Prevention and treatment of infectious complications in coloproctology patients

Kolozyan D.A., Gusarov V.G., Stojko Yu.M., Levchuk A.L., Maksimenkov A.V.

The review of literature data on prevention and treatment of infectious complications in coloproctology is presented. Summary of the main complications in patients with this profile is given. The main principles of prevention and treatment of infectious complications in conditions of growing antimicrobial resistance are given. The mechanisms that permit slowing down the rate of further growth of antimicrobial resistance are indicated. It is concluded that further research are needed to study the effectiveness of these mechanisms for the prevention and treatment of complications in colorectal surgery.

1. Abdominal’naya khirurgicheskaya infektsiya. Rossiiskie natsional’nye rekomendatsii. Ed by V.S. Savel’ev, B.R. Gel’fand. Moscow: Borges; 2011. 98 p. (In Russ).

2. Bagnenko SF, Zakharenko AA, Suvorov AN, Shlyk IV, Ten OA, Dzhamilov ShR, Belyaev MA, Trushin AA, Natkha AS, Zaitsev DA, Vovin KN, Rybal’chenko VA. Perioperative changes of colon microbiocenosis in patients with colon cancer. Vestn Khir Im I I Grek. 2016;175(6):33–37. (In Russ).

3. Voino- Yasenetskii VF. (Arkhiepiskop Luka) Ocherki gnoinoi khirurgii. Moscow, St. Petersburg: BINOM, Nevskii Dialekt; 2000. 704 p. (In Russ).

4. Global action plan on antimicrobial resistance. World Health Organization. 2016. (In Russ). [URL] Accessed 12.05.2019.

5. Demin AA, Rudnov VA. Kolit, assotsiirovannyi s Clostridium difficile, posle operatsii po povodu raka tolstoi kishki. Infektsii v khirurgii. 2007;5(2):29–33. (In Russ).

6. World Health Organization. WHO global strategy for containment of antimicrobial resistance. 2001. (In Russ). [URL] Accessed 12.05.2019.

7. Grigorievskaya ZV. Urgency of the problem of hospital infections in cancer patients. Journal of N.N. Blokhin Russian Cancer Research Center . 2013;24(3–4):46–49. (In Russ).

8. Golub AV, Dekhnich AV, Kozlov RS. Antimicrobial therapy of complicated intraabdominal infections: what are the success determinants? Clinical microbiology and antimicrobial chemotherapy. 2011;13(2): 158–162. (In Russ).

9. Gusarov VG, Karpov OJe, Zamjatin MN. Antibiotic resistance of surgical infections: current state of the problem. Bulletin of Pirogov National Medical & Surgical Center. 2017;12(2):95–102. (In Russ).

10. Gusarov VG, Zamyatin MN, Teplykh BA, Oprishchenko IV, Gogiberidze NM, Nesterova EE, Lashenkova NN. Antibiotikorezistentnost’: puti resheniya problemy v mnogoprofil’nom statsionare. Bulletin of Pirogov National Medical & Surgical Center. 2014;9(3):97–101. (In Russ).

11. Gusarov VG, Lashenkova NN, Petrova NV, Dementienko MV, Shilkin DN, Nesterova EE, Zamyatin MN. Protocols of empirical antimicrobial therapy in improving quality of emergency medical care to patients with infection in multidisciplinary surgical hospital. Meditsinskii alfavit. 2016;4(33):24–28. (In Russ).

12. Gusarov VG, Nesterova EE, Lashenkova NN, Petrova NV, Silaeva NA, Tertitskaya AB, Teplykh BA, Gorokhovatsky YuI, Zamyatin MN. Change of antibiotic-resistant nosocomial microflora: Results of implementation of the strategy for control of antimicrobial treatment in multi speciality in-patient hospital. Epidemiology and infectious diseases. 2015;20(5):11–18. (In Russ).

13. Gusarov VG, Nesterova EE, Oprishhenko IV, Petrova NV, Zamyatin MN. Clinical and pharmacoeconomic results of the use of the protocol empiric antimicrobial therapy in a multidisciplinary hospital. Bulletin of Pirogov National Medical & Surgical Center. 2015;10(4):100–103. (In Russ).

14. Zlokachestvennye novoobrazovaniya v Rossii v 2017 godu (zabolevaemost’ i smertnost’). Ed by A.D. Kaprin, V.V. Starinskii, G.V. Petrova. Moscow: MNIOI im. P.A. Gertsena; 2018. 250 p. (In Russ).

