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1. It is time to define an organizational model for the prevention and management of infections along the surgical pathway: a worldwide cross-sectional survey

Author

Sartelli, M, Labricciosa, F, Coccolini, F, Coimbra, R, Abu-Zidan, F, Ansaloni, L, Al-Hasan, M, Ansari, S, Barie, P, Cainzos, M, Ceresoli, M, Chiarugi, M, Claridge, J, Cicuttin, E, Dellinger, E, Fry, D, Guirao, X, Hardcastle, T, Hecker, A, Leppaniemi, A, Litvin, A, Marwah, S, Maseda, E, Mazuski, J, Memish, Z, Kirkpatrick, A, Pagani, L, Podda, M, Rasa, H, Sakakushev, B, Sawyer, R, Tumietto, F, Xiao, Y, Aboubreeg, W, Adamou, H, Akhmeteli, L, Akin, E, Alberio, M, Alconchel, F, Magagi, I, Arauz, A, Argenio, G, Atanasov, B, Atici, S, Awad, S, Baili, E, Bains, L, Bala, M, Baraket, O, Baral, S, Belskii, V, Benboubker, M, Ben-Ishay, O, Bordoni, P, Boumediene, A, Brisinda, G, Cavazzuti, L, Chandy, S, Chiarello, M, Cillara, N, Clarizia, G, Cocuz, M, Cocuz, I, Conti, L, Coppola, R, Cui, Y, Czepiel, J, D'Acapito, F, Damaskos, D, Das, K, De Simone, B, Delibegovic, S, Demetrashvili, Z, Detanac, D, Dhingra, S, Di Bella, S, Dimitrov, E, Dogjani, A, D'Oria, M, Dumitru, I, Elmangory, M, Enciu, O, Fantoni, M, Filipescu, D, Fleres, F, Foghetti, D, Fransvea, P, Gachabayov, M, Galeiras, R, Gattuso, G, Ghannam, W, Ghisetti, V, Giraudo, G, Gonfa, K, Gonullu, E, Hamad, Y, Hecker, M, Isik, A, Ismail, N, Ismail, A, Jain, S, Kanj, S, Kapoor, G, Karaiskos, I, Kavalakat, A, Kenig, J, Khamis, F, Khokha, V, Kiguba, R, Kim, J, Kobe, Y, Kok, K, Kovacevic, B, Kryvoruchko, I, Kuriyama, A, Landaluce-Olavarria, A, Lasithiotakis, K, Lohsiriwat, V, Lostoridis, E, Luppi, D, Vega, G, Maegele, M, Marinis, A, Martines, G, Martinez-Perez, A, Massalou, D, Mesina, C, Metan, G, Miranda-Novales, M, Mishra, S, Mohamed, M, Mohamedahmed, A, Mora-Guzman, I, Mulita, F, Musina, A, Navsaria, P, Negoi, I, Nita, G, O'Connor, D, Ordonez, C, Pantalone, D, Panyko, A, Papadopoulos, A, Pararas, N, Pata, F, Patel, T, Pellino, G, Perra, T, Perrone, G, Pesce, A, Pintar, T, Popivanov, G, Porcu, A, Quiodettis, M, Rahim, R, Mitul, A, Reichert, M, Rems, M, Campbell, G, Rocha-Pereira, N, Rodrigues, G, Villamil, G, Rossi, S, Sall, I, Kafil, H, Sasia, D, Seni, J, Seretis, C, Serradilla-Martin, M, Shelat, V, Siribumrungwong, B, Slavchev, M, Solaini, L, Tan, B, Tarasconi, A, Tartaglia, D, Toma, E, Tomadze, G, Toro, A, Tovani-Palone, M, van Goor, H, Vasilescu, A, Vereczkei, A, Veroux, M, Weckmann, S, Widmer, L, Yahya, A, Zachariah, S, Zakaria, A, Zubareva, N, Zuidema, W, Di Carlo, I, Cortese, F, Baiocchi, G, Maier, R, Catena, F, Sartelli M., Labricciosa F. M., Coccolini F., Coimbra R., Abu-Zidan F. M., Ansaloni L., Al-Hasan M. N., Ansari S., Barie P. S., Cainzos M. A., Ceresoli M., Chiarugi M., Claridge J. A., Cicuttin E., Dellinger E. P., Fry D. E., Guirao X., Hardcastle T. C., Hecker A., Leppaniemi A. K., Litvin A., Marwah S., Maseda E., Mazuski J. E., Memish Z. A., Kirkpatrick A. W., Pagani L., Podda M., Rasa H. K., Sakakushev B. E., Sawyer R. G., Tumietto F., Xiao Y., Aboubreeg W. F., Adamou H., Akhmeteli L., Akin E., Alberio M. G., Alconchel F., Magagi I. A., Arauz A. B., Argenio G., Atanasov B. C., Atici S. D., Awad S. S., Baili E., Bains L., Bala M., Baraket O., Baral S., Belskii V. A., Benboubker M., Ben-Ishay O., Bordoni P., Boumediene A., Brisinda G., Cavazzuti L., Chandy S. J., Chiarello M. M., Cillara N., Clarizia G., Cocuz M. -E., Cocuz I. G., Conti L., Coppola R., Cui Y., Czepiel J., D'Acapito F., Damaskos D., Das K., De Simone B., Delibegovic S., Demetrashvili Z., Detanac D. S., Dhingra S., Di Bella S., Dimitrov E. N., Dogjani A., D'Oria M., Dumitru I. M., Elmangory M. M., Enciu O., Fantoni M., Filipescu D., Fleres F., Foghetti D., Fransvea P., Gachabayov M., Galeiras R., Gattuso G., Ghannam W. M., Ghisetti V., Giraudo G., Gonfa K. B., Gonullu E., Hamad Y. T. E. Y., Hecker M., Isik A., Ismail N., Ismail A., Jain S. A., Kanj S. S., Kapoor G., Karaiskos I., Kavalakat A. J., Kenig J., Khamis F., Khokha V., Kiguba R., Kim J. I., Kobe Y., Kok K. Y. Y., Kovacevic B. M., Kryvoruchko I. A., Kuriyama A., Landaluce-Olavarria A., Lasithiotakis K., Lohsiriwat V., Lostoridis E., Luppi D., Vega G. M. M., Maegele M., Marinis A., Martines G., Martinez-Perez A., Massalou D., Mesina C., Metan G., Miranda-Novales M. G., Mishra S. K., Mohamed M. I. H., Mohamedahmed A. Y. Y., Mora-Guzman I., Mulita F., Musina A. -M., Navsaria P. H., Negoi I., Nita G. E., O'Connor D. B., Ordonez C. A., Pantalone D., Panyko A., Papadopoulos A., Pararas N., Pata F., Patel T., Pellino G., Perra T., Perrone G., Pesce A., Pintar T., Popivanov G. I., Porcu A., Quiodettis M. A., Rahim R., Mitul A. R., Reichert M., Rems M., Campbell G. Y. R., Rocha-Pereira N., Rodrigues G., Villamil G. E. R., Rossi S., Sall I., Kafil H. S., Sasia D., Seni J., Seretis C., Serradilla-Martin M., Shelat V. G., Siribumrungwong B., Slavchev M., Solaini L., Tan B. K., Tarasconi A., Tartaglia D., Toma E. A., Tomadze G., Toro A., Tovani-Palone M. R., van Goor H., Vasilescu A., Vereczkei A., Veroux M., Weckmann S. A., Widmer L. W., Yahya A. I., Zachariah S. K., Zakaria A. D., Zubareva N., Zuidema W. P., Di Carlo I., Cortese F., Baiocchi G. L., Maier R. V., Catena F., Sartelli, M, Labricciosa, F, Coccolini, F, Coimbra, R, Abu-Zidan, F, Ansaloni, L, Al-Hasan, M, Ansari, S, Barie, P, Cainzos, M, Ceresoli, M, Chiarugi, M, Claridge, J, Cicuttin, E, Dellinger, E, Fry, D, Guirao, X, Hardcastle, T, Hecker, A, Leppaniemi, A, Litvin, A, Marwah, S, Maseda, E, Mazuski, J, Memish, Z, Kirkpatrick, A, Pagani, L, Podda, M, Rasa, H, Sakakushev, B, Sawyer, R, Tumietto, F, Xiao, Y, Aboubreeg, W, Adamou, H, Akhmeteli, L, Akin, E, Alberio, M, Alconchel, F, Magagi, I, Arauz, A, Argenio, G, Atanasov, B, Atici, S, Awad, S, Baili, E, Bains, L, Bala, M, Baraket, O, Baral, S, Belskii, V, Benboubker, M, Ben-Ishay, O, Bordoni, P, Boumediene, A, Brisinda, G, Cavazzuti, L, Chandy, S, Chiarello, M, Cillara, N, Clarizia, G, Cocuz, M, Cocuz, I, Conti, L, Coppola, R, Cui, Y, Czepiel, J, D'Acapito, F, Damaskos, D, Das, K, De Simone, B, Delibegovic, S, Demetrashvili, Z, Detanac, D, Dhingra, S, Di Bella, S, Dimitrov, E, Dogjani, A, D'Oria, M, Dumitru, I, Elmangory, M, Enciu, O, Fantoni, M, Filipescu, D, Fleres, F, Foghetti, D, Fransvea, P, Gachabayov, M, Galeiras, R, Gattuso, G, Ghannam, W, Ghisetti, V, Giraudo, G, Gonfa, K, Gonullu, E, Hamad, Y, Hecker, M, Isik, A, Ismail, N, Ismail, A, Jain, S, Kanj, S, Kapoor, G, Karaiskos, I, Kavalakat, A, Kenig, J, Khamis, F, Khokha, V, Kiguba, R, Kim, J, Kobe, Y, Kok, K, Kovacevic, B, Kryvoruchko, I, Kuriyama, A, Landaluce-Olavarria, A, Lasithiotakis, K, Lohsiriwat, V, Lostoridis, E, Luppi, D, Vega, G, Maegele, M, Marinis, A, Martines, G, Martinez-Perez, A, Massalou, D, Mesina, C, Metan, G, Miranda-Novales, M, Mishra, S, Mohamed, M, Mohamedahmed, A, Mora-Guzman, I, Mulita, F, Musina, A, Navsaria, P, Negoi, I, Nita, G, O'Connor, D, Ordonez, C, Pantalone, D, Panyko, A, Papadopoulos, A, Pararas, N, Pata, F, Patel, T, Pellino, G, Perra, T, Perrone, G, Pesce, A, Pintar, T, Popivanov, G, Porcu, A, Quiodettis, M, Rahim, R, Mitul, A, Reichert, M, Rems, M, Campbell, G, Rocha-Pereira, N, Rodrigues, G, Villamil, G, Rossi, S, Sall, I, Kafil, H, Sasia, D, Seni, J, Seretis, C, Serradilla-Martin, M, Shelat, V, Siribumrungwong, B, Slavchev, M, Solaini, L, Tan, B, Tarasconi, A, Tartaglia, D, Toma, E, Tomadze, G, Toro, A, Tovani-Palone, M, van Goor, H, Vasilescu, A, Vereczkei, A, Veroux, M, Weckmann, S, Widmer, L, Yahya, A, Zachariah, S, Zakaria, A, Zubareva, N, Zuidema, W, Di Carlo, I, Cortese, F, Baiocchi, G, Maier, R, Catena, F, Sartelli M., Labricciosa F. M., Coccolini F., Coimbra R., Abu-Zidan F. M., Ansaloni L., Al-Hasan M. N., Ansari S., Barie P. S., Cainzos M. A., Ceresoli M., Chiarugi M., Claridge J. A., Cicuttin E., Dellinger E. P., Fry D. E., Guirao X., Hardcastle T. C., Hecker A., Leppaniemi A. K., Litvin A., Marwah S., Maseda E., Mazuski J. E., Memish Z. A., Kirkpatrick A. W., Pagani L., Podda M., Rasa H. K., Sakakushev B. E., Sawyer R. G., Tumietto F., Xiao Y., Aboubreeg W. F., Adamou H., Akhmeteli L., Akin E., Alberio M. G., Alconchel F., Magagi I. A., Arauz A. B., Argenio G., Atanasov B. C., Atici S. D., Awad S. S., Baili E., Bains L., Bala M., Baraket O., Baral S., Belskii V. A., Benboubker M., Ben-Ishay O., Bordoni P., Boumediene A., Brisinda G., Cavazzuti L., Chandy S. J., Chiarello M. M., Cillara N., Clarizia G., Cocuz M. -E., Cocuz I. G., Conti L., Coppola R., Cui Y., Czepiel J., D'Acapito F., Damaskos D., Das K., De Simone B., Delibegovic S., Demetrashvili Z., Detanac D. S., Dhingra S., Di Bella S., Dimitrov E. N., Dogjani A., D'Oria M., Dumitru I. M., Elmangory M. M., Enciu O., Fantoni M., Filipescu D., Fleres F., Foghetti D., Fransvea P., Gachabayov M., Galeiras R., Gattuso G., Ghannam W. M., Ghisetti V., Giraudo G., Gonfa K. B., Gonullu E., Hamad Y. T. E. Y., Hecker M., Isik A., Ismail N., Ismail A., Jain S. A., Kanj S. S., Kapoor G., Karaiskos I., Kavalakat A. J., Kenig J., Khamis F., Khokha V., Kiguba R., Kim J. I., Kobe Y., Kok K. Y. Y., Kovacevic B. M., Kryvoruchko I. A., Kuriyama A., Landaluce-Olavarria A., Lasithiotakis K., Lohsiriwat V., Lostoridis E., Luppi D., Vega G. M. M., Maegele M., Marinis A., Martines G., Martinez-Perez A., Massalou D., Mesina C., Metan G., Miranda-Novales M. G., Mishra S. K., Mohamed M. I. H., Mohamedahmed A. Y. Y., Mora-Guzman I., Mulita F., Musina A. -M., Navsaria P. H., Negoi I., Nita G. E., O'Connor D. B., Ordonez C. A., Pantalone D., Panyko A., Papadopoulos A., Pararas N., Pata F., Patel T., Pellino G., Perra T., Perrone G., Pesce A., Pintar T., Popivanov G. I., Porcu A., Quiodettis M. A., Rahim R., Mitul A. R., Reichert M., Rems M., Campbell G. Y. R., Rocha-Pereira N., Rodrigues G., Villamil G. E. R., Rossi S., Sall I., Kafil H. S., Sasia D., Seni J., Seretis C., Serradilla-Martin M., Shelat V. G., Siribumrungwong B., Slavchev M., Solaini L., Tan B. K., Tarasconi A., Tartaglia D., Toma E. A., Tomadze G., Toro A., Tovani-Palone M. R., van Goor H., Vasilescu A., Vereczkei A., Veroux M., Weckmann S. A., Widmer L. W., Yahya A. I., Zachariah S. K., Zakaria A. D., Zubareva N., Zuidema W. P., Di Carlo I., Cortese F., Baiocchi G. L., Maier R. V., and Catena F.

