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[意大利坎帕尼亚地区外科手术后感染的多中心调查]

[Multicentre survey of post-surgical infections in Campania (Italy)].

作者信息

Esposito Silvano, Ianniello Filomena, Leone Sebastiano, Noviello Silvana, Marvaso Alberto, Iannantuoni Nicola, Esposito Eulalia, Imperato Luigi, Aiello Domenico, Aloisio Teresa, Maio Patrizia, Acierno Domenico, Romano Giovanni, Patrelli Germanico

机构信息

Dipartimento di Malattie Infettive, Seconda Universita di Napoli, Italy.

出版信息

Infez Med. 2003 Sep;11(3):146-52.

Abstract

The aim of the study was to evaluate the incidence of post-surgical infections and to assess the way of managing antibiotic surgical prophylaxis. The survey was carried out by means of a questionnaire in order to obtain diverse information such as demographics, length of pre- and post-operative hospitalization, type of surgery, intervention duration, possible antibiotic prophylaxis and onset of post-surgical infections also monitored by post-discharge ambulatory controls. Four General Surgery and five Obstetrics and Gynaecology Departments in Campania (southern Italy) participated in the study, which was carried out in the period December 2001-January 2002. Overall, 410 questionnaires were collected referring to as many patients; antibiotic prophylaxis was performed in 385 (93.9%) patients. Antibiotic prophylaxis was generally managed not according to the general principles suggested by the international guidelines either for timing or for its duration or for the route of administration. Substantial differences were also noted in patient selection and antibiotic choice. Surgical site infections were recorded in 0.6% of patients undergoing clean surgery, in 5.3% of patients undergoing clean-contaminated surgery and in 3.2% of those undergoing contaminated surgery. Distant infections occurred in 1.8% and 6.5% in clean-contaminated and contaminated surgery, respectively. The results of the present study suggest the need of a continuous and accurate monitoring of post-surgical infections and the need to adopt appropriate guidelines to improve the management of surgical prophylaxis.

摘要

本研究的目的是评估外科手术后感染的发生率,并评估抗生素外科预防性使用的管理方式。通过问卷调查进行此项调查,以获取各种信息,如人口统计学资料、术前和术后住院时间、手术类型、手术持续时间、可能的抗生素预防性使用情况以及术后感染的发生情况(出院后门诊随访也对此进行监测)。意大利南部坎帕尼亚大区的四个普通外科科室和五个妇产科科室参与了此项于2001年12月至2002年1月期间开展的研究。总体而言,共收集了410份问卷,涉及同样数量的患者;385例(93.9%)患者进行了抗生素预防性使用。抗生素预防性使用通常未按照国际指南建议的一般原则进行,无论是在用药时机、用药持续时间还是给药途径方面。在患者选择和抗生素选择上也存在显著差异。清洁手术患者的手术部位感染发生率为0.6%,清洁-污染手术患者为5.3%,污染手术患者为3.2%。清洁-污染手术和污染手术中远处感染的发生率分别为1.8%和6.5%。本研究结果表明,需要持续、准确地监测外科手术后感染,并需要采用适当的指南来改善外科预防性使用的管理。

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