Skin and Soft Tissue Infections in the Surgical Area at the Kara Teaching Hospital

Objective: To report the management of skin and soft tissue infections in the surgical area of Kara University Hospital in Togo. Material and Methods: This study was conducted retrospectively from January 1, 2021, to December 31, 2022, in the general surgery and orthopedic trauma departments. The study focused on soft tissue infections of the pelvic and thoracic limbs and analyzed epidemiological, clinical, paraclinical, therapeutic, and evolutionary data. Results: We registered 165 patients, comprising 109 men and 56 women.The sex ratio (F/H) were 0.51. The mean age was 45 years with extremes ranging from 23 to 90 years. Farmers (64.8%) followed by housewives (34.0%) were the social strata most affected. The consultation period varied between 1 and 90 days. The pathologies found were necrotizing fasciitis (53.3%), erysipelas (18.2%), infected limb wounds (12.1%), pyomyositis (9.7%), and necrotizing dermo-hypodermitis (1.8%). The main procedures performed were necrosectomy and grafting (62.9%), sample necrosectomy (18.8%), drainage (9.7%), and pelvic limb amputation (1.2%). Follow-up was favorable in 86.7% of cases. The study noted a death rate of 13.3% due to septic shock secondary to a delay in consultation. Conclusion: Skin and soft tissue infections were a common reason for surgical hospitalization at Kara University Hospital, with a high mortality rate due to delayed consultations.

Urgent call for attention to diabetes-associated hospital infections

In this editorial,we discuss the recent article by Zhao et al published in the World Journal of Diabetes,which highlights the importance of recognizing the risk indicators associated with diabetes mellitus(DM).Given the severe implications of healthcare-associated infections(HAIs)in hospitalized individuals-such as heightened mortality rates,prolonged hospitalizations,and increased costs-we focus on elucidating the connection between DM and nosocomial infections.Diabetic patients are susceptible to pathogenic bacterial invasion and subsequent infection,with some already harboring co-infections upon admission.Notably,DM is an important risk factor for nosocomial urinary tract infections and surgical site infections,which may indirectly affect the occurrence of nosocomial bloodstream infections,especially in patients with DM with poor glycemic control.Although evidence regarding the impact of DM on healthcare-associated pneumonias remains inconclusive,attention to this potential association is warranted.Hospitalized patients with DM should prioritize meticulous blood glucose management,adherence to standard operating procedures,hand hygiene practices,environmental disinfection,and rational use of drugs during hospitalization.Further studies are imperative to explore the main risk factors of HAIs in patients with DM,enabling the development of preventative measures and mitigating the occurrence of HAIs in these patients.

The Prevalence of Methicillin-Resistant Staphylococcus aureus Colonization in Patients with Complicated Skin and Skin Structure Infections after Treatment with Linezolid or Vancomycin

Background: Complicated skin and skin structure infections (cSSSIs) due to Staphylococcus aureus, including methicillin-resistant S. aureus (MRSA), are associated with significant morbidity. Re-ducing MRSA carriage has been a focus of infection control interventions. The prevalence of MRSA colonization after successful treatment of a MRSA cSSSI is unknown. Methods: Secondary analysis of a randomized controlled trial comparing linezolid and vancomycin for the treatment of MRSA cSSSI. Adult patients that had a colonization culture, confirmed MRSA cSSSI, received at least one dose of study treatment, and had an outcome recorded at end of study. Patient, clinical characteristics and prevalence of colonization were compared by treatment regimens. A multivariate regression model identified predictors of MRSA colonization at EOS. Results: There were 456 patients evaluated. The prevalence of MRSA colonization was higher for vancomycin treated patients compared to linezolid treated patients at end of treatment (EOT) (28% vs. 5%, p < 0.001) and EOS (34% vs. 22%, p < 0.01). Independent predictors of colonization at EOS after treatment for a MRSA cSSSI included diagnosis, primarily driven by abscess, black race, treatment with vancomycin, MRSA mixed infection and male gender. Conclusion: Patients treated with linezolid for a cSSSI had less MRSA colonization at EOT and EOS compared to those treated with vancomycin. Multiple independent predictors of MRSA colonization were identified. Additional studies evaluating the relationship of MRSA colonization after treatment of cSSSI are needed.

