scholarly journals Study of Inflammatory and Infection Markers in Periprosthetic Fluid: Correlation with Blood Analysis in Retrospective and Prospective Studies

2021 ◽  
Vol 2021 ◽  
pp. 1-9
Author(s):  
Andrea Lisa ◽  
Cristina Belgiovine ◽  
Luca Maione ◽  
Andrea Rimondo ◽  
Andrea Battistini ◽  
...  
Keyword(s):  
Surgical Site Infection ◽  
Tissue Expander ◽  
Blood Analysis ◽  
Site Infection ◽  
Initial Value ◽  
Early Management ◽  
Two Fluids ◽  
Risk Profiling ◽  
Increasing Trend ◽  
Periprosthetic Fluid

Background. Surgical site infection represents the most severe complication in prosthetic breast reconstruction. Risk profiling represents a useful tool for both clinicians and patients. Materials and Methods. In our hospital, 534 breast reconstructions with tissue expander implants, in 500 patients, were performed. Several clinical variables were collected. In our study, we evaluated the different inflammatory markers present in the periprosthetic fluid and we compared them with the ones present in plasma. Results. The surgical site infection rate resulted to be 10.5%, and reconstruction failed in 4.5% of the cases. The hazard ratio for complications was 2.3 in women over 60 (CI: 1.3-4.07; p = 0.004 ), 2.57 in patients with expander   volume ≥ 500   cc (CI: 1.51-4.38; p < 0.001 ), 2.14 in patients submitted to previous radiotherapy (CI: 1.05-4.36; p < 0.037 ), and 1.05 in prolonged drain use (CI: 1.03-1.07; p < 0.001 ). 25-OH, PCT, and total protein were less concentrated, and ferritin and LDH were more concentrated in the periprosthetic fluid than in plasma ( p < 0.001 ). CRP ( p = 0.190 ) and β-2 microglobulin ( p = 0.344 ) did not change in the two fluids analyzed. PCT initial value is higher in patients who underwent radiotherapy, and it could be related to the higher rate of their postoperative complications. Patients with a tissue expander with a volume ≥ 500   cc show an increasing trend for CRP in time ( p = 0.009 ). Conclusions. Several risk factors (prolonged time of drains, age older than 60 years, and radiotherapy) have been confirmed by our study. The study of markers in the periprosthetic fluid with respect to their study in plasma could point toward earlier infection detection and support early management.

scholarly journals 890. Incidence and Microbiology of Surgical Site Infection (SSI) after Breast Surgery

2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. S479-S479
Author(s):  
Farah Tanveer ◽  
Dima Youssef ◽  
Mamta Youssef ◽  
Susanna Szpunar ◽  
Michelle Flood
Keyword(s):  
Surgical Site Infection ◽  
Breast Surgery ◽  
Tissue Expander ◽  
Empiric Therapy ◽  
Site Infection ◽  
Gram Positive ◽  
Historical Cohort ◽  
Gram Negative ◽  
Tissue Expanders ◽  
Student’S T

Abstract Background Surgical site infection (SSI) after breast surgery is much more common than expected after a clean surgical procedure. Although breast SSIs are primarily Gram-positive; recent literature shows an increase in Gram-negative infections. We assessed the risk factors and microbiology of SSI following breast surgery at our institution. Methods We conducted a historical cohort study of all (³ 18 y) females who had surgery from 1/1/2014-3/31/2019 and subsequent SSI within 90 days of the procedure. Two controls, matched for surgery type, were selected per case. Data were collected on demographic and clinical characteristics, surgery type, microbiology and antibiotics. Data were analyzed using the χ 2 test, Student’s t-test and multivariable logistic regression with a forward likelihood ratio algorithm. Results After excluding patients with limited data, we reviewed 284 charts: 95 of 132 cases and 189 controls. The 90-day incidence of SSI was 3.5 % (132/3755). Cases were younger than controls: 53.9 ± 12.4 years vs. 58.3± 13.7 years, respectively, p=0.02. Controls had more comorbidities: 1.8 ± 1.3 vs. 1.4 ± 0.7,respectively, p=0.001. Tissue expanders were placed in 65 (70%) cases versus 11 (5.8%) controls (p &lt; 0.0001). After controlling for age, BMI, comorbidities and post-operative antibiotics, only tissue expanders were associated with infection (OR=35.1, p&lt; 0.0001, 95% CI: 16.6, 74.0). Microbiological data were available for 84 cases. Gram-positive organisms accounted for 45 (53.6%) infections and Gram-negative organisms accounted for 39 (46.4%) infections. Over 72% of African Americans (p= 0.014), 76.5% of patients with diabetes (p=0.005) and 57.1 % with tissue expanders (p= 0.02) had Gram-negative infections. The table shows the multivariable predictors of Gram-negative infection. Tissue expander removal was required in 61.5% of patients with Gram-negative infections compared to 39% with Gram-positive infections. Predictors of Gram-negative SSI after breast surgery Conclusion Patients with tissue expanders had a higher incidence of SSI after breast surgery; removal was often required in Gram-negative infections. Diabetes and post-operative antibiotics were significant predictors of Gram-negative infection. Knowledge of local epidemiology is a key factor in deciding empiric therapy for SSI. Disclosures All Authors: No reported disclosures

