Incidence Of Infections In Patients Research Articles

Application of lenalidomide in chronic lymphocytic leukemia

In recent years, the incidence of chronic lymphocytic leukemia (CLL) is increasing. Microenvironment and immune system play a key role in the pathogenesis of CLL. The immune system is aggravated by the use of chemotherapeutic agents, such as fludarabine and cyclophosphamide with rituximab(FCR) which are the current standards in frontline therapy. This leads to an increase of infection incidence in patients, resulting in a poor prognosis. The present situation was changed by lenalidomide. Recent studies indicated that lenalidomide monotherapy in treatment of refractory or relapsed CLL patients, the overall response rate(ORR) reached about 32%-47%, CR roughly was 7%-13%; when lenalidomide and rituximab were combined for treatment of refractory or relapsed CLL patients, the ORR reached about 53%-66%, CR about 12%-13%. Moreover, when lenalidomide and ofatumumab were combined, the efficacy is improved significantly and the adverse reactions are greatly reduced. The adverse reactions are neutrophilic granulocytopenia, thrombocytopenia, anemia, tumor lysis syndrome(TLS), tumor flare reaction(TFR) and venous thromboembolism(VTE). This review focuses on the related studies and the latest progress about lenalidomide in CLL.

MP16-14 RECTAL CULTURE PRIOR TO PROSTATE BIOPSY IDENTIFIES MEN AT RISK FOR INFECTION: A MULTI-INSTITUTIONAL INTERNATIONAL COLLABORATIVE STUDY

INTRODUCTION AND OBJECTIVES: The use of rectal swab cultures to guide antimicrobial prophylaxis for transrectal ultrasound (TRUS)-guided prostate biopsy has been suggested as a way to reduce infectious complications from antibiotic-resistant microorganisms. We assessed the incidence of fluoroquinolone resistance in men undergoing prostate biopsy and evaluated the effect of culture-directed prophylaxis on the risk of infectious complications after prostate biopsy. METHODS: All men who received prostate biopsies 2/1/13 e 10/31/13 at our institution were included in an IRB approved retrospective cohort study. At the discretion of the attending physician, patients received either a pre-procedural rectal swab and culture to guide antimicrobial prophylaxis, or routine prophylaxis with a fluoroquinolone antibiotic. Basic patient demographic and clinical information were collected, as well as data on any infectious complications within 30 days of biopsy. Fisher’s exact test and Welch’s t-test were used for statistical analysis. Confounding variables were controlled for with a multivariate logistic regression model. RESULTS: 347 patients were included in the study. Of these, 205 patients received a pre-procedure rectal swab culture and 142 did not. Average patient age was 62.6 and 64.4 years, respectively (p1⁄40.04). There was no difference in mean PSA value (p1⁄40.30) or age-adjusted Charlson comorbidity score (p1⁄40.10) between the two groups. 13.1% of rectal cultures demonstrated fluoroquinoloneresistant microorganisms. Infectious complications occurred in 0.9% of the rectal swab group and 2.9% of the control group (p1⁄40.16), which included hospital admissions for bacteremia, pyelonephritis, sepsis, or septic shock. Rectal swab culture-directed antibiotics were associated with a decreased risk for post-biopsy infection (RR 0.17, 95% CI 0.02-1.53). A multivariate logistic regression model demonstrated a decreased risk of infection if a rectal swab culture was done (p1⁄40.11). CONCLUSIONS: The incidence of fluoroquinolone resistance is relatively high in our patient population. Overall, infection rates after prostate biopsy are low, with a non-significant reduction in incidence of post-biopsy infection for patients receiving rectal swab-directed antimicrobial prophylaxis. Though not statistically significant, these differences remain clinically significant, given the severity of observed infectious complications.

The incidence of yeastlike fungi infection in patients using removable dentures by gender and age

The incidence of yeastlike fungi infection in patients using removable dentures by gender and age

Powering the immune system: mitochondria in immune function and deficiency.

