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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

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Leonardo Pagani
Jean Carlet
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Ashish Khanna
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Miguel Caínzos
  • Function : Author
Adrian Camacho-Ortiz
  • Function : Author
Sujith Chandy
  • Function : Author
Asri Che Jusoh
  • Function : Author
Jill Cherry-Bukowiec
  • Function : Author
Osvaldo Chiara
  • Function : Author
Elif Colak
  • Function : Author
Yunfeng Cui
  • Function : Author
Zaza Demetrashvili
  • Function : Author
Belinda de Simone
  • Function : Author
Jan de Waele
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Sameer Dhingra
  • Function : Author
Francesco Di Marzo
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Agron Dogjani
  • Function : Author
Gereltuya Dorj
  • Function : Author
Laurent Dortet
Therese Duane
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Mutasim Elmangory
  • Function : Author
Mushira Enani
  • Function : Author
Paula Ferrada
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J. Esteban Foianini
  • Function : Author
Mahir Gachabayov
  • Function : Author
Chinmay Gandhi
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Wagih Mommtaz Ghnnam
  • Function : Author
Georgios Gkiokas
  • Function : Author
Harumi Gomi
  • Function : Author
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
  • Function : Author
Hong Kim
  • Function : Author
Wen-Chien Ko
  • Function : Author
Kaoru Koike
  • Function : Author
Iryna Kozlovska
  • Function : Author
Leonel Lagunes
  • Function : Author
Rifat Latifi
  • Function : Author
Jae Yeol Lee
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  • PersonId : 1050385
Young Lee
  • Function : Author
Ari Leppäniemi
  • Function : Author
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
  • Function : Author
Ionut Negoi
  • Function : Author
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
  • Function : Author
Vishalkumar Shelat
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Costi Sifri
  • Function : Author
Boonying Siribumrungwong
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Kjetil Søreide
  • Function : Author
Rodolfo Soto
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Hamilton de Souza
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Peep Talving
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Ngo Tat Trung
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Jeffrey Tessier
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Mario Tumbarello
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Jan Ulrych
  • Function : Author
Selman Uranues
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Harry van Goor
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Andras Vereczkei
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Florian Wagenlehner
  • Function : Author
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)

Identifiers

Cite

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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