Revisiting the Surgical Infection Society Delphi Analysis of the Research Agenda in Surgical Infections: Advancements and Unanswered Questions

2020 ◽  
Author(s):  
Patrick T. Delaplain ◽  
Austin R. Dosch ◽  
Haytham M.A. Kaafarani ◽  
Philip S. Barie ◽  
Sebastian D. Schubl ◽  
...  
2021 ◽  
Author(s):  
Patrick T. Delaplain ◽  
Haytham M.A. Kaafarani ◽  
L. Andrew O. Benedict ◽  
Christopher A. Guidry ◽  
Dennis Kim ◽  
...  

Pathogens ◽  
2021 ◽  
Vol 10 (6) ◽  
pp. 667
Author(s):  
Pavel Rudenko ◽  
Yuriy Vatnikov ◽  
Nadezhda Sachivkina ◽  
Andrei Rudenko ◽  
Evgeny Kulikov ◽  
...  

Despite the introduction of modern methods of treatment, the creation of new generations of antibacterial agents, and the constant improvement of aseptic and antiseptic methods, the treatment of purulent–inflammatory processes remains one of the most complex and urgent problems in veterinary practice. The article presents the results of the isolation of indigenous microbiota from various biotopes of healthy cats, as well as the study of their biological marker properties for the selection of the most optimal strains in probiotic medicines for the control of surgical infections. It was demonstrated that isolated cultures of bifidobacteria and lactobacilli, which we isolated, revealed high sensitivity to antibiotics of the β-lactam group (excepting L. acidophilus No. 24, L. plantarum “Victoria” No. 22, L. rhamnosus No. 5, L. rhamnosus No. 20, and L. rhamnosus No. 26, which showed a significant variability in sensitivity to antibacterial drugs of this group, indicating the great potential of these microorganisms) and resistance to aminoglycosides, lincosamides, and fluoroquinolones (with the exception of gatifloxacin, which showed high efficiency in relation to all lactic acid microorganisms). The adhesive properties of the isolated lactobacteria and bifidobacteria were variable, even within the same species. It was found that the B. adolescentis No. 23 strain of the Bifidobacterium genus, as well as the L. plantarum No. 8, L. plantarum “Victoria” No. 22, L. rhamnosus No. 6, L. rhamnosus No. 26, L. acidophilus No. 12, and L. acidophilus No. 24 strains of the Lactobacillus genus had the highest adhesive activity. Thus, when conducting a detailed analysis of the biological marker properties of candidate cultures (determining their sensitivity to antimicrobial agents, studying the adhesive properties, and antagonistic activity in relation to causative agents of surgical infection in cats), it was found that the most promising are L. plantarum “Victoria” No. 22, L. rhamnosus No. 26, and L. acidophilus No. 24.


Author(s):  
S. A. Orudjeva ◽  
A. A. Zvyagin ◽  
S. I. Agafonova ◽  
V. Yu. Usu Olaku ◽  
Yu. A. Gerasimova

Possibilities of application of various methods of anesthesia of patients with surgical infections are reviewed in the article. The problems of anesthesia related with peculiarities of the process of surgical infection, localization, and characteristics of surgical treatment, as well as with the initial physical status of the patient determined with the age and severity of accompanying diseases were discussed. 


2019 ◽  
Vol 6 (Supplement_2) ◽  
pp. S931-S931
Author(s):  
Evelyn Villacorta ◽  
Luis Acosta ◽  
Thein Myint ◽  
Nicole Leedy ◽  
Ana Lia Castellanos ◽  
...  

Abstract Background Sarcopenia (reduced skeletal muscle mass) has been associated with serious infection in liver transplant recipients. We analyzed the association of sarcopenia and early post-surgical infections in kidney transplant recipients. Methods Retrospective cohort study of 125 patients underwent kidney transplantation from 2010 to 2014 at University of Kentucky Medical Center. Sarcopenia was diagnosed by measuring the skeletal muscle mass on computed tomography imaging obtained during the pre-transplant evaluation using SliceOmatic 5.0 software at L3 level (≤ 52.4 cm2/m2 in males and ≤ 38.5 cm2/m2 in females). Early post-transplant infections were confirmed by positive culture from blood, urine, and/or peritoneal fluid within 30 days after kidney transplantation. A generalized linear model (GLM) was used to identify variables predictive of post- surgical infection and Risk Ratio (RR) was obtained, with a P-value of < 0.05. The statistical analysis was performed with STATA version 12.0 (College Station, Texas). Results Among 125 patients, 52 (41.6%) were identified with sarcopenia, 110 (88.0%) patients were white, 76 (60.8%) male, with a median age of 56 (range 20–72) at the time of transplant. Diabetes was reported in 50 (40.0%) patients, obesity in 64 (51.6%) patients and smoking in 43 (34.6%) patients. Six (4.8%) patients had graft failure. Infections were identified in 22 (17.6%) patients, more than one source of infection was reported in 4 (3.2%) cases. The most common infections were urinary tract infection in 13 (10.4%) patients and bacteremia in 5 (4.0%) patients. The median time to development of infection was 9 days (range 1–27). In the bivariate analysis, sarcopenia was associated with high risk of post-surgical infections (RR 2.45; 95% CI 1.10–5.44). In multivariable analysis, sarcopenia was a significant independent predictor of infection (RR 2.58; 95% CI 1.20–5.52). None associations were found with other variables; age over 40 years, male sex, smoking, obesity and diabetes. Conclusion Our study suggested that sarcopenia was associated with an increased risk of early post-surgical infection in kidney transplant recipients. Disclosures All authors: No reported disclosures.


1987 ◽  
Vol 8 (8) ◽  
pp. 320-324 ◽  
Author(s):  
Luigi Ortona ◽  
Giovanni Federico ◽  
Massimo Fantoni ◽  
Federico Pallavicini ◽  
Francesco Ricci ◽  
...  