Mitochondria are critical subcellular organelles that are required for several metabolic processes, including oxidative phosphorylation, as well as signaling and tissue-specific processes. Current understanding of the role of mitochondria in both the innate and adaptive immune systems is expanding. Concurrently, immunodeficiencies arising from perturbation of mitochondrial elements are increasingly recognized. Recent observations of immune dysfunction and increased incidence of infection in patients with primary mitochondrial disorders further support an important role for mitochondria in the proper function of the immune system. Here we review current findings.

Evaluation the incidence of infections in patients with systemic lupus erythematous

زمینه و هدف : بیماری لوپوس اریتماتوی سیستمیک یک بیماری مزمن است که تقریبا تمام ارگانهای بدن را درگیر می کند. کورتیکو استرویید ها و داروهای سرکوب ایمنی از درمانهای رایج است که همراه با عوارض فراوان بخصوص عفونت می باشد. در این مطالعه به بررسی شیوع و همچنین نوع عفونت با نوع درمان می پردازیم. مواد و روش کار : در اين مطالعه توصيفي ـ مقطعي 94 بيمار مبتلا به لوپوس اريتماتوتي سيستميك مراجعه كننده به بيمارستان امام رضا در سال 1384 هجری شمسی به صورت تصادفي انتخاب و تحت نظر قرار گرفتند. این 94 بيمار مراجعه كننده به بخش داخلي ـ روماتولوژي، به صورت تصادفي تحت معاينه و تستهاي تشخيصي آزمايشگاهي قرار داده و مرحله فعاليت بيماري در آنها ارزيابي گرديد. اطلاعات دارويي مرتبط با نوع و دوز مصرفي بيماران نيز ثبت گرديد. یافته ها : از اين تـــــعداد (81 نفر) 2/86% زن و (13 نفر) 8/13% مرد بودند. ميانگين سني در مجموع 4/9 ± 12/28 سال بود. از بيماران مورد مطالعه در 34% (32 نفر) تشخيص عفونت وجود داشت. نتیجه گیری : شيوع عفونت در بيماران لوپوسي و الگوي شيوع پاتوژن، نوع پاتوژن و محل درگيري در بيماران مطابق با ديگر نقاط دنياست. افزايش دوز استروئيد با افزايش شيوع عفونت همراه مي باشد. واژه های کلیدی : لوپوس اریتماتوی سیستمیک، داروهای سرکوب ایمنی، عفونت

Effects of Using Intravenous Antibiotic Only Versus Local Intrawound Vancomycin Antibiotic Powder Application in Addition to Intravenous Antibiotics on Postoperative Infection in Spine Surgery in 907 Patients

A prospective randomized controlled trial. To assess the ability of local vancomycin powder in controlling postoperative infection in spine surgery. Despite improvements through the use of prophylactic systemic antibiotics, surgical site infections remain a significant problem in spine surgical procedures. Various retrospective and prospective studies have reported the efficacy of local application of vancomycin powder in reducing the infection in animal and human studies. However, there were no randomized control trials that reported on its efficacy. Prospective randomized controls of 907 patients with various spinal pathologies were treated surgically during a period of 18 months. The control group received standard systemic prophylaxis only, whereas the treatment group received vancomycin powder in the surgical wound in addition to systemic prophylaxis. Patient demographics, comorbidities, level of spinal pathology, estimated blood loss, nutritional status, and hemoglobin were recorded. Incidence of infection was the primary outcome evaluated. There were 8 infections (1.68%) in the control group (6 instrumented and 2 noninstrumented, 6 deep and 2 superficial) with bacteria cultured in 3 (1 Escherichia coli and 2 Staphylococcus aureus). In the treatment group, 7 infections (1.61%) were observed (6 instrumented and 1 noninstrumented surgical procedures, 6 deep and 1 superficial) with bacteria cultured in 3 (1 Staphylococcus aureus and 2 Klebsiella). No adverse effects were observed from the use of vancomycin powder. Statistically no significant difference was seen in infection rate between the treatment group and control group. The local application of vancomycin powder in surgical wounds did not significantly reduce the incidence of infection in patients with surgically treated spinal pathologies. The use of vancomycin powder may not be effective when incidence of infection is low.

