The Global Alliance for Infections in Surgery

Defining a model for antimicrobial stewardship-results from an international cross-sectional survey

Massimo Sartelli, Francesco M. Labricciosa, Pamela Barbadoro, Leonardo Pagani, Luca Ansaloni, Adrian J. Brink, Jean Carlet, Ashish Khanna, Alain Chichom-Mefire, Federico Coccolini, Salomone Di Saverio, Addison K. May, Pierluigi Viale, Richard R. Watkins, Luigia Scudeller, Lilian M. Abbo, Fikri M. Abu-Zidan, Abdulrashid K. Adesunkanmi, Sara Al-Dahir, Majdi N. Al-Hasan & 144 others Halil Alis, Carlos Alves, André R. Araujo da Silva, Goran Augustin, Miklosh Bala, Philip S. Barie, Marcelo A. Beltrán, Aneel Bhangu, Belefquih Bouchra, Stephen M. Brecher, Miguel A. Caínzos, Adrian Camacho-Ortiz, Marco Catani, Sujith J. Chandy, Asri Che Jusoh, Jill R. Cherry-Bukowiec, Osvaldo Chiara, Elif Colak, Oliver A. Cornely, Yunfeng Cui, Zaza Demetrashvili, Belinda De Simone, Jan J. De Waele, Sameer Dhingra, Francesco Di Marzo, Agron Dogjani, Gereltuya Dorj, Laurent Dortet, Therese M. Duane, Mutasim M. Elmangory, Mushira A. Enani, Paula Ferrada, J. Esteban Foianini, Mahir Gachabayov, Chinmay Gandhi, Wagih Mommtaz Ghnnam, Helen Giamarellou, Georgios Gkiokas, Harumi Gomi, Tatjana Goranovic, Ewen A. Griffiths, Rosio I. Guerra Gronerth, Julio C. Haidamus Monteiro, Timothy C. Hardcastle, Andreas Hecker, Adrien M. Hodonou, Orestis Ioannidis, Arda Isik, Katia A. Iskandar, Hossein S. Kafil, Souha S. Kanj, Lewis J. Kaplan, Garima Kapoor, Aleksandar R. Karamarkovic, Jakub Kenig, Ivan Kerschaever, Faryal Khamis, Vladimir Khokha, Ronald Kiguba, Hong B. Kim, Wen Chien Ko, Kaoru Koike, Iryna Kozlovska, Anand Kumar, Leonel Lagunes, Rifat Latifi, JaeGil Lee, Young R. Lee, Ari Leppäniemi, Yousheng Li, Stephen Y. Liang, Warren Lowman, Gustavo M. Machain, Marc Maegele, Piotr Major, Sydney Malama, Ramiro Manzano-Nunez, Athanasios Marinis, Isidro Martinez Casas, Sanjay Marwah, Emilio Maseda, Michael E. McFarlane, Ziad Memish, Dominik Mertz, Cristian Mesina, Shyam K. Mishra, Ernest E. Moore, Akutu Munyika, Eleftherios Mylonakis, Lena Napolitano, Ionut Negoi, Milica D. Nestorovic, David P. Nicolau, Abdelkarim H. Omari, Carlos A. Ordonez, José Artur Paiva, Narayan D. Pant, Jose G. Parreira, Michal Pedziwiatr, Bruno M. Pereira, Alfredo Ponce-de-Leon, Garyphallia Poulakou, Jacobus Preller, Céline Pulcini, Guntars Pupelis, Martha Quiodettis, Timothy M. Rawson, Tarcisio Reis, Miran Rems, Sandro Rizoli, Jason Roberts, Nuno Rocha Pereira, Jesús Rodríguez-Baño, Boris Sakakushev, James Sanders, Natalia Santos, Norio Sato, Robert G. Sawyer, Sandro Scarpelini, Loredana Scoccia, Nusrat Shafiq, Vishalkumar Shelat, Costi D. Sifri, Boonying Siribumrungwong, Kjetil Søreide, Rodolfo Soto, Hamilton P. de Souza, Peep Talving, Ngo Tat Trung, Jeffrey M. 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, Tanya L. Zakrison, Brian Zuckerbraun, Wietse P. Zuidema, Fausto Catena

Research output: Contribution to journalArticle

12 Citations (Scopus)

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.