Prevalence of Latent Tuberculosis Infection (LTBI) among House Hold Contacts of Sudanese Patients with Pulmonary Tuberculosis in Eastern Sudan: Revisiting the Tuberculin Skin Test

A third of the world’s population is latently infected with TB with an increased risk of developing active TB. Household contacts (HHCs) of pulmonary TB cases are at a greater risk of developing disease. Early identification and treatment of latent TB infected individuals may reduce progression to active TB. This study aimed to determine latent TB infections (LTBI) point prevalence among HHCs and community contacts (CCs) using Tuberculin Skin Test (TST) and whole blood IFN-γ release assay in an area of high TB prevalence. In a prospective, longitudinal and community-based study and following informed consent, 768 volunteers (HHCs n = 245;CCs n = 523) were enrolled. Tuberculin Skin Test (TST), whole blood stimulation with PPD and IFN-γ levels determination using ELISA were performed. Mean ages of HHCs and the CCs were not significantly different (HHCs 35.6 ± 15.7 and CCs 30.6 ± 11.7 years;p = 0.99), with a Male:Female ratio of 1:2. Mean recruitment TST indurations were 4.6 ± 5.5 mm and 2.8 ± 3 mm for HHCs and CCs respectively (p = 0.000). Follow-up (Day 614) mean TST indurations increased significantly to 9.1 ± 7.2 mm and 4.4 ± 3.2 mm for HHCs and CCs respectively (p = 0.001). Using TST indurations ≥ 10 mm, LTBI point prevalence for HHCs and CCs was significantly different (HHCs 461/1000 and 367/1000 individuals, p = 0.03). The mean IFN-γ levels for HHCs and CCs at recruitment day (Day 0) were 0.66 ± 0.17 IU/ml and 0.06 ± 0.04 respectively. The mean of IFN-γ production levels dropped significantly at Day 614 for HHCs and CCs to 0.66 ± 0.15 IU/ml and 0.02 ± 0.02 respectively (p = 0.03) (p = 0.00001). Recruitment LTBI point prevalence using IFN-γ level ≥ 0.35 IU/ml for HHCs and CCs was 440/1000 and 203/1000 respectively (p = 0.000000001). No correlations between TST indurations and IFN-γ levels were detected among HHCs or CCs (p > 0.05). TST is a simple, efficient and cheap technique for LTBI diagnosis and triaging individuals for treatment.

Effectiveness of <i>Thymus vulgaris</i>Essential Oil in the Treatment of Skin Infections in Dogs

Currently, there are no data in the literature on the topical treatment with Thymus vulgaris essential oil (EO) in bacterial skin infections of dogs. This study evaluates the effectiveness of Thymus vulgaris EO for topical use in dogs with skin 18 half-breed dogs, affected by skin infections housed in a rescue shelter were studied. The bacteria isolated from these dogs were identified by MALDI-TOF-MS. The susceptibility of the isolated microorganisms to Thymus vulgaris L. EO was estimated in vitro by bacteriological test (CLSI 2015), in comparison to some antimicrobials drugs (amoxicillin-clavulanic acid, doxycy-cline, thiamphenicol and marbofloxacin) and to Citrus bergamia EO. The dogs, divided in two groups at random, were treated topically for 7 days with Thymus vulgaris L. EO (Group 1: n. 10 animals) and Citrus bergamia Risso e Poiteau EO (Group 2: n. 8 animals) respectively. The bacteria isolated were: Staphylococcus pseudintermedius (7 samples), Staphylococcus sciuri (4), ESBL Escherichia coli (3) and Proteus mirabilis (4). In all animals treated with Thymus vulgaris EO, the clinical signs decreased rapidly within 5 days from the administration, with complete remission 7 days after the treatment. No bacterial growth was observed from skin swabs after 7 days of treatment. None of the treated animals showed local or general side effects. The use of Thymus vulgaris EO could be a possible alternative or additional treatment to antibiotics in dermatological infections, particularly in cases refractory to conventional therapy.

Methicillin-Resistant <i>Staphylococcus aureus</i>SCC<i>mec</i>Type and Its Association with Clinical Presentation, Severity, and Length of Stay among Patients with Complicated Skin and Skin Structure Infections

Data from a prospective, randomized, open-label, active-controlled, multicenter, Phase 4 study comparing oral or intravenous linezolid with intravenous vancomycin for treatment of complicated skin and soft-tissue infections caused by methicillin resistant Staphylococcus aureus was used to determine the association between staphylococcal cassette chromosome mec (SCCmec) type and patient’s clinical presentation, infection severity, intravenous therapy duration and length of stay (LOS). Compared to SCCmec types I, II, and III, SCCmec type IV, PVL+ was associated with more frequent presentation of abscesses, lower severity scores, and shorter intravenous therapy duration and LOS in both treatment groups.