Abstract

Background: The objectives of the study were to investigate the organizational characteristics of acute care facilities worldwide in preventing and managing infections in surgery; assess participants’ perception regarding infection prevention and control (IPC) measures, antibiotic prescribing practices, and source control; describe awareness about the global burden of antimicrobial resistance (AMR) and IPC measures; and determine the role of the Coronavirus Disease 2019 pandemic on said awareness. Methods: A cross-sectional web-based survey was conducted contacting 1432 health care workers (HCWs) belonging to a mailing list provided by the Global Alliance for Infections in Surgery. The self-administered questionnaire was developed by a multidisciplinary team. The survey was open from May 22, 2021, and June 22, 2021. Three reminders were sent, after 7, 14, and 21 days. Results: Three hundred four respondents from 72 countries returned a questionnaire, with an overall response rate of 21.2%. Respectively, 90.4% and 68.8% of participants stated their hospital had a multidisciplinary IPC team or a multidisciplinary antimicrobial stewardship team. Local protocols for antimicrobial therapy of surgical infections and protocols for surgical antibiotic prophylaxis were present in 76.6% and 90.8% of hospitals, respectively. In 23.4% and 24.0% of hospitals no surveillance systems for surgical site infections and no monitoring systems of used antimicrobials were implemented. Patient and family involvement in IPC management was considered to be slightly or not important in their hospital by the majority of respondents (65.1%). Awareness of the global burden of AMR among HCWs was considered very important or important by 54.6% of participants. The COVID-19 pandemic was considered by 80.3% of respondents as a very important or important factor in raising HCWs awareness of the IPC programs in their hospital. Based on the survey results, the authors developed 15 statements for

Published
2022

2. It is time to define an organizational model for the prevention and management of infections along the surgical pathway: a worldwide cross-sectional survey