Original languageEnglish
Article number34
JournalWorld Journal of Emergency Surgery
Volume12
Issue number1
DOIs
Publication statusPublished - 2017 Aug 1

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Cross-Sectional Studies
Infection Control
Infection
Intraabdominal Infections
Physicians
Community Hospital
Teaching Hospitals
Communicable Diseases
Organizations
Surveys and Questionnaires
Therapeutics
Surgeons

All Science Journal Classification (ASJC) codes

  • Surgery
  • Emergency Medicine

Cite this

Sartelli, Massimo ; Labricciosa, Francesco M. ; Barbadoro, Pamela ; Pagani, Leonardo ; Ansaloni, Luca ; Brink, Adrian J. ; Carlet, Jean ; Khanna, Ashish ; Chichom-Mefire, Alain ; Coccolini, Federico ; Di Saverio, Salomone ; May, Addison K. ; Viale, Pierluigi ; Watkins, Richard R. ; Scudeller, Luigia ; Abbo, Lilian M. ; Abu-Zidan, Fikri M. ; Adesunkanmi, Abdulrashid K. ; Al-Dahir, Sara ; Al-Hasan, Majdi N. ; Alis, Halil ; Alves, Carlos ; Araujo da Silva, André R. ; Augustin, Goran ; Bala, Miklosh ; Barie, Philip S. ; Beltrán, Marcelo A. ; Bhangu, Aneel ; Bouchra, Belefquih ; Brecher, Stephen M. ; Caínzos, Miguel A. ; Camacho-Ortiz, Adrian ; Catani, Marco ; Chandy, Sujith J. ; Jusoh, Asri Che ; Cherry-Bukowiec, Jill R. ; Chiara, Osvaldo ; Colak, Elif ; Cornely, Oliver A. ; Cui, Yunfeng ; Demetrashvili, Zaza ; De Simone, Belinda ; De Waele, Jan J. ; Dhingra, Sameer ; Di Marzo, Francesco ; Dogjani, Agron ; Dorj, Gereltuya ; Dortet, Laurent ; Duane, Therese M. ; Elmangory, Mutasim M. ; Enani, Mushira A. ; Ferrada, Paula ; Esteban Foianini, J. ; Gachabayov, Mahir ; Gandhi, Chinmay ; Ghnnam, Wagih Mommtaz ; Giamarellou, Helen ; Gkiokas, Georgios ; Gomi, Harumi ; Goranovic, Tatjana ; Griffiths, Ewen A. ; Guerra Gronerth, Rosio I. ; Haidamus Monteiro, Julio C. ; Hardcastle, Timothy C. ; Hecker, Andreas ; Hodonou, Adrien M. ; Ioannidis, Orestis ; Isik, Arda ; Iskandar, Katia A. ; Kafil, Hossein S. ; Kanj, Souha S. ; Kaplan, Lewis J. ; Kapoor, Garima ; Karamarkovic, Aleksandar R. ; Kenig, Jakub ; Kerschaever, Ivan ; Khamis, Faryal ; Khokha, Vladimir ; Kiguba, Ronald ; Kim, Hong B. ; Ko, Wen Chien ; Koike, Kaoru ; Kozlovska, Iryna ; Kumar, Anand ; Lagunes, Leonel ; Latifi, Rifat ; Lee, JaeGil ; Lee, Young R. ; Leppäniemi, Ari ; Li, Yousheng ; Liang, Stephen Y. ; Lowman, Warren ; Machain, Gustavo M. ; Maegele, Marc ; Major, Piotr ; Malama, Sydney ; Manzano-Nunez, Ramiro ; Marinis, Athanasios ; Martinez Casas, Isidro ; Marwah, Sanjay ; Maseda, Emilio ; McFarlane, Michael E. ; Memish, Ziad ; Mertz, Dominik ; Mesina, Cristian ; Mishra, Shyam K. ; Moore, Ernest E. ; Munyika, Akutu ; Mylonakis, Eleftherios ; Napolitano, Lena ; Negoi, Ionut ; Nestorovic, Milica D. ; Nicolau, David P. ; Omari, Abdelkarim H. ; Ordonez, Carlos A. ; Paiva, José Artur ; Pant, Narayan D. ; Parreira, Jose G. ; Pedziwiatr, Michal ; Pereira, Bruno M. ; Ponce-de-Leon, Alfredo ; Poulakou, Garyphallia ; Preller, Jacobus ; Pulcini, Céline ; Pupelis, Guntars ; Quiodettis, Martha ; Rawson, Timothy M. ; Reis, Tarcisio ; Rems, Miran ; Rizoli, Sandro ; Roberts, Jason ; Pereira, Nuno Rocha ; Rodríguez-Baño, Jesús ; Sakakushev, Boris ; Sanders, James ; Santos, Natalia ; Sato, Norio ; Sawyer, Robert G. ; Scarpelini, Sandro ; Scoccia, Loredana ; Shafiq, Nusrat ; Shelat, Vishalkumar ; Sifri, Costi D. ; Siribumrungwong, Boonying ; Søreide, Kjetil ; Soto, Rodolfo ; de Souza, Hamilton P. ; Talving, Peep ; Trung, Ngo Tat ; Tessier, Jeffrey M. ; Tumbarello, Mario ; Ulrych, Jan ; Uranues, Selman ; Van Goor, Harry ; Vereczkei, Andras ; Wagenlehner, Florian ; Xiao, Yonghong ; Yuan, Kuo Ching ; Wechsler-Fördös, Agnes ; Zahar, Jean Ralph ; Zakrison, Tanya L. ; Zuckerbraun, Brian ; Zuidema, Wietse P. ; Catena, Fausto. / The Global Alliance for Infections in Surgery : Defining a model for antimicrobial stewardship-results from an international cross-sectional survey. In: World Journal of Emergency Surgery. 2017 ; Vol. 12, No. 1.
@article{087b668cc74541a5a31236b93ece7870,
title = "The Global Alliance for Infections in Surgery: Defining a model for antimicrobial stewardship-results from an international cross-sectional survey",
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.",
author = "Massimo Sartelli and Labricciosa, {Francesco M.} and Pamela Barbadoro and Leonardo Pagani and Luca Ansaloni and Brink, {Adrian J.} and Jean Carlet and Ashish Khanna and Alain Chichom-Mefire and Federico Coccolini and {Di Saverio}, Salomone and May, {Addison K.} and Pierluigi Viale and Watkins, {Richard R.} and Luigia Scudeller and Abbo, {Lilian M.} and Abu-Zidan, {Fikri M.} and Adesunkanmi, {Abdulrashid K.} and Sara Al-Dahir and Al-Hasan, {Majdi N.} and Halil Alis and Carlos Alves and {Araujo da Silva}, {Andr{\'e} R.} and Goran Augustin and Miklosh Bala and Barie, {Philip S.} and Beltr{\'a}n, {Marcelo A.} and Aneel Bhangu and Belefquih Bouchra and Brecher, {Stephen M.} and Ca{\'i}nzos, {Miguel A.} and Adrian Camacho-Ortiz and Marco Catani and Chandy, {Sujith J.} and Jusoh, {Asri Che} and Cherry-Bukowiec, {Jill R.} and Osvaldo Chiara and Elif Colak and Cornely, {Oliver A.} and Yunfeng Cui and Zaza Demetrashvili and {De Simone}, Belinda and {De Waele}, {Jan J.} and Sameer Dhingra and {Di Marzo}, Francesco and Agron Dogjani and Gereltuya Dorj and Laurent Dortet and Duane, {Therese M.} and Elmangory, {Mutasim M.} and Enani, {Mushira A.