The Frequency of Skin Tumors and Infections in Patients with Autoimmune Diseases

Background: Autoimmune diseases are a vast array of organ-specific as well as systemic diseases, whose pathogenesis results from the activation of B and T lymphocytes reacting against antigens of the body’s own tissues (defined as self). Objective: To record skin tumors and infections in all autoimmune diseases gathered together in a one pathological state, compared with renal transplant recipients and normal control. Patients and Methods: Four hundred patients with different autoimmune diseases were examined. Fifty patients with pemphigus (15 males, 35 females) are aged from 20 - 70 (41.23 ± 3.89) years. Fifty patients with systemic lupus erythematosus (50 females) are aged from 17 - 45 (30.58 ± 10.08) years. One hundred patients with vitiligo (59 males, 41 females) are aged from 9 - 71 (42.89 ± 5.28) years. One hundred patients with alopecia areata (42 males, 58 females) are aged from 7 - 52 (38.67 ± 9.52) years. One hundred patients with psoriasis (56 males, 44 females) are aged from 7 - 71 (47.36 ± 8.62) years were evaluated. One hundred twenty kidney transplant recipients’ (101 males, 19 females) ages ranged from 14 - 70 (45.43 ± 4.63) years. All patients were examined thoroughly for any cutaneous manifestations and tumors and the findings were compared with the general population as a control group, which consisted of 500 healthy control individuals whose ages ranged from 20 - 71 (44.53 ± 11.48) years. This case series, descriptive, controlled study was performed in Baghdad Teaching Hospital from June 2014 to October 2015. Results: In renal transplant recipients, the findings were observed as follow herpetic infection in 30(25%), bacterial 12(10%) while fungal 24(20%) patients. These infections appeared early in the course of immunosuppression. While the tumors were noticed, the benign tumors were the commonest manifestations, which included viral warts in 45(37.5%) followed by actinic keratosis 15(12.5%), seborrheic keratosis 14(11.6%), sebaceous hyperplasia 13(10.8%) and keratoacanthoma 1(0.8%). While the malignant tumors were basal cell carcinoma 4(3.3%) followed by squamous cell carcinoma 3(2.5%), and kaposi’s sarcoma 4(3.3%), Bowen’s disease 1(0.8%). These malignancy usually appeared late in the course of immunosuppression. In pemphigus, viral warts were observed in 4(8%) cases;fungal infection was seen in 4(8%) cases and bacterial infections in 2(4%) of cases and herpetic infection in only 1(2%) of case;no tumors were found in all patients. In vitiligo, viral warts were observed in 2(2%) cases, while seborrhic keratosis and sebaceous hyperplasia were observed in 1(1%) case;herpetic and fungal infections were seen in 3(3%) of cases while bacterial infections were recorded in 2(2%) of cases but no tumors were found in all patients. In alopecia areata viral warts were observed in 9(9%) of cases, sebaceous hyperplasia in 1(1%) case, herpetic and bacterial in 3(3%) of cases and fungal in 4(4%) of cases;no tumors were found in all patients. In systemic lupus erythymatosus (SLE) viral warts were observed in 4(8%) of cases, herpetic infection in 12(12%) of cases, fungal infection in 10(20%) of cases, bacterial infection in 3(3%) of cases and sebaceous hyperplasia in only 1(2%) of case, but no tumors were seen. In psoriasis, viral warts were observed in 14(14%) of cases, herpetic infection in 10(10%) of cases, bacterial infection in 3(3%) of cases, fungal infection in 2(2%) of cases, sebaceous hyperplasia in 2(2%) of cases and seborrhiec hyperkeratosis in 1(1%) case, while no tumors were demonstrated. In healthy control individuals, herpetic infection was present in 36(7.2%) and viral warts in 52(10.4%) individuals, fungal infection in 29(5.8%) of individuals and regarding tumors solar keratosis was present in 24(4.8%);basal cell carcinoma and squamous cell carcinoma were present in 2(0.4%) individuals of each. Conclusions: Patients with autoimmune diseases were protected against infections and tumors while kidney transplant recipients had no such protection although all these groups were on prolonged immunosuppression.

