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<record><TEI><teiHeader><fileDesc><titleStmt><title xml:lang="en">The <italic>Global Alliance for Infections in Surgery:</italic>
defining a model for antimicrobial stewardship—results from an international cross-sectional survey</title>
<author><name sortKey="Sartelli, Massimo" sort="Sartelli, Massimo" uniqKey="Sartelli M" first="Massimo" last="Sartelli">Massimo Sartelli</name>
<affiliation><nlm:aff id="Aff1">Department of Surgery, Macerata Hospital, Macerata, Italy</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Labricciosa, Francesco M" sort="Labricciosa, Francesco M" uniqKey="Labricciosa F" first="Francesco M." last="Labricciosa">Francesco M. Labricciosa</name>
<affiliation><nlm:aff id="Aff2"><institution-wrap><institution-id institution-id-type="ISNI">0000 0001 1017 3210</institution-id>
<institution-id institution-id-type="GRID">grid.7010.6</institution-id>
<institution>Department of Biomedical Sciences and Public Health, Unit of Hygiene, Preventive Medicine and Public Health,</institution>
<institution>Università Politecnica delle Marche,</institution>
</institution-wrap>
Ancona, Italy</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Barbadoro, Pamela" sort="Barbadoro, Pamela" uniqKey="Barbadoro P" first="Pamela" last="Barbadoro">Pamela Barbadoro</name>
<affiliation><nlm:aff id="Aff2"><institution-wrap><institution-id institution-id-type="ISNI">0000 0001 1017 3210</institution-id>
<institution-id institution-id-type="GRID">grid.7010.6</institution-id>
<institution>Department of Biomedical Sciences and Public Health, Unit of Hygiene, Preventive Medicine and Public Health,</institution>
<institution>Università Politecnica delle Marche,</institution>
</institution-wrap>
Ancona, Italy</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Pagani, Leonardo" sort="Pagani, Leonardo" uniqKey="Pagani L" first="Leonardo" last="Pagani">Leonardo Pagani</name>
<affiliation><nlm:aff id="Aff3">Infectious Diseases Unit, Bolzano Central Hospital, Bolzano, Italy</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Ansaloni, Luca" sort="Ansaloni, Luca" uniqKey="Ansaloni L" first="Luca" last="Ansaloni">Luca Ansaloni</name>
<affiliation><nlm:aff id="Aff4"><institution-wrap><institution-id institution-id-type="ISNI"> 0000 0004 1757 8431</institution-id>
<institution-id institution-id-type="GRID">grid.460094.f</institution-id>
<institution>General Surgery Department,</institution>
<institution>Papa Giovanni XXIII Hospital,</institution>
</institution-wrap>
Bergamo, Italy</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Brink, Adrian J" sort="Brink, Adrian J" uniqKey="Brink A" first="Adrian J." last="Brink">Adrian J. Brink</name>
<affiliation><nlm:aff id="Aff5"><institution-wrap><institution-id institution-id-type="ISNI">0000 0004 0634 9246</institution-id>
<institution-id institution-id-type="GRID">grid.415666.6</institution-id>
<institution>Department of Clinical microbiology, Ampath National Laboratory Services,</institution>
<institution>Milpark Hospital,</institution>
</institution-wrap>
Johannesburg, South Africa</nlm:aff>
</affiliation>
<affiliation><nlm:aff id="Aff6"><institution-wrap><institution-id institution-id-type="ISNI">0000 0004 1937 1151</institution-id>
<institution-id institution-id-type="GRID">grid.7836.a</institution-id>
<institution>Division of Infectious Diseases and HIV Medicine, Department of Medicine,</institution>
<institution>University of Cape Town,</institution>
</institution-wrap>
Cape town, South Africa</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Carlet, Jean" sort="Carlet, Jean" uniqKey="Carlet J" first="Jean" last="Carlet">Jean Carlet</name>
<affiliation><nlm:aff id="Aff7">World Alliance against Antibiotics Resistance, Rome, Italy</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Khanna, Ashish" sort="Khanna, Ashish" uniqKey="Khanna A" first="Ashish" last="Khanna">Ashish Khanna</name>
<affiliation><nlm:aff id="Aff8"><institution-wrap><institution-id institution-id-type="ISNI">0000 0001 0675 4725</institution-id>
<institution-id institution-id-type="GRID">grid.239578.2</institution-id>
<institution>Center for Critical Care, Anaesthesiology Institute and Department of Outcomes Research,</institution>
<institution>Cleveland Clinic,</institution>
</institution-wrap>
Cleveland, OH USA</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Chichom Mefire, Alain" sort="Chichom Mefire, Alain" uniqKey="Chichom Mefire A" first="Alain" last="Chichom-Mefire">Alain Chichom-Mefire</name>
<affiliation><nlm:aff id="Aff9">Department of Surgery and Obstetrics/Gynaecology, Regional Hospital, Limbe, Cameroon</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Coccolini, Federico" sort="Coccolini, Federico" uniqKey="Coccolini F" first="Federico" last="Coccolini">Federico Coccolini</name>
<affiliation><nlm:aff id="Aff10"><institution-wrap><institution-id institution-id-type="GRID">grid.414614.2</institution-id>
<institution>Department of Surgery,</institution>
<institution>Infermi Hospital,</institution>
</institution-wrap>
Rimini, Italy</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Di Saverio, Salomone" sort="Di Saverio, Salomone" uniqKey="Di Saverio S" first="Salomone" last="Di Saverio">Salomone Di Saverio</name>
<affiliation><nlm:aff id="Aff11"><institution-wrap><institution-id institution-id-type="ISNI">0000 0004 1759 7093</institution-id>
<institution-id institution-id-type="GRID">grid.416290.8</institution-id>
<institution>Department of Surgery,</institution>
<institution>Maggiore Hospital,</institution>
</institution-wrap>
Bologna, Italy</nlm:aff>
</affiliation>
</author>
<author><name sortKey="May, Addison K" sort="May, Addison K" uniqKey="May A" first="Addison K." last="May">Addison K. May</name>
<affiliation><nlm:aff id="Aff12"><institution-wrap><institution-id institution-id-type="ISNI">0000 0004 1936 9916</institution-id>
<institution-id institution-id-type="GRID">grid.412807.8</institution-id>
<institution>Department of Surgery,</institution>
<institution>Vanderbilt University Medical Center,</institution>
</institution-wrap>
Nashville, Tennessee USA</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Viale, Pierluigi" sort="Viale, Pierluigi" uniqKey="Viale P" first="Pierluigi" last="Viale">Pierluigi Viale</name>
<affiliation><nlm:aff id="Aff13">Infectious Diseases Unit, Department of Medical and Surgical Sciences, Sant’Orsola Hospital, University of Bologna, Bologna, Italy</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Watkins, Richard R" sort="Watkins, Richard R" uniqKey="Watkins R" first="Richard R." last="Watkins">Richard R. Watkins</name>
<affiliation><nlm:aff id="Aff14"><institution-wrap><institution-id institution-id-type="ISNI">0000 0001 0675 4725</institution-id>
<institution-id institution-id-type="GRID">grid.239578.2</institution-id>
<institution>Division of Infectious Diseases,</institution>
<institution>Cleveland Clinic Akron General,</institution>
</institution-wrap>
Akron, OH USA</nlm:aff>
</affiliation>
<affiliation><nlm:aff id="Aff15"><institution-wrap><institution-id institution-id-type="ISNI">0000 0004 0459 7529</institution-id>
<institution-id institution-id-type="GRID">grid.261103.7</institution-id>
<institution>Department of Medicine,</institution>
<institution>Northeast Ohio Medical University,</institution>
</institution-wrap>
Rootstown, OH USA</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Scudeller, Luigia" sort="Scudeller, Luigia" uniqKey="Scudeller L" first="Luigia" last="Scudeller">Luigia Scudeller</name>
<affiliation><nlm:aff id="Aff16"><institution-wrap><institution-id institution-id-type="ISNI">0000 0004 1760 3027</institution-id>
<institution-id institution-id-type="GRID">grid.419425.f</institution-id>
<institution></institution>
<institution>Clinical Epidemiology Unit, IRCCS Policlinico San Matteo Foundation,</institution>
</institution-wrap>
Pavia, Italy</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Abbo, Lilian M" sort="Abbo, Lilian M" uniqKey="Abbo L" first="Lilian M." last="Abbo">Lilian M. Abbo</name>
<affiliation><nlm:aff id="Aff17"><institution-wrap><institution-id institution-id-type="ISNI">0000 0004 1936 8606</institution-id>
<institution-id institution-id-type="GRID">grid.26790.3a</institution-id>
<institution>Division of Infectious Diseases, Jackson Health System,</institution>
<institution>University of Miami Miller School of Medicine,</institution>
</institution-wrap>
Miami, FL USA</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Abu Zidan, Fikri M" sort="Abu Zidan, Fikri M" uniqKey="Abu Zidan F" first="Fikri M." last="Abu-Zidan">Fikri M. Abu-Zidan</name>
<affiliation><nlm:aff id="Aff18"><institution-wrap><institution-id institution-id-type="ISNI">0000 0001 2193 6666</institution-id>
<institution-id institution-id-type="GRID">grid.43519.3a</institution-id>
<institution>Department of Surgery, College of Medicine and Health Sciences,</institution>
<institution>UAE University,</institution>
</institution-wrap>
Al-Ain, United Arab Emirates</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Adesunkanmi, Abdulrashid K" sort="Adesunkanmi, Abdulrashid K" uniqKey="Adesunkanmi A" first="Abdulrashid K." last="Adesunkanmi">Abdulrashid K. Adesunkanmi</name>
<affiliation><nlm:aff id="Aff19"><institution-wrap><institution-id institution-id-type="ISNI">0000 0001 2183 9444</institution-id>
<institution-id institution-id-type="GRID">grid.10824.3f</institution-id>
<institution>Department of Surgery, College of Health Sciences,</institution>
<institution>Obafemi Awolowo University,</institution>
</institution-wrap>
Ile-Ife, Nigeria</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Al Dahir, Sara" sort="Al Dahir, Sara" uniqKey="Al Dahir S" first="Sara" last="Al-Dahir">Sara Al-Dahir</name>
<affiliation><nlm:aff id="Aff20"><institution-wrap><institution-id institution-id-type="ISNI">0000 0000 9679 3586</institution-id>
<institution-id institution-id-type="GRID">grid.268355.f</institution-id>
<institution>Division of Clinical and Administrative Sciences, College of Pharmacy,</institution>
<institution>Xavier University of Louisiana,</institution>
</institution-wrap>
New Orleans, LA USA</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Al Hasan, Majdi N" sort="Al Hasan, Majdi N" uniqKey="Al Hasan M" first="Majdi N." last="Al-Hasan">Majdi N. Al-Hasan</name>
<affiliation><nlm:aff id="Aff21"><institution-wrap><institution-id institution-id-type="ISNI">0000 0000 9075 106X</institution-id>
<institution-id institution-id-type="GRID">grid.254567.7</institution-id>
<institution>Department of Medicine, Division of Infectious Diseases,</institution>
<institution>University of South Carolina School of Medicine,</institution>
</institution-wrap>
Columbia, SC USA</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Alis, Halil" sort="Alis, Halil" uniqKey="Alis H" first="Halil" last="Alis">Halil Alis</name>
<affiliation><nlm:aff id="Aff22"><institution-wrap><institution-id institution-id-type="ISNI">0000 0004 0419 1043</institution-id>
<institution-id institution-id-type="GRID">grid.414177.0</institution-id>
<institution>General Surgery Department,</institution>
<institution>Bakirkoy Dr Sadi Konuk Training and Research Hospital,</institution>
</institution-wrap>
Instanbul, Turkey</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Alves, Carlos" sort="Alves, Carlos" uniqKey="Alves C" first="Carlos" last="Alves">Carlos Alves</name>
<affiliation><nlm:aff id="Aff23"><institution-wrap><institution-id institution-id-type="ISNI">0000 0000 9375 4688</institution-id>
<institution-id institution-id-type="GRID">grid.414556.7</institution-id>
<institution>Unit of Prevention and Infection Control, Center of Hospital Epidemiology,</institution>
<institution>São João Hospital Centre,</institution>
</institution-wrap>
Porto, Portugal</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Araujo Da Silva, Andre R" sort="Araujo Da Silva, Andre R" uniqKey="Araujo Da Silva A" first="André R." last="Araujo Da Silva">André R. Araujo Da Silva</name>
<affiliation><nlm:aff id="Aff24">Infection Control Committee, Prontobaby Hospital da Criança, Rio de Janeiro, Brazil</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Augustin, Goran" sort="Augustin, Goran" uniqKey="Augustin G" first="Goran" last="Augustin">Goran Augustin</name>
<affiliation><nlm:aff id="Aff25"><institution-wrap><institution-id institution-id-type="ISNI">0000 0004 0397 9648</institution-id>
<institution-id institution-id-type="GRID">grid.412688.1</institution-id>
<institution>Department of Surgery,</institution>
<institution>University Hospital Center,</institution>
</institution-wrap>
Zagreb, Croatia</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Bala, Miklosh" sort="Bala, Miklosh" uniqKey="Bala M" first="Miklosh" last="Bala">Miklosh Bala</name>
<affiliation><nlm:aff id="Aff26"><institution-wrap><institution-id institution-id-type="ISNI">0000 0001 2221 2926</institution-id>
<institution-id institution-id-type="GRID">grid.17788.31</institution-id>
<institution>Trauma and Acute Care Surgery Unit,</institution>
<institution>Hadassah Hebrew University Medical Center,</institution>
</institution-wrap>
Jerusalem, Israel</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Barie, Philip S" sort="Barie, Philip S" uniqKey="Barie P" first="Philip S." last="Barie">Philip S. Barie</name>
<affiliation><nlm:aff id="Aff27"><institution-wrap><institution-id institution-id-type="ISNI">000000041936877X</institution-id>
<institution-id institution-id-type="GRID">grid.5386.8</institution-id>
<institution>Department of Surgery,</institution>
<institution>Weill Cornell Medicine,</institution>
</institution-wrap>
New York, NY USA</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Beltran, Marcelo A" sort="Beltran, Marcelo A" uniqKey="Beltran M" first="Marcelo A." last="Beltrán">Marcelo A. Beltrán</name>
<affiliation><nlm:aff id="Aff28">Department of General Surgery, Hospital San Juan de Dios de La Serena, La Serena, Chile</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Bhangu, Aneel" sort="Bhangu, Aneel" uniqKey="Bhangu A" first="Aneel" last="Bhangu">Aneel Bhangu</name>
<affiliation><nlm:aff id="Aff29"><institution-wrap><institution-id institution-id-type="ISNI">0000 0001 2177 007X</institution-id>
<institution-id institution-id-type="GRID">grid.415490.d</institution-id>
<institution>Academic Department of Surgery,</institution>
<institution>Queen Elizabeth Hospital,</institution>
</institution-wrap>
Birmingham, UK</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Bouchra, Belefquih" sort="Bouchra, Belefquih" uniqKey="Bouchra B" first="Belefquih" last="Bouchra">Belefquih Bouchra</name>
<affiliation><nlm:aff id="Aff30">Department of Microbiology National Reference Laboratory Cheikh Khalifa Ibn Zaid Hospital, Mohammed 6th University of Health Sciences, Casablanca, Morocco</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Brecher, Stephen M" sort="Brecher, Stephen M" uniqKey="Brecher S" first="Stephen M." last="Brecher">Stephen M. Brecher</name>
<affiliation><nlm:aff id="Aff31"><institution-wrap><institution-id institution-id-type="ISNI">0000 0004 4657 1992</institution-id>
<institution-id institution-id-type="GRID">grid.410370.1</institution-id>
<institution>Department of Pathology and Laboratory Medicine,</institution>
<institution>VA Boston HealthCare System,</institution>
</institution-wrap>
Boston, MA USA</nlm:aff>
</affiliation>
<affiliation><nlm:aff id="Aff32"><institution-wrap><institution-id institution-id-type="ISNI">0000 0004 0367 5222</institution-id>
<institution-id institution-id-type="GRID">grid.475010.7</institution-id>
<institution>Department of Pathology and Laboratory Medicine,</institution>
<institution>Boston University School of Medicine,</institution>
</institution-wrap>
Boston, MA USA</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Cainzos, Miguel A" sort="Cainzos, Miguel A" uniqKey="Cainzos M" first="Miguel A." last="Caínzos">Miguel A. Caínzos</name>
<affiliation><nlm:aff id="Aff33"><institution-wrap><institution-id institution-id-type="ISNI">0000 0000 8816 6945</institution-id>
<institution-id institution-id-type="GRID">grid.411048.8</institution-id>
<institution>Department of Surgery,</institution>
<institution>Hospital Clínico Universitario,</institution>
</institution-wrap>
Santiago de Compostela, Spain</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Camacho Ortiz, Adrian" sort="Camacho Ortiz, Adrian" uniqKey="Camacho Ortiz A" first="Adrian" last="Camacho-Ortiz">Adrian Camacho-Ortiz</name>
<affiliation><nlm:aff id="Aff34"><institution-wrap><institution-id institution-id-type="ISNI">0000 0004 1760 058X</institution-id>
<institution-id institution-id-type="GRID">grid.464574.0</institution-id>
<institution>Hospital Epidemiology and Infectious Diseases,</institution>
<institution>Hospital Universitario Dr Jose Eleuterio Gonzalez,</institution>
</institution-wrap>
Monterrey, Mexico</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Catani, Marco" sort="Catani, Marco" uniqKey="Catani M" first="Marco" last="Catani">Marco Catani</name>
<affiliation><nlm:aff id="Aff35"><institution-wrap><institution-id institution-id-type="GRID">grid.417007.5</institution-id>
<institution>Department of Emergency,</institution>
<institution>Umberto I Hospital,</institution>
</institution-wrap>
Rome, Italy</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Chandy, Sujith J" sort="Chandy, Sujith J" uniqKey="Chandy S" first="Sujith J." last="Chandy">Sujith J. Chandy</name>
<affiliation><nlm:aff id="Aff36"><institution-wrap><institution-id institution-id-type="ISNI">0000 0004 1781 1790</institution-id>
<institution-id institution-id-type="GRID">grid.448741.a</institution-id>
<institution>Department of Pharmacology,</institution>
<institution>Pushpagiri Institute of Medical Sciences and Research Centre,</institution>
</institution-wrap>
Thiruvalla, Kerala India</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Jusoh, Asri Che" sort="Jusoh, Asri Che" uniqKey="Jusoh A" first="Asri Che" last="Jusoh">Asri Che Jusoh</name>
<affiliation><nlm:aff id="Aff37">Department of General Surgery, Kuala Krai Hospital, Kuala Krai, Kelantan Malaysia</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Cherry Bukowiec, Jill R" sort="Cherry Bukowiec, Jill R" uniqKey="Cherry Bukowiec J" first="Jill R." last="Cherry-Bukowiec">Jill R. Cherry-Bukowiec</name>
<affiliation><nlm:aff id="Aff38"><institution-wrap><institution-id institution-id-type="ISNI">0000000086837370</institution-id>
<institution-id institution-id-type="GRID">grid.214458.e</institution-id>
<institution>Division of Acute Care Surgery, Department of Surgery,</institution>
<institution>University of Michigan,</institution>
</institution-wrap>
Ann Arbor, MI USA</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Chiara, Osvaldo" sort="Chiara, Osvaldo" uniqKey="Chiara O" first="Osvaldo" last="Chiara">Osvaldo Chiara</name>
<affiliation><nlm:aff id="Aff39"><institution-wrap><institution-id institution-id-type="GRID">grid.416200.1</institution-id>
<institution></institution>
<institution>Niguarda Hospital,</institution>
</institution-wrap>
Milano, Italy</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Colak, Elif" sort="Colak, Elif" uniqKey="Colak E" first="Elif" last="Colak">Elif Colak</name>
<affiliation><nlm:aff id="Aff40">Department of General Surgery, Health Sciences University, Samsun Training and Research Hospital, Samsun, Turkey</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Cornely, Oliver A" sort="Cornely, Oliver A" uniqKey="Cornely O" first="Oliver A." last="Cornely">Oliver A. Cornely</name>
<affiliation><nlm:aff id="Aff41"><institution-wrap><institution-id institution-id-type="ISNI">0000 0000 8580 3777</institution-id>
<institution-id institution-id-type="GRID">grid.6190.e</institution-id>
<institution>Department of Internal Medicine and Infectious Diseases,</institution>
<institution>University of Cologne,</institution>
</institution-wrap>
Cologne, Germany</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Cui, Yunfeng" sort="Cui, Yunfeng" uniqKey="Cui Y" first="Yunfeng" last="Cui">Yunfeng Cui</name>
<affiliation><nlm:aff id="Aff42"><institution-wrap><institution-id institution-id-type="ISNI">0000 0000 9792 1228</institution-id>
<institution-id institution-id-type="GRID">grid.265021.2</institution-id>
<institution>Department of Surgery, Tianjin Nankai Hospital, Nankai Clinical School of Medicine,</institution>
<institution>Tianjin Medical University,</institution>
</institution-wrap>
Tianjin, China</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Demetrashvili, Zaza" sort="Demetrashvili, Zaza" uniqKey="Demetrashvili Z" first="Zaza" last="Demetrashvili">Zaza Demetrashvili</name>
<affiliation><nlm:aff id="Aff43">Department General Surgery, Kipshidze Central University Hospital, Tbilisi, Georgia</nlm:aff>
</affiliation>
</author>
<author><name sortKey="De Simone, Belinda" sort="De Simone, Belinda" uniqKey="De Simone B" first="Belinda" last="De Simone">Belinda De Simone</name>
<affiliation><nlm:aff id="Aff44"><institution-wrap><institution-id institution-id-type="ISNI">0000 0004 1795 3510</institution-id>
<institution-id institution-id-type="GRID">grid.418062.9</institution-id>
<institution>Department of Digestive Surgery,</institution>
<institution>Cannes Hospital,</institution>
</institution-wrap>
Cannes, France</nlm:aff>
</affiliation>
</author>
<author><name sortKey="De Waele, Jan J" sort="De Waele, Jan J" uniqKey="De Waele J" first="Jan J." last="De Waele">Jan J. De Waele</name>
<affiliation><nlm:aff id="Aff45"><institution-wrap><institution-id institution-id-type="ISNI">0000 0004 0626 3303</institution-id>
<institution-id institution-id-type="GRID">grid.410566.0</institution-id>
<institution>Department of Critical Care Medicine,</institution>
<institution>Ghent University Hospital,</institution>
</institution-wrap>
Ghent, Belgium</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Dhingra, Sameer" sort="Dhingra, Sameer" uniqKey="Dhingra S" first="Sameer" last="Dhingra">Sameer Dhingra</name>
<affiliation><nlm:aff id="Aff46"><institution-wrap><institution-id institution-id-type="GRID">grid.430529.9</institution-id>
<institution>School of Pharmacy, Faculty of Medical Sciences,</institution>
<institution>The University of the West Indies,</institution>
</institution-wrap>
St. Augustine, Trinidad and Tobago</nlm:aff>
</affiliation>
<affiliation><nlm:aff id="Aff47">Eric Williams Medical Sciences Complex, Uriah Butler Highway, Champ Fleurs, Trinidad and Tobago</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Di Marzo, Francesco" sort="Di Marzo, Francesco" uniqKey="Di Marzo F" first="Francesco" last="Di Marzo">Francesco Di Marzo</name>
<affiliation><nlm:aff id="Aff48">Department of Surgery, Versilia Hospita, Lido di Camaiore, Italy</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Dogjani, Agron" sort="Dogjani, Agron" uniqKey="Dogjani A" first="Agron" last="Dogjani">Agron Dogjani</name>
<affiliation><nlm:aff id="Aff49">Department of Surgery, University Hospital of Trauma, Tirana, Albania</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Dorj, Gereltuya" sort="Dorj, Gereltuya" uniqKey="Dorj G" first="Gereltuya" last="Dorj">Gereltuya Dorj</name>
<affiliation><nlm:aff id="Aff50"><institution-wrap><institution-id institution-id-type="GRID">grid.444534.6</institution-id>
<institution>School of Pharmacy and Biomedicine,</institution>
<institution>Mongolian National University of Medical Sciences,</institution>
</institution-wrap>
Ulaanbaatar, Mongolia</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Dortet, Laurent" sort="Dortet, Laurent" uniqKey="Dortet L" first="Laurent" last="Dortet">Laurent Dortet</name>
<affiliation><nlm:aff id="Aff51"><institution-wrap><institution-id institution-id-type="ISNI">0000 0001 2171 2558</institution-id>
<institution-id institution-id-type="GRID">grid.5842.b</institution-id>
<institution>Department of Microbiology, Bicêtre Hospital,</institution>
<institution>Paris-Sud University,</institution>
</institution-wrap>
La Kremlin-Bicêtre, France</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Duane, Therese M" sort="Duane, Therese M" uniqKey="Duane T" first="Therese M." last="Duane">Therese M. Duane</name>
<affiliation><nlm:aff id="Aff52">Department of Surgery, John Peter Smith Health Network, Fort Worth, Texas USA</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Elmangory, Mutasim M" sort="Elmangory, Mutasim M" uniqKey="Elmangory M" first="Mutasim M." last="Elmangory">Mutasim M. Elmangory</name>
