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Prevention of Surgical Site Infections in Neonates and Children: Non-Pharmacological Measures of Prevention.

ABSTRACT: A surgical site infection (SSI) is an infection that occurs in the incision created by an invasive surgical procedure. Although most infections are treatable with antibiotics, SSIs remain a significant cause of morbidity and mortality after surgery and have a significant economic impact on health systems. Preventive measures are essential to decrease the incidence of SSIs and antibiotic abuse, but data in the literature regarding risk factors for SSIs in the pediatric age group are scarce, and current guidelines for the prevention of the risk of developing SSIs are mainly focused on the adult population. This document describes the current knowledge on risk factors for SSIs in neonates and children undergoing surgery and has the purpose of providing guidance to health care professionals for the prevention of SSIs in this population. Our aim is to consider the possible non-pharmacological measures that can be adopted to prevent SSIs. To our knowledge, this is the first study to provide recommendations based on a careful review of the available scientific evidence for the non-pharmacological prevention of SSIs in neonates and children. The specific scenarios developed are intended to guide the healthcare professional in practice to ensure standardized management of the neonatal and pediatric patients, decrease the incidence of SSIs and reduce antibiotic abuse.

SUBMITTER: Meoli A

PROVIDER: S-EPMC9311619 | biostudies-literature | 2022 Jun

REPOSITORIES: biostudies-literature

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Prevention of Surgical Site Infections in Neonates and Children: Non-Pharmacological Measures of Prevention.

Meoli Aniello A Ciavola Lorenzo L Rahman Sofia S Masetti Marco M Toschetti Tommaso T Morini Riccardo R Dal Canto Giulia G Auriti Cinzia C Caminiti Caterina C Castagnola Elio E Conti Giorgio G Donà Daniele D Galli Luisa L La Grutta Stefania S Lancella Laura L Lima Mario M Lo Vecchio Andrea A Pelizzo Gloria G Petrosillo Nicola N Simonini Alessandro A Venturini Elisabetta E Caramelli Fabio F Gargiulo Gaetano Domenico GD Sesenna Enrico E Sgarzani Rossella R Vicini Claudio C Zucchelli Mino M Mosca Fabio F Staiano Annamaria A Principi Nicola N Esposito Susanna S On Behalf Of The Peri-Operative Prophylaxis In Neonatal And Paediatric Age Pop-NeoPed Study Group

Antibiotics (Basel, Switzerland) 20220627 7

A surgical site infection (SSI) is an infection that occurs in the incision created by an invasive surgical procedure. Although most infections are treatable with antibiotics, SSIs remain a significant cause of morbidity and mortality after surgery and have a significant economic impact on health systems. Preventive measures are essential to decrease the incidence of SSIs and antibiotic abuse, but data in the literature regarding risk factors for SSIs in the pediatric age group are scarce, and c ...[more]

PMID: 35884117

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Project description:Surgical site infections have a remarkable impact on morbidity, extended hospitalization and mortality. Sutures strongly contribute to development of surgical site infections as they are considered foreign material in the human body. Sutures serve as excellent surfaces for microbial adherence and subsequent colonization, biofilm formation and infection on the site of a surgery. Various antimicrobial sutures have been developed to prevent suture-mediated surgical site infection. However, depending on the site of surgery, antimicrobial sutures may remain ineffective, and antimicrobial agents on them might have drawbacks. Plasma, defined as the fourth state of matter, composed of ionized gas, reactive oxygen and nitrogen species, free radical and neutrals, draws attention for the control and prevention of hospital-acquired infections due to its excellent antimicrobial activities. In the present study, the efficacy of non-thermal atmospheric plasma treatment for prevention of surgical site infections was investigated. First, contaminated poly (glycolic-co-lactic acid), polyglycolic acid, polydioxanone and poly (glycolic acid-co-caprolactone) sutures were treated with non-thermal atmospheric plasma to eradicate contaminating bacteria like Staphylococcus aureus and Escherichia coli. Moreover, sutures were pre-treated with non-thermal atmospheric plasma and then exposed to S. aureus and E. coli. Our results revealed that non-thermal atmospheric plasma treatment effectively eradicates contaminating bacteria on sutures, and non-thermal atmospheric plasma pre-treatment effectively prevents bacterial colonization on sutures without altering their mechanical properties. Chemical characterization of sutures was performed with FT-IR and XPS and results showed that non-thermal atmospheric plasma treatment substantially increased the hydrophilicity of sutures which might be the primary mechanism for the prevention of bacterial colonization. In conclusion, plasma-treated sutures could be considered as novel alternative materials for the control and prevention of surgical site infections.

