Lawsonella clevelandensis: an emerging cause of vascular graft infection

2021 ◽  
Vol 14 (2) ◽  
pp. e237350
Author(s):  
Rommel Ramesh ◽  
Mariam Assi ◽  
Zerelda Esquer Garrigos ◽  
Muhammad Rizwan Sohail
Keyword(s):  
16S Rrna ◽  
Antibiotic Therapy ◽  
Surgical Resection ◽  
Vascular Graft ◽  
Graft Infection ◽  
Clinical Diagnostics ◽  
Emerging Pathogen ◽  
Vascular Graft Infection ◽  
Intravenous Antibiotic

Lawsonella clevelandensis, an emerging pathogen, was first described in 2016, and has been implicated in abdominal, breast and spinal abscesses in a limited number of cases. Being a fastidious organism, it is primarily identified with molecular methods. With the incorporation of broad-range PCR testing in clinical diagnostics, L. clevelandensis has been increasingly reported in the literature. We describe a case of a 65-year-old man who presented with bilateral psoas abscesses secondary to aorto-bi-iliac vascular graft infection with L. clevelandensis identified using 16S rRNA/PCR sequencing. The patient underwent surgical resection and replacement of infected graft, followed by 6 weeks of intravenous antibiotic therapy and then chronic suppression with doxycycline and cefadroxil. He was infection-free at last follow-up.

scholarly journals Efficacy of Preoperative Antibiotic Therapy for the Treatment of Vascular Graft Infection

2018 ◽  
Vol 11 (2) ◽  
pp. 191-195 ◽  
Author(s):  
Takuya Miyahara ◽  
Katsuyuki Hoshina ◽  
Masahiko Ozaki ◽  
Masanori Ogiwara
Keyword(s):  
Antibiotic Therapy ◽  
Vascular Graft ◽  
Graft Infection ◽  
Vascular Graft Infection

Inadequate Perioperative Prophylaxis and Postsurgical Complications After Graft Implantation Are Important Risk Factors for Subsequent Vascular Graft Infections: Prospective Results From the Vascular Graft Infection Cohort Study

2018 ◽  
Vol 69 (4) ◽  
pp. 621-630 ◽  
Author(s):  
Alexia Anagnostopoulos ◽  
Bruno Ledergerber ◽  
Stefan P Kuster ◽  
Alexandra U Scherrer ◽  
Bettina Näf ◽  
...  
Keyword(s):  
Risk Factors ◽  
Antibiotic Treatment ◽  
Vascular Graft ◽  
Graft Infection ◽  
Observation Time ◽  
Procedure Time ◽  
Prevention Strategies ◽  
Vascular Graft Infection ◽  
Perioperative Prophylaxis

Abstract Background Reconstructive vascular surgery has become increasingly common. Vascular graft infections (VGIs) are serious complications, leading to increased morbidity and mortality. Previously described risk factors for VGIs include groin incisions, wound infections, and comorbidities. We aimed to identify modifiable predictors for VGIs as targets for infection prevention strategies. Methods Participants of the prospective Vascular Graft Infection Cohort (VASGRA) with surgery between 2013 and 2017 were included. The observation time was calculated from surgery until a confirmed VGI or the last follow-up. Variables were assessed by infection status, using non-parametric tests. Univariable and multivariable Cox proportional hazard regression models, adjusted for demographic factors, were applied to assess risk factors for a VGI. Results A total of 438 predominantly male (83.1%) patients with a median age of 71 years (interquartile range [IQR] 63 – 76) contributed to 554 person years of follow-up. Thereof, 39 (8.9%) developed a VGI, amounting to an incidence rate of 7.0/100 person years. We found incisional surgical site infections (adjusted hazard ratio [aHR] 10.09, 95% CI 2.88 – 35.34); hemorrhage (aHR 4.92, 1.28–18.94); renal insufficiency (aHR 4.85, 1.20 – 19.61); inadequate perioperative prophylaxis in patients with an established antibiotic treatment, compared to the additional application of perioperative prophylaxis (aHR 2.87, 95% CI 1.17 – 7.05); and procedure time increases of 1-hour intervals (aHR 1.22, 95% CI 1.08 – 1.39) to be risk factors for VGIs. Conclusions We identified procedure time; inadequate perioperative prophylaxis, especially among patients with an established antibiotic treatment; and several postsurgical infectious and non-infectious complications as modifiable, predictive factors for VGIs and, therefore, as keys to improved surveillance programs and prevention strategies. Clinical Trials Registration NCT01821664

