Nosocomial Infections and Microbiologic Spectrum after Major Elective Surgery of the Pancreas, Liver, Stomach, and Esophagus

Jannasch, Olof; Kelch, B; Adolf, Daniela; Tammer, Ina; Lodes, Uwe; Weiß, Günter; Lippert, H.; Mroczkowski, Paweł

doi:10.1089/sur.2013.248

Cited by 16 publications

(13 citation statements)

References 46 publications

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“…( 9 , 10 ) However, MDR is also increasing in community-acquired infections, with extended-spectrum beta-lactamase (ESBL)-producing bacteria being the most globally widespread problem, although there is important regional variation in its prevalence. ( 11 , 12 ) In nosocomial infections, ( 4 , 9 , 13 ) both Gram-positive and Gram-negative pathogens that have MDR may be encountered, and these include methicillin-resistant Staphylococcus aureus (MRSA), vancomycin-resistant enterococci (VRE) and ESBL-producing Enterobacteraceae but also carbapenem-resistant Enterobacteraceae (CRE), MDR Pseudomonas aeruginosa and Acinetobacter spp., which also have important geographical variations.…”

Section: Multidrug Resistance Is a Pressing Issue Also In Peritonitimentioning

confidence: 99%

What every intensivist should know about the management of peritonitis in the intensive care unit

Waele

2018

Revista Brasileira De Terapia Intensiva

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Section: Multidrug Resistance Is a Pressing Issue Also In Peritonitimentioning

confidence: 99%

What every intensivist should know about the management of peritonitis in the intensive care unit

Waele

2018

Revista Brasileira De Terapia Intensiva

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“…minimally invasive versus open surgery) as opposed to case-mix or complications [33]. It is known that increased LOS is associated with higher rates of nosocomial infection and mortality [34,35] as well as a decline in mobility and functional status [36]. A decreased LOS also relieves pressure on the often-overburdened hospital system.…”

Section: Discussionmentioning

confidence: 99%

“…Barendse et al (2018) [16],34 Barendse et al (2011),35 Jung et al (2018) [19],36 Kawaguti et al (2013),37 Jeon et al (2014) [25],38 Yan et al (2016) [21],39 Mao et al (2017) [22],40 Park et al (2012) [23],41 Son et al (2013) [28],42 Kiriyama et al (2011) [24],43 Hon et al (2011) [20] …”

mentioning

confidence: 99%

Endoscopic management versus transanal surgery for early primary or early locally recurrent rectal neoplasms—a systematic review and meta-analysis

Naughton

Ryan

Bardon

et al. 2020

Int J Colorectal Dis

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Background Both endoscopic techniques and transanal surgery are viable options that allow organ preservation for early rectal neoplasms. Whilst endoscopic approaches are less invasive and carry less morbidity, it is unclear whether they are as oncologically effective. Aim To compare endoscopic techniques with transanal surgery in the management of early rectal neoplasms. Methods A systematic literature search was performed for randomised and observational studies comparing these techniques. The pre-specified main outcomes measured were en bloc and R0 resection rates and recurrence. Pair-wise meta-analysis was performed. Results This review included 1044 patients. Transanal surgery had increased R0 resection rates (odds ratio (OR) 2.66; 95% CI 1.64; 4.31; p < 0.001) versus endoscopic management. The latter was associated with higher rates of incomplete resection (OR 2.25; 95% CI 1.14, 4.46; p = 0.02) and further intervention (OR 1.78; 95% CI 1.09, 2.88; p = 0.02). There was no difference in the rates of late recurrence (OR 1.01; 95% CI 0.53, 1.91; p = 0.99) or further major surgery (OR 0.87; 95% CI 0.39, 1.94; p = 0.73) between the groups. Endoscopic treatment was associated with a shorter operating time (weighted mean difference (WMD) − 12.08; 95% CI − 18.97, − 5.19; p < 0.001) and LOS (WMD − 1.94; 95% CI − 2.43, − 1.44; p < 0.001), as well as lower rates of urinary retention post-operatively (OR 0.12; 95% CI 0.02, 0.63; p = 0.01). Conclusion Endoscopic techniques should be favoured in the setting of benign early rectal neoplasms given their decreased morbidity and increased cost-effectiveness. However, where malignancy is suspected transanal surgery should be the preferred option given the superior R0 resection rate.