} and Paula Ferrada and {Esteban Foianini}, J. and Mahir Gachabayov and Chinmay Gandhi and Ghnnam, {Wagih Mommtaz} and Helen Giamarellou and Georgios Gkiokas and Harumi Gomi and Tatjana Goranovic and Griffiths, {Ewen A.} and {Guerra Gronerth}, {Rosio I.} and {Haidamus Monteiro}, {Julio C.} and Hardcastle, {Timothy C.} and Andreas Hecker and Hodonou, {Adrien M.} and Orestis Ioannidis and Arda Isik and Iskandar, {Katia A.} and Kafil, {Hossein S.} and Kanj, {Souha S.} and Kaplan, {Lewis J.} and Garima Kapoor and Karamarkovic, {Aleksandar R.} and Jakub Kenig and Ivan Kerschaever and Faryal Khamis and Vladimir Khokha and Ronald Kiguba and Kim, {Hong B.} and Ko, {Wen Chien} and Kaoru Koike and Iryna Kozlovska and Anand Kumar and Leonel Lagunes and Rifat Latifi and JaeGil Lee and Lee, {Young R.} and Ari Lepp{\"a}niemi and Yousheng Li and Liang, {Stephen Y.} and Warren Lowman and Machain, {Gustavo M.} and Marc Maegele and Piotr Major and Sydney Malama and Ramiro Manzano-Nunez and Athanasios Marinis and {Martinez Casas}, Isidro and Sanjay Marwah and Emilio Maseda and McFarlane, {Michael E.} and Ziad Memish and Dominik Mertz and Cristian Mesina and Mishra, {Shyam K.} and Moore, {Ernest E.} and Akutu Munyika and Eleftherios Mylonakis and Lena Napolitano and Ionut Negoi and Nestorovic, {Milica D.} and Nicolau, {David P.} and Omari, {Abdelkarim H.} and Ordonez, {Carlos A.} and Paiva, {Jos{\'e} Artur} and Pant, {Narayan D.} and Parreira, {Jose G.} and Michal Pedziwiatr and Pereira, {Bruno M.} and Alfredo Ponce-de-Leon and Garyphallia Poulakou and Jacobus Preller and C{\'e}line Pulcini and Guntars Pupelis and Martha Quiodettis and Rawson, {Timothy M.} and Tarcisio Reis and Miran Rems and Sandro Rizoli and Jason Roberts and Pereira, {Nuno Rocha} and Jes{\'u}s Rodr{\'i}guez-Ba{\~n}o and Boris Sakakushev and James Sanders and Natalia Santos and Norio Sato and Sawyer, {Robert G.} and Sandro Scarpelini and Loredana Scoccia and Nusrat Shafiq and Vishalkumar Shelat and Sifri, {Costi D.} and Boonying Siribumrungwong and Kjetil S{\o}reide and Rodolfo Soto and {de Souza}, {Hamilton P.} and Peep Talving and Trung, {Ngo Tat} and Tessier, {Jeffrey M.} and Mario Tumbarello and Jan Ulrych and Selman Uranues and {Van Goor}, Harry and Andras Vereczkei and Florian Wagenlehner and Yonghong Xiao and Yuan, {Kuo Ching} and Agnes Wechsler-F{\"o}rd{\"o}s and Zahar, {Jean Ralph} and Zakrison, {Tanya L.} and Brian Zuckerbraun and Zuidema, {Wietse P.} and Fausto Catena",
year = "2017",
month = "8",
day = "1",
doi = "10.1186/s13017-017-0145-2",
language = "English",
volume = "12",
journal = "World Journal of Emergency Surgery",
issn = "1749-7922",
publisher = "BioMed Central",
number = "1",

