Abstract:
: Background: The greatest burden of sepsis- and septic shock-related morbidity and mortality is in low- and middle-income countries (LMICs). Accurate tracking of incidence and outcomes of patients in LMICs with sepsis has been limited by changing definitions, lack of diagnosis coding and health records, and deficits in personnel. Improving sepsis care in LMICs requires studying outcomes prospectively so that setting appropriate definitions, scoring systems, and treatment guidelines can be created. Our goal is to review the burden of sepsis and septic shock in LMICs, the evolution and applicability of definitions to LMICs, and management. Methods: The literature was searched through PubMed using a Boolean approach and the following terms: sepsis, septic shock, low- and middle-income countries. Articles were read by the authors and relevant information was abstracted and included with citations to create a narrative review. Results: The estimated worldwide incidence of sepsis admissions is 31.5 million cases per year leading to 5.3 million deaths. The World Health Organization (WHO) has urged LMICs to establish sepsis prevalence and outcomes. Most authors and societies involved in creating sepsis and septic shock definitions have been from high-income countries (HICs). Applicability of sepsis definitions in LMICs is uncertain. Quick-Sequential Organ Failure Assessment (qSOFA) and universal vital assessment (UVA) are useful screening and triage tools in LMICs because they can be done at the bedside. The key tenets of management of sepsis and septic shock in LMICs include early fluid resuscitation and antibiotic therapy coupled with source control when there is a surgical process. Surgical causes of sepsis should be identified rapidly. Scaling up surgical capacity in LMICs is an important step to improve source control of sepsis. Conclusion: Management guidelines specific to LMICs for sepsis and septic shock need to be refined further and studied prospectively. Improving access to surgery will improve outcomes of surgical cases of sepsis.
journal_name
Surg Infect (Larchmt)journal_title
Surgical infectionsauthors
Stephen AH,Montoya RL,Aluisio ARdoi
10.1089/sur.2020.047subject
Has Abstractpub_date
2020-09-01 00:00:00pages
571-578issue
7eissn
1096-2964issn
1557-8674journal_volume
21pub_type
杂志文章abstract:BACKGROUND:The aim of this study was to review the post-operative and infectious complications and determine the risk factors associated with infections in cytoreductive surgery (CRS) and hyperthermic intra-peritoneal chemotherapy (HIPEC). PATIENTS AND METHODS:Between October 2007 and December 2013, patients who under...
journal_title:Surgical infections
pub_type: 杂志文章
doi:10.1089/sur.2016.102
更新日期:2017-02-01 00:00:00
abstract:BACKGROUND:Blood stream infections (BSIs) remain as a serious life-threatening condition after solid organ transplant (SOT). In recent years, a progressive growth in the incidence of bacteremia caused by non-lactose fermenting gram-negative bacilli (NLF GNB) has been observed. NLF GNB led to high mortality among SOT re...
journal_title:Surgical infections
pub_type: 杂志文章,评审
doi:10.1089/sur.2015.005
更新日期:2015-10-01 00:00:00
abstract:BACKGROUND:Data on antimicrobial prophylaxis for open fractures is limited, with many protocols based on expert recommendations. These protocols include aminoglycosides (AGs) for fractures with significant soft tissue injury, but these drugs are associated with acute kidney injury (AKI) in other settings; this risk has...
journal_title:Surgical infections
pub_type: 杂志文章
doi:10.1089/sur.2015.086
更新日期:2016-12-01 00:00:00
abstract:BACKGROUND:The approach to perioperative antibiotic prophylaxis, bowel preparation, and postoperative routines in elective colorectal resections has changed over the last two decades. The aim of this national survey was to document the current methods of perioperative management of those patients scheduled for elective...
journal_title:Surgical infections
pub_type: 杂志文章
doi:10.1089/sur.2005.6.305
更新日期:2005-10-01 00:00:00
abstract:BACKGROUND:The optimal duration of antimicrobial therapy for treatment of complicated intra-abdominal infections (cIAI) in critically ill surgical patients is unknown. Recent evidence suggests that a short (four-day) course of therapy may be effective, however data in severely critically ill patients are limited. PATI...
journal_title:Surgical infections
pub_type: 杂志文章
doi:10.1089/sur.2017.011
更新日期:2017-08-01 00:00:00
abstract:: Background: This study was performed to investigate the combination of admission serum procalcitonin (PCT) and albumin (alb) concentrations as a diagnostic predictor for discriminating patients with nosocomial blood stream infection (BSI) among those with spontaneous intra...
journal_title:Surgical infections
pub_type: 杂志文章
doi:10.1089/sur.2018.260
更新日期:2019-12-01 00:00:00
abstract:: Background: Fungal isolates from peritoneal fluid sampling in patients with perforated peptic ulcer (PPU) is not uncommon and its management unclear. This study aims to evaluate whether the presence of fungus in peritoneal fluid cultures is a predictor of morbidity and mor...
