Unveiling the Pathogenic Bacteria Causing Descending Necrotizing Mediastinitis

Sun, Qiang; Li, Zixuan; Wang, Panpan; Zhao, Junfang; Chen, Shuai; Sun, Minglei

doi:10.3389/fcimb.2022.873161

Cited by 9 publications

(6 citation statements)

References 49 publications

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“…The sensitivity test of pathogens can provide important guidance for subsequent antibiotic use. Our study found that the most frequent pathogens were S. constellatus and A. baumannii , while in a study for patients with DNM, the dominant species were Prevotella oris and S. constellatus ( 20 ). Therefore, collection of multiple abscess samples during surgery is recommended to identify the causative pathogens.…”

Section: Discussioncontrasting

confidence: 46%

Video-assisted thoracic surgery drainage is feasible and safe for acute necrotizing mediastinitis: a retrospective cohort study

Liang,

Peng,

Lin

et al. 2023

J Thorac Dis

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Background Acute necrotizing mediastinitis (ANM) is a severe infection of the mediastinal loose connective tissue. Traditionally, it has been treated with thoracotomy, but video-assisted thoracic surgery (VATS) is been increasingly used in patients with this condition. This study aimed to compare the outcomes of VATS and open thoracotomy in treating ANM. Methods The medical records of patients with ANM who underwent surgery between March 2012 and April 2021 were retrieved. A retrospective screening was conducted based on clinical characteristics, bacterial pathogens, surgical approach, and outcomes. The patients were divided into a VATS group and an open thoracotomy (Open) group. The patient characteristics and surgical outcomes of the two groups were summarized and compared. Results A total of 64 cases were enrolled in this study, including 48 in the VATS group (75%) and 16 in the Open group (25%). The most common site of infection was the neck (n=26, 40.6%). Streptococcus constellatus and Acinetobacter baumannii ( A. baumannii ) were the most frequently found pathogens in secretion culture. In sputum culture, the most common pathogens were Klebsiella pneumonia and A. baumannii . Postoperative outcomes, including blood transfusion (33.3% vs . 43.8%; P=0.45), duration of postoperative drainage {14 [1–47] vs . 17 [4–54] days; P=0.15}, length of antibiotic medication {14.5 [1–54] vs . 18 [4–54] days; P=0.29}, admission to intensive care unit (ICU) (87.5% vs . 75.0%; P=0.43), length of ICU stay {5 [1–58] vs . 8.5 [1–37] days; P=0.20}, postoperative hospital stay {17 [2–61] vs . 21 [5–56] days; P=0.22}, reoperation rate (12.5% vs . 6.25%; P=0.82), and mortality rate (14.6% vs . 12.5%; P>0.99) were comparable between the two groups. Conclusions ANM treated by both the VATS and open approach had comparable outcomes. Therefore, VATS is a viable option for patients with ANM.

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Section: Discussioncontrasting

confidence: 46%

Video-assisted thoracic surgery drainage is feasible and safe for acute necrotizing mediastinitis: a retrospective cohort study

Liang,

Peng,

Lin

et al. 2023

J Thorac Dis

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“…Mogibacterium and Denitratisoma have been identified as potential causative agents of gingival disease ( Liu et al, 2023 ; Wu et al, 2023 ). Mogibacterium is also associated with intermaxillary gap infections ( Sun et al, 2022 ). Denitratisoma is involved in denitrification and are used in sewage treatment ( Wang et al, 2023 ), but their role in the gut requires further investigation.…”

Section: Discussionmentioning

confidence: 99%

Different effects of acute and chronic oxidative stress on the intestinal flora and gut-liver axis in weaned piglets

Zhang,

Xiang,

Wang

et al. 2024

Front. Microbiol.

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IntroductionOxidative stress plays a pivotal role in modulating the balance of intestinal flora and the gut-liver axis, while also serving as a key determinant of the growth potential of weaned piglets. However, few studies have subdivided and compared acute and chronic oxidative stress.MethodsIn this study, an intestinal model of acute oxidative stress in weaned piglets using paraquat (PQ) and a chronic oxidative stress model using D-galactosa in weaned piglets were conducted. And we further systematically compare their effects.ResultsBoth acute and chronic oxidative stress models impaired intestinal barrier function and liver function. Chronic stress caused by D-galactose can result in severe redox dysregulation, while acute stress caused by paraquat can lead to inflammation and liver damage. Additionally, the components involved in the CAR pathway were expressed differently. Chronic or acute oxidative stress can reduce the diversity and composition of intestinal flora. In the PQ group, the richness of Mogibacterium and Denitratisoma improved, but in the D-gal group, the richness of Catenisphaera and Syntrophococcus increased.DiscussionNot only does this research deepen our understanding of the effects of acute and chronic oxidative stress on intestinal functions, but it also characterizes characteristic changes in the gut flora, potentially identifying novel therapeutic targets and opening new avenues for future research.

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“…This rare but fatal illness involves a severe soft tissue infection that progresses along the fascia to the mediastinum [4]. The dissemination of the DNI to the mediastinum can be facilitated by gravity, the pressure of the abscess, and negative thoracic pressure during respiration [41]. The symptoms of descending mediastinitis include odynodysphagia, dyspnea, respiratory distress, chest discomfort, and fever, even though the patients would not necessarily present these clinical manifestations [42].…”

Section: Discussionmentioning

confidence: 99%

A Machine Learning Approach to Assess Patients with Deep Neck Infection Progression to Descending Mediastinitis: Preliminary Results

Chen,

Chin,

Chan

et al. 2023

Diagnostics

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Background: Deep neck infection (DNI) is a serious infectious disease, and descending mediastinitis is a fatal infection of the mediastinum. However, no study has applied artificial intelligence to assess progression to descending mediastinitis in DNI patients. Thus, we developed a model to assess the possible progression of DNI to descending mediastinitis. Methods: Between August 2017 and December 2022, 380 patients with DNI were enrolled; 75% of patients (n = 285) were assigned to the training group for validation, whereas the remaining 25% (n = 95) were assigned to the test group to determine the accuracy. The patients’ clinical and computed tomography (CT) parameters were analyzed via the k-nearest neighbor method. The predicted and actual progression of DNI patients to descending mediastinitis were compared. Results: In the training and test groups, there was no statistical significance (all p > 0.05) noted at clinical variables (age, gender, chief complaint period, white blood cells, C-reactive protein, diabetes mellitus, and blood sugar), deep neck space (parapharyngeal, submandibular, retropharyngeal, and multiple spaces involved, ≥3), tracheostomy performance, imaging parameters (maximum diameter of abscess and nearest distance from abscess to level of sternum notch), or progression to mediastinitis. The model had a predictive accuracy of 82.11% (78/95 patients), with sensitivity and specificity of 41.67% and 87.95%, respectively. Conclusions: Our model can assess the progression of DNI to descending mediastinitis depending on clinical and imaging parameters. It can be used to identify DNI patients who will benefit from prompt treatment.

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Unveiling the Pathogenic Bacteria Causing Descending Necrotizing Mediastinitis

Cited by 9 publications

References 49 publications

Video-assisted thoracic surgery drainage is feasible and safe for acute necrotizing mediastinitis: a retrospective cohort study

Video-assisted thoracic surgery drainage is feasible and safe for acute necrotizing mediastinitis: a retrospective cohort study

Different effects of acute and chronic oxidative stress on the intestinal flora and gut-liver axis in weaned piglets

A Machine Learning Approach to Assess Patients with Deep Neck Infection Progression to Descending Mediastinitis: Preliminary Results

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