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“…Inpatient bed shortage delays elective admissions and increases emergency department boarding, which denies critically ill patients timely access to treatment, as inpatient care conventionally begins only after the patient arrives at the assigned inpatient ward [ 3 , 4 ]. Patients with prolonged LOS are also at higher risks of nosocomial infections and unplanned readmissions [ 5 , 6 ]. In short, prolonged LOS disadvantages both hospitals and patients [ 7 ].…”

Section: Introductionmentioning

confidence: 99%

“…Postoperative treatment for wound or surgical site infections [ 23 ], polypharmacy [ 40 , 42 ] where multiple drug consumption increased the risk of drug interactions and adverse reactions, as well as use of dialysis, ventilator support, and catheter insertions [ 3 ] also contributed to LOS. Other hospital acquired nosocomial infections include infections from clostridium difficile colitis [ 43 ] or methicillin-resistant Staphylococcus aureus [ 6 ]. Research has also shown that discharge planning affects LOS, where discharge to a nursing home was associated with prolonged LOS by 89% for surgical patients compared to being discharged to home [ 3 , 36 ].…”

Section: Introductionmentioning

confidence: 99%

Factors associated with prolonged length of stay for elective hepatobiliary and neurosurgery patients: a retrospective medical record review

Lee

Tan

et al. 2018

BMC Health Serv Res

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BackgroundPatients with prolonged length of hospital stay (LOS) not only increase their risks of nosocomial infections but also deny other patients access to inpatient care. Hepatobiliary (HPB) malignancies have some of highest incidences in East and Southeast Asia and the management of patients undergoing HPB surgeries have yet to be standardized. With improved neurosurgery techniques for intracranial aneurysms and tumors, neurosurgeries (NS) can be expected to increase. Elective surgeries account for far more operations than emergencies surgeries. Thus, with potentially increased numbers of elective HPB and NS, this study seeks to explore perioperative factors associated with prolonged LOS for these patients to improve safety and quality of practice.MethodsA retrospective cross-sectional medical record review study from January 2014 to January 2015 was conducted at a 1250-bed tertiary academic hospital in Singapore. All elective HPB and NS patients over 18 years old were included in the study except day and emergency surgeries, resulting in 150 and 166 patients respectively. Prolonged LOS was defined as above median LOS based on the complexity of the surgical procedure. The predictor variables were preoperative, intraoperative, and postoperative factors. Student’s t-test and stepwise logistic regression analyses were conducted to determine which factors were associated with prolonged LOS.ResultsFactors associated with prolonged LOS for the HPB sample were age and admission after 5 pm but for the NS sample, they were functional status, referral to occupational therapy, and the number of hospital-acquired infections.ConclusionOur findings indicate that preoperative factors had the greatest association with prolonged LOS for HPB and NS elective surgeries even after adjusting for surgical complexity, suggesting that patient safety and quality of care may be improved with better pre-surgery patient preparation and admission practices.Electronic supplementary materialThe online version of this article (10.1186/s12913-017-2817-8) contains supplementary material, which is available to authorized users.

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Nosocomial Infections and Microbiologic Spectrum after Major Elective Surgery of the Pancreas, Liver, Stomach, and Esophagus

Cited by 16 publications

References 46 publications

What every intensivist should know about the management of peritonitis in the intensive care unit

What every intensivist should know about the management of peritonitis in the intensive care unit

Endoscopic management versus transanal surgery for early primary or early locally recurrent rectal neoplasms—a systematic review and meta-analysis

Factors associated with prolonged length of stay for elective hepatobiliary and neurosurgery patients: a retrospective medical record review

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