Erregerspektrum chirurgischer Infektionen im 10-Jahres-Vergleich 1995–2004 eines mikrobiologischen Routinemonitorings

Mroczkowski, Paweł; Lauf, H; Lippert, Hans-Dieter; König, Wirsing von; Meyer, Franc

doi:10.1055/s-0028-1098697

Cited by 3 publications

(2 citation statements)

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“…Von dieser Warte aus hatte das Screening einen positiven Effekt auf das Outcome von MRSA-Infektionenim Gegensatz zu Barrieremaßnahmen [9]. Allgemein gibt es starke Argumente für ein systematisches mikrobiologisches Langzeitmonitoring, um Resistenzen auf der Station und bei individuellen Patienten zu erfassen [10,11].…”

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Relevanz von MRSA auf einer viszeralchirurgischen Intensivstation

et al. 2014

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Resistance to antibiotics is a worldwide increasing problem. A well-known example is methicillin resistant Staphylococcus aureus, MRSA. What is the relevance of MRSA on a surgical ICU? On a 20 bed academic SICU/intermediate care ward 14,976 patients were treated in a seven-year period. We identified only 98 MRSA-positive patients. 56 (57 %) of them were merely colonised, 42 (43 %) suffered from an MRSA infection. A control group comprised 56 similar patients without MRSA detection. Patients with MRSA infection had a higher mortality rate (OR 4.18; p = 0.002), but only 4 out of 20 patients died due to the MRSA infection. APACHE 2 score of more than 20 was predictive for being colonised with MRSA (OR 3.08; p = 0.04), but it was not a risk factor for developing an MRSA infection (OR 1.03; p = 0.95). Patients with MRSA colonisation did not have a higher mortality rate than patients without. Outcome depended on severity of the disease, but not on the MRSA colonisation status. Patients with MRSA infection were more likely to die, but the reason of death rarely was MRSA.

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Relevanz von MRSA auf einer viszeralchirurgischen Intensivstation

et al. 2014

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“…Specific recommendations on PAP require data from clinical studies which are not available for many indications. Therefore, guidelines usually give general recommendations and advocate taking into account local pathogen and susceptibility data [ 19 , 20 ]. A multidisciplinary team including infectious disease specialists, pharmacologist, and microbiologists should evaluate the in-house recommendations annually [ 13 , 14 ].…”

Section: Risk Factors For Post-operative Infection and Antibiotic Pro...mentioning

confidence: 99%

The Need of Antimicrobial Stewardship in Post-Operative Infectious Complications of Abdominal Surgery

et al. 2022

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Background: Post-operative infection is a common complication following abdominal surgery. The two most common infections are secondary peritonitis and surgical site infections, which lead to increased perioperative morbidity, prolonged hospitalization, higher mortality rates, and increased treatment costs. In addition to surgical procedures, treatment is based on effective antibiotic therapy. Due to increasing antimicrobial resistance, the correct use of antimicrobials is becoming more complex. Many initiatives call for the implementation of an antimicrobial stewardship (AMS) programme to optimize anti-infective therapy. The review article summarizes current recommendations in anti-infective therapy of post-operative peritonitis and surgical site infections and highlights the importance of an AMS programme in abdominal surgery. Summary: Larger studies evaluating the benefit of AMS in abdominal surgery are lacking. However, national and international guidelines have formulated appropriate recommendations for the rational use of antibiotics in post-operative peritonitis and surgical site infections. The rate of post-operative infections can be significantly reduced by perioperative antibiotic prophylaxis. The increase in multidrug-resistant bacteria complicates anti-infective therapy for post-operative infections. Analysis of local susceptibility patterns helps choose an adequate empiric therapy. A high rate of extended-spectrum beta-lactamase-producing bacteria may necessitate the use of other reserve antibiotics in addition to carbapenems, which are approved for the treatment of complicated intra-abdominal infections. A key role for the AMS team is the subsequent de-escalation of antibiotic therapy which limits the use of unnecessary broad-spectrum antibiotics. Key Messages: The increase in multidrug-resistant bacteria poses challenges for abdominal surgery. Post-operative infections should be treated by an interdisciplinary team of surgeons and specialists for AMS.

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Post‐surgical wound infections involving Enterobacteriaceae with reduced susceptibility to β‐lactams in two Portuguese hospitals

Fernandes

Prudêncio

2010

International Wound Journal

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The post-surgical period is often critical for infection acquisition. The combination of patient injury and environmental exposure through breached skin add risk to pre-existing conditions such as drug or depressed immunity. Several factors such as the period of hospital staying after surgery, base disease, age, immune system condition, hygiene policies, careless prophylactic drug administration and physical conditions of the healthcare centre may contribute to the acquisition of a nosocomial infection. A purulent wound can become complicated whenever antimicrobial therapy becomes compromised. In this pilot study, we analysed Enterobacteriaceae strains, the most significant gram-negative rods that may occur in post-surgical skin and soft tissue infections (SSTI) presenting reduced β-lactam susceptibility and those presenting extended-spectrum β-lactamases (ESBL). There is little information in our country regarding the relationship between β-lactam susceptibility, ESBL and development of resistant strains of microorganisms in SSTI. Our main results indicate Escherichia coli and Klebsiella spp. are among the most frequent enterobacteria (46% and 30% respectively) with ESBL production in 72% of Enterobacteriaceae isolates from SSTI. Moreover, coinfection occurred extensively, mainly with Pseudomonas aeruginosa and Methicillin-resistant Staphylococcus aureus (18% and 13%, respectively). These results suggest future research to explore if and how these associations are involved in the development of antibiotic resistance.

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Erregerspektrum chirurgischer Infektionen im 10-Jahres-Vergleich 1995–2004 eines mikrobiologischen Routinemonitorings

Cited by 3 publications

References 0 publications

Relevanz von MRSA auf einer viszeralchirurgischen Intensivstation

Relevanz von MRSA auf einer viszeralchirurgischen Intensivstation

The Need of Antimicrobial Stewardship in Post-Operative Infectious Complications of Abdominal Surgery

Post‐surgical wound infections involving Enterobacteriaceae with reduced susceptibility to β‐lactams in two Portuguese hospitals

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