The Global Alliance for Infections in Surgery: defining a model for antimicrobial stewardship-results from an international cross-sectional survey.

Sartelli, Massimo and Labricciosa, Francesco M. and Barbadoro, Pamela and Pagani, Leonardo and Ansaloni, Luca and Brink, Adrian J. and Carlet, Jean and Khanna, Ashish and Chichom-Mefire, Alain and Coccolini, Federico and Di Saverio, Salomone and May, Addison K. and Viale, Pierluigi and Watkins, Richard R. and Scudeller, Luigia and Abbo, Lilian M. and Abu-Zidan, Fikri M. and Adesunkanmi, Abdulrashid K. and Al-Dahir, Sara and Al-Hasan, Majdi N. and Alis, Halil and Alves, Carlos and Araujo da Silva, André R. and Augustin, Goran and Bala, Miklosh and Barie, Philip S. and Beltrán, Marcelo A. and Bhangu, Aneel and Bouchra, Belefquih and Brecher, Stephen M. and Caínzos, Miguel A. and Camacho-Ortiz, Adrian and Catani, Marco and Chandy, Sujith J. and Jusoh, Asri Che and Cherry-Bukowiec, Jill R. and Chiara, Osvaldo and Colak, Elif and Cornely, Oliver A. and Cui, Yunfeng and Demetrashvili, Zaza and De Simone, Belinda and De Waele, Jan J. and Dhingra, Sameer and Di Marzo, Francesco and Dogjani, Agron and Dorj, Gereltuya and Dortet, Laurent and Duane, Therese M. and Elmangory, Mutasim M. and Enani, Mushira A. and Ferrada, Paula and Esteban Foianini, J. and Gachabayov, Mahir and Gandhi, Chinmay and Ghnnam, Wagih Mommtaz and Giamarellou, Helen and Gkiokas, Georgios and Gomi, Harumi and Goranović, Tatjana and Griffiths, Ewen A. and Guerra Gronerth, Rosio I. and Haidamus Monteiro, Julio C. and Hardcastle, Timothy C. and Hecker, Andreas and Hodonou, Adrien M. and Ioannidis, Orestis and Isik, Arda and Iskandar, Katia A. and Kafil, Hossein S. and Kanj, Souha S. and Kaplan, Lewis J. and Kapoor, Garima and Karamarkovic, Aleksandar R. and Kenig, Jakub and Kerschaever, Ivan and Khamis, Faryal and Khokha, Vladimir and Kiguba, Ronald and Kim, Hong B. and Ko, Wen-Chien and Koike, Kaoru and Kozlovska, Iryna and Kumar, Anand and Lagunes, Leonel and Latifi, Rifat and Lee, Jae G. and Lee, Young R. and Leppäniemi, Ari and Li, Yousheng and Liang, Stephen Y. and Lowman, Warren and Machain, Gustavo M. and Maegele, Marc and Major, Piotr and Malama, Sydney and Manzano-Nunez, Ramiro and Marinis, Athanasios and Martinez Casas, Isidro and Marwah, Sanjay and Maseda, Emilio and McFarlane, Michael E. and Memish, Ziad and Mertz, Dominik and Mesina, Cristian and Mishra, Shyam K. and Moore, Ernest E. and Munyika, Akutu and Mylonakis, Eleftherios and Napolitano, Lena and Negoi, Ionut and Nestorovic, Milica D. and Nicolau, David P. and Omari, Abdelkarim H. and Ordonez, Carlos A. and Paiva, José-Artur and Pant, Narayan D. and Parreira, Jose G. and Pędziwiatr, Michal and Pereira, Bruno M. and Ponce-de-Leon, Alfredo and Poulakou, Garyphallia and Preller, Jacobus and Pulcini, Céline and Pupelis, Guntars and Quiodettis, Martha and Rawson, Timothy M. and Reis, Tarcisio and Rems, Miran and Rizoli, Sandro and Roberts, Jason and Pereira, Nuno Rocha and Rodríguez-Baño, Jesús and Sakakushev, Boris and Sanders, James and Santos, Natalia and Sato, Norio and Sawyer, Robert G. and Scarpelini, Sandro and Scoccia, Loredana and Shafiq, Nusrat and Shelat, Vishalkumar and Sifri, Costi D. and Siribumrungwong, Boonying and Søreide, Kjetil and Soto, Rodolfo and de Souza, Hamilton P. and Talving, Peep and Trung, Ngo Tat and Tessier, Jeffrey M. and Tumbarello, Mario and Ulrych, Jan and Uranues, Selman and Van Goor, Harry and Vereczkei, Andras and Wagenlehner, Florian and Xiao, Yonghong and Yuan, Kuo-Ching and Wechsler-Fördös, Agnes and Zahar, Jean-Ralph and Zakrison, Tanya L. and Zuckerbraun, Brian and Zuidema, Wietse P. and Catena, Fausto (2017) The Global Alliance for Infections in Surgery: defining a model for antimicrobial stewardship-results from an international cross-sectional survey. World Journal of Emergency Surgery, 12. p. 34. ISSN 1749-7922

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Abstract

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.

