[Critical points to implement an antibiotic form for management of surgical wound infection].

Andrea Socorro Álvarez-Villaseñor, Diana Florencia Zeceña-Uribe, Jorge Isaac Morales-Alvarado, Jesús Alberto Castorena-Pérez, Clotilde Fuentes-Orozco, Alejandro González-Ojeda
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Abstract

Background: Surgical site infection (SSI) is a major complication of surgical procedures and contributes to morbidity, mortality, and healthcare costs. It is commonly caused by Gram-negative bacteria and should be monitored in hospital units.

Objective: To identify critical points to implement an antibiotic form for surgical wound infection management.

Material and methods: Descriptive observational study in 100 cultures of wounds with SSI. The most common diagnosis, the microorganism involved, sensitivity to antibiotics and prescription consistency were identified. In addition, demographic variables were assessed and a questionnaire was applied to surgeons in order to identify the critical points to implement a local formulary of antibiotics.

Results: 37% of cultures came from female patients. The most common diagnosis was hollow viscus perforation in 31%. The most common microorganism was Escherichia coli ESBL in 20% and 55% of these were sensitive to imipenem. The critical points observed were consistency in the prescription of antimicrobials, which reached only 29%, and that surgeons did not actively participate in strategies for the rational use of antibiotics.

Conclusions: As a critical point to implement the antibiotic form, little involvement of surgeons with the hospital infection control team was found. The incidence of SSI was 2.4%, predominantly in emergency surgery. The presence of E. coli ESBL is frequent, with resistance to broad-spectrum antimicrobials.

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【实施外科伤口感染处理抗生素表格的关键点】。
背景:手术部位感染(SSI)是外科手术的主要并发症,是导致发病率、死亡率和医疗费用的重要因素。它通常由革兰氏阴性菌引起,应在医院进行监测。目的:确定外科伤口感染处理中应用抗生素表的关键点。材料与方法:对100例SSI创面培养进行描述性观察研究。确定了最常见的诊断、涉及的微生物、对抗生素的敏感性和处方一致性。此外,还对人口统计学变量进行了评估,并对外科医生进行了问卷调查,以确定实施当地抗生素处方的关键点。结果:37%的培养来自女性患者。最常见的诊断是空心内脏穿孔,占31%。最常见的微生物是大肠杆菌ESBL,占20%,其中55%对亚胺培南敏感。观察到的临界点是抗菌药物处方的一致性,只有29%,外科医生没有积极参与合理使用抗菌药物的策略。结论:外科医生作为实施抗生素剂型的关键环节,极少参与医院感染控制小组的工作。SSI的发生率为2.4%,主要发生在急诊手术中。大肠杆菌ESBL的存在是常见的,对广谱抗菌素具有耐药性。
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