Trichophytonas a Rare Cause of Postoperative Wound Infection Resistant to Standard Empiric Antimicrobial Therapy

Fungal infections are rare causes of acute surgical wound infections, butCandidais not an infrequent etiology in chronic wound infections.Trichophytonspecies is a common cause of tinea capitis but has not been reported as a cause of neurosurgical wound infection. We report a case ofTrichophyton tonsuranscausing a nonhealing surgical wound infection in a 14-year-old male after hemicraniectomy. His wound infection was notable for production of purulent exudate from the wound and lack of clinical improvement despite empiric treatment with multiple broad-spectrum antibiotics targeting typical bacterial causes of wound infection. Multiple wound cultures consistently grewTrichophytonfungus, and his wound infection clinically improved rapidly after starting terbinafine and discontinuing antibiotics.

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Surgical wound infections after peripheral vascular surgery

Scandinavian Journal of Surgery ◽

10.1177/1457496913514384 ◽

2014 ◽

Vol 103 (4) ◽

pp. 226-231 ◽

Cited By ~ 20

Author(s):

J. Turtiainen ◽

T. Hakala

Keyword(s):

Vascular Surgery ◽

Wound Infection ◽

Major Amputation ◽

Review Article ◽

Surgical Wound Infection ◽

Wound Infections ◽

Peripheral Vascular ◽

Surgical Wound ◽

Related Factors ◽

Peripheral Vascular Surgery

Surgical wound infection is one of the most common complications after peripheral vascular surgery. It increases the affected patient’s risk for major amputation as well as mortality. Furthermore, surgical wound infection is an additional cost. Wound infections after vascular surgery are of multifactorial nature and generally result from the interplay of patient- and procedure-related factors. The use of systemic antibiotic prophylaxis may be the most important method in preventing surgical wound infections. In this review article, we report the current literature of surgical wound infections after peripheral vascular surgery.

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Outbreak of Surgical Wound Infections Associated With Total Hip Arthroplasty

Infection Control and Hospital Epidemiology ◽

10.1086/646592 ◽

1992 ◽

Vol 13 (9) ◽

pp. 526-534 ◽

Cited By ~ 3

Author(s):

Consuelo M. Beck-Sague ◽

Wang H. Chong ◽

Connie Roy ◽

Roger Anderson ◽

William R Jarvis

Keyword(s):

Risk Factors ◽

Total Hip Arthroplasty ◽

Wound Infection ◽

Hip Arthroplasty ◽

Posterior Approach ◽

Surgical Wound Infection ◽

Wound Infections ◽

Surgical Wound ◽

Total Hip ◽

Drop Plate

AbstractObjectives:Describe an outbreak of surgical wound infections associated with total hip arthroplasty; identify risk factors for surgical wound infection during the pre-outbreak and outbreak periods.Setting:A 100-bed hospital. From May 1 to September 30, 1988, 7 of 15 patients who underwent total hip arthroplasty developed surgical wound infections from Staphylococcus aureus (5), Enterobacter cloacae (1), b-hemolytic streptococci (1), enterococci (1), coagulase-negative staphylococci (1), and Escherichia coli (1) (attack rate = 46.7%).Design:Retrospective cohort studies comparing surgical wound infection rates by patient-and procedure-related risk factors during the pre-outbreak and outbreak periods were conducted. Drop plate quantitative air culturing was conducted in 10 consecutive total hip artbroplasties in the subsequent 6 months.Results:Rates of surgical wound infection were significantly higher for arthroplasties in which no intraoperative prophylactic antimicrobials were given (44% versus 8%, relative risk [RR] = 5.4, p= .01), or in which the posterior approach (20% versus 3%, RR= 6.7, p = .04) or a specific prosthesis (39% versus 5%, RR=6.3, p = 0.01) was used. The surgical wound infection rate was highest when one circulating nurse, Nurse A, assisted (47% versus 4%, RR= 12.8, p<.001). Logistic regression analysis identified use of the posterior approach (RR= 1.8, p= .04) and Nurse A's participation (RR= 5.0, p <.001) as independent risk factors for surgical wound infection. Interviews of the nursing supervisor indicated that Nurse A had recurrent dermatitis on her bands. During 6 months following Nurse A's reassignment, the rate declined significantly (from 7/15 to 0/10, p=.01). Drop plate culturing yielded 2 to 10 colonies per plate of organisms that did not match outbreak organisms.Conclusions:Outbreaks associated with personnel generally involve only 1 species. In this outbreak, Nurse A (possibly because of her dermatitis), technique, the posterior approach, and/or other undetermined factors were the primary predictors of surgical wound infection.

