Rrisk factors, pathogenic bacteria and drug resistance of postoperative surgical site infection in patients with Crohn's disease / 中华普通外科杂志

Objective:To analyze the risk factors for postoperative surgical site infections (SSIs) in patients with Crohn's disease (CD).Methods:This retrospective observational study included CD patients undergoing bowel resection between July 2015 and July 2018. The prevalence and risk factors of SSIs were evaluated. The microbiological evaluation from patients with SSIs was performed by bacterial culture and drug sensitivity test.Results:There were 66 patients suffering SSIs, with 41 incisional SSIs and 32 organ/space SSIs. Multivariate analysis identified the preoperative infliximab therapy ( OR 2.338,95% CI 1.192-4.587, P=0.013), laparoscopic surgery ( OR 0.460,95% CI 0.226-0.936, P=0.013), and preoperative white blood cell ( OR 2.008,95% CI 1.018-3.961, P=0.044) as independent factors for SSIs. Fifty-nine strains of pathogenic bacteria were detected in 66 cases of CD combined with SSIs, including 36 strains of gram-negative bacteria, 5 strains of gram-positive bacteria, and 2 strains of fungi. Escherichia coli and Klebsiella pneumoniae were main G - bacteria, with high resistance to common used antibiotics. Enterococcus faecalis and Enterococcus faecium were main G -. 62.1% of the SSIs grew extended-spectrum β-lactamase (ESBL)-producing pathogens in their bacteria cultures and 37.9% grew non-ESBL microbes. Conclusion:The incidence of SSIs was higher in CD patients. Preoperative infliximab therapy, preoperative white blood cell, and laparoscopic surgery were predictors of SSIs.

Nocardiosis Associated with Novel Agents at Relapsed Multiple Myeloma: Case Series

Nocardiosis is a gram positive bacterial infection caused by aerobicactinomycetes. It抯 nonspesific presentation and radiographic findings usually make it undiagnosed with highly fatal outcomes. The patients with intracelluler defects are prone to nocardiosis. Multiplemyelom(MM) itself is a mainly humoral deficiency disorder because of defective antibodies but recent drugs such as proteasome inhibitors and immuno modulatory drugs also cause cellular deficiency. Here we presented two definite and oneprobable pulmonary nocardiosis patients who have a diagnosis of MM, autologou shematopoetic stem cell transplant history in their past and anti myeloma therapy presently.