Author

Sartelli, M., Labricciosa, F. M., Coccolini, F., Coimbra, R., Abu-Zidan, F. M., Ansaloni, L., Al-Hasan, M. N., Ansari, S., Barie, P. S., Cainzos, M. A., Ceresoli, M., Chiarugi, M., Claridge, J. A., Cicuttin, E., Dellinger, E. P., Fry, D. E., Guirao, X., Hardcastle, T. C., Hecker, A., Leppaniemi, A. K., Litvin, A., Marwah, S., Maseda, E., Mazuski, J. E., Memish, Z. A., Kirkpatrick, A. W., Pagani, L., Podda, Maria Vittoria, Rasa, H. K., Sakakushev, B. E., Sawyer, R. G., Tumietto, F., Xiao, Y., Aboubreeg, W. F., Adamou, H., Akhmeteli, L., Akin, E., Alberio, M. G., Alconchel, F., Magagi, I. A., Arauz, A. B., Argenio, G., Atanasov, B. C., Atici, S. D., Awad, S. S., Baili, E., Bains, L., Bala, M., Baraket, O., Baral, S., Belskii, V. A., Benboubker, M., Ben-Ishay, O., Bordoni, P., Boumediene, A., Brisinda, Giuseppe, Cavazzuti, L., Chandy, S. J., Chiarello, M. M., Cillara, N., Clarizia, G., Cocuz, M. -E., Cocuz, I. G., Conti, L., Coppola, R., Cui, Y., Czepiel, J., D'Acapito, Fabrizio, Damaskos, D., Das, Anil Kumar, De Simone, B., Delibegovic, S., Demetrashvili, Z., Detanac, D. S., Dhingra, S., Di Bella, S., Dimitrov, E. N., Dogjani, A., D'Oria, M., Dumitru, I. M., Elmangory, M. M., Enciu, O., Fantoni, M., Filipescu, D., Fleres, F., Foghetti, D., Fransvea, Pietro, Gachabayov, M., Galeiras, R., Gattuso, G., Ghannam, W. M., Ghisetti, Valeria, Giraudo, G., Gonfa, K. B., Gonullu, E., Hamad, Y. T. E. Y., Hecker, M., Isik, A., Ismail, N., Ismail, A., Jain, S. A., Kanj, S. S., Kapoor, G., Karaiskos, I., Kavalakat, A. J., Kenig, J., Khamis, F., Khokha, V., Kiguba, R., Kim, J. I., Kobe, Y., Kok, K. Y. Y., Kovacevic, B. M., Kryvoruchko, I. A., Kuriyama, A., Landaluce-Olavarria, A., Lasithiotakis, K., Lohsiriwat, V., Lostoridis, E., Luppi, D., Vega, G. M. M., Maegele, M., Marinis, A., Martines, G., Martinez-Perez, A., Massalou, D., Mesina, C., Metan, G., Miranda-Novales, M. G., Mishra, S. K., Mohamed, M. I. H., Mohamedahmed, A. Y. Y., Mora-Guzman, I., Mulita, F., Musina, A. -M., Navsaria, P. H., Negoi, I., Nita, G. E., O'Connor, D. B., Ordonez, C. A., Pantalone, D., Panyko, A., Papadopoulos, A., Pararas, N., Pata, F., Patel, T., Pellino, Giuseppe, Perra, T., Perrone, G., Pesce, Antonio, Pintar, T., Popivanov, G. I., Porcu, A., Quiodettis, M. A., Rahim, R., Mitul, A. R., Reichert, M., Rems, M., Campbell, G. Y. R., Rocha-Pereira, N., Rodrigues, G., Villamil, G. E. R., Rossi, S., Sall, I., Kafil, H. S., Sasia, D., Seni, J., Seretis, C., Serradilla-Martin, M., Shelat, V. G., Siribumrungwong, B., Slavchev, M., Solaini, L., Tan, B. K., Tarasconi, A., Tartaglia, D., Toma, E. A., Tomadze, G., Toro, A., Tovani-Palone, M. R., van Goor, H., Vasilescu, A., Vereczkei, A., Veroux, M., Weckmann, S. A., Widmer, L. W., Yahya, A. I., Zachariah, S. K., Zakaria, A. D., Zubareva, N., Zuidema, W. P., Di Carlo, I., Cortese, Francesco, Baiocchi, G. L., Maier, R. V., Catena, F., Podda M. (ORCID:0000-0002-2779-8417), Brisinda G. (ORCID:0000-0001-8820-9471), D'Acapito F., Das K., Fransvea P. (ORCID:0000-0003-4969-3373), Ghisetti V., Pellino G., Pesce A., Cortese F., Sartelli, M., Labricciosa, F. M., Coccolini, F., Coimbra, R., Abu-Zidan, F. M., Ansaloni, L., Al-Hasan, M. N., Ansari, S., Barie, P. S., Cainzos, M. A., Ceresoli, M., Chiarugi, M., Claridge, J. A., Cicuttin, E., Dellinger, E. P., Fry, D. E., Guirao, X., Hardcastle, T. C., Hecker, A., Leppaniemi, A. K., Litvin, A., Marwah, S., Maseda, E., Mazuski, J. E., Memish, Z. A., Kirkpatrick, A. W., Pagani, L., Podda, Maria Vittoria, Rasa, H. K., Sakakushev, B. E., Sawyer, R. G., Tumietto, F., Xiao, Y., Aboubreeg, W. F., Adamou, H., Akhmeteli, L., Akin, E., Alberio, M. G., Alconchel, F., Magagi, I. A., Arauz, A. B., Argenio, G., Atanasov, B. C., Atici, S. D., Awad, S. S., Baili, E., Bains, L., Bala, M., Baraket, O., Baral, S., Belskii, V. A., Benboubker, M., Ben-Ishay, O., Bordoni, P., Boumediene, A., Brisinda, Giuseppe, Cavazzuti, L., Chandy, S. J., Chiarello, M. M., Cillara, N., Clarizia, G., Cocuz, M. -E., Cocuz, I. G., Conti, L., Coppola, R., Cui, Y., Czepiel, J., D'Acapito, Fabrizio, Damaskos, D., Das, Anil Kumar, De Simone, B., Delibegovic, S., Demetrashvili, Z., Detanac, D. S., Dhingra, S., Di Bella, S., Dimitrov, E. N., Dogjani, A., D'Oria, M., Dumitru, I. M., Elmangory, M. M., Enciu, O., Fantoni, M., Filipescu, D., Fleres, F., Foghetti, D., Fransvea, Pietro, Gachabayov, M., Galeiras, R., Gattuso, G., Ghannam, W. M., Ghisetti, Valeria, Giraudo, G., Gonfa, K. B., Gonullu, E., Hamad, Y. T. E. Y., Hecker, M., Isik, A., Ismail, N., Ismail, A., Jain, S. A., Kanj, S. S., Kapoor, G., Karaiskos, I., Kavalakat, A. J., Kenig, J., Khamis, F., Khokha, V., Kiguba, R., Kim, J. I., Kobe, Y., Kok, K. Y. Y., Kovacevic, B. M., Kryvoruchko, I. A., Kuriyama, A., Landaluce-Olavarria, A., Lasithiotakis, K., Lohsiriwat, V., Lostoridis, E., Luppi, D., Vega, G. M. M., Maegele, M., Marinis, A., Martines, G., Martinez-Perez, A., Massalou, D., Mesina, C., Metan, G., Miranda-Novales, M. G., Mishra, S. K., Mohamed, M. I. H., Mohamedahmed, A. Y. Y., Mora-Guzman, I., Mulita, F., Musina, A. -M., Navsaria, P. H., Negoi, I., Nita, G. E., O'Connor, D. B., Ordonez, C. A., Pantalone, D., Panyko, A., Papadopoulos, A., Pararas, N., Pata, F., Patel, T., Pellino, Giuseppe, Perra, T., Perrone, G., Pesce, Antonio, Pintar, T., Popivanov, G. I., Porcu, A., Quiodettis, M. A., Rahim, R., Mitul, A. R., Reichert, M., Rems, M., Campbell, G. Y. R., Rocha-Pereira, N., Rodrigues, G., Villamil, G. E. R., Rossi, S., Sall, I., Kafil, H. S., Sasia, D., Seni, J., Seretis, C., Serradilla-Martin, M., Shelat, V. G., Siribumrungwong, B., Slavchev, M., Solaini, L., Tan, B. K., Tarasconi, A., Tartaglia, D., Toma, E. A., Tomadze, G., Toro, A., Tovani-Palone, M. R., van Goor, H., Vasilescu, A., Vereczkei, A., Veroux, M., Weckmann, S. A., Widmer, L. W., Yahya, A. I., Zachariah, S. K., Zakaria, A. D., Zubareva, N., Zuidema, W. P., Di Carlo, I., Cortese, Francesco, Baiocchi, G. L., Maier, R. V., Catena, F., Podda M. (ORCID:0000-0002-2779-8417), Brisinda G. (ORCID:0000-0001-8820-9471), D'Acapito F., Das K., Fransvea P. (ORCID:0000-0003-4969-3373), Ghisetti V., Pellino G., Pesce A., and Cortese F.

