{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,20]],"date-time":"2026-05-20T13:09:01Z","timestamp":1779282541823,"version":"3.51.4"},"reference-count":21,"publisher":"SAGE Publications","issue":"4","license":[{"start":{"date-parts":[[2026,1,9]],"date-time":"2026-01-09T00:00:00Z","timestamp":1767916800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Surgical Infections"],"published-print":{"date-parts":[[2026,5,1]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>The role of empiric antifungal therapy in patients with gastrointestinal (GI) perforations because of penetrating trauma remains unclear. Existing literature suggests minimal benefit in non-traumatic GI perforations. This study aimed to evaluate the association between empiric antifungal use and post-operative infectious complications in patients with upper GI perforations because of penetrating trauma.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>This was a prospective, multi-center cohort study conducted across 15 institutions between August 2021 and January 2024. We included adult patients with upper GI perforations because of penetrating trauma. The primary outcome was organ\/space surgical site infection (SSI) within 30 days. Secondary outcomes included superficial and deep SSI, any SSI (superficial, deep, or organ\/space), sepsis, pneumonia, return to the operating room, acute kidney injury (AKI), and in-hospital mortality. Multi-variable logistic regression was used to adjust for confounders.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>A total of 173 patients were included, of whom 23.1% (n = 40) received empiric antifungals. There was no significant difference in the rate of organ\/space SSI between patients who received antifungals and those who did not (17.5% vs. 9.8%, p = 0.180). Antifungal use was also not associated with any significant difference in superficial, deep, or any SSI rates. On multi-variable analysis, antifungal therapy was not independently associated with reduced risk of organ\/space SSI (odds ratio 1.72, 95% confidence interval 0.58\u20135.07). Patients who received antifungals had higher rates of sepsis, pneumonia, AKI, return to the operating room, and in-hospital mortality.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>Empiric antifungal therapy was not associated with a reduction in organ\/space SSI or any SSI, among patients with penetrating upper GI injuries. Trauma patients with upper GI injuries do not appear to benefit from empiric antifungal coverage.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/10962964251412214","type":"journal-article","created":{"date-parts":[[2026,1,10]],"date-time":"2026-01-10T04:08:57Z","timestamp":1768018137000},"page":"304-310","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Empiric Antifungal Therapy Is Not Associated with Improved Infectious Outcomes in Penetrating Upper Gastrointestinal Injuries: A Subgroup Analysis of the Surgical Infection Society Multi-Center Observational Study"],"prefix":"10.1177","volume":"27","author":[{"given":"Vahe S.","family":"Panossian","sequence":"first","affiliation":[{"name":"Department of Surgery, Massachusetts General Hospital, Boston, Massachusetts, USA."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yasmin","family":"Arda","sequence":"additional","affiliation":[{"name":"Department of Surgery, Massachusetts General Hospital, Boston, Massachusetts, USA."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Wardah","family":"Rafaqat","sequence":"additional","affiliation":[{"name":"Massachusetts General Hospital, Boston, Massachusetts, USA."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andrea M.","family":"Gochi","sequence":"additional","affiliation":[{"name":"Department of Surgery, University of California San Francisco East Bay Surgery Program, Oakland, California, USA."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mira","family":"Ghneim","sequence":"additional","affiliation":[{"name":"Department of Surgery, University of Maryland School of Medicine, Baltimore, Maryland, USA."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Seema","family":"Anandalwar","sequence":"additional","affiliation":[{"name":"Department of Surgery, Penn Medicine, Philadelphia, Pennsylvania, USA."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dias","family":"Argandykov","sequence":"additional","affiliation":[{"name":"Department of Surgery, Division of Trauma Emergency Surgery &amp; Surgical Critical Care, Massachusetts General Hospital, Boston, Massachusetts, USA."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Cynthia","family":"Susai","sequence":"additional","affiliation":[{"name":"Department of Surgery, University of California San Francisco, San Francisco, California, USA."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nathan","family":"Alcasid","sequence":"additional","affiliation":[{"name":"Department of Surgery, University of California San Francisco East Bay Surgery Program, Oakland, California, USA."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Geoffrey A.","family":"Anderson","sequence":"additional","affiliation":[{"name":"Department of Surgery, Center for Surgery and Public Health, Brigham and Women's Hospital, Boston, Massachusetts, USA."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alexander J.","family":"Ordoobadi","sequence":"additional","affiliation":[{"name":"Department of Surgery, Center for Surgery and Public Health, Brigham and Women's Hospital, Boston, Massachusetts, USA."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Erik J.","family":"Teicher","sequence":"additional","affiliation":[{"name":"Department of Trauma Services, Inova Fairfax Medical Campus, Falls Church, Virginia, USA."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"David P.","family":"Blake","sequence":"additional","affiliation":[{"name":"Department of Surgery, Inova Fairfax Medical Campus, Falls Church, Virginia, USA."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Brendin R.","family":"Beaulieu-Jones","sequence":"additional","affiliation":[{"name":"Department of Surgery, Boston Medical Center, Boston, Massachusetts, USA."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sabrina E.","family":"Sanchez","sequence":"additional","affiliation":[{"name":"Department of Surgery, Boston Medical Center, Boston, Massachusetts, USA."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Christopher A.","family":"Guidry","sequence":"additional","affiliation":[{"name":"University of Kansas Medical Center, Kansas City, Kansas, USA."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Pedro","family":"Teixeira","sequence":"additional","affiliation":[{"name":"Department of Surgery, Ascension Seton, Austin, Texas, USA."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jonathan","family":"Meizoso","sequence":"additional","affiliation":[{"name":"DeWitt Daughtry Family Department of Surgery, Ryder Trauma Center, University of Miami Leonard M. Miller School of Medicine, Miami, Florida, USA."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Brianna L.","family":"Collie","sequence":"additional","affiliation":[{"name":"University of Miami DeWitt Daughtry Family Department of Surgery, Miami, Florida, USA."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sarah","family":"McWilliam","sequence":"additional","affiliation":[{"name":"Department of Surgery and Perioperative Care, University of Texas at Austin Dell Seton Medical Center, Austin, Texas, USA."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Patrick","family":"McGonagill","sequence":"additional","affiliation":[{"name":"University of Iowa Health Care, Iowa City, Iowa, USA."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nicole","family":"Nitschke","sequence":"additional","affiliation":[{"name":"Department of Surgery, University of Iowa Hospitals and Clinics, Iowa City, Iowa, USA."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Colete","family":"Galet","sequence":"additional","affiliation":[{"name":"Department of Surgery, University of Iowa Hospitals and Clinics, Iowa City, Iowa, USA."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lillian","family":"Nefcy","sequence":"additional","affiliation":[{"name":"Department of Surgery, Henry Ford Hospital, Detroit, Michigan, USA."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jeffrey L.","family":"Johnson","sequence":"additional","affiliation":[{"name":"Department of Surgery, Henry Ford Hospital, Detroit, Michigan, USA."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michael P.","family":"DeWane","sequence":"additional","affiliation":[{"name":"Department of Surgery, Division of Trauma Emergency Surgery &amp; 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