The burden of infections in acute care surgery (ACS) is huge. Surgical emergencies alone account for three million admissions per year in the United States (US) with estimated financial costs of USD 28 billion per year. Acute care facilities and ACS patients represent boost sanctuaries for the emergence, development and transmission of infections and multi-resistant organisms. According to the World Health Organization, healthcare-associated infections affected around 4 million cases in Europe and 1.7 million in the US alone in 2011 with 39,000 and 99,000 directly attributable deaths, respectively. In this scenario, antimicrobial resistance arose as a public-health emergency that worsens patients’ morbidity and mortality and increases healthcare costs. The optimal patient care requires the application of comprehensive evidence-based policies and strategies aiming at minimizing the impact of healthcare associated infections and antimicrobial resistance, while optimizing the treatment of intra-abdominal infections. The present review provides a snapshot of two hot topics, such as antimicrobial resistance and systemic inflammatory response, and three milestones of infection management, such as source control, infection prevention, and control and antimicrobial stewardship.

中文翻译：

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急性护理手术中的抗菌挑战

急性护理手术 (ACS) 中的感染负担是巨大的。在美国（US），仅外科急诊就占每年 300 万次入院，估计每年的财务成本为 280 亿美元。急性护理设施和 ACS 患者是感染和多重耐药生物出现、发展和传播的助推器。根据世界卫生组织的数据，2011 年，仅在欧洲就有大约 400 万例与医疗保健相关的感染，在美国就有 170 万例，分别有 39,000 和 99,000 人直接死亡。在这种情况下，抗菌素耐药性作为公共卫生紧急事件出现，会加剧患者的发病率和死亡率，并增加医疗保健成本。最佳的患者护理需要应用全面的循证政策和策略，旨在最大限度地减少医疗保健相关感染和抗菌素耐药性的影响，同时优化腹腔内感染的治疗。本综述简要介绍了两个热门话题，例如抗菌素耐药性和全身炎症反应，以及感染管理的三个里程碑，例如感染源控制、感染预防和控制以及抗菌素管理。