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Napolitano LM. Intra-abdominal Infections. Semin Respir Crit Care Med 2022; 43:10-27. [PMID: 35172355 DOI: 10.1055/s-0041-1741053] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/07/2022]
Abstract
Intra-abdominal infections (IAIs) are a common cause of sepsis, and frequently occur in intensive care unit (ICU) patients. IAIs include many diagnoses, including peritonitis, cholangitis, diverticulitis, pancreatitis, abdominal abscess, intestinal perforation, abdominal trauma, and pelvic inflammatory disease. IAIs are the second most common cause of infectious morbidity and mortality in the ICU after pneumonia. IAIs are also the second most common cause of sepsis in critically ill patients, and affect approximately 5% of ICU patients. Mortality with IAI in ICU patients ranges from 5 to 50%, with the wide variability related to the specific IAI present, associated patient comorbidities, severity of illness, and organ dysfunction and failures. It is important to have a comprehensive understanding of IAIs as potential causes of life-threatening infections in ICU patients to provide the best diagnostic and therapeutic care for optimal patient outcomes in the ICU.
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Banodkar AB, Nandgaonkar VP, Gaikwad RP, Fernandes LC, Patil CL, Batho AD. Comparative evaluation of the efficacy of a novel tetracycline-coated suture with triclosan-coated and noncoated sutures on bacterial load reduction: A prospective in vitro study. J Indian Soc Periodontol 2022; 26:539-543. [PMID: 36582963 PMCID: PMC9793923 DOI: 10.4103/jisp.jisp_453_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2021] [Revised: 04/09/2022] [Accepted: 05/03/2022] [Indexed: 12/12/2022] Open
Abstract
Background Surgical site infection (SSI) is one of the common postoperative complications observed after various periodontal surgeries, and sutures play a vital role in its causation. Thus, the aim of this study is to evaluate and compare the efficacy of a novel tetracycline-coated suture with triclosan-coated and nonantibacterial-coated sutures on bacterial load reduction to prevent SSI by measuring the zone of inhibition. Materials and Methods Twenty systemically healthy individuals with moderate chronic periodontitis were included in this study. Fresh unstimulated saliva was collected from each patient and inoculated on three different blood agar plates. Sutures were divided into three groups (Group A: Tetracycline-coated suture, Group B: Triclosan-coated suture, Group C [control group]: Nonantibacterial-coated suture). The antibacterial efficacy of each suture was evaluated by performing agar diffusion test. The zone of inhibition around each suture was calculated, and statistical analysis was performed for the same using Kruskall-Wallis ANOVA test and Mann-Whitney U-test. Results On intergroup comparison, there was a statistically highly significant difference seen for the zone of inhibition between the groups (P < 0.01) with the highest values in Group A (14.45 mm), followed by Group B (1.4 mm) and least in Group C (0 mm). Conclusion Tetracycline-coated suture is more efficacious than triclosan-coated suture to reduce bacterial load and further prevent SSIs. However, in vivo clinical trial is must to prove the same.
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Affiliation(s)
- Akshaya Bhupesh Banodkar
- Department of Periodontology, Government Dental College and Hospital, St. George Hospital Campus, Mumbai, Maharashtra, India
| | - Vaibhavi Pandurang Nandgaonkar
- Department of Periodontology, Government Dental College and Hospital, St. George Hospital Campus, Mumbai, Maharashtra, India,Address for correspondence: Dr. Vaibhavi Pandurang Nandgaonkar, 2-C/307, Shree Ganesh Nagar CHS Ltd., Lalbaug Market, Lalbaug, Mumbai - 400 012, Maharashtra, India. E-mail:
| | - Rajesh Prabhakar Gaikwad
- Department of Periodontology, Government Dental College and Hospital, St. George Hospital Campus, Mumbai, Maharashtra, India
| | - Lynette Custodio Fernandes
- Department of Periodontology, Government Dental College and Hospital, St. George Hospital Campus, Mumbai, Maharashtra, India
| | - Chitra Laxmikant Patil
- Department of Periodontology, Government Dental College and Hospital, St. George Hospital Campus, Mumbai, Maharashtra, India
| | - Amrita Dharmendra Batho
- Department of Periodontology, Government Dental College and Hospital, St. George Hospital Campus, Mumbai, Maharashtra, India
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Effectiveness of active nasal surveillance culture for Methicillin-resistant Staphylococcus aureus in patients undergoing colorectal surgery. J Infect Chemother 2020; 26:1244-1248. [DOI: 10.1016/j.jiac.2020.06.013] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2019] [Revised: 05/21/2020] [Accepted: 06/15/2020] [Indexed: 01/02/2023]
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Lotfinejad N, Tuor C, Peters A, Pittet D. The duality of nurses' work: How can the profession that saves the most lives in the world avoid spreading disease? Int J Nurs Stud 2020; 107:103616. [PMID: 32446019 DOI: 10.1016/j.ijnurstu.2020.103616] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2020] [Accepted: 04/17/2020] [Indexed: 11/16/2022]
Affiliation(s)
- Nasim Lotfinejad
- Department of Research, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
| | | | - Alexandra Peters
- Infection Control Programme, University of Geneva Hospitals and Faculty of Medicine, Geneva, Switzerland.
