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‘ workplace:
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:
Prakt. Lék. 2017; 97(4): 147-150
Category:
Reviews
Overview
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
Sources
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General practitioner for children and adolescents General practitioner for adultsArticle was published in
General Practitioner
2017 Issue 4
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