Microbiological Profile and Antimicrobial Susceptibility in Surgical Site Infections Following Hollow Viscus Injury

Schnüriger, Beat; Inaba, Kenji; Eberle, Barbara M.; Wu, Tzi Yi; Talving, Peep; Bukur, Marko; Belzberg, Howard; Δημητριάδης, Δημήτριος

doi:10.1007/s11605-010-1231-x

Cited by 22 publications

(7 citation statements)

References 43 publications

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“…As has been previously reported in patients with traumatic abdominal wounds, Enterobacteriaceae may demonstrate significant resistance to ampicillin-sulbactam, risking inadequate therapy in up to 50% of patients [22]. This is consistent with our study finding of 54% ampicillin-sulbactam resistance in non-MDR E.coli isolates from the Afghanistan-based participants.…”

Section: Discussionsupporting

confidence: 93%

Multidrug-resistant gram-negative bacteria colonization of healthy US military personnel in the US and Afghanistan

et al. 2013

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BackgroundThe US military has seen steady increases in multidrug-resistant (MDR) gram-negative bacteria (GNB) infections in casualties from Iraq and Afghanistan. This study evaluates the prevalence of MDR GNB colonization in US military personnel.MethodsGNB colonization surveillance of healthy, asymptomatic military personnel (101 in the US and 100 in Afghanistan) was performed by swabbing 7 anatomical sites. US-based personnel had received no antibiotics within 30 days of specimen collection, and Afghanistan-based personnel were receiving doxycycline for malaria chemoprophylaxis at time of specimen collection. Isolates underwent genotypic and phenotypic characterization.ResultsThe only colonizing MDR GNB recovered in both populations was Escherichia coli (p=0.01), which was seen in 2% of US-based personnel (all perirectal) and 11% of Afghanistan-based personnel (10 perirectal, 1 foot+groin). Individuals with higher off-base exposures in Afghanistan did not show a difference in overall GNB colonization or MDR E. coli colonization, compared with those with limited off-base exposures.ConclusionHealthy US- and Afghanistan-based military personnel have community onset-MDR E. coli colonization, with Afghanistan-based personnel showing a 5.5-fold higher prevalence. The association of doxycycline prophylaxis or other exposures with antimicrobial resistance and increased rates of MDR E. coli colonization needs further evaluation.

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Section: Discussionsupporting

confidence: 93%

Multidrug-resistant gram-negative bacteria colonization of healthy US military personnel in the US and Afghanistan

et al. 2013

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“…The most common microorganisms isolated from SSIs after small bowel surgery are aerobic gram-negative enteric organisms. Among the species isolated from patients with SSI after small intestine surgery are gram-negative bacilli of gastrointestinal enteric origin (aerobic and anaerobic) and grampositive species, such as streptococci, staphylococci, and enterococci, which is consistent with similar studies [401]. Escherichia coli is the most frequently identified aerobe, indicating that the bowel flora constitute a major source of pathogens.…”

Section: Organismssupporting

confidence: 85%

Clinical Practice Guidelines for Antimicrobial Prophylaxis in Surgery

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Dellinger

Olsen

et al. 2013

Surgical Infections

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T hese guidelines were developed jointly by the American Society of Health-System Pharmacists (ASHP), the Infectious Diseases Society of America (IDSA), the Surgical Infection Society (SIS), and the Society for Healthcare Epidemiology of America (SHEA). This work represents an update to the previously published ASHP Therapeutic Guidelines on Antimicrobial Prophylaxis in Surgery [1], as well as guidelines from IDSA and SIS [2,3]. The guidelines are intended to provide practitioners with a standardized approach to the rational, safe, and effective use of antimicrobial agents for the prevention of surgical site infections (SSIs) based on currently available clinical evidence and emerging issues. Prophylaxis refers to the prevention of an infection and can be characterized as primary prophylaxis, secondary prophylaxis, or eradication. Primary prophylaxis refers to the prevention of an initial infection. Secondary prophylaxis refers to the prevention of recurrence or reactivation of a preexisting infection. Eradication refers to the elimination of a colonized organism to prevent the development of an infection. These guidelines focus on primary perioperative prophylaxis. Guidelines development and use Members of ASHP, IDSA, SIS, and SHEA were appointed to serve on an expert panel established to ensure the validity, reliability, and utility of the revised guidelines. The work of the panel was facilitated by faculty of the

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“…Among the species isolated from patients with SSI after small intestine surgery are gram-negative bacilli of gastrointestinal enteric origin (aerobic and anaerobic) and grampositive species, such as streptococci, staphylococci, and enterococci, which is consistent with similar studies. 401 E. coli is the most frequently identified aerobe, indicating that the bowel flora constitute a major source of pathogens. Aerobic and anaerobic streptococci, Staphylococcus species, and Enterococcus species also have been reported.…”

Section: Small Intestine Proceduresmentioning

confidence: 99%