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[PMID]:29169595
[Au] Autor:Iorio ML; Harper CM; Rozental TD
[Ad] Endereço:Department of Orthopaedics, Division of Plastic Surgery, Beth Israel Deaconess Medical Center, Harvard Medical School, 330 Brookline Avenue, Stoneman 10, Boston, MA 02215, USA. Electronic address: mattiorio@gmail.com.
[Ti] Título:Open Distal Radius Fractures: Timing and Strategies for Surgical Management.
[So] Source:Hand Clin;34(1):33-40, 2018 02.
[Is] ISSN:1558-1969
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Open distal radius fractures are rare injuries with few studies to guide treatment. Degree of soft tissue injury and contamination may be a primary consideration to dictate timing and operative intervention. Antibiotics should be started as early as possible and include a first-generation cephalosporin. Surgical fixation remains a matter of surgeon preference: although studies support the use of definitive internal fixation, many surgeons address contaminated injuries with external fixation. Although postoperative outcomes are similar to closed injuries for low-grade open distal radius fractures, high-grade injuries with more complex fracture patterns carry a high risk of complications, poor outcomes, and repeat surgical procedures.
[Mh] Termos MeSH primário: Fraturas Expostas/cirurgia
Fraturas do Rádio/cirurgia
[Mh] Termos MeSH secundário: Antibacterianos/uso terapêutico
Desbridamento
Fixação Interna de Fraturas
Fraturas Expostas/classificação
Seres Humanos
Lesões dos Tecidos Moles/cirurgia
Irrigação Terapêutica
Tempo para o Tratamento
Infecção dos Ferimentos/prevenção & controle
[Pt] Tipo de publicação:JOURNAL ARTICLE; REVIEW
[Nm] Nome de substância:
0 (Anti-Bacterial Agents)
[Em] Mês de entrada:1712
[Cu] Atualização por classe:180303
[Lr] Data última revisão:
180303
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171125
[St] Status:MEDLINE


  2 / 9701 MEDLINE  
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[PMID]:29176757
[Au] Autor:Radlinski L; Rowe SE; Kartchner LB; Maile R; Cairns BA; Vitko NP; Gode CJ; Lachiewicz AM; Wolfgang MC; Conlon BP
[Ad] Endereço:Department of Microbiology and Immunology, University of North Carolina at Chapel Hill, North Carolina, United States of America.
[Ti] Título:Pseudomonas aeruginosa exoproducts determine antibiotic efficacy against Staphylococcus aureus.
[So] Source:PLoS Biol;15(11):e2003981, 2017 Nov.
[Is] ISSN:1545-7885
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Chronic coinfections of Staphylococcus aureus and Pseudomonas aeruginosa frequently fail to respond to antibiotic treatment, leading to significant patient morbidity and mortality. Currently, the impact of interspecies interaction on S. aureus antibiotic susceptibility remains poorly understood. In this study, we utilize a panel of P. aeruginosa burn wound and cystic fibrosis (CF) lung isolates to demonstrate that P. aeruginosa alters S. aureus susceptibility to bactericidal antibiotics in a variable, strain-dependent manner and further identify 3 independent interactions responsible for antagonizing or potentiating antibiotic activity against S. aureus. We find that P. aeruginosa LasA endopeptidase potentiates lysis of S. aureus by vancomycin, rhamnolipids facilitate proton-motive force-independent tobramycin uptake, and 2-heptyl-4-hydroxyquinoline N-oxide (HQNO) induces multidrug tolerance in S. aureus through respiratory inhibition and reduction of cellular ATP. We find that the production of each of these factors varies between clinical isolates and corresponds to the capacity of each isolate to alter S. aureus antibiotic susceptibility. Furthermore, we demonstrate that vancomycin treatment of a S. aureus mouse burn infection is potentiated by the presence of a LasA-producing P. aeruginosa population. These findings demonstrate that antibiotic susceptibility is complex and dependent not only upon the genotype of the pathogen being targeted, but also on interactions with other microorganisms in the infection environment. Consideration of these interactions will improve the treatment of polymicrobial infections.