Effects of UV-, Visible-, Near-Infrared Beams in Three Therapy Resistance Case Studies of Fungal Skin infections

Fungal and bacterial diseases, directly infecting various parts of body, have received much attention in recent years. Bacterial infections, such as Tinea Pedis, Pityriasis versicolor and Mycetoma can secondarily occur in superficial fungal damaged skin. They often occur in immune compromised individuals including diabetics and patients with peripheral arterial diseases. Mycetoma infections can travel through the bloodstream affecting different organs. In this paper, we investigate the photo-inactivation of the pathogens causing Tinea Pedis, Pityriasis versicolor, and Mycetoma infections in three therapy resistant patients without photosensitizing drugs. We have used a combination of visible to near-infrared (VIS/NIR) laser beams in association with blue (B), red (R) and ultra-violet (UV) light emitted diodes (LEDs) with incident doses of 0.63 - 21.43 J/cm2. These beams have minimum side effects on the normal part of the skin. According to the physicians’ assessments, all case study patients achieved an observable progress such as decreases in inflammatory lesions, rapid process of wound healing and scars improvements. Side effects such as inflammation, crusting, or hypopigmentation were not observed. The presented irradiation protocol may be a valuable complementary treatment for patients suffering from fungal and bacterial skin infections.

Antiseptic Skin Preparation for Preventing Surgical Site Infection at Caesarean Section

Purpose: To compare the effect of chlorhexidine-alcohol and povidone iodine on surgical site infection (SSI) after caesarean section. Methodology: A randomized control trial of 374 patients (188 in the chlorhexidine-alcohol group and 186 in the povidone iodine group) who had elective caesarean section with no overt risk for SSI was done. Patients were followed up until thirty days after delivery to assess for symptoms and signs of SSI. Results: Fifty-one (13.6%) of the study population developed SSI. Although the incidence of SSI was lower in the chlorhexidine-alcohol group than the povidone iodine group (12.2% vs. 15.1%;p = 0.26);the difference was not statistically significant. The incidence of adverse skin reaction in Chlorhexidine-alcohol vs. povidone iodine was also not statistically significant (4.0% vs. 5.4%;p = 0.40). Conclusion: The study demonstrates that there was no statistically significant difference in antiseptic property and side effect profile of chlorhexidine-alcohol and povidone-iodine when used as skin antisepsis in caesarean section.

Bronchogenic cysts with infection in the chest wall skin of a 64-yearold asymptomatic patient: A case report

BACKGROUND Skin bronchogenic cysts are extremely rare congenital bronchocystic changes caused by the abnormal development of the trachea,bronchial trees or lung buds during the embryonic period.The first case of skin bronchogenic cysts was reported in 1945.Since then,this disease has attracted increasing attention,but due to the low incidence,its pathogenesis is still not clear.CASE SUMMARY Here,we report another case of skin bronchogenic cysts with infection in a 64-year-old female patient.The patient had no symptoms for more than 60 years until her chest wall was recently found to be swollen,and she felt pain and discomfort.At the same time,secretions were found on the surface of the swelling.Color Doppler ultrasound examination showed abnormal echoes in the soft tissue under the frontal chest wall,suggesting the presence of cysts.Cytological puncture resulted in about 2 mL of pus and showed the presence of more acute inflammatory cells.The final clinical diagnosis was skin cyst with infection,and surgery was carried out.The pathological results obtained after surgery showed that the cystic wall was covered with column-like cilia epithelial cells,and the interstitial structure was partially inundated with inflammatory cells.After a variety of examinations and clinical diagnoses,we finally confirmed that the patient was suffering from bronchogenic cyst.CONCLUSION This article not only describes the case of an elderly patient with rare skin bronchogenic cysts with infection but also provides a detailed and correct diagnosis and a successful treatment process,which is of great value for the diagnosis and treatment of the disease.

