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Mediastinitis caused by an NDM-1 Escherichia coli in a child with Dacron Sano shunt after pulmonary atresia with ventricular septal defect surgery treated with combination of aztreonam-avibactam.

Int J Antimicrob Agents

October 2024

Paediatric Infectious Disease Unit, Department of Woman, Child and Adolescent Health, Geneva University Hospitals, and Department of Paediatrics, Gynaecology and Obstetrics, Faculty of Medicine, University of Geneva, Geneva, Switzerland.

Article Synopsis
  • - Carbapenem-resistant Enterobacterales are rising in frequency, leading to hospital-acquired infections like postoperative mediastinitis.
  • - A case study details a 13-month-old boy with DiGeorge syndrome who developed this infection from an Escherichia coli strain producing NDM-1 carbapenemase.
  • - The boy was treated successfully with surgery and a combination of antibiotics over 6 weeks, showing positive recovery without any relapses in a follow-up period of 10 weeks.
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Introduction: Surgical site infections (SSIs) are one of the leading causes of operation-related adverse effects. To create an effective hospital infection program, information about a local pattern is essential. The ever-changing pattern of infections and inappropriate use of antibiotics has predisposed to the development of drug-resistant strains and has made the management of SSIs arduous.

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Article Synopsis
  • A rare case of an intra-abdominal abscess and bacteremia due to a specific pathogen was reported in a 75-year-old man following total gastrectomy for gastric cancer.
  • The patient developed symptoms 17 days post-surgery, leading to the diagnosis confirmed by imaging and culture results.
  • This case underscores the need for awareness among healthcare professionals about this pathogen as a possible cause of atypical post-surgical infections, alongside typical pathogens like Enterobacteriaceae, and suggests further research is needed on this topic.
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Background: The appropriate timing of surgery and perioperative management of patients with previous SARS-CoV-2 infection are open issues. The purpose of this document is to support the clinical decision-making process regarding the patient with previous Sars-CoV-2 infection to undergo elective surgery. The recipients of this document are physicians, nurses, healthcare personnel, and other professionals involved in the patient's surgical process.

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Millions of people worldwide have been impacted by biofilm-associated disorders, which are impregnable owing to frequent changes in surface antigens and gene expression. Globally, about 11% of nosocomial infections, including cystic fibrosis, chronic wound infections, and post-surgical infections, are caused by , the most prevalent Gram-negative bacterial species. Moreover, biofilms are highly resistant to the host's immune system, and exhibit increased tolerance to stress factors such as starvation, dehydration, and antimicrobials.

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