[Mh] Termos MeSH primário: Antibacterianos/farmacologia
Farmacorresistência Bacteriana
Glicolipídeos/farmacologia
Interações Microbianas/fisiologia
Pseudomonas aeruginosa/metabolismo
Staphylococcus aureus/efeitos dos fármacos
[Mh] Termos MeSH secundário: Animais
Queimaduras/microbiologia
Queimaduras/patologia
Coinfecção
Glicolipídeos/metabolismo
Camundongos
Camundongos Endogâmicos C57BL
Testes de Sensibilidade Microbiana
Viabilidade Microbiana/efeitos dos fármacos
Consumo de Oxigênio/efeitos dos fármacos
Infecções por Pseudomonas/metabolismo
Infecções por Pseudomonas/microbiologia
Infecções por Pseudomonas/patologia
Infecções Estafilocócicas/microbiologia
Infecções Estafilocócicas/patologia
Staphylococcus aureus/crescimento & desenvolvimento
Vancomicina/farmacologia
Infecção dos Ferimentos/microbiologia
Infecção dos Ferimentos/patologia
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Anti-Bacterial Agents); 0 (Glycolipids); 0 (rhamnolipid); 6Q205EH1VU (Vancomycin)
[Em] Mês de entrada:1712
[Cu] Atualização por classe:180206
[Lr] Data última revisão:
180206
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171128
[St] Status:MEDLINE
[do] DOI:10.1371/journal.pbio.2003981


  3 / 9701 MEDLINE  
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[PMID]:29261244
[Au] Autor:Swanson T; Angel D
[Ti] Título:WOUND INFECTION IN CLINICAL PRACTICE UPDATE.
[So] Source:Aust Nurs Midwifery J;24(8):33, 2017 Mar.
[Is] ISSN:2202-7114
[Cp] País de publicação:Australia
[La] Idioma:eng
[Mh] Termos MeSH primário: Infecção dos Ferimentos/enfermagem
[Mh] Termos MeSH secundário: Conferências de Consenso como Assunto
Seres Humanos
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1801
[Cu] Atualização por classe:180118
[Lr] Data última revisão:
180118
[Sb] Subgrupo de revista:N
[Da] Data de entrada para processamento:171221
[St] Status:MEDLINE


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[PMID]:28461267
[Au] Autor:Muwaffak Z; Goyanes A; Clark V; Basit AW; Hilton ST; Gaisford S
[Ad] Endereço:UCL School of Pharmacy, University College London, 29-39 Brunswick Square, London, WC1N 1AX, UK.
[Ti] Título:Patient-specific 3D scanned and 3D printed antimicrobial polycaprolactone wound dressings.
[So] Source:Int J Pharm;527(1-2):161-170, 2017 Jul 15.
[Is] ISSN:1873-3476
[Cp] País de publicação:Netherlands
[La] Idioma:eng
[Ab] Resumo:The increasing prevalence of wound infections caused by antibiotic resistant bacteria is an urgent challenge facing modern medicine. To address this issue the expedient use of antimicrobial metals such as zinc, copper and silver were incorporated into an FDA-approved polymer (polycaprolactone - PCL) to produce filaments for 3D printing. These metals have broad-spectrum antimicrobial properties, and moreover, copper and zinc can enhance the wound healing process. 3D scanning was used to construct 3D models of a nose and ear to provide the opportunity to customize shape and size of a wound dressing to an individual patient. Hot melt extrusion was used to extrude pellets obtained by vacuum-drying of solutions of PCL and the different metals in order to manufacture metal-homogeneously-loaded filaments. Wound dressings with different shapes were produced with the filaments containing different concentrations of metals. Release of the metals from the dressings was determined by inductively coupled plasma atomic emission spectroscopy. All the different metal dressings show fast release (up to 24h) followed by slow release (up to 72h). The antibacterial efficacy of the wound dressings was tested using a thermal activity monitor system, revealing that silver and copper wound dressings had the most potent bactericidal properties. This study shows that 3D scanning and 3D printing, which are becoming simpler and more affordable, have the potential to offer solutions to produce personalised wound dressings.
[Mh] Termos MeSH primário: Anti-Infecciosos/administração & dosagem
Bandagens
Poliésteres/química
Impressão Tridimensional
Infecção dos Ferimentos/prevenção & controle
[Mh] Termos MeSH secundário: Seres Humanos
Modelos Anatômicos
Cicatrização
Infecção dos Ferimentos/tratamento farmacológico
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Anti-Infective Agents); 0 (Polyesters); 24980-41-4 (polycaprolactone)
[Em] Mês de entrada:1801
[Cu] Atualização por classe:180105
[Lr] Data última revisão:
180105
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170503
[St] Status:MEDLINE


  5 / 9701 MEDLINE  
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[PMID]:29187917
[Au] Autor:Oli AN; Eze DE; Gugu TH; Ezeobi I; Maduagwu UN; Ihekwereme CP
[Ad] Endereço:Department of Pharmaceutical Microbiology and Biotechnology, Faculty of Pharmaceutical Sciences, Nnamdi Azikiwe University, Awka, Anambra State, Nigeria.
