Surgical infections
-
Surgical infections · Aug 2011
Liver X receptor protects against liver injury in sepsis caused by rodent cecal ligation and puncture.
Liver X receptor (LXR) is a transcription factor of the nuclear receptor family, regulating genes involved in metabolism, inflammation, and apoptosis. In the present investigation, we examined the role of LXR in organ injury and systemic inflammation in rodent models of polymicrobial peritonitis caused by cecal ligation and puncture (CLP). ⋯ Collectively, these results argue in favor of a role for LXRα in protection against liver injury in experimental sepsis induced by CLP.
-
Surgical infections · Aug 2011
Comparative Study Clinical TrialPeripherally inserted central catheters may lower the incidence of catheter-related blood stream infections in patients in surgical intensive care units.
Long-term central venous catheterization is associated with a higher rate of catheter-related blood stream infections (CR-BSI). It is unclear whether there is a difference in the CR-BSI rate associated with central venous catheters (CVCs) and peripherally inserted central catheters (PICCs) in long-stay patients in surgical intensive care units (SICUs). We hypothesized that PICC use reduces the rate of CR-BSI compared with use of antiseptic CVCs in these patients. ⋯ In this non-randomized study, PICC was associated with fewer CR-BSIs in long-stay SICU patients, although CVCs were in place longer than PICC lines. The only predictor of CVC infection was the duration the line was in place. These results suggest that minimizing the duration of central venous access and substituting PICC for CVC may reduce the incidence of CR-BSI in long-stay SICU patients.
-
Surgical infections · Aug 2011
Antibiotic regimen and the timing of prophylaxis are important for reducing surgical site infection after elective abdominal colorectal surgery.
Surgical site infections (SSIs) cause morbidity after elective colorectal surgery, and antibiotic prophylaxis can decrease SSIs. The aim of this study was to determine compliance with an antibiotic administration protocol, including regimen, initial dose timing, and re-dosing, and determine the risk of SSI associated with each. We hypothesized that appropriate antibiotic administration reduces the risk of SSI. ⋯ Appropriate antibiotic selection and timing of administration for prophylaxis are crucial to reduce the likelihood of SSI after elective colorectal surgery with intestinal anastomosis.
-
Surgical infections · Aug 2011
Patient outcomes associated with 2-octyl cyanoacrylate topical skin adhesive in coronary artery bypass graft surgery.
Surgical site infection (SSI) is an important cause of morbidity and occasionally death after coronary artery bypass graft (CABG) surgery. These infections also are associated with higher costs and poorer surgical outcomes. We used a retrospective observational database to examine and quantify the effects of the topical skin adhesive 2-octyl cyanoacrylate, used as the final layer of site closure in patients undergoing CABG surgery, on the incidence of post-operative SSI. ⋯ The observed rates of post-CABG SSI were consistent with the rates observed in the literature. The SSI rate for patients who had sutures and 2-octyl cyanoacrylate used as the final layer of site closure was significantly lower than the rates for patients having other types of closure.
-
Surgical infections · Aug 2011
Multidrug-resistant pathogens and pneumonia: comparing the trauma and surgical intensive care units.
As acute care surgery evolves, more trauma surgeons are caring for critically ill general surgery as well as trauma patients. However, these two populations are unique, and infectious complications may need to be addressed differently, as the causative organisms may not be the same in the two groups. To study this, we evaluated ventilator-associated (VAP) and hospital-acquired (HAP) pneumonia in the trauma (TICU) and general surgical (SICU) intensive care units to investigate differences in the causative pathogens. Our hypothesis was that SICU patients would have a higher incidence of multi-drug-resistant (MDR) organisms causing VAP/HAP, possibly contributing to inadequate empiric antibiotic (IEA) coverage. ⋯ Multiply-resistant pathogens cause a significantly greater number of VAP/HAPs in the SICU than in the TICU. Associated with this, when using an antibiotic algorithm based on TICU bacterial pathogens, there is a trend toward a greater likelihood of subsequent pneumonias and toward more IEA coverage in the SICU population compared with TICU patients. Our results indicate that these distinct patient populations have different pathogens causing VAP/HAP and affirm the necessity for population-specific algorithms to tailor empiric coverage for presumed VAP/HAP.