Clinical Issues in the Management of Surgical Infections, with an Emphasis on Antibiotic Management of Infections Caused by Multi-Drug-Resistant Pathogens

摘要

Although many surgical infections are caused by community-associated pathogens that are not likely to be highly resistant to antibiotics, there are certain clinical settings where multi-drug-resistant pathogens may play a role in the pathogenesis and virulence of infections. Examples of such infections are complicated skin/skin structure infections caused by community-acquired methicillin-resistant Staphylococcus aureus, or hospital-acquired complicated intra-abdominal infections (e.g., colon anastomotic dehiscence, tertiary peritonitis as a consequence of multiple failed attempts at surgical source control). Moreover, as surgical patients become increasingly aged and immunosuppressed, the potential for hospital-acquired infections such as ventilator-associated pneumonia and catheter-related blood stream infection threatens every seriously ill, hospitalized patient.