Ultraconformable Integrated Wireless Charging Micro-Supercapacitor Skin

Conformable and wire-less charging energy storage devices play important roles in enabling the fast development of wearable,non-contact soft electronics.However,current wire-less charging power sources are still restricted by limited flexural angles and fragile connection of components,resulting in the failure expression of performance and constraining their fur-ther applications in health monitoring wearables and moveable artificial limbs.Herein,we present an ultracompatible skin-like integrated wireless charging micro-supercapacitor,which building blocks(including electrolyte,electrode and substrate)are all evaporated by liquid precursor.Owing to the infiltration and permeation of the liquid,each part of the integrated device attached firmly with each other,forming a compact and all-in-one configuration.In addition,benefitting from the controllable volume of electrode solution precursor,the electrode thickness is easily regulated varying from 11.7 to 112.5μm.This prepared thin IWC-MSC skin can fit well with curving human body,and could be wireless charged to store electricity into high capacitive micro-supercapacitors(11.39 F cm-3)of the integrated device.We believe this work will shed light on the construction of skin-attachable electronics and irregular sensing microrobots.

Knowledge of Hospital Acquired Infections (HAIs) among Medical Students in a Tertiary Hospital in Jos North Local Government Area, Plateau State, Nigeria

Background: Hospital Acquired Infections (HAIs) remain a common cause of death, functional disability, emotional suffering and economic burden among hospitalized patients. Knowledge of HAIs is important in its prevention and control. This study seeks to assess the knowledge of Hospital Acquired Infections (HAIs) among medical students in a Tertiary Hospital in Jos North Local Government Area, Plateau State, Nigeria. Methods: This was a descriptive cross-sectional study done in October 2019 among clinical medical students using a Multistage sampling technique. Data was collected using a self-administered structured questionnaire and analyzed using the IBM SPSS 20 (Statistical Package for the Social Sciences). Ethical approval was granted by Bingham University Teaching Hospital, Ethics Committee, Jos, Plateau State. Results: A total of 219 students in the clinical arm of the College of Medicine and Health Sciences were selected. A higher proportion (97.7%) of respondents knew about Hospital Acquired Infections and 85.4% knew that Hospital Acquired infections occur in the hospital, and (86.3%) considered patients contagious with half (58.9%) considered patients as the most important source of HAIs, followed by care givers (13.2%), then doctors including medical students and interns (10.0%) and lastly nurses (8.7%). The majority of respondents (70.8%) considered Surgical Wound Infections to be the most commonly occurring HAI, followed by UTIs (69.9%), RTIs (61.2%), BSIs (37.0%) and others (0.9%). The clinical thermometer was the instrument that most commonly transmits HAIs (82.6%), then followed by stethoscope (62.1%), white coats (53.9%), and blood pressure cuff (51.1%). Most respondents knew the infectious substances, like blood (96.3%), nasal discharge (82.6%), saliva (85.3%), and faeces (79.4%) transmitted HAIs, 72.6% of the respondents said that they were aware of the recommended hand washing techniques by WHO. Conclusion: The majority of students 91.3% had good knowledge while 8.7% had poor knowledge of HAIs. Lower classes had more respondents with poor knowledge. This finding was statistically significant (p = 0.002, Chi-square 12.819). Students are encouraged to keep up the level of knowledge they have about HAIs. These students can help improve the knowledge of those whose knowledge level is low. Government and NGOs should support sponsorship for capacity-building events targeted at HAIs for healthcare workers and medical students.

The Place of Nursing Theory in the Management of Post-Operative Infections in a Hospital Environment: Case of Cibitoke District Hospital

Introduction: Post-operative infections, such as surgical site infections (SSIs), are a significant concern in healthcare settings. Nurses play a crucial role in the prevention and management of these infections. The use of nursing theory could contribute to the prevention of SSIs. The aim of this study was to evaluate the role of nursing theory in the management of surgical site infections (SSIs) in a hospital environment. Method: A cross-sectional study was conducted using descriptive and analytical methods to assess the role of nursing theory in the management of Post-operative infections (POI) in a hospital setting in October 2023. The study population consisted of nurses working in the Surgery, Emergency, and Maternity units at Cibitoke District Hospital. A sample size of 71 nurses working full or part time in the Surgery were invited to participate in this study. A questionnaire was used to collect the data, and SPSS version 21.0 software was used for analysis. Results: The study found that nursing theory did not have any statistically significant place in the management of POI (p-value = 0.523). However, the results showed that experience was the only significant factor influencing the management of POI (p-value = 0.004). This is explained by the analysis of the net effects of the explanatory variable where we noticed that those who had more experience were more likely to manage post-operative infections. The participants’ knowledge regarding nursing theory in the management was poor as they scored less than 30% in all the variables used to measure their knowledge. Conclusion: The study revealed that nurses’ knowledge of nursing theories and their applications in the management of SSIs was poor. Continuing professional development, curriculum review, and in-service training were highly recommended.

