William G Cheadle

..Treating SSIs imposes a substantial strain on the financial resources of the health care system...

..Our faculty includes surgeons with both broad-based and narrowly focused practices. In light of duty-hour restrictions and proposed changes in surgical training, we assessed the results of this model over an extended period...

..Adjunctive antibiotic therapy against gram-negative aerobes and anaerobes should be limited to a 7- to 10-day course, except in selected patients, such as those with inadequate source controls...

..We conclude that endogenous IL-10 is detrimental for survival and bacterial clearance in this model of chronic peritonitis...

..Previously, we developed an infection model by intraperitoneal (IP) injection of Klebsiella pneumoniae. The high early mortality rate prompted a study of the effect of gentamicin on the disease course...

..This model will allow future study of specific host defense mechanisms over a prolonged time period...

..Persistent intraabdominal bacterial infection induced dose dependent microbial tolerance in peritoneal macrophages...

..This suggests a role for NKT and NK cell activation in the development of Th1 and Th2 responses during bacterial infection independently of IL-12 or IL-18...

..Despite higher bacterial and PMN levels at remote sites, there was increased survival in BLT-1(-/-) mice compared to WT mice. Decreased PMN activation may result in less remote organ dysfunction and improved survival...

..These effects were not mediated by IL-12 and IL-18 alone, and reinforce a role for NK cells in remote organ dysfunction following peritonitis...

..Peritoneal concentrations of TNF-α, IL-10 and nitric oxide (NO), as well as characteristic cell patterns, were determined. Long-term consequences of microbial tolerance were assessed by measuring survival and weight-loss...

..To investigate liver damage and abscess formation in murine, secondary peritonitis...

..The aim of the present study was to further characterize the association of alveolar IL-8 and IL-10 after trauma with neutrophil activation, apoptosis, and phagocytic capacity...

..rVCP may, however, increase neutrophil function potentially by prevention of accumulation of complement factors that inhibit leukocytes. Further studies will be needed to elucidate this pathway...

..We aimed in this study to investigate the molecular mechanisms behind microbial tolerance and the early innate immune response resolution in this model...

..The alteration of alveolar inflammatory cell apoptosis may be dependent on the local production of IL-10. A reduction in apoptosis immediately preceded the onset of clinically significant pulmonary dysfunction...

..coli following nonlethal CLP. Our data indicate that E. coli plays a key role in mortality from polymicrobial peritonitis and that Proteus may be antagonistic to E. coli in murine peritonitis...

..In an attempt to produce peritonitis by Klebsiella, we found evidence of pneumonia on autopsy and further developed this approach as a new experimental model...

..CONCLUSIONS: Swiss Webster and BALB/c mice have significantly different susceptibilities to the lethal effects of CLP, and this difference may be related to IL-12 responsiveness...

..Our data suggest that NK cells participate in the early local and systemic eradication of bacteria and regulation of IL-12 during polymicrobial sepsis. These effects are likely due to their interactions with macrophages...

..This article broadly describes current microbial pathogens and related issues in surgical disease...

..The focus will be on Gram-positive organisms because of their increasing prevalence in SSIs and their high potential to develop resistance against several antibiotic agents, including vancomycin...

..This article describes surgical infections and organ failure from a historical perspective, with emphasis on Polk's contributions, and describes our current understanding of the pathophysiology of organ dysfunction in surgical patients...

..The purpose of this review is therefore to describe the immunological events after trauma and to introduce important mediators and pathways of the inflammatory immune response...

..6% in controls to 30.6%, p < 0.001). This increase in direct neutrophil necrosis following LPS activation may amplify local proinflammatory effects through less well controlled release of neutrophil contents into surrounding tissue...

..This suggests that a policy of administering limited duration, narrow spectrum antibiotics may reduce drug resistance...

..Macrophages are less able to clear bacteria when NK cells are depleted without activation. NK cells are therefore important in bacterial clearance through interactions with macrophages...

..To elucidate the cause of posttraumatic empyema, preoperative bronchoalveolar lavage (BAL)/sputum cultures obtained from patients with posttraumatic empyema were compared with cultures obtained at the time of decortication...

..Review of the literature and our own 1990 study indicate a mortality rate of 5% to 20% for enterocutaneous fistula, and a healing rate of 75% to 85% after definitive surgery...

..Application of skin sealant prior to incision reduces microbial contamination of the wound...