Endemic Fungal Infections in Inflammatory Bowel Disease Associated with Anti-TNF Antibody Therapy

Patients with inflammatory bowel disease are susceptible to complications from pharmacologic treatment of their disease. Tumor necrosis factor (TNF)-α inhibitors are being used increasingly in the treatment of inflammatory bowel disease and can be associated with adverse events, including common infections, and rarely the development of serious life-threatening opportunistic infections. TNF-α inhibitors have the ability to prevent an effective patient granulomatous response, and this may be associated with an increased risk of developing mycobacterial and certain fungal infections, including histoplasmosis, blastomycosis, and coccidioidomycosis, endemic in several parts of the United States. The concern for invasive fungal infection was realized during clinical trials and further demonstrated after the marketing of TNF-α inhibitors. Because of this awareness, the Food and Drug Administration developed an adverse event-reporting system to capture cases of infections associated with the use of TNF-α inhibitors. These opportunistic fungi have a great degree of regional variability, and it has been very difficult to quantify the incidence of infection in patients treated with TNF-α inhibitors. Currently, there are no formal guidelines regarding the use of TNF-α inhibitors and these fungal infections. Considering that gastroenterologists have embraced the use TNF-α inhibitors as a valuable armamentarium in the treatment of inflammatory bowel disease, they must be aware of therapy-related infectious complications, including appropriate diagnostic, therapeutic, and preventive strategies. In this article, we explore the association of these fungal entities in relation to the TNF-α inhibitor therapy by considering information provided in the gastroenterology, infectious diseases, rheumatology, and transplant literature. Finally, we provide some recommendations on diagnosis and treatment.

Su1151 Incidence of Tbc Infection in Patients With Inflammatory Bowels Disease (IBD) Treated With Infliximab in Russia

Su1151 Incidence of Tbc Infection in Patients With Inflammatory Bowels Disease (IBD) Treated With Infliximab in Russia

Mo1387 Is a History of Gastrointestinal Surgery a Risk Factor for an Increased Incidence of Clostridium difficile Infection in Patients With Inflammatory Bowel Disease?

Background: Antibiotic use is the most widely recognized risk factor for Clostridium difficile infection (CDI). Other established risk factors include hospitalization, advanced age, severe illness, inflammatory bowel disease (IBD), and possibly gastrointestinal surgery. Although studies have reported a higher prevalence of CDI in IBD patients, there is a paucity of data examining the incidence of CDI in patients who have received surgical intervention for IBD. Aim: The aim of this study is to investigate the incidence of CDI in patients with IBD who never had gastrointestinal surgery compared to patients with IBD who underwent disease related surgical intervention. We theorize that patients who have had surgical intervention for IBD are more prone to CDI due to greater severity of disease, more frequent hospitalizations, and increased exposure to antibiotics. Methods: Data was retrieved from Albany Medical Center's electronic records to conduct a retrospective chart review of patients with Crohn's disease and ulcerative colitis from the years 2000-2012. Parameters studied included type of surgery, result of Clostridium difficile toxin testing, age at surgery related to IBD, age at CDI positivity (if applicable), and gender. Patients with IBD who never had testing for CDI were excluded. Results: 1434 patients were identified with IBD. After inclusion criterion was met, 908 patients with Crohn's disease and 104 patients with ulcerative colitis were studied. The data is summarized in the tables below. Among patients with Crohn's disease, 48 were found to be positive for CDI out 506 patients with a history of gastrointestinal surgery for IBD (9.49%). 60 patients were found to be positive for CDI out of 402 patients without a prior surgical history related to IBD (14.92%). P value = 0.8869. Among patients with ulcerative colitis, 2 patients were found to be positive for CDI out of 16 patients with a history of prior gastrointestinal surgery related to IBD (12.5%). 7 patients were found to be CDI positive out of 88 patients without a prior surgical history related to IBD (7.95%). P value = 0.4478. Conclusion: Crohn's disease and ulcerative colitis are chronic relapsing inflammatory conditions that require long term medical therapy, periodic hospitalizations, and even surgery. Chronic use of antibiotics and immunosuppressants has been shown to increase the risk of CDI in IBD patients. CDI has been reported in ulcerative colitis patients with restorative protocolectomy and ileal pouch anal anastomosis. Our data shows that surgery did not appear to increase the incidence of CDI in patients with Crohn's disease or ulcerative colitis. Crohn's Disease Patients

