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Introduction
Healthcare-associated infections (HCAIs) remain a significant and persistent challenge in hospital environments, particularly in trauma and surgical units. These units are especially vulnerable due to the invasive nature of procedures and the compromised health status of many patients. Traumatic and surgical patients are at a higher risk of developing infections due to factors such as the disruption of natural barriers, prolonged hospitalization, and exposure to multidrug-resistant organisms (MDROs)1.
MDROs are a group of bacteria that have developed resistance to multiple classes of antibiotics, making them extremely difficult to treat and posing a serious threat to patient safety 2. Their rise and dissemination are largely attributed to the overuse and misuse of antibiotics, insufficient infection prevention and control measures, and extended hospital stays. While fungi are not typically classified as MDROs, they can develop resistance to antifungal medications, referred to as multidrug-resistant fungi. Examples include Candida species, Aspergillus species, and Penicillium species. Multidrug-resistant fungi also present challenges, particularly in immunocompromised patients, requiring alternative treatment strategies.
In surgical units, the risk of MDRO transmission is exacerbated by the frequent use of invasive devices, surgical interventions, and prolonged antibiotic prophylaxis3. Moreover, surgical patients often have underlying health conditions and multiple comorbidities, making them more susceptible to infections and complications. The implications of MDRO infections in surgical patients are serious, leading to increased morbidity, mortality, and healthcare costs. This underscores the urgent need for comprehensive surveillance, research, and targeted interventions.
Trauma continues to be a major global health issue, contributing significantly to mortality and morbidity4. It accounts for approximately 9% of global deaths, with nearly 100 million people suffering temporary or permanent disabilities annually5. In Egypt, injury-related morbidity and mortality are on the rise, with road traffic accidents being a predominant cause6. Research has shown that trauma care delivered in high-volume, specialized level-one trauma centers leads to improved patient outcomes. Managing critically injured trauma patients in specialized TICUs has been associated with enhanced outcomes, especially for patients with multiple injuries and traumatic brain injury (TBI)7.
The Surgical Intensive Care Unit (SICU) is a vital component of modern healthcare, providing specialized care for patients requiring close monitoring and advanced medical interventions due to critical illness or...