<affiliation><nlm:aff id="Aff53"><institution-wrap><institution-id institution-id-type="GRID">grid.414827.c</institution-id>
<institution>Sudan National Public Health Laboratory,</institution>
<institution>Federal Ministry of Health,</institution>
</institution-wrap>
Khartoum, Sudan</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Enani, Mushira A" sort="Enani, Mushira A" uniqKey="Enani M" first="Mushira A." last="Enani">Mushira A. Enani</name>
<affiliation><nlm:aff id="Aff54"><institution-wrap><institution-id institution-id-type="ISNI">0000 0004 0593 1832</institution-id>
<institution-id institution-id-type="GRID">grid.415277.2</institution-id>
<institution>Department of Medicine, Infectious Disease Division,</institution>
<institution>King Fahad Medical City,</institution>
</institution-wrap>
Riyadh, Saudi Arabia</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Ferrada, Paula" sort="Ferrada, Paula" uniqKey="Ferrada P" first="Paula" last="Ferrada">Paula Ferrada</name>
<affiliation><nlm:aff id="Aff55"><institution-wrap><institution-id institution-id-type="ISNI">0000 0004 0458 8737</institution-id>
<institution-id institution-id-type="GRID">grid.224260.0</institution-id>
<institution>Department of Surgery,</institution>
<institution>Virginia Commonwealth University,</institution>
</institution-wrap>
Richmond, VA USA</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Esteban Foianini, J" sort="Esteban Foianini, J" uniqKey="Esteban Foianini J" first="J." last="Esteban Foianini">J. Esteban Foianini</name>
<affiliation><nlm:aff id="Aff56">Department of Surgery, Clinica Foianini, Santa Cruz, Bolivia</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Gachabayov, Mahir" sort="Gachabayov, Mahir" uniqKey="Gachabayov M" first="Mahir" last="Gachabayov">Mahir Gachabayov</name>
<affiliation><nlm:aff id="Aff57">Department of Abdominal Surgery, Vladimir City Clinical Hospital of Emergency Medicine, Vladimir, Russia</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Gandhi, Chinmay" sort="Gandhi, Chinmay" uniqKey="Gandhi C" first="Chinmay" last="Gandhi">Chinmay Gandhi</name>
<affiliation><nlm:aff id="Aff58">Department of Surgery, Bharati Vidyapeeth Deemed University Medical College and Hospital, Sangli, Maharashtra India</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Ghnnam, Wagih Mommtaz" sort="Ghnnam, Wagih Mommtaz" uniqKey="Ghnnam W" first="Wagih Mommtaz" last="Ghnnam">Wagih Mommtaz Ghnnam</name>
<affiliation><nlm:aff id="Aff59"><institution-wrap><institution-id institution-id-type="ISNI">0000000103426662</institution-id>
<institution-id institution-id-type="GRID">grid.10251.37</institution-id>
<institution>Department of General Surgery, Mansoura Faculty of Medicine,</institution>
<institution>Mansoura University,</institution>
</institution-wrap>
Mansoura, Egypt</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Giamarellou, Helen" sort="Giamarellou, Helen" uniqKey="Giamarellou H" first="Helen" last="Giamarellou">Helen Giamarellou</name>
<affiliation><nlm:aff id="Aff60"><institution-wrap><institution-id institution-id-type="GRID">grid.414012.2</institution-id>
<institution>Sixth Department of Internal Medicine,</institution>
<institution>Hygeia General Hospital,</institution>
</institution-wrap>
Athens, Greece</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Gkiokas, Georgios" sort="Gkiokas, Georgios" uniqKey="Gkiokas G" first="Georgios" last="Gkiokas">Georgios Gkiokas</name>
<affiliation><nlm:aff id="Aff61"><institution-wrap><institution-id institution-id-type="ISNI">0000 0001 2155 0800</institution-id>
<institution-id institution-id-type="GRID">grid.5216.0</institution-id>
<institution>Second Department of Surgery,</institution>
<institution>Aretaieion University Hospital, National and Kapodistrian University of Athens,</institution>
</institution-wrap>
Athens, Greece</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Gomi, Harumi" sort="Gomi, Harumi" uniqKey="Gomi H" first="Harumi" last="Gomi">Harumi Gomi</name>
<affiliation><nlm:aff id="Aff62"><institution-wrap><institution-id institution-id-type="ISNI">0000 0001 2369 4728</institution-id>
<institution-id institution-id-type="GRID">grid.20515.33</institution-id>
<institution>Center for Global Health, Mito Kyodo General Hospital,</institution>
<institution>University of Tsukuba,</institution>
</institution-wrap>
Mito, Ibaraki Japan</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Goranovic, Tatjana" sort="Goranovic, Tatjana" uniqKey="Goranovic T" first="Tatjana" last="Goranovic">Tatjana Goranovic</name>
<affiliation><nlm:aff id="Aff63">University Department for Tumours, Sestre Milosrrdnice UHC, Zagreb, Croatia</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Griffiths, Ewen A" sort="Griffiths, Ewen A" uniqKey="Griffiths E" first="Ewen A." last="Griffiths">Ewen A. Griffiths</name>
<affiliation><nlm:aff id="Aff64"><institution-wrap><institution-id institution-id-type="ISNI">0000 0001 2177 007X</institution-id>
<institution-id institution-id-type="GRID">grid.415490.d</institution-id>
<institution>General and Upper GI Surgery,</institution>
<institution>Queen Elizabeth Hospital,</institution>
</institution-wrap>
Birmingham, UK</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Guerra Gronerth, Rosio I" sort="Guerra Gronerth, Rosio I" uniqKey="Guerra Gronerth R" first="Rosio I." last="Guerra Gronerth">Rosio I. Guerra Gronerth</name>
<affiliation><nlm:aff id="Aff65">Peruvian Navy Medical Center, Lima, Peru</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Haidamus Monteiro, Julio C" sort="Haidamus Monteiro, Julio C" uniqKey="Haidamus Monteiro J" first="Julio C." last="Haidamus Monteiro">Julio C. Haidamus Monteiro</name>
<affiliation><nlm:aff id="Aff66"><institution-wrap><institution-id institution-id-type="ISNI">0000 0001 2198 9354</institution-id>
<institution-id institution-id-type="GRID">grid.415169.e</institution-id>
<institution>Department of Gastrointestinal Surgery,</institution>
<institution>Santa Casa Hospital,</institution>
</institution-wrap>
Campo Grande, Brazil</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Hardcastle, Timothy C" sort="Hardcastle, Timothy C" uniqKey="Hardcastle T" first="Timothy C." last="Hardcastle">Timothy C. Hardcastle</name>
<affiliation><nlm:aff id="Aff67"><institution-wrap><institution-id institution-id-type="ISNI">0000 0001 0723 4123</institution-id>
<institution-id institution-id-type="GRID">grid.16463.36</institution-id>
<institution>Trauma and Trauma ICU, Inkosi Albert Luthuli Central Hospital and Department of Surgery,</institution>
<institution>University of KwaZulu-Natal,</institution>
</institution-wrap>
Durban, South Africa</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Hecker, Andreas" sort="Hecker, Andreas" uniqKey="Hecker A" first="Andreas" last="Hecker">Andreas Hecker</name>
<affiliation><nlm:aff id="Aff68"><institution-wrap><institution-id institution-id-type="ISNI">0000 0000 8584 9230</institution-id>
<institution-id institution-id-type="GRID">grid.411067.5</institution-id>
<institution>Department of General and Thoracic Surgery,</institution>
<institution>University Hospital Giessen,</institution>
</institution-wrap>
Giessen, Germany</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Hodonou, Adrien M" sort="Hodonou, Adrien M" uniqKey="Hodonou A" first="Adrien M." last="Hodonou">Adrien M. Hodonou</name>
<affiliation><nlm:aff id="Aff69"><institution-wrap><institution-id institution-id-type="GRID">grid.440525.2</institution-id>
<institution>Department of Surgery, Faculty of Medicine,</institution>
<institution>University of Parakou,</institution>
</institution-wrap>
BP 123 Parakou, Benin</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Ioannidis, Orestis" sort="Ioannidis, Orestis" uniqKey="Ioannidis O" first="Orestis" last="Ioannidis">Orestis Ioannidis</name>
<affiliation><nlm:aff id="Aff70"><institution-wrap><institution-id institution-id-type="ISNI">0000000109457005</institution-id>
<institution-id institution-id-type="GRID">grid.4793.9</institution-id>
<institution>Fourth Surgical Department, General Hospital G. Papanikolaou, Medical School,</institution>
<institution>Aristotle University of Thessaloniki,</institution>
</institution-wrap>
Thessaloniki, Greece</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Isik, Arda" sort="Isik, Arda" uniqKey="Isik A" first="Arda" last="Isik">Arda Isik</name>
<affiliation><nlm:aff id="Aff71"><institution-wrap><institution-id institution-id-type="ISNI">0000 0001 1498 7262</institution-id>
<institution-id institution-id-type="GRID">grid.412176.7</institution-id>
<institution>Department of General Surgery,</institution>
<institution>Erzincan University, Faculty of Medicine,</institution>
</institution-wrap>
Erzincan, Turkey</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Iskandar, Katia A" sort="Iskandar, Katia A" uniqKey="Iskandar K" first="Katia A." last="Iskandar">Katia A. Iskandar</name>
<affiliation><nlm:aff id="Aff72">Department of Pharmacy, Lebanese, International University, Beirut, Lebanon</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Kafil, Hossein S" sort="Kafil, Hossein S" uniqKey="Kafil H" first="Hossein S." last="Kafil">Hossein S. Kafil</name>
<affiliation><nlm:aff id="Aff73"><institution-wrap><institution-id institution-id-type="ISNI">0000 0001 2174 8913</institution-id>
<institution-id institution-id-type="GRID">grid.412888.f</institution-id>
<institution>Drug Applied Research Center,</institution>
<institution>Tabriz University of Medical Sciences,</institution>
</institution-wrap>
Tabriz, Iran</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Kanj, Souha S" sort="Kanj, Souha S" uniqKey="Kanj S" first="Souha S." last="Kanj">Souha S. Kanj</name>
<affiliation><nlm:aff id="Aff74"><institution-wrap><institution-id institution-id-type="ISNI">0000 0004 1936 9801</institution-id>
<institution-id institution-id-type="GRID">grid.22903.3a</institution-id>
<institution>Division of Infectious Diseases,</institution>
<institution>American University of Beirut,</institution>
</institution-wrap>
Beirut, Lebanon</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Kaplan, Lewis J" sort="Kaplan, Lewis J" uniqKey="Kaplan L" first="Lewis J." last="Kaplan">Lewis J. Kaplan</name>
<affiliation><nlm:aff id="Aff75"><institution-wrap><institution-id institution-id-type="ISNI">0000 0004 1936 8972</institution-id>
<institution-id institution-id-type="GRID">grid.25879.31</institution-id>
<institution>Department of Surgery Philadelphia VA Medical Center, Perelman School of Medicine,</institution>
<institution>University of Pennsylvania,</institution>
</institution-wrap>
Philadelphia, PA USA</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Kapoor, Garima" sort="Kapoor, Garima" uniqKey="Kapoor G" first="Garima" last="Kapoor">Garima Kapoor</name>
<affiliation><nlm:aff id="Aff76"><institution-wrap><institution-id institution-id-type="GRID">grid.415285.f</institution-id>
<institution>Department of Microbiology,</institution>
<institution>Gandhi Medical College,</institution>
</institution-wrap>
Bhopal, India</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Karamarkovic, Aleksandar R" sort="Karamarkovic, Aleksandar R" uniqKey="Karamarkovic A" first="Aleksandar R." last="Karamarkovic">Aleksandar R. Karamarkovic</name>
<affiliation><nlm:aff id="Aff77"><institution-wrap><institution-id institution-id-type="ISNI">0000 0001 2166 9385</institution-id>
<institution-id institution-id-type="GRID">grid.7149.b</institution-id>
<institution></institution>
<institution>Clinic for Emergency Surgery, Medical Faculty University of Belgrade,</institution>
</institution-wrap>
Belgrade, Serbia</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Kenig, Jakub" sort="Kenig, Jakub" uniqKey="Kenig J" first="Jakub" last="Kenig">Jakub Kenig</name>
<affiliation><nlm:aff id="Aff78"><institution-wrap><institution-id institution-id-type="ISNI">0000 0001 2162 9631</institution-id>
<institution-id institution-id-type="GRID">grid.5522.0</institution-id>
<institution>Third Department of General Surgery,</institution>
<institution>Jagiellonian University Medical College,</institution>
</institution-wrap>
Krakow, Poland</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Kerschaever, Ivan" sort="Kerschaever, Ivan" uniqKey="Kerschaever I" first="Ivan" last="Kerschaever">Ivan Kerschaever</name>
<affiliation><nlm:aff id="Aff79">Department of Abdominal Surgery, Regional Hospital of Tienen, Tienen, Belgium</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Khamis, Faryal" sort="Khamis, Faryal" uniqKey="Khamis F" first="Faryal" last="Khamis">Faryal Khamis</name>
<affiliation><nlm:aff id="Aff80"><institution-wrap><institution-id institution-id-type="ISNI">0000 0004 1772 5665</institution-id>
<institution-id institution-id-type="GRID">grid.416132.3</institution-id>
<institution>Department of Internal Medicine,</institution>
<institution>Royal Hospital,</institution>
</institution-wrap>
Muscat, Oman</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Khokha, Vladimir" sort="Khokha, Vladimir" uniqKey="Khokha V" first="Vladimir" last="Khokha">Vladimir Khokha</name>
<affiliation><nlm:aff id="Aff81">Department of Emergency Surgery, City Hospital, Mozyr, Belarus</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Kiguba, Ronald" sort="Kiguba, Ronald" uniqKey="Kiguba R" first="Ronald" last="Kiguba">Ronald Kiguba</name>
<affiliation><nlm:aff id="Aff82"><institution-wrap><institution-id institution-id-type="ISNI">0000 0004 0620 0548</institution-id>
<institution-id institution-id-type="GRID">grid.11194.3c</institution-id>
<institution>Department of Pharmacology and Therapeutics, College of Health Sciences,</institution>
<institution>Makerere University,</institution>
</institution-wrap>
Kampala, Uganda</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Kim, Hong B" sort="Kim, Hong B" uniqKey="Kim H" first="Hong B." last="Kim">Hong B. Kim</name>
<affiliation><nlm:aff id="Aff83"><institution-wrap><institution-id institution-id-type="ISNI">0000 0004 0647 3378</institution-id>
<institution-id institution-id-type="GRID">grid.412480.b</institution-id>
<institution>Department of Internal Medicine,</institution>
<institution>Seoul National University Bundang Hospital,</institution>
</institution-wrap>
Seongnam, Republic of Korea</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Ko, Wen Chien" sort="Ko, Wen Chien" uniqKey="Ko W" first="Wen-Chien" last="Ko">Wen-Chien Ko</name>
<affiliation><nlm:aff id="Aff84"><institution-wrap><institution-id institution-id-type="ISNI">0000 0004 0639 0054</institution-id>
<institution-id institution-id-type="GRID">grid.412040.3</institution-id>
<institution>Department of Internal Medicine,</institution>
<institution>National Cheng Kung University Hospital,</institution>
</institution-wrap>
Tainan, Taiwan</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Koike, Kaoru" sort="Koike, Kaoru" uniqKey="Koike K" first="Kaoru" last="Koike">Kaoru Koike</name>
<affiliation><nlm:aff id="Aff85"><institution-wrap><institution-id institution-id-type="ISNI">0000 0004 0372 2033</institution-id>
<institution-id institution-id-type="GRID">grid.258799.8</institution-id>
<institution>Department of Primary Care and Emergency Medicine,</institution>
<institution>Kyoto University Graduate School of Medicine,</institution>
</institution-wrap>
Kyoto, Japan</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Kozlovska, Iryna" sort="Kozlovska, Iryna" uniqKey="Kozlovska I" first="Iryna" last="Kozlovska">Iryna Kozlovska</name>
<affiliation><nlm:aff id="Aff86">Department of Surgery n. 2, Higher educational institutions of Ukraine Bukovina State Medical University, Chernivtci City, Ukraine</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Kumar, Anand" sort="Kumar, Anand" uniqKey="Kumar A" first="Anand" last="Kumar">Anand Kumar</name>
<affiliation><nlm:aff id="Aff87"><institution-wrap><institution-id institution-id-type="ISNI">0000 0004 1936 9609</institution-id>
<institution-id institution-id-type="GRID">grid.21613.37</institution-id>
<institution>Section of Critical Care Medicine and Section of Infectious Diseases, Department of Medicine, Medical Microbiology and Pharmacology/Therapeutics,</institution>
<institution>University of Manitoba,</institution>
</institution-wrap>
Winnipeg, MB Canada</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Lagunes, Leonel" sort="Lagunes, Leonel" uniqKey="Lagunes L" first="Leonel" last="Lagunes">Leonel Lagunes</name>
<affiliation><nlm:aff id="Aff88"><institution-wrap><institution-id institution-id-type="ISNI">0000 0004 0633 6808</institution-id>
<institution-id institution-id-type="GRID">grid.414410.4</institution-id>
<institution></institution>
<institution>Hospital Central Dr Ignacio Morones Prieto,</institution>
</institution-wrap>
San Luis Potosi, Mexico</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Latifi, Rifat" sort="Latifi, Rifat" uniqKey="Latifi R" first="Rifat" last="Latifi">Rifat Latifi</name>
<affiliation><nlm:aff id="Aff89"><institution-wrap><institution-id institution-id-type="ISNI">0000 0001 2168 186X</institution-id>
<institution-id institution-id-type="GRID">grid.134563.6</institution-id>
<institution>Department of Surgery, Division of Trauma,</institution>
<institution>University of Arizona,</institution>
</institution-wrap>
Tucson, AZ USA</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Lee, Jae G" sort="Lee, Jae G" uniqKey="Lee J" first="Jae G." last="Lee">Jae G. Lee</name>
<affiliation><nlm:aff id="Aff90"><institution-wrap><institution-id institution-id-type="ISNI">0000 0004 0470 5454</institution-id>
<institution-id institution-id-type="GRID">grid.15444.30</institution-id>
<institution>Department of Surgery,</institution>
<institution>Yonsei University College of Medicine,</institution>
</institution-wrap>
Seoul, South Korea</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Lee, Young R" sort="Lee, Young R" uniqKey="Lee Y" first="Young R." last="Lee">Young R. Lee</name>
<affiliation><nlm:aff id="Aff91"><institution-wrap><institution-id institution-id-type="GRID">grid.449754.f</institution-id>
<institution></institution>
<institution>Texas Tech University, Health Sciences Center School of Pharmacy,</institution>
</institution-wrap>
Abilene, TX USA</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Lepp Niemi, Ari" sort="Lepp Niemi, Ari" uniqKey="Lepp Niemi A" first="Ari" last="Lepp Niemi">Ari Lepp Niemi</name>
<affiliation><nlm:aff id="Aff92">Abdominal Center, University Hospital Meilahti, Helsinki, Finland</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Li, Yousheng" sort="Li, Yousheng" uniqKey="Li Y" first="Yousheng" last="Li">Yousheng Li</name>
<affiliation><nlm:aff id="Aff93"><institution-wrap><institution-id institution-id-type="ISNI">0000 0001 2314 964X</institution-id>
<institution-id institution-id-type="GRID">grid.41156.37</institution-id>
<institution>Department of Surgery, Inling Hospital,</institution>
<institution>Nanjing University School of Medicine,</institution>
</institution-wrap>
Nanjing, China</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Liang, Stephen Y" sort="Liang, Stephen Y" uniqKey="Liang S" first="Stephen Y." last="Liang">Stephen Y. Liang</name>
<affiliation><nlm:aff id="Aff94"><institution-wrap><institution-id institution-id-type="ISNI">0000 0001 2355 7002</institution-id>
<institution-id institution-id-type="GRID">grid.4367.6</institution-id>
<institution>Division of Infectious Diseases, Division of Emergency Medicine,</institution>
<institution>Washington University School of Medicine,</institution>
</institution-wrap>
St. Louis, MO USA</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Lowman, Warren" sort="Lowman, Warren" uniqKey="Lowman W" first="Warren" last="Lowman">Warren Lowman</name>
<affiliation><nlm:aff id="Aff95"><institution-wrap><institution-id institution-id-type="ISNI">0000 0004 1937 1135</institution-id>
<institution-id institution-id-type="GRID">grid.11951.3d</institution-id>
<institution>Clinical Microbiology and Infectious Diseases, School of Pathology, Faculty of Health Sciences,</institution>
<institution>University of the Witwatersrand,</institution>
</institution-wrap>
Johannesburg, South Africa</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Machain, Gustavo M" sort="Machain, Gustavo M" uniqKey="Machain G" first="Gustavo M." last="Machain">Gustavo M. Machain</name>
<affiliation><nlm:aff id="Aff96"><institution-wrap><institution-id institution-id-type="ISNI">0000 0001 2289 5077</institution-id>
<institution-id institution-id-type="GRID">grid.412213.7</institution-id>
<institution>Department of Surgery,</institution>
<institution>Universidad Nacional de Asuncion,</institution>
</institution-wrap>
Asuncion, Paraguay</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Maegele, Marc" sort="Maegele, Marc" uniqKey="Maegele M" first="Marc" last="Maegele">Marc Maegele</name>
<affiliation><nlm:aff id="Aff97"><institution-wrap><institution-id institution-id-type="ISNI">0000 0000 9024 6397</institution-id>
<institution-id institution-id-type="GRID">grid.412581.b</institution-id>
<institution>Department for Traumatology and Orthopedic Surgery, Cologne Merheim Medical Center (CMMC),</institution>
<institution>University of Witten/Herdecke (UW/H),</institution>
</institution-wrap>
Cologne, Germany</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Major, Piotr" sort="Major, Piotr" uniqKey="Major P" first="Piotr" last="Major">Piotr Major</name>
<affiliation><nlm:aff id="Aff98"><institution-wrap><institution-id institution-id-type="ISNI">0000 0001 2162 9631</institution-id>
<institution-id institution-id-type="GRID">grid.5522.0</institution-id>
<institution>Second Department of General Surgery,</institution>
<institution>Jagiellonian University Medical College,</institution>
</institution-wrap>
Krakow, Poland</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Malama, Sydney" sort="Malama, Sydney" uniqKey="Malama S" first="Sydney" last="Malama">Sydney Malama</name>
<affiliation><nlm:aff id="Aff99"><institution-wrap><institution-id institution-id-type="ISNI">0000 0000 8914 5257</institution-id>
<institution-id institution-id-type="GRID">grid.12984.36</institution-id>
<institution>Health Research Program, Institute of Economic and Social Research,</institution>
<institution>University of Zambia,</institution>
</institution-wrap>
Lusaka, Zambia</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Manzano Nunez, Ramiro" sort="Manzano Nunez, Ramiro" uniqKey="Manzano Nunez R" first="Ramiro" last="Manzano-Nunez">Ramiro Manzano-Nunez</name>
<affiliation><nlm:aff id="Aff100"><institution-wrap><institution-id institution-id-type="GRID">grid.477264.4</institution-id>
<institution></institution>
<institution>Clinical Research Center, Fundacion Valle del Lili,</institution>
</institution-wrap>
Cali, Colombia</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Marinis, Athanasios" sort="Marinis, Athanasios" uniqKey="Marinis A" first="Athanasios" last="Marinis">Athanasios Marinis</name>
<affiliation><nlm:aff id="Aff101"><institution-wrap><institution-id institution-id-type="GRID">grid.417374.2</institution-id>
<institution>First Department of Surgery,</institution>
<institution>Tzaneion General Hospital,</institution>
</institution-wrap>
Piraeus, Greece</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Martinez Casas, Isidro" sort="Martinez Casas, Isidro" uniqKey="Martinez Casas I" first="Isidro" last="Martinez Casas">Isidro Martinez Casas</name>
<affiliation><nlm:aff id="Aff102">Service of General Surgery, Hospital Complex of Jaén, Jaén, Spain</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Marwah, Sanjay" sort="Marwah, Sanjay" uniqKey="Marwah S" first="Sanjay" last="Marwah">Sanjay Marwah</name>
<affiliation><nlm:aff id="Aff103"><institution-wrap><institution-id institution-id-type="ISNI">0000 0004 1771 1642</institution-id>
<institution-id institution-id-type="GRID">grid.412572.7</institution-id>
<institution>Department of Surgery,</institution>
<institution>Post-Graduate Institute of Medical Sciences,</institution>
</institution-wrap>
Rohtak, India</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Maseda, Emilio" sort="Maseda, Emilio" uniqKey="Maseda E" first="Emilio" last="Maseda">Emilio Maseda</name>
<affiliation><nlm:aff id="Aff104">Servicio de Anestesia y Reanimación, Hospital Universitario La Paz Madrid, Madrid, Spain</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Mcfarlane, Michael E" sort="Mcfarlane, Michael E" uniqKey="Mcfarlane M" first="Michael E." last="Mcfarlane">Michael E. Mcfarlane</name>
<affiliation><nlm:aff id="Aff105"><institution-wrap><institution-id institution-id-type="ISNI">0000 0004 0500 5353</institution-id>