Research Concerning the Correlations Between Urinary Tract Infections and Congenital Malformations of the Renourinary System

Abstract Introduction: Congenital malformations of the urinary system are risk factors for the development of urinary tract infections (UTI). Besides the severity of the malformation, urinary infection is always associated with poor prognosis for these patients. Late discovery of the malformation background, after several urinary tract infection episodes, contributes to the development of chronic pyelonephritis that may lead to chronic renal failure. Material and method: The study involved patients with renal and urinary tract congenital malformations treated at the Pediatric Nephrology Department from Tîrgu Mureș over a period of 6 years, who associated urinary tract infection. Results: Out of the total of 432 patients with congenital malformations of the urinary system, 270 had had at least one or several episode(s) of urinary tract infections in their medical history. Vesico-ureteral reflux and obstructive lesions of the urinary tract were most frequently associated with urinary infections. During the time when no ultrasound screening had been performed, the malformation background was usually diagnosed at the time of the first urinary infection episodes. Conclusions: The incidence of urinary tract infections in patients with renal and urinary tract congenital malformations depends on the type of the underlying malformation, and the time of diagnosis of the malformation background. Prevention of irreversible complications requires early diagnosis of the urinary system malformations that can be performed through ultrasound screening in the neonatal period.

Infections of external ventricular drainages

Abstract

Association between Preoperative Statin Therapy and Postoperative Infectious Complications in Patients Undergoing Cardiac Surgery: A Systematic Review and Meta-analysis

Infectious complications of cardiac surgery are often severe and life threatening. Statins having both immunomodulatory and anti-inflammatory effects were intuitively thought to influence the development of postsurgical infections. We sought to systematically examine whether any association exists between statin use and risk of infectious complications in patients undergoing cardiac surgery. We searched Ovid MEDLINE, Ovid EMBASE, Thomson Scientific Web of Science, and Elsevier Scopus from inception through February 2011 for comparative studies examining the association between statin use and risk of postoperative infections in patients undergoing cardiac surgery. We contacted a study's author for missing information. We conducted a random-effects meta-analysis of individual studies' odds ratios (adjusted for potential confounders). We identified 6 cohort studies for inclusion, 3 of which were conducted in Canada and 3 of which were conducted in the United States. Four were single-center studies, and 2 were population based. Exposure ascertainment was based on a review of admission medication list or prescription databases. Infectious outcomes were heterogeneous and included surgical site infections within 30 days, serious infections (sepsis), or any other postoperative infection. Statin use in the preoperative period was associated with a trend toward reduction in the incidence of postoperative infections in patients who underwent cardiac surgery (odds ratio, 0.81 [95% confidence interval, 0.64-1.01]; [Formula: see text]; [Formula: see text]). Heterogeneity was explained by country effect. Studies performed in Canada showed weaker associations than studies performed in the United States. This difference could not be attributed to study quality alone. We did not find good evidence to support an association between statin use and postoperative infectious complications. However, the trend toward statistical significance for this association indicates that further investigation is warranted.