Project description:Introduction: The objective of the analysis was to determine the epidemiology of healthcare-associated infections (HAIs) in neurosurgical patients, paying special attention to two time points, 2003 and 2017, in order to evaluate the effectiveness of a surveillance program introduced in 2003 and efforts to reduce infection rates. Materials and methods: Continuous surveillance during 2003⁻2017 carried out using the HAI-Net methodology allowed us to detect 476 cases of HAIs among 10,332 patients staying in a 42-bed neurosurgery unit. The intervention in this before⁻after study (2003⁻2017) comprised standardized HAI surveillance with regular analysis and feedback. Results: The HAI incidence during the whole study was 4.6%. Surgical site infections (SSIs) accounted for 33% of all HAIs with an incidence rate of 1.5%. The remaining infections were pneumonia (1.1%) and bloodstream infections (0.9%). The highest SSI incidence concerned spinal fusion (FUSN, 2.2%), craniotomy (1.9%), and ventricular shunt (5.1%) while the associated total HAI incidence rates were 4.1%, 8.0%, and 18.6%, respectively. A significant reduction was found in HAI incidence between 2003 and 2017 in regard to the most common surgery types: laminectomy (4.5% vs. 0.8%); FUSN (11.8% vs. 0.8%); and craniotomy (10.1% vs. 0.4%). Significant changes were also achieved in selected elements of the unit's work: pre-hospitalization duration, hospital stay, and surgery length reductions. Simultaneously, the general condition of patients became significantly worse: there was an increase in patients' age and decreases in their general condition as expressed by ASA scores (The American Society of Anesthesiologists physical status classification system). Conclusions: HAI epidemiology changed substantially during the study period. Among the main types of HAI, SSIs were slightly predominant, but non-surgical HAIs accounted for almost two thirds of all infections; this indicates the need for surveillance of infection types other than SSIs in surgical patients. The implementation of active surveillance based on regular analysis and feedback led to a significant reduction in HAI incidence.

Project description:Excessive fatigue and insomnia are common among shift workers and can lead to negative effects such as reduced work performance, processing errors, accidents at work, absenteeism, reduced quality of life, and symptoms of depression. Moreover, work in rotating shifts can be a risk factor for different somatic and psychiatric diseases and may contribute to poor health, especially in elder adults and women. This review aims to show non-pharmacological preventive measures against fatigue and insomnia in shift workers.Computerized literature searches in MedLine and in the Cochrane Library were performed with the following key words: shift work disorder, fatigue, insomnia, shift work, measures, treatment, therapy, strategies and coping. The search was limited to non-pharmacological studies that were conducted on human subjects and published as English-language articles in peer-reviewed journals since 1970. Additional studies were identified through the reference sections of relevant articles. Eighteen articles on fatigue in shift workers, including six original research articles with a total sample size of 3504 probands consisting of industrial workers, office employees, aircraft maintenance engineers, and non-shift workers working in simulated shifts, were analyzed, as well as seven articles on insomnia, including an original research article with a sample size of 26 media workers. Also, 4 reviews on shift work disorder were analyzed.The occurrence of fatigue and insomnia in shift workers associated with a working period is described as shift work disorder. Estimations on the prevalence of shift work disorder in shift workers vary between 5 % and about 20 %; about one in three shift workers is affected by insomnia and up to 90 % of shift workers report regular fatigue and sleepiness at the workplace. We concluded that there is a necessity for treatments to improve the sleep quality of the shift working population. The most common non-pharmacological recommendations to improve sleep quality and to reduce insomnia and fatigue were scheduling, bright light exposure, napping, psychoeducation for sleep hygiene, and cognitive-behavioral measures.Some important preventive coping strategies for fatigue associated with shift work such as napping and exposure to bright light have already been investigated and are generally approved. A few studies also provide good evidence for the efficacy of cognitive-behavioral techniques in the treatment of chronic primary and comorbid insomnia. These coping strategies summarized in this paper should be considered in the workplace health promotion programs of each work environment to improve working conditions for shift workers and to save money.

Dataset Information

Prevention of Surgical Site Infections in Neonates and Children: Non-Pharmacological Measures of Prevention.

Publications

Prevention of Surgical Site Infections in Neonates and Children: Non-Pharmacological Measures of Prevention.

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