journal_title:Surgical infections
pub_type: 杂志文章
doi:10.1089/sur.2019.024
更新日期:2019-12-01 00:00:00
abstract:BACKGROUND:Surgical site infection (SSI), the third most common type of nosocomial infection in Sweden, is a patient injury that should be prevented. Methods of reducing SSIs include, for instance, disinfecting the skin, maintaining body temperature, and ensuring an aseptic environment. Guidelines for most of these int...
journal_title:Surgical infections
pub_type: 杂志文章
doi:10.1089/sur.2017.286
更新日期:2018-05-01 00:00:00
abstract:BACKGROUND:The aim of this study was to investigate the effect of door opening rates on air quality in the operation room during hip revision surgery by measuring the number of colony forming units per cubic meter (CFU/m(3)). METHODS:During 70 hip revision operations the number of CFU/m(3) was measured at four time po...
journal_title:Surgical infections
pub_type: 杂志文章,多中心研究
doi:10.1089/sur.2015.174
更新日期:2016-10-01 00:00:00
abstract:: Background: Biliary tract infection (BTI) is a common complication in patients with biliary obstruction caused by various biliary tract disorders. To improve the management of patients with BTI, microbial profiles from bile cultures and antibiotic resistance patterns were ...
journal_title:Surgical infections
pub_type: 杂志文章
doi:10.1089/sur.2019.041
更新日期:2019-09-01 00:00:00
abstract:BACKGROUND:Pre-existing humoral barriers challenge the transplantation of living donor kidneys (LDK) into highly sensitized ABO- and human leukocyte antigen (HLA)-incompatible recipients. Conditioning these LDK recipients' immune systems is required before they undergo transplantation. We hypothesized that medical dese...
journal_title:Surgical infections
pub_type: 杂志文章
doi:10.1089/sur.2012.231
更新日期:2014-06-01 00:00:00
abstract:: Background: Faulty cleaning of surgical instruments may lead to corrosion damage and a higher risk of surgical site infection. We have developed a method in which each instrument has an attached radiofrequency identification (RFID) tag for individual management. However, b...
journal_title:Surgical infections
pub_type: 杂志文章
doi:10.1089/sur.2019.034
更新日期:2019-12-01 00:00:00
abstract:BACKGROUND:We defined the contemporary conversion rate from laparoscopic appendectomy (LA) to open appendectomy and identified pre-operative factors associated with conversion. METHODS:Retrospective review of 941 consecutive LAs performed for suspected acute appendicitis in a single urban university hospital between 2...
journal_title:Surgical infections
pub_type: 杂志文章
doi:10.1089/sur.2010.079
更新日期:2011-08-01 00:00:00
abstract:BACKGROUND:Portal hypertension in the mucosa of the intestine and the presence of granulomas in the wall of this organ can alter digestive function in patients with schistosomiasis. Citrulline is a potential marker of intestinal function in some diseases that affect the morphometry of the mucosa because of its close as...
journal_title:Surgical infections
pub_type: 杂志文章
doi:10.1089/sur.2009.066
更新日期:2010-10-01 00:00:00
abstract:BACKGROUND:To determine if there is a difference in periocular post-operative infection rates when utilizing new versus re-processed monopolar electrocautery tips. METHODS:Retrospective cohort study of 4,976 consecutive surgical cases involving 17,149 procedures. Post-operative infections were identified using chart r...
journal_title:Surgical infections
pub_type: 杂志文章
doi:10.1089/sur.2014.055
更新日期:2015-06-01 00:00:00
abstract:BACKGROUND:Implant-related infections in hand surgery are dreaded complications, potentially leading to loss of finger joint function or amputation. Knowledge about the clinical presentation and treatment concepts of these infections is limited. The aim of this study is to present a consecutive series of patients with ...
journal_title:Surgical infections
pub_type: 杂志文章
doi:10.1089/sur.2018.133
更新日期:2018-10-01 00:00:00
abstract:BACKGROUND:The designation "gram-positive bacillus" includes a variety of pleomorphic microorganisms, including diphtheroids, coryneform species, coccobacilli, and other small rods. Despite differing greatly in their virulence, sources, and even genus, these microscopically similar organisms are often difficult to diff...
journal_title:Surgical infections
pub_type: 杂志文章,评审
doi:10.1089/sur.2008.085
更新日期:2010-02-01 00:00:00
abstract:BACKGROUND:In recent years, there has been a worldwide increase in infections caused by microorganisms resistant to multiple antimicrobial agents. METHODS:In the past few decades, an increased prevalence of infections caused by antibiotic-resistant pathogens, including Enterococcus spp., carbapenem-resistant Pseudomon...
journal_title:Surgical infections
pub_type: 杂志文章,评审
doi:10.1089/sur.2013.262
更新日期:2015-06-01 00:00:00
abstract:BACKGROUND:The pathogenic organisms responsible for the manifestations of secondary peritonitis have been well characterized through almost 30 years of experimental and clinical studies. Enteric gram-negative organisms and anaerobes predominate, with Escherichia coli and Bacteroides fragilis, respectively, being the mo...
