Journal of Japan Society for Surgical Infection
Online ISSN : 2434-0103
Print ISSN : 1349-5755
Volume 17, Issue 6
Displaying 1-7 of 7 articles from this issue
  • Tokuji Ito, Hiroji Shinkawa, Shigekazu Takemura, Shogo Tanaka, Ryosuke ...
    2020 Volume 17 Issue 6 Pages 503-508
    Published: December 31, 2020
    Released on J-STAGE: September 30, 2021
    JOURNAL FREE ACCESS

    【Purpose】This study was aimed to evaluate the preventive effect of olanexidine gluconate (OLG) for the development of surgical site infection (SSI) in patients with hepatectomy. 【Methods】This study included a total of 582 patients undergoing hepatectomy without biliary reconstruction or other organs resection. For preoperative skin antisepsis, 10% povidone–iodine (PVP–I group) was used in 465 patients, whereas 1.5% OLG was used in 117 patients (OLG group). Propensity score matching was conducted to adjust for confounding factors between the two groups. 【Results】After propensity score matching, the incidence rate of SSI [9 patients (7.7%) vs. 6 patients (5.1%); P = 0.60], incisional SSI [1 (0.9%) vs. 2 (1.7%); P >0.99], and organ/space SSI [9 (7.7%) vs. 5 (4.3%); P = 0.41] were comparable between the OLG and PVP–I groups. There was no significant difference in the incidence rate of MRSA infection [1 (0.9%) vs. 2 (1.7%); P >0.99]. 【Conclusions】OLG had similar preventive effect for the SSI development with PVP–I in patients with hepatectomy.

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  • Junzo Shimizu
    2020 Volume 17 Issue 6 Pages 510-513
    Published: December 31, 2020
    Released on J-STAGE: September 30, 2021
    JOURNAL FREE ACCESS

    Even if there is no sign of infection, the drainage tip and drainage can be cultivated by culturing the drainage and the drainage tip in advance. It is considered to be a very natural response to try to respond by knowing the information as soon as possible. On the other hand, the diagnostic value of such a uniform drain tip culture has been debated, and since the examination requires cost and time, research is being conducted to review its significance. A meta–analysis concluded that it had no effect on predicting SSI. Furthermore, the guidelines published by the Japanese Society for Surgical Infection also state that drain placement itself is not necessary for many surgical procedures, and the premise of discussion is broken. Drains are needed, and difficult surgical cases where drain management holds the fate of patients will not disappear, and proper drain management is important now and in the future.

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  • Junichi Yoshida, Tetsuro Tamura, Tetsuya Kikuchi, Akiko Mataga, Takako ...
    2020 Volume 17 Issue 6 Pages 514-519
    Published: December 31, 2020
    Released on J-STAGE: September 30, 2021
    JOURNAL FREE ACCESS

    Background: Diagnostic stewardship (DS) constitutes a triad of strategy in combination with antimicrobial stewardship (AS) and infection control. Of note, blood culture (BC) plays a pivotal role for resistant microbe. Herein, we analyzed risk factors such as age, gender, resistant microbes in BC, and difference in Sepsis Organ Failure Assessment (SOFA) score (Δ) for the primary endpoint of in–hospital death. Patients and methods: Subjects were in–patients during 2011–18 aged 15 years old or older, whose BC showed microbes excluding coagulase negative Staphylococci. Methods were logistic regression analyses to see risk factors for in–hospital deaths. Results: A total of 868 patients showed a total of 926 microbes at BC. They were aged 80 by median and included 474 men and 394 women. Their disease organs included the central nervous system (n=3), the respiratory system (n=188), the bloodstream (n=66), the urinary tract (n=270), the hepatobiliary pancreatic system (n=125), the peritoneal and alimentary tract (n=100), and the bone and soft tissue (n=116). For the primary endpoint of in–hospital death, significant factors were Δ≧2 (Odds Ratio 2.786, 95% Confidence Interval 1.856–4.181; P<0.001), methicillin–resistant S. aureus (MRSA) at BC (3.405, 1.646–7.046; P=0.001), and respiratory disease (2.850, 1.915–4.242; P<0.001, respectively). Conclusion: For DS strategy, BC submitted before antimicrobial administration is the foremost. Targeting MRSA, its rapid diagnosis and specific treatment along with infection control are strongly indicated to prevent another drug–resistant infection.

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  • Minoru Nagayama, Masafumi Imamura, Shigenori Ohta, Akina Kimura, Toru ...
    2020 Volume 17 Issue 6 Pages 520-526
    Published: December 31, 2020
    Released on J-STAGE: September 30, 2021
    JOURNAL FREE ACCESS

    Hepatobiliary and pancreatic surgery often involve excessively invasive surgery such as extensive hepatectomy and pancreaticoduodenectomy. Furthermore, the risk of infectious complications such as having a damaged liver in the background and bile contamination during biliary tract reconstruction is generally considered to be high. Perioperative culture results are helpful in preventing the onset of surgical site infection (SSI), which is the most common postoperative infection, and in using appropriate antibiotics when it does occur. The use of preventive antibacterial agents based on the results of various cultures obtained before surgery and the perioperative management that fully utilizes the information obtained from the drainage effluent culture indwelled at the time of surgery prevent SSI and develop it. It is necessary to avoid the seriousness of the disease.

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  • Ibuki Fujinuma, Suefumi Aosasa, Kenta Kikuya, Takahiro Einama, Fukumi ...
    2020 Volume 17 Issue 6 Pages 527-530
    Published: December 31, 2020
    Released on J-STAGE: September 30, 2021
    JOURNAL FREE ACCESS

    A 66–year–old woman was admitted for treatment of nausea and vomiting. The patient had been followed up without recurrence after subtotal stomach–preserving pancreatoduodenectomy (SSPPD) and right hemicolectomy for duodenal cancer and ascending colon cancer 34 months ago. After contrast–enhanced CT, she went into shock. Anaphylactic shock was initially suspected, but she remained critical even after treatment with adrenaline and steroids. Serratia marcescens was detected in the blood culture and she was treated with antibiotics thereafter. However, it took nearly a month for her condition to improve despite the administration of appropriate antimicrobial treatment based on the results of susceptibility test.

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  • Haruka Okada, Hiroaki Hata, Kentaro Goto, Ryo Matsusue, Takashi Yamagu ...
    2020 Volume 17 Issue 6 Pages 531-535
    Published: December 31, 2020
    Released on J-STAGE: September 30, 2021
    JOURNAL FREE ACCESS

    Rapidly growing mycobacteria (RGM) are environmental organisms that cause broad range of nosocomial infections including pulmonary, skin, bone, and soft tissue disease. RGM are also known as a cause of catheter─related bloodstream infection (CRBSI). Because it usually takes an incubation of 3–4 days to identify RGM on blood culture media, clinicians should consider extending incubation period when RGM bloodstream infection is suspected. We present a case of CRBSI caused by Mycobacterium fortuitum in a surgical patient with central venous access device. Blood cultures were positive after an incubation of 6 days, and antibiotic therapy with levofloxacin and azithromycin was started, besides the catheter was removed. The patient fully recovered after 4 weeks of oral antibiotics. Combination antimicrobials for 4 weeks and prompt catheter removal seem to lead a good outcome.

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