<institution-id institution-id-type="GRID">grid.412963.b</institution-id>
<institution>Department of Surgery, Radiology,</institution>
<institution>University Hospital of the West Indies,</institution>
</institution-wrap>
Kingston, Jamaica</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Memish, Ziad" sort="Memish, Ziad" uniqKey="Memish Z" first="Ziad" last="Memish">Ziad Memish</name>
<affiliation><nlm:aff id="Aff106"><institution-wrap><institution-id institution-id-type="GRID">grid.415696.9</institution-id>
<institution>Infectious Diseases Division, Department of Medicine,</institution>
<institution>Prince Mohamed Bin Abdulaziz Hospital, Ministry of Health,</institution>
</institution-wrap>
Riyadh, Saudi Arabia</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Mertz, Dominik" sort="Mertz, Dominik" uniqKey="Mertz D" first="Dominik" last="Mertz">Dominik Mertz</name>
<affiliation><nlm:aff id="Aff107"><institution-wrap><institution-id institution-id-type="ISNI">0000 0004 1936 8227</institution-id>
<institution-id institution-id-type="GRID">grid.25073.33</institution-id>
<institution>Departments of Medicine, Clinical Epidemiology and Biostatistics, and Pathology and Molecular Medicine,</institution>
<institution>McMaster University,</institution>
</institution-wrap>
Hamilton, ON Canada</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Mesina, Cristian" sort="Mesina, Cristian" uniqKey="Mesina C" first="Cristian" last="Mesina">Cristian Mesina</name>
<affiliation><nlm:aff id="Aff108">Second Surgical Clinic, Emergency Hospital of Craiova, Craiova, Romania</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Mishra, Shyam K" sort="Mishra, Shyam K" uniqKey="Mishra S" first="Shyam K." last="Mishra">Shyam K. Mishra</name>
<affiliation><nlm:aff id="Aff109">Department of Microbiology, Tribhuvan University Teaching Hospital, Institute of Medicine, Kathmandu, Nepal</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Moore, Ernest E" sort="Moore, Ernest E" uniqKey="Moore E" first="Ernest E." last="Moore">Ernest E. Moore</name>
<affiliation><nlm:aff id="Aff110">Department of Surgery, University of Colorado, Denver Health Medical Center, Denver, CO USA</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Munyika, Akutu" sort="Munyika, Akutu" uniqKey="Munyika A" first="Akutu" last="Munyika">Akutu Munyika</name>
<affiliation><nlm:aff id="Aff111">Department of Surgery, Onandjokwe Hospital, Ondangwa, Namibia</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Mylonakis, Eleftherios" sort="Mylonakis, Eleftherios" uniqKey="Mylonakis E" first="Eleftherios" last="Mylonakis">Eleftherios Mylonakis</name>
<affiliation><nlm:aff id="Aff112"><institution-wrap><institution-id institution-id-type="ISNI">0000 0004 1936 9094</institution-id>
<institution-id institution-id-type="GRID">grid.40263.33</institution-id>
<institution>Infectious Diseases Division,</institution>
<institution>Warren Alpert Medical School of Brown University, Rhode Island Hospital,</institution>
</institution-wrap>
Providence, RI USA</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Napolitano, Lena" sort="Napolitano, Lena" uniqKey="Napolitano L" first="Lena" last="Napolitano">Lena Napolitano</name>
<affiliation><nlm:aff id="Aff113"><institution-wrap><institution-id institution-id-type="ISNI">0000000086837370</institution-id>
<institution-id institution-id-type="GRID">grid.214458.e</institution-id>
<institution>Department of Surgery,</institution>
<institution>University of Michigan,</institution>
</institution-wrap>
Ann Arbor, MI USA</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Negoi, Ionut" sort="Negoi, Ionut" uniqKey="Negoi I" first="Ionut" last="Negoi">Ionut Negoi</name>
<affiliation><nlm:aff id="Aff114">Department of Surgery, Emergency Hospital of Bucharest, Bucharest, Romania</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Nestorovic, Milica D" sort="Nestorovic, Milica D" uniqKey="Nestorovic M" first="Milica D." last="Nestorovic">Milica D. Nestorovic</name>
<affiliation><nlm:aff id="Aff115"><institution-wrap><institution-id institution-id-type="ISNI">0000 0004 0517 2741</institution-id>
<institution-id institution-id-type="GRID">grid.418653.d</institution-id>
<institution></institution>
<institution>Clinic for General Surgery, Clinical Centre,</institution>
</institution-wrap>
Nis, Serbia</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Nicolau, David P" sort="Nicolau, David P" uniqKey="Nicolau D" first="David P." last="Nicolau">David P. Nicolau</name>
<affiliation><nlm:aff id="Aff116">Center of Anti-Infective Research and Development, Hartford, CT USA</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Omari, Abdelkarim H" sort="Omari, Abdelkarim H" uniqKey="Omari A" first="Abdelkarim H." last="Omari">Abdelkarim H. Omari</name>
<affiliation><nlm:aff id="Aff117"><institution-wrap><institution-id institution-id-type="ISNI">0000 0004 0411 3985</institution-id>
<institution-id institution-id-type="GRID">grid.460946.9</institution-id>
<institution>Department of Surgery,</institution>
<institution>King Abdullah University Hospital,</institution>
</institution-wrap>
Irbid, Jordan</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Ordonez, Carlos A" sort="Ordonez, Carlos A" uniqKey="Ordonez C" first="Carlos A." last="Ordonez">Carlos A. Ordonez</name>
<affiliation><nlm:aff id="Aff118"><institution-wrap><institution-id institution-id-type="ISNI">0000 0001 2295 7397</institution-id>
<institution-id institution-id-type="GRID">grid.8271.c</institution-id>
<institution>Department of Surgery and Critical Care,</institution>
<institution>Universidad del Valle, Fundación Valle del Lili,</institution>
</institution-wrap>
Cali, Colombia</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Paiva, Jose Artur" sort="Paiva, Jose Artur" uniqKey="Paiva J" first="José-Artur" last="Paiva">José-Artur Paiva</name>
<affiliation><nlm:aff id="Aff119"><institution-wrap><institution-id institution-id-type="ISNI">0000 0001 1503 7226</institution-id>
<institution-id institution-id-type="GRID">grid.5808.5</institution-id>
<institution>Intensive Care Medicine Department,</institution>
<institution>Centro Hospitalar São João, University of Porto,</institution>
</institution-wrap>
Porto, Portugal</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Pant, Narayan D" sort="Pant, Narayan D" uniqKey="Pant N" first="Narayan D." last="Pant">Narayan D. Pant</name>
<affiliation><nlm:aff id="Aff120"><institution-wrap><institution-id institution-id-type="GRID">grid.461024.5</institution-id>
<institution>Department of Microbiology,</institution>
<institution>Grande International Hospital,</institution>
</institution-wrap>
Dhapasi, Kathmandu, Nepal</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Parreira, Jose G" sort="Parreira, Jose G" uniqKey="Parreira J" first="Jose G." last="Parreira">Jose G. Parreira</name>
<affiliation><nlm:aff id="Aff121"><institution-wrap><institution-id institution-id-type="ISNI">0000 0004 0576 9812</institution-id>
<institution-id institution-id-type="GRID">grid.419014.9</institution-id>
<institution>Department of Surgery,</institution>
<institution>Santa Casa de Sao Paulo School of Medical Sciences,</institution>
</institution-wrap>
São Paulo, Brazil</nlm:aff>
</affiliation>
</author>
<author><name sortKey="P Dziwiatr, Michal" sort="P Dziwiatr, Michal" uniqKey="P Dziwiatr M" first="Michal" last="P Dziwiatr">Michal P Dziwiatr</name>
<affiliation><nlm:aff id="Aff122"><institution-wrap><institution-id institution-id-type="ISNI">0000 0001 1216 0093</institution-id>
<institution-id institution-id-type="GRID">grid.412700.0</institution-id>
<institution>Department of General and Emergency Surgery,</institution>
<institution>University Hospital Kraków,</institution>
</institution-wrap>
Kraków, Poland</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Pereira, Bruno M" sort="Pereira, Bruno M" uniqKey="Pereira B" first="Bruno M." last="Pereira">Bruno M. Pereira</name>
<affiliation><nlm:aff id="Aff123"><institution-wrap><institution-id institution-id-type="ISNI">0000 0001 0723 2494</institution-id>
<institution-id institution-id-type="GRID">grid.411087.b</institution-id>
<institution>Department of Surgery,</institution>
<institution>University of Campinas,</institution>
</institution-wrap>
Campinas, Brazil</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Ponce De Leon, Alfredo" sort="Ponce De Leon, Alfredo" uniqKey="Ponce De Leon A" first="Alfredo" last="Ponce-De-Leon">Alfredo Ponce-De-Leon</name>
<affiliation><nlm:aff id="Aff124"><institution-wrap><institution-id institution-id-type="ISNI">0000 0001 0698 4037</institution-id>
<institution-id institution-id-type="GRID">grid.416850.e</institution-id>
<institution>Laboratory of Clinical Microbiology, Department of Infectious Diseases,</institution>
<institution>Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán,</institution>
</institution-wrap>
Mexico City, Mexico</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Poulakou, Garyphallia" sort="Poulakou, Garyphallia" uniqKey="Poulakou G" first="Garyphallia" last="Poulakou">Garyphallia Poulakou</name>
<affiliation><nlm:aff id="Aff125"><institution-wrap><institution-id institution-id-type="ISNI">0000 0004 0622 4662</institution-id>
<institution-id institution-id-type="GRID">grid.411449.d</institution-id>
<institution>Fourth Department of Internal Medicine and Infectious Diseases Unit,</institution>
<institution>National and Kapodstrian University-Medical School, Attikon University General Hospital,</institution>
</institution-wrap>
Athens, Greece</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Preller, Jacobus" sort="Preller, Jacobus" uniqKey="Preller J" first="Jacobus" last="Preller">Jacobus Preller</name>
<affiliation><nlm:aff id="Aff126">John Farman Intensive Care Unit, University Hospitals, NHS Foundation Trust, Cambridge, UK</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Pulcini, Celine" sort="Pulcini, Celine" uniqKey="Pulcini C" first="Céline" last="Pulcini">Céline Pulcini</name>
<affiliation><nlm:aff id="Aff127">Infectious and Tropical Diseases Department, University Hospital of Nancy, and EA 4360 APEMAC, Lorraine University, Nancy, France</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Pupelis, Guntars" sort="Pupelis, Guntars" uniqKey="Pupelis G" first="Guntars" last="Pupelis">Guntars Pupelis</name>
<affiliation><nlm:aff id="Aff128">Department of General and Emergency Surgery, Riga East University Hospital ‘Gailezers’, Riga, Latvia</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Quiodettis, Martha" sort="Quiodettis, Martha" uniqKey="Quiodettis M" first="Martha" last="Quiodettis">Martha Quiodettis</name>
<affiliation><nlm:aff id="Aff129"><institution-wrap><institution-id institution-id-type="ISNI">0000 0004 0465 2778</institution-id>
<institution-id institution-id-type="GRID">grid.461067.2</institution-id>
<institution>Department of Trauma,</institution>
<institution>Hospital Santo Tomas,</institution>
</institution-wrap>
Panama, Panama</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Rawson, Timothy M" sort="Rawson, Timothy M" uniqKey="Rawson T" first="Timothy M." last="Rawson">Timothy M. Rawson</name>
<affiliation><nlm:aff id="Aff130"><institution-wrap><institution-id institution-id-type="ISNI">0000 0001 2113 8111</institution-id>
<institution-id institution-id-type="GRID">grid.7445.2</institution-id>
<institution>National Institute for Health Research, Health Protection Research Unit in Healthcare Associated Infections and Antimicrobial Resistance,</institution>
<institution>Imperial College London,</institution>
</institution-wrap>
Hammersmith Campus, London, UK</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Reis, Tarcisio" sort="Reis, Tarcisio" uniqKey="Reis T" first="Tarcisio" last="Reis">Tarcisio Reis</name>
<affiliation><nlm:aff id="Aff131">Emergency Post-operative Department, Otavio de Freitas Hospital and Hosvaldo Cruz Hospital, Recife, Brazil</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Rems, Miran" sort="Rems, Miran" uniqKey="Rems M" first="Miran" last="Rems">Miran Rems</name>
<affiliation><nlm:aff id="Aff132">Department of General Surgery, Jesenice General Hospital, Jesenice, Slovenia</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Rizoli, Sandro" sort="Rizoli, Sandro" uniqKey="Rizoli S" first="Sandro" last="Rizoli">Sandro Rizoli</name>
<affiliation><nlm:aff id="Aff133"><institution-wrap><institution-id institution-id-type="ISNI">0000 0001 2157 2938</institution-id>
<institution-id institution-id-type="GRID">grid.17063.33</institution-id>
<institution>Trauma and Acute Care Service, St Michael’s Hospital,</institution>
<institution>University of Toronto,</institution>
</institution-wrap>
Toronto, Canada</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Roberts, Jason" sort="Roberts, Jason" uniqKey="Roberts J" first="Jason" last="Roberts">Jason Roberts</name>
<affiliation><nlm:aff id="Aff134"><institution-wrap><institution-id institution-id-type="ISNI">0000 0000 9320 7537</institution-id>
<institution-id institution-id-type="GRID">grid.1003.2</institution-id>
<institution>Burns, Trauma and Critical Care Research Centre,</institution>
<institution>The University of Queensland,</institution>
</institution-wrap>
Brisbane, Queensland Australia</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Pereira, Nuno Rocha" sort="Pereira, Nuno Rocha" uniqKey="Pereira N" first="Nuno Rocha" last="Pereira">Nuno Rocha Pereira</name>
<affiliation><nlm:aff id="Aff23"><institution-wrap><institution-id institution-id-type="ISNI">0000 0000 9375 4688</institution-id>
<institution-id institution-id-type="GRID">grid.414556.7</institution-id>
<institution>Unit of Prevention and Infection Control, Center of Hospital Epidemiology,</institution>
<institution>São João Hospital Centre,</institution>
</institution-wrap>
Porto, Portugal</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Rodriguez Ba O, Jesus" sort="Rodriguez Ba O, Jesus" uniqKey="Rodriguez Ba O J" first="Jesús" last="Rodríguez-Ba O">Jesús Rodríguez-Ba O</name>
<affiliation><nlm:aff id="Aff135"><institution-wrap><institution-id institution-id-type="ISNI">0000 0001 2168 1229</institution-id>
<institution-id institution-id-type="GRID">grid.9224.d</institution-id>
<institution>Unidad Clínica Intercentros de Enfermedades Infecciosas, Microbiología y Medicina Preventiva, Hospitales Universitarios Virgen Macarena y Virgen del Rocío-IBiS and Departamento de Medicina,</institution>
<institution>Universidad de Sevilla,</institution>
</institution-wrap>
Seville, Spain</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Sakakushev, Boris" sort="Sakakushev, Boris" uniqKey="Sakakushev B" first="Boris" last="Sakakushev">Boris Sakakushev</name>
<affiliation><nlm:aff id="Aff136"><institution-wrap><institution-id institution-id-type="ISNI">0000 0001 0726 0380</institution-id>
<institution-id institution-id-type="GRID">grid.35371.33</institution-id>
<institution>General Surgery Department,</institution>
<institution>Medical University, University Hospital St George,</institution>
</institution-wrap>
Plovdiv, Bulgaria</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Sanders, James" sort="Sanders, James" uniqKey="Sanders J" first="James" last="Sanders">James Sanders</name>
<affiliation><nlm:aff id="Aff137"><institution-wrap><institution-id institution-id-type="GRID">grid.414766.6</institution-id>
<institution></institution>
<institution>JPS Health Network,</institution>
</institution-wrap>
Texas, TX USA</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Santos, Natalia" sort="Santos, Natalia" uniqKey="Santos N" first="Natalia" last="Santos">Natalia Santos</name>
<affiliation><nlm:aff id="Aff138">Hospital Center Tondela Viseu, Tondela, Portugal</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Sato, Norio" sort="Sato, Norio" uniqKey="Sato N" first="Norio" last="Sato">Norio Sato</name>
<affiliation><nlm:aff id="Aff139"><institution-wrap><institution-id institution-id-type="ISNI">0000 0001 1011 3808</institution-id>
<institution-id institution-id-type="GRID">grid.255464.4</institution-id>
<institution>Department of Aeromedical Services for Emergency and Trauma Care,</institution>
<institution>Ehime University Graduate School of Medicine,</institution>
</institution-wrap>
Ehime, Japan</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Sawyer, Robert G" sort="Sawyer, Robert G" uniqKey="Sawyer R" first="Robert G." last="Sawyer">Robert G. Sawyer</name>
<affiliation><nlm:aff id="Aff140"><institution-wrap><institution-id institution-id-type="ISNI">0000 0004 1936 9932</institution-id>
<institution-id institution-id-type="GRID">grid.412587.d</institution-id>
<institution>Department of Surgery,</institution>
<institution>University of Virginia Health System,</institution>
</institution-wrap>
Charlottesville, VA USA</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Scarpelini, Sandro" sort="Scarpelini, Sandro" uniqKey="Scarpelini S" first="Sandro" last="Scarpelini">Sandro Scarpelini</name>
<affiliation><nlm:aff id="Aff141"><institution-wrap><institution-id institution-id-type="ISNI">0000 0004 1937 0722</institution-id>
<institution-id institution-id-type="GRID">grid.11899.38</institution-id>
<institution>Department of Surgery,</institution>
<institution>University of Sao Paulo,</institution>
</institution-wrap>
Ribeirao Preto, Brazil</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Scoccia, Loredana" sort="Scoccia, Loredana" uniqKey="Scoccia L" first="Loredana" last="Scoccia">Loredana Scoccia</name>
<affiliation><nlm:aff id="Aff142">Unit of Hospital Pharmacy, Macerata Hospital, Macerata, Italy</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Shafiq, Nusrat" sort="Shafiq, Nusrat" uniqKey="Shafiq N" first="Nusrat" last="Shafiq">Nusrat Shafiq</name>
<affiliation><nlm:aff id="Aff143"><institution-wrap><institution-id institution-id-type="ISNI">0000 0004 1767 2903</institution-id>
<institution-id institution-id-type="GRID">grid.415131.3</institution-id>
<institution>Department of Pharmacology,</institution>
<institution>Postgraduate Institute of Medical Education and Research,</institution>
</institution-wrap>
Chandigarh, India</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Shelat, Vishalkumar" sort="Shelat, Vishalkumar" uniqKey="Shelat V" first="Vishalkumar" last="Shelat">Vishalkumar Shelat</name>
<affiliation><nlm:aff id="Aff144"><institution-wrap><institution-id institution-id-type="GRID">grid.240988.f</institution-id>
<institution>Department of General Surgery,</institution>
<institution>Tan Tock Seng Hospital,</institution>
</institution-wrap>
Tan Tock Seng, Singapore</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Sifri, Costi D" sort="Sifri, Costi D" uniqKey="Sifri C" first="Costi D." last="Sifri">Costi D. Sifri</name>
<affiliation><nlm:aff id="Aff145"><institution-wrap><institution-id institution-id-type="ISNI">0000 0004 1936 9932</institution-id>
<institution-id institution-id-type="GRID">grid.412587.d</institution-id>
<institution>Office of Hospital Epidemiology/Infection Prevention and Control,</institution>
<institution>University of Virginia Health System,</institution>
</institution-wrap>
Charlottesville, VA USA</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Siribumrungwong, Boonying" sort="Siribumrungwong, Boonying" uniqKey="Siribumrungwong B" first="Boonying" last="Siribumrungwong">Boonying Siribumrungwong</name>
<affiliation><nlm:aff id="Aff146"><institution-wrap><institution-id institution-id-type="ISNI">0000 0004 1937 1127</institution-id>
<institution-id institution-id-type="GRID">grid.412434.4</institution-id>
<institution>Department of Surgery, Faculty of Medicine,</institution>
<institution>Thammasat University Hospital, Thammasat University,</institution>
</institution-wrap>
Pathum Thani, Thailand</nlm:aff>
</affiliation>
</author>
<author><name sortKey="S Reide, Kjetil" sort="S Reide, Kjetil" uniqKey="S Reide K" first="Kjetil" last="S Reide">Kjetil S Reide</name>
<affiliation><nlm:aff id="Aff147"><institution-wrap><institution-id institution-id-type="ISNI">0000 0004 0627 2891</institution-id>
<institution-id institution-id-type="GRID">grid.412835.9</institution-id>
<institution>Department of Gastrointestinal Surgery,</institution>
<institution>Stavanger University Hospital,</institution>
</institution-wrap>
Stavanger, Norway</nlm:aff>
</affiliation>
<affiliation><nlm:aff id="Aff148"><institution-wrap><institution-id institution-id-type="ISNI">0000 0004 1936 7443</institution-id>
<institution-id institution-id-type="GRID">grid.7914.b</institution-id>
<institution>Department of Clinical Medicine,</institution>
<institution>University of Bergen,</institution>
</institution-wrap>
Bergen, Norway</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Soto, Rodolfo" sort="Soto, Rodolfo" uniqKey="Soto R" first="Rodolfo" last="Soto">Rodolfo Soto</name>
<affiliation><nlm:aff id="Aff149">Department of Emergency Surgery and Critical Care, Centro Medico Imbanaco, Cali, Colombia</nlm:aff>
</affiliation>
</author>
<author><name sortKey="De Souza, Hamilton P" sort="De Souza, Hamilton P" uniqKey="De Souza H" first="Hamilton P." last="De Souza">Hamilton P. De Souza</name>
<affiliation><nlm:aff id="Aff150"><institution-wrap><institution-id institution-id-type="ISNI">0000 0001 2166 9094</institution-id>
<institution-id institution-id-type="GRID">grid.412519.a</institution-id>
<institution>Department of Surgery, School of Medicine,</institution>
<institution>Pontifícia Universidade Católica do Rio Grande do Sul (PUCRS),</institution>
</institution-wrap>
Porto Alegre, Brazil</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Talving, Peep" sort="Talving, Peep" uniqKey="Talving P" first="Peep" last="Talving">Peep Talving</name>
<affiliation><nlm:aff id="Aff151">Department of Surgery, North Estonia Medical Center, Tallinn, Estonia</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Trung, Ngo Tat" sort="Trung, Ngo Tat" uniqKey="Trung N" first="Ngo Tat" last="Trung">Ngo Tat Trung</name>
<affiliation><nlm:aff id="Aff152">Department of Molecular Biology, Tran Hung Dao Hospital, No 1, Tran Hung Dao Street, Hai Ba Trung Dist, Hanoi, Vietnam</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Tessier, Jeffrey M" sort="Tessier, Jeffrey M" uniqKey="Tessier J" first="Jeffrey M." last="Tessier">Jeffrey M. Tessier</name>
<affiliation><nlm:aff id="Aff153">Department of Infectious Diseases, John Peter Smith Health Network, Fort Worth, Texas USA</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Tumbarello, Mario" sort="Tumbarello, Mario" uniqKey="Tumbarello M" first="Mario" last="Tumbarello">Mario Tumbarello</name>
<affiliation><nlm:aff id="Aff154"><institution-wrap><institution-id institution-id-type="ISNI">0000 0001 0941 3192</institution-id>
<institution-id institution-id-type="GRID">grid.8142.f</institution-id>
<institution>Institute of Infectious Diseases,</institution>
<institution>Catholic University,</institution>
</institution-wrap>
Rome, Italy</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Ulrych, Jan" sort="Ulrych, Jan" uniqKey="Ulrych J" first="Jan" last="Ulrych">Jan Ulrych</name>
<affiliation><nlm:aff id="Aff155"><institution-wrap><institution-id institution-id-type="ISNI">0000 0000 9100 9940</institution-id>
<institution-id institution-id-type="GRID">grid.411798.2</institution-id>
<institution>First Department of Surgery—Department of Abdominal, Thoracic Surgery and Traumatology,</institution>
<institution>General University Hospital,</institution>
</institution-wrap>
Prague, Czech Republic</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Uranues, Selman" sort="Uranues, Selman" uniqKey="Uranues S" first="Selman" last="Uranues">Selman Uranues</name>
<affiliation><nlm:aff id="Aff156"><institution-wrap><institution-id institution-id-type="ISNI">0000 0000 8988 2476</institution-id>
<institution-id institution-id-type="GRID">grid.11598.34</institution-id>
<institution>Department of Surgery,</institution>
<institution>Medical University of Graz,</institution>
</institution-wrap>
Graz, Austria</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Van Goor, Harry" sort="Van Goor, Harry" uniqKey="Van Goor H" first="Harry" last="Van Goor">Harry Van Goor</name>
<affiliation><nlm:aff id="Aff157"><institution-wrap><institution-id institution-id-type="ISNI">0000 0004 0444 9382</institution-id>
<institution-id institution-id-type="GRID">grid.10417.33</institution-id>
<institution>Department of Surgery,</institution>
<institution>Radboud University Nijmegen Medical Center,</institution>
</institution-wrap>