Item Type: Article
Additional Information: © The Author(s). 2017 Open Access. This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver(http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
Departments: Katedra za kirurgiju
Depositing User: Martina Žužak
Status: Published
Creators:
CreatorsEmail
Sartelli, MassimoUNSPECIFIED
Labricciosa, Francesco M.UNSPECIFIED
Barbadoro, PamelaUNSPECIFIED
Pagani, LeonardoUNSPECIFIED
Ansaloni, LucaUNSPECIFIED
Brink, Adrian J.UNSPECIFIED
Carlet, JeanUNSPECIFIED
Khanna, AshishUNSPECIFIED
Chichom-Mefire, AlainUNSPECIFIED
Coccolini, FedericoUNSPECIFIED
Di Saverio, SalomoneUNSPECIFIED
May, Addison K.UNSPECIFIED
Viale, PierluigiUNSPECIFIED
Watkins, Richard R.UNSPECIFIED
Scudeller, LuigiaUNSPECIFIED
Abbo, Lilian M.UNSPECIFIED
Abu-Zidan, Fikri M.UNSPECIFIED
Adesunkanmi, Abdulrashid K.UNSPECIFIED
Al-Dahir, SaraUNSPECIFIED
Al-Hasan, Majdi N.UNSPECIFIED
Alis, HalilUNSPECIFIED
Alves, CarlosUNSPECIFIED
Araujo da Silva, André R.UNSPECIFIED
Augustin, GoranUNSPECIFIED
Bala, MikloshUNSPECIFIED
Barie, Philip S.UNSPECIFIED
Beltrán, Marcelo A.UNSPECIFIED
Bhangu, AneelUNSPECIFIED
Bouchra, BelefquihUNSPECIFIED
Brecher, Stephen M.UNSPECIFIED
Caínzos, Miguel A.UNSPECIFIED
Camacho-Ortiz, AdrianUNSPECIFIED
Catani, MarcoUNSPECIFIED
Chandy, Sujith J.UNSPECIFIED
Jusoh, Asri CheUNSPECIFIED
Cherry-Bukowiec, Jill R.UNSPECIFIED
Chiara, OsvaldoUNSPECIFIED
Colak, ElifUNSPECIFIED
Cornely, Oliver A.UNSPECIFIED
Cui, YunfengUNSPECIFIED
Demetrashvili, ZazaUNSPECIFIED
De Simone, BelindaUNSPECIFIED
De Waele, Jan J.UNSPECIFIED
Dhingra, SameerUNSPECIFIED
Di Marzo, FrancescoUNSPECIFIED
Dogjani, AgronUNSPECIFIED
Dorj, GereltuyaUNSPECIFIED
Dortet, LaurentUNSPECIFIED
Duane, Therese M.UNSPECIFIED
Elmangory, Mutasim M.UNSPECIFIED
Enani, Mushira A.UNSPECIFIED
Ferrada, PaulaUNSPECIFIED
Esteban Foianini, J.UNSPECIFIED
Gachabayov, MahirUNSPECIFIED
Gandhi, ChinmayUNSPECIFIED
Ghnnam, Wagih MommtazUNSPECIFIED
Giamarellou, HelenUNSPECIFIED
Gkiokas, GeorgiosUNSPECIFIED
Gomi, HarumiUNSPECIFIED
Goranović, TatjanaUNSPECIFIED
Griffiths, Ewen A.UNSPECIFIED
Guerra Gronerth, Rosio I.UNSPECIFIED
Haidamus Monteiro, Julio C.UNSPECIFIED
Hardcastle, Timothy C.UNSPECIFIED
Hecker, AndreasUNSPECIFIED
Hodonou, Adrien M.UNSPECIFIED
Ioannidis, OrestisUNSPECIFIED
Isik, ArdaUNSPECIFIED
Iskandar, Katia A.UNSPECIFIED
Kafil, Hossein S.UNSPECIFIED
Kanj, Souha S.UNSPECIFIED
Kaplan, Lewis J.UNSPECIFIED
Kapoor, GarimaUNSPECIFIED
Karamarkovic, Aleksandar R.UNSPECIFIED
Kenig, JakubUNSPECIFIED
Kerschaever, IvanUNSPECIFIED
Khamis, FaryalUNSPECIFIED
Khokha, VladimirUNSPECIFIED
Kiguba, RonaldUNSPECIFIED