Infection surveillance and prevention strategies to detect and prevent postaccess breast tissue expander infections

2019 ◽  
Vol 40 (11) ◽  
pp. 1275-1277
Author(s):  
Sima L. Sharara ◽  
Heather M. Saunders ◽  
Valeria Fabre ◽  
Sara E. Cosgrove ◽  
Donna P. Fellerman ◽  
...  
Keyword(s):  
Surgical Site Infection ◽  
Infection Prevention ◽  
Breast Tissue ◽  
Tissue Expander ◽  
Site Infection ◽  
Prevention Strategies ◽  
Contributing Factors ◽  
Infection Surveillance ◽  
Prevention Guidelines ◽  
Expansion Period

AbstractNo standardized surveillance criteria exist for surgical site infection after breast tissue expander (BTE) access. This report provides a framework for defining postaccess BTE infections and identifies contributing factors to infection during the expansion period. Implementing infection prevention guidelines for BTE access may reduce postaccess BTE infections.

scholarly journals Antibiotic Sensitivity in Post Cesarean Surgical Site Infection at a Tertiary Care Centre in Eastern Nepal

2016 ◽  
Vol 4 (2) ◽  
pp. 55
Author(s):  
Manisha Chhetry ◽  
Shanti Subedi ◽  
Sita Ghimire ◽  
Sabina Lamichhane ◽  
Basudev Banerjee ◽  
...  
Keyword(s):  
Surgical Site Infection ◽  
Tertiary Care ◽  
Antibiotic Sensitivity ◽  
Resistance Pattern ◽  
Site Infection ◽  
Tertiary Care Centre ◽  
Diffusion Technique ◽  
Highly Sensitive ◽  
Increasing Trend ◽  
The Common

Introduction: Post cesarean surgical site infection (SSI) is one of the common complications diagnosed in 2.5%-16% of the cases and is associated with significant increase in maternal morbidity, hospital stay, costs, and psychological stress to the new parents. This study was designed to study the incidence of SSI and the antimicrobial resistance pattern in our hospital.   Methods: This was a prospective observational study conducted from July 2015 to December 2015, in which all patients who were admitted with post cesarean SSI or developed SSI during their stay were included.  Wound specimens were collected and susceptibility testing was carried out using disc diffusion technique.   Results: The incidence of post cesarean SSI was 6.07% (47/774). Out of the 47 patients who had SSI, 35 (74.75%) had positive swab culture. The most important organism isolated was Staphylococcus aureus (82.85%) out of which 17 (58.62%) were MRSA strain. The resistance of Staphylococcus to penicillin was 84.6% whereas amikacin was found to be highly sensitive (>96%). Among the MRSA strain, resistance to ciprofloxacin, which is the currently used drug for prophylaxis, was 94%. Resistance to penicillins, cephalosporins, and clavulanate was also high. Resistance to vancomycin was also high (53%). Amikacin and chloramphenicol were found to be highly sensitive  (94% and 90% respectively) in the MRSA group.   Conclusion: MRSA is the leading cause of post cesarean SSI and is a matter of great concern. Amikacin and chloramphenicol were found to be highly sensitive in this group but unlike other studies, resistance of vancomycin was showing an increasing trend.

