11 research outputs found
The Global Alliance for Infections in Surgery : defining a model for antimicrobial stewardship-results from an international cross-sectional survey
Background: Antimicrobial Stewardship Programs (ASPs) have been promoted to optimize antimicrobial usage and patient outcomes, and to reduce the emergence of antimicrobial-resistant organisms. However, the best strategies for an ASP are not definitively established and are likely to vary based on local culture, policy, and routine clinical practice, and probably limited resources in middle-income countries. The aim of this study is to evaluate structures and resources of antimicrobial stewardship teams (ASTs) in surgical departments from different regions of the world. Methods: A cross-sectional web-based survey was conducted in 2016 on 173 physicians who participated in the AGORA (Antimicrobials: A Global Alliance for Optimizing their Rational Use in Intra-Abdominal Infections) project and on 658 international experts in the fields of ASPs, infection control, and infections in surgery. Results: The response rate was 19.4%. One hundred fifty-six (98.7%) participants stated their hospital had a multidisciplinary AST. The median number of physicians working inside the team was five [interquartile range 4-6]. An infectious disease specialist, a microbiologist and an infection control specialist were, respectively, present in 80.1, 76.3, and 67.9% of the ASTs. A surgeon was a component in 59.0% of cases and was significantly more likely to be present in university hospitals (89.5%, p <0.05) compared to community teaching (83.3%) and community hospitals (66.7%). Protocols for pre-operative prophylaxis and for antimicrobial treatment of surgical infections were respectively implemented in 96.2 and 82.3% of the hospitals. The majority of the surgical departments implemented both persuasive and restrictive interventions (72.8%). The most common types of interventions in surgical departments were dissemination of educational materials (62.5%), expert approval (61.0%), audit and feedback (55.1%), educational outreach (53.7%), and compulsory order forms (51.5%). Conclusion: The survey showed a heterogeneous organization of ASPs worldwide, demonstrating the necessity of a multidisciplinary and collaborative approach in the battle against antimicrobial resistance in surgical infections, and the importance of educational efforts towards this goal.Peer reviewe
Global validation of the WSES Sepsis Severity Score for patients with complicated intra-abdominal infections : a prospective multicentre study (WISS Study)
Background: To validate a new practical Sepsis Severity Score for patients with complicated intra-abdominal infections (cIAIs) including the clinical conditions at the admission (severe sepsis/septic shock), the origin of the cIAIs, the delay in source control, the setting of acquisition and any risk factors such as age and immunosuppression. Methods: The WISS study (WSES cIAIs Score Study) is a multicenter observational study underwent in 132 medical institutions worldwide during a four-month study period (October 2014-February 2015). Four thousand five hundred thirty-three patients with a mean age of 51.2 years (range 18-99) were enrolled in the WISS study. Results: Univariate analysis has shown that all factors that were previously included in the WSES Sepsis Severity Score were highly statistically significant between those who died and those who survived (p <0.0001). The multivariate logistic regression model was highly significant (p <0.0001, R-2 = 0.54) and showed that all these factors were independent in predicting mortality of sepsis. Receiver Operator Curve has shown that the WSES Severity Sepsis Score had an excellent prediction for mortality. A score above 5.5 was the best predictor of mortality having a sensitivity of 89.2 %, a specificity of 83.5 % and a positive likelihood ratio of 5.4. Conclusions: WSES Sepsis Severity Score for patients with complicated Intra-abdominal infections can be used on global level. It has shown high sensitivity, specificity, and likelihood ratio that may help us in making clinical decisions.Peer reviewe
Sepiolite as environmental friendly and reusable catalyst for the selective synthesis of (E)-nitrostyrenes
Selective Nitroaldol Condensations over Heterogeneous Catalysts in the Presence of Supercritical Carbon Dioxide
The State and Environmental Degradation in Nigeria: A Study of the 1988 Toxic Waste Dump in Koko
The Global Alliance for Infections in Surgery: defining a model for antimicrobial stewardship-results from an international cross-sectional survey
Background: Antimicrobial Stewardship Programs (ASPs) have been promoted
to optimize antimicrobial usage and patient outcomes, and to reduce the
emergence of antimicrobial-resistant organisms. However, the best
strategies for an ASP are not definitively established and are likely to
vary based on local culture, policy, and routine clinical practice, and
probably limited resources in middle-income countries. The aim of this
study is to evaluate structures and resources of antimicrobial
stewardship teams (ASTs) in surgical departments from different regions
of the world.
Methods: A cross-sectional web-based survey was conducted in 2016 on 173
physicians who participated in the AGORA (Antimicrobials: A Global
Alliance for Optimizing their Rational Use in Intra-Abdominal
Infections) project and on 658 international experts in the fields of
ASPs, infection control, and infections in surgery.
Results: The response rate was 19.4%. One hundred fifty-six (98.7%)
participants stated their hospital had a multidisciplinary AST. The
median number of physicians working inside the team was five
[interquartile range 4-6]. An infectious disease specialist, a
microbiologist and an infection control specialist were, respectively,
present in 80.1, 76.3, and 67.9% of the ASTs. A surgeon was a component
in 59.0% of cases and was significantly more likely to be present in
university hospitals (89.5%, p < 0.05) compared to community teaching
(83.3%) and community hospitals (66.7%). Protocols for pre-operative
prophylaxis and for antimicrobial treatment of surgical infections were
respectively implemented in 96.2 and 82.3% of the hospitals. The
majority of the surgical departments implemented both persuasive and
restrictive interventions (72.8%). The most common types of
interventions in surgical departments were dissemination of educational
materials (62.5%), expert approval (61.0%), audit and feedback
(55.1%), educational outreach (53.7%), and compulsory order forms
(51.5%).
Conclusion: The survey showed a heterogeneous organization of ASPs
worldwide, demonstrating the necessity of a multidisciplinary and
collaborative approach in the battle against antimicrobial resistance in
surgical infections, and the importance of educational efforts towards
this goal