| | - Didier Pittet
- Infection Control Programme, University of Geneva Hospitals and Faculty of Medicine, Geneva, Switzerland.
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Testa M, Stillo M, Giacomelli S, Scoffone S, Argentero PA, Farina EC, Zotti CM. Appropriate use of antimicrobial prophylaxis: an observational study in 21 surgical wards. BMC Surg 2015; 15:63. [PMID: 25968324 PMCID: PMC4434534 DOI: 10.1186/s12893-015-0048-7] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2014] [Accepted: 05/04/2015] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Surveillance of Surgical Site Infections (SSI) in 2010 found 39 % compliance with hospital guidelines in Piedmont (Italy). The aim of the study was to estimate the appropriate use of antimicrobial prophylaxis and compliance with hospitals guidelines in surgical wards. METHODS This survey study took place in 21 surgery wards of 4 public hospitals. Forms were completed by public health resident doctors together with a medical ward referent and infection control nurses. 15 consecutive surgical procedures were randomly chosen from each ward. A total of 320 cases were analyzed. The study period was from July 2012 to January 2013. Data were collected using a survey form. A final score variable from 0 to 4 was given to each case. The results were compared with hospital and international guidelines. Data were analyzed using Epi-Info software. RESULTS Of the 320 cases collected, 63 were excluded; of the remaining 257 cases, 56.4 % of the procedures were appropriate (score 4), 15.2 % were acceptable and 28.4 % were not acceptable. The study found an unjustified continuation of antimicrobial prophylaxis in 17.1 % of the 257 cases, an unjustified re-start of antimicrobial therapy in 9.7 % and a re-dosing omission in 7.8 %. CONCLUSIONS The study demonstrated critical problems in antimicrobial prophylaxis management in surgical wards due to a lack of compliance between hospitals and national guidelines, a shortage of specific and updated recommendations for some surgical interventions and incorrect local specific procedures. Coordination between local and national recommendations, strengthening of evidence based decisions and continuous sharing of policy updates are needed.
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Affiliation(s)
- Marco Testa
- School of specialization in Hygiene and Preventive Medicine, Turin, Italy. .,Department of Public Health and Pediatrics, University of Turin, Turin, Italy.
| | - Michela Stillo
- School of specialization in Hygiene and Preventive Medicine, Turin, Italy.,Department of Public Health and Pediatrics, University of Turin, Turin, Italy
| | - Sebastian Giacomelli
- School of specialization in Hygiene and Preventive Medicine, Turin, Italy.,Department of Public Health and Pediatrics, University of Turin, Turin, Italy
| | - Silvia Scoffone
- School of specialization in Hygiene and Preventive Medicine, Turin, Italy.,Department of Public Health and Pediatrics, University of Turin, Turin, Italy
| | | | - Enzo Carlo Farina
- Department of General Surgery, City of Science and Health, Turin, Italy
| | - Carla Maria Zotti
- Department of Public Health and Pediatrics, University of Turin, Turin, Italy
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Watanabe M, Suzuki H, Nomura S, Hanawa H, Chihara N, Mizutani S, Yoshino M, Uchida E. Performance Assessment of the Risk Index Category for Surgical Site Infection after Colorectal Surgery. Surg Infect (Larchmt) 2015; 16:84-9. [DOI: 10.1089/sur.2013.260] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023] Open
Affiliation(s)
- Masanori Watanabe
- Institute of Gastroenterology, Nippon Medical School Musashikosugi Hospital, Kawasaki, Kanagawa, Japan
| | - Hideyuki Suzuki
- Institute of Gastroenterology, Nippon Medical School Musashikosugi Hospital, Kawasaki, Kanagawa, Japan
| | - Satoshi Nomura
- Institute of Gastroenterology, Nippon Medical School Musashikosugi Hospital, Kawasaki, Kanagawa, Japan
| | - Hidetsugu Hanawa
- Institute of Gastroenterology, Nippon Medical School Musashikosugi Hospital, Kawasaki, Kanagawa, Japan
| | - Naoto Chihara
- Institute of Gastroenterology, Nippon Medical School Musashikosugi Hospital, Kawasaki, Kanagawa, Japan
| | - Satoshi Mizutani
- Institute of Gastroenterology, Nippon Medical School Musashikosugi Hospital, Kawasaki, Kanagawa, Japan
| | - Masanori Yoshino
- Institute of Gastroenterology, Nippon Medical School Musashikosugi Hospital, Kawasaki, Kanagawa, Japan
| | - Eiji Uchida
- Department of Surgery, Nippon Medical School, Tokyo, Japan
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Cheadle WG, Barnett R. Never Say Never Again! The Thirty-third Presidential Address to the Surgical Infection Society. Surg Infect (Larchmt) 2014. [DOI: 10.1089/sur.2013.107] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
Affiliation(s)