Abstract

Background: The objectives of the study were to investigate the organizational characteristics of acute care facilities worldwide in preventing and managing infections in surgery; assess participants’ perception regarding infection prevention and control (IPC) measures, antibiotic prescribing practices, and source control; describe awareness about the global burden of antimicrobial resistance (AMR) and IPC measures; and determine the role of the Coronavirus Disease 2019 pandemic on said awareness. Methods: A cross-sectional web-based survey was conducted contacting 1432 health care workers (HCWs) belonging to a mailing list provided by the Global Alliance for Infections in Surgery. The self-administered questionnaire was developed by a multidisciplinary team. The survey was open from May 22, 2021, and June 22, 2021. Three reminders were sent, after 7, 14, and 21 days. Results: Three hundred four respondents from 72 countries returned a questionnaire, with an overall response rate of 21.2%. Respectively, 90.4% and 68.8% of participants stated their hospital had a multidisciplinary IPC team or a multidisciplinary antimicrobial stewardship team. Local protocols for antimicrobial therapy of surgical infections and protocols for surgical antibiotic prophylaxis were present in 76.6% and 90.8% of hospitals, respectively. In 23.4% and 24.0% of hospitals no surveillance systems for surgical site infections and no monitoring systems of used antimicrobials were implemented. Patient and family involvement in IPC management was considered to be slightly or not important in their hospital by the majority of respondents (65.1%). Awareness of the global burden of AMR among HCWs was considered very important or important by 54.6% of participants. The COVID-19 pandemic was considered by 80.3% of respondents as a very important or important factor in raising HCWs awareness of the IPC programs in their hospital. Based on the survey results, the authors developed 15 statements for

Published
2022

6. It is time to define an organizational model for the prevention and management of infections along the surgical pathway : a worldwide cross-sectional survey

