Effect of Hand Antisepsis Agent Selection and Population Characteristics on Surgical Site Infection Pathogens.


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 effect of this implementation on SSI pathogen characteristics. In addition, we sought to compare our SSI culture data with available National Healthcare Safety Network (NHSN) data. We hypothesized that SSI pathogens and resistant isolates are affected by surgical hand antisepsis technique. METHODS:Data collected prospectively between 2007 and 2014 were retrospectively analyzed for two time periods at the Veterans Affairs Boston Healthcare System (VABHS): Before ABR implementation (TSS group) and after (ABR group). Pathogen distribution and pathogenic isolate resistance profiles were compared for TSS and ABR, and similar comparisons, along with procedure-associated SSI comparisons, were made between VABHS and NHSN. All VABHS data were interpreted and categorized according to NHSN definitions. RESULTS:Compared with TSS (n = 4,051), ABR (n = 2,293) had a greater rate of Staphylococcus aureus (42.6% vs. 38.0%), Escherichia coli (12.8% vs. 9.9%), Pseudomonas aeruginosa (8.5% vs. 2.8%), and Enterobacter spp. (10.6% vs. 2.8%), and a lower rate of Klebsiella pneumoniae/K. oxytoca (4.3% vs. 8.5%) cultured from superficial and deep SSIs (p < 0.05). Of the S. aureus isolates, 35.0% and 44.4% were resistant to oxacillin/methicillin (MRSA) in ABR and TSS, respectively (p = 0.06). Looking at all SSIs, coagulase-negative staphylococci and K. pneumoniae/K. oxytoca at VABHS (4.0% and 10.4%, respectively) accounted for the biggest difference from NHSN (11.7% and 4.0%, respectively). Aside from MRSA, where there was no difference between VABHS and NHSN (42.9% vs. 43.7%, respectively; p = 0.87), statistically significant (p < 0.05) differences were observed among multi-drug-resistant K. pneumoniae/K. oxytoca (0% vs. 6.8%, respectively) and Escherichia coli (10.0% vs. 1.6%, respectively), as well as among extended-spectrum cephalosporin-resistant K. pneumoniae/K. oxytoca (4.8% vs. 13.2%, respectively) and Enterobacter (58.3% vs. 27.7%, respectively). VABHS had a greater proportion of SSIs in abdominal and vascular cases than did NHSN (48.6% vs. 22.5% and 13.2% vs. 1.5%, respectively). Overall, these differences were significant (p < 0.05). CONCLUSIONS:The TSS and ABR groups differed in the distribution of pathogens recovered. Those differences, along with SSI pathogen distribution, pathogenic isolate resistance profiles, and procedure-associated SSIs between VABHS and NHSN, warrant further investigation.


Surg Infect (Larchmt)


Surgical infections


Oriel BS,Chen Q,Wong K,Itani KMF




Has Abstract


2017-05-01 00:00:00












  • Pediatric Sepsis Update: How Are Children Different?

    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


    authors: Emr BM,Alcamo AM,Carcillo JA,Aneja RK,Mollen KP

    更新日期:2018-02-01 00:00:00

  • Abdominal wall thickness: is it associated with superficial and deep incisional surgical site infection after colorectal surgery?

    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


    authors: Kwaan MR,Sirany AM,Rothenberger DA,Madoff RD

    更新日期:2013-08-01 00:00:00

  • Not just full of hot air: hyperbaric oxygen therapy increases survival in cases of necrotizing soft tissue infections.

    abstract:BACKGROUND:The utility of hyperbaric oxygen therapy (HBOT) in the treatment of necrotizing soft tissue infections (NSTIs) has not been proved. Previous studies have been subject to substantial selection bias because HBOT is not available universally at all medical centers, and there is often considerable delay associat...

    journal_title:Surgical infections

    pub_type: 杂志文章


    authors: Shaw JJ,Psoinos C,Emhoff TA,Shah SA,Santry HP

    更新日期:2014-06-01 00:00:00

  • Infective complications in laparoscopic surgery.

    abstract:BACKGROUND AND PURPOSE:One of the main benefits of minimally invasive surgery compared with open surgery is the significant reduction in the incidence of postoperative infections. Possible explanations include the smaller incision, minimal use of central venous catheters for parenteral nutrition, faster mobilization, r...

    journal_title:Surgical infections

    pub_type: 杂志文章,评审


    authors: Boni L,Benevento A,Rovera F,Dionigi G,Di Giuseppe M,Bertoglio C,Dionigi R

    更新日期:2006-01-01 00:00:00

  • Preoperative verification of timely antimicrobial prophylaxis does not improve compliance with guidelines.

    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


    authors: Nemeth TA,Beilman GJ,Hamlin CL,Chipman JG

    更新日期:2010-08-01 00:00:00

  • Scoring System to Predict the Risk of Surgical Site Infection in Patients with Esophageal Cancer after Esophagectomy with Cervical Anastomosis.

