Surgical infections
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Surgical infections · Jun 2007
Comparative StudyStudy of the efficacy of coated Vicryl plus antibacterial suture in an animal model of orthopedic surgery.
To evaluate the efficacy in vitro and in vivo of a new antibacterial suture, polyglactin 910 suture with triclosan, compared with a traditional braided suture, polyglactin (Vicryl), in a validated animal model of orthopedic infection. Our primary goal was to compare the microbiologic effectiveness of the two sutures. The secondary goal was to evaluate histopathologic signs of an inflammatory response. ⋯ Under simulated conditions of severe intraoperative contamination, the antibacterial suture reduced the number of positive cultures after surgery by 66.6%. Judging from the available clinical information, its use might contribute to reducing the number of infected implants by 25.8%. Human studies are needed to determine the clinical implications of these results.
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Surgical infections · Apr 2007
Review Case ReportsKlebsiella pneumoniae necrotizing fasciitis and septic arthritis: an appearance in the Western hemisphere.
Necrotizing fasciitis caused by Klebsiella pneumoniae is rare, with 11 documented cases in the literature, all occurring in Asia and the Middle East. These reports have become more frequent in recent years in association with the emergence of the highly virulent K1 capsular serotype of Klebsiella. We report a case of Klebsiella necrotizing fasciitis and con-current septic arthritis in the Western hemisphere. ⋯ Although K. pneumoniae is common, monomicrobial necrotizing fasciitis and septic arthritis caused by this pathogen has not been reported previously outside Asia, where it is rare. The appearance of this infection in the Western hemisphere may reflect geographic spread of the aggressive K1 phenotype. Physicians treating patients with symptoms and signs of necrotizing fasciitis or septic arthritis, particularly in the setting of underlying chronic illness or recent travel to Asia, should consider K. pneumoniae as a potential cause and treat accordingly.
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Surgical infections · Apr 2007
Clinical TrialAddition of vasopressin to norepinephrine as independent predictor of mortality in patients with refractory septic shock: an observational study.
To identify predictors of 28-day mortality among patients with refractory septic shock treated with norepinephrine with or without vasopressin. ⋯ Our study found an association between the use of norepinephrine plus vasopressin and 28-day mortality in refractory septic shock. In view of its known mechanism of action, vasopressin contributed to this excess mortality. Further recommendations regarding the use of vasopressin await the results of large randomized trials evaluating its efficacy and safety for septic shock.
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Surgical infections · Feb 2007
Randomized Controlled Trial Multicenter StudyRandomized, multicenter, double-blind study of efficacy, safety, and tolerability of intravenous ertapenem versus piperacillin/tazobactam in treatment of complicated intra-abdominal infections in hospitalized adults.
Complicated intra-abdominal infections are a common problem in surgical practice. This study compared the effectiveness of ertapenem (1 g qd) and piperacillin/tazobactam (3.375 g q6h) in the treatment of these infections. ⋯ Ertapenem was non-inferior to piperacillin/tazobactam in the cure of intra-abdominal infections caused by susceptible pathogens. Both study drugs generally were well tolerated.