Author

Massimo Sartelli, Francesco M. Labricciosa, Federico Coccolini, Raul Coimbra, Fikri M. Abu-Zidan, Luca Ansaloni, Majdi N. Al-Hasan, Shamshul Ansari, Philip S. Barie, Miguel Angel Caínzos, Marco Ceresoli, Massimo Chiarugi, Jeffrey A. Claridge, Enrico Cicuttin, Evan Patchen Dellinger, Donald E. Fry, Xavier Guirao, Timothy Craig Hardcastle, Andreas Hecker, Ari K. Leppäniemi, Andrey Litvin, Sanjay Marwah, Emilio Maseda, John E. Mazuski, Ziad Ahmed Memish, Andrew W. Kirkpatrick, Leonardo Pagani, Mauro Podda, Huseyin Kemal Rasa, Boris E. Sakakushev, Robert G. Sawyer, Fabio Tumietto, Yonghong Xiao, Wedad Faraj Aboubreeg, Harissou Adamou, Lali Akhmeteli, Emrah Akin, Maria Grazia Alberio, Felipe Alconchel, Ibrahim Amadou Magagi, Ana Belén Araúz, Giulio Argenio, Boyko C. Atanasov, Semra Demirli Atici, Selmy Sabry Awad, Efstratia Baili, Lovenish Bains, Miklosh Bala, Oussama Baraket, Suman Baral, Vladislav A. Belskii, Moussa Benboubker, Offir Ben-Ishay, Pierpaolo Bordoni, Abdalia Boumédiène, Giuseppe Brisinda, Laura Cavazzuti, Sujith J. Chandy, Maria Michela Chiarello, Nicola Cillara, Guglielmo Clarizia, Maria-Elena Cocuz, Iuliu Gabriel Cocuz, Luigi Conti, Raffaella Coppola, Yunfeng Cui, Jacek Czepiel, Fabrizio D’Acapito, Dimitrios Damaskos, Koray Das, Belinda De Simone, Samir Delibegovic, Zaza Demetrashvili, Dzemail S. Detanac, Sameer Dhingra, Stefano Di Bella, Evgeni N. Dimitrov, Agron Dogjani, Mario D’Oria, Irina Magdalena Dumitru, Mutasim M. Elmangory, Octavian Enciu, Massimo Fantoni, Daniela Filipescu, Francesco Fleres, Domitilla Foghetti, Pietro Fransvea, Mahir Gachabayov, Rita Galeiras, Gianni Gattuso, Wagih M. Ghannam, Valeria Ghisetti, Giorgio Giraudo, Kebebe Bekele Gonfa, Emre Gonullu, Yousif Tag Elsir Y. Hamad, Matthias Hecker, Arda Isik, Nizar Ismail, Azzain Ismail, Sumita Agarwal Jain, Souha S. Kanj, Garima Kapoor, Ilias Karaiskos, Alfie J. Kavalakat, Jakub Kenig, Faryal Khamis, Vladimir Khokha, Ronald Kiguba, Jae Il Kim, Yoshiro Kobe, Kenneth Yuh Yen Kok, Bojan M. Kovacevic, Igor Andreevich Kryvoruchko, Akira Kuriyama, Aitor Landaluce-Olavarria, Konstantinos Lasithiotakis, Varut Lohsiriwat, Eftychios Lostoridis, Davide Luppi, Gustavo Miguel Machain Vega, Marc Maegele, Athanasios Marinis, Gennaro Martines, Aleix Martínez-Pérez, Damien Massalou, Cristian Mesina, Gökhan Metan, María Guadalupe Miranda-Novales, Shyam Kumar Mishra, Mohaned Ibrahim Hussein Mohamed, Ali Yasen Y. Mohamedahmed, Ismael Mora-Guzmán, Francesk Mulita, Ana-Maria Musina, Pradeep H. Navsaria, Ionut Negoi, Gabriela Elisa Nita, Donal B. O’Connor, Carlos Alberto Ordoñez, Desiré Pantalone, Arpád Panyko, Aristeidis Papadopoulos, Nikolaos Pararas, Francesco Pata, Tapan Patel, Gianluca Pellino, Teresa Perra, Gennaro Perrone, Antonio Pesce, Tadeja Pintar, Georgi Ivanov Popivanov, Alberto Porcu, Martha Alexa Quiodettis, Razrim Rahim, Ashrarur Rahman Mitul, Martin Reichert, Miran Rems, Glendee Yolande Reynolds Campbell, Nuno Rocha-Pereira, Gabriel Rodrigues, Gustavo Eduardo Roncancio Villamil, Stefano Rossi, Ibrahima Sall, Hossein Samadi Kafil, Diego Sasia, Jeremiah Seni, Charalampos Seretis, Mario Serradilla-Martín, Vishal G. Shelat, Boonying Siribumrungwong, Mihail Slavchev, Leonardo Solaini, Boun Kim Tan, Antonio Tarasconi, Dario Tartaglia, Elena Adelina Toma, Gia Tomadze, Adriana Toro, Marcos Roberto Tovani-Palone, Harry van Goor, Alin Vasilescu, Andras Vereczkei, Massimiliano Veroux, Sergio Alberto Weckmann, Lukas Werner Widmer, AliIbrahim Yahya, Sanoop K. Zachariah, Andee Dzulkarnaen Zakaria, Nadezhda Zubareva, Wietse P. Zuidema, Isidoro Di Carlo, Francesco Cortese, Gian Luca Baiocchi, Ronald V. Maier, Fausto Catena, Surgery, Other Research, AMS - Musculoskeletal Health, APH - Quality of Care, HUS Abdominal Center, II kirurgian klinikka, Sartelli M., Labricciosa F.M., Coccolini F., Coimbra R., Abu-Zidan F.M., Ansaloni L., Al-Hasan M.N., Ansari S., Barie P.S., Cainzos M.A., Ceresoli M., Chiarugi M., Claridge J.A., Cicuttin E., Dellinger E.P., Fry D.E., Guirao X., Hardcastle T.C., Hecker A., Leppaniemi A.K., Litvin A., Marwah S., Maseda E., Mazuski J.E., Memish Z.A., Kirkpatrick A.W., Pagani L., Podda M., Rasa H.K., Sakakushev B.E., Sawyer R.G., Tumietto F., Xiao Y., Aboubreeg W.F., Adamou H., Akhmeteli L., Akin E., Alberio M.G., Alconchel F., Magagi I.A., Arauz A.B., Argenio G., Atanasov B.C., Atici S.D., Awad S.S., Baili E., Bains L., Bala M., Baraket O., Baral S., Belskii V.A., Benboubker M., Ben-Ishay O., Bordoni P., Boumediene A., Brisinda G., Cavazzuti L., Chandy S.J., Chiarello M.M., Cillara N., Clarizia G., Cocuz M.-E., Cocuz I.G., Conti L., Coppola R., Cui Y., Czepiel J., D'Acapito F., Damaskos D., Das K., De Simone B., Delibegovic S., Demetrashvili Z., Detanac D.S., Dhingra S., Di Bella S., Dimitrov E.N., Dogjani A., D'Oria M., Dumitru I.M., Elmangory M.M., Enciu O., Fantoni M., Filipescu D., Fleres F., Foghetti D., Fransvea P., Gachabayov M., Galeiras R., Gattuso G., Ghannam W.M., Ghisetti V., Giraudo G., Gonfa K.B., Gonullu E., Hamad Y.T.E.Y., Hecker M., Isik A., Ismail N., Ismail A., Jain S.A., Kanj S.S., Kapoor G., Karaiskos I., Kavalakat A.J., Kenig J., Khamis F., Khokha V., Kiguba R., Kim J.I., Kobe Y., Kok K.Y.Y., Kovacevic B.M., Kryvoruchko I.A., Kuriyama A., Landaluce-Olavarria A., Lasithiotakis K., Lohsiriwat V., Lostoridis E., Luppi D., Vega G.M.M., Maegele M., Marinis A., Martines G., Martinez-Perez A., Massalou D., Mesina C., Metan G., Miranda-Novales M.G., Mishra S.K., Mohamed M.I.H., Mohamedahmed A.Y.Y., Mora-Guzman I., Mulita F., Musina A.-M., Navsaria P.H., Negoi I., Nita G.E., O'Connor D.B., Ordonez C.A., Pantalone D., Panyko A., Papadopoulos A., Pararas N., Pata F., Patel T., Pellino G., Perra T., Perrone G., Pesce A., Pintar T., Popivanov G.I., Porcu A., Quiodettis M.A., Rahim R., Mitul A.R., Reichert M., Rems M., Campbell G.Y.R., Rocha-Pereira N., Rodrigues G., Villamil G.E.R., Rossi S., Sall I., Kafil H.S., Sasia D., Seni J., Seretis C., Serradilla-Martin M., Shelat V.G., Siribumrungwong B., Slavchev M., Solaini L., Tan B.K., Tarasconi A., Tartaglia D., Toma E.A., Tomadze G., Toro A., Tovani-Palone M.R., van Goor H., Vasilescu A., Vereczkei A., Veroux M., Weckmann S.A., Widmer L.W., Yahya A.I., Zachariah S.K., Zakaria A.D., Zubareva N., Zuidema W.P., Di Carlo I., Cortese F., Baiocchi G.L., Maier R.V., Catena F., Sartelli, M, Labricciosa, F, Coccolini, F, Coimbra, R, Abu-Zidan, F, Ansaloni, L, Al-Hasan, M, Ansari, S, Barie, P, Cainzos, M, Ceresoli, M, Chiarugi, M, Claridge, J, Cicuttin, E, Dellinger, E, Fry, D, Guirao, X, Hardcastle, T, Hecker, A, Leppaniemi, A, Litvin, A, Marwah, S, Maseda, E, Mazuski, J, Memish, Z, Kirkpatrick, A, Pagani, L, Podda, M, Rasa, H, Sakakushev, B, Sawyer, R, Tumietto, F, Xiao, Y, Aboubreeg, W, Adamou, H, Akhmeteli, L, Akin, E, Alberio, M, Alconchel, F, Magagi, I, Arauz, A, Argenio, G, Atanasov, B, Atici, S, Awad, S, Baili, E, Bains, L, Bala, M, Baraket, O, Baral, S, Belskii, V, Benboubker, M, Ben-Ishay, O, Bordoni, P, Boumediene, A, Brisinda, G, Cavazzuti, L, Chandy, S, Chiarello, M, Cillara, N, Clarizia, G, Cocuz, M, Cocuz, I, Conti, L, Coppola, R, Cui, Y, Czepiel, J, D'Acapito, F, Damaskos, D, Das, K, De Simone, B, Delibegovic, S, Demetrashvili, Z, Detanac, D, Dhingra, S, Di Bella, S, Dimitrov, E, Dogjani, A, D'Oria, M, Dumitru, I, Elmangory, M, Enciu, O, Fantoni, M, Filipescu, D, Fleres, F, Foghetti, D, Fransvea, P, Gachabayov, M, Galeiras, R, Gattuso, G, Ghannam, W, Ghisetti, V, Giraudo, G, Gonfa, K, Gonullu, E, Hamad, Y, Hecker, M, Isik, A, Ismail, N, Ismail, A, Jain, S, Kanj, S, Kapoor, G, Karaiskos, I, Kavalakat, A, Kenig, J, Khamis, F, Khokha, V, Kiguba, R, Kim, J, Kobe, Y, Kok, K, Kovacevic, B, Kryvoruchko, I, Kuriyama, A, Landaluce-Olavarria, A, Lasithiotakis, K, Lohsiriwat, V, Lostoridis, E, Luppi, D, Vega, G, Maegele, M, Marinis, A, Martines, G, Martinez-Perez, A, Massalou, D, Mesina, C, Metan, G, Miranda-Novales, M, Mishra, S, Mohamed, M, Mohamedahmed, A, Mora-Guzman, I, Mulita, F, Musina, A, Navsaria, P, Negoi, I, Nita, G, O'Connor, D, Ordonez, C, Pantalone, D, Panyko, A, Papadopoulos, A, Pararas, N, Pata, F, Patel, T, Pellino, G, Perra, T, Perrone, G, Pesce, A, Pintar, T, Popivanov, G, Porcu, A, Quiodettis, M, Rahim, R, Mitul, A, Reichert, M, Rems, M, Campbell, G, Rocha-Pereira, N, Rodrigues, G, Villamil, G, Rossi, S, Sall, I, Kafil, H, Sasia, D, Seni, J, Seretis, C, Serradilla-Martin, M, Shelat, V, Siribumrungwong, B, Slavchev, M, Solaini, L, Tan, B, Tarasconi, A, Tartaglia, D, Toma, E, Tomadze, G, Toro, A, Tovani-Palone, M, van Goor, H, Vasilescu, A, Vereczkei, A, Veroux, M, Weckmann, S, Widmer, L, Yahya, A, Zachariah, S, Zakaria, A, Zubareva, N, Zuidema, W, Di Carlo, I, Cortese, F, Baiocchi, G, Maier, R, Catena, F, Sartelli, Massimo, Labricciosa, Francesco M, Coccolini, Federico, Coimbra, Raul, Abu-Zidan, Fikri M, Ansaloni, Luca, Al-Hasan, Majdi N, Ansari, Shamshul, Barie, Philip S, Caínzos, Miguel Angel, Ceresoli, Marco, Chiarugi, Massimo, Claridge, Jeffrey A, Cicuttin, Enrico, Dellinger, Evan Patchen, Fry, Donald E, Guirao, Xavier, Hardcastle, Timothy Craig, Hecker, Andrea, Leppäniemi, Ari K, Litvin, Andrey, Marwah, Sanjay, Maseda, Emilio, Mazuski, John E, Memish, Ziad Ahmed, Kirkpatrick, Andrew W, Pagani, Leonardo, Podda, Mauro, Rasa, Huseyin Kemal, Sakakushev, Boris E, Sawyer, Robert G, Tumietto, Fabio, Xiao, Yonghong, Aboubreeg, Wedad Faraj, Adamou, Harissou, Akhmeteli, Lali, Akin, Emrah, Alberio, Maria Grazia, Alconchel, Felipe, Magagi, Ibrahim Amadou, Araúz, Ana Belén, Argenio, Giulio, Atanasov, Boyko C, Atici, Semra Demirli, Awad, Selmy Sabry, Baili, Efstratia, Bains, Lovenish, Bala, Miklosh, Baraket, Oussama, Baral, Suman, Belskii, Vladislav A, Benboubker, Moussa, Ben-Ishay, Offir, Bordoni, Pierpaolo, Boumédiène, Abdalia, Brisinda, Giuseppe, Cavazzuti, Laura, Chandy, Sujith J, Chiarello, Maria Michela, Cillara, Nicola, Clarizia, Guglielmo, Cocuz, Maria-Elena, Cocuz, Iuliu Gabriel, Conti, Luigi, Coppola, Raffaella, Cui, Yunfeng, Czepiel, Jacek, D'Acapito, Fabrizio, Damaskos, Dimitrio, Das, Koray, De Simone, Belinda, Delibegovic, Samir, Demetrashvili, Zaza, Detanac, Dzemail S, Dhingra, Sameer, Di Bella, Stefano, Dimitrov, Evgeni N, Dogjani, Agron, D'Oria, Mario, Dumitru, Irina Magdalena, Elmangory, Mutasim M, Enciu, Octavian, Fantoni, Massimo, Filipescu, Daniela, Fleres, Francesco, Foghetti, Domitilla, Fransvea, Pietro, Gachabayov, Mahir, Galeiras, Rita, Gattuso, Gianni, Ghannam, Wagih M, Ghisetti, Valeria, Giraudo, Giorgio, Gonfa, Kebebe Bekele, Gonullu, Emre, Hamad, Yousif Tag Elsir Y, Hecker, Matthia, Isik, Arda, Ismail, Nizar, Ismail, Azzain, Jain, Sumita Agarwal, Kanj, Souha S, Kapoor, Garima, Karaiskos, Ilia, Kavalakat, Alfie J, Kenig, Jakub, Khamis, Faryal, Khokha, Vladimir, Kiguba, Ronald, Kim, Jae Il, Kobe, Yoshiro, Kok, Kenneth Yuh Yen, Kovacevic, Bojan M, Kryvoruchko, Igor Andreevich, Kuriyama, Akira, Landaluce-Olavarria, Aitor, Lasithiotakis, Konstantino, Lohsiriwat, Varut, Lostoridis, Eftychio, Luppi, Davide, Vega, Gustavo Miguel Machain, Maegele, Marc, Marinis, Athanasio, Martines, Gennaro, Martínez-Pérez, Aleix, Massalou, Damien, Mesina, Cristian, Metan, Gökhan, Miranda-Novales, María Guadalupe, Mishra, Shyam Kumar, Mohamed, Mohaned Ibrahim Hussein, Mohamedahmed, Ali Yasen Y, Mora-Guzmán, Ismael, Mulita, Francesk, Musina, Ana-Maria, Navsaria, Pradeep H, Negoi, Ionut, Nita, Gabriela Elisa, O'Connor, Donal B, Ordoñez, Carlos Alberto, Pantalone, Desiré, Panyko, Arpád, Papadopoulos, Aristeidi, Pararas, Nikolao, Pata, Francesco, Patel, Tapan, Pellino, Gianluca, Perra, Teresa, Perrone, Gennaro, Pesce, Antonio, Pintar, Tadeja, Popivanov, Georgi Ivanov, Porcu, Alberto, Quiodettis, Martha Alexa, Rahim, Razrim, Mitul, Ashrarur Rahman, Reichert, Martin, Rems, Miran, Campbell, Glendee Yolande Reynold, Rocha-Pereira, Nuno, Rodrigues, Gabriel, Villamil, Gustavo Eduardo Roncancio, Rossi, Stefano, Sall, Ibrahima, Kafil, Hossein Samadi, Sasia, Diego, Seni, Jeremiah, Seretis, Charalampo, Serradilla-Martín, Mario, Shelat, Vishal G, Siribumrungwong, Boonying, Slavchev, Mihail, Solaini, Leonardo, Tan, Boun Kim, Tarasconi, Antonio, Tartaglia, Dario, Toma, Elena Adelina, Tomadze, Gia, Toro, Adriana, Tovani-Palone, Marcos Roberto, van Goor, Harry, Vasilescu, Alin, Vereczkei, Andra, Veroux, Massimiliano, Weckmann, Sergio Alberto, Widmer, Lukas Werner, Yahya, Aliibrahim, Zachariah, Sanoop K, Zakaria, Andee Dzulkarnaen, Zubareva, Nadezhda, Zuidema, Wietse P, Di Carlo, Isidoro, Cortese, Francesco, Baiocchi, Gian Luca, Maier, Ronald V, Catena, Fausto, Department of Medicine, and Faculty of Health Sciences