Thoracic spine infection caused by Pseudomonas fluorescens:A case report and review of literature

BACKGROUND The clinical incidence of spinal infection is gradually increasing,and its onset is insidious,easily leading to missed diagnosis and misdiagnosis,which may lead to serious complications such as nervous system dysfunction,spinal instability and/or deformity,and cause a huge burden on society and families.Early identification of the causative agent and precision medicine will greatly reduce the suffering of patients.At present,the main pathogenic bacteria that cause spinal infection are Staphylococcus aureus,Streptococcus,Pneumococcus,Escherichia coli,and Klebsiella.There are no reports of spinal infection caused by Pseudomonas fluorescens.CASE SUMMARY We report a 32-year-old female patient with spinal infection.She presented with flank pain,initially thought to be bone metastases or bone tuberculosis,and had a family background of tumors.Her clinical features and changes in imaging and laboratory tests led to the suspicion of thoracic spine infection.Histopathology of the lesion showed inflammation,tissue culture of the lesion was negative several times,and the possible pathogen-Pseudomonas fluorescens was found after gene sequencing of the lesion.The patient recovered completely after a full course of antibiotic treatment.CONCLUSION This report increases the range of pathogens involved in spinal infections,highlights the unique advantages of gene sequencing technology in difficult-todiagnose diseases,and validates conservative treatment with a full course of antibiotics for spinal infections without complications.

The Impact of Optimizing Details in the Operating Room on the Level of Knowledge, Attitude, and Practice of Hospital Infection Prevention and Control by Surgeons, as Well as the Effectiveness of Infection Control

Objective: This paper aims to explore the impact of optimizing details in the operating room on the level of knowledge, attitude, and practice of hospital infection prevention and control by surgeons, as well as the effectiveness of infection control. Methods: From January 2022 to June 2023, a total of 120 patients were screened and randomly divided into a control group (routine care and hospital infection management) and a study group (optimizing details in the operating room). Results: Significant differences were found between the two groups in the data of surgeons’ level of knowledge, attitude, and practice in hospital infection prevention and control, infection rates, and nursing satisfaction, with the study group showing better results (P Conclusion: The use of optimizing details in the operating room among surgeons can effectively improve surgeons’ level of knowledge, attitude, and practice in hospital infection prevention and control, reduce infection occurrence, and is worth promoting.

Preventive effect of probiotics on infections following colorectal cancer surgery:An umbrella meta-analysis

BACKGROUND Postoperative infections remain a significant source of morbidity among patients undergoing colorectal cancer(CRC)surgery.While probiotics have been pro-posed as a potential strategy to mitigate the risk of these infections,contemporary meta-analyses have produced conflicting findings.AIM To synthesize the available evidence regarding the prophylactic efficacy of probiotics in preventing infections following CRC surgery.METHODS A comprehensive search of PubMed and Scopus was conducted to identify relevant meta-analyses published up to February 2024.To assess the efficacy of probiotics on outcomes,relative risks(RR)and their corresponding 95%CI were pooled using a random effects model.RESULTS This comprehensive umbrella meta-analysis integrated eleven meta-analyses encompassing 11518 participants who fulfilled the inclusion criteria.Probiotics administration resulted in a statistically significant reduction in the incidence of total infections(RR:0.40,95%CI:0.31-0.51;moderate certainty),surgical site infections(RR:0.56,95%CI:0.49-0.63;high certainty),pneumonia(RR:0.38,95%CI:0.30-0.48;high certainty),urinary tract infections(RR:0.44,95%CI:0.31-0.61;moderate certainty),bacteremia(RR:0.41,95%CI:0.30-0.56;high certainty),and sepsis(RR:0.35,95%CI:0.25-0.44;high certainty).However,probiotics did not significantly affect intra-abdominal,central line,or peritoneal infections.CONCLUSION Probiotics have demonstrated potential in mitigating postoperative infectious complications among patients undergoing CRC surgery.