Nijmegen, The Netherlands</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Vereczkei, Andras" sort="Vereczkei, Andras" uniqKey="Vereczkei A" first="Andras" last="Vereczkei">Andras Vereczkei</name>
<affiliation><nlm:aff id="Aff158"><institution-wrap><institution-id institution-id-type="ISNI">0000 0001 0663 9479</institution-id>
<institution-id institution-id-type="GRID">grid.9679.1</institution-id>
<institution>Department of Surgery,</institution>
<institution>Medical School University of Pécs,</institution>
</institution-wrap>
Pécs, Hungary</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Wagenlehner, Florian" sort="Wagenlehner, Florian" uniqKey="Wagenlehner F" first="Florian" last="Wagenlehner">Florian Wagenlehner</name>
<affiliation><nlm:aff id="Aff159"><institution-wrap><institution-id institution-id-type="ISNI">0000 0001 2165 8627</institution-id>
<institution-id institution-id-type="GRID">grid.8664.c</institution-id>
<institution>Department of Urology, Pediatric Urology and Andrology,</institution>
<institution>Medical Faculty of the Justus Liebig University Giessen,</institution>
</institution-wrap>
Giessen, Germany</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Xiao, Yonghong" sort="Xiao, Yonghong" uniqKey="Xiao Y" first="Yonghong" last="Xiao">Yonghong Xiao</name>
<affiliation><nlm:aff id="Aff160"><institution-wrap><institution-id institution-id-type="ISNI">0000 0004 1759 700X</institution-id>
<institution-id institution-id-type="GRID">grid.13402.34</institution-id>
<institution>State Key Laboratory for Diagnosis and Treatment of Infectious Diseases,</institution>
<institution>The First Affilliated Hospital, Zhejiang University,</institution>
</institution-wrap>
Zhejiang, China</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Yuan, Kuo Ching" sort="Yuan, Kuo Ching" uniqKey="Yuan K" first="Kuo-Ching" last="Yuan">Kuo-Ching Yuan</name>
<affiliation><nlm:aff id="Aff161"><institution-wrap><institution-id institution-id-type="ISNI">0000 0004 1756 1461</institution-id>
<institution-id institution-id-type="GRID">grid.454210.6</institution-id>
<institution>Trauma and Emergency Surgery Department,</institution>
<institution>Chang Gung Memorial Hospital,</institution>
</institution-wrap>
Taoyuan City, Taiwan</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Wechsler Fordos, Agnes" sort="Wechsler Fordos, Agnes" uniqKey="Wechsler Fordos A" first="Agnes" last="Wechsler-Fördös">Agnes Wechsler-Fördös</name>
<affiliation><nlm:aff id="Aff162"><institution-wrap><institution-id institution-id-type="ISNI">0000 0004 0522 8258</institution-id>
<institution-id institution-id-type="GRID">grid.413303.6</institution-id>
<institution>Department of Antibiotics and Infection Control,</institution>
<institution>Rudolfstiftung Hospital,</institution>
</institution-wrap>
Vienna, Austria</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Zahar, Jean Ralph" sort="Zahar, Jean Ralph" uniqKey="Zahar J" first="Jean-Ralph" last="Zahar">Jean-Ralph Zahar</name>
<affiliation><nlm:aff id="Aff163">Infection Control Unit, Angers University, CHU d’Angers, Angers, France</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Zakrison, Tanya L" sort="Zakrison, Tanya L" uniqKey="Zakrison T" first="Tanya L." last="Zakrison">Tanya L. Zakrison</name>
<affiliation><nlm:aff id="Aff164"><institution-wrap><institution-id institution-id-type="ISNI">0000 0004 1936 8606</institution-id>
<institution-id institution-id-type="GRID">grid.26790.3a</institution-id>
<institution>Division of Trauma and Surgical Critical Care, DeWitt Daughtry Family Department of Surgery,</institution>
<institution>University of Miami,</institution>
</institution-wrap>
Miami, FL USA</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Zuckerbraun, Brian" sort="Zuckerbraun, Brian" uniqKey="Zuckerbraun B" first="Brian" last="Zuckerbraun">Brian Zuckerbraun</name>
<affiliation><nlm:aff id="Aff165"><institution-wrap><institution-id institution-id-type="ISNI">0000 0004 1936 9000</institution-id>
<institution-id institution-id-type="GRID">grid.21925.3d</institution-id>
<institution>Department of Surgery,</institution>
<institution>University of Pittsburgh,</institution>
</institution-wrap>
Pittsburgh, PA USA</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Zuidema, Wietse P" sort="Zuidema, Wietse P" uniqKey="Zuidema W" first="Wietse P." last="Zuidema">Wietse P. Zuidema</name>
<affiliation><nlm:aff id="Aff166"><institution-wrap><institution-id institution-id-type="ISNI">0000 0004 0435 165X</institution-id>
<institution-id institution-id-type="GRID">grid.16872.3a</institution-id>
<institution></institution>
<institution>VU University Medical Center,</institution>
</institution-wrap>
Amsterdam, The Netherlands</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Catena, Fausto" sort="Catena, Fausto" uniqKey="Catena F" first="Fausto" last="Catena">Fausto Catena</name>
<affiliation><nlm:aff id="Aff167">Department of General Surgery, Maggiore Hospital, Parma, Italy</nlm:aff>
</affiliation>
</author>
</titleStmt>
<publicationStmt><idno type="wicri:source">PMC</idno>
<idno type="pmid">28775763</idno>
<idno type="pmc">5540347</idno>
<idno type="url">http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5540347</idno>
<idno type="RBID">PMC:5540347</idno>
<idno type="doi">10.1186/s13017-017-0145-2</idno>
<date when="2017">2017</date>
<idno type="wicri:Area/Pmc/Corpus">000E65</idno>
<idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Corpus" wicri:corpus="PMC">000E65</idno>
</publicationStmt>
<sourceDesc><biblStruct><analytic><title xml:lang="en" level="a" type="main">The <italic>Global Alliance for Infections in Surgery:</italic>
defining a model for antimicrobial stewardship—results from an international cross-sectional survey</title>
<author><name sortKey="Sartelli, Massimo" sort="Sartelli, Massimo" uniqKey="Sartelli M" first="Massimo" last="Sartelli">Massimo Sartelli</name>
<affiliation><nlm:aff id="Aff1">Department of Surgery, Macerata Hospital, Macerata, Italy</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Labricciosa, Francesco M" sort="Labricciosa, Francesco M" uniqKey="Labricciosa F" first="Francesco M." last="Labricciosa">Francesco M. Labricciosa</name>
<affiliation><nlm:aff id="Aff2"><institution-wrap><institution-id institution-id-type="ISNI">0000 0001 1017 3210</institution-id>
<institution-id institution-id-type="GRID">grid.7010.6</institution-id>
<institution>Department of Biomedical Sciences and Public Health, Unit of Hygiene, Preventive Medicine and Public Health,</institution>
<institution>Università Politecnica delle Marche,</institution>
</institution-wrap>
Ancona, Italy</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Barbadoro, Pamela" sort="Barbadoro, Pamela" uniqKey="Barbadoro P" first="Pamela" last="Barbadoro">Pamela Barbadoro</name>
<affiliation><nlm:aff id="Aff2"><institution-wrap><institution-id institution-id-type="ISNI">0000 0001 1017 3210</institution-id>
<institution-id institution-id-type="GRID">grid.7010.6</institution-id>
<institution>Department of Biomedical Sciences and Public Health, Unit of Hygiene, Preventive Medicine and Public Health,</institution>
<institution>Università Politecnica delle Marche,</institution>
</institution-wrap>
Ancona, Italy</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Pagani, Leonardo" sort="Pagani, Leonardo" uniqKey="Pagani L" first="Leonardo" last="Pagani">Leonardo Pagani</name>
<affiliation><nlm:aff id="Aff3">Infectious Diseases Unit, Bolzano Central Hospital, Bolzano, Italy</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Ansaloni, Luca" sort="Ansaloni, Luca" uniqKey="Ansaloni L" first="Luca" last="Ansaloni">Luca Ansaloni</name>
<affiliation><nlm:aff id="Aff4"><institution-wrap><institution-id institution-id-type="ISNI"> 0000 0004 1757 8431</institution-id>
<institution-id institution-id-type="GRID">grid.460094.f</institution-id>
<institution>General Surgery Department,</institution>
<institution>Papa Giovanni XXIII Hospital,</institution>
</institution-wrap>
Bergamo, Italy</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Brink, Adrian J" sort="Brink, Adrian J" uniqKey="Brink A" first="Adrian J." last="Brink">Adrian J. Brink</name>
<affiliation><nlm:aff id="Aff5"><institution-wrap><institution-id institution-id-type="ISNI">0000 0004 0634 9246</institution-id>
<institution-id institution-id-type="GRID">grid.415666.6</institution-id>
<institution>Department of Clinical microbiology, Ampath National Laboratory Services,</institution>
<institution>Milpark Hospital,</institution>
</institution-wrap>
Johannesburg, South Africa</nlm:aff>
</affiliation>
<affiliation><nlm:aff id="Aff6"><institution-wrap><institution-id institution-id-type="ISNI">0000 0004 1937 1151</institution-id>
<institution-id institution-id-type="GRID">grid.7836.a</institution-id>
<institution>Division of Infectious Diseases and HIV Medicine, Department of Medicine,</institution>
<institution>University of Cape Town,</institution>
</institution-wrap>
Cape town, South Africa</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Carlet, Jean" sort="Carlet, Jean" uniqKey="Carlet J" first="Jean" last="Carlet">Jean Carlet</name>
<affiliation><nlm:aff id="Aff7">World Alliance against Antibiotics Resistance, Rome, Italy</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Khanna, Ashish" sort="Khanna, Ashish" uniqKey="Khanna A" first="Ashish" last="Khanna">Ashish Khanna</name>
<affiliation><nlm:aff id="Aff8"><institution-wrap><institution-id institution-id-type="ISNI">0000 0001 0675 4725</institution-id>
<institution-id institution-id-type="GRID">grid.239578.2</institution-id>
<institution>Center for Critical Care, Anaesthesiology Institute and Department of Outcomes Research,</institution>
<institution>Cleveland Clinic,</institution>
</institution-wrap>
Cleveland, OH USA</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Chichom Mefire, Alain" sort="Chichom Mefire, Alain" uniqKey="Chichom Mefire A" first="Alain" last="Chichom-Mefire">Alain Chichom-Mefire</name>
<affiliation><nlm:aff id="Aff9">Department of Surgery and Obstetrics/Gynaecology, Regional Hospital, Limbe, Cameroon</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Coccolini, Federico" sort="Coccolini, Federico" uniqKey="Coccolini F" first="Federico" last="Coccolini">Federico Coccolini</name>
<affiliation><nlm:aff id="Aff10"><institution-wrap><institution-id institution-id-type="GRID">grid.414614.2</institution-id>
<institution>Department of Surgery,</institution>
<institution>Infermi Hospital,</institution>
</institution-wrap>
Rimini, Italy</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Di Saverio, Salomone" sort="Di Saverio, Salomone" uniqKey="Di Saverio S" first="Salomone" last="Di Saverio">Salomone Di Saverio</name>
<affiliation><nlm:aff id="Aff11"><institution-wrap><institution-id institution-id-type="ISNI">0000 0004 1759 7093</institution-id>
<institution-id institution-id-type="GRID">grid.416290.8</institution-id>
<institution>Department of Surgery,</institution>
<institution>Maggiore Hospital,</institution>
</institution-wrap>
Bologna, Italy</nlm:aff>
</affiliation>
</author>
<author><name sortKey="May, Addison K" sort="May, Addison K" uniqKey="May A" first="Addison K." last="May">Addison K. May</name>
<affiliation><nlm:aff id="Aff12"><institution-wrap><institution-id institution-id-type="ISNI">0000 0004 1936 9916</institution-id>
<institution-id institution-id-type="GRID">grid.412807.8</institution-id>
<institution>Department of Surgery,</institution>
<institution>Vanderbilt University Medical Center,</institution>
</institution-wrap>
Nashville, Tennessee USA</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Viale, Pierluigi" sort="Viale, Pierluigi" uniqKey="Viale P" first="Pierluigi" last="Viale">Pierluigi Viale</name>
<affiliation><nlm:aff id="Aff13">Infectious Diseases Unit, Department of Medical and Surgical Sciences, Sant’Orsola Hospital, University of Bologna, Bologna, Italy</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Watkins, Richard R" sort="Watkins, Richard R" uniqKey="Watkins R" first="Richard R." last="Watkins">Richard R. Watkins</name>
<affiliation><nlm:aff id="Aff14"><institution-wrap><institution-id institution-id-type="ISNI">0000 0001 0675 4725</institution-id>
<institution-id institution-id-type="GRID">grid.239578.2</institution-id>
<institution>Division of Infectious Diseases,</institution>
<institution>Cleveland Clinic Akron General,</institution>
</institution-wrap>
Akron, OH USA</nlm:aff>
</affiliation>
<affiliation><nlm:aff id="Aff15"><institution-wrap><institution-id institution-id-type="ISNI">0000 0004 0459 7529</institution-id>
<institution-id institution-id-type="GRID">grid.261103.7</institution-id>
<institution>Department of Medicine,</institution>
<institution>Northeast Ohio Medical University,</institution>
</institution-wrap>
Rootstown, OH USA</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Scudeller, Luigia" sort="Scudeller, Luigia" uniqKey="Scudeller L" first="Luigia" last="Scudeller">Luigia Scudeller</name>
<affiliation><nlm:aff id="Aff16"><institution-wrap><institution-id institution-id-type="ISNI">0000 0004 1760 3027</institution-id>
<institution-id institution-id-type="GRID">grid.419425.f</institution-id>
<institution></institution>
<institution>Clinical Epidemiology Unit, IRCCS Policlinico San Matteo Foundation,</institution>
</institution-wrap>
Pavia, Italy</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Abbo, Lilian M" sort="Abbo, Lilian M" uniqKey="Abbo L" first="Lilian M." last="Abbo">Lilian M. Abbo</name>
<affiliation><nlm:aff id="Aff17"><institution-wrap><institution-id institution-id-type="ISNI">0000 0004 1936 8606</institution-id>
<institution-id institution-id-type="GRID">grid.26790.3a</institution-id>
<institution>Division of Infectious Diseases, Jackson Health System,</institution>
<institution>University of Miami Miller School of Medicine,</institution>
</institution-wrap>
Miami, FL USA</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Abu Zidan, Fikri M" sort="Abu Zidan, Fikri M" uniqKey="Abu Zidan F" first="Fikri M." last="Abu-Zidan">Fikri M. Abu-Zidan</name>
<affiliation><nlm:aff id="Aff18"><institution-wrap><institution-id institution-id-type="ISNI">0000 0001 2193 6666</institution-id>
<institution-id institution-id-type="GRID">grid.43519.3a</institution-id>
<institution>Department of Surgery, College of Medicine and Health Sciences,</institution>
<institution>UAE University,</institution>
</institution-wrap>
Al-Ain, United Arab Emirates</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Adesunkanmi, Abdulrashid K" sort="Adesunkanmi, Abdulrashid K" uniqKey="Adesunkanmi A" first="Abdulrashid K." last="Adesunkanmi">Abdulrashid K. Adesunkanmi</name>
<affiliation><nlm:aff id="Aff19"><institution-wrap><institution-id institution-id-type="ISNI">0000 0001 2183 9444</institution-id>
<institution-id institution-id-type="GRID">grid.10824.3f</institution-id>
<institution>Department of Surgery, College of Health Sciences,</institution>
<institution>Obafemi Awolowo University,</institution>
</institution-wrap>
Ile-Ife, Nigeria</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Al Dahir, Sara" sort="Al Dahir, Sara" uniqKey="Al Dahir S" first="Sara" last="Al-Dahir">Sara Al-Dahir</name>
<affiliation><nlm:aff id="Aff20"><institution-wrap><institution-id institution-id-type="ISNI">0000 0000 9679 3586</institution-id>
<institution-id institution-id-type="GRID">grid.268355.f</institution-id>
<institution>Division of Clinical and Administrative Sciences, College of Pharmacy,</institution>
<institution>Xavier University of Louisiana,</institution>
</institution-wrap>
New Orleans, LA USA</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Al Hasan, Majdi N" sort="Al Hasan, Majdi N" uniqKey="Al Hasan M" first="Majdi N." last="Al-Hasan">Majdi N. Al-Hasan</name>
<affiliation><nlm:aff id="Aff21"><institution-wrap><institution-id institution-id-type="ISNI">0000 0000 9075 106X</institution-id>
<institution-id institution-id-type="GRID">grid.254567.7</institution-id>
<institution>Department of Medicine, Division of Infectious Diseases,</institution>
<institution>University of South Carolina School of Medicine,</institution>
</institution-wrap>
Columbia, SC USA</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Alis, Halil" sort="Alis, Halil" uniqKey="Alis H" first="Halil" last="Alis">Halil Alis</name>
<affiliation><nlm:aff id="Aff22"><institution-wrap><institution-id institution-id-type="ISNI">0000 0004 0419 1043</institution-id>
<institution-id institution-id-type="GRID">grid.414177.0</institution-id>
<institution>General Surgery Department,</institution>
<institution>Bakirkoy Dr Sadi Konuk Training and Research Hospital,</institution>
</institution-wrap>
Instanbul, Turkey</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Alves, Carlos" sort="Alves, Carlos" uniqKey="Alves C" first="Carlos" last="Alves">Carlos Alves</name>
<affiliation><nlm:aff id="Aff23"><institution-wrap><institution-id institution-id-type="ISNI">0000 0000 9375 4688</institution-id>
<institution-id institution-id-type="GRID">grid.414556.7</institution-id>
<institution>Unit of Prevention and Infection Control, Center of Hospital Epidemiology,</institution>
<institution>São João Hospital Centre,</institution>
</institution-wrap>
Porto, Portugal</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Araujo Da Silva, Andre R" sort="Araujo Da Silva, Andre R" uniqKey="Araujo Da Silva A" first="André R." last="Araujo Da Silva">André R. Araujo Da Silva</name>
<affiliation><nlm:aff id="Aff24">Infection Control Committee, Prontobaby Hospital da Criança, Rio de Janeiro, Brazil</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Augustin, Goran" sort="Augustin, Goran" uniqKey="Augustin G" first="Goran" last="Augustin">Goran Augustin</name>
<affiliation><nlm:aff id="Aff25"><institution-wrap><institution-id institution-id-type="ISNI">0000 0004 0397 9648</institution-id>
<institution-id institution-id-type="GRID">grid.412688.1</institution-id>
<institution>Department of Surgery,</institution>
<institution>University Hospital Center,</institution>
</institution-wrap>
Zagreb, Croatia</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Bala, Miklosh" sort="Bala, Miklosh" uniqKey="Bala M" first="Miklosh" last="Bala">Miklosh Bala</name>
<affiliation><nlm:aff id="Aff26"><institution-wrap><institution-id institution-id-type="ISNI">0000 0001 2221 2926</institution-id>
<institution-id institution-id-type="GRID">grid.17788.31</institution-id>
<institution>Trauma and Acute Care Surgery Unit,</institution>
<institution>Hadassah Hebrew University Medical Center,</institution>
</institution-wrap>
Jerusalem, Israel</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Barie, Philip S" sort="Barie, Philip S" uniqKey="Barie P" first="Philip S." last="Barie">Philip S. Barie</name>
<affiliation><nlm:aff id="Aff27"><institution-wrap><institution-id institution-id-type="ISNI">000000041936877X</institution-id>
<institution-id institution-id-type="GRID">grid.5386.8</institution-id>
<institution>Department of Surgery,</institution>
<institution>Weill Cornell Medicine,</institution>
</institution-wrap>
New York, NY USA</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Beltran, Marcelo A" sort="Beltran, Marcelo A" uniqKey="Beltran M" first="Marcelo A." last="Beltrán">Marcelo A. Beltrán</name>
<affiliation><nlm:aff id="Aff28">Department of General Surgery, Hospital San Juan de Dios de La Serena, La Serena, Chile</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Bhangu, Aneel" sort="Bhangu, Aneel" uniqKey="Bhangu A" first="Aneel" last="Bhangu">Aneel Bhangu</name>
<affiliation><nlm:aff id="Aff29"><institution-wrap><institution-id institution-id-type="ISNI">0000 0001 2177 007X</institution-id>
<institution-id institution-id-type="GRID">grid.415490.d</institution-id>
<institution>Academic Department of Surgery,</institution>
<institution>Queen Elizabeth Hospital,</institution>
</institution-wrap>
Birmingham, UK</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Bouchra, Belefquih" sort="Bouchra, Belefquih" uniqKey="Bouchra B" first="Belefquih" last="Bouchra">Belefquih Bouchra</name>
<affiliation><nlm:aff id="Aff30">Department of Microbiology National Reference Laboratory Cheikh Khalifa Ibn Zaid Hospital, Mohammed 6th University of Health Sciences, Casablanca, Morocco</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Brecher, Stephen M" sort="Brecher, Stephen M" uniqKey="Brecher S" first="Stephen M." last="Brecher">Stephen M. Brecher</name>
<affiliation><nlm:aff id="Aff31"><institution-wrap><institution-id institution-id-type="ISNI">0000 0004 4657 1992</institution-id>
<institution-id institution-id-type="GRID">grid.410370.1</institution-id>
<institution>Department of Pathology and Laboratory Medicine,</institution>
<institution>VA Boston HealthCare System,</institution>
</institution-wrap>
Boston, MA USA</nlm:aff>
</affiliation>
<affiliation><nlm:aff id="Aff32"><institution-wrap><institution-id institution-id-type="ISNI">0000 0004 0367 5222</institution-id>
<institution-id institution-id-type="GRID">grid.475010.7</institution-id>
<institution>Department of Pathology and Laboratory Medicine,</institution>
<institution>Boston University School of Medicine,</institution>
</institution-wrap>
Boston, MA USA</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Cainzos, Miguel A" sort="Cainzos, Miguel A" uniqKey="Cainzos M" first="Miguel A." last="Caínzos">Miguel A. Caínzos</name>
<affiliation><nlm:aff id="Aff33"><institution-wrap><institution-id institution-id-type="ISNI">0000 0000 8816 6945</institution-id>
<institution-id institution-id-type="GRID">grid.411048.8</institution-id>
<institution>Department of Surgery,</institution>
<institution>Hospital Clínico Universitario,</institution>
</institution-wrap>
Santiago de Compostela, Spain</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Camacho Ortiz, Adrian" sort="Camacho Ortiz, Adrian" uniqKey="Camacho Ortiz A" first="Adrian" last="Camacho-Ortiz">Adrian Camacho-Ortiz</name>
<affiliation><nlm:aff id="Aff34"><institution-wrap><institution-id institution-id-type="ISNI">0000 0004 1760 058X</institution-id>
<institution-id institution-id-type="GRID">grid.464574.0</institution-id>
<institution>Hospital Epidemiology and Infectious Diseases,</institution>
<institution>Hospital Universitario Dr Jose Eleuterio Gonzalez,</institution>
</institution-wrap>
Monterrey, Mexico</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Catani, Marco" sort="Catani, Marco" uniqKey="Catani M" first="Marco" last="Catani">Marco Catani</name>
<affiliation><nlm:aff id="Aff35"><institution-wrap><institution-id institution-id-type="GRID">grid.417007.5</institution-id>
<institution>Department of Emergency,</institution>
<institution>Umberto I Hospital,</institution>
</institution-wrap>
Rome, Italy</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Chandy, Sujith J" sort="Chandy, Sujith J" uniqKey="Chandy S" first="Sujith J." last="Chandy">Sujith J. Chandy</name>
<affiliation><nlm:aff id="Aff36"><institution-wrap><institution-id institution-id-type="ISNI">0000 0004 1781 1790</institution-id>
<institution-id institution-id-type="GRID">grid.448741.a</institution-id>
<institution>Department of Pharmacology,</institution>
<institution>Pushpagiri Institute of Medical Sciences and Research Centre,</institution>
</institution-wrap>
Thiruvalla, Kerala India</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Jusoh, Asri Che" sort="Jusoh, Asri Che" uniqKey="Jusoh A" first="Asri Che" last="Jusoh">Asri Che Jusoh</name>
<affiliation><nlm:aff id="Aff37">Department of General Surgery, Kuala Krai Hospital, Kuala Krai, Kelantan Malaysia</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Cherry Bukowiec, Jill R" sort="Cherry Bukowiec, Jill R" uniqKey="Cherry Bukowiec J" first="Jill R." last="Cherry-Bukowiec">Jill R. Cherry-Bukowiec</name>
<affiliation><nlm:aff id="Aff38"><institution-wrap><institution-id institution-id-type="ISNI">0000000086837370</institution-id>
<institution-id institution-id-type="GRID">grid.214458.e</institution-id>
<institution>Division of Acute Care Surgery, Department of Surgery,</institution>
<institution>University of Michigan,</institution>
</institution-wrap>
Ann Arbor, MI USA</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Chiara, Osvaldo" sort="Chiara, Osvaldo" uniqKey="Chiara O" first="Osvaldo" last="Chiara">Osvaldo Chiara</name>
<affiliation><nlm:aff id="Aff39"><institution-wrap><institution-id institution-id-type="GRID">grid.416200.1</institution-id>
<institution></institution>
<institution>Niguarda Hospital,</institution>
</institution-wrap>
