Antibiotics for preventing infection at the surgical site: Single dose vs. multiple doses

Comparative Analysis of Antibiotic Prophylaxis Guidelines in Cardiac Surgery: A Survey in Czechia and Slovakia

OBJECTIVES

Surgical site infections (SSIs) in cardiac surgery significantly impact patient outcomes. This study examines cardiac antimicrobial prophylaxis guidelines in Czech and Slovak hospitals, crucial for reducing SSI incidence.

METHODS

An electronic survey was conducted across cardiac surgery departments in both countries, focusing on surgical antibiotic prophylaxis (SAP) protocols, antibiotic choices, dosages, timing, and postoperative infection rates. Responses were collected over three months, ensuring a comprehensive overview.

RESULTS

Most surveyed hospitals (79 %) implement SAP, but guidelines exhibit notable variability. Cefazolin dominates as the primary prophylactic choice, with varying dosing regimens. Challenges include timing inconsistencies and prolonged prophylaxis durations, particularly in implant-related procedures. Regular guideline revisions are reported in 18 % of hospitals within the last year, emphasizing the need for updated practices.

CONCLUSION

This study shows the importance of standardizing SAP practices, aligning them with evolving evidence, and implementing regular guideline revisions. The observed variations highlight opportunities for enhanced SSI prevention strategies in cardiac surgery, ultimately contributing to improved patient outcomes.

Point-Prevalence Survey of Antimicrobial Use and Healthcare-Associated Infections in Four Acute Care Hospitals in Kazakhstan

BACKGROUND/OBJECTIVES

Few studies have examined the prevalence of healthcare-associated infections (HAIs) and antimicrobial use (AMU) in acute care hospitals in Kazakhstan. This study aimed to address this gap by conducting a point-prevalence survey (PPS) of HAIs and AMU, as well as evaluating hospital antibiotic consumption via internationally recognized methodologies.

METHODS

PPS was conducted in four acute care hospitals in Kazakhstan on 11 May 2022, following the methodology of the European Center for Disease Prevention and Control, and included 701 patients. Antibiotic consumption in the same hospitals was assessed via the Global Antimicrobial Resistance and Use Surveillance System methodology.

RESULTS

HAIs were observed in 3.8% of patients (27/701), with intensive care unit wards accounting for 48.1% of these cases (13/27). Pseudomonas aeruginosa was the most frequently identified pathogen (5 out of 14 documented cases, 35.7%). Resistance to carbapenems was the most common resistance, followed by resistance to glycopeptides and third-generation cephalosporins. The rate of AMU was 38.2%, with an average of 1.37 antibiotics administered per patient. Surgical prophylaxis lasting more than one day was the most common indication for antimicrobial prescription (44.8%). Ceftriaxone and cefazolin are the most commonly used antibiotics.

CONCLUSIONS

The results of this study are important for understanding the current situation in Kazakhstan and for informing national antimicrobial stewardship and infection control strategies.

A significant antibiofilm and antimicrobial activity of chitosan-polyacrylic acid nanoparticles against pathogenic bacteria

Chitosan is known to exert antimicrobial activity without the need for any chemical modification; however, new derivatives of chitosan can be created to target multi-drug resistant bacteria. In this study, chitosan (CS) was cross-linked with sodium tripolyphosphate to form nanoparticles, which were then coated with polyacrylic acid (PAA). The SEM images revealed that the CS-PAA nanoparticles had spherical shapes with smooth surfaces and the size of the dried nanoparticles was approximately 222 nm. Biofilm formation was significantly inhibited by 0.5 mg/mL of CS-PAA. In-situ optical microscopy showed that CS-PAA nanoparticles inhibited the bacterial biofilm formation in Campylobacter jejuni, Pseudomonas aeruginosa, and Escherichia coli after a single treatment with 40 μg. Additionally, 20 µg of CS-PAA nanoparticles demonstrated antibacterial activity against the growth of C. jejuni, P. aeruginosa, and E. coli with notable inhibitory zones of 9, 12, and 13 mm, respectively (P < 0.01). The development of a novel and ecofriendly method for the preparation of chitosan nanoparticles through an interaction of chitosan with PAA shows promise tool to combat bacterial infections and validates effective antibacterial and antibiofilm properties against antibiotic resistant pathogens.