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Surgical Infections, An Issue of Surgical Clinics, E-Book

Surgical Infections, An Issue of Surgical Clinics, E-Book

Robert G. Sawyer

(2015)

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Book Details

Abstract

Editors Robert Sawyer and Tracy Hedrick and authors review the latest in Surgical Infections. Articles will include Bloodstream Infections and Central Line-Associated Bloodstream Infections; Surgical Intervention for Thoracic Infections; Intra-abdominal Infections; Clostridium difficile infection; Urinary Tract Infections; Surgical Site Infections; Prosthetic Joint Infections; Resistant Pathogens, Fungi, and Viruses; Infection Control in the Intensive Care Unit; Pneumonia; Differences Between Murine and Human sepsis; of the intestinal Microbiome and the emerging pathobiome; Advancing Technologies for the Diagnosis and Management of Infections; Upcoming Rules and Benchmarks Affecting the Monitoring and Payment for Surgical Infections; and more!

Table of Contents

Section Title Page Action Price
Front Cover Cover
Surgical Infections i
Copyright\r ii
Contributors iii
Contents vii
Surgical Clinics\rOf North America\r\r xi
Foreword xiii
Preface\r xvii
Differences Between Murine and Human Sepsis 1135
Key points 1135
Introduction 1135
Systemic Inflammatory Response Syndrome 1136
Sepsis 1136
Severe Sepsis 1136
Septic Shock 1137
Immune pathophysiology 1137
What are animal models actually modeling? 1138
Immunologic mouse models of sepsis 1139
Toxemia 1139
Live Bacteria Infection 1140
Host Barrier Disruption 1140
Cecal ligation and puncture: similarities with human disease 1140
Cecal ligation and puncture: differences with human disease 1141
Cecal ligation and puncture: possible explanations for the observed differences 1141
Colon ascendens stent peritonitis: similarities with human disease 1142
Colon ascendens stent peritonitis: differences with human disease 1142
Colon ascendens stent peritonitis: possible explanations for the observed differences 1142
Cecal ligation and puncture versus colon ascendens stent peritonitis 1142
Discussion 1143
References 1146
The Opposing Forces of the Intestinal Microbiome and the Emerging Pathobiome 1151
Key points 1151
Introduction 1151
Rising incidence of surgical infections, antibiotic resistance, bowel preparations, and beyond 1152
Emerging importance of human microbiome in health and disease 1154
Genomics, metagenomics, proteomics, and metabolomics: the future of surgical research 1155
Application of next-generation sequencing technology to surgical problems 1156
Anastomotic Leak 1156
Gut-Derived Sepsis 1156
Wound Infection 1158
Summary 1158
References 1158
Advancing Technologies for the Diagnosis and Management of Infections 1163
Key points 1163
Introduction 1163
Diagnosis 1164
Polymerase Chain Reaction 1164
Next-Generation Sequencing 1164
Microarray Analysis 1165
Bacteriophages 1165
Microfluidics 1165
Matrix-Assisted Laser Desorption/Ionization Time-of-Flight Mass Spectrometry 1165
On the Horizon 1166
Treatment and nanotechnology 1166
Drug Design 1166
Treatment 1167
Prophylaxis 1168
Computational modeling 1169
Summary 1170
References 1170
Infection Control in the Intensive Care Unit 1175
Key points 1175
Introduction 1175
General infection control measures 1176
Optimizing Nutritional Status 1176
Glycemic Control 1176
Staff Education and System-Based Practices 1176
Intensive Care Unit Environment 1177
Hand Hygiene 1177
Patient Screening 1177
Isolation Measures 1177
Patient Decolonization 1178
Specific infections 1178
Ventilator-Associated Pneumonia 1178
Risk Factors 1178
Prevention 1178
Nonpharmacologic strategies 1178
Pharmacologic strategies 1179
Catheter-related bloodstream infections 1179
Risk Factors 1180
Prevention 1180
Clostridium difficile colitis 1181
Risk Factors 1181
Prevention 1182
Catheter-associated urinary tract infections 1182
Risk Factors 1183
Prevention Strategies 1183
Summary 1183
References 1184
Resistant Pathogens, Fungi, and Viruses 1195
Key points 1195
Resistant pathogens and fungi 1195
Introduction 1195
Hospital-Associated Methicillin-Resistant Staphylococcus aureus 1196
Risk factors for hospital-acquired methicillin-resistant S aureus 1196
Community-Associated Methicillin-Resistant S aureus 1196
Various definitions of community-acquired methicillin-resistant S aureus 1197
Risk factors for community-acquired methicillin-resistant S aureus infection 1197
Vancomycin-Resistant Enterococcus spp 1198
Risk factors for vancomycin-resistant Enterococcus spp infection 1198
Extended-Spectrum β-Lactamase–Producing Bacteria 1199
Carbapenem-Resistant Enterobacteriaceae 1200
Risk factors for carbapenem-resistant enterobacteriaceae 1200
Candida 1200
Risk factors for invasive candidiasis 1201
Viruses 1202
