{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,10]],"date-time":"2026-04-10T03:58:01Z","timestamp":1775793481709,"version":"3.50.1"},"reference-count":7,"publisher":"Springer Science and Business Media LLC","issue":"4","license":[{"start":{"date-parts":[[2021,1,13]],"date-time":"2021-01-13T00:00:00Z","timestamp":1610496000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2021,1,13]],"date-time":"2021-01-13T00:00:00Z","timestamp":1610496000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Spine Deform"],"published-print":{"date-parts":[[2021,7]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec>\n                <jats:title>Purpose<\/jats:title>\n                <jats:p>Post-operative wound infections increase patient morbidity and mortality as well as the length of hospital stay, with a profound personal and institutional cost. The aim of this study was to decrease post-operative infections through development of a surgical antibiotic prophylaxis policy based on institution-specific risk factors and microbiology data.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Methods<\/jats:title>\n                <jats:p>We conducted a retrospective review of deep wound infections at our institution over a 5-year period (2014\u20132018). 399 spinal fusion procedures were performed with a 2.5% post-operative infection rate. Patients with neuromuscular scoliosis were six times more likely to develop deep wound infections (7.6%) compared to patients with congenital and idiopathic scoliosis (combined rate of 1.25%). The microbiology data revealed that polymicrobial, extended spectrum beta-lactamase (ESBL) gram negative organisms predominated in patients with neuromuscular scoliosis. Based on these findings, we implemented an evidence-based quality improvement intervention: all patients with neuromuscular scoliosis undergoing spinal fusion were given a single 15\u00a0mg\/kg dose of amikacin, in addition to our standard practice of perioperative cefazolin plus vancomycin with intra-operative betadine wash and vancomycin powder application. This intervention was put into practice in January 2019.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Results<\/jats:title>\n                <jats:p>Since the implementation of our quality improvement initiative, the overall post-operative infection rate decreased to 1.1% (2 infections in 176 cases). Ninety-eight percent of the 43 neuromuscular scoliosis patients who underwent spinal fusion in the post-intervention time frame have remained infection free.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusion<\/jats:title>\n                <jats:p>Examination of post-operative infection and microbiology data at the institution level can guide the development of institution specific, evidence-based quality improvement initiatives that reduce post-operative wound infections.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1007\/s43390-020-00274-3","type":"journal-article","created":{"date-parts":[[2021,1,14]],"date-time":"2021-01-14T06:17:39Z","timestamp":1610605059000},"page":"955-958","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":13,"title":["Prevention of spinal fusion post-operative wound infections in pediatric patients with scoliosis: a quality improvement initiative"],"prefix":"10.1007","volume":"9","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8207-6804","authenticated-orcid":false,"given":"Elizabeth","family":"Partridge","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dean","family":"Blumberg","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rolando F.","family":"Roberto","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2021,1,13]]},"reference":[{"issue":"4","key":"274_CR1","doi-asserted-by":"publisher","first-page":"234","DOI":"10.1089\/sur.2012.131","volume":"13","author":"SS Awad","year":"2012","unstructured":"Awad SS (2012) Adherence to surgical care improvement project measures and post- operative surgical site infections. Surg Infect (Larchmt) 13(4):234\u2013237","journal-title":"Surg Infect (Larchmt)"},{"issue":"22","key":"274_CR2","doi-asserted-by":"publisher","first-page":"2039","DOI":"10.1001\/jamainternmed.2013.9763","volume":"173","author":"E Zimlichman","year":"2013","unstructured":"Zimlichman E, Henderson D, Tamir O, Franz C, Song P, Yamin CK, Keohane C, Denham CR, Bates DW (2013) Health care-associated infections. A meta-analysis of costs and financial impact on the US Health care system. JAMA Intern Med 173(22):2039\u20132046","journal-title":"JAMA Intern Med"},{"issue":"5","key":"274_CR3","doi-asserted-by":"publisher","first-page":"387","DOI":"10.1016\/j.ajic.2008.12.010","volume":"37","author":"G de Lissovoy","year":"2009","unstructured":"de Lissovoy G, Fraeman K, Hutchins V, Murphy D, Song D, Vaughn BB (2009) Surgical site infection: incidence and impact on hospital utilization and treatment costs. Am J Infect Control 37(5):387\u2013397","journal-title":"Am J Infect Control"},{"issue":"3","key":"274_CR4","doi-asserted-by":"publisher","first-page":"195","DOI":"10.2146\/ajhp120568","volume":"70","author":"DW Bratzler","year":"2013","unstructured":"Bratzler DW, Dellinger EP, Olsen KM et al (2013) Clinical practice guidelines for antimicrobial prophylaxis in surgery. Am J Health-Syst Pharm 70(3):195\u2013283","journal-title":"Am J Health-Syst Pharm"},{"issue":"8","key":"274_CR5","doi-asserted-by":"publisher","first-page":"784","DOI":"10.1001\/jamasurg.2017.0904","volume":"152","author":"SI Berr\u00edos-Torres","year":"2017","unstructured":"Berr\u00edos-Torres SI, Umscheid CA, Bratzler DW et al (2017) Centers for disease control and prevention guideline for the prevention of surgical site infection. JAMA Surg 152(8):784\u2013791","journal-title":"JAMA Surg"},{"issue":"18","key":"274_CR6","doi-asserted-by":"publisher","first-page":"1732","DOI":"10.1056\/NEJMoa1801550","volume":"379","author":"SS Magill","year":"2018","unstructured":"Magill SS et al (2018) Changes in prevalence of health care-associated infection in U.S. hospitals. N Engl J Med 379(18):1732\u20131744","journal-title":"N Engl J Med"},{"key":"274_CR7","unstructured":"CDC National and State Healthcare-Associated Infections Progress Report (2019). https:\/\/www.cdc.gov\/hai\/data\/portal\/progress-report.html. Accessed 10 May 2020"}],"updated-by":[{"DOI":"10.1007\/s43390-021-00299-2","type":"correction","label":"Correction","source":"publisher","updated":{"date-parts":[[2021,2,10]],"date-time":"2021-02-10T00:00:00Z","timestamp":1612915200000}}],"container-title":["Spine Deformity"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s43390-020-00274-3.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s43390-020-00274-3\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s43390-020-00274-3.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,7,9]],"date-time":"2021-07-09T12:04:47Z","timestamp":1625832287000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1007\/s43390-020-00274-3"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,1,13]]},"references-count":7,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2021,7]]}},"alternative-id":["274"],"URL":"https:\/\/doi.org\/10.1007\/s43390-020-00274-3","relation":{"correction":[{"id-type":"doi","id":"10.1007\/s43390-021-00299-2","asserted-by":"object"}]},"ISSN":["2212-134X","2212-1358"],"issn-type":[{"value":"2212-134X","type":"print"},{"value":"2212-1358","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,1,13]]},"assertion":[{"value":"12 July 2020","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"14 December 2020","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"13 January 2021","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"10 February 2021","order":4,"name":"change_date","label":"Change Date","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"Correction","order":5,"name":"change_type","label":"Change Type","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"A Correction to this paper has been published:","order":6,"name":"change_details","label":"Change Details","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"https:\/\/doi.org\/10.1007\/s43390-021-00299-2","URL":"https:\/\/doi.org\/10.1007\/s43390-021-00299-2","order":7,"name":"change_details","label":"Change Details","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Compliance with ethical standards"}},{"value":"The authors declare that they have no conflict of interest.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of interest"}},{"value":"Does not meet criteria for human subjects research and formal IRB approval.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethical approval"}},{"value":"Not applicable.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Informed consent"}}]}}