4,976 consecutive surgical cases involving 17,149 procedures. Post-operative infections were identified using chart r...
journal_title:Surgical infections
pub_type: 杂志文章
doi:10.1089/sur.2014.055
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
pub_type: 杂志文章
doi:10.1089/sur.2016.219
更新日期:2017-04-01 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: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: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: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: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
pub_type: 杂志文章
doi:10.1089/sur.2017.011
更新日期:2017-08-01 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: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
pub_type: 杂志文章
doi:10.1089/sur.2018.051
更新日期:2018-10-01 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: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