Carriage of Extended-spectrum Beta-lactamase–producing Enterobacteriaceae and the Risk of Surgical Site Infection After Colorectal Surgery: A Prospective Cohort Study

Dubinsky‐Pertzov, Biana; Temkin, Elizabeth; Harbarth, Stéphan Juergen; Fankhauser-Rodriguez, Carolina; Carević, Biljana; Radovanović, Ivana; Ris, Frédéric; Kariv, Yehuda; Buchs, Nicolas; Schiffer, Eduardo; Percia, S. Cohen; Nutman, Amir; Fallach, Noga; Klausner, Joseph M.; Carmeli, Yehuda

doi:10.1093/cid/ciy768

Cited by 51 publications

(36 citation statements)

References 24 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Studies from Europe suggest that ESBL enteric colonization ranges between 18% and 29% among patients who undergo colorectal surgery, with a 2-fold increase in deep SSI among patients with enteric ESBL-producing Enterobacteriaceae colonization. 10,11 Similar to a previous study, 11 the risk of SSI, particularly deep SSI, remains high in ESBL-prevalent regions. On the contrary, our population included all patients who underwent clean-contaminated, contaminated, or dirty abdominal surgical procedures.…”

Section: Discussionsupporting

confidence: 79%

Outcomes of extended-spectrum beta-lactamases producing Enterobacteriaceae colonization among patients abdominal surgery patients

Apisarnthanarak

Kondo

Mingmalairak

et al. 2019

Infect. Control Hosp. Epidemiol.

View full text Add to dashboard Cite

show abstract

Section: Discussionsupporting

confidence: 79%

Outcomes of extended-spectrum beta-lactamases producing Enterobacteriaceae colonization among patients abdominal surgery patients

Apisarnthanarak

Kondo

Mingmalairak

et al. 2019

Infect. Control Hosp. Epidemiol.

View full text Add to dashboard Cite

show abstract

“…Further, anastomosis creation was shown to result in a 200- and 500-fold increase in the relative abundance of Enterococcus and Escherichia/Shigella, respectively, in a rodent model[36]. In a prospective multicentric cohort of patients undergoing colorectal surgery, including our center, Dubinsky-Pertzov et al[37] showed that carriers of beta lactamase-producing Enterobacteriaceae receiving cephalosporin-based antibioprophylaxsis were at risk of surgical site infection [odds ratio (OR) 2.36]. These findings suggest that changes in the local microbiome caused by surgery or unappropriate prophylactic antibiotherapy might worsen the situation of patients with already unfavorable microbiome profiles.…”

Section: Preoperative Measures To Prevent Almentioning

confidence: 99%

Reducing anastomotic leak in colorectal surgery: The old dogmas and the new challenges

Meyer¹,

Naiken²,

Christou³

et al. 2019

WJG

View full text Add to dashboard Cite

Anastomotic leak (AL) constitutes a significant issue in colorectal surgery, and its incidence has remained stable over the last years. The use of intra-abdominal drain or the use of mechanical bowel preparation alone have been proven to be useless in preventing AL and should be abandoned. The role or oral antibiotics preparation regimens should be clarified and compared to other routes of administration, such as the intravenous route or enema. In parallel, preoperative antibiotherapy should aim at targeting collagenase-inducing pathogens, as identified by the microbiome analysis. AL can be further reduced by fluorescence angiography, which leads to significant intraoperative changes in surgical strategies. Implementation of fluorescence angiography should be encouraged. Progress made in AL comprehension and prevention might probably allow reducing the rate of diverting stoma and conduct to a revision of its indications.

show abstract

“… 73 , 74 There are also uncertainties regarding whether AMR surveillance should drive antibiotic surgical prophylaxis against MDR Gram-negative bacteria, although more evidence is available on the increased risk of surgical site infections in MDR Gram-negative carriers. 75 , 76 AMR surveillance data on screening isolates can be useful for the AMS team to individualize surgical prophylaxis practice in selected cases.…”

Section: Resultsmentioning

confidence: 99%

Linking antimicrobial resistance surveillance to antibiotic policy in healthcare settings: the COMBACTE-Magnet EPI-Net COACH project

Pezzani

Mazzaferri

Compri

et al. 2020

Journal of Antimicrobial Chemotherapy

Self Cite

View full text Add to dashboard Cite

Objectives To systematically summarize the evidence on how to collect, analyse and report antimicrobial resistance (AMR) surveillance data to inform antimicrobial stewardship (AMS) teams providing guidance on empirical antibiotic treatment in healthcare settings. Methods The research group identified 10 key questions about the link between AMR surveillance and AMS using a checklist of 9 elements for good practice in health research priority settings and a modified 3D combined approach matrix, and conducted a systematic review of published original studies and guidelines on the link between AMR surveillance and AMS. Results The questions identified focused on AMS team composition; minimum infrastructure requirements for AMR surveillance; organisms, samples and susceptibility patterns to report; data stratification strategies; reporting frequency; resistance thresholds to drive empirical therapy; surveillance in high-risk hospital units, long-term care, outpatient and veterinary settings; and surveillance data from other countries. Twenty guidelines and seven original studies on the implementation of AMR surveillance as part of an AMS programme were included in the literature review. Conclusions The evidence summarized in this review provides a useful basis for a more integrated process of developing procedures to report AMR surveillance data to drive AMS interventions. These procedures should be extended to settings outside the acute-care institutions, such as long-term care, outpatient and veterinary. Without proper AMR surveillance, implementation of AMS policies cannot contribute effectively to the fight against MDR pathogens and may even worsen the burden of adverse events from such interventions.

show abstract

Carriage of Extended-spectrum Beta-lactamase–producing Enterobacteriaceae and the Risk of Surgical Site Infection After Colorectal Surgery: A Prospective Cohort Study

Abstract: ESBL-PE carriers who receive cephalosporin-based prophylaxis are at increased risk of SSI following colorectal surgery.

Cited by 51 publications

References 24 publications

Outcomes of extended-spectrum beta-lactamases producing Enterobacteriaceae colonization among patients abdominal surgery patients

Outcomes of extended-spectrum beta-lactamases producing Enterobacteriaceae colonization among patients abdominal surgery patients

Reducing anastomotic leak in colorectal surgery: The old dogmas and the new challenges

Linking antimicrobial resistance surveillance to antibiotic policy in healthcare settings: the COMBACTE-Magnet EPI-Net COACH project

Contact Info

Product

Resources

About