OBJECTIVETo summarize the pathogenic characteristics of bacterial infection and analyze the risk factors after orthotopic liver transplantation (OLT) in patients over 60 years of age.

METHODSA retrospective study of 69 patients that were over 60 years of age and underwent OLT was carried out. Descriptive statistics and risk factor analysis were performed with SPSS 11.0.

RESULTSThirty-eight patients developed bacterial infection (55.1%) after OLT, and thirty recipients suffered from mixed bacterial infection (79.0%). Multi-location infection was most commonly seen (68.4%). Nine patients died of bacterial infection. The primary pathogenic germs included enterococcus, methicillin-resistant coagulase negative staphylococcus, c maltophilia. The risk factors related to bacterial infection included preoperative malnutrition, long anhepatic phase, use of ventilator and duration of ICU stay.

CONCLUSIONSThe old patients that have undergone OLT are susceptible to bacterial infection. Bacterial infections are associated with high rate of mortality and multidrug resistance. Eliminating various risk factors can reduce the incidence of bacterial infection.

Aged ; Bacterial Infections ; etiology ; microbiology ; prevention & control ; Drug Resistance, Bacterial ; Female ; Humans ; Liver Transplantation ; Male ; Middle Aged ; Postoperative Complications ; etiology ; microbiology ; prevention & control ; Retrospective Studies ; Risk Factors

Arthroscopy ; adverse effects ; instrumentation ; methods ; Diagnostic Equipment ; adverse effects ; microbiology ; Disinfection ; methods ; Equipment Failure ; Humans ; Materials Testing ; methods ; Orthopedic Equipment ; adverse effects ; microbiology ; Postoperative Complications ; etiology ; prevention & control

OBJECTIVETo investigate the effect of microbial immune enteral nutrition composed of probiotics, deep sea fish oil, glutamine and nutrison on postoperative immune status, insulin resistance and infectious complication morbidity in patients with abdominal infection.

METHODSFrom September 2010 to April 2013 in Shandong Liaocheng City Hospital, 96 patients with upper gastrointestinal perforation were prospectively randomized into the treatment group (microbial immune enteral nutrition, n=48) and the control group(conventional enteral nutrition, n=48). Number of T cell subsets (CD3(+), CD4(+), CD8(+), CD4(+)/CD8(+)) and natural killer (NK) cell, procalcitonin (PCT), fasting blood glucose (FBG), fasting insulin (FINS), insulin resistance index (InHOMA-IR) calculated by the homeostasis model assessment(HOMA) were detected before operation and on days 3 and 7 after operation and compared between the two groups. The incidence of postoperative infectious complication was collected and compared as well.

RESULTSThere were no significant differences in immune indexes and insulin resistance-associated indexes between the two groups before operation and on the day 3 after operation(all P>0.05). On postoperative day 7, CD4(+), CD4(+)/CD8(+) and NK cells in treatment group were significantly higher than those in control group [(39.1±4.3)% vs. (30.1±5.7)%, P=0.043; 1.76±0.21 vs. 1.36±0.12, P=0.038; (19.3±4.8)% vs. (13.3±3.2)%, P=0.032], while FINS, lnHOMA-IR and PCT in treatment group were significantly lower than those in control group [(7.3±1.7) mU/L vs. (10.2±2.1) mU/L, P=0.041; 0.60±0.05 vs. 0.88±0.06, P=0.039; (0.12±0.07) μg/L vs. (0.35±0.12) μg/L, P=0.028]. Postoperative infectious complication morbidity was significantly lower in treatment group as compared to control group [18.8%(9/48) vs. 39.6%(19/48), P=0.025].

CONCLUSIONMicrobial immune enteral nutrition composed of probiotics, deep sea fish oil, glutamine and nutrison can improve the immune status, decrease the level of insulin resistance, and reduce the incidence of postoperative infectious complication for patients with abdominal infection due to upper gastrointestinal perforation.