Micro-power negative pressure wound technique reduces risk of incision infection following loop ileostomy closure

BACKGROUND Prophylactic loop ileostomy is an effective way to reduce the clinical severity of anastomotic leakage following radical resection of rectal cancer.Incisional surgical site infection(SSI)is a common complication after ileostomy closure.AIM To evaluate the efficacy and safety of the micro-power negative pressure wound technique(MPNPWT)in preventing incisional SSI.METHODS This was a prospective,randomized controlled clinical trial conducted at a single center.A total of 101 consecutive patients who underwent ileostomy closure after rectal cancer surgery with a prophylactic ileostomy were enrolled from January 2019 to December 2021.Patients were randomly allocated into an MPNPWT group and a control group.The MPNPWT group underwent intermittent suturing of the surgical incision with 2-0 Prolene and was covered with a micro-power negative pressure dressing.The surgical outcomes were compared between the MPNPWT(n=50)and control(n=51)groups.Risk factors for incisional SSI were identified using logistic regression.RESULTS There were no differences in baseline characteristics between the MPNPWT(n=50)and control groups(n=51).The incisional SSI rate was significantly higher in the control group than in the MPNPWT group(15.7%vs 2.0%,P=0.031).However,MPNPWT did not affect other surgical outcomes,including intra-abdominal complications,operative time,and blood loss.Postoperative hospital stay length and hospitalization costs did not differ significantly between the two groups(P=0.069 and 0.843,respectively).None of the patients experienced adverse effects of MPNPWT,including skin allergy,dermatitis,and pain.MPNPWT also helped heal the infected incision.Our study indicated that MPNPWT was an independent protective factor[odds ratio(OR)=0.005,P=0.025)]and diabetes was a risk factor(OR=26.575,P=0.029)for incisional SSI.CONCLUSION MPNPWT is an effective and safe way to prevent incisional SSI after loop ileostomy closure.

Improving treatment plan and mental health in children with abdominal infection for broad-spectrum bacterial infections

BACKGROUND Pediatric abdominal infection is a common but serious disease that requires timely and effective treatment.In surgical treatment,accurate diagnosis and rational application of antibiotics are the keys to improving treatment effects.AIM To investigate the effect of broad-spectrum bacterial detection on postoperative antibiotic therapy.METHODS A total of 100 children with abdominal infection who received surgical treatment in our hospital from September 2020 to July 2021 were grouped.The observation group collected blood samples upon admission and sent them for broad-spectrum bacterial infection nucleic acid testing,and collected pus or exudate during the operation for bacterial culture and drug sensitivity testing;the control group only sent bacterial culture and drug sensitivity testing during the operation.RESULTS White blood cell count,C-reactive protein,procalcitonin,3 days after surgery,showed better postoperative index than the control group(P<0.05).The hospital stay in the observation group was significantly shorter than that in the control group.The hospitalization cost in the observation group was significantly lower than that in the control group,and the difference between the two groups was statistically significant(P<0.05).CONCLUSION Early detection of broad-spectrum bacterial infection nucleic acids in pediatric abdominal infections can help identify pathogens sooner and guide the appropriate use of antibiotics,improving treatment outcomes and reducing medical costs to some extent.

Fatal Skin and Soft Tissue Infection, Peritonitis and Bacteriemia Caused by Shewanella petrefaciens

We report a case of skin and soft tissue infection, peritonitis and bacteriemia in a 51-year-old drug abuse male. His wife found him lifeless lying on the kitchen floor at his residence. At the time of autopsy, multiple skin ulcers with deep soft tissue infection and peritonitis were found on gross examination. Cultures of postmortem blood and a swab of soft tissue were positive for Shewanella putrefaciens, a gram-negative bacterium that had been isolated from many foods, sewage and fresh and salt water. This is the first reported case in the United States of fatal skin and soft tissue infection, peritonitis and bacteremia caused by this micro-organism.

Anti-nuclear matrix protein 2+ juvenile dermatomyositis with severe skin ulcer and infection: A case report and literature review

BACKGROUND Juvenile dermatomyositis(JDM)is an idiopathic inflammatory myopathy that occurs in childhood.It is characterized by muscle weakness and a characteristic rash.Previous literature reports have rarely described JDM with severe skin ulcers and infections.CASE SUMMARY Herein,we describe a case of a 2-year-old female patient who suffered from JDM,whose myositis-specific autoantibodies were positive for anti-nuclear matrix protein 2 antibody,with progressively worsening skin ulcers and severe infections.The patient was treated with glucocorticoids and various immunosuppressants.Nevertheless,further progression of the disease and the combination of primary disease and severe infection in the later period were fatal.CONCLUSION In children,anti-nuclear matrix protein 2+JDM combined with skin ulcers often indicates severe disease.In such cases,personalized treatment for the primary disease and infection prevention and control are essential.