Purpose: In postoperative peritonitis, Gram stain examination (GSE) of peritoneal fluid has been proposed as a guide for the prescription of glycopeptides and antifungal therapy in empirical antibiotherapy. No data support this approach for Gram-positive cocci. We aimed to evaluate the performance of GSE in predicting the results of the culture of peritoneal fluid.
Methods: In this retrospective single-center study, concordance between GSE and culture of peritoneal fluid was assessed for different types of microorganisms. Factors associated with concordance of the two tests were evaluated in the subpopulation of Gram-positive cocci peritonitis.
Results: Among the 152 episodes, the GSE was negative in 57 cases. The negative predictive value and the positive predictive value were 41% and 87% for Gram-positive cocci (GPC), 31% and 86% for Gram-negative bacilli, and 78% and 94% for fungi. GSE is not a reliable guide for the choice of empirical antibiotherapy and cannot reliably rule out the presence of GPC at culture. If we aim to achieve a high rate of adequacy, the systematic use of glycopeptide in the empirical antibiotherapy may be considered.
Conclusion: GSE shows poor performance to predict the results of culture of peritoneal fluid in postoperative peritonitis. Avoiding covering resistant GPC cannot be based on the result of GSE.
Download full-text PDF |
Source |
|---|---|
| http://dx.doi.org/10.1007/s00068-019-01161-x | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Neutrophil extracellular traps promote pre-metastatic niche formation in the omentum by expanding innate-like B cells that express IL-10.
Cancer Cell
December 2024
Department of Molecular and Cellular Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA. Electronic address:
Disseminated cancer cells in the peritoneal fluid often colonize omental fat-associated lymphoid clusters but the mechanisms are unclear. Here, we identify that innate-like B cells accumulate in the omentum of mice and women with early-stage ovarian cancer concomitantly with the extrusion of chromatin fibers by neutrophils called neutrophil extracellular traps (NETs). Studies using genetically modified NET-deficient mice, pharmacologic inhibition of NETs, and adoptive B cell transfer show that NETs induce expression of the chemoattractant CXCL13 in the pre-metastatic omentum, stimulating recruitment of peritoneal innate-like B cells that in turn promote expansion of regulatory T cells and omental metastasis through producing interleukin (IL)-10.
View Article and Find Full Text PDFEvaluation of postoperative intracranial pressure in patients with radiological diagnosis of idiopathic intracranial hypertension.
Am J Otolaryngol
December 2024
Skull Base and Rhinology Department, Hospital Universitario Pedro Ernesto, Rio de Janeiro, Brazil; Skull Base and Rhinology Department, Policlinica de Botafogo, Rio de Janeiro, Brazil.
Objective: This study aimed to assess postoperative intracranial pressure in patients with clinical and/or radiological features of idiopathic intracranial hypertension (IIH) undergoing endoscopic endonasal surgery for primary cerebrospinal fluid (CSF) leak repair.
Methods: Data was prospectively collected from 9 patients diagnosed with CSF nasal leaks who underwent corrective endonasal surgery between January 1, 2021, and October 31, 2022. Postoperative intracranial pressure was measured via lumbar puncture at least one month after surgery.
When Elevated Creatinine Is Not What It Seems: Intraperitoneal Urinary Leak Mimicking Acute Kidney Injury.
Cureus
December 2024
Hospital Medicine, Cleveland Clinic Abu Dhabi, Abu Dhabi, ARE.
Acute kidney injury (AKI) is typically classified as prerenal, renal, or postrenal in etiology, with postrenal often referring to obstructive causes. However, certain uncommon conditions, such as intraperitoneal urinary leaks, may not fit clearly into these categories. In patients with a recent history of pelvic procedure, a complication such as intraperitoneal urinary leak can mimic AKI due to urine reabsorption across the peritoneum.
View Article and Find Full Text PDFIntrathecal methotrexate injection combined treatment of gastric cancer with leptomeningeal metastasis: case report.
Front Oncol
December 2024
Department of Neuro-Oncology, Cancer Center, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.
Background: Leptomeningeal metastasis of gastric adenocarcinoma (LM-GC) is a rare and severe complication with a poor prognosis, its prognosis is significantly poorer than liver, lung, and peritoneal metastases. Studies on LM-GC have been limited to clinical case reports. Despite advances in systemic therapies, there is a lack of standardized treatment protocols for LM-GC due to its rarity and the challenges it presents.
View Article and Find Full Text PDFIntroduction: The lack of peritoneal dialysis (PD) catheters designed explicitly for neonates creates significant challenges in the provision of neonatal peritoneal dialysis. High resource settings can circumvent this limitation by resorting to alternative extracorporeal dialysis methods. However, low resource settings (LRS), PD remains the preferred dialysis modality, and the use of off-label catheters for PD results in complications such as omental wrapping and occlusion.
View Article and Find Full Text PDFWant AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!