15. Karpov OE, Gusarov VG, Lashenkova NN, Petrova NV, Dementienko MV, Shilkin DN, Nesterova EE, Zamyatin MN. Register of microorganisms as a tool for automated antibiotics consumption planning and monitoring of antibiotic resistance in intensive care units and specilized hospital departments. General reanimatology. 2016;12(6):39–48. (In Russ).

16. Karpov OE, Maksimenkov AV, Stepanjuk IV, Levchuk AL, Nazarov VA, Stojko YuM. Laparoscopic and robotic technologies in treatment of patients with rectal cancer. Bulletin of Pirogov National Medical & Surgical Center. 2016;11(2):49–53. (In Russ).

17. Kuz’menkov AYu, Azovskova OV. Aktivnost’ karbapenemov v otnoshenii gramotritsatel’nykh vozbuditelei nozokomial’nykh khirurgicheskikh infektsii. Infektsii v khirurgii. 2017;15(1):34–40. (In Russ).

18. Shelygin YuA, Bagnenko SF, Davydov MI, et al. Ostraya kishechnaya neprokhodimost’ opukholevoi etiologii. Klinicheskie rekomendatsii. Moscow; 2014. 29 p. (In Russ).

19. Aslanov BI, Zueva LP, Kolosovskaya EN, et al. Printsipy organizatsii perioperatsionnoi antibiotikoprofilaktiki v uchrezhdeniyakh zdravookhraneniya. Federal’nye klinicheskie rekomendatsii. Moscow: 2014. 42 p. (In Russ).

20. Programma SKAT (Strategiya Kontrolya Antimikrobnoi Terapii) pri okazanii statsionarnoi meditsinskoi pomoshchi: Rossiiskie klinicheskie rekomendatsii. Ed by S.V. Yakovleva, N.I. Briko, S.V. Sidorenko, D.N. Protsenko. Moscow: Pero; 2018. 156 p. (In Russ).

21. Briko NI, Bozhkova SA, Brusina EB, et al. Profilaktika infektsii oblasti khirurgicheskogo vmeshatel’stva. Klinicheskie rekomendatsii. Nigny Novgorod: Remedium Privolzh’e, 2018. 72 p. (In Russ).

22. Rasulov AO, Mamedli ZZ, Kulushev VM, Gordeev SS, Jumabaev HE. Minimal invasive technologies in rectal cancer surgery. Koloproktologiia. 2014;(1):28–36. (In Russ).

23. Romashov OV, Ivzhits MA, Rodoman GV, Sumedi IR, Kuznetsova EA. The role of antibiotic prophylaxis in rehabilitation of colorectal cancer patients after surgery. Vestnik Vserossiiskogo obshchestva spetsialistov po mediko-sotsial’noi ekspertize, reabilitatsii i reabilitatsionnoi industrii. 2016;(1):32–42. (In Russ).

24. Solovyev IA, Navmatulja AJu. Modern view of and approach to the tactics of treatment of patients “distal rectal cancer”. Bulletin of Pirogov National Medical & Surgical Center. 2013;8(2):125–130. (In Russ).

25. Stoiko YuM, Levchuk AL, Stepaniuk IV, Fedotov DYu. Application of high-tech operations in surgical treatment of rectal cancer. Bulletin of Pirogov National Medical & Surgical Center. 2011;6(4):49–53. (In Russ).

26. Strategiya i taktika ispol’zovaniya antimikrobnykh sredstv v LPU Rossii. Rossiiskie natsional’nye rekomendatsii. Ed by V.S. Savel’ev, B.R. Gel’fand, S.V. Yakovlev. Moscow; 2012. 94 p. (In Russ).

27. Governmental Directory № 2045-р “O Strategii preduprezhdeniya rasprostraneniya antimikrobnoi rezistentnosti v Rossiiskoi Federatsii na period do 2030 goda”. dated 25 September 2017. (In Russ). [URL] Accessed 10.06.2019.

28. Khirurgicheskie infektsii kozhi i myagkikh tkanei. Rossiiskie natsional’nye rekomendatsii. Ed by B.R. Gel’fand, V.A. Kubyshkin, R.S. Kozlov, N.N. Khachatryan. Moscow; 2015. 109 p. (In Russ).

29. Khubezov DA, Puchkov KV. Ogorel’tsev AYu. Vybor optimal’nykh granits perednei rezektsii pryamoi kishki pri rektal’nom rake. Bulletin of Pirogov National Medical & Surgical Center. 2009;4(1):53–59. (In Russ).