AbstractReported are the results of a study on the incidence of nosocomial surgical infections in ten wards of the university hospital A. Gemelli, Rome. One thousand, five hundred five patients were studied and the overall incidence of surgical infections was 8.7%. Factors that influenced infection rates included age, immunosuppressive diseases, and immunosuppressive therapy. We assessed the inutility of antibiotic prophylaxis in clean operations and its usefulness in clean operations with insertion of prostheses or other devices. The importance of the duration of preoperative hospitalization and of the length of the operation were also noted. The most frequent etiological agents proved to be Pseudomonas aeruginosa, Staphylococcus aureus, and Escherichia coli. The average hospital stay for patients with surgical infection was more than double that of patients with no infection (25.7 days v 11.7 days).


2006 ◽  
Vol 7 (2) ◽  
pp. 101-110 ◽  
Author(s):  
Avery B. Nathens ◽  
Charles H. Cook ◽  
George Machiedo ◽  
Ernest E. Moore ◽  
Nicholas Namias ◽  
...  

2008 ◽  
Vol 31 (2) ◽  
pp. 158-165 ◽  
Author(s):  
E.A. Hoste ◽  
D.N. Cruz ◽  
A. Davenport ◽  
R.L. Mehta ◽  
P. Piccinni ◽  
...  

Purpose To describe current knowledge on the epidemiology of cardiac surgery-associated acute kidney injury (CSA-AKI) and to formulate recommendations for clinical practice and a research agenda. Methods After a modified Delphi analysis by the Acute Dialysis Quality Initiative (ADQI), 4 questions on the epidemiology of CSA-AKI and recommendations for clinical practice and a research agenda were formulated and addressed. Results Existing studies on CSA-AKI use over 35 different definitions for CSA-AKI. In addition, there may be important differences in patient characteristics and procedures. This explains the significant variations in reported incidence. Most studies report on CSA-AKI as defined by the need for renal replacement therapy. However, even small decreases in kidney function are associated with a worsened outcome. The workgroup formulated the recommendation to use the AKIN consensus criteria for AKI. One should differentiate early CSA-AKI, caused by the procedure, and late CSA-AKI, associated with the procedure. There may be different clinical scenarios: acute on chronic CSA-AKI, AKI prior to CS, and AKI occurring post CS. Risk factors should be differentiated between pre-, intra-, and post-CS, and between patient-, process-, and procedure-related. Endpoints should include both short-term and long-term outcomes. Conclusions Existing data on the epidemiology of CSA-AKI are difficult to compare due to variations in definition and patient cohort. A modified Delphi analysis resulted in a series of recommendations for future research on CSA-AKI.


2021 ◽  
Vol 12 ◽  
pp. 544
Author(s):  
Omar Marroquin-Herrera ◽  
Santiago Andres Rosales-Camargo ◽  
Luis Carlos Morales-Sáenz ◽  
Fernando Alvarado-Gomez

Background: Post-surgical infections of the spine occur in from 0% to 18% of cases. Postoperative spine infections due to Clostridium Perfringens (CP) resulting in necrotizing fasciitis are extremely rare. However, since they may be fatal, early and definitive treatment is critical. Case Description: A 62-year-old male with a T8-T9 Type C fracture, in ASIA Grade “E” (neurologically intact) underwent a posterior T6-T10 arthrodesis. However, 2 weeks postoperatively, he developed a postoperative thoracic wound infection; the cultures were positive for CP. As the patient developed necrotizing fasciitis, emergent debridement, negative pressure continued drainage, and initiation of appropriate antibiotic therapy were critical. Conclusion: Postoperative spinal infections due to CP with accompanying necrotizing fasciitis are extremely rare. As these infections may be fatal, they must be rapidly diagnosed and treated.


2021 ◽  
Vol In Press (In Press) ◽  
Author(s):  
Seyed Alireza Fahimzad ◽  
Bahador Mirrahimi ◽  
Farideh Shiva ◽  
Niloofar Esfahanian ◽  
Seyyedeh Azam Mousavizadeh ◽  
...  

Background: Surgical procedures may be complicated by post-surgical infections. This study investigates the role of administering perioperative narrow-spectrum antibiotic prophylaxis in preventing post-surgical infections as compared to routine broad-spectrum antibiotic usage in the surgical ward. Methods: Narrow-spectrum perioperative antibiotic prophylaxis, in accordance with CDC guidelines, was implemented in our hospital in October 2019. In this quasi-experimental study, all the children (one month to fifteen years old) who underwent surgery from April to September 2019 and had received broad-spectrum antibiotics for various durations, as well as those operated after the implementation of the perioperative narrow-spectrum antibiotic prophylaxis plan (October 2019 to March 2020) were enrolled. Surgical wound type (clean, clean/contaminated, contaminated, and dirty), type and site of the infection, and the patient’s age and sex were recorded. Cases with postoperative infections were followed up in the two groups during hospitalization and for 30 days (or 90 days if a prosthetic material was implanted) after discharge. The rate of post-surgical infections was compared between the two groups by the Mann-Whitney and Chi-squared tests. Results: In total, 4308 cases were enrolled in the first six months and 3650 in the second six months of the study. The rate of post-surgical infections in the first group was 31/4380 (23.7%) as compared to 22/3650 (20%) in the second group (P-value = 0.3365) Conclusions: There was no increase in the frequency of post-surgical infections after the implementation of the perioperative narrow-spectrum antibiotic prophylaxis protocol. Reducing the use of antibiotics before surgery shrinks costs and antibiotic resistance without any effect on the post-surgical infection rate.


Sign in / Sign up

Export Citation Format

Share Document