Milano, Italy</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Colak, Elif" sort="Colak, Elif" uniqKey="Colak E" first="Elif" last="Colak">Elif Colak</name>
<affiliation><nlm:aff id="Aff40">Department of General Surgery, Health Sciences University, Samsun Training and Research Hospital, Samsun, Turkey</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Cornely, Oliver A" sort="Cornely, Oliver A" uniqKey="Cornely O" first="Oliver A." last="Cornely">Oliver A. Cornely</name>
<affiliation><nlm:aff id="Aff41"><institution-wrap><institution-id institution-id-type="ISNI">0000 0000 8580 3777</institution-id>
<institution-id institution-id-type="GRID">grid.6190.e</institution-id>
<institution>Department of Internal Medicine and Infectious Diseases,</institution>
<institution>University of Cologne,</institution>
</institution-wrap>
Cologne, Germany</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Cui, Yunfeng" sort="Cui, Yunfeng" uniqKey="Cui Y" first="Yunfeng" last="Cui">Yunfeng Cui</name>
<affiliation><nlm:aff id="Aff42"><institution-wrap><institution-id institution-id-type="ISNI">0000 0000 9792 1228</institution-id>
<institution-id institution-id-type="GRID">grid.265021.2</institution-id>
<institution>Department of Surgery, Tianjin Nankai Hospital, Nankai Clinical School of Medicine,</institution>
<institution>Tianjin Medical University,</institution>
</institution-wrap>
Tianjin, China</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Demetrashvili, Zaza" sort="Demetrashvili, Zaza" uniqKey="Demetrashvili Z" first="Zaza" last="Demetrashvili">Zaza Demetrashvili</name>
<affiliation><nlm:aff id="Aff43">Department General Surgery, Kipshidze Central University Hospital, Tbilisi, Georgia</nlm:aff>
</affiliation>
</author>
<author><name sortKey="De Simone, Belinda" sort="De Simone, Belinda" uniqKey="De Simone B" first="Belinda" last="De Simone">Belinda De Simone</name>
<affiliation><nlm:aff id="Aff44"><institution-wrap><institution-id institution-id-type="ISNI">0000 0004 1795 3510</institution-id>
<institution-id institution-id-type="GRID">grid.418062.9</institution-id>
<institution>Department of Digestive Surgery,</institution>
<institution>Cannes Hospital,</institution>
</institution-wrap>
Cannes, France</nlm:aff>
</affiliation>
</author>
<author><name sortKey="De Waele, Jan J" sort="De Waele, Jan J" uniqKey="De Waele J" first="Jan J." last="De Waele">Jan J. De Waele</name>
<affiliation><nlm:aff id="Aff45"><institution-wrap><institution-id institution-id-type="ISNI">0000 0004 0626 3303</institution-id>
<institution-id institution-id-type="GRID">grid.410566.0</institution-id>
<institution>Department of Critical Care Medicine,</institution>
<institution>Ghent University Hospital,</institution>
</institution-wrap>
Ghent, Belgium</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Dhingra, Sameer" sort="Dhingra, Sameer" uniqKey="Dhingra S" first="Sameer" last="Dhingra">Sameer Dhingra</name>
<affiliation><nlm:aff id="Aff46"><institution-wrap><institution-id institution-id-type="GRID">grid.430529.9</institution-id>
<institution>School of Pharmacy, Faculty of Medical Sciences,</institution>
<institution>The University of the West Indies,</institution>
</institution-wrap>
St. Augustine, Trinidad and Tobago</nlm:aff>
</affiliation>
<affiliation><nlm:aff id="Aff47">Eric Williams Medical Sciences Complex, Uriah Butler Highway, Champ Fleurs, Trinidad and Tobago</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Di Marzo, Francesco" sort="Di Marzo, Francesco" uniqKey="Di Marzo F" first="Francesco" last="Di Marzo">Francesco Di Marzo</name>
<affiliation><nlm:aff id="Aff48">Department of Surgery, Versilia Hospita, Lido di Camaiore, Italy</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Dogjani, Agron" sort="Dogjani, Agron" uniqKey="Dogjani A" first="Agron" last="Dogjani">Agron Dogjani</name>
<affiliation><nlm:aff id="Aff49">Department of Surgery, University Hospital of Trauma, Tirana, Albania</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Dorj, Gereltuya" sort="Dorj, Gereltuya" uniqKey="Dorj G" first="Gereltuya" last="Dorj">Gereltuya Dorj</name>
<affiliation><nlm:aff id="Aff50"><institution-wrap><institution-id institution-id-type="GRID">grid.444534.6</institution-id>
<institution>School of Pharmacy and Biomedicine,</institution>
<institution>Mongolian National University of Medical Sciences,</institution>
</institution-wrap>
Ulaanbaatar, Mongolia</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Dortet, Laurent" sort="Dortet, Laurent" uniqKey="Dortet L" first="Laurent" last="Dortet">Laurent Dortet</name>
<affiliation><nlm:aff id="Aff51"><institution-wrap><institution-id institution-id-type="ISNI">0000 0001 2171 2558</institution-id>
<institution-id institution-id-type="GRID">grid.5842.b</institution-id>
<institution>Department of Microbiology, Bicêtre Hospital,</institution>
<institution>Paris-Sud University,</institution>
</institution-wrap>
La Kremlin-Bicêtre, France</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Duane, Therese M" sort="Duane, Therese M" uniqKey="Duane T" first="Therese M." last="Duane">Therese M. Duane</name>
<affiliation><nlm:aff id="Aff52">Department of Surgery, John Peter Smith Health Network, Fort Worth, Texas USA</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Elmangory, Mutasim M" sort="Elmangory, Mutasim M" uniqKey="Elmangory M" first="Mutasim M." last="Elmangory">Mutasim M. Elmangory</name>
<affiliation><nlm:aff id="Aff53"><institution-wrap><institution-id institution-id-type="GRID">grid.414827.c</institution-id>
<institution>Sudan National Public Health Laboratory,</institution>
<institution>Federal Ministry of Health,</institution>
</institution-wrap>
Khartoum, Sudan</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Enani, Mushira A" sort="Enani, Mushira A" uniqKey="Enani M" first="Mushira A." last="Enani">Mushira A. Enani</name>
<affiliation><nlm:aff id="Aff54"><institution-wrap><institution-id institution-id-type="ISNI">0000 0004 0593 1832</institution-id>
<institution-id institution-id-type="GRID">grid.415277.2</institution-id>
<institution>Department of Medicine, Infectious Disease Division,</institution>
<institution>King Fahad Medical City,</institution>
</institution-wrap>
Riyadh, Saudi Arabia</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Ferrada, Paula" sort="Ferrada, Paula" uniqKey="Ferrada P" first="Paula" last="Ferrada">Paula Ferrada</name>
<affiliation><nlm:aff id="Aff55"><institution-wrap><institution-id institution-id-type="ISNI">0000 0004 0458 8737</institution-id>
<institution-id institution-id-type="GRID">grid.224260.0</institution-id>
<institution>Department of Surgery,</institution>
<institution>Virginia Commonwealth University,</institution>
</institution-wrap>
Richmond, VA USA</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Esteban Foianini, J" sort="Esteban Foianini, J" uniqKey="Esteban Foianini J" first="J." last="Esteban Foianini">J. Esteban Foianini</name>
<affiliation><nlm:aff id="Aff56">Department of Surgery, Clinica Foianini, Santa Cruz, Bolivia</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Gachabayov, Mahir" sort="Gachabayov, Mahir" uniqKey="Gachabayov M" first="Mahir" last="Gachabayov">Mahir Gachabayov</name>
<affiliation><nlm:aff id="Aff57">Department of Abdominal Surgery, Vladimir City Clinical Hospital of Emergency Medicine, Vladimir, Russia</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Gandhi, Chinmay" sort="Gandhi, Chinmay" uniqKey="Gandhi C" first="Chinmay" last="Gandhi">Chinmay Gandhi</name>
<affiliation><nlm:aff id="Aff58">Department of Surgery, Bharati Vidyapeeth Deemed University Medical College and Hospital, Sangli, Maharashtra India</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Ghnnam, Wagih Mommtaz" sort="Ghnnam, Wagih Mommtaz" uniqKey="Ghnnam W" first="Wagih Mommtaz" last="Ghnnam">Wagih Mommtaz Ghnnam</name>
<affiliation><nlm:aff id="Aff59"><institution-wrap><institution-id institution-id-type="ISNI">0000000103426662</institution-id>
<institution-id institution-id-type="GRID">grid.10251.37</institution-id>
<institution>Department of General Surgery, Mansoura Faculty of Medicine,</institution>
<institution>Mansoura University,</institution>
</institution-wrap>
Mansoura, Egypt</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Giamarellou, Helen" sort="Giamarellou, Helen" uniqKey="Giamarellou H" first="Helen" last="Giamarellou">Helen Giamarellou</name>
<affiliation><nlm:aff id="Aff60"><institution-wrap><institution-id institution-id-type="GRID">grid.414012.2</institution-id>
<institution>Sixth Department of Internal Medicine,</institution>
<institution>Hygeia General Hospital,</institution>
</institution-wrap>
Athens, Greece</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Gkiokas, Georgios" sort="Gkiokas, Georgios" uniqKey="Gkiokas G" first="Georgios" last="Gkiokas">Georgios Gkiokas</name>
<affiliation><nlm:aff id="Aff61"><institution-wrap><institution-id institution-id-type="ISNI">0000 0001 2155 0800</institution-id>
<institution-id institution-id-type="GRID">grid.5216.0</institution-id>
<institution>Second Department of Surgery,</institution>
<institution>Aretaieion University Hospital, National and Kapodistrian University of Athens,</institution>
</institution-wrap>
Athens, Greece</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Gomi, Harumi" sort="Gomi, Harumi" uniqKey="Gomi H" first="Harumi" last="Gomi">Harumi Gomi</name>
<affiliation><nlm:aff id="Aff62"><institution-wrap><institution-id institution-id-type="ISNI">0000 0001 2369 4728</institution-id>
<institution-id institution-id-type="GRID">grid.20515.33</institution-id>
<institution>Center for Global Health, Mito Kyodo General Hospital,</institution>
<institution>University of Tsukuba,</institution>
</institution-wrap>
Mito, Ibaraki Japan</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Goranovic, Tatjana" sort="Goranovic, Tatjana" uniqKey="Goranovic T" first="Tatjana" last="Goranovic">Tatjana Goranovic</name>
<affiliation><nlm:aff id="Aff63">University Department for Tumours, Sestre Milosrrdnice UHC, Zagreb, Croatia</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Griffiths, Ewen A" sort="Griffiths, Ewen A" uniqKey="Griffiths E" first="Ewen A." last="Griffiths">Ewen A. Griffiths</name>
<affiliation><nlm:aff id="Aff64"><institution-wrap><institution-id institution-id-type="ISNI">0000 0001 2177 007X</institution-id>
<institution-id institution-id-type="GRID">grid.415490.d</institution-id>
<institution>General and Upper GI Surgery,</institution>
<institution>Queen Elizabeth Hospital,</institution>
</institution-wrap>
Birmingham, UK</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Guerra Gronerth, Rosio I" sort="Guerra Gronerth, Rosio I" uniqKey="Guerra Gronerth R" first="Rosio I." last="Guerra Gronerth">Rosio I. Guerra Gronerth</name>
<affiliation><nlm:aff id="Aff65">Peruvian Navy Medical Center, Lima, Peru</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Haidamus Monteiro, Julio C" sort="Haidamus Monteiro, Julio C" uniqKey="Haidamus Monteiro J" first="Julio C." last="Haidamus Monteiro">Julio C. Haidamus Monteiro</name>
<affiliation><nlm:aff id="Aff66"><institution-wrap><institution-id institution-id-type="ISNI">0000 0001 2198 9354</institution-id>
<institution-id institution-id-type="GRID">grid.415169.e</institution-id>
<institution>Department of Gastrointestinal Surgery,</institution>
<institution>Santa Casa Hospital,</institution>
</institution-wrap>
Campo Grande, Brazil</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Hardcastle, Timothy C" sort="Hardcastle, Timothy C" uniqKey="Hardcastle T" first="Timothy C." last="Hardcastle">Timothy C. Hardcastle</name>
<affiliation><nlm:aff id="Aff67"><institution-wrap><institution-id institution-id-type="ISNI">0000 0001 0723 4123</institution-id>
<institution-id institution-id-type="GRID">grid.16463.36</institution-id>
<institution>Trauma and Trauma ICU, Inkosi Albert Luthuli Central Hospital and Department of Surgery,</institution>
<institution>University of KwaZulu-Natal,</institution>
</institution-wrap>
Durban, South Africa</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Hecker, Andreas" sort="Hecker, Andreas" uniqKey="Hecker A" first="Andreas" last="Hecker">Andreas Hecker</name>
<affiliation><nlm:aff id="Aff68"><institution-wrap><institution-id institution-id-type="ISNI">0000 0000 8584 9230</institution-id>
<institution-id institution-id-type="GRID">grid.411067.5</institution-id>
<institution>Department of General and Thoracic Surgery,</institution>
<institution>University Hospital Giessen,</institution>
</institution-wrap>
Giessen, Germany</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Hodonou, Adrien M" sort="Hodonou, Adrien M" uniqKey="Hodonou A" first="Adrien M." last="Hodonou">Adrien M. Hodonou</name>
<affiliation><nlm:aff id="Aff69"><institution-wrap><institution-id institution-id-type="GRID">grid.440525.2</institution-id>
<institution>Department of Surgery, Faculty of Medicine,</institution>
<institution>University of Parakou,</institution>
</institution-wrap>
BP 123 Parakou, Benin</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Ioannidis, Orestis" sort="Ioannidis, Orestis" uniqKey="Ioannidis O" first="Orestis" last="Ioannidis">Orestis Ioannidis</name>
<affiliation><nlm:aff id="Aff70"><institution-wrap><institution-id institution-id-type="ISNI">0000000109457005</institution-id>
<institution-id institution-id-type="GRID">grid.4793.9</institution-id>
<institution>Fourth Surgical Department, General Hospital G. Papanikolaou, Medical School,</institution>
<institution>Aristotle University of Thessaloniki,</institution>
</institution-wrap>
Thessaloniki, Greece</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Isik, Arda" sort="Isik, Arda" uniqKey="Isik A" first="Arda" last="Isik">Arda Isik</name>
<affiliation><nlm:aff id="Aff71"><institution-wrap><institution-id institution-id-type="ISNI">0000 0001 1498 7262</institution-id>
<institution-id institution-id-type="GRID">grid.412176.7</institution-id>
<institution>Department of General Surgery,</institution>
<institution>Erzincan University, Faculty of Medicine,</institution>
</institution-wrap>
Erzincan, Turkey</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Iskandar, Katia A" sort="Iskandar, Katia A" uniqKey="Iskandar K" first="Katia A." last="Iskandar">Katia A. Iskandar</name>
<affiliation><nlm:aff id="Aff72">Department of Pharmacy, Lebanese, International University, Beirut, Lebanon</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Kafil, Hossein S" sort="Kafil, Hossein S" uniqKey="Kafil H" first="Hossein S." last="Kafil">Hossein S. Kafil</name>
<affiliation><nlm:aff id="Aff73"><institution-wrap><institution-id institution-id-type="ISNI">0000 0001 2174 8913</institution-id>
<institution-id institution-id-type="GRID">grid.412888.f</institution-id>
<institution>Drug Applied Research Center,</institution>
<institution>Tabriz University of Medical Sciences,</institution>
</institution-wrap>
Tabriz, Iran</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Kanj, Souha S" sort="Kanj, Souha S" uniqKey="Kanj S" first="Souha S." last="Kanj">Souha S. Kanj</name>
<affiliation><nlm:aff id="Aff74"><institution-wrap><institution-id institution-id-type="ISNI">0000 0004 1936 9801</institution-id>
<institution-id institution-id-type="GRID">grid.22903.3a</institution-id>
<institution>Division of Infectious Diseases,</institution>
<institution>American University of Beirut,</institution>
</institution-wrap>
Beirut, Lebanon</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Kaplan, Lewis J" sort="Kaplan, Lewis J" uniqKey="Kaplan L" first="Lewis J." last="Kaplan">Lewis J. Kaplan</name>
<affiliation><nlm:aff id="Aff75"><institution-wrap><institution-id institution-id-type="ISNI">0000 0004 1936 8972</institution-id>
<institution-id institution-id-type="GRID">grid.25879.31</institution-id>
<institution>Department of Surgery Philadelphia VA Medical Center, Perelman School of Medicine,</institution>
<institution>University of Pennsylvania,</institution>
</institution-wrap>
Philadelphia, PA USA</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Kapoor, Garima" sort="Kapoor, Garima" uniqKey="Kapoor G" first="Garima" last="Kapoor">Garima Kapoor</name>
<affiliation><nlm:aff id="Aff76"><institution-wrap><institution-id institution-id-type="GRID">grid.415285.f</institution-id>
<institution>Department of Microbiology,</institution>
<institution>Gandhi Medical College,</institution>
</institution-wrap>
Bhopal, India</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Karamarkovic, Aleksandar R" sort="Karamarkovic, Aleksandar R" uniqKey="Karamarkovic A" first="Aleksandar R." last="Karamarkovic">Aleksandar R. Karamarkovic</name>
<affiliation><nlm:aff id="Aff77"><institution-wrap><institution-id institution-id-type="ISNI">0000 0001 2166 9385</institution-id>
<institution-id institution-id-type="GRID">grid.7149.b</institution-id>
<institution></institution>
<institution>Clinic for Emergency Surgery, Medical Faculty University of Belgrade,</institution>
</institution-wrap>
Belgrade, Serbia</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Kenig, Jakub" sort="Kenig, Jakub" uniqKey="Kenig J" first="Jakub" last="Kenig">Jakub Kenig</name>
<affiliation><nlm:aff id="Aff78"><institution-wrap><institution-id institution-id-type="ISNI">0000 0001 2162 9631</institution-id>
<institution-id institution-id-type="GRID">grid.5522.0</institution-id>
<institution>Third Department of General Surgery,</institution>
<institution>Jagiellonian University Medical College,</institution>
</institution-wrap>
Krakow, Poland</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Kerschaever, Ivan" sort="Kerschaever, Ivan" uniqKey="Kerschaever I" first="Ivan" last="Kerschaever">Ivan Kerschaever</name>
<affiliation><nlm:aff id="Aff79">Department of Abdominal Surgery, Regional Hospital of Tienen, Tienen, Belgium</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Khamis, Faryal" sort="Khamis, Faryal" uniqKey="Khamis F" first="Faryal" last="Khamis">Faryal Khamis</name>
<affiliation><nlm:aff id="Aff80"><institution-wrap><institution-id institution-id-type="ISNI">0000 0004 1772 5665</institution-id>
<institution-id institution-id-type="GRID">grid.416132.3</institution-id>
<institution>Department of Internal Medicine,</institution>
<institution>Royal Hospital,</institution>
</institution-wrap>
Muscat, Oman</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Khokha, Vladimir" sort="Khokha, Vladimir" uniqKey="Khokha V" first="Vladimir" last="Khokha">Vladimir Khokha</name>
<affiliation><nlm:aff id="Aff81">Department of Emergency Surgery, City Hospital, Mozyr, Belarus</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Kiguba, Ronald" sort="Kiguba, Ronald" uniqKey="Kiguba R" first="Ronald" last="Kiguba">Ronald Kiguba</name>
<affiliation><nlm:aff id="Aff82"><institution-wrap><institution-id institution-id-type="ISNI">0000 0004 0620 0548</institution-id>
<institution-id institution-id-type="GRID">grid.11194.3c</institution-id>
<institution>Department of Pharmacology and Therapeutics, College of Health Sciences,</institution>
<institution>Makerere University,</institution>
</institution-wrap>
Kampala, Uganda</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Kim, Hong B" sort="Kim, Hong B" uniqKey="Kim H" first="Hong B." last="Kim">Hong B. Kim</name>
<affiliation><nlm:aff id="Aff83"><institution-wrap><institution-id institution-id-type="ISNI">0000 0004 0647 3378</institution-id>
<institution-id institution-id-type="GRID">grid.412480.b</institution-id>
<institution>Department of Internal Medicine,</institution>
<institution>Seoul National University Bundang Hospital,</institution>
</institution-wrap>
Seongnam, Republic of Korea</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Ko, Wen Chien" sort="Ko, Wen Chien" uniqKey="Ko W" first="Wen-Chien" last="Ko">Wen-Chien Ko</name>
<affiliation><nlm:aff id="Aff84"><institution-wrap><institution-id institution-id-type="ISNI">0000 0004 0639 0054</institution-id>
<institution-id institution-id-type="GRID">grid.412040.3</institution-id>
<institution>Department of Internal Medicine,</institution>
<institution>National Cheng Kung University Hospital,</institution>
</institution-wrap>
Tainan, Taiwan</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Koike, Kaoru" sort="Koike, Kaoru" uniqKey="Koike K" first="Kaoru" last="Koike">Kaoru Koike</name>
<affiliation><nlm:aff id="Aff85"><institution-wrap><institution-id institution-id-type="ISNI">0000 0004 0372 2033</institution-id>
<institution-id institution-id-type="GRID">grid.258799.8</institution-id>
<institution>Department of Primary Care and Emergency Medicine,</institution>
<institution>Kyoto University Graduate School of Medicine,</institution>
</institution-wrap>
Kyoto, Japan</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Kozlovska, Iryna" sort="Kozlovska, Iryna" uniqKey="Kozlovska I" first="Iryna" last="Kozlovska">Iryna Kozlovska</name>
<affiliation><nlm:aff id="Aff86">Department of Surgery n. 2, Higher educational institutions of Ukraine Bukovina State Medical University, Chernivtci City, Ukraine</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Kumar, Anand" sort="Kumar, Anand" uniqKey="Kumar A" first="Anand" last="Kumar">Anand Kumar</name>
<affiliation><nlm:aff id="Aff87"><institution-wrap><institution-id institution-id-type="ISNI">0000 0004 1936 9609</institution-id>
<institution-id institution-id-type="GRID">grid.21613.37</institution-id>
<institution>Section of Critical Care Medicine and Section of Infectious Diseases, Department of Medicine, Medical Microbiology and Pharmacology/Therapeutics,</institution>
<institution>University of Manitoba,</institution>
</institution-wrap>
Winnipeg, MB Canada</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Lagunes, Leonel" sort="Lagunes, Leonel" uniqKey="Lagunes L" first="Leonel" last="Lagunes">Leonel Lagunes</name>
<affiliation><nlm:aff id="Aff88"><institution-wrap><institution-id institution-id-type="ISNI">0000 0004 0633 6808</institution-id>
<institution-id institution-id-type="GRID">grid.414410.4</institution-id>
<institution></institution>
<institution>Hospital Central Dr Ignacio Morones Prieto,</institution>
</institution-wrap>
San Luis Potosi, Mexico</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Latifi, Rifat" sort="Latifi, Rifat" uniqKey="Latifi R" first="Rifat" last="Latifi">Rifat Latifi</name>
<affiliation><nlm:aff id="Aff89"><institution-wrap><institution-id institution-id-type="ISNI">0000 0001 2168 186X</institution-id>
<institution-id institution-id-type="GRID">grid.134563.6</institution-id>
<institution>Department of Surgery, Division of Trauma,</institution>
<institution>University of Arizona,</institution>
</institution-wrap>
Tucson, AZ USA</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Lee, Jae G" sort="Lee, Jae G" uniqKey="Lee J" first="Jae G." last="Lee">Jae G. Lee</name>
<affiliation><nlm:aff id="Aff90"><institution-wrap><institution-id institution-id-type="ISNI">0000 0004 0470 5454</institution-id>
<institution-id institution-id-type="GRID">grid.15444.30</institution-id>
<institution>Department of Surgery,</institution>
<institution>Yonsei University College of Medicine,</institution>
</institution-wrap>
Seoul, South Korea</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Lee, Young R" sort="Lee, Young R" uniqKey="Lee Y" first="Young R." last="Lee">Young R. Lee</name>
<affiliation><nlm:aff id="Aff91"><institution-wrap><institution-id institution-id-type="GRID">grid.449754.f</institution-id>
<institution></institution>
<institution>Texas Tech University, Health Sciences Center School of Pharmacy,</institution>
</institution-wrap>
Abilene, TX USA</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Lepp Niemi, Ari" sort="Lepp Niemi, Ari" uniqKey="Lepp Niemi A" first="Ari" last="Lepp Niemi">Ari Lepp Niemi</name>
<affiliation><nlm:aff id="Aff92">Abdominal Center, University Hospital Meilahti, Helsinki, Finland</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Li, Yousheng" sort="Li, Yousheng" uniqKey="Li Y" first="Yousheng" last="Li">Yousheng Li</name>
<affiliation><nlm:aff id="Aff93"><institution-wrap><institution-id institution-id-type="ISNI">0000 0001 2314 964X</institution-id>
<institution-id institution-id-type="GRID">grid.41156.37</institution-id>
<institution>Department of Surgery, Inling Hospital,</institution>
<institution>Nanjing University School of Medicine,</institution>
</institution-wrap>
Nanjing, China</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Liang, Stephen Y" sort="Liang, Stephen Y" uniqKey="Liang S" first="Stephen Y." last="Liang">Stephen Y. Liang</name>