}

Sartelli, M, Labricciosa, FM, Barbadoro, P, Pagani, L, Ansaloni, L, Brink, AJ, Carlet, J, Khanna, A, Chichom-Mefire, A, Coccolini, F, Di Saverio, S, May, AK, Viale, P, Watkins, RR, Scudeller, L, Abbo, LM, Abu-Zidan, FM, Adesunkanmi, AK, Al-Dahir, S, Al-Hasan, MN, Alis, H, Alves, C, Araujo da Silva, AR, Augustin, G, Bala, M, Barie, PS, Beltrán, MA, Bhangu, A, Bouchra, B, Brecher, SM, Caínzos, MA, Camacho-Ortiz, A, Catani, M, Chandy, SJ, Jusoh, AC, Cherry-Bukowiec, JR, Chiara, O, Colak, E, Cornely, OA, Cui, Y, Demetrashvili, Z, De Simone, B, De Waele, JJ, Dhingra, S, Di Marzo, F, Dogjani, A, Dorj, G, Dortet, L, Duane, TM, Elmangory, MM, Enani, MA, Ferrada, P, Esteban Foianini, J, Gachabayov, M, Gandhi, C, Ghnnam, WM, Giamarellou, H, Gkiokas, G, Gomi, H, Goranovic, T, Griffiths, EA, Guerra Gronerth, RI, Haidamus Monteiro, JC, Hardcastle, TC, Hecker, A, Hodonou, AM, Ioannidis, O, Isik, A, Iskandar, KA, Kafil, HS, Kanj, SS, Kaplan, LJ, Kapoor, G, Karamarkovic, AR, Kenig, J, Kerschaever, I, Khamis, F, Khokha, V, Kiguba, R, Kim, HB, Ko, WC, Koike, K, Kozlovska, I, Kumar, A, Lagunes, L, Latifi, R, Lee, J, Lee, YR, Leppäniemi, A, Li, Y, Liang, SY, Lowman, W, Machain, GM, Maegele, M, Major, P, Malama, S, Manzano-Nunez, R, Marinis, A, Martinez Casas, I, Marwah, S, Maseda, E, McFarlane, ME, Memish, Z, Mertz, D, Mesina, C, Mishra, SK, Moore, EE, Munyika, A, Mylonakis, E, Napolitano, L, Negoi, I, Nestorovic, MD, Nicolau, DP, Omari, AH, Ordonez, CA, Paiva, JA, Pant, ND, Parreira, JG, Pedziwiatr, M, Pereira, BM, Ponce-de-Leon, A, Poulakou, G, Preller, J, Pulcini, C, Pupelis, G, Quiodettis, M, Rawson, TM, Reis, T, Rems, M, Rizoli, S, Roberts, J, Pereira, NR, Rodríguez-Baño, J, Sakakushev, B, Sanders, J, Santos, N, Sato, N, Sawyer, RG, Scarpelini, S, Scoccia, L, Shafiq, N, Shelat, V, Sifri, CD, Siribumrungwong, B, Søreide, K, Soto, R, de Souza, HP, Talving, P, Trung, NT, Tessier, JM, Tumbarello, M, Ulrych, J, Uranues, S, Van Goor, H, Vereczkei, A, Wagenlehner, F, Xiao, Y, Yuan, KC, Wechsler-Fördös, A, Zahar, JR, Zakrison, TL, Zuckerbraun, B, Zuidema, WP & Catena, F 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, vol. 12, no. 1, 34. https://doi.org/10.1186/s13017-017-0145-2

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

In: World Journal of Emergency Surgery, Vol. 12, No. 1, 34, 01.08.2017.

Research output: Contribution to journalArticle

TY - JOUR

T1 - The Global Alliance for Infections in Surgery

T2 - Defining a model for antimicrobial stewardship-results from an international cross-sectional survey

AU - Sartelli, Massimo

AU - Labricciosa, Francesco M.

AU - Barbadoro, Pamela

AU - Pagani, Leonardo

AU - Ansaloni, Luca

AU - Brink, Adrian J.

AU - Carlet, Jean

AU - Khanna, Ashish

AU - Chichom-Mefire, Alain

AU - Coccolini, Federico

AU - Di Saverio, Salomone

AU - May, Addison K.

AU - Viale, Pierluigi

AU - Watkins, Richard R.

AU - Scudeller, Luigia

AU - Abbo, Lilian M.

AU - Abu-Zidan, Fikri M.

AU - Adesunkanmi, Abdulrashid K.

AU - Al-Dahir, Sara

AU - Al-Hasan, Majdi N.

AU - Alis, Halil

AU - Alves, Carlos

AU - Araujo da Silva, André R.

AU - Augustin, Goran

AU - Bala, Miklosh

AU - Barie, Philip S.

AU - Beltrán, Marcelo A.

AU - Bhangu, Aneel

AU - Bouchra, Belefquih

AU - Brecher, Stephen M.

AU - Caínzos, Miguel A.

AU - Camacho-Ortiz, Adrian

AU - Catani, Marco

AU - Chandy, Sujith J.

AU - Jusoh, Asri Che

AU - Cherry-Bukowiec, Jill R.

AU - Chiara, Osvaldo

AU - Colak, Elif

AU - Cornely, Oliver A.

AU - Cui, Yunfeng

AU - Demetrashvili, Zaza

AU - De Simone, Belinda

AU - De Waele, Jan J.

AU - Dhingra, Sameer

AU - Di Marzo, Francesco

AU - Dogjani, Agron

AU - Dorj, Gereltuya

AU - Dortet, Laurent

AU - Duane, Therese M.

AU - Elmangory, Mutasim M.

AU - Enani, Mushira A.

AU - Ferrada, Paula

AU - Esteban Foianini, J.

AU - Gachabayov, Mahir

AU - Gandhi, Chinmay

AU - Ghnnam, Wagih Mommtaz

AU - Giamarellou, Helen

AU - Gkiokas, Georgios

AU - Gomi, Harumi

AU - Goranovic, Tatjana

AU - Griffiths, Ewen A.