[Ti] Título:Multi-antibiotic resistant extended-spectrum beta-lactamase producing bacteria pose a challenge to the effective treatment of wound and skin infections.
[So] Source:Pan Afr Med J;27:66, 2017.
[Is] ISSN:1937-8688
[Cp] País de publicação:Uganda
[La] Idioma:eng
[Ab] Resumo:Introduction: The increasing incidence of antibiotic resistant bacteria is a concern both to the clinicians and the patients due to obvious consequences such as treatment failures, prolonged patients' stay in hospital and nosocomial infections. The choice of the first antibiotic therapy in emergency wards in hospitals is usually not based on patient-specific microbial culture and susceptibility test result.This study is aimed at profiling extended-spectrum beta-lactamase (ESBL) producing bacteria associated with wound injuries and highlighting their multi-antibiotic resistance character. Methods: Sixty-three wound swab samples were collected and cultured on nutrient agar and on selective media. Evaluation for ESBL production was by phenotypic method while the antibiogram screening was by disc-diffusion. Results: The wounds evaluated were diabetic sore (14), cancer wounds (12), surgical wounds (17), wounds due to road traffic accidents (10) and wounds from fire burn (10). The result showed that 61 wounds were infected and the prevalence of the infecting pathogens was 17.46%, 14.28%, 12.79%, 34.92% and 17.46%. Thirty four (55.74 %) isolates were ESBL producers, greater than 50% of which being . The antibiogram study of the ESBL producers showed multi-drug resistance with resistance highest against ampicillin (100%), followed by cephalosporins: cefuroxime (94.12%) and ceftriaxone (61.76%). No resistance was recorded against the ß-lactamase inhibitors: amoxicillin/clavulanate and ceftriaxone/sulbactam. There was a high incidence (55.74 %) of ESBL-producing microbes in the wounds. The isolates were mostly multi-antibiotic resistant. Conclusion: Multi-drug resistant ESBL-producing bacteria are common in wound infections in the community. However, amoxicillin/clavulanate or ceftriaxone/sulbactam may be used to treat most patients with such infections in the hospital. This may guide antibiotic selection and use in trauma, most especially in resource limited countries where laboratory test is unaffordable for a majority of patients.
[Mh] Termos MeSH primário: Antibacterianos/farmacologia
Infecções Bacterianas/tratamento farmacológico
Dermatopatias Infecciosas/tratamento farmacológico
Infecção dos Ferimentos/tratamento farmacológico
[Mh] Termos MeSH secundário: Bactérias/efeitos dos fármacos
Bactérias/isolamento & purificação
Infecções Bacterianas/microbiologia
Farmacorresistência Bacteriana Múltipla
Seres Humanos
Testes de Sensibilidade Microbiana
Estudos Prospectivos
Dermatopatias Infecciosas/microbiologia
Infecção dos Ferimentos/microbiologia
beta-Lactamases/metabolismo
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Anti-Bacterial Agents); EC 3.5.2.6 (beta-Lactamases)
[Em] Mês de entrada:1712
[Cu] Atualização por classe:171219
[Lr] Data última revisão:
171219
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171201
[St] Status:MEDLINE
[do] DOI:10.11604/pamj.2017.27.66.10226


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[PMID]:28745707
[Au] Autor:Bystrov SA; Bezborodov AI; Katorkin SE
[Ad] Endereço:Samara State Medical University, Ministry of Health, Department of Hospital Surgery, Head of the department: Candidate of Medical Sciences S.E. Katorkin, Samara, Russia.
[Ti] Título:[Treatment of purulent wounds with wound dressing on a foamy basis with Hydrofiber technology].
[Ti] Título:Lechenie gnoinykh ran s primeneniem ranevykh pokrytii na pennoi osnove s tekhnologiei Gidrofaiber..
[So] Source:Khirurgiia (Mosk);(7):49-53, 2017.