<affiliation><nlm:aff id="Aff94"><institution-wrap><institution-id institution-id-type="ISNI">0000 0001 2355 7002</institution-id>
<institution-id institution-id-type="GRID">grid.4367.6</institution-id>
<institution>Division of Infectious Diseases, Division of Emergency Medicine,</institution>
<institution>Washington University School of Medicine,</institution>
</institution-wrap>
St. Louis, MO USA</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Lowman, Warren" sort="Lowman, Warren" uniqKey="Lowman W" first="Warren" last="Lowman">Warren Lowman</name>
<affiliation><nlm:aff id="Aff95"><institution-wrap><institution-id institution-id-type="ISNI">0000 0004 1937 1135</institution-id>
<institution-id institution-id-type="GRID">grid.11951.3d</institution-id>
<institution>Clinical Microbiology and Infectious Diseases, School of Pathology, Faculty of Health Sciences,</institution>
<institution>University of the Witwatersrand,</institution>
</institution-wrap>
Johannesburg, South Africa</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Machain, Gustavo M" sort="Machain, Gustavo M" uniqKey="Machain G" first="Gustavo M." last="Machain">Gustavo M. Machain</name>
<affiliation><nlm:aff id="Aff96"><institution-wrap><institution-id institution-id-type="ISNI">0000 0001 2289 5077</institution-id>
<institution-id institution-id-type="GRID">grid.412213.7</institution-id>
<institution>Department of Surgery,</institution>
<institution>Universidad Nacional de Asuncion,</institution>
</institution-wrap>
Asuncion, Paraguay</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Maegele, Marc" sort="Maegele, Marc" uniqKey="Maegele M" first="Marc" last="Maegele">Marc Maegele</name>
<affiliation><nlm:aff id="Aff97"><institution-wrap><institution-id institution-id-type="ISNI">0000 0000 9024 6397</institution-id>
<institution-id institution-id-type="GRID">grid.412581.b</institution-id>
<institution>Department for Traumatology and Orthopedic Surgery, Cologne Merheim Medical Center (CMMC),</institution>
<institution>University of Witten/Herdecke (UW/H),</institution>
</institution-wrap>
Cologne, Germany</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Major, Piotr" sort="Major, Piotr" uniqKey="Major P" first="Piotr" last="Major">Piotr Major</name>
<affiliation><nlm:aff id="Aff98"><institution-wrap><institution-id institution-id-type="ISNI">0000 0001 2162 9631</institution-id>
<institution-id institution-id-type="GRID">grid.5522.0</institution-id>
<institution>Second Department of General Surgery,</institution>
<institution>Jagiellonian University Medical College,</institution>
</institution-wrap>
Krakow, Poland</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Malama, Sydney" sort="Malama, Sydney" uniqKey="Malama S" first="Sydney" last="Malama">Sydney Malama</name>
<affiliation><nlm:aff id="Aff99"><institution-wrap><institution-id institution-id-type="ISNI">0000 0000 8914 5257</institution-id>
<institution-id institution-id-type="GRID">grid.12984.36</institution-id>
<institution>Health Research Program, Institute of Economic and Social Research,</institution>
<institution>University of Zambia,</institution>
</institution-wrap>
Lusaka, Zambia</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Manzano Nunez, Ramiro" sort="Manzano Nunez, Ramiro" uniqKey="Manzano Nunez R" first="Ramiro" last="Manzano-Nunez">Ramiro Manzano-Nunez</name>
<affiliation><nlm:aff id="Aff100"><institution-wrap><institution-id institution-id-type="GRID">grid.477264.4</institution-id>
<institution></institution>
<institution>Clinical Research Center, Fundacion Valle del Lili,</institution>
</institution-wrap>
Cali, Colombia</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Marinis, Athanasios" sort="Marinis, Athanasios" uniqKey="Marinis A" first="Athanasios" last="Marinis">Athanasios Marinis</name>
<affiliation><nlm:aff id="Aff101"><institution-wrap><institution-id institution-id-type="GRID">grid.417374.2</institution-id>
<institution>First Department of Surgery,</institution>
<institution>Tzaneion General Hospital,</institution>
</institution-wrap>
Piraeus, Greece</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Martinez Casas, Isidro" sort="Martinez Casas, Isidro" uniqKey="Martinez Casas I" first="Isidro" last="Martinez Casas">Isidro Martinez Casas</name>
<affiliation><nlm:aff id="Aff102">Service of General Surgery, Hospital Complex of Jaén, Jaén, Spain</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Marwah, Sanjay" sort="Marwah, Sanjay" uniqKey="Marwah S" first="Sanjay" last="Marwah">Sanjay Marwah</name>
<affiliation><nlm:aff id="Aff103"><institution-wrap><institution-id institution-id-type="ISNI">0000 0004 1771 1642</institution-id>
<institution-id institution-id-type="GRID">grid.412572.7</institution-id>
<institution>Department of Surgery,</institution>
<institution>Post-Graduate Institute of Medical Sciences,</institution>
</institution-wrap>
Rohtak, India</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Maseda, Emilio" sort="Maseda, Emilio" uniqKey="Maseda E" first="Emilio" last="Maseda">Emilio Maseda</name>
<affiliation><nlm:aff id="Aff104">Servicio de Anestesia y Reanimación, Hospital Universitario La Paz Madrid, Madrid, Spain</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Mcfarlane, Michael E" sort="Mcfarlane, Michael E" uniqKey="Mcfarlane M" first="Michael E." last="Mcfarlane">Michael E. Mcfarlane</name>
<affiliation><nlm:aff id="Aff105"><institution-wrap><institution-id institution-id-type="ISNI">0000 0004 0500 5353</institution-id>
<institution-id institution-id-type="GRID">grid.412963.b</institution-id>
<institution>Department of Surgery, Radiology,</institution>
<institution>University Hospital of the West Indies,</institution>
</institution-wrap>
Kingston, Jamaica</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Memish, Ziad" sort="Memish, Ziad" uniqKey="Memish Z" first="Ziad" last="Memish">Ziad Memish</name>
<affiliation><nlm:aff id="Aff106"><institution-wrap><institution-id institution-id-type="GRID">grid.415696.9</institution-id>
<institution>Infectious Diseases Division, Department of Medicine,</institution>
<institution>Prince Mohamed Bin Abdulaziz Hospital, Ministry of Health,</institution>
</institution-wrap>
Riyadh, Saudi Arabia</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Mertz, Dominik" sort="Mertz, Dominik" uniqKey="Mertz D" first="Dominik" last="Mertz">Dominik Mertz</name>
<affiliation><nlm:aff id="Aff107"><institution-wrap><institution-id institution-id-type="ISNI">0000 0004 1936 8227</institution-id>
<institution-id institution-id-type="GRID">grid.25073.33</institution-id>
<institution>Departments of Medicine, Clinical Epidemiology and Biostatistics, and Pathology and Molecular Medicine,</institution>
<institution>McMaster University,</institution>
</institution-wrap>
Hamilton, ON Canada</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Mesina, Cristian" sort="Mesina, Cristian" uniqKey="Mesina C" first="Cristian" last="Mesina">Cristian Mesina</name>
<affiliation><nlm:aff id="Aff108">Second Surgical Clinic, Emergency Hospital of Craiova, Craiova, Romania</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Mishra, Shyam K" sort="Mishra, Shyam K" uniqKey="Mishra S" first="Shyam K." last="Mishra">Shyam K. Mishra</name>
<affiliation><nlm:aff id="Aff109">Department of Microbiology, Tribhuvan University Teaching Hospital, Institute of Medicine, Kathmandu, Nepal</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Moore, Ernest E" sort="Moore, Ernest E" uniqKey="Moore E" first="Ernest E." last="Moore">Ernest E. Moore</name>
<affiliation><nlm:aff id="Aff110">Department of Surgery, University of Colorado, Denver Health Medical Center, Denver, CO USA</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Munyika, Akutu" sort="Munyika, Akutu" uniqKey="Munyika A" first="Akutu" last="Munyika">Akutu Munyika</name>
<affiliation><nlm:aff id="Aff111">Department of Surgery, Onandjokwe Hospital, Ondangwa, Namibia</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Mylonakis, Eleftherios" sort="Mylonakis, Eleftherios" uniqKey="Mylonakis E" first="Eleftherios" last="Mylonakis">Eleftherios Mylonakis</name>
<affiliation><nlm:aff id="Aff112"><institution-wrap><institution-id institution-id-type="ISNI">0000 0004 1936 9094</institution-id>
<institution-id institution-id-type="GRID">grid.40263.33</institution-id>
<institution>Infectious Diseases Division,</institution>
<institution>Warren Alpert Medical School of Brown University, Rhode Island Hospital,</institution>
</institution-wrap>
Providence, RI USA</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Napolitano, Lena" sort="Napolitano, Lena" uniqKey="Napolitano L" first="Lena" last="Napolitano">Lena Napolitano</name>
<affiliation><nlm:aff id="Aff113"><institution-wrap><institution-id institution-id-type="ISNI">0000000086837370</institution-id>
<institution-id institution-id-type="GRID">grid.214458.e</institution-id>
<institution>Department of Surgery,</institution>
<institution>University of Michigan,</institution>
</institution-wrap>
Ann Arbor, MI USA</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Negoi, Ionut" sort="Negoi, Ionut" uniqKey="Negoi I" first="Ionut" last="Negoi">Ionut Negoi</name>
<affiliation><nlm:aff id="Aff114">Department of Surgery, Emergency Hospital of Bucharest, Bucharest, Romania</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Nestorovic, Milica D" sort="Nestorovic, Milica D" uniqKey="Nestorovic M" first="Milica D." last="Nestorovic">Milica D. Nestorovic</name>
<affiliation><nlm:aff id="Aff115"><institution-wrap><institution-id institution-id-type="ISNI">0000 0004 0517 2741</institution-id>
<institution-id institution-id-type="GRID">grid.418653.d</institution-id>
<institution></institution>
<institution>Clinic for General Surgery, Clinical Centre,</institution>
</institution-wrap>
Nis, Serbia</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Nicolau, David P" sort="Nicolau, David P" uniqKey="Nicolau D" first="David P." last="Nicolau">David P. Nicolau</name>
<affiliation><nlm:aff id="Aff116">Center of Anti-Infective Research and Development, Hartford, CT USA</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Omari, Abdelkarim H" sort="Omari, Abdelkarim H" uniqKey="Omari A" first="Abdelkarim H." last="Omari">Abdelkarim H. Omari</name>
<affiliation><nlm:aff id="Aff117"><institution-wrap><institution-id institution-id-type="ISNI">0000 0004 0411 3985</institution-id>
<institution-id institution-id-type="GRID">grid.460946.9</institution-id>
<institution>Department of Surgery,</institution>
<institution>King Abdullah University Hospital,</institution>
</institution-wrap>
Irbid, Jordan</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Ordonez, Carlos A" sort="Ordonez, Carlos A" uniqKey="Ordonez C" first="Carlos A." last="Ordonez">Carlos A. Ordonez</name>
<affiliation><nlm:aff id="Aff118"><institution-wrap><institution-id institution-id-type="ISNI">0000 0001 2295 7397</institution-id>
<institution-id institution-id-type="GRID">grid.8271.c</institution-id>
<institution>Department of Surgery and Critical Care,</institution>
<institution>Universidad del Valle, Fundación Valle del Lili,</institution>
</institution-wrap>
Cali, Colombia</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Paiva, Jose Artur" sort="Paiva, Jose Artur" uniqKey="Paiva J" first="José-Artur" last="Paiva">José-Artur Paiva</name>
<affiliation><nlm:aff id="Aff119"><institution-wrap><institution-id institution-id-type="ISNI">0000 0001 1503 7226</institution-id>
<institution-id institution-id-type="GRID">grid.5808.5</institution-id>
<institution>Intensive Care Medicine Department,</institution>
<institution>Centro Hospitalar São João, University of Porto,</institution>
</institution-wrap>
Porto, Portugal</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Pant, Narayan D" sort="Pant, Narayan D" uniqKey="Pant N" first="Narayan D." last="Pant">Narayan D. Pant</name>
<affiliation><nlm:aff id="Aff120"><institution-wrap><institution-id institution-id-type="GRID">grid.461024.5</institution-id>
<institution>Department of Microbiology,</institution>
<institution>Grande International Hospital,</institution>
</institution-wrap>
Dhapasi, Kathmandu, Nepal</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Parreira, Jose G" sort="Parreira, Jose G" uniqKey="Parreira J" first="Jose G." last="Parreira">Jose G. Parreira</name>
<affiliation><nlm:aff id="Aff121"><institution-wrap><institution-id institution-id-type="ISNI">0000 0004 0576 9812</institution-id>
<institution-id institution-id-type="GRID">grid.419014.9</institution-id>
<institution>Department of Surgery,</institution>
<institution>Santa Casa de Sao Paulo School of Medical Sciences,</institution>
</institution-wrap>
São Paulo, Brazil</nlm:aff>
</affiliation>
</author>
<author><name sortKey="P Dziwiatr, Michal" sort="P Dziwiatr, Michal" uniqKey="P Dziwiatr M" first="Michal" last="P Dziwiatr">Michal P Dziwiatr</name>
<affiliation><nlm:aff id="Aff122"><institution-wrap><institution-id institution-id-type="ISNI">0000 0001 1216 0093</institution-id>
<institution-id institution-id-type="GRID">grid.412700.0</institution-id>
<institution>Department of General and Emergency Surgery,</institution>
<institution>University Hospital Kraków,</institution>
</institution-wrap>
Kraków, Poland</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Pereira, Bruno M" sort="Pereira, Bruno M" uniqKey="Pereira B" first="Bruno M." last="Pereira">Bruno M. Pereira</name>
<affiliation><nlm:aff id="Aff123"><institution-wrap><institution-id institution-id-type="ISNI">0000 0001 0723 2494</institution-id>
<institution-id institution-id-type="GRID">grid.411087.b</institution-id>
<institution>Department of Surgery,</institution>
<institution>University of Campinas,</institution>
</institution-wrap>
Campinas, Brazil</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Ponce De Leon, Alfredo" sort="Ponce De Leon, Alfredo" uniqKey="Ponce De Leon A" first="Alfredo" last="Ponce-De-Leon">Alfredo Ponce-De-Leon</name>
<affiliation><nlm:aff id="Aff124"><institution-wrap><institution-id institution-id-type="ISNI">0000 0001 0698 4037</institution-id>
<institution-id institution-id-type="GRID">grid.416850.e</institution-id>
<institution>Laboratory of Clinical Microbiology, Department of Infectious Diseases,</institution>
<institution>Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán,</institution>
</institution-wrap>
Mexico City, Mexico</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Poulakou, Garyphallia" sort="Poulakou, Garyphallia" uniqKey="Poulakou G" first="Garyphallia" last="Poulakou">Garyphallia Poulakou</name>
<affiliation><nlm:aff id="Aff125"><institution-wrap><institution-id institution-id-type="ISNI">0000 0004 0622 4662</institution-id>
<institution-id institution-id-type="GRID">grid.411449.d</institution-id>
<institution>Fourth Department of Internal Medicine and Infectious Diseases Unit,</institution>
<institution>National and Kapodstrian University-Medical School, Attikon University General Hospital,</institution>
</institution-wrap>
Athens, Greece</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Preller, Jacobus" sort="Preller, Jacobus" uniqKey="Preller J" first="Jacobus" last="Preller">Jacobus Preller</name>
<affiliation><nlm:aff id="Aff126">John Farman Intensive Care Unit, University Hospitals, NHS Foundation Trust, Cambridge, UK</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Pulcini, Celine" sort="Pulcini, Celine" uniqKey="Pulcini C" first="Céline" last="Pulcini">Céline Pulcini</name>
<affiliation><nlm:aff id="Aff127">Infectious and Tropical Diseases Department, University Hospital of Nancy, and EA 4360 APEMAC, Lorraine University, Nancy, France</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Pupelis, Guntars" sort="Pupelis, Guntars" uniqKey="Pupelis G" first="Guntars" last="Pupelis">Guntars Pupelis</name>
<affiliation><nlm:aff id="Aff128">Department of General and Emergency Surgery, Riga East University Hospital ‘Gailezers’, Riga, Latvia</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Quiodettis, Martha" sort="Quiodettis, Martha" uniqKey="Quiodettis M" first="Martha" last="Quiodettis">Martha Quiodettis</name>
<affiliation><nlm:aff id="Aff129"><institution-wrap><institution-id institution-id-type="ISNI">0000 0004 0465 2778</institution-id>
<institution-id institution-id-type="GRID">grid.461067.2</institution-id>
<institution>Department of Trauma,</institution>
<institution>Hospital Santo Tomas,</institution>
</institution-wrap>
Panama, Panama</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Rawson, Timothy M" sort="Rawson, Timothy M" uniqKey="Rawson T" first="Timothy M." last="Rawson">Timothy M. Rawson</name>
<affiliation><nlm:aff id="Aff130"><institution-wrap><institution-id institution-id-type="ISNI">0000 0001 2113 8111</institution-id>
<institution-id institution-id-type="GRID">grid.7445.2</institution-id>
<institution>National Institute for Health Research, Health Protection Research Unit in Healthcare Associated Infections and Antimicrobial Resistance,</institution>
<institution>Imperial College London,</institution>
</institution-wrap>
Hammersmith Campus, London, UK</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Reis, Tarcisio" sort="Reis, Tarcisio" uniqKey="Reis T" first="Tarcisio" last="Reis">Tarcisio Reis</name>
<affiliation><nlm:aff id="Aff131">Emergency Post-operative Department, Otavio de Freitas Hospital and Hosvaldo Cruz Hospital, Recife, Brazil</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Rems, Miran" sort="Rems, Miran" uniqKey="Rems M" first="Miran" last="Rems">Miran Rems</name>
<affiliation><nlm:aff id="Aff132">Department of General Surgery, Jesenice General Hospital, Jesenice, Slovenia</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Rizoli, Sandro" sort="Rizoli, Sandro" uniqKey="Rizoli S" first="Sandro" last="Rizoli">Sandro Rizoli</name>
<affiliation><nlm:aff id="Aff133"><institution-wrap><institution-id institution-id-type="ISNI">0000 0001 2157 2938</institution-id>
<institution-id institution-id-type="GRID">grid.17063.33</institution-id>
<institution>Trauma and Acute Care Service, St Michael’s Hospital,</institution>
<institution>University of Toronto,</institution>
</institution-wrap>
Toronto, Canada</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Roberts, Jason" sort="Roberts, Jason" uniqKey="Roberts J" first="Jason" last="Roberts">Jason Roberts</name>
<affiliation><nlm:aff id="Aff134"><institution-wrap><institution-id institution-id-type="ISNI">0000 0000 9320 7537</institution-id>
<institution-id institution-id-type="GRID">grid.1003.2</institution-id>
<institution>Burns, Trauma and Critical Care Research Centre,</institution>
<institution>The University of Queensland,</institution>
</institution-wrap>
Brisbane, Queensland Australia</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Pereira, Nuno Rocha" sort="Pereira, Nuno Rocha" uniqKey="Pereira N" first="Nuno Rocha" last="Pereira">Nuno Rocha Pereira</name>
<affiliation><nlm:aff id="Aff23"><institution-wrap><institution-id institution-id-type="ISNI">0000 0000 9375 4688</institution-id>
<institution-id institution-id-type="GRID">grid.414556.7</institution-id>
<institution>Unit of Prevention and Infection Control, Center of Hospital Epidemiology,</institution>
<institution>São João Hospital Centre,</institution>
</institution-wrap>
Porto, Portugal</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Rodriguez Ba O, Jesus" sort="Rodriguez Ba O, Jesus" uniqKey="Rodriguez Ba O J" first="Jesús" last="Rodríguez-Ba O">Jesús Rodríguez-Ba O</name>
<affiliation><nlm:aff id="Aff135"><institution-wrap><institution-id institution-id-type="ISNI">0000 0001 2168 1229</institution-id>
<institution-id institution-id-type="GRID">grid.9224.d</institution-id>
<institution>Unidad Clínica Intercentros de Enfermedades Infecciosas, Microbiología y Medicina Preventiva, Hospitales Universitarios Virgen Macarena y Virgen del Rocío-IBiS and Departamento de Medicina,</institution>
<institution>Universidad de Sevilla,</institution>
</institution-wrap>
Seville, Spain</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Sakakushev, Boris" sort="Sakakushev, Boris" uniqKey="Sakakushev B" first="Boris" last="Sakakushev">Boris Sakakushev</name>
<affiliation><nlm:aff id="Aff136"><institution-wrap><institution-id institution-id-type="ISNI">0000 0001 0726 0380</institution-id>
<institution-id institution-id-type="GRID">grid.35371.33</institution-id>
<institution>General Surgery Department,</institution>
<institution>Medical University, University Hospital St George,</institution>
</institution-wrap>
Plovdiv, Bulgaria</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Sanders, James" sort="Sanders, James" uniqKey="Sanders J" first="James" last="Sanders">James Sanders</name>
<affiliation><nlm:aff id="Aff137"><institution-wrap><institution-id institution-id-type="GRID">grid.414766.6</institution-id>
<institution></institution>
<institution>JPS Health Network,</institution>
</institution-wrap>
Texas, TX USA</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Santos, Natalia" sort="Santos, Natalia" uniqKey="Santos N" first="Natalia" last="Santos">Natalia Santos</name>
<affiliation><nlm:aff id="Aff138">Hospital Center Tondela Viseu, Tondela, Portugal</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Sato, Norio" sort="Sato, Norio" uniqKey="Sato N" first="Norio" last="Sato">Norio Sato</name>
<affiliation><nlm:aff id="Aff139"><institution-wrap><institution-id institution-id-type="ISNI">0000 0001 1011 3808</institution-id>
<institution-id institution-id-type="GRID">grid.255464.4</institution-id>
<institution>Department of Aeromedical Services for Emergency and Trauma Care,</institution>
<institution>Ehime University Graduate School of Medicine,</institution>
</institution-wrap>
Ehime, Japan</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Sawyer, Robert G" sort="Sawyer, Robert G" uniqKey="Sawyer R" first="Robert G." last="Sawyer">Robert G. Sawyer</name>
<affiliation><nlm:aff id="Aff140"><institution-wrap><institution-id institution-id-type="ISNI">0000 0004 1936 9932</institution-id>
<institution-id institution-id-type="GRID">grid.412587.d</institution-id>
<institution>Department of Surgery,</institution>
<institution>University of Virginia Health System,</institution>
</institution-wrap>
Charlottesville, VA USA</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Scarpelini, Sandro" sort="Scarpelini, Sandro" uniqKey="Scarpelini S" first="Sandro" last="Scarpelini">Sandro Scarpelini</name>
<affiliation><nlm:aff id="Aff141"><institution-wrap><institution-id institution-id-type="ISNI">0000 0004 1937 0722</institution-id>
<institution-id institution-id-type="GRID">grid.11899.38</institution-id>
<institution>Department of Surgery,</institution>
<institution>University of Sao Paulo,</institution>
</institution-wrap>
Ribeirao Preto, Brazil</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Scoccia, Loredana" sort="Scoccia, Loredana" uniqKey="Scoccia L" first="Loredana" last="Scoccia">Loredana Scoccia</name>
<affiliation><nlm:aff id="Aff142">Unit of Hospital Pharmacy, Macerata Hospital, Macerata, Italy</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Shafiq, Nusrat" sort="Shafiq, Nusrat" uniqKey="Shafiq N" first="Nusrat" last="Shafiq">Nusrat Shafiq</name>
<affiliation><nlm:aff id="Aff143"><institution-wrap><institution-id institution-id-type="ISNI">0000 0004 1767 2903</institution-id>
<institution-id institution-id-type="GRID">grid.415131.3</institution-id>
<institution>Department of Pharmacology,</institution>
<institution>Postgraduate Institute of Medical Education and Research,</institution>
</institution-wrap>
Chandigarh, India</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Shelat, Vishalkumar" sort="Shelat, Vishalkumar" uniqKey="Shelat V" first="Vishalkumar" last="Shelat">Vishalkumar Shelat</name>
<affiliation><nlm:aff id="Aff144"><institution-wrap><institution-id institution-id-type="GRID">grid.240988.f</institution-id>
<institution>Department of General Surgery,</institution>
<institution>Tan Tock Seng Hospital,</institution>
</institution-wrap>
Tan Tock Seng, Singapore</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Sifri, Costi D" sort="Sifri, Costi D" uniqKey="Sifri C" first="Costi D." last="Sifri">Costi D. Sifri</name>
<affiliation><nlm:aff id="Aff145"><institution-wrap><institution-id institution-id-type="ISNI">0000 0004 1936 9932</institution-id>
<institution-id institution-id-type="GRID">grid.412587.d</institution-id>
<institution>Office of Hospital Epidemiology/Infection Prevention and Control,</institution>
<institution>University of Virginia Health System,</institution>
</institution-wrap>