Subjects
Anti-Infective Agent, Infection prevention and control, Antibiotic resistance, Settore MED/18 - CHIRURGIA GENERALE, 610 Medicine & health, Antimicrobial stewardship, Cross-sectional survey, Antimicrobial stewardship, Antibiotic prescribing, Antibiotic resistance, Infection prevention and control, Organizational, Antibiotic prescribing, Cross-sectional survey, Anti-Infective Agents, Models, Anti-Bacterial Agent, Humans, Pandemics, Cross-Sectional Studie, ANTIMICROBIAL RESISTANCE, Pandemic, COVID-19, 3126 Surgery, anesthesiology, intensive care, radiology, Anti-Bacterial Agents, Reconstructive and regenerative medicine Radboud Institute for Health Sciences [Radboudumc 10], Cross-Sectional Studies, Models, Organizational, HEALTH-CARE, Emergency Medicine, Surgery, Human
Abstract

Background The objectives of the study were to investigate the organizational characteristics of acute care facilities worldwide in preventing and managing infections in surgery; assess participants’ perception regarding infection prevention and control (IPC) measures, antibiotic prescribing practices, and source control; describe awareness about the global burden of antimicrobial resistance (AMR) and IPC measures; and determine the role of the Coronavirus Disease 2019 pandemic on said awareness. Methods A cross-sectional web-based survey was conducted contacting 1432 health care workers (HCWs) belonging to a mailing list provided by the Global Alliance for Infections in Surgery. The self-administered questionnaire was developed by a multidisciplinary team. The survey was open from May 22, 2021, and June 22, 2021. Three reminders were sent, after 7, 14, and 21 days. Results Three hundred four respondents from 72 countries returned a questionnaire, with an overall response rate of 21.2%. Respectively, 90.4% and 68.8% of participants stated their hospital had a multidisciplinary IPC team or a multidisciplinary antimicrobial stewardship team. Local protocols for antimicrobial therapy of surgical infections and protocols for surgical antibiotic prophylaxis were present in 76.6% and 90.8% of hospitals, respectively. In 23.4% and 24.0% of hospitals no surveillance systems for surgical site infections and no monitoring systems of used antimicrobials were implemented. Patient and family involvement in IPC management was considered to be slightly or not important in their hospital by the majority of respondents (65.1%). Awareness of the global burden of AMR among HCWs was considered very important or important by 54.6% of participants. The COVID-19 pandemic was considered by 80.3% of respondents as a very important or important factor in raising HCWs awareness of the IPC programs in their hospital. Based on the survey results, the authors developed 15 statements for several questions regarding the prevention and management of infections in surgery. The statements may be the starting point for designing future evidence-based recommendations. Conclusion Adequacy of prevention and management of infections in acute care facilities depends on HCWs behaviours and on the organizational characteristics of acute health care facilities to support best practices and promote behavioural change. Patient involvement in the implementation of IPC is still little considered. A debate on how operationalising a fundamental change to IPC, from being solely the HCWs responsibility to one that involves a collaborative relationship between HCWs and patients, should be opened.

Published
2022
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7. [Congenital rubella syndrome in infants treated at a pediatrics hospital].

Author

Solórzano-Santos F, López-Kirwan A, Alvarez y Muñoz MT, Miranda-Novales MG, Gadea-Alvarez T, and Vázquez-Rosales G

Subjects
Female, Hospitals, Pediatric, Humans, Infant, Male, Mexico, Retrospective Studies, Rubella Syndrome, Congenital diagnosis
Abstract

Unlabelled: Congenital rubella syndrome (CRS) has been considered an uncommon problem in Mexico., Objective: To analyze and describe clinical features of CRS cases in infants from a pediatric hospital in Mexico City during an 8 year period., Design: retrospective study. Patients younger than 18 months of age with a positive serologic test for IgG and IgM rubella antibodies were included. Antibodies were measured by an immunoenzymatic microparticles assay., Results: Fifty-six cases were identified, 42 complete clinical records were available for review. Of these, 23 (54.7%) were female and 19 (45.3%) male. Median for age was five months. A total of 9/42 mothers (21%) had history of rash during pregnancy. IgM antibodies were detected in 15 infants and IgG in 27. Major manifestations were ocular (74%), neurologic (66%), and congenital heart disease (67%). Congenital cataracts were detected in 69%, in 52% hepatomegaly, in 43% jaundice, in 40% anemia, in 48% thrombocytopenia, and hearing loss 19%., Conclusion: Five confirmed cases with CRS per year in one hospital indicate a high frequency. Only a small percentage of women had a history of rash during pregnancy. CRS must be investigated in infants with ocular, neurologic, and congenital heart diseases.

Published
2001

8. [Prevalence of Moraxella catarrhalis colonization in asymptomatic carriers under 6 years of age].

Author

Leaños-Miranda B, Miranda-Novales MG, Solórzano-Santos F, Ortiz-Ocampo L, and Guiscafré-Gallardo H

Subjects
Age Distribution, Carrier State microbiology, Child, Preschool, Confidence Intervals, Cross-Sectional Studies, Female, Humans, Infant, Male, Mexico epidemiology, Microbial Sensitivity Tests, Moraxella catarrhalis drug effects, Neisseriaceae Infections microbiology, Prevalence, Sex Distribution, Carrier State epidemiology, Moraxella catarrhalis isolation & purification, Neisseriaceae Infections epidemiology
Abstract

Objective: To determine the prevalence of upper respiratory tract colonization by Moraxella catarrhalis in children under six years of age., Material and Methods: A survey was conducted between January and December 1998 in Mexico City, among children aged 2 months to 5 years, selected through cluster sampling. Pharyngeal samples were taken for M. catarrhalis identification. The minimal inhibitory concentration to different antibiotics was obtained and beta-lactamases were determined by the iodometric test. Statistical analysis consisted of frequency distributions, odds ratios, 95% confidence intervals, and Mantel-Haenszel chi 2. Statistical significance was set at p < 0.05., Results: After excluding 37 children, the study population was 604 children from Mexico City; M. catarrhalis was present in 130 pharyngeal specimens (22.9%). Most of the strains were positive for beta-lactamase production (75.4%). Eighty percent of the strains was resistant to penicillin and 70% to ampicillin and amoxicillin. None were resistant to cefotaxime, imipenem, meropenem and erythromycin., Conclusions: Prevalence of M. catarrhalis upper respiratory tract colonization is similar to that of other respiratory pathogens. These findings warrant future research on the role of M. catarrhalis as an etiologic agent in acute and chronic respiratory infections in Mexico.