Clinical Implications High Frequency Chest Wall Oscillation (HFCWO)

Purpose: patients with neuromuscular diseases presents an high incidence of respiratory infections favoured by stagnation of deep bronchial secretions and deficit of cough. The aim of the study is to evaluate the correct treatment of this condition and the role of High Frequency Chest Wall Oscillation (HFCWO) in helping the removal of bronchial secretions and reduce the incidence of infections in patients with neuromuscular disease. Methods: analysis of the current bibliography related to respiratory infections and neuromuscular disease. PCEF (Peak Cough Expiratory Flow) is used as a standardized indicator of efficiency of cough. Results: the High Frequency Chest Wall Oscillation (HFCWO) is useful, in cases of increased production of mucus and impairment of muco-ciliary clearance, to remove the tracheobronchial secretions and reduce the incidence of infections. Conclusions: the correct approach to patients with neuromuscular disease and frequent respiratory infections is focused on treatment of cough ineffective and management of bronchial secretions. High Frequency Chest Wall Oscillation (HFCWO) (VEST) has a central role in treatment of cough ineffective and management of bronchial secretions reducing respiratory infections.

Abstract 88: The effect of statins on incidence of infections after Coronary Artery Bypass Grafting

Statin therapy has been associated with improved outcomes in patients with infections. Our aim was to determine whether preoperative statin therapy is associated with a decrease in the incidence of infections after coronary artery bypass grafting (CABG) surgery. Methods: We conducted a retrospective cohort study of 6,253 patients undergoing isolated CABG from January 1, 2000 to December 31, 2010 (3,869 receiving statins and 2,384 not receiving statins). Primary outcome was the development of any postoperative infection (composite of deep sternal wound infection, leg harvest-site infection, pneumonia and sepsis) after CABG. Secondary outcome was the effect of statins on incidence of each aforementioned infection individually. Logistic regression analyses were performed. Results (Table): Incidence of any postoperative infection in patients who received statins preoperatively was 6.5% (250 of 3,869) compared to 8.3% (198 of 2,384) in controls. In fully adjusted models, preoperative statin therapy was independently associated with a significant reduction in the development of any postoperative infection. Among individual infections, preoperative statin therapy was associated with a reduced incidence of sternal wound and leg harvest site infections. An association with a reduced incidence of pneumonia and sepsis was not found. Conclusions: Preoperative statin use is associated with a decreased incidence of sternal wound infections and leg harvest site infections after CABG

Incidence of infections in patients with giant cell arteritis: A cohort study

Giant cell arteritis (GCA) is the most frequent form of vasculitis in adults. We sought to estimate the infectious risk associated with GCA and its treatment. We conducted a matched historical cohort study using data from The Health Improvement Research Network. Patients with newly diagnosed GCA were matched with up to 6 non-GCA patients by age, sex, general practice, and date of entry into the cohort. Random-effects Poisson regression models were used to obtain incidence rates and rate ratios for lower respiratory tract infections (LRTI), urinary tract infections (UTI), and sepsis, as well as for the subset of these that comprised serious infections (pneumonias, upper UTI, and sepsis). Effect modification by age, sex, and time since diagnosis of GCA was assessed. A total of 1,664 patients with GCA were matched to 8,078 patients without GCA. Overall, 805 (48%) of the GCA patients and 3,007 (37%) of the non-GCA patients experienced ≥1 episode of systemic infection during followup, with adjusted rate ratios for LRTI, UTI, and serious infections of 1.48 (95% confidence interval [95% CI] 1.34-1.65), 1.27 (95% CI 1.10-1.46), and 1.55 (95% CI 1.22-1.96), respectively (P < 0.001 for all). The rate ratio for sepsis was 1.63 (95% CI 0.78-3.40, P = 0.20). Rate ratios for infection were highest in the first 6 months following diagnosis of GCA and in patients age <75 years, but did not vary by sex. This is the first study to show that patients with GCA are at increased risk of systemic infections, particularly in the first few months following diagnosis. New GCA medications that allow steroid sparing are needed to treat this condition.

