Possibilities of prevention of nosocomial infections in patients before serious surgical procedures
Authors:
V. Bencko 1; L. Glasauer 1; S. Wissel 1; M. Schneiderová 2
Authors place of work:
Ústav hygieny a epidemiologie 1. LF UK a VFN, Praha
Přednosta: prof. MUDr. Milan Tuček, CSc.
1; I. chirurgická klinika – břišní, hrudní a úrazová chirurgie 1. LF UK a VFN, Praha
Přednosta: prof. MUDr. Zdeněk Krška, DrSc.
2
Published in the journal:
Prakt. Lék. 2017; 97(4): 147-150
Category:
Reviews
Summary
Patients who undergo any major surgery face considerable physical and mental stress. A surgery, especially e.g. colon resection for colorectal cancer has a significant influence on the immune system of the patient. Even psychological stress during the preoperative period, depending on patient mental condition is leading to some degree of immunosuppression that reduces the level of its resistance to any load. Therefore, in patients undergoing major surgery, increased risk of infections, not only at the surgical site, but the risk of current nosocomial infections. The classic examples are inflammation of lungs or in extreme cases the sepsis. To avoid these infections, or significantly reduce the risk of these infections, surgery provides current perioperative antibiotic prophylaxis (PAP) in patients undergoing major, increasingly planned surgery. In patients with an increased risk of complications (heart valve implanted, joints, diabetes etc.) is continued use of antibiotics in the postoperative period mandatory. The choice of a suitable antibiotic is consulted with antibiotic centre and microbiologists with respect to the patient’s condition and the current epidemiological situation in the hospital. To prevent the emergence of resistance and nosocomial infections, antibiotic prophylaxis is strictly individual, taking into account all the circumstances. In the area of prevention of nosocomial infections it is possible to think about another ways to boost preoperative immunity of patients and also to take into account the side effects of antibiotics use, such as increasing antibiotic resistance and the associated incidence of multidrug-resistant strains of infectious agents in the hospital and community settings. In this context, there are emerging two other options that can support the immune status of the patient and help to prevent post-operative infections. Beta-glucans and specific vaccination using Clostridium toxoid are promising options, suitable for reducing the incidence of infections and to improve the immune status of patients. The results available so far justify considering the possibility of initiating evidence based clinical study in which the PAP would combine with either vaccination or application of beta-glucans in the context of applied or basic biomedical research.
Keywords:
perioperative antibiotic prophylaxis – antibiotic resistance – nosocomial infections – beta-glucans – vaccination
Zdroje
1. Mohabir PK, Gurney J. Antibiotic prophylaxis for surgical procedures [online]. Dostupné z: http://www.merckmanuals.com/professional/special--subjects/care-of-the-surgical-patient/antibiotic-prophylaxis-for-surgical-procedures [cit. 24-04-2017].
2. European Centre for Disease Prevention and Control (ECDC). Systematic review and evidence-based guidance on perioperative antibiotic prophylaxis [online]. Dostupné z: http://ecdc.europa.eu/en/publications/Publications/Perioperative%20antibiotic%20prophylaxis%20-%20June%202013.pdf [cit. 24-04-2017].
3. World Health Organization. WHO Guidelines for safe surgery 2009. Dostupné z: http://apps.who.int/iris/bitstream//10665/44185/1/9789241598552_eng.pdf [cit. 24-04-2017].
4. Wesley JA, Solomkin JS, Edwards MJ. Updated recommendations for control of surgical site infections. Ann Surg 2011; 253(6): 1082–1093.
5. Nelson RL, Glenny AM, Song F. Antimicrobial prophylaxis for colorectal surgery. Cochrane Database Syst Rev 2009; (1): CD001181.
6. Sandvik A. A study on immunomodulating beta-glucan: Effects of oral application on inflammation, tissue injury, and the mucosal immune system in experimental animals [online]. Dostupné z: https://www.duo.uio.no/bitstream/handle/10852/28131/754_Sandvik_17x24.pdf?sequence=1 [cit. 24-04-2017].
7. Bencko V, Šíma P, Turek B. Imunomodulační účinky betaglukanů. Hygiena 2016; 61(4): 167–171.
8. Akramiene D, Kondrotas A, Didziapetriene J, Kevelaitis E. Effects of beta-glucans on the immune system. Medicina (Kaunas) 2007; 43(8): 597–606.
9. Babineau TJ, Marcello P, Swails W, et al. Randomized phase I/II trial of a macrophage-specific immunomodulator (PGG-glucan) in high-risk surgical patients. Ann Surg 1994; 220(5): 601–609.
10. Suzuki I, Hashimoto K, Ohno N, et al. Immunomodulation by orally administered beta-glucan in mice. Int J Immunopharmacol 1989; 11(7): 761–769.
11. Stier H, Ebbeskotte V, Gruenwald J. Immune-modulatory effects of dietary Yeast Beta-1,3/1,6-D-glucan. Nutr J. 2014; 13: 38. doi:10.1186/1475-2891-13-38.
12. Bone and joint hospital at St. Anthony. Pre-operative instructions for your upcoming surgery [online]. Dostupné z: http://www.boneand joint.com/patientsfamilies/Documents/Online%20Forms/Pre-Operative_Instructions.pdf [cit. 24-04-2017].
13. CDC. Pneumococcal vaccination [online]. Dostupné z: https://www.cdc.gov/pneumococcal/vaccination.html [cit. 24-04-2017].
14. Khafagy M, Mayla AM, Khafagy A, et al. Postoperative anaerobic sepsis could be combated by prophylactic vaccination. J Chem Pharm Res 2016; 8(3): 402–404.
15. Khafagy M, Mayla AM, Khafagy A, El-Dweik M. Drop of post-operative infection after pre-operative vaccination with anaerobic toxoids (a clinical study of 445 patients). Poster. Liverpool, UK, Microbiology Society Annual Conference 2016. Dostupný z: https://www.researchgate.net/publication//300105928_Drop_of_post-operative_infection_after_pre- operative_vaccination_with_anaerobic_toxoids_a_clinical_study_of_445_patients [cit. 24-04-2017].
Štítky
General practitioner for children and adolescents General practitioner for adultsČlánok vyšiel v časopise
General Practitioner
2017 Číslo 4
- Advances in the Treatment of Myasthenia Gravis on the Horizon
- Memantine Eases Daily Life for Patients and Caregivers
- What Effect Can Be Expected from Limosilactobacillus reuteri in Mucositis and Peri-Implantitis?
- Spasmolytic Effect of Metamizole
- Metamizole at a Glance and in Practice – Effective Non-Opioid Analgesic for All Ages
Najčítanejšie v tomto čísle
- Relationship between patients’ falls and selected risk factors
- Differentiations in the quality of life perception in seniors
- Possibilities of prevention of nosocomial infections in patients before serious surgical procedures
- Trends and correlates of overweight and obesity in Czech adolescents in relation to socioeconomic status of their families between 2002–2014