Intraperitoneal drain placement and outcomes after elective colorectal surgery: international matched, prospective, cohort study

Despite current guidelines, intraperitoneal drain placement after elective colorectal surgery remains widespread. Drains were not associated with earlier detection of intraperitoneal collections, but were associated with prolonged hospital stay and increased risk of surgical-site infections.Background Many surgeons routinely place intraperitoneal drains after elective colorectal surgery. However, enhanced recovery after surgery guidelines recommend against their routine use owing to a lack of clear clinical benefit. This study aimed to describe international variation in intraperitoneal drain placement and the safety of this practice. Methods COMPASS (COMPlicAted intra-abdominal collectionS after colorectal Surgery) was a prospective, international, cohort study which enrolled consecutive adults undergoing elective colorectal surgery (February to March 2020). The primary outcome was the rate of intraperitoneal drain placement. Secondary outcomes included: rate and time to diagnosis of postoperative intraperitoneal collections; rate of surgical site infections (SSIs); time to discharge; and 30-day major postoperative complications (Clavien-Dindo grade at least III). After propensity score matching, multivariable logistic regression and Cox proportional hazards regression were used to estimate the independent association of the secondary outcomes with drain placement. Results Overall, 1805 patients from 22 countries were included (798 women, 44.2 per cent; median age 67.0 years). The drain insertion rate was 51.9 per cent (937 patients). After matching, drains were not associated with reduced rates (odds ratio (OR) 1.33, 95 per cent c.i. 0.79 to 2.23; P = 0.287) or earlier detection (hazard ratio (HR) 0.87, 0.33 to 2.31; P = 0.780) of collections. Although not associated with worse major postoperative complications (OR 1.09, 0.68 to 1.75; P = 0.709), drains were associated with delayed hospital discharge (HR 0.58, 0.52 to 0.66; P < 0.001) and an increased risk of SSIs (OR 2.47, 1.50 to 4.05; P < 0.001). Conclusion Intraperitoneal drain placement after elective colorectal surgery is not associated with earlier detection of postoperative collections, but prolongs hospital stay and increases SSI risk

Contaminação experimental de albúmen e gema de ovos por Salmonella Enteritidis e Escherichia coli isoladas ou associadas – influência da temperatura e tempo de armazenagem

Avaliou-se o comportamento de Salmonella Enteritidis (SE) e Escherichia coli em albúmen e gema de ovos de galinha, submetidos a duas diferentes temperaturas, 8 e 30°C, quando inoculadas isoladamente ou na forma de culturas mistas. Não houve diferença no comportamento dos agentes testados mesmo quando inoculadas em conjunto. Mesmo sob temperatura alta, E. coli não se multiplicou no albúmen, demonstrando o poder inibidor de seus constituintes para esse microrganismo, enquanto a SE aumentou sua população em até três ciclos logarítmicos. Em gema de ovo, SE demonstrou características psicrotróficas.The behavior of Salmonella Enteritidis (SE) and Escherichia coli in albumen and yolk of chicken eggs submitted to two different temperatures, 8oC and 30oC, when separately inoculated or in the form of mixed cultures was studied. There was no difference in the behaviour of the tested agents even when inoculated together. Even under high temperature, E. coli did not multiply in the albumen, demonstrating the inhibition power for that microorganism, while SE increased its population up to three logarithmic cycles. In egg yolk, SE demonstrated psychrotrophic characteristics

Penetration of Salmonella Enteritidis in chicken eggs, comparing different shell quality, industrial washing and temperature of storage

Estudou-se o comportamento da Salmonella Enteritidis quando em contato com a superfície de ovos de consumo, classificados de acordo com a qualidade da casca ou com tratamentos (lavados ou não), usando fezes de aves como veículo de contaminação, e armazenados a 8°C e 70% de umidade relativa ou a 30°C e 90% de umidade relativa. A 8°C, o microrganismo permaneceu viável na superfície dos ovos, ao longo do tempo, enquanto a 30°C foi possível identificar a sua inibição e até sua eliminação da superfície. A contaminação do conteúdo de ovos com defeito de casca foi mais frequente quando os ovos foram submetidos a temperaturas inadequadas de armazenagem (30°C).Salmonella Enteriditis behavior was studied when present on the surface of consume eggs, classified according to the shell quality or treatments (washed or not). Stools of fowls were used as a vehicle for contamination. The eggs were stored at 8°C and 70% relative humidity or at 30°C and 90% of relative humidity. At 8°C, the microorganism stayed viable on the surface of the eggs throughout the study, while at 30°C it was inhibited and eliminated from the egg shell. The contamination of content of the eggs with shell defect was more frequent when they were submitted to inappropriate temperatures of storage (30°C)

Penetration of Salmonella Enteritidis in chicken eggs, comparing different shell quality, industrial washing and temperature of storage

Estudou-se o comportamento da Salmonella Enteritidis quando em contato com a superfície de ovos de consumo, classificados de acordo com a qualidade da casca ou com tratamentos (lavados ou não), usando fezes de aves como veículo de contaminação, e armazenados a 8°C e 70% de umidade relativa ou a 30°C e 90% de umidade relativa. A 8°C, o microrganismo permaneceu viável na superfície dos ovos, ao longo do tempo, enquanto a 30°C foi possível identificar a sua inibição e até sua eliminação da superfície. A contaminação do conteúdo de ovos com defeito de casca foi mais frequente quando os ovos foram submetidos a temperaturas inadequadas de armazenagem (30°C).Salmonella Enteriditis behavior was studied when present on the surface of consume eggs, classified according to the shell quality or treatments (washed or not). Stools of fowls were used as a vehicle for contamination. The eggs were stored at 8°C and 70% relative humidity or at 30°C and 90% of relative humidity. At 8°C, the microorganism stayed viable on the surface of the eggs throughout the study, while at 30°C it was inhibited and eliminated from the egg shell. The contamination of content of the eggs with shell defect was more frequent when they were submitted to inappropriate temperatures of storage (30°C)

Contaminação experimental de albúmen e gema de ovos por Salmonella Enteritidis e Escherichia coli isoladas ou associadas – influência da temperatura e tempo de armazenagem

Avaliou-se o comportamento de Salmonella Enteritidis (SE) e Escherichia coli em albúmen e gema de ovos de galinha, submetidos a duas diferentes temperaturas, 8 e 30°C, quando inoculadas isoladamente ou na forma de culturas mistas. Não houve diferença no comportamento dos agentes testados mesmo quando inoculadas em conjunto. Mesmo sob temperatura alta, E. coli não se multiplicou no albúmen, demonstrando o poder inibidor de seus constituintes para esse microrganismo, enquanto a SE aumentou sua população em até três ciclos logarítmicos. Em gema de ovo, SE demonstrou características psicrotróficas.The behavior of Salmonella Enteritidis (SE) and Escherichia coli in albumen and yolk of chicken eggs submitted to two different temperatures, 8oC and 30oC, when separately inoculated or in the form of mixed cultures was studied. There was no difference in the behaviour of the tested agents even when inoculated together. Even under high temperature, E. coli did not multiply in the albumen, demonstrating the inhibition power for that microorganism, while SE increased its population up to three logarithmic cycles. In egg yolk, SE demonstrated psychrotrophic characteristics