Empirical Antibiotic Treatment of Obstetric and Gynecologic Surgical Site Infections: Are the Right Pathogens Being Targeted?

2018 ◽  
Vol 34 (5) ◽  
pp. 229-233 ◽  
Author(s):  
Yuval Fouks ◽  
Shiri Shinar ◽  
Ariel Many ◽  
Ishai Levin ◽  
Gal Hershkovitz ◽  
...  
Keyword(s):  
Antibiotic Treatment ◽  
Surgical Site Infections ◽  
Empirical Antibiotic Treatment ◽  
The Right

scholarly journals Relevance of empirical antibiotic treatment in the evolution of prosthetic joint infection treated with implant retention

2021 ◽  
Author(s):  
José María Barbero Allende ◽  
◽  
Marta García Sánchez ◽  
Miguel Vacas Córdoba ◽  
Eduardo Montero Ruiz ◽  
...  
Keyword(s):  
Antibiotic Therapy ◽  
Antibiotic Treatment ◽  
Prosthetic Joint Infection ◽  
Joint Infection ◽  
Multidrug Resistant ◽  
Empirical Antibiotic Therapy ◽  
Empirical Antibiotic Treatment ◽  
Prosthetic Joint ◽  
Implant Retention ◽  
The Right

Introduction. Several factors have been associated with the prognosis of prosthetic joint infection (PJI) treated with surgical debridement, antibiotic therapy, and implant retention (DAIR). There is no evidence about the right empirical antibiotic treatment when the causal microorganism is not still identified. Material and methods. We conducted a retrospective observational study in patients with PJI treated with DAIR between 2009 and 2018 in our center. We analyze the risk factors related with their prognosis and the influence of active empirical antibiotic therapy against causative microorganisms in final outcomes. Results. A total of 80 PJI cases treated with DAIR, from 79 patients (58.7% women, mean age 76.3 years), were included in the study period. Among the cases in which empirical antibiotic therapy were active against the causative microorganisms, the success rate was 46/65 (69.2%) vs 1/15 when not (6.7%, OR 31.5, p = 0.001). Factors related to the success or failure of the DAIR were analyzed with multivariate analysis. We found that active empirical antibiotic treatment remained statistically significant as a good prognostic factor (OR 0.04, p <0.01). Conclusions. Empirical antibiotic treatment could be an important factor in the prognosis of PJI treated with DAIR. To identify cases at risk of infection by multidrug resistant microorganisms could be useful to guide empirical antibiotic therapy

scholarly journals Multisite Infection withMycobacterium abscessusafter Replacement of Breast Implants and Gluteal Lipofilling

2015 ◽  
Vol 2015 ◽  
pp. 1-6 ◽  
Author(s):  
Eva Rüegg ◽  
Alexandre Cheretakis ◽  
Ali Modarressi ◽  
Stephan Harbarth ◽  
Brigitte Pittet-Cuénod
Keyword(s):  
Antibiotic Treatment ◽  
Medical Tourism ◽  
Acute Infection ◽  
Surgical Site Infections ◽  
Breast Implants ◽  
Aesthetic Surgery ◽  
Mycobacterium Abscessus ◽  
Wound Management ◽  
The Right ◽  
Periprosthetic Fluid

Introduction. Medical tourism for aesthetic surgery is popular. Nontuberculous mycobacteria (NTM) occasionally cause surgical-site infections. As NTM grow in biofilms, implantations of foreign bodies are at risk. Due to late manifestation, infections occur when patients are back home, where they must be managed properly.Case Report. A 39-year-old healthy female was referred for acute infection of the right gluteal area. Five months before, she had breast implants replacement, abdominal liposuction, and gluteal lipofilling in Mexico. Three months postoperatively, implants were removed for NTM-infection in Switzerland. Adequate antibiotic treatment was stopped after seven days for drug-related hepatitis. At entrance, gluteal puncture for bacterial analysis was performed. MRI showed large subcutaneous collection. Debridement under general anaesthesia was followed by open wound management. Total antibiotic treatment was 20 weeks.Methods. Bacterial analysis of periprosthetic and gluteal liquids included Gram-stain plus acid-fast stain, and aerobic, anaerobic and mycobacterial cultures.  Results. In periprosthetic fluid,Mycobacterium abscessus, Propionibacterium, andStaphylococcus epidermidiswere identified. The sameM. abscessusstrain was found gluteally. The gluteal wound healed within six weeks. At ten months’ follow-up, gluteal asymmetry persists for deep scarring.Conclusion. This case presents major complications of multisite aesthetic surgery. Surgical-site infections in context of medical tourism need appropriate bacteriological investigations, considering potential NTM-infections.

Should we take into account ESBLs in empirical antibiotic treatment?