[Is] ISSN:0023-1207
[Cp] País de publicação:Russia (Federation)
[La] Idioma:rus
[Ab] Resumo:AIM: to evaluate the effectiveness of modern approaches to the treatment of purulent wounds with the use of foam-based wound coatings with the Hydrofiber technology in comparison with the traditional method of wounds. MATERIAL AND METHODS: An analysis of the results of treatment of 34 patients with purulent wounds of various etiologies was performed. Patients were divided into two groups: control and basic. In the main group, local treatment of wounds was carried out using a foam-based wound coating with Hydrofiber technology. In the control group, local treatment of wounds was carried out using traditional methods with the use of gauze bandages. RESULTS: With the use of foam-based wound coatings with Hydrofiber® technology, the inflammation process in the wound and surrounding tissues is more rapidly eliminated, the periods of purification and microbial decontamination in the purulent focus are reduced.
[Mh] Termos MeSH primário: Curativos Hidrocoloides
Administração dos Cuidados ao Paciente/métodos
Staphylococcus aureus
Cicatrização/efeitos dos fármacos
Infecção dos Ferimentos
[Mh] Termos MeSH secundário: Adulto
Feminino
Seres Humanos
Masculino
Meia-Idade
Staphylococcus aureus/efeitos dos fármacos
Staphylococcus aureus/isolamento & purificação
Resultado do Tratamento
Cicatrização/fisiologia
Infecção dos Ferimentos/microbiologia
Infecção dos Ferimentos/fisiopatologia
Infecção dos Ferimentos/cirurgia
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1711
[Cu] Atualização por classe:171130
[Lr] Data última revisão:
171130
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170727
[St] Status:MEDLINE
[do] DOI:10.17116/hirurgia2017749-53


  7 / 9701 MEDLINE  
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[PMID]:29068939
[Au] Autor:Israel JS; McCarthy JE; Rose KR; Rao VK
[Ad] Endereço:Madison, Wis.; and Fort Collins, Colo. From the Division of Plastic Surgery, University of Wisconsin, Madison; and Northern Colorado Plastic and Hand Surgery.
[Ti] Título:Watch Out for Wild Animals: A Systematic Review of Upper Extremity Injuries Caused by Uncommon Species.
[So] Source:Plast Reconstr Surg;140(5):1008-1022, 2017 Nov.
[Is] ISSN:1529-4242
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Across the world, many species of nondomesticated animals dwell among humans in metropolitan areas. Rare animal bites pose a dilemma for hand surgeons, as they often result in operative injuries and recalcitrant infections. The authors treated an 85-year-old man who experienced severe cellulitis of the index finger following an opossum bite. This case prompted a systematic review of upper extremity injuries caused by species other than dogs, cats, snakes, and insects. METHODS: The authors conducted a systematic review of PubMed and Scopus databases to identify relevant articles published between 1980 and 2016. Two reviewers critically appraised the studies that met inclusion and exclusion criteria. RESULTS: The hand infection in the man who sustained an opossum bite at the authors' institution was successfully treated with targeted antibiotic therapy, hand elevation, and splinting. Seventy-one articles met inclusion criteria for and were included in this systematic review. The vast majority of existing articles represent level IV and level V evidence. The relevant literature suggests that the majority of hand infections attributable to animal bites and stings are polymicrobial. CONCLUSIONS: Injuries secondary to aquatic animals appear to be the most frequently described in the literature, and hot water immersion should be used for the majority of envenomation attributable to aquatic species. Infections can often be treated with an aminopenicillin antibiotic combined with a beta-lactamase inhibitor. Given the variability in presentation and potential for sequelae such as soft-tissue necrosis and systemic reactions, hand surgeons should approach such upper extremity injuries with a high degree of caution.