Abdominal Injuries ; Calcitonin ; Calcitonin Gene-Related Peptide ; Enteral Nutrition ; Fish Oils ; Glutamine ; Humans ; Insulin Resistance ; Killer Cells, Natural ; Postoperative Complications ; immunology ; microbiology ; prevention & control ; Postoperative Period ; Probiotics ; Protein Precursors ; T-Lymphocyte Subsets

This multicenter study was undertaken to determine the efficacy of antibiotic prophylaxis and identify the risk factors for infectious complications after prostate surgery in Korean patients. A total of 424 patients who underwent surgery of the prostate were reviewed. All patients underwent urinalysis and urine culture preoperatively and postoperatively. Efficacy of antibiotic prophylaxis and risk factors for infectious complications were investigated. Infectious complications were observed in 34.9% of all patients. Factors independently associated with infectious complications were diabetes mellitus (adjusted OR, 1.99; 95% CI, 1.09-3.65, P=0.025) and operation time (adjusted OR, 1.08; 95% CI, 1.03-1.13, P=0.004). Clinicians should be aware of the high risk of infectious complications in patients with diabetes and those who undergo a prolonged operation time. Neither the type nor duration of prophylactic antibiotics resulted in differences in infectious complications.
Aged ; Anti-Bacterial Agents/pharmacology/therapeutic use ; Antibiotic Prophylaxis ; Diabetes Mellitus, Type 2/complications ; Drug Resistance, Bacterial/drug effects ; Enterococcus/drug effects/isolation & purification ; Escherichia coli/isolation & purification ; Humans ; Klebsiella pneumoniae/drug effects/isolation & purification ; Male ; Middle Aged ; Odds Ratio ; Postoperative Complications/microbiology/prevention & control ; Prospective Studies ; Prostatic Neoplasms/complications/*surgery ; Quinolones/pharmacology ; Risk Factors ; Time Factors ; Transurethral Resection of Prostate ; Urinalysis ; Urinary Tract Infections/microbiology

ObjectiveTo evaluate the effect of cefoxitin prophylactic in reducing the incidence of severe infection after transrectal prostate biopsy (TRPB).

METHODSThis retrospective study included 155 cases of TRPB with a 5-day administration of oral levofloxacin at 200 mg bid (the control group) and another 167 cases with a 3-day administration of oral levofloxacin at the same dose plus intravenous cefoxitin at 2.0 g 2 hours before TRPB (the experimental group) according to the distribution characteristics of drug-resistance bacteria in our department. The patients of the control and experimental groups were aged (68.68 ± 8.12) and (68.72 ± 7.51) years, with PSA levels of (19.78 ± 21.57) and (21.15 ± 42.63) μg/L, involving (11.68 ± 1.44) and (11.77±1.02) biopsy cores, respectively. Comparisons were made between the two groups of patients in the incidence rate of severe infection, which was defined as lower urinary track symptoms plus the systemic inflammatory response syndrome (SIRS) within 7 days after TRPB.

RESULTSThe incidence rate of postoperative severe infection was significantly lower in the experimental group than in the control (0.6% ［1/167］ vs 5.8% ［9/155］, P < 0.05). Blood cultures revealed positive E-coli strains in 6 cases in the control group, including 5 ESBL-positive and 4 quinolone-resistant and amikacin-sensitive cases, all sensitive to cefoxitin, cefoperazone/sulbactam and imipenem. The only one case of severe infection was shown to be negative in blood culture.

CONCLUSIONSPreoperative intravenous administration of cefoxitin according to the specific distribution characteristics of drug-resistance bacteria can significantly reduce the incidence of severe infection after TRPB.

Aged ; Anti-Bacterial Agents ; therapeutic use ; Biopsy ; adverse effects ; methods ; Cefoxitin ; therapeutic use ; Drug Resistance, Bacterial ; Escherichia coli ; isolation & purification ; Escherichia coli Infections ; microbiology ; prevention & control ; Humans ; Levofloxacin ; therapeutic use ; Male ; Middle Aged ; Postoperative Complications ; blood ; prevention & control ; Prostate ; pathology ; Retrospective Studies