30. Shevchenko YuL, Gorohovatskii YuI, Azizova OA, Zamyatin MN. Sistemnyi vospalitel’nyi otvet pri ekstremal’noi khirurgicheskoi agressii. Moscow: Izdanie RAEN; 2009. 273 p. (In Russ).

31. Shelygin UA, Golovenko OV, Golovenko AO, Sukhina MA. Fecal microbiota transplantation -perspectives of use in bowel diseases (review). Koloproktologiia. 2015;(4):65–73. (In Russ).

32. Shurkalin BK, Volenko AV, Titkov BE. Posleoperatsionnye oslozhneniya v khirurgii tolstoi kishki. Bulletin of Pirogov National Medical & Surgical Center. 2009;4(1):60–62. (In Russ).

33. Shaeva SN, Narezkin DV. Colorectal cancer bleeding complications. Koloproktologiia. 2016;(2):37–41. (In Russ).

34. Anderson DJ, Podgorny K, Berríos-Torres SI, Bratzler DW, Dellinger EP, Greene L, Nyquist AC, Saiman L, Yokoe DS, Maragakis LL, Kaye KS. Strategies to prevent Surgical Site Infections in Acute Care Hospitals: 2014 Update. Infect Control Hosp Epidemiol. 2014;35 Suppl 2:S66–627.

35. Borowski DW, Bradburn DM, Mills SJ, Bharathan B, Wilson RG, Ratcliffe AA, Kelly SB; Northern Region Colorectal Cancer Audit Group (NORCCAG). Volume–outcome analysis of colorectal cancer-related outcomes. Br J Surg. 2010;97(9):1416–1430. doi: 10.1002/bjs.7111.

36. Bratzler DW, Dellinger EP, Olsen KM, Perl TM, Auwaerter PG, Bolon MK, Fish DN, Napolitano LM, Sawyer RG, Slain D, Steinberg JP, Weinstein RA; American Society of Health-System Pharmacists; Infectious Disease Society of America; Surgical Infection Society; Society for Healthcare Epidemiology of America. Clinical practice guidelines for antimicrobial prophylaxis in surgery. Am J Health Syst Pharm. 2013;70(3):195–283. doi: 10.2146/ajhp120568.

37. Bruno-Murtha LA, Brusch J, Bor D, Li W, Zucker D. A pilot study of antibiotic cycling in the community hospital setting. Infect Control Hosp Epidemiol. 2005; 26(1):81–87.

38. Burke JF. The effective period of preventive antibiotic action in experimental incisions and dermal lesions. Surgery. 1961;50:161–168.

39. Carling P, Fung T, Killion A, Terrin N, Barza M. Favorable impact of a multidisciplinary antibiotic management program conducted during 7 years. Infect Control Hosp Epidemiol. 2003;24(9):699–706.

40. Colon Cancer Laparoscopic or Open Resection Study Group, Buunen M, Veldkamp R, Hop WC, Kuhry E, Jeekel J, Haglind E, Påhlman L, Cuesta MA, Msika S, Morino M, Lacy A, Bonjer HJ. Survival after laparoscopic surgery versus open surgery for colon cancer: long-term outcome of a randomised clinical trial. Lancet Oncol. 2009; 10(1):44–52. doi: 10.1016/S1470-2045(08)70310-3.

41. Dellit TH, Owens RC, McGowan JE Jr, Gerding DN, Weinstein RA, Burke JP, Huskins WC, Paterson DL, Fishman NO, Carpenter CF, Brennan PJ, Billeter M, Hooton TM; Infectious Diseases Society of America; Society for Healthcare Epidemiology of America. Infectious Diseases Society of America and the Society for Healthcare Epidemiology of America guidelines for developing an institutional program to enhance antimicrobial stewardship. Clin Infect Dis. 2007; 44(2):159–177.

42. Guillou PJ, Quirke P, Thorpe H, Walker J, Jayne DG, Smith AM, Heath RM, Brown JM; MRC CLASICC trial group. Short-term endpoints of conventional versus laparoscopic-assisted surgery in patients with colorectal cancer (MRC CLASICC trial): multicentre, randomised controlled trial. Lancet. 2005;365(9472):1718–1726. doi: 10.1016/S0140-6736(05)66545-2.

43. Geissler A, Gerbeaux P, Granier I, Blanc P, Facon K, Durand-Gasselin J. Rational use of antibiotics in the intensive care unit: impact on microbial resistance and costs. Intensive Care Med. 2003;29(1):49–54.

