Surgical infections
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Surgical infections · Aug 2014
Comparative StudyWhere's the difference? Presentation of nosocomial infection in critically ill trauma versus general surgery patients.
Diagnosing infection efficiently is integral to managing critically ill patients. Knowing if and how trauma and general surgery patients differ in their presentation of new infectious complications could be useful. We hypothesized these populations would differ in presentation in the intensive care unit (ICU). ⋯ Differences exist in how new infections manifest in trauma and general surgery patients in the ICU. General surgery patients appeared sicker on their first day of infection, as evidenced by a higher leukocyte count, lower blood pressure, and substantial positive fluid balance. Intensivists may need differing thresholds for triggering infection workups when employed in a mixed unit.
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Surgical infections · Aug 2014
Prevalence of methicillin resistant Staphylococcus aureus among Egyptian patients after surgical interventions.
Staphylococcus aureus (S. aureus) is isolated frequently from surgical site infections and other soft tissue infections. There are limited data examining the prevalence of methicillin resistant S. aureus (MRSA) among Egyptian patients after surgery. The current study determined the prevalence of MRSA isolated from surgical site and soft tissue infections at Minia University Hospital (MUH), determined their susceptibility to β-lactams and other antimicrobials, and examined their mecA gene expression. ⋯ Staphylococcus aureus isolates are the major pathogens responsible for wound and surgical site infections at MUH and MRSA are a potential threat for wound patients in Egypt.
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Cefazolin remains the preferred preoperative antibiotic for the majority of surgical procedures. However, outcome evidence supporting current dosing recommendations for pre-operative prophylaxis is scarce, particularly for obese patients. With more than 33% of adults in the United States classified as obese, it is crucial that we determine the correct dosing regimen in order to maximize the potential to prevent surgical site infections (SSIs). The purpose of this study was to evaluate whether surgical prophylaxis with cefazolin 2 g, as recommended by practice guidelines, is as effective in preventing SSIs in obese as compared to non-obese patients. ⋯ Obese patients may continue to receive 2 g of cefazolin preoperatively until large-scale controlled trials show differently.
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Surgical infections · Aug 2014
Review Case ReportsPyoderma gangrenosum after minor trauma in a pregnant woman, mistaken for necrotizing fasciitis: report of a case and literature review.
Pyoderma gangrenosum is an ulcerative, non-infectious skin disorder. However, it can be mistaken as necrotizing fasciitis, a life-threatening infective condition. We describe here a case of pyoderma gangrenosum after minor trauma treated as necrotizing fasciitis. ⋯ Pyoderma gangrenosum can mimic infectious necrotizing fasciitis. Differentiating these two conditions is important because mistreatment of pyoderma can lead to disfigurement.