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Journal Articles World Journal of Emergency Surgery Year : 2017

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

Massimo Sartelli (1) , Francesco Labricciosa (2) , Pamela Barbadoro (2) , Leonardo Pagani (3) , Luca Ansaloni (4) , Adrian Brink (5, 6) , Jean Carlet (7) , Ashish Khanna (8) , Alain Chichom-Mefire (9) , Federico Coccolini (10) , Salomone Di Saverio (11) , Addison May (12) , Pierluigi Viale (13) , Richard Watkins (8, 14) , Luigia Scudeller (15) , Lilian Abbo (16) , Fikri Abu-Zidan (17) , Abdulrashid Adesunkanmi (18) , Sara Al-Dahir (19) , Majdi Al-Hasan (20) , Halil Alis (21) , Carlos Alves (22) , André Araujo da Silva (23) , Goran Augustin (24) , Miklosh Bala (25) , Philip S. Barie (26) , Marcelo Beltrán (27) , Aneel Bhangu (28) , Belefquih Bouchra (29) , Stephen Brecher (30, 31) , Miguel Caínzos , Adrian Camacho-Ortiz , Marco Catani (32) , Sujith Chandy , Asri Che Jusoh , Jill Cherry-Bukowiec , Osvaldo Chiara , Elif Colak , Oliver Cornely (33) , Yunfeng Cui , Zaza Demetrashvili , Belinda de Simone , Jan de Waele , Sameer Dhingra , Francesco Di Marzo , Agron Dogjani , Gereltuya Dorj , Laurent Dortet , Therese Duane , Mutasim Elmangory , Mushira Enani , Paula Ferrada , J. Esteban Foianini , Mahir Gachabayov , Chinmay Gandhi , Wagih Mommtaz Ghnnam , Helen Giamarellou (34) , Georgios Gkiokas , Harumi Gomi , Tatjana Goranovic , Ewen Griffiths , Rosio Guerra Gronerth , Julio Haidamus Monteiro , Timothy Hardcastle , Andreas Hecker , Adrien Hodonou , Orestis Ioannidis , Arda Isik , Katia Iskandar , Hossein Kafil , Souha Kanj , Lewis Kaplan , Garima Kapoor , Aleksandar Karamarkovic , Jakub Kenig , Ivan Kerschaever , Faryal Khamis , Vladimir Khokha , Ronald Kiguba , Hong Kim , Wen-Chien Ko , Kaoru Koike , Iryna Kozlovska , Anand Kumar (35) , Leonel Lagunes , Rifat Latifi , Jae Yeol Lee (36) , Young Lee , Ari Leppäniemi , Yousheng Li (37) , Stephen Liang , Warren Lowman , Gustavo Machain , Marc Maegele , Piotr Major , Sydney Malama , Ramiro Manzano-Nunez , Athanasios Marinis , Isidro Martinez Casas , Sanjay Marwah , Emilio Maseda , Michael Mcfarlane , Ziad Memish , Dominik Mertz , Cristian Mesina , Shyam Mishra , Ernest Moore , Akutu Munyika , Eleftherios Mylonakis , Lena Napolitano , Ionut Negoi , Milica Nestorovic , David Nicolau , Abdelkarim Omari , Carlos Ordonez (38) , José-Artur Paiva (39) , Narayan Pant , Jose Parreira , Michal Pędziwiatr , Bruno Pereira (40) , Alfredo Ponce-De-Leon , Garyphallia Poulakou (41) , Jacobus Preller , Céline Pulcini (42) , Guntars Pupelis , Martha Quiodettis , Timothy Rawson , Tarcisio Reis , Miran Rems , Sandro Rizoli , Jason Roberts (43) , Nuno Rocha Pereira , Jesús Rodríguez-Baño (44) , Boris Sakakushev , James Sanders , Natalia Santos , Norio Sato , Robert Sawyer , Sandro Scarpelini , Loredana Scoccia , Nusrat Shafiq , Vishalkumar Shelat , Costi Sifri , Boonying Siribumrungwong , Kjetil Søreide , Rodolfo Soto , Hamilton de Souza , Peep Talving , Ngo Tat Trung , Jeffrey Tessier , Mario Tumbarello , Jan Ulrych , Selman Uranues , Harry van Goor , Andras Vereczkei , Florian Wagenlehner , Yonghong Xiao , Kuo-Ching Yuan , Agnes Wechsler-Fördös , Jean-Ralph Zahar (45) , Tanya Zakrison , Brian Zuckerbraun , Wietse Zuidema , Fausto Catena
1 UNIMC - Università degli Studi di Macerata = University of Macerata
2 UNIVPM - Polytechnic University of Marche [Ancona, Italy] / Università Politecnica delle Marche [Ancona, Italia]
3 Bolzano Central Hospital = Ospedale Provinciale di Bolzano
4 Hosp P Giovanni XXIII - Hospital Papa Giovanni XXIII
5 Milpark Hospital - Milpark Hospital
6 University of Cape Town
7 World Alliance against Antibiotics Resistance
8 Cleveland Clinic
9 Regional Hospital, Limbe
10 Rimini Infermi Hospital
11 Maggiore Hospital
12 Vanderbilt University Medical Center [Nashville]
13 UNIBO - Alma Mater Studiorum Università di Bologna = University of Bologna
14 NEOMED - Northeastern Ohio Medical University
15 Foundation IRCCS Policlinico San Matteo
16 UMMSM - University of Miami Leonard M. Miller School of Medicine
17 UAEU - United Arab Emirates University
18 OAU - Obafemi Awolowo University
19 Xavier University of Louisiana
20 School of Medicine [University of South Carolina]
21 Training Hospital Istanbul
22 Hospital de São João [Porto]
23 CIEC - Centro de Investigação em Estudos da Criança
24 University Hospital Center Zagreb
25 Hadassah Hebrew University Medical Center [Jerusalem]
26 Weill Cornell Medicine [Cornell University]
27 USERENA - Universidad de La Serena
28 Queens Elizabeth Hospital [Birmingham]
29 UIC - Université Internationale de Casablanca
30 VA Boston Healthcare System
31 BUSM - Boston University School of Medicine
32 Natbrainlab, Department of Forensic and Neurodevelopmental Sciences
33 University Hospital of Cologne [Cologne]
34 4th Department of Internal Medicine
35 CVIT - Center for Visual Information Technology [Hyderabad]
36 Chonnam National University [Gwangju]
37 Shangaï Jiao Tong University [Shangaï]
38 University of Houston
39 Centro Hospitalar Universitário São João - Faculty of Medicine - University of Porto - Grupo de Infecção e Sepsis, Porto
40 Unité de biostatistiques
41 4th Department of Internal Medicine
42 APEMAC - Maladies chroniques, santé perçue, et processus d'adaptation
43 Duke University Marine Laboratory
44 University Hospital Virgen Macarena
45 Service de bactériologie, virologie, parasitologie et hygiène [CHU Necker]
Jean Carlet
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Ashish Khanna
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Miguel Caínzos
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Adrian Camacho-Ortiz
  • Function : Author
Sujith Chandy
  • Function : Author
Asri Che Jusoh
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Jill Cherry-Bukowiec
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Osvaldo Chiara
  • Function : Author
Elif Colak
  • Function : Author
Yunfeng Cui
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Zaza Demetrashvili
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Belinda de Simone
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Jan de Waele
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Sameer Dhingra
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Francesco Di Marzo
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Agron Dogjani
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Gereltuya Dorj
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Laurent Dortet
Therese Duane
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Mutasim Elmangory
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Mushira Enani
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Paula Ferrada
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J. Esteban Foianini
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Mahir Gachabayov
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Chinmay Gandhi
