دورية أكاديمية
أعرض في EDS

Perioperative antimicrobial prophylaxis and prevention of hepatobiliary surgical site infections.

التفاصيل البيبلوغرافية
العنوان: Perioperative antimicrobial prophylaxis and prevention of hepatobiliary surgical site infections.
المؤلفون: Stack CM; Division of Infection Control/Hospital Epidemiology, Silverman Institute of Health Care Quality & Safety, Beth Israel Deaconess Medical Center, Boston, Massachusetts.; Division of Infectious Diseases, Department of Medicine, Beth Israel Deaconess Medical Center, Boston, Massachusetts., Gold HS; Division of Infection Control/Hospital Epidemiology, Silverman Institute of Health Care Quality & Safety, Beth Israel Deaconess Medical Center, Boston, Massachusetts.; Division of Infectious Diseases, Department of Medicine, Beth Israel Deaconess Medical Center, Boston, Massachusetts., Wright SB; Division of Infection Control/Hospital Epidemiology, Silverman Institute of Health Care Quality & Safety, Beth Israel Deaconess Medical Center, Boston, Massachusetts.; Division of Infectious Diseases, Department of Medicine, Beth Israel Deaconess Medical Center, Boston, Massachusetts., Baldini LM; Division of Infection Control/Hospital Epidemiology, Silverman Institute of Health Care Quality & Safety, Beth Israel Deaconess Medical Center, Boston, Massachusetts., Snyder GM; Division of Infection Control/Hospital Epidemiology, Silverman Institute of Health Care Quality & Safety, Beth Israel Deaconess Medical Center, Boston, Massachusetts.; Division of Infectious Diseases, Department of Medicine, Beth Israel Deaconess Medical Center, Boston, Massachusetts.
المصدر: Infection control and hospital epidemiology [Infect Control Hosp Epidemiol] 2018 Sep; Vol. 39 (9), pp. 1037-1041. Date of Electronic Publication: 2018 Aug 01.
نوع المنشور: Journal Article
اللغة: English
بيانات الدورية: Publisher: Cambridge University Press Country of Publication: United States NLM ID: 8804099 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1559-6834 (Electronic) Linking ISSN: 0899823X NLM ISO Abbreviation: Infect Control Hosp Epidemiol Subsets: MEDLINE
أسماء مطبوعة: Publication: Jan. 2015- : Cambridge : Cambridge University Press
Original Publication: [Thorofare, N.J. ] : SLACK Inc., c1988-
مواضيع طبية MeSH: Anti-Infective Agents/*therapeutic use , Antibiotic Prophylaxis/*statistics & numerical data , Digestive System Surgical Procedures/*adverse effects , Surgical Wound Infection/*epidemiology, Aged ; Ampicillin/therapeutic use ; Boston/epidemiology ; Case-Control Studies ; Cefazolin/therapeutic use ; Drug Combinations ; Female ; Humans ; Logistic Models ; Male ; Metronidazole/therapeutic use ; Middle Aged ; Multivariate Analysis ; Perioperative Care ; Retrospective Studies ; Risk Factors ; Sulbactam/therapeutic use ; Surgical Wound Infection/prevention & control ; beta-Lactams/therapeutic use
مستخلص: Objective: To characterize the microbiology of hepatobiliary surgical site infections (SSIs) and to explore the relationship between specific antimicrobial prophylaxis regimens and the development of SSIs.
Design: Retrospective matched case-control study comparing patient, procedure, and antimicrobial prophylaxis characteristics among patients undergoing a hepatobiliary surgical procedure with and without an SSI.
Setting: A tertiary referral acute-care facility.
Methods: Patients undergoing procedures defined as "BILI" (bile duct, liver, or pancreas surgery) using National Healthcare Safety Network (NHSN) definitions, excluding those undergoing concomitant liver transplantation, from January 2013 through June 2016 were included in the study population. The SSIs were identified through routine infection control surveillance using NHSN definitions. All patients who developed an SSI were considered cases. Controls were selected randomly matched 2:1 with cases based on fiscal quarter of the procedure. Logistic regression modeling was performed to explore variables associated with SSI, including antimicrobial prophylaxis received.
Results: Among 975 procedures, 80 (8.2%) resulted in an SSI. Most cases involved an organism nonsusceptible to standard prophylaxis regimens, including cefazolin (68.8%), cefazolin plus metronidazole (61.3%), and ampicillin-sulbactam (52.5%). In a multivariate model, antimicrobial coverage against Enterococcus spp (aOR, 0.58; 95% confidence interval [CI], 0.17-2.04; P=.40) and against Pseudomonas spp (aOR, 2.40; 95% CI, 0.56-10.29; P=.24) were not protective against the development of an SSI. The presence of a documented β-lactam allergy was significantly associated with the development of an SSI (aOR, 3.54; 95% CI, 1.36-9.19; P=.009).
Conclusions: Although SSIs at the study institution were associated with pathogens nonsusceptible to the most commonly used prophylaxis regimens, broader-spectrum coverage was not associated with a reduction in SSIs.
المشرفين على المادة: 0 (Anti-Infective Agents)
0 (Drug Combinations)
0 (beta-Lactams)
140QMO216E (Metronidazole)
65DT0ML581 (sultamicillin)
7C782967RD (Ampicillin)
IHS69L0Y4T (Cefazolin)
S4TF6I2330 (Sulbactam)
تواريخ الأحداث: Date Created: 20180802 Date Completed: 20190712 Latest Revision: 20200205
رمز التحديث: 20240628
DOI: 10.1017/ice.2018.164
PMID: 30064539
قاعدة البيانات: MEDLINE
الوصف
تدمد:1559-6834
DOI:10.1017/ice.2018.164