Published
2001

9. [Cryptosporidium parvum infection in malnourished and non malnourished children without diarrhea in a Mexican rural population].

Author

Solórzano-Santos F, Penagos-Paniagua M, Meneses-Esquivel R, Miranda-Novales MG, Leaños-Miranda B, Angulo-González D, and Fajardo-Gutiérrez A

Subjects
Animals, Child, Child, Preschool, Cryptosporidiosis epidemiology, Cryptosporidium parvum, Diarrhea, Infantile complications, Female, Humans, Infant, Male, Mexico, Rural Population, Cryptosporidiosis complications, Nutrition Disorders complications
Abstract

Unlabelled: Cryptosporidium parvum is associated with diarrheic disease and mainly affects children and immunocompromised hosts. In most of the cases, cryptosporidiosis infection is asymptomatic in immunocompetent subjects. The objectives of the study were to determine the frequency of asymptomatic infection caused by the parasite in children with and without malnutrition and to determine the risk factors associated to infection., Methods: Children from one to fifteen years old without diarrhea were included, somatometry were performed. The socioeconomic and sanitary conditions were investigated for each family and community. The Faust method and Kinyoun stain were employed identify parasites and Cryptosporidium parvum in feces. Odds ratio (OR), 95% confidence intervals (75% CI), chi 2 Mantel-Haenszel, Fisher exact test and chi 2 trends were calculated., Results: One hundred thirty two children were included. In 10/132 (7.5%) cysts of Cryptosporidium were found, 7/71 in children with malnutrition (9.8%) and 3/61 without malnutrition (4.9%) p = 0.23. 69.7% of the children had parasitosis. According to the presence of C. parvum in feces, the different factors calculated were: Diarrhea in family OR = 5.82 (95%IC 0.86-39.18), not hand washing OR = 5.08 (95%IC 0.62-110.49), age less than 5 years old OR = 4.90 (95%IC 0.60-106.9), drinking non-potable water OR = 3.34 (95%IC 0.40-73.01) and malnutrition 2.11 (95%IC 0.46-10.89). Association was found between the number of people in the same house and the risk of infection (p = 0.005). The presence of diarrhea in the family (OR = 4.15, 95%IC 0.47-36.91) and drinking non-potable water (OR = 4.19, 95%IC 0.48-36.32) were the significant factors in the regression logistic model., Conclusions: The frequency of Cryptosporidium infection were 7.5%. Diarrhea in the family, overcrowding and drinking non-potable water were associated with C. parvum infection, malnutrition was not a significant risk factor.

Published
2000

10. [Nosocomial infections. Experience at a third-level pediatric hospital].

Author

Díaz-Ramos RD, Solórzano-Santos F, Padilla-Barrón G, Miranda-Novales MG, González-Robledo R, and Trejo y Pérez JA

Subjects
Adolescent, Age Factors, Child, Child, Preschool, Cohort Studies, Hospital Bed Capacity, 100 to 299, Hospitals, Pediatric, Humans, Infant, Infant, Newborn, Mexico epidemiology, Cross Infection epidemiology
Abstract

Objective: To describe the results of an epidemiologic surveillance program, from 1990 to the first semester of 1997, in a new high-specialty pediatric hospital and perform a comparison with previous reports., Material and Methods: The total number and type of nosocomial infections, the incidence rate and density incidence for department and division, for different age groups and according to immune statues were registered., Results: The global incidence of nosocomial infections during the period was 25.7 per 100 discharges, with a progressive decrease during the last three years. Although immunocompromised patients had more infections than immunocompetent ones, the difference was not significative. The three most common infections were: pneumonia, vascular line infections and upper respiratory tract infections. It is possible that upper respiratory tract infections are contributing to the elevation of global incidence rates of nosocomial infections., Conclusions: The change of infection epidemiology regarding previous experience has led to the implementation of programs to prevent the most frequent problems. It is necessary to intensify the different prevention programs and to increase their reach in order to cut down costs in a short term.

Published
1999

11. Empirical antimicrobial therapy in pediatric patients with neutropenia and fever. Risk factors for treatment failure.

Author

Miranda-Novales MG, Belmont-Martinez L, Villasis-Keever MA, Penagos-Paniagua M, Bernaldez-Rios R, and Solorzano-Santos F

Subjects
Amikacin administration & dosage, Anti-Bacterial Agents administration & dosage, Anti-Bacterial Agents therapeutic use, Carbenicillin administration & dosage, Ceftazidime administration & dosage, Child, Drug Therapy, Combination, Fever complications, Humans, Neutropenia complications, Risk Factors, Treatment Failure, Amikacin therapeutic use, Carbenicillin therapeutic use, Ceftazidime therapeutic use, Fever drug therapy, Neutropenia drug therapy
Abstract

Background: The use of combinations of antibiotics has been the cornerstone of therapy for febrile patients with cancer and severe neutropenia. Each empirical regimen should be selected according to the epidemiology and susceptibility patterns in each center. We describe here the experience with empirical antimicrobial treatments in pediatric patients with cancer, fever and severe neutropenia, and identify the risk factors associated with treatment failure., Methods: This is a prospective study including 145 patients with cancer, and 171 episodes of neutropenia and fever. Blood cultures were taken before initiating empirical treatment: a) carbenicillin (400 mg/kg/day) plus amikacin (21 mg/kg/day) (Cb/ak), and b) ceftazidime (100 mg/kg/day), plus amikacin at the same dosage (Cz/ak)., Results: The overall response rate was 54.9% and 56.3% for Cb/ak and Cz/ak, respectively. Fifty-seven episodes (33.3%) were microbiologically documented, gram-positive isolated in 38% and gram-negative in 49%. Risk factors associated significantly with treatment failure were acute myelocytic leukemia (AML) (RR 2.59, CI 95% 1.42-4.7, p = 0.003); bacteriological identification (RR = 4.41, CI 95% 2.21-8.8, p < 0.001), and the presence of two or more sites of infection (RR = 2.89, CI 95% 1.03-8.11, p = 0.03)., Conclusions: The rates of response are similar to the combinations used in the hospital (Cb/ak, Cz/ak). The risk factors associated with treatment failure were AML diagnosis, bacteriological identification, and the presence of two or more sites of infection.

Published
1998

12. [Resistance of respiratory and enteral bacteria to antibiotics].

Author

Solórzano-Santos F and Miranda-Novales MG

Subjects
Adult, Ampicillin pharmacology, Ampicillin Resistance, Animals, Campylobacter jejuni drug effects, Child, Preschool, Clostridioides difficile drug effects, Diarrhea microbiology, Drug Resistance, Microbial, Drug Resistance, Multiple, Escherichia coli drug effects, Haemophilus influenzae drug effects, Humans, Infant, Penicillin Resistance, Penicillins pharmacology, Salmonella typhi drug effects, Salmonella typhimurium drug effects, Shigella drug effects, Shigella dysenteriae drug effects, Streptococcus pneumoniae drug effects, Streptococcus pyogenes drug effects, Vibrio cholerae drug effects, Anti-Bacterial Agents pharmacology, Bacteria drug effects, Intestines microbiology, Respiratory System microbiology
Published
1998

13. [Case-control study of an outbreak of S. marcescens in a neonatal intensive care unit].

Author

Miranda-Novales MG, Gordillo-Pérez MG, Solórzano-Santos F, Leaños-Miranda B, Villasís-Keever MA, and Villegas-Silva R

Subjects
Anti-Bacterial Agents therapeutic use, Bacteremia microbiology, Case-Control Studies, Catheterization, Central Venous, Female, Humans, Immunocompromised Host, Infant, Newborn, Male, Mexico epidemiology, Multivariate Analysis, Nebulizers and Vaporizers, Odds Ratio, Parenteral Nutrition, Total, Prevalence, Respiration, Artificial, Risk Factors, Bacteremia epidemiology, Disease Outbreaks, Intensive Care Units, Neonatal, Serratia Infections epidemiology, Serratia marcescens
Abstract

Objective: To analyze an outbreak of Serratia marcescens in a neonatal intensive care unit and identify the risk factors associated to the development of infection., Material and Methods: It was a case-control study from March to July 1995. Factors included were age, sex, intravascular devices, nebulizers, mechanical ventilation, use of total parenteral nutrition (TPN), underlying diseases, surgical interventions, tubes, previous antimicrobial treatment and days of exposure. The associations were explored using the odds ratio., Results: 24 cases and 30 controls were included. In the univariate analysis the significant risk factors (OR,IC) were use of central venous catheter (4.57, 1.01-23.5), days of use of TPN (4.38, 1.03-16.5), days of previous antimicrobial treatment (4.87, 1.60-22) and days of exposure (2.7, 2.65-27.6). In the multivariate analysis the significant risk factors were previous antimicrobial treatment (3.98, 2.36-18.2), days of previous antimicrobial treatment (6.76, 3.02-24.6) and days of use of TPN (4.87, 1.67-15.6)., Conclusions: The significant risk factors in our study were previous antimicrobial treatment, days of antimicrobial and days of use of TPN.

