Abstract:
BACKGROUND:In 2013, the Centers for Disease Control and Prevention (CDC) developed new surveillance definitions for ventilator-associated events (VAE), leading to concerns that hospitals may be underreporting the true incidence of ventilator-associated pneumonias (VAPs). We sought to compare rates of clinically diagnosed VAP with CDC defined possible VAPs (PVAPs) in patients with a VAE in the surgical/trauma intensive care unit (STICU). HYPOTHESIS:Significant difference exists between rates of clinical VAP and PVAP in patients with at least one VAE. PATIENTS AND METHODS:All STICU patients with ≥1 VAE, between 1/1/2013 and 10/31/2015 were identified. Age, length of stay (LOS), ICU and ventilator days were collected. RESULTS:There were 134 patients who had ≥1 VAE. Mean age was 54.3 (±17.1) years. Mean LOS, median ICU, and median ventilator days were 26.3 (±14.1), 21.0 (17.0-33.0), and 17.0 (12.8-24.0) days, respectively. There were 68 cases of clinically diagnosed VAP, but only 37% met PVAP criteria. We compared 43 cases of clinical VAP, not meeting PVAP criteria, with the 25 PVAPs. Both groups had similar outcomes. The PVAPs were more likely to have an abnormal temperature (48.0% vs. 14.0%, p = 0.004), abnormal white blood cell count (84.0% vs. 18.6%, p < 0.001), or new antibiotic agent initiated (100% vs. 18.6%, p < 0.001) as VAE triggers. Comparison of the 93 trauma and 41 surgical patients demonstrated trauma patients were younger (51.2 vs. 61.5 y, p = 0.001), but had similar outcomes and rates of clinical VAP (48.4% and 43.9%, p = NS). Only 20.4% of trauma and 14.6% of surgical patients, however, had a PVAP reported. For patients with at least one VAE, the sensitivity and specificity for PVAP detecting VAP was 36.8% and 96.0%, respectively. CONCLUSION:The new CDC definition for PVAP grossly underestimates the clinical diagnosis of VAP and reports less than a third of the patients treated for VAP. Reporting differences were similar for trauma and surgical patients.
journal_name
Surg Infect (Larchmt)journal_title
Surgical infectionsauthors
Zosa BM,Golob JF,Conrad-Schnetz KJ,Schechtman D,Kreiner LA,Claridge JAdoi
10.1089/sur.2016.152subject
Has Abstractpub_date
2017-07-01 00:00:00pages
558-562issue
5eissn
1096-2964issn
1557-8674journal_volume
18pub_type
杂志文章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: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: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: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: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: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: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
doi:10.1089/sur.2012.135
更新日期:2014-06-01 00:00:00
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
doi:10.1089/sur.2006.7.s2-109
更新日期:2006-01-01 00:00:00
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
doi:10.1089/109629600750018123
更新日期:2000-10-01 00:00:00
abstract:BACKGROUND:The pathogenic organisms responsible for the manifestations of secondary peritonitis have been well characterized through almost 30 years of experimental and clinical studies. Enteric gram-negative organisms and anaerobes predominate, with Escherichia coli and Bacteroides fragilis, respectively, being the mo...
journal_title:Surgical infections
pub_type: 杂志文章,评审
doi:10.1089/109629601750469474
更新日期:2001-07-01 00:00:00
abstract:BACKGROUND:Guidelines advise that patients with ventilator-associated pneumonia (VAP) should respond clinically by Day 3 of antibiotics. White blood cell (WBC) count, maximum temperature (Tmax), and PaO2:FIO2 ratio are all said to respond significantly by Day 6. Resolution of abnormalities has not been evaluated in tra...
journal_title:Surgical infections
pub_type: 杂志文章
doi:10.1089/sur.2011.128
更新日期:2013-02-01 00:00:00
abstract:BACKGROUND:Surgical site infections (SSIs) are a significant healthcare quality issue, resulting in increased morbidity, disability, length of stay, resource utilization, and costs. Identification of high-risk patients may improve pre-operative counseling, inform resource utilization, and allow modifications in peri-op...
journal_title:Surgical infections
pub_type: 杂志文章,评审
doi:10.1089/sur.2017.058
更新日期:2017-05-01 00:00:00
abstract:BACKGROUND:Staphylococcus aureus nasal carriage is an independent risk factor for developing nosocomial infections and for developing surgical site infection (SSI) in particular. The number of post-operative nosocomial S. aureus infections can be reduced by screening patients and decolonizing nasal carriers. In additio...
journal_title:Surgical infections
pub_type: 杂志文章
doi:10.1089/sur.2014.022
更新日期:2015-04-01 00:00:00
abstract:BACKGROUND:A substantial proportion of operative procedures are complicated by infections, either remote from or related to the surgical site. These infections account for substantive morbidity and health care costs. With limited research funds available to study interventions designed to either prevent or reduce the m...
journal_title:Surgical infections
pub_type: 杂志文章
doi:10.1089/sur.2006.7.101
更新日期:2006-04-01 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::Antibiotics are important in the prophylaxis and treatment of surgical infections as well as in the management of nosocomial infections acquired postoperatively in surgical patients. Surgeons encounter a range of infectious conditions, including established single-pathogen infections of soft tissues, polymicrobial int...
journal_title:Surgical infections
pub_type: 杂志文章,评审
doi:10.1089/sur.2001.2.s1-3
更新日期:2001-01-01 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: 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:Treatment of peritonitis requires prompt surgery and antibiotic therapy. It usually takes two or three days to obtain definitive results of peritoneal cultures and to adapt empirical antibiotic therapy. We assessed the potential time gain associated with direct culture of peritoneal samples on antibiotic aga...
journal_title:Surgical infections
pub_type: 杂志文章
doi:10.1089/sur.2008.095
更新日期:2009-08-01 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: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:Current scolicidal agents, which have been used for inactivation of protoscoleces during surgical procedures, are associated with adverse side effects including sclerosing cholangitis. This investigation aimed to evaluate the scolicidal effects of Bunium persicum (Boiss) essential oil against protoscoleces o...
journal_title:Surgical infections
pub_type: 杂志文章
doi:10.1089/sur.2016.010
更新日期:2016-12-01 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: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:Cefazolin remains the preferred preoperative antibiotic for the majority of surgical procedures. However, outcome evidence supporting current dosing recommendations for pre-operative prophylaxis is scarce, particularly for obese patients. With more than 33% of adults in the United States classified as obese,...
journal_title:Surgical infections
pub_type: 杂志文章
doi:10.1089/sur.2012.167
更新日期:2014-08-01 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: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: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: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:Chronic osteomyelitis associated with a stage IV decubitus ulcer is a challenging condition to manage, characterized by frequent relapses and need for long-term anti-microbial therapy. Although gram-positive cocci are the most common causes, fungal infections have been reported, usually in immunocompromised ...
journal_title:Surgical infections
pub_type: 杂志文章
doi:10.1089/sur.2018.046
更新日期:2018-07-01 00:00:00