    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


    authors: Yin LX,Chen BM,Zhao GF,Yuan QF,Xue Q,Xu K

    更新日期:2018-10-01 00:00:00

  • Surgical Site Infections after Open Reduction Internal Fixation for Trauma in Low and Middle Human Development Index Countries: A Systematic Review.

    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


    authors: McQuillan TJ,Cai LZ,Corcoran-Schwartz I,Weiser TG,Forrester JD

    更新日期:2018-04-01 00:00:00

  • Pathogenesis of multiple organ dysfunction syndrome--endotoxin, inflammatory cells, and their mediators: cytokines and reactive oxygen species.

    abstract::Multiple organ dysfunction syndrome (MODS) is caused by an overwhelming, uncontrolled systemic inflammatory response that is activated by a number of hostile stimuli including sepsis, hypovolemic shock, and severe trauma resulting in massive tissue injury. The indiscriminate activation of the inflammatory response due...

    journal_title:Surgical infections

    pub_type: 杂志文章,评审


    authors: Maier RV

    更新日期:2000-10-01 00:00:00

  • Scoring system development and validation for initial treatment failure in suppurative kidney infections.

    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


    authors: Stojadinović MM,Milovanović DR,Gajić BS

    更新日期:2011-04-01 00:00:00

  • Comprehensive Approach to Reduce Surgical Site Infections in Patients Undergoing Neurosurgical Procedures.

    abstract:: Background: Surgical site infections (SSIs) are recognized complications of surgical procedures. Methicillin-resistant Staphylococcus aureus (MRSA) colonization increases the likelihood of developing SSIs. Decolonization of MRSA has been shown to reduce post-operative SSIs...

    journal_title:Surgical infections

    pub_type: 杂志文章


    authors: Nusair AR,El Nekidy WS,Reynolds L,Evans D,El-Lababidi R,Alatoom A

    更新日期:2020-05-04 00:00:00

  • Oral Nutrition as a Form of Pre-Operative Enhancement in Patients Undergoing Surgery for Colorectal Cancer: A Systematic Review.

    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


    authors: Bruns ERJ,Argillander TE,Van Den Heuvel B,Buskens CJ,Van Duijvendijk P,Winkels RM,Kalf A,Van Der Zaag ES,Wassenaar EB,Bemelman WA,Van Munster BC

    更新日期:2018-01-01 00:00:00

  • Epinephrine, cortisol, endotoxin, nutrition, and the neutrophil.

    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


    authors: Parks KR,Davis JM

    更新日期:2012-10-01 00:00:00

  • The Bacteremia Caused by Non-Lactose Fermenting Gram-Negative Bacilli in Solid Organ Transplant Recipients.

    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


    authors: Wan Q,Ye Q,Huang F

    更新日期:2015-10-01 00:00:00

  • Comparison of Traditional and Skin-Sparing Approaches for Surgical Treatment of Necrotizing Soft-Tissue Infections.

    abstract:: Background: A skin-sparing approach for the treatment of necrotizing soft-tissue infections (NSTIs) removes necrotic tissue planes while leaving viable overlying skin. Subsequent closure of the spared skin may decrease the need for graft-based reconstruction, which is asso...

    journal_title:Surgical infections

    pub_type: 杂志文章


    authors: Tom LK,Maine RG,Wang CS,Parent BA,Bulger EM,Keys KA

    更新日期:2020-05-01 00:00:00

  • Literature-based evaluation of the potential risks associated with impregnation of medical devices and implants with triclosan.

    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


    authors: Gilbert P,McBain AJ

    更新日期:2002-01-01 00:00:00

  • Evaluation of a Short Course of Antimicrobial Therapy for Complicated Intra-Abdominal Infections in Critically Ill Surgical Patients.

    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


    authors: Smith SE,Rumbaugh KA,May AK

    更新日期:2017-08-01 00:00:00

  • Can Nasal Methicillin-Resistant Staphylococcus aureus Screening Be Used to Avoid Empiric Vancomycin Use in Intra-Abdominal Infection?