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Wagih Mommtaz Ghnnam
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Georgios Gkiokas
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Harumi Gomi
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Tatjana Goranovic
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Ewen Griffiths
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Rosio Guerra Gronerth
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Julio Haidamus Monteiro
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Timothy Hardcastle
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Andreas Hecker
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Adrien Hodonou
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Orestis Ioannidis
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Arda Isik
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Katia Iskandar
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Hossein Kafil
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Souha Kanj
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Lewis Kaplan
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Garima Kapoor
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Aleksandar Karamarkovic
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Jakub Kenig
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Ivan Kerschaever
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Faryal Khamis
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Vladimir Khokha
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Ronald Kiguba
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Hong Kim
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Wen-Chien Ko
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Kaoru Koike
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Iryna Kozlovska
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Leonel Lagunes
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Rifat Latifi
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Jae Yeol Lee
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Young Lee
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Ari Leppäniemi
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Stephen Liang
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Warren Lowman
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Gustavo Machain
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Marc Maegele
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Piotr Major
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Sydney Malama
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Ramiro Manzano-Nunez
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Athanasios Marinis
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Isidro Martinez Casas
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Sanjay Marwah
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Emilio Maseda
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Michael Mcfarlane
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Ziad Memish
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Dominik Mertz
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Cristian Mesina
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Shyam Mishra
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Ernest Moore
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Akutu Munyika
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Eleftherios Mylonakis
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Lena Napolitano
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Ionut Negoi
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Milica Nestorovic
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David Nicolau
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Abdelkarim Omari
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Narayan Pant
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Jose Parreira
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Michal Pędziwiatr
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Alfredo Ponce-De-Leon
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Jacobus Preller
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Guntars Pupelis
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Martha Quiodettis
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Timothy Rawson
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Tarcisio Reis
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Miran Rems
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Sandro Rizoli
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Jason Roberts
Nuno Rocha Pereira
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Boris Sakakushev
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James Sanders
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Natalia Santos
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Norio Sato
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Robert Sawyer
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Sandro Scarpelini
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Loredana Scoccia
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Nusrat Shafiq
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Vishalkumar Shelat
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Costi Sifri
  • Function : Author
Boonying Siribumrungwong
  • Function : Author
Kjetil Søreide
  • Function : Author
Rodolfo Soto
  • Function : Author
Hamilton de Souza
  • Function : Author
Peep Talving
  • Function : Author
Ngo Tat Trung
  • Function : Author
Jeffrey Tessier
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Mario Tumbarello
  • Function : Author
Jan Ulrych
  • Function : Author
Selman Uranues
  • Function : Author
Harry van Goor
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Andras Vereczkei
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Florian Wagenlehner
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Yonghong Xiao
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Kuo-Ching Yuan
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Agnes Wechsler-Fördös
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Tanya Zakrison
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Brian Zuckerbraun
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Wietse Zuidema
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Fausto Catena
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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.

Dates and versions

hal-02341331 , version 1 (31-10-2019)

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Massimo Sartelli, Francesco Labricciosa, Pamela Barbadoro, Leonardo Pagani, Luca Ansaloni, et al.. 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, 2017, 12, pp.34. ⟨10.1186/s13017-017-0145-2⟩. ⟨hal-02341331⟩
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