Parietal bone osteomyelitis in melioidosis

Shetty, Hariprasad; Mallela, Ajay Raj; Shastry, BA; Acharya, Vasudeva

doi:10.1136/bcr-2014-208612

Cited by 5 publications

(2 citation statements)

References 18 publications

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“…In the treatment of polymicrobial SSIs, meropenem was found to be the most effective single agent (90–95%), and its efficacy was even improved by adding vancomycin (97–98%). 27 , 28 …”

Section: Discussionmentioning

confidence: 99%

“…In the treatment of polymicrobial SSIs, meropenem was found to be the most effective single agent (90-95%), and its efficacy was even improved by adding vancomycin (97-98%). 27,28 It was also worth noting that the higher rate of GNB infections in the +VP SSIs, which means in high-risk patients antibiotics covering GNB should be considered in primary surgery. This will help reduce the incidence of SSI, either GPB infection or GNB infection.…”

Section: Discussionmentioning

confidence: 99%

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Does the Microflora of Surgery Site Infection Change After Prophylactic Use of Vancomycin Powder in the Spine Surgery

Wang

et al. 2023

IDR

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Study Design Retrospective cohort study. Objective This study aimed to investigate the characteristics of microflora in patients with deep spinal surgical site infection (SSI) after prophylactic use of vancomycin powder (VP). Methods A retrospective analysis was performed on patients after spinal surgery. Patients were grouped according to whether VP use and only patients with deep SSI were included in this study. General information of the patients, the dose of vancomycin, bacterial culture results, drug sensitivity test results, and SSI treatment methods were recorded. The differences of microflora between the two groups were analyzed, and the sensitivity of bacteria in the +VP group to antibiotics was analyzed. Results The infection rate in the +VP group was 4.9% (56/1124) vs 6.3% (93/1476) in the No-VP group (P < 0.05). The proportion of Gram-positive bacteria (GPB) in the +VP SSIs was 55.4% vs.74.1% in the No-VP group (P < 0.05). The percentage of Gram-negative bacteria (GNB) in the +VP SSIs was 46.4% vs.30.1% in the No-VP group (P < 0.05). More dose of VP cannot decrease the SSI, but the proportion of GNB in VP >1g SSIs was higher (59.0% vs 32.4%, P < 0.05). In the +VP SSIs, all of the GNB cultured were sensitive to meropenem, and linezolid covered most of the GPB cultured. Conclusion Local use of vancomycin powder can reduce the incidence of SSI, but this may lead to changes in the bacterial flora. Once the SSI occurs, the case of GNB infection may be increased. The more dose of VP cannot decrease SSI but may increase the rate of GNB in the +VP SSIs. Once infections still occur after VP use, antibiotics covering GNB may be added. These findings may help guide choice of empiric antibiotics while awaiting culture data.

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“…In the treatment of polymicrobial SSIs, meropenem was found to be the most effective single agent (90–95%), and its efficacy was even improved by adding vancomycin (97–98%). 27 , 28 …”

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%