    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


    authors: Hennessy SA,Shah PM,Guidry CA,Davies SW,Hranjec T,Sawyer RG

    更新日期:2015-08-01 00:00:00

  • Fascia-to-fascia closure with abdominal topical negative pressure for severe abdominal infections: preliminary results in a department of general surgery and intensive care unit.

    abstract:BACKGROUND:Vacuum-assisted fascial closure (VAFC-KCI(®)) of an open abdomen is one of the latest methods. METHODS:A prospective observational study was performed with medical records of nine patients who had been treated by abdominal VAFC-KCI(®) from March 2006 to October 2007 in the Department of Surgical Sciences, U...

    journal_title:Surgical infections

    pub_type: 杂志文章


    authors: Padalino P,Dionigi G,Minoja G,Carcano G,Rovera F,Boni L,Dionigi R

    更新日期:2010-12-01 00:00:00

  • Prophylactic Gentamicin Is Not Associated with Acute Kidney Injury in Patients with Open Fractures.

    abstract:BACKGROUND:Data on antimicrobial prophylaxis for open fractures is limited, with many protocols based on expert recommendations. These protocols include aminoglycosides (AGs) for fractures with significant soft tissue injury, but these drugs are associated with acute kidney injury (AKI) in other settings; this risk has...

    journal_title:Surgical infections

    pub_type: 杂志文章


    authors: Tessier JM,Moore B,Putty B,Gandhi RR,Duane TM

    更新日期:2016-12-01 00:00:00

  • In vitro antimicrobial activity of oxidized regenerated cellulose against antibiotic-resistant microorganisms.

    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


    authors: Spangler D,Rothenburger S,Nguyen K,Jampani H,Weiss S,Bhende S

    更新日期:2003-10-01 00:00:00

  • Primary orbital hydatid cyst in an elderly patient.

    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


    authors: Limaiem F,Bellil S,Bellil K,Chelly I,Mekni A,Khaldi M,Haouet S,Kchir N,Zitouna M

    更新日期:2010-08-01 00:00:00

  • Literature Review of Criteria for Defining Recipient-Site Infection after Oral Oncologic Surgery with Simultaneous Reconstruction.

    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


    authors: Akashi M,Kusumoto J,Sakakibara A,Hashikawa K,Furudoi S,Komori T

    更新日期:2017-10-01 00:00:00

  • New strategies to improve outcomes in the surgical intensive care unit.

    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


    authors: Beilman GJ

    更新日期:2004-10-01 00:00:00

  • History of Urinary Retention Is a Risk Factor for Infection after Prostate Biopsy: A Nationwide, Population-Based Cohort Study.

    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


    authors: Lin SL,Lin CT,Huang WT,Jou YC,Tzai TS,Tsai YS

    更新日期:2019-04-01 00:00:00

  • Influence of bronchoscopy on the diagnosis of and outcomes from ventilator-associated pneumonia.

    abstract:BACKGROUND:Ventilator-associated pneumonia (VAP) is a common healthcare-associated infection affecting as many as 27% of mechanically ventilated patients. Ventilator-associated pneumonia is an important source of morbidity and mortality in the surgical intensive care unit (SICU). The optimal diagnostic method for VAP h...

    journal_title:Surgical infections

    pub_type: 杂志文章


    authors: Guidry CA,Mallicote MU,Petroze RT,Hranjec T,Rosenberger LH,Davies SW,Sawyer RG

    更新日期:2014-10-01 00:00:00

  • Reflections on the Complexity of Surgical Site Infection Prevention and Detection from an Organizational Lens.

    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


    authors: Collins CR,Wick EC

    更新日期:2019-10-01 00:00:00

  • Validation and Performance Comparison of Two Scoring Systems Created Specifically to Predict the Risk of Deep Sternal Wound Infection after Bilateral Internal Thoracic Artery Grafting.

    abstract:: Background: The Gatti and the bilateral internal mammary artery (BIMA) scores were created to predict the risk of deep sternal wound infection (DSWI) after bilateral internal thoracic artery (BITA) grafting. Methods: Both score...

    journal_title:Surgical infections

    pub_type: 杂志文章


    authors: Gatti G,Pappalardo A,Chocron S,Biondi F,Porcari A,Ceschia A,Luzzati R,Ecarnot F,Perrotti A

    更新日期:2020-06-01 00:00:00

  • Daptomycin-associated eosinophilic pneumonia in two patients with prosthetic joint infection.

    abstract:BACKGROUND:Daptomycin is used increasingly to treat prosthetic joint infection (PJI). A possible side effect of this drug is eosinophilic pneumonia. We describe two patients with PJI treated with daptomycin who had this side effect with different clinical presentations. METHODS:Case reports and review of the literatur...

    journal_title:Surgical infections

    pub_type: 杂志文章


    authors: Yusuf E,Perrottet N,Orasch C,Borens O,Trampuz A

    更新日期:2014-12-01 00:00:00

  • Intestinal Fatty Acid Binding Protein: A Sensitive Marker in Abdominal Surgery and Abdominal Infection.

    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


    authors: Bingold TM,Franck K,Holzer K,Zacharowski K,Bechstein WO,Wissing H,Scheller B

    更新日期:2015-06-01 00:00:00

  • Fever after percutaneous nephrolithotomy: contributing factors.

    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


    authors: Sharifi Aghdas F,Akhavizadegan H,Aryanpoor A,Inanloo H,Karbakhsh M

    更新日期:2006-08-01 00:00:00