Trocador de calor e umidade: proteção contra infecções pulmonares? Estudo piloto

O objetivo deste trabalho foi realizar um estudo bacteriológico comparativo entre os sistemas de umidificação aquoso aquecido (UAA) e filtro trocador de calor e umidade (FTCU) quanto à colonização bacteriana e a incidência de infecção respiratória em pacientes submetidos à ventilação mecânica (VM). Trata-se de uma pesquisa prospectiva, controlada e randomizada, na qual 15 pacientes internados na Unidade de Terapia Intensiva (UTI) foram distribuídos em dois grupos. O primeiro fez uso de UAA (n=7) e o outro de FTCU (n=8). Foram coletadas amostras da secreção traqueal, condensado do circuito e FTCU na admissão do paciente, no quarto e oitavo dias, e realizada análise bacteriológica dos mesmos. Quanto às características antropométricas, não observou-se diferenças entre os grupos estudados. A prevalência de pneumonia associada à ventilação (PAV) foi de 57,1% no UAA e 62,5% no FTCU. Ao realizar a análise bacteriológica quantitativa entre eles, não foram observadas variações, sugerindo não haver diferença na prevenção de PAV entre os sistemas de umidificação; porém a presença das mesmas bactérias na secreção traqueal e no condensado e ausência destas na membrana do FTCU podem indicar que a principal fonte de contaminação é o próprio paciente.

Efficacy of prophylactic single-dose therapy using fluoroquinolone for prostate brachytherapy

There is little definitive evidence to guide the use of prophylactic antibiotics for prostate brachytherapy. The purpose of this study is to evaluate the incidence of postimplant infections in patients who receive antimicrobial prophylaxis with pazufloxacin (PZFX). A total of 84 patients who underwent prostate brachytherapy received a single intravenous dose of PZFX at 500 mg perioperatively for 1 day. No postimplant antibiotic medication was prescribed. Urinalysis, plasma white blood cell (WBC) count, and C reactive protein (CRP) levels were evaluated before the implantation, on the day after implantation, and on the 7th and 28th days after brachytherapy. None of the 84 patients (0.0%) developed a symptomatic urinary tract infection or had febrile infectious complications after brachytherapy. There were statistically significant elevations in the levels of erythrocytes, leukocytes, bacteria in urine, plasma WBC and CRP postoperatively, but these values did not exceed the normal range or were only slightly elevated on the day after brachytherapy (day 1) and on day 7. All laboratory examinations had returned to the normal range on day 28. Single-dose therapy with fluoroquinolone helps to prevent infections after prostate brachytherapy.

Compliance with the Eastern Association for the Surgery of Trauma guidelines for prophylactic antibiotics after open extremity fracture

Context:Prophylactic antibiotics, paired with wound care and surgical intervention, is considered the standard of care for patients with open fracture. Guidelines from the Eastern Association for the Surgery of Trauma (EAST) recommend specific prophylactic antimicrobial therapy based on the type of open fracture.Aims:We quantified adherence to EAST guideline recommendations and documented the incidence of infection in patients with open fracture.Settings and Design:A retrospective, observational study of all patients with open fracture admitted to our facility from January 2004 to December 2008 was conducted.Materials and Methods:Patients were divided into compliant and noncompliant groups according to the EAST guideline recommendations. Compliance was defined as an appropriate spectrum of therapy for guideline suggested duration. We assessed for surgical and non-surgical site infections, and morbidity outcomes.Statistical Analysis:Nominal data were explored using summary measures. Continuous variables were compared using the Student t-test or the Mann–Whitney U-test. Dichotomous data were compared using χ2 statistic or Fisher's exact test.Results:The final analysis included 214 patients. Prophylactic antibiotics were guideline compliant in 28.5% of patients, and ranged from 10.0% in type 3b fractures to 52.7% in type 1 fractures. The most common reason for non-compliance was the use of guideline recommended coverage that exceeded the suggested duration (71.2%). Patients who received non-compliant therapy required prolonged hospital lengths of stay (6 vs. 3 days, P = 0.0001). The overall incidence of infection was similar regardless of guideline compliance (17.0% vs. 11.5%, P = 0.313).Conclusions:Prophylactic antibiotics for open fracture frequently exceeded guideline recommendations in duration and spectrum of coverage, especially in more severe fracture types. Non-compliance with EAST recommendations was associated with increased in-hospital morbidity.

