Surgical infections
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Surgical infections · Aug 2013
Case ReportsBabesia microti infection presenting as acute splenic laceration.
Blunt abdominal trauma leading to splenic injury can cause substantial morbidity, particularly in patients with established splenic pathology. In such cases, the extant pathology may increase a patient's susceptibility to blunt injury, most notably by inducing hypersplenism; Babesia microti may create such a condition. ⋯ Failure to treat such infections may delay solid organ healing, leading to the patient being released to unrestricted and therefore risky activity with persistently abnormal splenic architecture.
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Surgical infections · Aug 2013
Randomized Controlled TrialProspective, randomized, study of ampicillin-sulbactam versus moxifloxacin monotherapy for the treatment of community-acquired complicated intra-abdominal infections.
The ideal antimicrobial treatment for intra-abdominal infections (IAIs) in the setting of fast-paced emergency departments (EDs) should be effective, convenient, and of limited resource utilization. Antibiotic monotherapy is a feasible option for this. We conducted a study in which we compared two regimens for antibiotic monotherapy recommended by published guidelines in ED patients with community-acquired, complicated IAIs (cIAIs). ⋯ A significant difference existed in the clinical responses of the two groups. As compared with ampicillin-sulbactam, moxifloxacin was more effective for the treatment of community-acquired cIAIs of the lower GI tract. A higher risk of treatment failure for antibiotic therapy was found for patients presenting to the ED with symptoms of cIAIs lasting >24 h. Alternative antimicrobial agents should be considered for treating these patients.
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Surgical infections · Aug 2013
Multicenter StudyAppropriateness of surgical antimicrobial prophylaxis in the Latium region of Italy, 2008: a multicenter study.
There is still wide variability in surgical antimicrobial prophylaxis (SAP) practice by different surgical teams and specialties, with potential impact on adverse events and the emergence of antibiotic resistance. ⋯ These results suggest the need for implementation of an antimicrobial stewardship program in this surgical setting.
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Surgical infections · Aug 2013
Pre-operative and early post-operative factors associated with surgical site infection after laparoscopic sleeve gastrectomy.
Surgical procedures on obese patients are expected to have a high incidence of surgical site infection (SSI). The identification of pre-operative or early post-operative risk factors for SSI may help the surgeon to identify subjects in risk and adequately optimize their status. We conducted a study of the association of comorbidities and pre- and post-operative analytical variables with SSI following laparoscopic sleeve gastrectomy for the treatment of morbid obesity. ⋯ The study supports the role of restrictive lung disorders and the values specified above for preoperative BMI, serum total protein and cortisol concentrations, and MCV, and of post-operative anemia and hyperglycemia as risk factors for SSI. In these situations, the surgeon must be aware of and seek to control these risk factors.
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Surgical infections · Aug 2013
Vancomycin versus linezolid in the treatment of methicillin-resistant Staphylococcus aureus meningitis.
Vancomycin is the mainstay of treatment for methicillin-resistant Staphylococcus aureus (MRSA) meningitis. However, successful outcomes with linezolid have not been reported in a large series of patients. We conducted a single-center retrospective cohort study to compare vancomycin with linezolid in the treatment of MRSA meningitis. ⋯ Analysis of the findings in the limited cohorts in our study suggests that linezolid is superior to vancomycin for treating MRSA meningitis, especially in cases in which there is a high MIC (2 mg/L) for vancomycin. A clinical study involving larger cohorts may increase the evidence available in relation to this question.