journal_title:Surgical infections
pub_type: 杂志文章,评审
doi:10.1089/109629601750469474
更新日期:2001-07-01 00:00:00
abstract:BACKGROUND:Surgical infections, and sepsis in particular, are characterized by extensive release of mediators. Our laboratories have been interested in understanding how these substances contribute to morbidity and mortality during various stages of surgical infections in order to develop new and more effective therape...
journal_title:Surgical infections
pub_type: 杂志文章,评审
doi:10.1089/sur.2006.7.s2-3
更新日期:2006-01-01 00:00:00
abstract:BACKGROUND:Previously, we developed an infection model by intraperitoneal (IP) injection of Klebsiella pneumoniae. The high early mortality rate prompted a study of the effect of gentamicin on the disease course. METHODS:Infection was induced in Balb/c mice by IP inoculation of 10(3) colony-forming units (cfu) of K. p...
journal_title:Surgical infections
pub_type: 杂志文章
doi:10.1089/sur.2006.060
更新日期:2007-06-01 00:00:00
abstract::Antibiotics are important in the prophylaxis and treatment of surgical infections as well as in the management of nosocomial infections acquired postoperatively in surgical patients. Surgeons encounter a range of infectious conditions, including established single-pathogen infections of soft tissues, polymicrobial int...
journal_title:Surgical infections
pub_type: 杂志文章,评审
doi:10.1089/sur.2001.2.s1-3
更新日期:2001-01-01 00:00:00
abstract:BACKGROUND:The utility of tigecycline as compared with other antibiotic therapies in the treatment of patients with complicated intra-abdominal infection (cIAI) and the short- and long-term outcomes of a large cohort of severely ill patients were examined. We provide the first published data on post-discharge events fo...
journal_title:Surgical infections
pub_type: 杂志文章,多中心研究
doi:10.1089/sur.2015.075
更新日期:2016-08-01 00:00:00
abstract:BACKGROUND:With high morbidity and potentially devastating consequences, surgical site infections (SSIs) after cardiac surgery add substantially to the healthcare burden. Inhibiting migration of skin microbes is likely to reduce contamination of the surgical incision by endogenous potential pathogens. We studied the ef...
journal_title:Surgical infections
pub_type: 杂志文章
doi:10.1089/sur.2011.050
更新日期:2011-12-01 00:00:00
abstract::Multiple organ dysfunction syndrome (MODS) is caused by an overwhelming, uncontrolled systemic inflammatory response that is activated by a number of hostile stimuli including sepsis, hypovolemic shock, and severe trauma resulting in massive tissue injury. The indiscriminate activation of the inflammatory response due...
journal_title:Surgical infections
pub_type: 杂志文章,评审
doi:10.1089/109629600750018123
更新日期:2000-10-01 00:00:00
abstract:BACKGROUND:We investigated the clinical effectiveness of antimicrobial prophylaxis in lower-extremity open fractures following the Eastern Association for the Surgery of Trauma Guidelines. METHODS:This observational, retrospective, single-center study included adults with lower-extremity open fractures of the ankle, t...
journal_title:Surgical infections
pub_type: 杂志文章
doi:10.1089/sur.2016.219
更新日期:2017-04-01 00:00:00
abstract:BACKGROUND:In 2013, the Centers for Disease Control and Prevention (CDC) developed new surveillance definitions for ventilator-associated events (VAE), leading to concerns that hospitals may be underreporting the true incidence of ventilator-associated pneumonias (VAPs). We sought to compare rates of clinically diagnos...
journal_title:Surgical infections
pub_type: 杂志文章
doi:10.1089/sur.2016.152
更新日期:2017-07-01 00:00:00
abstract:BACKGROUND:Clostridium perfringens myonecrosis following an elective surgical procedure in a previously healthy child is a rare incident. METHODS:Case report and literature review. RESULTS:A two-year old boy admitted for elective bilateral osteotomies of tibiae was detected to be febrile at day one post-operatively w...
journal_title:Surgical infections
pub_type: 杂志文章
doi:10.1089/sur.2012.192
更新日期:2014-10-01 00:00:00
abstract:BACKGROUND:Patients with necrotizing soft tissue infections (NSTIs) require prompt surgical debridement, appropriate intravenous antibiotics, and intensive support. Despite aggressive treatment, their mortality and morbidity rates remain high. The benefit of hyperbaric oxygen (HBO) as an adjunctive treatment is controv...
journal_title:Surgical infections
pub_type: 杂志文章,多中心研究
doi:10.1089/sur.2007.085
更新日期:2009-02-01 00:00:00
abstract:BACKGROUND:Surgical site infections are reduced by appropriate and timely antimicrobial prophylaxis. Consensus guidelines recommend that antimicrobial infusion begin within 60 min prior to creation of the incision. An internal audit of our institution suggested poor guideline compliance. We hypothesized that the additi...
journal_title:Surgical infections
pub_type: 杂志文章
doi:10.1089/sur.2008.054
更新日期:2010-08-01 00:00:00