Human Herpes Viruses in Surgical Patients 1202
Introduction to human herpes viruses 1202
Latency and reactivation 1202
Diagnosis of human herpes virus infection/reactivation 1204
Triggers of human herpes virus reactivation 1204
Human herpes viruses following cardiac surgery 1204
Human herpes viruses after trauma/burn injury 1205
Human herpes viruses in critical care/sepsis 1206
Human herpes viruses in gastrointestinal disease 1207
Treatment of human herpes virus reactivation/infection 1208
Summary 1209
References 1209
Upcoming Rules and Benchmarks Concerning the Monitoring of and the Payment for Surgical Infections 1219
Key points 1219
Introduction 1220
The inpatient prospective payment system and the value-based purchasing system 1220
Surgical care improvement project 1222
Other surgical infections measures 1224
Catheter-associated urinary tract infection 1224
Thirty-day mortality for pneumonia 1226
Central line–associated blood stream infection 1227
Surgical site infections 1227
Summary 1228
References 1228
Bloodstream Infections and Central Line–Associated Bloodstream Infections 1233
Key points 1233
Introduction 1233
Definitions 1234
Epidemiology 1235
Diagnosis 1236
History and Physical Examination 1236
Laboratory and Imaging Data 1237
Treatment 1237
Empirical Antimicrobial Therapy 1237
Source Control 1239
Identification of Bloodstream Infection Complications 1240
Definitive Antimicrobial Therapy 1240
Prevention of Bloodstream Infections 1241
Summary 1242
References 1242
Surgical Site Infections 1245
Key points 1245
Introduction 1245
Definitions 1246
Epidemiology 1246
Risk factors for surgical site infection 1246
Microbial factors 1249
Patient factors 1252
Perioperative factors 1253
Skin Decontamination 1253
Antibiotic Prophylaxis 1254
Additional Measures 1255
Major limitations in prevention 1256
Therapy 1256
The economic and quality of care impact of surgical site infections 1257
Summary 1258
References 1258
Prosthetic Joint Infections 1265
Key points 1265
Introduction 1265
Diagnosis of infection 1266
Medical treatment of infection 1266
Surgical treatment of infection 1266
Irrigation and Debridement 1268
One-Stage Exchange Arthroplasty 1268
Two-Stage Exchange Arthroplasty 1270
Other Surgical Situations 1273
Postoperative care 1274
Complications 1274
Outcomes 1275
Summary 1275
References 1275
Surgical Intervention for Thoracic Infections 1283
Key points 1283
Parapneumonic effusion and empyema 1283
Pathophysiology 1283
Diagnosis 1284
Imaging 1284
Pleural Fluid Sampling 1285
To Drain or Not to Drain 1287
Surgical Intervention 1289
Video-Assisted Thoracic Surgery and Thoracotomy 1289
Open Thoracostomy 1291
Pulmonary abscess 1291
Mycobacterial pulmonary disease 1294
Pulmonary aspergillosis 1296
Aspergilloma 1296
Invasive Aspergillosis 1299
Sternoclavicular joint infection 1299
References 1301
Pneumonia 1305
Key points 1305
Defining pneumonia 1306
Incidence 1307
Defining severity of pneumonia 1307
Definitions guiding antibiotic use 1308
Causative organisms 1308
Predictive models 1308
Prevention 1309
Diagnosis 1310
Empirical therapy 1311
Initial antibiotic selection and dosing 1311
Double coverage is not recommended 1313
Response to therapy 1313
Duration of treatment 1313
Reasons for treatment failure 1313
Special considerations in the population with trauma 1314
Summary 1315
References 1315
Intra-abdominal Infections 1319
Key points 1319
Introduction 1319
Pathophysiology 1320
Diagnosis 1320
Treatment 1322
Resuscitation 1322
Source Control 1322
Antibiotics 1323
Specific considerations and controversies 1326
Appendicitis 1326
Source Control 1326
Acute Cholangitis 1327
Source control 1327
Antibiotics 1327
Pancreatitis 1328
Source control 1328
Antibiotics 1328
Infected Pancreatic Necrosis 1328
Source control 1329
Antibiotics 1329
Diverticulitis 1329
Source control 1330
Antibiotics 1330
Summary 1331
References 1331
Clostridium Difficile Infection 1335
Key points 1335
Introduction 1335
Bacterial characteristics 1336
Diagnosis 1337
Medical management of acute infection 1338
Surgical options in the management of acute disease 1340
Recurrent disease 1341
Prevention 1343
Summary 1343
References 1344
Urinary Tract Infections in Surgical Patients 1351
Key points 1351
Introduction 1351
Pathogenesis 1352
Evaluation 1354
Definitions 1354
Management 1355
Asymptomatic Catheter-Associated Urinary Tract Infection 1356
Symptomatic Catheter-Associated Urinary Tract Infection 1357
Epidural Analgesia and Urinary Catheters 1359
Cather-associated urinary tract infection prevention 1359
Types of Urinary Catheters 1360
Alternatives to Indwelling Urinary Catheterization 1361
Indwelling Urinary Catheter Indications 1362
Indwelling Urinary Catheter Duration 1362
Catheter Care 1362
Post-Removal Monitoring 1363
Prevention Strategies 1363
Summary 1364
References 1364
Index 1369