Abstract:
: Background: We aimed to assess independent risk factors for inadequate initial antimicrobial treatment (IAT) in critically ill patients with ventilator-associated pneumonia (VAP) treated in intensive care units (ICU) and to determine whether IAT is associated with adverse outcomes in patients with VAP. Patients and Methods: A prospective cohort study was performed and included 152 patients with VAP treated in an ICU for more than 48 hours. The main outcomes of interest were all-cause ICU mortality and VAP-related mortality. Other outcomes considered were: intra-hospital mortality, VAP-related sepsis, relapse, re-infection, length of stay in ICU (ICU LOS), and number of days on mechanical ventilation (MV). Results: One-third of patients (35.5%) received inadequate antimicrobial therapy. Trauma (odds ratio [OR], 3.55; 95% confidence interval [CI], 1.25-10.06) and extensively drug-resistant (XDR) causative agent (OR, 3.09; 95% CI, 1.23-7.74) were independently associated with inadequate IAT. Inadequate IAT was associated with a higher mortality rate (OR, 3.08; 95% CI, 1.30-7.26), VAP-related sepsis (OR, 2.39; 95% CI, 1.07-5.32), relapse (OR, 3.25; 95% CI, 1.34-7.89), re-infection (OR, 6.06; 95% CI, 2.48-14.77), and ICU LOS (β 4.65; 95% CI, 0.93-8.36). Acinetobacter spp., Pseudomonas aeruginosa and Klebsiella/Enterobacter spp. were the most common bacteria in patients with IAT and those with adequate antimicrobial therapy. Conclusions: This study demonstrated that inadequate IAT is associated with a higher risk of the majority of adverse outcomes in patients with VAP treated in ICUs. Trauma and XDR strains of bacteria are independent predictors of inadequate IAT of VAP in critically ill patients.
journal_name
Surg Infect (Larchmt)journal_title
Surgical infectionsauthors
Jovanovic B,Djuric O,Hadzibegovic A,Jovanovic S,Stanisavljevic J,Milenkovic M,Rajkovic M,Ratkovic S,Markovic-Denic Ldoi
10.1089/sur.2020.306subject
Has Abstractpub_date
2021-01-13 00:00:00eissn
1096-2964issn
1557-8674pub_type
杂志文章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 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:Gentamicin is used commonly as an empiric antibiotic prior to culture evidence in the treatment of ventilator-associated pneumonia (VAP) in surgical patients. METHODS:The published literature on the use of gentamicin for empiric therapy in VAP was reviewed and in combination with the author's personal exper...
journal_title:Surgical infections
pub_type: 杂志文章,评审
doi:10.1089/sur.2015.278
更新日期:2016-06-01 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:Nucleated red blood cells (NRBCs) are present in certain non-oncologic disease states and are associated with a poor prognosis. The purpose of this study was to evaluate NRBCs as an early prognostic marker for death in patients with surgical sepsis. METHODS:Retrospective evaluation of data collected prospec...
journal_title:Surgical infections
pub_type: 杂志文章
doi:10.1089/sur.2011.089
更新日期:2012-12-01 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: 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: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
doi:10.1089/sur.2017.273
更新日期:2018-04-01 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: 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:The use of silver for the treatment of various maladies or to prevent the transmission of infection dates back to at least 4000 b.c.e. Medical applications are documented in the literature throughout the 17th and 18th centuries. The bactericidal activity of silver is well established. Silver nitrate was used...
journal_title:Surgical infections
pub_type: 杂志文章,评审
doi:10.1089/sur.2011.097
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: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:The Donor Risk Index (DRI) is used to predict graft survival following liver transplantation, but has not been used to predict post-operative infections in graft recipients. We hypothesized that lower-quality grafts would result in more frequent infectious complications. METHODS:Using a prospectively collec...
journal_title:Surgical infections
pub_type: 杂志文章
doi:10.1089/sur.2013.035
更新日期:2014-04-01 00:00:00
abstract:BACKGROUND:The prevalence of human immunodeficiency virus (HIV) is disproportionately elevated in trauma patients. Although HIV traditionally has been associated with poorer outcomes among the critically ill, recent evidence suggests that the outcomes of surgical patients have improved with the greater use of antiretro...
journal_title:Surgical infections
pub_type: 杂志文章
doi:10.1089/sur.2008.050
更新日期:2010-02-01 00:00:00
abstract:BACKGROUND:The utility of tigecycline as compared with other antibiotic therapies in the treatment of patients with complicated intra-abdominal infection (cIAI) and the short- and long-term outcomes of a large cohort of severely ill patients were examined. We provide the first published data on post-discharge events fo...
journal_title:Surgical infections
pub_type: 杂志文章,多中心研究
doi:10.1089/sur.2015.075
更新日期:2016-08-01 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: 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:Six hours from injury to washout is considered the gold standard in the treatment of open traumatic fractures. Despite this being our hospital policy, the rural nature of our Level I trauma center causes delays in discovery and transport, creating a unique randomization of time to washout. We hypothesized th...
journal_title:Surgical infections
pub_type: 杂志文章
doi:10.1089/sur.2010.075
更新日期:2011-10-01 00:00:00
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
doi:10.1089/sur.2008.054
更新日期:2010-08-01 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: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 diagnos...
journal_title:Surgical infections
pub_type: 杂志文章
doi:10.1089/sur.2016.152
更新日期:2017-07-01 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:We defined the contemporary conversion rate from laparoscopic appendectomy (LA) to open appendectomy and identified pre-operative factors associated with conversion. METHODS:Retrospective review of 941 consecutive LAs performed for suspected acute appendicitis in a single urban university hospital between 2...
journal_title:Surgical infections
pub_type: 杂志文章
doi:10.1089/sur.2010.079
更新日期:2011-08-01 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
abstract:BACKGROUND:We reported similar rates of ventilator-associated pneumonia (VAP) previously in trauma patients intubated either in a pre-hospital (PH) venue or the emergency department. A subset of PH intubations with continuous quality assessment was re-examined to identify the intubation factors associated with VAP. ME...
journal_title:Surgical infections
pub_type: 杂志文章
doi:10.1089/sur.2010.074
更新日期:2011-10-01 00:00:00
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:Previously, we developed an infection model by intraperitoneal (IP) injection of Klebsiella pneumoniae. The high early mortality rate prompted a study of the effect of gentamicin on the disease course. METHODS:Infection was induced in Balb/c mice by IP inoculation of 10(3) colony-forming units (cfu) of K. p...
journal_title:Surgical infections
pub_type: 杂志文章
doi:10.1089/sur.2006.060
更新日期:2007-06-01 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: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