Effect of a program to control perioperative blood glucose on the incidence of nosocomial infections in patients with diabetes: A pilot study

Aim: To evaluate the safety and effectiveness of a pilot program to control perioperative blood glucose in patients with diabetes. Methods: A pre-post intervention study was conducted in a 280-bed hospital in Spain. In the year 2008 we implemented perioperative insulin protocols aimed at blood glucose values from 80 to 180 mg/dL. Surgical patients with diabetes admitted on year 2009 (intervention group) were compared with a control group of patients with diabetes admitted for surgery on year 2007, matched 1:1 by traditional wound class. Results: We analyzed 96 patients. Implemented protocols were followed in 48% of patients intra-operatively and 75% of patients postoperatively. Patients in the intervention group had reductions in blood glucose at surgery 150 +/- 61 mg/dL vs. 172 +/- 53 mg/dL; p = 0.05), greater proportion of target glucose values throughout hospitalization (67% vs. 55%; p = 0.07), and reductions in the incidence of nosocomial infections after controlling for confounders (Odds Ratio: 0.20; 95% Confidence intervals: 0.06 - 0.72; p = 0.014) when they were compared with the control group: The incidence of hypoglycemia was similar between two groups (0.12% vs. 0.10%, p = 0.867), respectively. Conclusion: Although our protocol needs improvements to increase implementation it was useful to control blood glucose safely and for reducing nosocomial infections.

Reduced surgical site infections in patients undergoing posterior spinal stabilization of traumatic injuries using vancomycin powder

Background context Despite improvements through the use of prophylactic systemic antibiotics, surgical site infections remain a significant problem in the treatment of traumatic spine injuries. Infection rates as high as 10% have been reported in this population. The impact on patients and cost of treating such infections is profound. Local delivery of antibiotics has been found to be efficacious in animal and human studies as an adjunct to systemic antibiotics in surgical site infection prophylaxis. Purpose To evaluate the efficacy of using vancomycin powder in surgical sites to prevent infections. Study design Retrospective case review. Patient sample Patients who underwent posterior spine fusions for traumatic injuries over a 2-year period at a single academic center. Outcome measures Clinical outcome determined was the incidence of either superficial or deep postoperative wound infections. Methods A retrospective review of 110 patients with traumatic spine injuries treated with instrumented posterior spine fusions over a 2-year period at a single academic center was performed. One group (control group) received standard systemic prophylaxis only, whereas another (treatment group) received vancomycin powder in the surgical wound in addition to systemic prophylaxis. Patient demographics and perioperative information obtained included history of previous spine surgeries, substance use, diabetes, body mass index, level of injury, presence of neurologic deficit, operative time, and estimated blood loss. Incidence of infection was the primary outcome evaluated. Results The control (N=54) and treatment groups (N=56) were statistically similar. A statistically significant difference in infection rate was found between the treatment group (0%) and control group (13%, p=.02) without any adverse events. No adverse effects were noted from use of the vancomycin powder. Conclusions The use of vancomycin powder in surgical wounds may significantly reduce the incidence of infection in patients with traumatic spine injuries treated with instrumented posterior spine fusion. Applying vancomycin powder to surgical wounds is a promising means of preventing costly and harmful postoperative wound infections in high-risk populations.