[Mh] Termos MeSH primário: Animais Selvagens
Mordeduras e Picadas
Extremidade Superior/lesões
[Mh] Termos MeSH secundário: Idoso de 80 Anos ou mais
Animais
Antibacterianos/uso terapêutico
Mordeduras e Picadas/diagnóstico
Mordeduras e Picadas/etiologia
Mordeduras e Picadas/terapia
Terapia Combinada
Traumatismos da Mão/diagnóstico
Traumatismos da Mão/etiologia
Traumatismos da Mão/terapia
Seres Humanos
Masculino
Gambás
Procedimentos Ortopédicos
Infecção dos Ferimentos
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE; REVIEW
[Nm] Nome de substância:
0 (Anti-Bacterial Agents)
[Em] Mês de entrada:1711
[Cu] Atualização por classe:171109
[Lr] Data última revisão:
171109
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:171026
[St] Status:MEDLINE
[do] DOI:10.1097/PRS.0000000000003754


  8 / 9701 MEDLINE  
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[PMID]:28810038
[Au] Autor:Banker TP; McClellan AJ; Wilson BD; Juan FM; Kuriyan AE; Relhan N; Chen FV; Weichel ED; Albini TA; Berrocal AM; Sridhar J; Gregori NZ; Townsend JH; Flynn HW
[Ti] Título:Culture-Positive Endophthalmitis After Open Globe Injuries With and Without Retained Intraocular Foreign Bodies.
[So] Source:Ophthalmic Surg Lasers Imaging Retina;48(8):632-637, 2017 Aug 01.
[Is] ISSN:2325-8179
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND AND OBJECTIVE: To report the visual and anatomical outcomes and microbiologic spectrum of culture-positive endophthalmitis in open globe injuries (OGIs) with or without intraocular foreign bodies (IOFBs). PATIENTS AND METHODS: A retrospective, interventional case series of OGIs (n = 718) treated between 2004 and 2015. Patients underwent a management protocol for OGI, including systemic broad-spectrum antibiotics, on presentation. RESULTS: Culture-positive cases of endophthalmitis after open globe repair occurred in 2.1% of eyes (n = 15 of 718 eyes); two eyes had evidence of endophthalmitis on presentation. The most common organism was Staphylococcus species (five of 17 eyes). An IOFB was present in 6.8% of eyes (n = 49 of 718 eyes). All of these eyes received prophylactic intravitreal antimicrobials. In eyes with IOFB, the rate of culture-positive endophthalmitis after initial globe repair was 8.1% (n = 4 of 49 eyes) versus 1.6% (n = 11 of 669 eyes) in eyes without IOFB (P < .01). CONCLUSION: Culture-positive endophthalmitis was identified after OGIs more often in eyes with a concurrent IOFB. [Ophthalmic Surg Lasers Imaging Retina. 2017;48:632-637.].
[Mh] Termos MeSH primário: Bactérias/isolamento & purificação
Endoftalmite/microbiologia
Corpos Estranhos no Olho/complicações
Infecções Oculares Bacterianas/microbiologia
Ferimentos Oculares Penetrantes/complicações
Órbita/lesões
Infecção dos Ferimentos/diagnóstico
[Mh] Termos MeSH secundário: Adolescente
Adulto
Idoso
Idoso de 80 Anos ou mais
Bactérias/patogenicidade
Endoftalmite/diagnóstico
Endoftalmite/etiologia
Corpos Estranhos no Olho/diagnóstico
Infecções Oculares Bacterianas/diagnóstico
Infecções Oculares Bacterianas/etiologia
Ferimentos Oculares Penetrantes/diagnóstico
Feminino
Seguimentos
Seres Humanos
Masculino
Meia-Idade
Estudos Retrospectivos
Virulência
Acuidade Visual
Infecção dos Ferimentos/etiologia
Infecção dos Ferimentos/microbiologia
Adulto Jovem
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1709
[Cu] Atualização por classe:170929
[Lr] Data última revisão:
170929
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170816
[St] Status:MEDLINE
[do] DOI:10.3928/23258160-20170802-05


  9 / 9701 MEDLINE  
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[PMID]:28763905
[Au] Autor:Liu S; Wang C; Fu YX
[Ad] Endereço:Department of Burns and Plastic Surgery, Children's Hospital of Chongqing Medical University, Chongqing 400014, China.
[Ti] Título:[Analysis of drug resistance of in wound of children with traffic injury and its relationship with antibiotic use].
[So] Source:Zhonghua Shao Shang Za Zhi;33(7):404-409, 2017 Jul 20.