Antibiotic Prophylaxis and Resistance in Surgical Site Infection After Immediate Tissue Expander Reconstruction of the Breast

2016 ◽  
Vol 77 (5) ◽  
pp. 501-505 ◽  
Author(s):  
Meghan C. McCullough ◽  
Carrie K. Chu ◽  
Claire S. Duggal ◽  
Albert Losken ◽  
Grant W. Carlson
Keyword(s):  
Surgical Site Infection ◽  
Antibiotic Prophylaxis ◽  
Tissue Expander ◽  
Site Infection

Use of an Amikacin-Infused Collagen Sponge Concurrent with Implant Removal for Treatment of TPLO Surgical Site Infection in 30 Cases

2019 ◽  
Author(s):  
S.W. Frederick ◽  
J.N. Forbes ◽  
S.J. Lee ◽  
A.R. Cross
Keyword(s):  
Surgical Site Infection ◽  
Collagen Sponge ◽  
Implant Removal ◽  
Site Infection

Bacteriological Profile of Surgical Site Infection From A Tertiary Care Hospital, From Western India

2011 ◽  
Vol 4 (1) ◽  
pp. 397-400
Author(s):  
Dr.Arti Jain ◽  
◽  
Dr. Sunita Bhatawadekar ◽  
Dr. Meera Modak
Keyword(s):  
Surgical Site Infection ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Western India ◽  
Care Hospital ◽  
Site Infection ◽  
Bacteriological Profile

Allograft versus autograft in cervical and lumbar spinal fusions: an examination of operative time, length of stay, surgical site infection, and blood transfusions

2018 ◽  
Vol 63 (1) ◽  
Author(s):  
Meghan E. Murphy ◽  
Brandon A. Mccutcheon ◽  
Jennifer Grauberger ◽  
Daniel Shepherd ◽  
Patrick R. Maloney ◽  
...  
Keyword(s):  
Length Of Stay ◽  
Surgical Site Infection ◽  
Operative Time ◽  
Blood Transfusions ◽  
Site Infection ◽  
Time Length ◽  
Spinal Fusions ◽  
Lumbar Spinal

Surgical Site Infections - A Hospital Havoc: Retrospective Study of Surgical Site Infections in Tertiary Health Care Centre in North East India

2018 ◽  
Vol 3 (01) ◽  
Author(s):  
V Singh ◽  
A B Khyriem, W V Lyngdoh ◽  
C J Lyngdoh
Keyword(s):  
Surgical Site Infection ◽  
Multiple Drug Resistance ◽  
Surgical Site Infections ◽  
Multidrug Resistant ◽  
Multiple Drug ◽  
Site Infection ◽  
Retrospective Case ◽  
Acinetobacter Baumanii ◽  
Health Care Centre ◽  
North East

Objectives - Surgical site infections (SSI) has turn out to be a major problem even in hospital with most modern facilities and standard protocols of pre -operative preparation and antibiotic prophylaxis. Objective of this study is to know the prevalence of surgical site infection among the postoperative patients and to identify the relationship between SSI and etiological pathogens along with their antimicrobial susceptibility at North Eastern Indira Gandhi Regional Institute of Health and Medical Sciences (NEIGRIHMS), Shillong. Methods - A retrospective case study conducted at NEIGRIHMS, among patients admitted to the surgical departments during the period between January 1st and December 31st 2016. Swabs from the surgical sites were collected under sterile conditions and standard bacteriological tests were performed for identification and appropriate statistical methods were employed to look for association between SSI and etiological pathogens. Results - Out of the 1284 samples included in the study, 192 samples showed evidence of SSI yielding an infection rate of 14.9%. The most commonly isolated bacteria were: Escherichia coli, Acinetobacter baumanii and Staphylococcus aureus, of the gram negative isolates 6.2% were multidrug resistant of which 19% were carbapenem resistant. Conclusion - SSI with multiple drug resistance strains and polymicrobial etiology reflects therapeutic failure. The outcome of the SSI surveillance in our hospital revealed that in order to decrease the incidence of SSI we would have to: a) incorporate a proper antibiotic stewardship  b) conduct periodic surveillance to keep a check on SSI d) educate medical staffs regarding the prevention of surgical site infection.

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