Charlottesville, VA USA</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Siribumrungwong, Boonying" sort="Siribumrungwong, Boonying" uniqKey="Siribumrungwong B" first="Boonying" last="Siribumrungwong">Boonying Siribumrungwong</name>
<affiliation><nlm:aff id="Aff146"><institution-wrap><institution-id institution-id-type="ISNI">0000 0004 1937 1127</institution-id>
<institution-id institution-id-type="GRID">grid.412434.4</institution-id>
<institution>Department of Surgery, Faculty of Medicine,</institution>
<institution>Thammasat University Hospital, Thammasat University,</institution>
</institution-wrap>
Pathum Thani, Thailand</nlm:aff>
</affiliation>
</author>
<author><name sortKey="S Reide, Kjetil" sort="S Reide, Kjetil" uniqKey="S Reide K" first="Kjetil" last="S Reide">Kjetil S Reide</name>
<affiliation><nlm:aff id="Aff147"><institution-wrap><institution-id institution-id-type="ISNI">0000 0004 0627 2891</institution-id>
<institution-id institution-id-type="GRID">grid.412835.9</institution-id>
<institution>Department of Gastrointestinal Surgery,</institution>
<institution>Stavanger University Hospital,</institution>
</institution-wrap>
Stavanger, Norway</nlm:aff>
</affiliation>
<affiliation><nlm:aff id="Aff148"><institution-wrap><institution-id institution-id-type="ISNI">0000 0004 1936 7443</institution-id>
<institution-id institution-id-type="GRID">grid.7914.b</institution-id>
<institution>Department of Clinical Medicine,</institution>
<institution>University of Bergen,</institution>
</institution-wrap>
Bergen, Norway</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Soto, Rodolfo" sort="Soto, Rodolfo" uniqKey="Soto R" first="Rodolfo" last="Soto">Rodolfo Soto</name>
<affiliation><nlm:aff id="Aff149">Department of Emergency Surgery and Critical Care, Centro Medico Imbanaco, Cali, Colombia</nlm:aff>
</affiliation>
</author>
<author><name sortKey="De Souza, Hamilton P" sort="De Souza, Hamilton P" uniqKey="De Souza H" first="Hamilton P." last="De Souza">Hamilton P. De Souza</name>
<affiliation><nlm:aff id="Aff150"><institution-wrap><institution-id institution-id-type="ISNI">0000 0001 2166 9094</institution-id>
<institution-id institution-id-type="GRID">grid.412519.a</institution-id>
<institution>Department of Surgery, School of Medicine,</institution>
<institution>Pontifícia Universidade Católica do Rio Grande do Sul (PUCRS),</institution>
</institution-wrap>
Porto Alegre, Brazil</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Talving, Peep" sort="Talving, Peep" uniqKey="Talving P" first="Peep" last="Talving">Peep Talving</name>
<affiliation><nlm:aff id="Aff151">Department of Surgery, North Estonia Medical Center, Tallinn, Estonia</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Trung, Ngo Tat" sort="Trung, Ngo Tat" uniqKey="Trung N" first="Ngo Tat" last="Trung">Ngo Tat Trung</name>
<affiliation><nlm:aff id="Aff152">Department of Molecular Biology, Tran Hung Dao Hospital, No 1, Tran Hung Dao Street, Hai Ba Trung Dist, Hanoi, Vietnam</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Tessier, Jeffrey M" sort="Tessier, Jeffrey M" uniqKey="Tessier J" first="Jeffrey M." last="Tessier">Jeffrey M. Tessier</name>
<affiliation><nlm:aff id="Aff153">Department of Infectious Diseases, John Peter Smith Health Network, Fort Worth, Texas USA</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Tumbarello, Mario" sort="Tumbarello, Mario" uniqKey="Tumbarello M" first="Mario" last="Tumbarello">Mario Tumbarello</name>
<affiliation><nlm:aff id="Aff154"><institution-wrap><institution-id institution-id-type="ISNI">0000 0001 0941 3192</institution-id>
<institution-id institution-id-type="GRID">grid.8142.f</institution-id>
<institution>Institute of Infectious Diseases,</institution>
<institution>Catholic University,</institution>
</institution-wrap>
Rome, Italy</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Ulrych, Jan" sort="Ulrych, Jan" uniqKey="Ulrych J" first="Jan" last="Ulrych">Jan Ulrych</name>
<affiliation><nlm:aff id="Aff155"><institution-wrap><institution-id institution-id-type="ISNI">0000 0000 9100 9940</institution-id>
<institution-id institution-id-type="GRID">grid.411798.2</institution-id>
<institution>First Department of Surgery—Department of Abdominal, Thoracic Surgery and Traumatology,</institution>
<institution>General University Hospital,</institution>
</institution-wrap>
Prague, Czech Republic</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Uranues, Selman" sort="Uranues, Selman" uniqKey="Uranues S" first="Selman" last="Uranues">Selman Uranues</name>
<affiliation><nlm:aff id="Aff156"><institution-wrap><institution-id institution-id-type="ISNI">0000 0000 8988 2476</institution-id>
<institution-id institution-id-type="GRID">grid.11598.34</institution-id>
<institution>Department of Surgery,</institution>
<institution>Medical University of Graz,</institution>
</institution-wrap>
Graz, Austria</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Van Goor, Harry" sort="Van Goor, Harry" uniqKey="Van Goor H" first="Harry" last="Van Goor">Harry Van Goor</name>
<affiliation><nlm:aff id="Aff157"><institution-wrap><institution-id institution-id-type="ISNI">0000 0004 0444 9382</institution-id>
<institution-id institution-id-type="GRID">grid.10417.33</institution-id>
<institution>Department of Surgery,</institution>
<institution>Radboud University Nijmegen Medical Center,</institution>
</institution-wrap>
Nijmegen, The Netherlands</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Vereczkei, Andras" sort="Vereczkei, Andras" uniqKey="Vereczkei A" first="Andras" last="Vereczkei">Andras Vereczkei</name>
<affiliation><nlm:aff id="Aff158"><institution-wrap><institution-id institution-id-type="ISNI">0000 0001 0663 9479</institution-id>
<institution-id institution-id-type="GRID">grid.9679.1</institution-id>
<institution>Department of Surgery,</institution>
<institution>Medical School University of Pécs,</institution>
</institution-wrap>
Pécs, Hungary</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Wagenlehner, Florian" sort="Wagenlehner, Florian" uniqKey="Wagenlehner F" first="Florian" last="Wagenlehner">Florian Wagenlehner</name>
<affiliation><nlm:aff id="Aff159"><institution-wrap><institution-id institution-id-type="ISNI">0000 0001 2165 8627</institution-id>
<institution-id institution-id-type="GRID">grid.8664.c</institution-id>
<institution>Department of Urology, Pediatric Urology and Andrology,</institution>
<institution>Medical Faculty of the Justus Liebig University Giessen,</institution>
</institution-wrap>
Giessen, Germany</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Xiao, Yonghong" sort="Xiao, Yonghong" uniqKey="Xiao Y" first="Yonghong" last="Xiao">Yonghong Xiao</name>
<affiliation><nlm:aff id="Aff160"><institution-wrap><institution-id institution-id-type="ISNI">0000 0004 1759 700X</institution-id>
<institution-id institution-id-type="GRID">grid.13402.34</institution-id>
<institution>State Key Laboratory for Diagnosis and Treatment of Infectious Diseases,</institution>
<institution>The First Affilliated Hospital, Zhejiang University,</institution>
</institution-wrap>
Zhejiang, China</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Yuan, Kuo Ching" sort="Yuan, Kuo Ching" uniqKey="Yuan K" first="Kuo-Ching" last="Yuan">Kuo-Ching Yuan</name>
<affiliation><nlm:aff id="Aff161"><institution-wrap><institution-id institution-id-type="ISNI">0000 0004 1756 1461</institution-id>
<institution-id institution-id-type="GRID">grid.454210.6</institution-id>
<institution>Trauma and Emergency Surgery Department,</institution>
<institution>Chang Gung Memorial Hospital,</institution>
</institution-wrap>
Taoyuan City, Taiwan</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Wechsler Fordos, Agnes" sort="Wechsler Fordos, Agnes" uniqKey="Wechsler Fordos A" first="Agnes" last="Wechsler-Fördös">Agnes Wechsler-Fördös</name>
<affiliation><nlm:aff id="Aff162"><institution-wrap><institution-id institution-id-type="ISNI">0000 0004 0522 8258</institution-id>
<institution-id institution-id-type="GRID">grid.413303.6</institution-id>
<institution>Department of Antibiotics and Infection Control,</institution>
<institution>Rudolfstiftung Hospital,</institution>
</institution-wrap>
Vienna, Austria</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Zahar, Jean Ralph" sort="Zahar, Jean Ralph" uniqKey="Zahar J" first="Jean-Ralph" last="Zahar">Jean-Ralph Zahar</name>
<affiliation><nlm:aff id="Aff163">Infection Control Unit, Angers University, CHU d’Angers, Angers, France</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Zakrison, Tanya L" sort="Zakrison, Tanya L" uniqKey="Zakrison T" first="Tanya L." last="Zakrison">Tanya L. Zakrison</name>
<affiliation><nlm:aff id="Aff164"><institution-wrap><institution-id institution-id-type="ISNI">0000 0004 1936 8606</institution-id>
<institution-id institution-id-type="GRID">grid.26790.3a</institution-id>
<institution>Division of Trauma and Surgical Critical Care, DeWitt Daughtry Family Department of Surgery,</institution>
<institution>University of Miami,</institution>
</institution-wrap>
Miami, FL USA</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Zuckerbraun, Brian" sort="Zuckerbraun, Brian" uniqKey="Zuckerbraun B" first="Brian" last="Zuckerbraun">Brian Zuckerbraun</name>
<affiliation><nlm:aff id="Aff165"><institution-wrap><institution-id institution-id-type="ISNI">0000 0004 1936 9000</institution-id>
<institution-id institution-id-type="GRID">grid.21925.3d</institution-id>
<institution>Department of Surgery,</institution>
<institution>University of Pittsburgh,</institution>
</institution-wrap>
Pittsburgh, PA USA</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Zuidema, Wietse P" sort="Zuidema, Wietse P" uniqKey="Zuidema W" first="Wietse P." last="Zuidema">Wietse P. Zuidema</name>
<affiliation><nlm:aff id="Aff166"><institution-wrap><institution-id institution-id-type="ISNI">0000 0004 0435 165X</institution-id>
<institution-id institution-id-type="GRID">grid.16872.3a</institution-id>
<institution></institution>
<institution>VU University Medical Center,</institution>
</institution-wrap>
Amsterdam, The Netherlands</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Catena, Fausto" sort="Catena, Fausto" uniqKey="Catena F" first="Fausto" last="Catena">Fausto Catena</name>
<affiliation><nlm:aff id="Aff167">Department of General Surgery, Maggiore Hospital, Parma, Italy</nlm:aff>
</affiliation>
</author>
</analytic>
<series><title level="j">World Journal of Emergency Surgery : WJES</title>
<idno type="eISSN">1749-7922</idno>
<imprint><date when="2017">2017</date>
</imprint>
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<profileDesc><textClass></textClass>
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<front><div type="abstract" xml:lang="en"><sec><title>Background</title>
<p id="Par1">Antimicrobial Stewardship Programs (ASPs) have been promoted to optimize antimicrobial usage and patient outcomes, and to reduce the emergence of antimicrobial-resistant organisms. However, the best strategies for an ASP are not definitively established and are likely to vary based on local culture, policy, and routine clinical practice, and probably limited resources in middle-income countries. The aim of this study is to evaluate structures and resources of antimicrobial stewardship teams (ASTs) in surgical departments from different regions of the world.</p>
</sec>
<sec><title>Methods</title>
<p id="Par2">A cross-sectional web-based survey was conducted in 2016 on 173 physicians who participated in the AGORA (Antimicrobials: A Global Alliance for Optimizing their Rational Use in Intra-Abdominal Infections) project and on 658 international experts in the fields of ASPs, infection control, and infections in surgery.</p>
</sec>
<sec><title>Results</title>
<p id="Par3">The response rate was 19.4%. One hundred fifty-six (98.7%) participants stated their hospital had a multidisciplinary AST. The median number of physicians working inside the team was five [interquartile range 4–6]. An infectious disease specialist, a microbiologist and an infection control specialist were, respectively, present in 80.1, 76.3, and 67.9% of the ASTs. A surgeon was a component in 59.0% of cases and was significantly more likely to be present in university hospitals (89.5%, <italic>p</italic>
< 0.05) compared to community teaching (83.3%) and community hospitals (66.7%). Protocols for pre-operative prophylaxis and for antimicrobial treatment of surgical infections were respectively implemented in 96.2 and 82.3% of the hospitals. The majority of the surgical departments implemented both persuasive and restrictive interventions (72.8%). The most common types of interventions in surgical departments were dissemination of educational materials (62.5%), expert approval (61.0%), audit and feedback (55.1%), educational outreach (53.7%), and compulsory order forms (51.5%).</p>
</sec>
<sec><title>Conclusion</title>
<p id="Par4">The survey showed a heterogeneous organization of ASPs worldwide, demonstrating the necessity of a multidisciplinary and collaborative approach in the battle against antimicrobial resistance in surgical infections, and the importance of educational efforts towards this goal.</p>
</sec>
<sec><title>Electronic supplementary material</title>
<p>The online version of this article (doi:10.1186/s13017-017-0145-2) contains supplementary material, which is available to authorized users.</p>
</sec>
</div>
</front>
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</TEI>
<pmc article-type="research-article"><pmc-dir>properties open_access</pmc-dir>
<front><journal-meta><journal-id journal-id-type="nlm-ta">World J Emerg Surg</journal-id>
<journal-id journal-id-type="iso-abbrev">World J Emerg Surg</journal-id>
<journal-title-group><journal-title>World Journal of Emergency Surgery : WJES</journal-title>
</journal-title-group>
<issn pub-type="epub">1749-7922</issn>
<publisher><publisher-name>BioMed Central</publisher-name>
<publisher-loc>London</publisher-loc>
</publisher>
</journal-meta>
<article-meta><article-id pub-id-type="pmid">28775763</article-id>
<article-id pub-id-type="pmc">5540347</article-id>
<article-id pub-id-type="publisher-id">145</article-id>
<article-id pub-id-type="doi">10.1186/s13017-017-0145-2</article-id>
<article-categories><subj-group subj-group-type="heading"><subject>Research Article</subject>
</subj-group>
</article-categories>
<title-group><article-title>The <italic>Global Alliance for Infections in Surgery:</italic>
defining a model for antimicrobial stewardship—results from an international cross-sectional survey</article-title>
</title-group>
<contrib-group><contrib contrib-type="author" corresp="yes"><name><surname>Sartelli</surname>
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<contrib contrib-type="author"><name><surname>Colak</surname>
<given-names>Elif</given-names>
</name>
<address><email>elifmangancolak@hotmail.com</email>
</address>
<xref ref-type="aff" rid="Aff40">40</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Cornely</surname>
<given-names>Oliver A.</given-names>
</name>
<address><email>oliver.cornely@uk-koeln.de</email>
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<xref ref-type="aff" rid="Aff41">41</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Cui</surname>
<given-names>Yunfeng</given-names>
</name>
<address><email>yunfengcuidoctor@aliyun.com</email>
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<xref ref-type="aff" rid="Aff42">42</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Demetrashvili</surname>
<given-names>Zaza</given-names>
</name>
<address><email>zdemetr@yahoo.com</email>
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<xref ref-type="aff" rid="Aff43">43</xref>
</contrib>
<contrib contrib-type="author"><name><surname>De Simone</surname>
<given-names>Belinda</given-names>
</name>
<address><email>desimone.belinda@gmail.com</email>
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<xref ref-type="aff" rid="Aff44">44</xref>
</contrib>
<contrib contrib-type="author"><name><surname>De Waele</surname>
<given-names>Jan J.</given-names>
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<address><email>Jan.dewaele@ugent.be</email>
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<xref ref-type="aff" rid="Aff45">45</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Dhingra</surname>
<given-names>Sameer</given-names>
</name>
<address><email>Sameer.Dhingra@sta.uwi.edu</email>
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<xref ref-type="aff" rid="Aff46">46</xref>
<xref ref-type="aff" rid="Aff47">47</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Di Marzo</surname>
<given-names>Francesco</given-names>
</name>
<address><email>dimarzo@yahoo.com</email>
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<xref ref-type="aff" rid="Aff48">48</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Dogjani</surname>
<given-names>Agron</given-names>
</name>
<address><email>agrondogjani@yahoo.com</email>
</address>
<xref ref-type="aff" rid="Aff49">49</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Dorj</surname>
<given-names>Gereltuya</given-names>
</name>
<address><email>gereltuya.dorj@mnums.edu.mn</email>
</address>
<xref ref-type="aff" rid="Aff50">50</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Dortet</surname>
<given-names>Laurent</given-names>
</name>
<address><email>laurent.dortet@aphp.fr</email>
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<xref ref-type="aff" rid="Aff51">51</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Duane</surname>
<given-names>Therese M.</given-names>
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<address><email>TDuane@jpshealth.org</email>
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<xref ref-type="aff" rid="Aff52">52</xref>
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<contrib contrib-type="author"><name><surname>Elmangory</surname>
<given-names>Mutasim M.</given-names>
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<address><email>mangory2000@gmail.com</email>
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<xref ref-type="aff" rid="Aff53">53</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Enani</surname>
<given-names>Mushira A.</given-names>
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<address><email>menani@kfmc.med.sa</email>
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<xref ref-type="aff" rid="Aff54">54</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Ferrada</surname>
<given-names>Paula</given-names>
</name>
<address><email>paula.ferrada@vcuhealth.org</email>
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<xref ref-type="aff" rid="Aff55">55</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Esteban Foianini</surname>
<given-names>J.</given-names>
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<address><email>efoianini@hotmail.com</email>
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<xref ref-type="aff" rid="Aff56">56</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Gachabayov</surname>
<given-names>Mahir</given-names>
</name>
<address><email>gachabayovmahir@gmail.com</email>
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<xref ref-type="aff" rid="Aff57">57</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Gandhi</surname>
<given-names>Chinmay</given-names>
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<address><email>chinmaygandhi00@yahoo.co.in</email>
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<xref ref-type="aff" rid="Aff58">58</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Ghnnam</surname>
<given-names>Wagih Mommtaz</given-names>
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<address><email>wghnnam@gmail.com</email>
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<xref ref-type="aff" rid="Aff59">59</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Giamarellou</surname>
<given-names>Helen</given-names>
</name>
<address><email>e.giamarellou@hygeia.gr</email>
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<xref ref-type="aff" rid="Aff60">60</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Gkiokas</surname>
<given-names>Georgios</given-names>
</name>
<address><email>georgiokas@yahoo.com</email>
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<xref ref-type="aff" rid="Aff61">61</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Gomi</surname>
<given-names>Harumi</given-names>
</name>
<address><email>hgomi-oky@umin.org</email>
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<xref ref-type="aff" rid="Aff62">62</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Goranovic</surname>
<given-names>Tatjana</given-names>
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<address><email>tanjagoranovic@hotmail.com</email>
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<xref ref-type="aff" rid="Aff63">63</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Griffiths</surname>
<given-names>Ewen A.</given-names>
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<address><email>Ewen.Griffiths@uhb.nhs.uk</email>
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<xref ref-type="aff" rid="Aff64">64</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Guerra Gronerth</surname>
<given-names>Rosio I.</given-names>
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<address><email>rthg357@gmail.com</email>
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<given-names>Julio C.</given-names>
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<address><email>juliochmonteiro@gmail.com</email>
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<xref ref-type="aff" rid="Aff66">66</xref>
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<contrib contrib-type="author"><name><surname>Hardcastle</surname>
<given-names>Timothy C.</given-names>
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<address><email>hardcastle@ukzn.ac.za</email>
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<xref ref-type="aff" rid="Aff67">67</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Hecker</surname>
<given-names>Andreas</given-names>
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<address><email>andreas.hecker@chiru.med.uni-giessen.de</email>
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<xref ref-type="aff" rid="Aff68">68</xref>
</contrib>
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<given-names>Adrien M.</given-names>
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<address><email>hodasm98@gmail.com</email>
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<xref ref-type="aff" rid="Aff69">69</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Ioannidis</surname>
<given-names>Orestis</given-names>
</name>
<address><email>telonakos@hotmail.com</email>
</address>
<xref ref-type="aff" rid="Aff70">70</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Isik</surname>
<given-names>Arda</given-names>
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<address><email>kararda@yahoo.com</email>
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<xref ref-type="aff" rid="Aff71">71</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Iskandar</surname>
<given-names>Katia A.</given-names>
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<address><email>katia.iskandar@liu.edu.lb</email>
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<xref ref-type="aff" rid="Aff72">72</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Kafil</surname>
<given-names>Hossein S.</given-names>
</name>
<address><email>h.s.kafil@gmail.com</email>
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<xref ref-type="aff" rid="Aff73">73</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Kanj</surname>
<given-names>Souha S.</given-names>
</name>
<address><email>sk11@aub.edu.lb</email>
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<xref ref-type="aff" rid="Aff74">74</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Kaplan</surname>
<given-names>Lewis J.</given-names>
</name>
<address><email>Lewis.Kaplan@uphs.upenn.edu</email>
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<xref ref-type="aff" rid="Aff75">75</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Kapoor</surname>
<given-names>Garima</given-names>
</name>
<address><email>garima.kapoor.001@gmail.com</email>
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<xref ref-type="aff" rid="Aff76">76</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Karamarkovic</surname>
<given-names>Aleksandar R.</given-names>
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<address><email>alekara@sbb.rs</email>