[Is] ISSN:1009-2587
[Cp] País de publicação:China
[La] Idioma:chi
[Ab] Resumo:To know the drug resistance of (AB) in wound of children with traffic injury and its relationship with antibiotic use. Wound exudate of 226 children with traffic injury admitted to our unit from January 2010 to December 2015 were collected. API bacteria identification panels and fully automatic microbiological identification system were used to identify pathogens. Kirby-Bauer paper disk diffusion method was used to detect the drug resistance of pathogens to 18 antibiotics including amoxycillin/clavulanic acid, piperacillin/tazobactam, and imipenem. The detection situation of pathogen of children's wounds and drug resistance of detected AB to 18 antibiotics in each year were collected. Forty-six AB positive children (2 children excluded) were divided into imipenem-resistant group (IR, =19) and non imipenem-resistant group (NIR, =25) according to whether AB was 100% resistant to imipenem. Drug resistance of AB in wounds of children to 18 antibiotics in two groups was compared. The antibiotic use of AB positive children was collected, and the antibiotic use intensity of children in two groups was compared. Data were processed with Fisher's exact test, independent sample test, and corrected test. (1) The detection rates of pathogen in wounds of children in 2010-2015 were 95.6% (43/45), 89.8% (53/59), 81.3% (148/182), 81.1% (107/132), 81.6% (120/147), and 77.5% (62/80), respectively, showing a trend of decreasing year by year. A total of 665 strains and 75 pathogens were detected, and the top 5 pathogens with detection rate from high to low were AB, and respectively. (2) Drug resistance rates of AB to amoxycillin/clavulanic acid, cefazolin, aztreonam, and piperacillin were all 100%, while AB was 100% sensitive to polymyxin, and the total drug resistance rates of AB to the other 13 antibiotics were all above 50%. The drug resistance rate of AB in wounds of children to piperacillin was higher than that to piperacillin/tazobactam in 2010-2015. (3) Except for imipenem, amoxycillin/clavulanic acid, cefazolin, aztreonam, piperacillin, and polymyxin, the drug resistance rates of AB in wounds of children in group IR to the other 12 antibiotics were higher than those in group NIR (with values below 0.01). Besides, AB strains in wounds of children in group IR were completely resistant to at least 3 kinds of antibiotics including carbapenems, aminoglycosides, and quinolones, so that they were multidrug-resistant AB. (4) A total of 32 antibiotics were used in 46 AB positive children, and the 10-top-used antibiotics with use intensity from high to low were cefoperazone/sulbactam, piperacillin/tazobactam, cefazolin, imipenem, ceftizoxime, amoxycillin/clavulanate, ceftazidime, cefepime, amoxycillin/sulbactam, and cefmetazole, respectively. (5) Twenty-one antibiotics were not included in the comparison because of their small amount of usage. For the other 11 antibiotics, only the use intensity of metronidazole of children in two groups was statistically different ( =-3.104, <0.05). There was no statistically significant difference in total antibiotic use of children in two groups ( =0.368, >0.05). AB is one of the main pathogens in wounds of children with traffic injury, with high drug resistant rate. The high intensity of antibiotic use may lead to its drug resistance. In this study, the top-used antibiotics were in accord with AB resistant drugs, indicating a lack of normative use of antibiotics.
[Mh] Termos MeSH primário: Acinetobacter baumannii/efeitos dos fármacos
Antibacterianos/farmacologia
Queimaduras/complicações
Queimaduras/microbiologia
Farmacorresistência Bacteriana
Infecção dos Ferimentos/microbiologia
[Mh] Termos MeSH secundário: Acinetobacter baumannii/isolamento & purificação
Antibacterianos/uso terapêutico
Queimaduras/tratamento farmacológico
Criança
Infecção Hospitalar/microbiologia
Seres Humanos
Testes de Sensibilidade Microbiana
Ácido Penicilânico/análogos & derivados
Piperacilina
Infecção dos Ferimentos/tratamento farmacológico
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Anti-Bacterial Agents); 157044-21-8 (piperacillin, tazobactam drug combination); 87-53-6 (Penicillanic Acid); X00B0D5O0E (Piperacillin)
[Em] Mês de entrada:1709
[Cu] Atualização por classe:170904
[Lr] Data última revisão:
170904
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170802
[St] Status:MEDLINE
[do] DOI:10.3760/cma.j.issn.1009-2587.2017.07.002


  10 / 9701 MEDLINE  
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[PMID]:28756043
[Au] Autor:Ricco JB; Gargiulo M; Stella A; Abualhin M; Gallitto E; Desvergnes M; Belmonte R; Schneider F
[Ad] Endereço:Department of Vascular Surgery, University Hospital of Poitiers, Poitiers, France. Electronic address: jean.baptiste.ricco@univ-poitiers.fr.