Published
1998

14. A blood micro-culture system for the diagnosis of bacteremia in pediatric patients.

Author

Solorzano-Santos F, Miranda-Novales MG, Leanos-Miranda B, Diaz-Ponce H, and Palacios-Saucedo G

Subjects
Bacteremia blood, Bacterial Typing Techniques, Blood microbiology, Blood Specimen Collection, Culture Media, Humans, Infant, Infant, Newborn, Sensitivity and Specificity, Bacteremia diagnosis, Bacteriological Techniques
Abstract

The aim of this study was to evaluate the utility of a volume-modified blood culture system to diagnose bacteremia in newborns and infants. A total of 793 paired blood cultures, obtained from 464 patients (173 newborns and 291 infants), were analyzed. Vacutainer tubes containing 18 ml supplemented peptone broth sodium-polyanethol-sulfonate were used as the gold standard, in comparison with a blood micro-culture system containing 1.8 ml of the broth. Prior to antibiotic treatment, 2.2 ml of blood was obtained from each patient; 0.2 ml was inoculated in a blood micro-culture tube and 2 ml in a routine tube. Sensitivity, specificity and predictive values were calculated. Microorganisms were isolated in 153 standard blood culture tubes and 151 blood micro-culture tubes. The sensitivity of the blood micro-culture system was 95%, specificity 99% and positive and negative predictive values 96% and 99% respectively. The sensitivity and specificity of blood micro-culture in neonates and infants is high. We recommend that this system be used for the diagnosis of bacteremia in newborns and infants in laboratories where manual systems are still in use.

Published
1998
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15. Streptococcus pneumoniae: low frequency of penicillin resistance and high resistance to trimethoprim-sulfamethoxazole in nasopharyngeal isolates from children in a rural area in Mexico.

Author

Miranda Novales MG, Solorzano Santos F, Guiscafre Gallardo H, Leaños Miranda B, Echaniz Aviles G, Carnalla Barajas MN, Palafox Torres M, and Muñoz Hernandez O

Subjects
Child, Preschool, Cross-Sectional Studies, Humans, Infant, Microbial Sensitivity Tests, Anti-Bacterial Agents pharmacology, Nasopharynx microbiology, Penicillin Resistance, Pneumococcal Infections microbiology, Respiratory Tract Infections microbiology, Rural Population, Streptococcus pneumoniae drug effects, Trimethoprim, Sulfamethoxazole Drug Combination pharmacology
Abstract

Due to the changes in the frequency of penicillin-resistant strains of S. pneumoniae, it is necessary to perform surveillance studies of bacterial resistance. Isolates from the upper respiratory tract of asymptomatic children have been useful. There is no information about the difference between isolates from children with and without upper respiratory tract infection (URTI). The objective of the authors in this paper is to establish the prevalence of carrier-state, serotype and antimicrobial resistance of S. pneumoniae isolates from children with and without acute upper respiratory tract infection (URTI) in a rural area in Mexico. A cross-sectional comparative study was performed in Tlaxcala, Mexico. Children from one month 5 years of age were included. Nasopharyngeal swabs were obtained. Identification was done by international microbiology standards. Serotyping was done by the capsular Quellung test. The susceptibility testing was performed by the agar dilution method. Four-hundred and fifty patients were included. S. pneumoniae was isolated in 134 children (29.7%). Frequency of carriers was greater in patients with URTI (107/323) than without URTI (27/127) (33.1% vs. 21.1% p = 0.012, OR 1.84, IC 95% 1.1-3.08). The six most frequent serotypes were: 6B (16.4%); 19F (11.9%); 19A (6.7%); 14, 23F, and 35 (5.2% each), with no difference among the groups. Only 3% of the strains had high level resistance to penicillin, and 12.6% had intermediate resistance, and for ampicillin 4%, amoxicillin 4%, amoxicillin-clavulanate 4%, ceftriaxone 3%, cefotaxime 1.5%, erythromycin 6%, miocamycin 3%, chloramphenicol 4%, and vancomycin 0%. Trimethoprim-sulfamethoxazole resistance was very high (42%). In conclusion, colonization is higher in children with URTI. Five of the most frequent serotypes identified in this study were the same as those identified in patients with S. pneumoniae invasive diseases in Mexico City. In Tlaxcala, Mexico, beta-lactams could be the drug of choice for the treatment of S. pneumoniae lower respiratory tract infections. It is necessary to perform clinical assays to evaluate the efficacy of trimethoprim-sulfamethoxazole due to the high resistance in vitro.

Published
1997

17. [Amikacin in single daily doses in children with fever].

Author

Solórzano-Santos F, Miranda-Novales MG, Díaz-Peña R, Bernaldez-Ríos R, Díaz-Bensussen S, Rivera-Márquez H, and Díaz-Ponce H

Subjects
Bacterial Infections etiology, Child, Child, Preschool, Drug Administration Schedule, Female, Fever etiology, Humans, Immunocompromised Host, Male, Treatment Outcome, Amikacin therapeutic use, Anti-Bacterial Agents therapeutic use, Bacterial Infections drug therapy, Fever drug therapy, Neutropenia complications
Abstract

A randomized clinical trial was performed in children with cancer, fever and neutropenia, to evaluate the efficacy of amikacin once daily versus thrice daily dosing plus carbenicillin in both groups. Fifty patients were included, 25 patients in group A who received amikacin once daily and 25 in group B who received amikacin thrice daily. No intergroup differences were observed, i.e., fever diminished in a median of 6 days (2-8 days) vs. 7 days (3-12 days) in groups A and B respectively (p = 0.37);clinical improvement was observed in a median of 6 days (3-10 days) vs 7 days (2-14 days) (p = 0.68). One patient in group A and two in B died. The peak levels of amikacin on the 7th day of treatment were 10-60 and 7-25 micrograms/mL in groups A and B respectively, and the serum creatinine levels were 0.3 - 0.7 for group A and 0.2 - 0.8 mg/dL for group B; none of the patients presented a creatinine above 40% of the basal value. Three patients of group A had amikacin levels higher than 40 micrograms/mL without increasing the creatinine levels; our observations do not suggest that toxicity is higher. We conclude that the administration of aminoglycoside once daily seems to be as effective as the traditional dosing.

Published
1996

18. [Kala-azar in Mexico: report of 2 cases].

Author

Trejo-Pérez JA, Miranda-Novales MG, Solórzano-Santos F, Cabrera-Muñoz L, and Díaz-Ponce H

Subjects
Female, Humans, Infant, Leishmaniasis, Visceral epidemiology, Leishmaniasis, Visceral parasitology, Male, Mexico epidemiology, Leishmaniasis, Visceral diagnosis
Abstract

Visceral leishmaniasis is a rare parasitosis in our country; in a 30 year period only exists the report of five cases, three in the state of Puebla and two in the state of Guerrero. Now it has been identified another two cases in the state of Chiapas. In these patients the common presentation of the disease were fever, hepatosplenomegaly, hypergammaglobulinemia and pancytopenia. The parasite can be found in liver, spleen, lymph nodes and bone marrow macrophages. A definitive diagnosis depends on the demonstration of the parasite in tissue; spleen biopsy is the most useful because it is positive in 98% of the cases, in other tissues the amastigotes are seen in 50-80% of the cases. Negative PAS-stained smears maintains the diagnosis until another more specific method as electronic microscopy or culture is available. Pentavalent antimonial compounds are the drugs of choice and as an alternative or in case of failure amphotericin B can be used.

Published
1993

19. [Disseminated histoplasmosis in pediatrics. Report of a case].

Author

Miranda-Novales MG, Solorzano-Santos F, Díaz-Ponce H, Ruíz-Rodríguez A, and Cabrera-Muñoz L

Subjects
Female, Humans, Infant, Histoplasmosis diagnosis
Abstract

We report a case of a female infant, from Acapulco Guerrero, Mexico. She had been sick for 45 days, with diarrhea and general malaise, fever during the last 20 days; at physical examination she was pale, with abdominal distention and hepatosplenomegaly. She had leukopenia, thrombocytopenia and anemia. The microscopic findings in the bone marrow sample were intracytoplasmic and extracellular bodies. Both bone marrow and blood cultures were positive for Histoplasma capsulatum. Seventy three pediatric cases of diseminated histoplasmosis have been described in the medical literature since 1934 to 1988. It is know that only about 1% of the persons that become infected will develop a diseminated disease.

Published
1993

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