TY - JOUR
T1 - Focus on the prophylaxis, epidemiology and therapy of methicillin-resistant Staphylococcus aureus surgical site infections and a position paper on associated risk factors: The perspective of an Italian group of surgeons
AU - Sganga, Gabriele
AU - Tascini, C.
AU - Sozio, E.
AU - Carlini, M.
AU - Chirletti, P.
AU - Cortese, F.
AU - Gattuso, R.
AU - Granone, Pierluigi
AU - Pempinello, C.
AU - Sartelli, M.
AU - Colizza, S.
PY - 2016
Y1 - 2016
N2 - Background: The aim of this research was to study the epidemiology, microbiology, prophylaxis, and antibiotic therapy of surgical site infections (SSIs), especially those caused by methicillin-resistant Staphylococcus aureus (MRSA), and identify the risk factors for these infections. In Italy SSIs occur in about 5% of all surgical procedures. They are predominantly caused by staphylococci, and 30% of them are diagnosed after discharge. In every surgical specialty there are specific procedures more associated with SSIs. Methods: The authors conducted a systematic review of the literature on SSIs, especially MRSA infections, and used the Delphi method to identify risk factors for these resistant infections. Results: Risk factors associated with MRSA SSIs identified by the Delphi method were: patients from long-term care facilities, recent hospitalization (within the preceding 30days), Charlson score > 5 points, chronic obstructive pulmonary disease and thoracic surgery, antibiotic therapy with beta-lactams (especially cephalosporins and carbapenem) and/or quinolones in the preceding 30days, age 75years or older, current duration of hospitalization >16days, and surgery with prothesis implantation. Protective factors were adequate antibiotic prophylaxis, laparoscopic surgery and the presence of an active, in-hospital surveillance program for the control of infections. MRSA therapy, especially with agents that enable the patient's rapid discharge from hospital is described. Conclusion: The prevention, identification and treatment of SSIs, especially those caused by MRSA, should be implemented in surgical units in order to improve clinical and economic outcomes.
AB - Background: The aim of this research was to study the epidemiology, microbiology, prophylaxis, and antibiotic therapy of surgical site infections (SSIs), especially those caused by methicillin-resistant Staphylococcus aureus (MRSA), and identify the risk factors for these infections. In Italy SSIs occur in about 5% of all surgical procedures. They are predominantly caused by staphylococci, and 30% of them are diagnosed after discharge. In every surgical specialty there are specific procedures more associated with SSIs. Methods: The authors conducted a systematic review of the literature on SSIs, especially MRSA infections, and used the Delphi method to identify risk factors for these resistant infections. Results: Risk factors associated with MRSA SSIs identified by the Delphi method were: patients from long-term care facilities, recent hospitalization (within the preceding 30days), Charlson score > 5 points, chronic obstructive pulmonary disease and thoracic surgery, antibiotic therapy with beta-lactams (especially cephalosporins and carbapenem) and/or quinolones in the preceding 30days, age 75years or older, current duration of hospitalization >16days, and surgery with prothesis implantation. Protective factors were adequate antibiotic prophylaxis, laparoscopic surgery and the presence of an active, in-hospital surveillance program for the control of infections. MRSA therapy, especially with agents that enable the patient's rapid discharge from hospital is described. Conclusion: The prevention, identification and treatment of SSIs, especially those caused by MRSA, should be implemented in surgical units in order to improve clinical and economic outcomes.
KW - Dalbavancin
KW - Emergency Medicine
KW - MRSA
KW - Surgery
KW - Surgical site infection
KW - Dalbavancin
KW - Emergency Medicine
KW - MRSA
KW - Surgery
KW - Surgical site infection
UR - http://hdl.handle.net/10807/94068
UR - http://www.wjes.org/
U2 - 10.1186/s13017-016-0086-1
DO - 10.1186/s13017-016-0086-1
M3 - Article
SN - 1749-7922
VL - 11
SP - 26
EP - 26
JO - World Journal of Emergency Surgery
JF - World Journal of Emergency Surgery
ER -