| | - Rebecca Barnett
- Research and Development Service, Robley Rex Veterans Affairs Medical Center, Louisville, Kentucky
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Abstract
Critically ill patients in intensive care units are subject to many complications associated with therapy. Many of these complications are health care-associated infections and are related to indwelling devices, including ventilator-associated pneumonia, central line-associated bloodstream infection, catheter-associated urinary tract infection; surgical site infection, venous thromboembolism, deep venous thrombosis, and pulmonary embolus are other common complications. All efforts should be undertaken to prevent these complications in surgical critical care, and national efforts are under way for each of these complications. In this article, epidemiology, risk factors, diagnosis, treatment, and prevention of these complications in critically ill patients are discussed.
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Affiliation(s)
- Kathleen B To
- Division of Acute Care Surgery [Trauma, Burns, Surgical Critical Care, Emergency Surgery], Department of Surgery, University of Michigan Health System, Ann Arbor, MI 48109-5033, USA
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Heineman J, Bubenik S, McClave S, Martindale R. Fighting fire with fire: is it time to use probiotics to manage pathogenic bacterial diseases? Curr Gastroenterol Rep 2012; 14:343-348. [PMID: 22763792 DOI: 10.1007/s11894-012-0274-4] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
Probiotics, when considered in clinical practice, have traditionally been used for prophylaxis; however, there is growing data suggesting treatment benefits in numerous disease states. In this review, we focus on probiotics as treatment for and prevention of several acute and chronic infectious processes including Helicobacter pylori, Clostridium difficile, necrotizing enterocolitis, ventilator-associated pneumonia, vancomycin-resistant enterococci, and nonalcoholic fatty liver disease. It is inaccurate to generalize findings observed in a single probiotic species to all probiotics. This reasoning is due to the variability of colonizing abilities of native intestinal floras, probiotic or otherwise, secondary to different combinations, doses, and duration of treatments. Given these limitations, multiple animal and human studies have shown anti-inflammatory and selective antimicrobial effects of specific probiotics. Some studies suggest a role for probiotics as supplemental treatment, in combination with antibiotics, for the aforementioned disease processes. It is apparent from this review that the efficacy of probiotics is widely variable and multifaceted. More focused clinical and basic science research is necessary to better understand the treatment potential of various probiotics.
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Affiliation(s)
- John Heineman
- Division of General Surgery, Oregon Health & Science University, Portland, 97239, USA
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Sachdev G, Napolitano LM. Postoperative pulmonary complications: pneumonia and acute respiratory failure. Surg Clin North Am 2012; 92:321-44, ix. [PMID: 22414416 DOI: 10.1016/j.suc.2012.01.013] [Citation(s) in RCA: 59] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
Postoperative pulmonary complications (atelectasis, pneumonia, pulmonary edema, acute respiratory failure) are common, particularly after abdominal and thoracic surgery, pneumonia and atelectasis being the most common. Postoperative pneumonia is associated with increased morbidity, length of hospital stay, and costs. Few institutions have pneumonia prevention programs for surgical patients, and these should be strongly considered. Acute respiratory failure is a life-threatening pulmonary complication that requires institution of mechanical ventilation and admission to the intensive care unit, and is associated with increased risk for ventilator-associated pneumonia. This article discusses epidemiology, risk factors, diagnosis, treatment, and prevention of these pulmonary complications in surgical patients.
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Affiliation(s)
- Gaurav Sachdev
- Division of Acute Care Surgery (Trauma, Burns, Critical Care, Emergency Surgery), Department of Surgery, University of Michigan, Ann Arbor, MI 48109-0033, USA
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Lipsett PA. Passing in the night: a tipping point in surgical training. Surg Infect (Larchmt) 2012; 13:1-8. [PMID: 22220507 DOI: 10.1089/sur.2011.061] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- Pamela A Lipsett
- Department of Surgery, Anesthesiology and Critical Care Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland 21287, USA.
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