TITLE

Infectious Complications After Hepatic Resection

PUB. DATE
September 2004
SOURCE
American Surgeon;Sep2004, Vol. 70 Issue 9, p787
SOURCE TYPE
Academic Journal
DOC. TYPE
Article
ABSTRACT
The purpose of this study was to assess the characteristics of surgical infections after hepatic resection (HR) to identify factors accounting for increased postoperative mortality. Advances in operative technique and care have decreased morbidity and mortality after HR. However, infections after HR continue to be a major contributor to postoperative morbidity and mortality. All HR done during a 7-year period were analyzed and compared to our prospective surgical infection database. Factors contributing to infectious complications and mortality were identified. HR (n = 207) were performed with an overall mortality of 5.8 per cent. Nine patients (3.3%) had 18 infections; 6 (60%) had multiple infection sites, most commonly the peritoneum, blood, or wound. Three infected patients died. Lung and line infections occurred in 2 (67%) infection-related deaths. No single comorbidity increased postoperative infection risk, but an average of 6.7 comorbid conditions were present. All infection-related deaths were associated with ventilator- dependence. All infection-related deaths occurred after resection of a mean of four segments. Additional procedures at the time of BR, operative drains, or transfusion requirements did not impact infectious complications or mortality. Methicillin-resistant Staphylococcus sp. was isolated in all infection-related deaths. The mean time from HR to initiation of treatment was 8 days for infection survivors and 13.3 days for infection-related deaths. Infectious mortality after BR remains significant. Contributing risk factors are advanced age, multiple comorbid conditions, and extent of HR. Ventilator-dependence and delays in antibiotic therapy were associated with infectious mortality. Although gram-negative enteric infections were more common, abdominal, lung, and line infections with gram-positive cocci had higher associated mortality; especially when antibiotic resistant strains were present.
ACCESSION #
14544630

 

Related Articles

  • Associations between Staphylococcus aureus Genotype, Infection, and In-Hospital Mortality: A Nested Case-Control Study. Wertheim, Heiman F. L.; van Leeuwen, Willem B.; Snijders, Susan; Vos, Margreet C.; Voss, Andreas; Vandenbroucke-Grauls, Christina M. J. E.; Kluytmans, Jan A. J. W.; Verbrugh, Henri A.; van Belkum, Alex // Journal of Infectious Diseases;10/1/2005, Vol. 192 Issue 7, p1196 

    We screened 14,008 adult nonsurgical patients for Staphylococcus aureus nasal carriage at hospital admission and assessed them for invasive S. aureus disease and in-hospital mortality. Multilocus sequence typing was performed on endogenous invasive strains and nasal strains of matched...

  • Formal infectious diseases consultation is associated with decreased mortality in Staphylococcus aureus bacteraemia. Robinson, J.; Pozzi - Langhi, S.; Phillips, M.; Pearson, J.; Christiansen, K.; Coombs, G.; Murray, R. // European Journal of Clinical Microbiology & Infectious Diseases;Sep2012, Vol. 31 Issue 9, p2421 

    To determine the impact of infectious diseases consultation (IDC) in Staphylococcus aureus bacteraemia. All MRSA bacteraemia and a random subset of MSSA bacteraemia were retrospectively analysed. Out of 599 SAB episodes, 162 (27%) were followed by an IDC. Patients with IDC were younger and more...

  • Chronic Recurrent Spontaneous Bacterial Peritonitis. Dave, Pradyuman; Romeu, Jose; Selbst, Allan // American Journal of Gastroenterology;Nov1983, Vol. 78 Issue 11, p745 

    The mortality rate in spontaneous bacterial peritonitis is reportedly high. Patients rarely survive the initial infection. Most patients die either because of infection or end-stage liver disease. A patient with alcoholic cirrhosis and portal hypertension with five distinct episodes of...

  • Study On Ascitic Fluid Complement3 Level In Cirrhotic Patients With Spontaneous Bacterial Peritonitis And Without Spontaneous Bacterial Peritonitis. Mustafa, Golam; Alam, Md. Shahinul; Khan, Mobin; Alam, Korshed; Rahman, Salimur; Ahmad, Nooruddin; Ahmed, Sharmeen // Internet Journal of Gastroenterology;2007, Vol. 6 Issue 1, p1 

    Background: Ascitic fluid Complement 3 is important factor to offer local defence against infection of ascitic fluid. Hepatic synthesis of Complement3 and it's concentration in ascitic fluid is reduced in patients with advanced cirrhosis. The study aimed to assess Complement3 in ascitic fluid in...

  • Vancomycin MIC may not affect mortality.  // Reactions Weekly;Nov2014, Vol. 1525 Issue 1, p12 

    The article reports on the meta-analysis and systematic review published in the "Journal of the American Medical Association" (JAMA) which found that the death risk of patients with Staphylococcus (S) aureus bacteraemia may not be affected by vancomycin minimum inhibitory concentration (MIC).

  • Staphylococcus aureus bacteraemia: 400 episodes in St Thomas's Hospital. Gransden, W.R.; Eykyn, Susannah J.; Phillips, Ian // British Medical Journal (Clinical Research Edition);1/28/1984, Vol. 288 Issue 6413, p300 

    Examines four hundred episodes of staphylococcus aureus bacteraemia in St. Thomas Hospital in London, England. Percentage of mortality rate in patients with the disease; Source of the organism; Resistance of staphylococci to penicillin.

  • Staphylococcus aureus Bacteremia: Predictors of 30-Day Mortality in a Large Cohort. Mylotte, Joseph M.; Tayara, Ammar // Clinical Infectious Diseases;11/1/2000, Vol. 31 Issue 5, p1170 

    Presents a study on a large cohort of patients with staphylococcus aureus bacteremia. Information on SAB; Risk factors for mortality among patients with SAB; Reason for the difference in the findings regarding predictors of mortality related to SAB in various studies.

  • Mortality after Staphylococcus aureus bacteraemia in two acute hospitals in Oxfordshire, 1997-2003: cohort study. Wyllie, David H.; Crook, Derrick W.; Peto, Tim E.A. // BMJ: British Medical Journal (International Edition);8/5/2006, Vol. 332 Issue 7562, p281 

    Objective To determine the incidence of methicillin resistant and methicillin sensitive Staphylococcus aureus (MRSA and MSSA) bacteraemia in inpatients and associated mortality within 30 days after diagnosis. Design Anonymised record linkage study of data from hospital information systems and...

  • Surgical site infections following transcatheter apical aortic valve implantation: incidence and management. Baillot, Richard; Fr‚chette, ric; Cloutier, Daniel; RodŠs-Cabau, Josep; Doyle, Daniel; Charbonneau, ric; Mohammadi, Siamak; Dumont, ric // Journal of Cardiothoracic Surgery;2012, Vol. 7 Issue 1, p122 

    Objective: The present study was undertaken to examine the incidence and management of surgical site infection (SSI) in patients submitted to transapical transcatheter aortic valve implantation (TA-TAVI). Methods: From April 2007 to December 2011, 154 patients underwent TA-TAVI with an Edwards...

Share

Read the Article

Courtesy of THE LIBRARY OF VIRGINIA

Sorry, but this item is not currently available from your library.

Try another library?
Sign out of this library

Other Topics