Treatment of <i>Candida</i> sternal infection following cardiac surgery – a review of literature

Arıkan, Ali Ahmet; Omay, Oğuz; Kanko, Mühip; Horuz, Emre; Yağlı, Gökhan; Kağan, Emrah Yaşar; Ağır, Hakan

doi:10.1080/23744235.2018.1518583

Cited by 12 publications

(13 citation statements)

References 26 publications

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“…Sporadic outbreaks of unexpected organisms, such as Candida spp. [35] and Legionella spp. [36], have also been found to cause DSWI following cardiac surgery, as have Nocardia spp.…”

Section: Mediastinitis After Cardiac Surgerymentioning

confidence: 99%

Mediastinitis in the intensive care unit patient: a narrative review

Pastène

Cassir

Tankel

et al. 2020

Clinical Microbiology and Infection

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Background: Mediastinitis is a rare but severe infection, defined as an inflammation of the connective tissues and structures within the mediastinum. Due to its proximity to vital structures, mediastinitis represents a highly morbid pathological process associated with a high risk of mortality. In most cases mediastinitis requires treatment in the intensive care unit. Objectives: To highlight to the reader the clinical features of mediastinitis, to attempt to define each clinical scenario, to describe the responsible pathogens and finally to depict both the medical and surgical treatments. Sources: We performed a literature search of the PubMed and Cochrane libraries, limited for articles published between January 2003 and December 2018, reporting on acute mediastinitis. Content: The term covers different entities of different aetiologies including deep sternal wound infection related to sternotomy; oesophageal perforation or anastomosis leakage; and finally descending necrotizing mediastinitis, often secondary to oropharyngeal abscess. The responsible pathogens and therefore subsequent management depends on the underlying aetiology. Empirical antimicrobial therapy should cover the suspected microorganisms while surgery and supportive measures should aim to reduce the inoculum of pathogens by providing adequate drainage and debridement. Implications: Literature concerning mediastinitis in the intensive care unit is relatively scarce. We have collated the evidence and reviewed the different causes and treatment options of acute mediastinitis with a particular focus on microbiological epidemiology. Future research in larger cohorts is needed to better understand the treatment of this difficult disease.

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“…Sporadic outbreaks of unexpected organisms, such as Candida spp. [35] and Legionella spp. [36], have also been found to cause DSWI following cardiac surgery, as have Nocardia spp.…”

Section: Mediastinitis After Cardiac Surgerymentioning

confidence: 99%

Mediastinitis in the intensive care unit patient: a narrative review

Pastène

Cassir

Tankel

et al. 2020

Clinical Microbiology and Infection

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“…1), что может влиять на фармакологические эффекты, развивающиеся в этих тканях и клетках (влияние на гемостаз, иммунитет, секрецию инсулина и т. д. [14]. Определенные фармацевтические препараты (в частности, глюкокортикоиды) способствуют усилению грибковой инвазии кожи и слизистых оболочек [14,15].…”

Section: Conclusion the Chemoreactomе Analysisunclassified

“…[14]. Определенные фармацевтические препараты (в частности, глюкокортикоиды) способствуют усилению грибковой инвазии кожи и слизистых оболочек [14,15]. Трансдермальное применение НПВП зачастую нацелено на снятие локального отека, вызванного воспалением.…”

Section: Conclusion the Chemoreactomе Analysisunclassified

The positive and negative effects of using transdermal nonsteroidal anti-inflammatory drugs: chemoreactome analysis

Torshin

Громова

Гришина

et al. 2020

RJTAO

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Transdermal nonsteroidal anti-inflammatory drugs (NSAIDs) are actively used for mild and moderate pain syndrome, muscle contusions and sprains, sports injuries, and the widest range of musculoskeletal diseases. The transdermal administration of NSAIDs aims to create sufficiently high drug concentrations in the lesion focus, provided that the side effects associated with its systemic action are maximally reduced.Objective: to comparatively simulate the effects of transdermal NSAIDs.Material and methods. Chemoreactome profiling of six NSAIDs (meloxicam, diclofenac, ibuprofen, ketoprofen, nimesulide, and dexketoprofen) was performed. The pharmacological capabilities of molecules were analyzed within the framework of a chemoreactome methodology, by comparing the chemical structure of the studied molecule with those of millions of other molecules, the pharmacological properties of which had already been studied in experimental and clinical studies. Training the artificial intelligence algorithms based on the big data available in in the databases PubChem/PHARMGKB, HMDB, STRING, and others was done with multi-level training quality control in the cross validation framework according to the combinatorial theory of solvability and the theory of feature value classification.Results and discussion. Meloxicam versus other NSAIDs accumulates primarily in the muscles and skin and, to a much lesser extent, in heart tissues, lymphocytes, gonads, and cartilage. This drug showed the greatest dose-dependent decongestant effect in the model of edema induced by croton oil. Analysis of the systemic effects of NSAIDs indicated that meloxicam might affect the metabolism of vitamins A, D, PP, and B6 to a lesser extent than other NSAIDs.Conclusion. The chemoreactomе analysis has demonstrated that meloxicam as a gel causing minimal side effects can be used effectively and long.

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“…With a reported mortality of 55% (2),Candida osteomyelitis represents a severe and uncommon condition that requires combined surgical debridement and prolonged antifungal treatment. Re-sternotomies due to noninfective causes, prolonged use of antibiotics, colonization of the respiratory and urinary tracts and the use of percutaneous dilatational tracheostomy devices, have been identified as risk factors facilitating Candida infections (2). Fungal osteomyelitis represents a treatment challenge for which a number of surgical strategies have been suggested (1, 2, 3).…”

Section: Commentmentioning

confidence: 99%

“…Fungal osteomyelitis represents a treatment challenge for which a number of surgical strategies have been suggested (1, 2, 3). The optimal treatment strategy is still not clear (2,3). There are no significant outcome differences between the different surgical approaches, although more promising results have been confirmed with omental flaps in a recent review by Arikan and colleagues (3).…”

Section: Commentmentioning

confidence: 99%

Sternectomy for Candida albicans sternal osteomyelitis after left ventricular assist device implantation

Hemelrijck¹,

Frank²,

Buechel³

et al. 2020

Preprint

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Fungal osteomyelitis is uncommon after cardiac surgery. A case of Candida albicans and S. epidermidis osteomyelitis with device infection after implantation of a left ventricular assist device in a male patient is presented. After confirmation with microbiological and radiological examinations, debridement was performed. Surgical specimens grew C. albicans and S. epidermidis. Fluconazole, daptomycin and negative pressure wound therapy failed to achieve healing. Total sternectomy and pectoralis muscle flap reconstruction were performed. There was no recurrent infection for C. albicans on a prolonged antifungal regime. The combination of antifungal therapy and aggressive surgical debridement may be useful to control fungal osteomyelitis.

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Treatment of Candida sternal infection following cardiac surgery – a review of literature

Cited by 12 publications

References 26 publications

Mediastinitis in the intensive care unit patient: a narrative review

Mediastinitis in the intensive care unit patient: a narrative review

The positive and negative effects of using transdermal nonsteroidal anti-inflammatory drugs: chemoreactome analysis

Sternectomy for Candida albicans sternal osteomyelitis after left ventricular assist device implantation

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