Factors Contributing to Surgical Site Infections: A Comprehensive Systematic Review of Etiology and Risk Factors

Bucataru, Alexandra; Balasoiu, Maria; Ghenea, Alice Elena; Zlatian, Ovidiu Mircea; Vulcanescu, Dan Dumitru; Horhat, Florin George; Bagiu, Iulia Cristina; Sorop, Virgiliu Bogdan; Sorop, Madalina Ioana; Oprisoni, Andrada; Boeriu, Estera; Mogoanta, Stelian Stefanita

doi:10.3390/clinpract14010006

Cited by 5 publications

(1 citation statement)

References 35 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…From the Gram-negatives, the Klebsiella strains are lately becoming more and more frequent both in hospital and community settings, with increasing antibiotic resistance [38][39][40]. The literature reported a high-morbidity keratitis with multidrug-resistant Pseudomonas aeruginosa [41].…”

Section: Etiology Of Bacterial and Fungal Keratitis And Antimicrobial...mentioning

confidence: 99%

Bacterial and Fungal Keratitis in a Tertiary Care Hospital from Romania

Bălășoiu,

Zlatian

et al. 2024

Microorganisms

Self Cite

View full text Add to dashboard Cite

Infectious keratitis is a significant global problem that can lead to corneal blindness and visual impairments. This study aimed to investigate the etiology of infectious bacterial and fungal keratitis, identify the causative pathogens and their antimicrobial resistance patterns, and analyze the risk factors associated with the development of infectious keratitis. The study was observational and retrospective, involving 226 eyes from 223 patients presented at the Ophthalmology Clinic of the County Clinical Emergency Hospital of Craiova, Romania. The inclusion criteria included corneal ulceration/abscess/infiltrate present on slit-lamp examination and positive microbiological sampling for bacteria or fungi. The study found that the most common causes of infectious keratitis were coagulase-negative staphylococci (35.40%), Staphylococcus aureus (11.06%), and Pseudomonas aeruginosa (14.16%). The Gram-positive bacteria showed high resistance rates to penicillin, moderate rates to gentamycin and clindamycin, and low resistance to chinolones. The Gram-negative bacteria were highly resistant to ampicillin and amoxicillin–clavulanic acid, while third-generation cephalosporins, quinolones, and carbapenems were effective. Systemic antibiotics, such as vancomycine, piperacillin–tazobactam, amikacin, and ceftazidime, show promise against keratitis with low resistance rates, whereas carbapenems and topical aminoglycosides had higher resistance, leaving moxifloxacin as a potential topical option for Gram-positive bacteria and Pseudomonas aeruginosa, albeit with resistance concerns for Klebsiella spp. Although fungal keratitis was rare, Fusarium spp. and Candida albicans were the leading fungal pathogens, with incidences of 2.65% and 2.21%, respectively. Candida albicans was broadly susceptible to most antifungals, while Fusarium solani, Curvularia lunata, and Alternaria alternata exhibited resistance to many antifungals. Amphotericin B and caspofungin can be used as systemic antifungals in fungal keratitis. The study also identified risk factors for keratitis such as ocular trauma (65.92%, OR: 2.5), contact lens wear (11.94%, OR: 1.8), and corneal scarring/leukoma (10.17%, OR: 1.6). Keratitis was more frequent in individuals over 60 years old. The findings of this study have implications for the development of effective diagnostic, therapeutic, and preventive strategies for infectious keratitis.

show abstract

Section: Etiology Of Bacterial and Fungal Keratitis And Antimicrobial...mentioning

confidence: 99%

Bacterial and Fungal Keratitis in a Tertiary Care Hospital from Romania

Bălășoiu,

Zlatian

et al. 2024

Microorganisms

Self Cite

View full text Add to dashboard Cite

show abstract

Maîtriser le risque infectieux au bloc opératoire

Skolski

2024

Oxymag

View full text Add to dashboard Cite

In Vitro and In Vivo Translational Insights into the Intraoperative Use of Antiseptics and Lavage Solutions Against Microorganisms Causing Orthopedic Infections

Dudek,

Brożyna,

Karoluk

et al. 2024

IJMS

View full text Add to dashboard Cite

The growing antibiotic resistance of microorganisms causing postoperative infections following orthopedic surgeries underscores the urgent need for localized antiseptic and lavage delivery systems to enhance infection control. This study evaluates the in vitro effectiveness of antiseptic and lavage solutions—including polyhexanide, povidone–iodine, low-concentrated hypochlorite, Ringer’s solution, and saline—against Staphylococcus epidermidis, Staphylococcus aureus MRSA, Cutibacterium acnes, Corynebacterium amycolatum, Pseudomonas aeruginosa, and Candida albicans. Using microplate models (Minimum Inhibitory Concentration, Minimum Biofilm Eradication Concentration, and Biofilm-Oriented Antiseptic Test assays), flow-based models (Bioflux system), and surfaces relevant to orthopedic implants (e.g., stainless steel disks/screws, Co-Cr-Mo, Ti-Al-Nb orthopedic alloys, and ultra-high-molecular-weight polyethylene), as well as a bio-nano-cellulose scaffold representing tissue, we assessed the solutions’ activity. The cytotoxicity of the solutions was evaluated using osteoblast and keratinocyte cell lines, with additional in vivo insights gained through the Galleria mellonella larval model. The results show that polyhexanide-based solutions outperformed povidone–iodine in biofilm eradication in most tests applied, particularly on complex surfaces, whereas iodine demonstrated higher cytotoxicity in applied in vitro and in vivo tests. Low-concentration hypochlorite solutions exhibited minimal antibiofilm activity but also showed no cytotoxicity in cell line and G. mellonella larval models. These findings highlight the importance of careful antiseptic selection and rinsing protocols to balance infection control efficacy with tissue compatibility in orthopedic applications.

show abstract

Factors Contributing to Surgical Site Infections: A Comprehensive Systematic Review of Etiology and Risk Factors

Cited by 5 publications

References 35 publications

Bacterial and Fungal Keratitis in a Tertiary Care Hospital from Romania

Bacterial and Fungal Keratitis in a Tertiary Care Hospital from Romania

Maîtriser le risque infectieux au bloc opératoire

In Vitro and In Vivo Translational Insights into the Intraoperative Use of Antiseptics and Lavage Solutions Against Microorganisms Causing Orthopedic Infections

Contact Info

Product

Resources

About