44. Hammond J, Lim S, Wan Y, Gao X, Patkar A. The burden of gastrointestinal anastomotic leaks: an evaluation of clinical and economic outcomes. J Gastrointest Surg. 2014;18(6):1176–1185. doi: 10.1007/s11605-014-2506-4.

45. Jayne D, Pigazzi A, Marshall H, Croft J, Corrigan N, Copeland J, Quirke P, West N, Rautio T, Thomassen N, Tilney H, Gudgeon M, Bianchi PP, Edlin R, Hulme C, Brown J. Effect of Robotic-Assisted vs Conventional Laparoscopic Surgery on Risk of Conversion to Open Laparotomy Among Patients Undergoing Resection for Rectal Cancer: The ROLARR Randomized Clinical Trial. JAMA. 2017; 318(16):1569-1580. doi: 10.1001/jama.2017.7219.

46. Johnson S, Gerding DN. Clostridium difficile--associated diarrhea. Clin Infect Dis. 1998;26(5):1027–1036.

47. Zhao JK, Chen NZ, Zheng JB, He S, Sun XJ. Laparoscopic versus open surgery for rectal cancer: Results of a systematic review and meta-analysis on clinical efficacy. Mol Clin Oncol. 2014;2(6):1097–1102.

48. Kobayashi M, Takesue Y, Kitagawa Y, Kusunoki M, Sumiyama Y. Antimicrobial prophylaxis and colon preparation for colorectal surgery: Results of a questionnaire survey of 721 certified institutions in Japan. Surg Today. 2011;41(10):1363–1369. doi: 10.1007/s00595-010-4511-x.

49. Lohde, E., Muller, S., Luck, M. Analysis of risk factors for postoperative infectious complications // 18th International Congress of Chemotherapy, Stockholm, Sweden, 27 June – 2 July, 1993. – P. 728–729.

50. Lovegrove RE, Constantinides VA, Heriot AG, Athanasiou T, Darzi A, Remzi FH, Nicholls RJ, Fazio VW, Tekkis PP. A comparison of hand-sewn versus stap led ileal pouch anal anastomosis (IPAA) following proctocolectomy: a meta-analysis of 4183 patients. Ann Surg. 2006;244(1):18–26.

51. Masud F, Vykoukal D. Preventing healthcare-associated infections in cardiac surgical patients as a hallmark of excellence. Methodist Debakey Cardiovasc J. 2011;7(2):48–50.

52. Nelson RL, Gladman E, Barbateskovic M. Antimicrobial prophylaxis for colorectal surgery. Cochrane Database Syst Rev. 2014;(5):CD001181. doi: 10.1002/14651858.CD001181.pub4.

53. O’Brien JA, Lahue BJ, Caro JJ, Davidson DM. The emerging infectious challenge of Clostridium difficile infection in adults: 2010 update by the Society of Healthcare Epidemiology of America (SHEA) and the Infectious Diseases Society of America (IDSA). Infect Control Hosp Epidemiol. 2010;31(5):431–455.

54. Patel D, Lawson W, Guglielmo BJ. Antimicrobial stewardship programs: interventions and associated outcomes. Expert Rev Anti Infect Ther. 2008;6(2):209–222. doi: 10.1586/14787210.6.2.209.

55. amr-review.org [Internet]. Tackling drug-resistant infections globally: final report and recommendations. The review on antimicrobial resistance 2016 [cited 2018 Dec 12]. [URL]

56. Trencheva K, Morrissey KP, Wells M, Mancuso CA, Lee SW, Sonoda T, Michelassi F, Charlson ME, Milsom JW. Identifying important predictors for anastomotic leak after colon and rectal resection: prospective study on 616 patients. Ann Surg. 2013;257(1):108–113. doi: 10.1097/SLA.0b013e318262a6cd.

57. Sadahiro S, Suzuki T, Tanaka A, Okada K, Kamata H, Ozaki T, Koga Y. Comparison between oral antibiotics and probiotics as bowel preparation for elective colon cancer surgery to prevent infection: Prospective randomized trial. Surgery. 2014;155(3):493–503. doi: 10.1016/j.surg.2013.06.002.

