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. PATIENTS AND METHODS:A single-center, retrospective, cohort study was conducted at a tertiary academic medical center. Adult patients admitted to the surgical intensive care unit (SICU) with cIAI between December 2011 and July 2015 were enrolled. Patients undergoing transplantation and those with less than 24 h in the SICU were excluded. Patients were divided into two groups, short (≤ 7 d) and long (> 7 d) antimicrobial therapy. The primary outcome was treatment failure, which was defined as a composite of recurrent cIAI, secondary extra-abdominal infection, and/or in-hospital mortality from any cause. Categorical and continuous data were analyzed with χ2 and Mann-Whitney U tests, respectively. Binary logistic regression was performed to determine factors associated with treatment failure and mortality. RESULTS:Of 1,679 patients screened, 240 were included, 103 in the short and 137 in the long group. Patients in the short and long groups received a median of 5 and 14 d of therapy, respectively (p < 0.001). Treatment failure occurred less frequently with a short duration of therapy (39% versus 63%, p < 0.001) and it occurred two days sooner after source control in patients receiving the shorter courses of antimicrobial therapy (short, median 6 d, interquartile range [IQR] 3-9; long, 8 d, IQR 6-14; p < 0.001). Logistic regression demonstrated that a long duration of therapy was associated with treatment failure (odds ratio [OR] 2.186, 95% confidence interval [CI] 1.251-3.820, p = 0.006), but not with mortality (OR 0.738, 95% CI 0.329-1.655, p = 0.461). CONCLUSIONS:In critically ill surgical patients with cIAI, a short duration of antimicrobial therapy after source control resulted in similar outcomes to previously published studies, providing support for the safety of this approach in critically ill patients.
journal_name
Surg Infect (Larchmt)journal_title
Surgical infectionsauthors
Smith SE,Rumbaugh KA,May AKdoi
10.1089/sur.2017.011subject
Has Abstractpub_date
2017-08-01 00:00:00pages
742-750issue
6eissn
1096-2964issn
1557-8674journal_volume
18pub_type
杂志文章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: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::Hospital-acquired infections, sepsis, and critically ill patients cost the healthcare system billions of dollars every year. Many factors contribute to these problems, and the remedies are multifactorial. Education is an important component in resolving many of the issues related to better combating the economic, soci...
journal_title:Surgical infections
pub_type: 杂志文章,评审
doi:10.1089/sur.2016.100
更新日期:2016-12-01 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: 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
doi:10.1089/sur.2019.263
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:An untreated hand infection can lead rapidly to tissue destruction and permanent disability. METHODS:Review of the pertinent English literature. RESULTS:Early diagnosis and timely, effective intervention is crucial to treatment. Anatomically, the hand consists of multiple potential spaces and tissue planes...
journal_title:Surgical infections
pub_type: 杂志文章,评审
doi:10.1089/sur.2004.5.210
更新日期:2004-07-01 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: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 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:: 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
abstract:BACKGROUND:By definition, the term "surgical infection" implies that surgery plays the major role in therapy, whereas antimicrobial chemotherapy is only supplementary. Despite this view, the efficacy of such drugs is relevant, and for this reason, drug activity surveillance is necessary, especially for opportunistic an...
journal_title:Surgical infections
pub_type: 杂志文章
doi:10.1089/sur.2006.7.269
更新日期:2006-06-01 00:00:00
abstract:BACKGROUND:Central venous catheters (CVCs) are used to deliver a variety of therapies, as well as for measurement of hemodynamic parameters. The major associated complication is catheter-related blood stream infection (CRBSI). METHOD:Review of the pertinent English-language literature. RESULTS:The incidence of CRBSI ...
journal_title:Surgical infections
pub_type: 杂志文章,评审
doi:10.1089/sur.2006.7.s2-65
更新日期:2006-01-01 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: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: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: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
doi:10.1089/109629603322419599
更新日期:2003-10-01 00:00:00
abstract:: Background: Skin and soft tissue infection (SSTI) after hernia surgery is infrequent yet catastrophic and is associated with mesh infection, interventions, and hernia recurrence. Although hernia repair is one of the most common general surgery procedures, uncertainty persi...
journal_title:Surgical infections
pub_type: 杂志文章
doi:10.1089/sur.2020.354
更新日期:2020-12-01 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: Faulty cleaning of surgical instruments may lead to corrosion damage and a higher risk of surgical site infection. We have developed a method in which each instrument has an attached radiofrequency identification (RFID) tag for individual management. However, b...
journal_title:Surgical infections
pub_type: 杂志文章
doi:10.1089/sur.2019.034
更新日期:2019-12-01 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: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:Ventilator-associated pneumonia (VAP) is a frequent complication during recovery of severely traumatized patients. The primary objective of this study was to determine if prophylactic administration of aerosolized ceftazidime reduced the incidence of VAP in high-risk injured patients without altering the inc...
journal_title:Surgical infections
pub_type: 杂志文章,随机对照试验
doi:10.1089/sur.2006.042
更新日期:2007-02-01 00:00:00
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
doi:10.1089/sur.2009.019
更新日期:2010-08-01 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: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: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: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
doi:10.1089/sur.2017.101
更新日期:2017-10-01 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: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