AU - Guerra Gronerth, Rosio I.

AU - Haidamus Monteiro, Julio C.

AU - Hardcastle, Timothy C.

AU - Hecker, Andreas

AU - Hodonou, Adrien M.

AU - Ioannidis, Orestis

AU - Isik, Arda

AU - Iskandar, Katia A.

AU - Kafil, Hossein S.

AU - Kanj, Souha S.

AU - Kaplan, Lewis J.

AU - Kapoor, Garima

AU - Karamarkovic, Aleksandar R.

AU - Kenig, Jakub

AU - Kerschaever, Ivan

AU - Khamis, Faryal

AU - Khokha, Vladimir

AU - Kiguba, Ronald

AU - Kim, Hong B.

AU - Ko, Wen Chien

AU - Koike, Kaoru

AU - Kozlovska, Iryna

AU - Kumar, Anand

AU - Lagunes, Leonel

AU - Latifi, Rifat

AU - Lee, JaeGil

AU - Lee, Young R.

AU - Leppäniemi, Ari

AU - Li, Yousheng

AU - Liang, Stephen Y.

AU - Lowman, Warren

AU - Machain, Gustavo M.

AU - Maegele, Marc

AU - Major, Piotr

AU - Malama, Sydney

AU - Manzano-Nunez, Ramiro

AU - Marinis, Athanasios

AU - Martinez Casas, Isidro

AU - Marwah, Sanjay

AU - Maseda, Emilio

AU - McFarlane, Michael E.

AU - Memish, Ziad

AU - Mertz, Dominik

AU - Mesina, Cristian

AU - Mishra, Shyam K.

AU - Moore, Ernest E.

AU - Munyika, Akutu

AU - Mylonakis, Eleftherios

AU - Napolitano, Lena

AU - Negoi, Ionut

AU - Nestorovic, Milica D.

AU - Nicolau, David P.

AU - Omari, Abdelkarim H.

AU - Ordonez, Carlos A.

AU - Paiva, José Artur

AU - Pant, Narayan D.

AU - Parreira, Jose G.

AU - Pedziwiatr, Michal

AU - Pereira, Bruno M.

AU - Ponce-de-Leon, Alfredo

AU - Poulakou, Garyphallia

AU - Preller, Jacobus

AU - Pulcini, Céline

AU - Pupelis, Guntars

AU - Quiodettis, Martha

AU - Rawson, Timothy M.

AU - Reis, Tarcisio

AU - Rems, Miran

AU - Rizoli, Sandro

AU - Roberts, Jason

AU - Pereira, Nuno Rocha

AU - Rodríguez-Baño, Jesús

AU - Sakakushev, Boris

AU - Sanders, James

AU - Santos, Natalia

AU - Sato, Norio

AU - Sawyer, Robert G.

AU - Scarpelini, Sandro

AU - Scoccia, Loredana

AU - Shafiq, Nusrat

AU - Shelat, Vishalkumar

AU - Sifri, Costi D.

AU - Siribumrungwong, Boonying

AU - Søreide, Kjetil

AU - Soto, Rodolfo

AU - de Souza, Hamilton P.

AU - Talving, Peep

AU - Trung, Ngo Tat

AU - Tessier, Jeffrey M.

AU - Tumbarello, Mario

AU - Ulrych, Jan

AU - Uranues, Selman

AU - Van Goor, Harry

AU - Vereczkei, Andras

AU - Wagenlehner, Florian

AU - Xiao, Yonghong

AU - Yuan, Kuo Ching

AU - Wechsler-Fördös, Agnes

AU - Zahar, Jean Ralph

AU - Zakrison, Tanya L.

AU - Zuckerbraun, Brian

AU - Zuidema, Wietse P.

AU - Catena, Fausto

PY - 2017/8/1

Y1 - 2017/8/1

N2 - 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.

AB - 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.

UR - http://www.scopus.com/inward/record.url?scp=85026663045&partnerID=8YFLogxK

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U2 - 10.1186/s13017-017-0145-2

DO - 10.1186/s13017-017-0145-2

M3 - Article

VL - 12

JO - World Journal of Emergency Surgery

JF - World Journal of Emergency Surgery

SN - 1749-7922

IS - 1

M1 - 34

ER -