99mTc-Leukocyte Scintigraphy in Prosthetic Vascular Graft Infections

1989 ◽  
Vol 28 (03) ◽  
pp. 95-99 ◽  
Author(s):  
J. Laitinen ◽  
J. Lehtonen ◽  
I. Soini ◽  
I. Toivio ◽  
R. Mokka ◽  
...  
Keyword(s):  
Vascular Graft ◽  
Graft Infection ◽  
Diagnostic Value ◽  
Late Infection ◽  
Vascular Graft Infection ◽  
Three Phase ◽  
Leukocyte Scintigraphy ◽  
99Mtc Hmpao ◽  
Prosthetic Vascular Graft Infection

The aim of this study was to determine the diagnostic value of scintigraphy with 99mTc-HMPAO-labelled leukocytes for the detection of prosthetic vascular graft infection. 51 scans were recorded in 19 patients with suspected vascular graft infection and 8 control patients. Three-phase scanning was used at 0.5, 3 – 6 and 18–24 h. 13 vascular graft infections (10 early, 3 late) were found. 12 of these healed with antibiotics and only one patient with late infection had to be reoperated. None of them died during the follow-up period. The sensitivity was 100% and the specificity 96%. 99mTc-leukocyte scintigraphy seems a useful tool to detect vascular graft infection and to differentiate it from infections elsewhere. The results suggest that the incidence of vascular graft infection may be greater, and the mortality rate lower, than supposed before.

In-vivo evaluation of the effect of cyanoacrylate on prosthetic vascular graft infection – does cyanoacrylate increase the severity of infection?

VASA ◽  
2020 ◽  
Vol 49 (4) ◽  
pp. 281-284
Author(s):  
Atıf Yolgosteren ◽  
Gencehan Kumtepe ◽  
Melda Payaslioglu ◽  
Cuneyt Ozakin
Keyword(s):  
Vascular Graft ◽  
Graft Infection ◽  
Vascular Graft Infection ◽  
Group 4 ◽  
Significant Difference ◽  
Group 3 ◽  
Group 2 ◽  
Prosthetic Vascular Graft Infection ◽  
Group 1

Summary. Background: Prosthetic vascular graft infection (PVGI) is a complication with high mortality. Cyanoacrylate (CA) is an adhesive which has been used in a number of surgical procedures. In this in-vivo study, we aimed to evaluate the relationship between PVGI and CA. Materials and methods: Thirty-two rats were equally divided into four groups. Pouch was formed on back of rats until deep fascia. In group 1, vascular graft with polyethyleneterephthalate (PET) was placed into pouch. In group 2, MRSA strain with a density of 1 ml 0.5 MacFarland was injected into pouch. In group 3, 1 cm 2 vascular graft with PET piece was placed into pouch and MRSA strain with a density of 1 ml 0.5 MacFarland was injected. In group 4, 1 cm 2 vascular graft with PET piece impregnated with N-butyl cyanoacrylate-based adhesive was placed and MRSA strain with a density of 1 ml 0.5 MacFarland was injected. All rats were scarified in 96th hour, culture samples were taken where intervention was performed and were evaluated microbiologically. Bacteria reproducing in each group were numerically evaluated based on colony-forming unit (CFU/ml) and compared by taking their average. Results: MRSA reproduction of 0 CFU/ml in group 1, of 1410 CFU/ml in group 2, of 180 200 CFU/ml in group 3 and of 625 300 CFU/ml in group 4 was present. A statistically significant difference was present between group 1 and group 4 (p < 0.01), between group 2 and group 4 (p < 0.01), between group 3 and group 4 (p < 0.05). In terms of reproduction, no statistically significant difference was found in group 1, group 2, group 3 in themselves. Conclusions: We observed that the rate of infection increased in the cyanoacyrylate group where cyanoacrylate was used. We think that surgeon should be more careful in using CA in vascular surgery.