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The Role of Hair Shaving in Skull Base Surgery

Otolaryngology ◽

10.1067/mhn.2003.14 ◽

2003 ◽

Vol 128 (1) ◽

pp. 43-47 ◽

Cited By ~ 23

Author(s):

Ziv Gil ◽

Jacob T. Cohen ◽

Sergei Spektor ◽

Dan M. Fliss

Keyword(s):

Wound Infection ◽

Skull Base ◽

Skull Base Surgery ◽

Fungal Infections ◽

Wound Infection Rate ◽

Surgical Wound Infection ◽

Hair Removal ◽

Surgical Wound ◽

Increased Risk ◽

Clean Contaminated

OBJECTIVE: We sought to evaluate surgical wound infection rates in patients undergoing skull base surgery without hair removal. METHODS: We undertook a retrospective study of 175 skull base operations performed without hair removal. Anterior operations were conducted via the subcranial approach (n = 120) and lateral or posterior procedures via various approaches (n = 55). Wounds were examined daily during hospitalization and at routine outpatient follow-up (8 to 45 months) and classified according to the Center for Disease Control and Prevention guidelines. RESULTS: The overall surgical wound infection rate was 1.1% (2 of 175): 0.8% (1 of 120) for anterior and 1.8% (1 of 55) for lateral or posterior procedures. It was similar for clean operations (lateral and posterior) and clean-contaminated (anterior) procedures and was less than or similar to the rates reported for skull base procedures with hair removal. No wound infection occurred among the infected (trauma, fungal infections, and brain abscess) patients. CONCLUSIONS: Skull base surgery without hair removal is safe and not associated with increased risk of wound infection. The method may prevent additional psychologic stress, promote restoration of the patient's self-image, and accelerate his or her return to normal life.

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CDC Definitions of Nosocomial Surgical Site Infections, 1992: A Modification of CDC Definitions of Surgical Wound Infections

Infection Control and Hospital Epidemiology ◽

10.1017/s0195941700015241 ◽

1992 ◽

Vol 13 (10) ◽

pp. 606-608 ◽

Cited By ~ 845

Author(s):

Teresa C. Horan ◽

Robert P. Gaynes ◽

William J. Martone ◽

William R. Jarvis ◽

T. Grace Emori

Keyword(s):

Wound Infection ◽

Nosocomial Infections ◽

Task Force ◽

Surgical Site Infections ◽

Surgical Wound Infection ◽

Wound Infections ◽

Surgical Wound ◽

Hospital Epidemiology ◽

Surgical Infection ◽

Definition Of

In 1988, the Centers for Disease Control (CDC) published definitions of nosocomial infections However, because of journalistic style and space constraints, these definitions lacked some of the detail provided to National Nosocomial Infections Surveillance (NNIS) System hospitals in the NNIS Manual (unpublished). After the NNIS System hospitals had had considerable experience with the definitions and in response to a request for review by The Surgical Wound Infection Task Force, a group composed of members of The Society for Hospital Epidemiology of America, the Association for Practitioners in Infection Control, the Surgical Infection Society, and the CDC, we slightly modified the definition of surgical wound infection and changed the name to surgical site infection (SSI).

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