[Ti] Título:Impact of angiosome- and nonangiosome-targeted peroneal bypass on limb salvage and healing in patients with chronic limb-threatening ischemia.
[So] Source:J Vasc Surg;66(5):1479-1487, 2017 Nov.
[Is] ISSN:1097-6809
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Direct (DIR) or indirect (IND) revascularization of pedal angiosomes in patients with chronic limb-threatening ischemia (CLTI) has an unclear impact on limb salvage and healing. The aim of this study was to evaluate the outcomes of DIR and IND revascularization in patients with a peroneal bypass and tissue loss. METHODS: We conducted a retrospective study of a prospectively maintained database in two European university centers from 2004 to 2015. We extracted from this database all patients with CLTI and tissue loss who had received a bypass to the peroneal artery. All patients underwent angiography before bypass. Revascularization was considered DIR if the wound was in a peroneal angiosome. Wounds, ischemia, and infection were categorized according to the Wound, Ischemia, and foot Infection (WIfI) classification. Limb salvage and amputation-free survival were calculated using the Kaplan-Meier method. Cox regression was used to compare the role of patient characteristics, including diabetes, peroneal runoff, pedal arch angiosome, WIfI grade, chronic kidney disease, and diabetes, in amputation-free-survival. RESULTS: From January 2004 through October 2015, there were 120 peroneal bypasses performed in 120 patients with CLTI and foot tissue loss. Only 55 wounds (46%) could be ascribed to a peroneal angiosome. At 3 years, amputation-free survival in patients with DIR revascularization was 54.9% ± 7.3% compared with 56.5% ± 6.3% in patients with IND revascularization (P = .44), with no significant difference in wound healing. Amputation-free survival at 3 years in patients with two patent peroneal branches was 74.8% ± 6.9% compared with 45.0% ± 6.0% in patients with one patent peroneal branch (P = .003). Amputation-free survival at 3 years in patients with a patent pedal arch (Rutherford 0-1) was 73.0% ± 7.0% vs 45.7% ± 6.0% in patients with incomplete pedal arch (Rutherford 2-3; P = .0002). Amputation-free survival at 3 years in patients with grade 1 or grade 2 WIfI was 87.4% ± 8.3% compared with 48.4% ± 5.3% in patients with grade 3 or grade 4 WIfI (P = .001). Amputation-free survival at 3 years in patients with diabetes was 43.7% ± 6.2% compared with 73.1% ± 6.7% in patients without diabetes (P = .002). Wound healing at 6 months was not significantly improved by its location within or outside a peroneal angiosome. Cox regression analysis demonstrated that diabetes, patency of both peroneal branches, patency of pedal arch, and WIfI stage but not DIR angiosome revascularization were significant predictors of amputation-free survival. CONCLUSIONS: Our results suggest that in patients with CLTI and tissue loss receiving a peroneal bypass, patency of both peroneal branches and pedal arch was associated with a better healing rate and a better amputation-free survival rate irrespective of wound angiosome location.
[Mh] Termos MeSH primário: Implante de Prótese Vascular
Isquemia/cirurgia
Salvamento de Membro
Extremidade Inferior/irrigação sanguínea
Modelos Cardiovasculares
Doença Arterial Periférica/cirurgia
Veias/transplante
Cicatrização
[Mh] Termos MeSH secundário: Centros Médicos Acadêmicos
Adulto
Idoso
Idoso de 80 Anos ou mais
Amputação
Implante de Prótese Vascular/efeitos adversos
Distribuição de Qui-Quadrado
Doença Crônica
Bases de Dados Factuais
Intervalo Livre de Doença
Feminino
França
Seres Humanos
Isquemia/diagnóstico por imagem
Isquemia/fisiopatologia
Itália
Estimativa de Kaplan-Meier
Masculino
Meia-Idade
Análise Multivariada
Doença Arterial Periférica/diagnóstico por imagem
Doença Arterial Periférica/fisiopatologia
Valor Preditivo dos Testes
Modelos de Riscos Proporcionais
Estudos Retrospectivos
Fatores de Risco
Fatores de Tempo
Resultado do Tratamento
Grau de Desobstrução Vascular
Infecção dos Ferimentos/microbiologia
[Pt] Tipo de publicação:COMPARATIVE STUDY; JOURNAL ARTICLE; MULTICENTER STUDY
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171030
[Lr] Data última revisão:
171030
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170731
[St] Status:MEDLINE



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