58. Sartelli M, Weber DG, Ruppé E, Bassetti M, Wright BJ, Ansaloni L, Catena F, Coccolini F, Abu-Zidan FM, Coimbra R, Moore EE, Moore FA, Maier RV, De Waele JJ, Kirkpatrick AW, Griffiths EA, Eckmann C, Brink AJ, Mazuski JE, May AK, Sawyer RG, Mertz D, Montravers P, Kumar A, Roberts JA, Vincent JL, Watkins RR, Lowman W, Spellberg B, Abbott IJ, Adesunkanmi AK, Al-Dahir S, Al-Hasan MN, Agresta F, Althani AA, Ansari S, Ansumana R, Augustin G, Bala M, Balogh ZJ, Baraket O, Bhangu A, Beltrán MA, Bernhard M, Biffl WL, Boermeester MA, Brecher SM, Cherry-Bukowiec JR, Buyne OR, Cainzos MA, Cairns KA, Camacho-Ortiz A, Chandy SJ, Che Jusoh A, Chichom-Mefire A, Colijn C, Corcione F, Cui Y, Curcio D, Delibegovic S, Demetrashvili Z, De Simone B, Dhingra S, Diaz JJ, Di Carlo I, Dillip A, Di Saverio S, Doyle MP, Dorj G, Dogjani A, Dupont H, Eachempati SR, Enani MA, Egiev VN, Elmangory MM, Ferrada P, Fitchett JR, Fraga GP, Guessennd N, Giamarellou H, Ghnnam W, Gkiokas G, Goldberg SR, Gomes CA, Gomi H, Guzmán-Blanco M, Haque M, Hansen S, Hecker A, Heizmann WR, Herzog T, Hodonou AM, Hong SK, Kafka-Ritsch R, Kaplan LJ, Kapoor G, Karamarkovic A, Kees MG, Kenig J, Kiguba R, Kim PK, Kluger Y, Khokha V, Koike K, Kok KY, Kong V, Knox MC, Inaba K, Isik A, Iskandar K, Ivatury RR, Labbate M, Labricciosa FM, Laterre PF, Latifi R, Lee JG, Lee YR, Leone M, Leppaniemi A, Li Y, Liang SY, Loho T, Maegele M, Malama S, Marei HE, Martin-Loeches I, Marwah S, Massele A, McFarlane M, Melo RB, Negoi I, Nicolau DP, Nord CE, Ofori-Asenso R, Omari AH, Ordonez CA, Ouadii M, Pereira Júnior GA, Piazza D, Pupelis G, Rawson TM, Rems M, Rizoli S, Rocha C, Sakakushev B, Sanchez-Garcia M, Sato N, Segovia Lohse HA, Sganga G, Siribumrungwong B, Shelat VG, Soreide K, Soto R, Talving P, Tilsed JV, Timsit JF, Trueba G, Trung NT, Ulrych J, van Goor H, Vereczkei A, Vohra RS, Wani I, Uhl W, Xiao Y, Yuan KC, Zachariah SK, Zahar JR, Zakrison TL, Corcione A, Melotti RM, Viscoli C, Viale P. Antimicrobials: a global alliance for optimizing their rational use in intra-abdominal infections (AGORA). World J Emerg Surg. 2016;11:33. doi: 10.1186/s13017-016-0089-y.

59. Solaini L, Bazzocchi F, Cavaliere D, Avanzolini A, Cucchetti A, Ercolani G. Robotic versus laparoscopic right colectomy: an updated systematic review and meta-analysis. Surg Endosc. 2018;32(3):1104–1110. doi: 10.1007/s00464-017-5980-4.

60. Solomkin JS, Mazuski JE, Bradley JS, Rodvold KA, Goldstein EJ, Baron EJ, O’Neill PJ, Chow AW, Dellinger EP, Eachempati SR, Gorbach S, Hilfiker M, May AK, Nathens AB, Sawyer RG, Bartlett JG. Diagnosis and management of complicated intra-abdominal infection in adults and children: guidelines by the Surgical Infection Society and the Infectious Diseases Society of America. Clin Infect Dis. 2010;50(2):133–164. doi: 10.1086/649554.

61. Vignali A, Gianotti L, Braga M, Radaelli G, Malvezzi L, Di Carlo V. Altered microperfusion at the rectal stump is predictive for rectal anastomotic leak. Dis Colon Rectum. 2000;43(1):76–82.

62. Vincent JL, Rello J, Marshall J, Silva E, Anzueto A, Martin CD, Moreno R, Lipman J, Gomersall C, Sakr Y, Reinhart K; EPIC II Group of Investigators. International study of the prevalence and outcomes of infection in intensive care units. JAMA. 2009;302(21):2323–2329. doi: 10.1001/jama.2009.1754.