scholarly journals Surgical Management of Vascular Graft Infection in Severely Ill Patients by Partial Resection of the Infected Prosthesis

2007 ◽  
Vol 33 (5) ◽  
pp. 610-613 ◽  
Author(s):  
M. Mirzaie ◽  
J.D. Schmitto ◽  
T. Tirilomis ◽  
S. Fatehpur ◽  
O.J. Liakopoulos ◽  
...  
Keyword(s):  
Surgical Management ◽  
Vascular Graft ◽  
Graft Infection ◽  
Partial Resection ◽  
Vascular Graft Infection

Diagnosing prosthetic vascular graft infection with the antigranulocyte antibody 99mTc-fanolesomab

2007 ◽  
Vol 28 (4) ◽  
pp. 297-300 ◽  
Author(s):  
Gene G. Tronco ◽  
Charito Love ◽  
Josephine N. Rini ◽  
Alice K. Yu ◽  
Kuldeep K. Bhargava ◽  
...  
Keyword(s):  
Vascular Graft ◽  
Graft Infection ◽  
Vascular Graft Infection ◽  
Prosthetic Vascular Graft Infection ◽  
Antigranulocyte Antibody

scholarly journals Late results following surgical management of vascular graft infection

1984 ◽  
Vol 1 (1) ◽  
pp. 36-44 ◽  
Author(s):  
Linda M. Reilly ◽  
Howard Altman ◽  
Robert J. Lusby ◽  
Robert A. Kersh ◽  
William K. Ehrenfeld ◽  
...  
Keyword(s):  
Surgical Management ◽  
Vascular Graft ◽  
Graft Infection ◽  
Late Results ◽  
Vascular Graft Infection

Management of complicated shunt infections: a clinical report

2008 ◽  
Vol 1 (3) ◽  
pp. 223-228 ◽  
Author(s):  
Hector E. James ◽  
John S. Bradley
Keyword(s):  
Antibiotic Therapy ◽  
Treatment Protocol ◽  
Shunt Infection ◽  
The Body ◽  
Clinical Report ◽  
Intravenous Antibiotic ◽  
Once Daily ◽  
Intravenous Antibiotic Therapy ◽  
Shunt Infections

Object The authors present their experience with a protocol for the treatment of patients with complicated shunt infections. Methods Complicated shunt infections are defined for the purpose of this protocol as multiple compartment hydrocephalus, multiple organism shunt infection, severe peritonitis, or infections in other sites of the body. The initial treatment protocol for these patients was 3 weeks of intravenous antibiotic therapy and 2 weeks of twice daily intraventricular/intrashunt antibiotic therapy. Cerebrospinal fluid (CSF) cultures were monitored during therapy and obtained again 48 hours after completion. The shunt was completely replaced. Additionally, follow-up cultures were obtained in all patients 3–6 months after therapy was completed. Results A cure of the infection was achieved in all patients as defined by negative cultures obtained at completion of antibiotic therapy and in follow-up studies. The follow-up period was 2–11 years (mean 4.4 ± 2.5 years). The treatment protocol was modified in the patients treated after 1991, and 18 patients were treated with this modified treatment regime. In these patients, intraventricular antibiotics were administered only once daily for 14 days, and the CSF was cultured 24 hours after antibiotic therapy had been stopped instead of after 48 hours. The results were similar to those obtained with the initial protocol. Conclusions Based on their prospective nonrandomized series, the authors believe that patients with complicated shunt infections can be successfully treated with 2 weeks of intraventricular antibiotic therapy administered once daily, concurrent with 3 weeks of intravenous antibiotic therapy. This protocol reduces length of treatment and hospital stay, and avoids recurrence of infection.

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