Kim, Hong B.UNSPECIFIED
Ko, Wen-ChienUNSPECIFIED
Koike, KaoruUNSPECIFIED
Kozlovska, IrynaUNSPECIFIED
Kumar, AnandUNSPECIFIED
Lagunes, LeonelUNSPECIFIED
Latifi, RifatUNSPECIFIED
Lee, Jae G.UNSPECIFIED
Lee, Young R.UNSPECIFIED
Leppäniemi, AriUNSPECIFIED
Li, YoushengUNSPECIFIED
Liang, Stephen Y.UNSPECIFIED
Lowman, WarrenUNSPECIFIED
Machain, Gustavo M.UNSPECIFIED
Maegele, MarcUNSPECIFIED
Major, PiotrUNSPECIFIED
Malama, SydneyUNSPECIFIED
Manzano-Nunez, RamiroUNSPECIFIED
Marinis, AthanasiosUNSPECIFIED
Martinez Casas, IsidroUNSPECIFIED
Marwah, SanjayUNSPECIFIED
Maseda, EmilioUNSPECIFIED
McFarlane, Michael E.UNSPECIFIED
Memish, ZiadUNSPECIFIED
Mertz, DominikUNSPECIFIED
Mesina, CristianUNSPECIFIED
Mishra, Shyam K.UNSPECIFIED
Moore, Ernest E.UNSPECIFIED
Munyika, AkutuUNSPECIFIED
Mylonakis, EleftheriosUNSPECIFIED
Napolitano, LenaUNSPECIFIED
Negoi, IonutUNSPECIFIED
Nestorovic, Milica D.UNSPECIFIED
Nicolau, David P.UNSPECIFIED
Omari, Abdelkarim H.UNSPECIFIED
Ordonez, Carlos A.UNSPECIFIED
Paiva, José-ArturUNSPECIFIED
Pant, Narayan D.UNSPECIFIED
Parreira, Jose G.UNSPECIFIED
Pędziwiatr, MichalUNSPECIFIED
Pereira, Bruno M.UNSPECIFIED
Ponce-de-Leon, AlfredoUNSPECIFIED
Poulakou, GaryphalliaUNSPECIFIED
Preller, JacobusUNSPECIFIED
Pulcini, CélineUNSPECIFIED
Pupelis, GuntarsUNSPECIFIED
Quiodettis, MarthaUNSPECIFIED
Rawson, Timothy M.UNSPECIFIED
Reis, TarcisioUNSPECIFIED
Rems, MiranUNSPECIFIED
Rizoli, SandroUNSPECIFIED
Roberts, JasonUNSPECIFIED
Pereira, Nuno RochaUNSPECIFIED
Rodríguez-Baño, JesúsUNSPECIFIED
Sakakushev, BorisUNSPECIFIED
Sanders, JamesUNSPECIFIED
Santos, NataliaUNSPECIFIED
Sato, NorioUNSPECIFIED
Sawyer, Robert G.UNSPECIFIED
Scarpelini, SandroUNSPECIFIED
Scoccia, LoredanaUNSPECIFIED
Shafiq, NusratUNSPECIFIED
Shelat, VishalkumarUNSPECIFIED
Sifri, Costi D.UNSPECIFIED
Siribumrungwong, BoonyingUNSPECIFIED
Søreide, KjetilUNSPECIFIED
Soto, RodolfoUNSPECIFIED
de Souza, Hamilton P.UNSPECIFIED
Talving, PeepUNSPECIFIED
Trung, Ngo TatUNSPECIFIED
Tessier, Jeffrey M.UNSPECIFIED
Tumbarello, MarioUNSPECIFIED
Ulrych, JanUNSPECIFIED
Uranues, SelmanUNSPECIFIED
Van Goor, HarryUNSPECIFIED
Vereczkei, AndrasUNSPECIFIED
Wagenlehner, FlorianUNSPECIFIED
Xiao, YonghongUNSPECIFIED
Yuan, Kuo-ChingUNSPECIFIED
Wechsler-Fördös, AgnesUNSPECIFIED
Zahar, Jean-RalphUNSPECIFIED
Zakrison, Tanya L.UNSPECIFIED
Zuckerbraun, BrianUNSPECIFIED
Zuidema, Wietse P.UNSPECIFIED
Catena, FaustoUNSPECIFIED
Date: 1 August 2017
Date Deposited: 14 Mar 2018 10:58
Last Modified: 14 Mar 2018 10:58
Subjects: UNSPECIFIED
Related URLs:
URI: http://medlib.mef.hr/id/eprint/2853

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