2016 ◽  
Vol 42 (12) ◽  
pp. 2059-2062 ◽  
Author(s):  
Bassetti Matteo ◽  
Jesús Rodríguez Baño
Keyword(s):  
Antibiotic Treatment ◽  
Empirical Antibiotic Treatment

Determinants of inappropriate empirical antibiotic treatment: systematic review and meta-analysis

2018 ◽  
Vol 51 (4) ◽  
pp. 548-553 ◽  
Author(s):  
Elena Carrara ◽  
Iris Pfeffer ◽  
Oren Zusman ◽  
Leonard Leibovici ◽  
Mical Paul
Keyword(s):  
Systematic Review ◽  
Antibiotic Treatment ◽  
Meta Analysis ◽  
Empirical Antibiotic Treatment

scholarly journals Systematic review and meta-analysis: susceptibility-guided versus empirical antibiotic treatment forHelicobacter pyloriinfection

2015 ◽  
Vol 70 (9) ◽  
pp. 2447-2455 ◽  
Author(s):  
Sheila López-Góngora ◽  
Ignasi Puig ◽  
Xavier Calvet ◽  
Albert Villoria ◽  
Mireia Baylina ◽  
...  
Keyword(s):  
Systematic Review ◽  
Antibiotic Treatment ◽  
Meta Analysis ◽  
Empirical Antibiotic Treatment

Microbiological pattern of prosthetic hip and knee infections: a high-volume, single-centre experience in China

2021 ◽  
Author(s):  
Yali Yu ◽  
Yiyi Kong ◽  
Jing Ye ◽  
Aiguo Wang ◽  
Wenteng Si
Keyword(s):  
Antibiotic Treatment ◽  
Prolonged Treatment ◽  
Resistant Bacteria ◽  
Gram Negative Bacteria ◽  
Gram Positive ◽  
Musculoskeletal Infection ◽  
Gram Negative ◽  
Content Type ◽  
Empirical Antibiotic Treatment ◽  
Link Type

Introduction. Prosthetic joint infection (PJI) is a serious complication after arthroplasty, which results in high morbidity, prolonged treatment and considerable healthcare expenses in the absence of accurate diagnosis. In China, microbiological data on PJIs are still scarce. Hypothesis/Gap Statement. The incidence of PJI is increasing year by year, and the proportion of drug-resistant bacteria infection is nicreasing, which brings severe challenges to the treatment of infection. Aim. This study aimed to identify the pathogens in PJIs, multi-drug resistance, and evaluate the effect of the treatment regimen in patients with PJI. Methodology. A total of 366 consecutive cases of PJI in the hip or knee joint were admitted at the Orthopedic Surgery Center in Zhengzhou, China from January 2012 to December 2018. Infections were confirmed in accordance with the Infectious Diseases Society of America and the Musculoskeletal Infection Society (MSIS) criteria. Concurrently, patient demographic data, incidence and antibiotic resistance were investigated. Statistical differences were analysed using Fisher’s exact test or chi-square test. Results. Altogether, 318 PJI cases satisfying the inclusion criteria were enrolled in this study, including 148 with hip PJIs and 170 with knee PJIs. The average age of patients with hip PJIs was lesser than that of patients with knee PJIs (56.4 vs. 68.6 years). Meanwhile, coagulase-negative staphylococcus (CNS, n=81, 25.5 %) was the predominant causative pathogen, followed by Staphylococcus aureus (n=67, 21.1 %). Methicillin-resistant Staphylococcus (MRS) was identified in 28.9 % of PJI patients. In addition, fungus accounted for 4.8 % (n=15), non-tuberculosis mycobacterium accounted for 1.6 % (n=5), polymicrobial pathogens accounted for 21.7 % (n=69), and Gram-negative bacteria accounted for 7.9 % (n=25) of the total infections. The results of antibiotic susceptibility testing showed that gentamicin and clindamycin β-lactam antibiotics were poorly susceptible to Gram-positive isolates, but they were sensitive to rifampicin, linezolid and vancomycin. While antibiotics such as amikacin and imipenem were effective against Gram-negative bacteria, there was a high resistance rate of other pathogens to gentamicin, clindamycin and some quinolone antibacterial drugs. Empirical antibiotic treatment should combine vancomycin and cephalosporin, levofloxacin or clindamycin. When the pathogen is confirmed, the treatment should be individualized. Conclusions. The prevalence of culture-negative PJIs is still very high. Gram-positive bacteria are still the main type of pathogens that cause PJIs. Attention should be paid to the high incidence of MRS, such as MRSA and MR-CNS, among PJI patients. Empirical antibiotic treatment should cover Gram-positive isolates, especially Staphylococcus .

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