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<xref ref-type="aff" rid="Aff77">77</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Kenig</surname>
<given-names>Jakub</given-names>
</name>
<address><email>jkenig@cm-uj.krakow.pl</email>
</address>
<xref ref-type="aff" rid="Aff78">78</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Kerschaever</surname>
<given-names>Ivan</given-names>
</name>
<address><email>ikerschaever@hotmail.com</email>
</address>
<xref ref-type="aff" rid="Aff79">79</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Khamis</surname>
<given-names>Faryal</given-names>
</name>
<address><email>khami001@gmail.com</email>
</address>
<xref ref-type="aff" rid="Aff80">80</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Khokha</surname>
<given-names>Vladimir</given-names>
</name>
<address><email>docvladimir@yandex.ru</email>
</address>
<xref ref-type="aff" rid="Aff81">81</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Kiguba</surname>
<given-names>Ronald</given-names>
</name>
<address><email>kiguba@gmail.com</email>
</address>
<xref ref-type="aff" rid="Aff82">82</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Kim</surname>
<given-names>Hong B.</given-names>
</name>
<address><email>hbkimmd@snu.ac.kr</email>
</address>
<xref ref-type="aff" rid="Aff83">83</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Ko</surname>
<given-names>Wen-Chien</given-names>
</name>
<address><email>winston3415@gmail.com</email>
</address>
<xref ref-type="aff" rid="Aff84">84</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Koike</surname>
<given-names>Kaoru</given-names>
</name>
<address><email>kkoike@kuhp.kyoto-u.ac.jp</email>
</address>
<xref ref-type="aff" rid="Aff85">85</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Kozlovska</surname>
<given-names>Iryna</given-names>
</name>
<address><email>irkakim@rambler.ru</email>
</address>
<xref ref-type="aff" rid="Aff86">86</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Kumar</surname>
<given-names>Anand</given-names>
</name>
<address><email>akumar61@yahoo.com</email>
</address>
<xref ref-type="aff" rid="Aff87">87</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Lagunes</surname>
<given-names>Leonel</given-names>
</name>
<address><email>leonel.lagunes@gmail.com</email>
</address>
<xref ref-type="aff" rid="Aff88">88</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Latifi</surname>
<given-names>Rifat</given-names>
</name>
<address><email>latifi@surgery.arizona.edu</email>
</address>
<xref ref-type="aff" rid="Aff89">89</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Lee</surname>
<given-names>Jae G.</given-names>
</name>
<address><email>jakii@yuhs.ac</email>
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<xref ref-type="aff" rid="Aff90">90</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Lee</surname>
<given-names>Young R.</given-names>
</name>
<address><email>young.lee@ttuhsc.edu</email>
</address>
<xref ref-type="aff" rid="Aff91">91</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Leppäniemi</surname>
<given-names>Ari</given-names>
</name>
<address><email>ari.leppaniemi@hus.fi</email>
</address>
<xref ref-type="aff" rid="Aff92">92</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Li</surname>
<given-names>Yousheng</given-names>
</name>
<address><email>liys@medmail.com.cn</email>
</address>
<xref ref-type="aff" rid="Aff93">93</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Liang</surname>
<given-names>Stephen Y.</given-names>
</name>
<address><email>syliang@wustl.edu</email>
</address>
<xref ref-type="aff" rid="Aff94">94</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Lowman</surname>
<given-names>Warren</given-names>
</name>
<address><email>rebel@mweb.co.za</email>
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<xref ref-type="aff" rid="Aff95">95</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Machain</surname>
<given-names>Gustavo M.</given-names>
</name>
<address><email>gmmachain@yahoo.com</email>
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<xref ref-type="aff" rid="Aff96">96</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Maegele</surname>
<given-names>Marc</given-names>
</name>
<address><email>Marc.Maegele@t-online.de</email>
</address>
<xref ref-type="aff" rid="Aff97">97</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Major</surname>
<given-names>Piotr</given-names>
</name>
<address><email>majorpiotr@gmail.com</email>
</address>
<xref ref-type="aff" rid="Aff98">98</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Malama</surname>
<given-names>Sydney</given-names>
</name>
<address><email>sydneymalama1971@gmail.com</email>
</address>
<xref ref-type="aff" rid="Aff99">99</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Manzano-Nunez</surname>
<given-names>Ramiro</given-names>
</name>
<address><email>ramiro.manzano@correounivalle.edu.co</email>
</address>
<xref ref-type="aff" rid="Aff100">100</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Marinis</surname>
<given-names>Athanasios</given-names>
</name>
<address><email>drmarinis@gmail.com</email>
</address>
<xref ref-type="aff" rid="Aff101">101</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Martinez Casas</surname>
<given-names>Isidro</given-names>
</name>
<address><email>isidromartinez@me.com</email>
</address>
<xref ref-type="aff" rid="Aff102">102</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Marwah</surname>
<given-names>Sanjay</given-names>
</name>
<address><email>drsanjay.marwah@gmail.com</email>
</address>
<xref ref-type="aff" rid="Aff103">103</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Maseda</surname>
<given-names>Emilio</given-names>
</name>
<address><email>emilio.maseda@gmail.com</email>
</address>
<xref ref-type="aff" rid="Aff104">104</xref>
</contrib>
<contrib contrib-type="author"><name><surname>McFarlane</surname>
<given-names>Michael E.</given-names>
</name>
<address><email>michaelm500@yahoo.com</email>
</address>
<xref ref-type="aff" rid="Aff105">105</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Memish</surname>
<given-names>Ziad</given-names>
</name>
<address><email>zmemish@yahoo.com</email>
</address>
<xref ref-type="aff" rid="Aff106">106</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Mertz</surname>
<given-names>Dominik</given-names>
</name>
<address><email>mertzd@mcmaster.ca</email>
</address>
<xref ref-type="aff" rid="Aff107">107</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Mesina</surname>
<given-names>Cristian</given-names>
</name>
<address><email>mesina.cristian@doctor.com</email>
</address>
<xref ref-type="aff" rid="Aff108">108</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Mishra</surname>
<given-names>Shyam K.</given-names>
</name>
<address><email>shyammishra@iom.edu.np</email>
</address>
<xref ref-type="aff" rid="Aff109">109</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Moore</surname>
<given-names>Ernest E.</given-names>
</name>
<address><email>Ernest.Moore@dhha.org</email>
</address>
<xref ref-type="aff" rid="Aff110">110</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Munyika</surname>
<given-names>Akutu</given-names>
</name>
<address><email>mbwale@yahoo.com</email>
</address>
<xref ref-type="aff" rid="Aff111">111</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Mylonakis</surname>
<given-names>Eleftherios</given-names>
</name>
<address><email>emylonakis@lifespan.org</email>
</address>
<xref ref-type="aff" rid="Aff112">112</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Napolitano</surname>
<given-names>Lena</given-names>
</name>
<address><email>lenan@umich.edu</email>
</address>
<xref ref-type="aff" rid="Aff113">113</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Negoi</surname>
<given-names>Ionut</given-names>
</name>
<address><email>negoiionut@gmail.com</email>
</address>
<xref ref-type="aff" rid="Aff114">114</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Nestorovic</surname>
<given-names>Milica D.</given-names>
</name>
<address><email>milica20@yahoo.com</email>
</address>
<xref ref-type="aff" rid="Aff115">115</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Nicolau</surname>
<given-names>David P.</given-names>
</name>
<address><email>David.Nicolau@hhchealth.org</email>
</address>
<xref ref-type="aff" rid="Aff116">116</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Omari</surname>
<given-names>Abdelkarim H.</given-names>
</name>
<address><email>akomari@just.edu.jo</email>
</address>
<xref ref-type="aff" rid="Aff117">117</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Ordonez</surname>
<given-names>Carlos A.</given-names>
</name>
<address><email>ordonezcarlosa@gmail.com</email>
</address>
<xref ref-type="aff" rid="Aff118">118</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Paiva</surname>
<given-names>José-Artur</given-names>
</name>
<address><email>jarturpaiva@gmail.com</email>
</address>
<xref ref-type="aff" rid="Aff119">119</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Pant</surname>
<given-names>Narayan D.</given-names>
</name>
<address><email>ndpant1987@gmail.com</email>
</address>
<xref ref-type="aff" rid="Aff120">120</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Parreira</surname>
<given-names>Jose G.</given-names>
</name>
<address><email>jgparreira@uol.com.br</email>
</address>
<xref ref-type="aff" rid="Aff121">121</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Pędziwiatr</surname>
<given-names>Michal</given-names>
</name>
<address><email>michal.pedziwiatr@uj.edu.pl</email>
</address>
<xref ref-type="aff" rid="Aff122">122</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Pereira</surname>
<given-names>Bruno M.</given-names>
</name>
<address><email>drbrunompereira@gmail.com</email>
</address>
<xref ref-type="aff" rid="Aff123">123</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Ponce-de-Leon</surname>
<given-names>Alfredo</given-names>
</name>
<address><email>alf.poncedeleon@gmail.com</email>
</address>
<xref ref-type="aff" rid="Aff124">124</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Poulakou</surname>
<given-names>Garyphallia</given-names>
</name>
<address><email>gpoulakou@gmail.com</email>
</address>
<xref ref-type="aff" rid="Aff125">125</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Preller</surname>
<given-names>Jacobus</given-names>
</name>
<address><email>kobus@preller.me.uk</email>
</address>
<xref ref-type="aff" rid="Aff126">126</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Pulcini</surname>
<given-names>Céline</given-names>
</name>
<address><email>celine.pulcini@univ-lorraine.fr</email>
</address>
<xref ref-type="aff" rid="Aff127">127</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Pupelis</surname>
<given-names>Guntars</given-names>
</name>
<address><email>aslimnicagp@gmail.com</email>
</address>
<xref ref-type="aff" rid="Aff128">128</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Quiodettis</surname>
<given-names>Martha</given-names>
</name>
<address><email>traumahst@gmail.com</email>
</address>
<xref ref-type="aff" rid="Aff129">129</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Rawson</surname>
<given-names>Timothy M.</given-names>
</name>
<address><email>timothy.rawson07@imperial.ac.uk</email>
</address>
<xref ref-type="aff" rid="Aff130">130</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Reis</surname>
<given-names>Tarcisio</given-names>
</name>
<address><email>tcr@hotlink.com.br</email>
</address>
<xref ref-type="aff" rid="Aff131">131</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Rems</surname>
<given-names>Miran</given-names>
</name>
<address><email>Miran.rems@sb-je.si</email>
</address>
<xref ref-type="aff" rid="Aff132">132</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Rizoli</surname>
<given-names>Sandro</given-names>
</name>
<address><email>rizolis@smh.ca</email>
</address>
<xref ref-type="aff" rid="Aff133">133</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Roberts</surname>
<given-names>Jason</given-names>
</name>
<address><email>j.roberts2@uq.edu.au</email>
</address>
<xref ref-type="aff" rid="Aff134">134</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Pereira</surname>
<given-names>Nuno Rocha</given-names>
</name>
<address><email>nunopereira85@gmail.com</email>
</address>
<xref ref-type="aff" rid="Aff23">23</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Rodríguez-Baño</surname>
<given-names>Jesús</given-names>
</name>
<address><email>jesusrb@us.es</email>
</address>
<xref ref-type="aff" rid="Aff135">135</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Sakakushev</surname>
<given-names>Boris</given-names>
</name>
<address><email>bsakakushev@gmail.com</email>
</address>
<xref ref-type="aff" rid="Aff136">136</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Sanders</surname>
<given-names>James</given-names>
</name>
<address><email>jsande02@jpshealth.org</email>
</address>
<xref ref-type="aff" rid="Aff137">137</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Santos</surname>
<given-names>Natalia</given-names>
</name>
<address><email>natybap@live.com.pt</email>
</address>
<xref ref-type="aff" rid="Aff138">138</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Sato</surname>
<given-names>Norio</given-names>
</name>
<address><email>drnori@kuhp.kyoto-u.ac.jp</email>
</address>
<xref ref-type="aff" rid="Aff139">139</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Sawyer</surname>
<given-names>Robert G.</given-names>
</name>
<address><email>rws2k@hscmail.mcc.virginia.edu</email>
</address>
<xref ref-type="aff" rid="Aff140">140</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Scarpelini</surname>
<given-names>Sandro</given-names>
</name>
<address><email>sandro@fmrp.usp.br</email>
</address>
<xref ref-type="aff" rid="Aff141">141</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Scoccia</surname>
<given-names>Loredana</given-names>
</name>
<address><email>Loredana.Scoccia@sanita.marche.it</email>
</address>
<xref ref-type="aff" rid="Aff142">142</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Shafiq</surname>
<given-names>Nusrat</given-names>
</name>
<address><email>nusha.pgi2302@yahoo.com</email>
</address>
<xref ref-type="aff" rid="Aff143">143</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Shelat</surname>
<given-names>Vishalkumar</given-names>
</name>
<address><email>Vishal_g_shelat@ttsh.com.sg</email>
</address>
<xref ref-type="aff" rid="Aff144">144</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Sifri</surname>
<given-names>Costi D.</given-names>
</name>
<address><email>csifri@virginia.edu</email>
</address>
<xref ref-type="aff" rid="Aff145">145</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Siribumrungwong</surname>
<given-names>Boonying</given-names>
</name>
<address><email>boonying22@gmail.com</email>
</address>
<xref ref-type="aff" rid="Aff146">146</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Søreide</surname>
<given-names>Kjetil</given-names>
</name>
<address><email>ksoreide@mac.com</email>
</address>
<xref ref-type="aff" rid="Aff147">147</xref>
<xref ref-type="aff" rid="Aff148">148</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Soto</surname>
<given-names>Rodolfo</given-names>
</name>
<address><email>rodolfo12@me.com</email>
</address>
<xref ref-type="aff" rid="Aff149">149</xref>
</contrib>
<contrib contrib-type="author"><name><surname>de Souza</surname>
<given-names>Hamilton P.</given-names>
</name>
<address><email>hpetrys@terra.com.br</email>
</address>
<xref ref-type="aff" rid="Aff150">150</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Talving</surname>
<given-names>Peep</given-names>
</name>
<address><email>Peep.Talving@regionaalhaigla.ee</email>
</address>
<xref ref-type="aff" rid="Aff151">151</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Trung</surname>
<given-names>Ngo Tat</given-names>
</name>
<address><email>tatrungngo@gmail.com</email>
</address>
<xref ref-type="aff" rid="Aff152">152</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Tessier</surname>
<given-names>Jeffrey M.</given-names>
</name>
<address><email>jmtessiermd@yahoo.com</email>
</address>
<xref ref-type="aff" rid="Aff153">153</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Tumbarello</surname>
<given-names>Mario</given-names>
</name>
<address><email>mario.tumbarello@unicatt.it</email>
</address>
<xref ref-type="aff" rid="Aff154">154</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Ulrych</surname>
<given-names>Jan</given-names>
</name>
<address><email>Jan.Ulrych@vfn.cz</email>
</address>
<xref ref-type="aff" rid="Aff155">155</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Uranues</surname>
<given-names>Selman</given-names>
</name>
<address><email>Selman.uranues@medunigraz.at</email>
</address>
<xref ref-type="aff" rid="Aff156">156</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Van Goor</surname>
<given-names>Harry</given-names>
</name>
<address><email>Harry.vangoor@radboudumc.nl</email>
</address>
<xref ref-type="aff" rid="Aff157">157</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Vereczkei</surname>
<given-names>Andras</given-names>
</name>
<address><email>vereczkei.andras@pte.hu</email>
</address>
<xref ref-type="aff" rid="Aff158">158</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Wagenlehner</surname>
<given-names>Florian</given-names>
</name>
<address><email>florian.wagenlehner@chiru.med.uni-giessen.de</email>
</address>
<xref ref-type="aff" rid="Aff159">159</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Xiao</surname>
<given-names>Yonghong</given-names>
</name>
<address><email>xiao-yonghong@163.com</email>
</address>
<xref ref-type="aff" rid="Aff160">160</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Yuan</surname>
<given-names>Kuo-Ching</given-names>
</name>
<address><email>traumayuan@gmail.com</email>
</address>
<xref ref-type="aff" rid="Aff161">161</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Wechsler-Fördös</surname>
<given-names>Agnes</given-names>
</name>
<address><email>agnes.wechsler-foerdoes@wienkav.at</email>
</address>
<xref ref-type="aff" rid="Aff162">162</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Zahar</surname>
<given-names>Jean-Ralph</given-names>
</name>
<address><email>jrzahar@gmail.com</email>
</address>
<xref ref-type="aff" rid="Aff163">163</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Zakrison</surname>
<given-names>Tanya L.</given-names>
</name>
<address><email>tzakrison@med.miami.edu</email>
</address>
<xref ref-type="aff" rid="Aff164">164</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Zuckerbraun</surname>
<given-names>Brian</given-names>
</name>
<address><email>zuckerbraunbs@upmc.edu</email>
</address>
<xref ref-type="aff" rid="Aff165">165</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Zuidema</surname>
<given-names>Wietse P.</given-names>
</name>
<address><email>w.zuidema@vumc.nl</email>
</address>
<xref ref-type="aff" rid="Aff166">166</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Catena</surname>
<given-names>Fausto</given-names>
</name>
<address><email>faustocatena@fgmail.com</email>
</address>
<xref ref-type="aff" rid="Aff167">167</xref>
</contrib>
<aff id="Aff1"><label>1</label>
Department of Surgery, Macerata Hospital, Macerata, Italy</aff>
<aff id="Aff2"><label>2</label>
<institution-wrap><institution-id institution-id-type="ISNI">0000 0001 1017 3210</institution-id>
<institution-id institution-id-type="GRID">grid.7010.6</institution-id>
<institution>Department of Biomedical Sciences and Public Health, Unit of Hygiene, Preventive Medicine and Public Health,</institution>
<institution>Università Politecnica delle Marche,</institution>
</institution-wrap>
Ancona, Italy</aff>
<aff id="Aff3"><label>3</label>
Infectious Diseases Unit, Bolzano Central Hospital, Bolzano, Italy</aff>
<aff id="Aff4"><label>4</label>
<institution-wrap><institution-id institution-id-type="ISNI"> 0000 0004 1757 8431</institution-id>
<institution-id institution-id-type="GRID">grid.460094.f</institution-id>
<institution>General Surgery Department,</institution>
<institution>Papa Giovanni XXIII Hospital,</institution>
</institution-wrap>
Bergamo, Italy</aff>
<aff id="Aff5"><label>5</label>
<institution-wrap><institution-id institution-id-type="ISNI">0000 0004 0634 9246</institution-id>
<institution-id institution-id-type="GRID">grid.415666.6</institution-id>
<institution>Department of Clinical microbiology, Ampath National Laboratory Services,</institution>
<institution>Milpark Hospital,</institution>
</institution-wrap>
Johannesburg, South Africa</aff>
<aff id="Aff6"><label>6</label>
<institution-wrap><institution-id institution-id-type="ISNI">0000 0004 1937 1151</institution-id>
<institution-id institution-id-type="GRID">grid.7836.a</institution-id>
<institution>Division of Infectious Diseases and HIV Medicine, Department of Medicine,</institution>
<institution>University of Cape Town,</institution>
</institution-wrap>
Cape town, South Africa</aff>
<aff id="Aff7"><label>7</label>
World Alliance against Antibiotics Resistance, Rome, Italy</aff>
<aff id="Aff8"><label>8</label>
<institution-wrap><institution-id institution-id-type="ISNI">0000 0001 0675 4725</institution-id>
<institution-id institution-id-type="GRID">grid.239578.2</institution-id>
<institution>Center for Critical Care, Anaesthesiology Institute and Department of Outcomes Research,</institution>
<institution>Cleveland Clinic,</institution>
</institution-wrap>
Cleveland, OH USA</aff>
<aff id="Aff9"><label>9</label>
Department of Surgery and Obstetrics/Gynaecology, Regional Hospital, Limbe, Cameroon</aff>
<aff id="Aff10"><label>10</label>
<institution-wrap><institution-id institution-id-type="GRID">grid.414614.2</institution-id>
<institution>Department of Surgery,</institution>
<institution>Infermi Hospital,</institution>
</institution-wrap>
Rimini, Italy</aff>
<aff id="Aff11"><label>11</label>
<institution-wrap><institution-id institution-id-type="ISNI">0000 0004 1759 7093</institution-id>
<institution-id institution-id-type="GRID">grid.416290.8</institution-id>
<institution>Department of Surgery,</institution>
<institution>Maggiore Hospital,</institution>
</institution-wrap>
Bologna, Italy</aff>
<aff id="Aff12"><label>12</label>
<institution-wrap><institution-id institution-id-type="ISNI">0000 0004 1936 9916</institution-id>
<institution-id institution-id-type="GRID">grid.412807.8</institution-id>
<institution>Department of Surgery,</institution>
<institution>Vanderbilt University Medical Center,</institution>
</institution-wrap>
Nashville, Tennessee USA</aff>
<aff id="Aff13"><label>13</label>
Infectious Diseases Unit, Department of Medical and Surgical Sciences, Sant’Orsola Hospital, University of Bologna, Bologna, Italy</aff>
<aff id="Aff14"><label>14</label>
<institution-wrap><institution-id institution-id-type="ISNI">0000 0001 0675 4725</institution-id>
<institution-id institution-id-type="GRID">grid.239578.2</institution-id>
<institution>Division of Infectious Diseases,</institution>
<institution>Cleveland Clinic Akron General,</institution>
</institution-wrap>
Akron, OH USA</aff>
<aff id="Aff15"><label>15</label>
<institution-wrap><institution-id institution-id-type="ISNI">0000 0004 0459 7529</institution-id>
<institution-id institution-id-type="GRID">grid.261103.7</institution-id>
<institution>Department of Medicine,</institution>
<institution>Northeast Ohio Medical University,</institution>
</institution-wrap>
Rootstown, OH USA</aff>
<aff id="Aff16"><label>16</label>
<institution-wrap><institution-id institution-id-type="ISNI">0000 0004 1760 3027</institution-id>
<institution-id institution-id-type="GRID">grid.419425.f</institution-id>
<institution></institution>
<institution>Clinical Epidemiology Unit, IRCCS Policlinico San Matteo Foundation,</institution>
</institution-wrap>
Pavia, Italy</aff>
<aff id="Aff17"><label>17</label>
<institution-wrap><institution-id institution-id-type="ISNI">0000 0004 1936 8606</institution-id>
<institution-id institution-id-type="GRID">grid.26790.3a</institution-id>
<institution>Division of Infectious Diseases, Jackson Health System,</institution>
<institution>University of Miami Miller School of Medicine,</institution>
</institution-wrap>
Miami, FL USA</aff>
<aff id="Aff18"><label>18</label>
<institution-wrap><institution-id institution-id-type="ISNI">0000 0001 2193 6666</institution-id>
<institution-id institution-id-type="GRID">grid.43519.3a</institution-id>
<institution>Department of Surgery, College of Medicine and Health Sciences,</institution>
<institution>UAE University,</institution>
</institution-wrap>
Al-Ain, United Arab Emirates</aff>
<aff id="Aff19"><label>19</label>
<institution-wrap><institution-id institution-id-type="ISNI">0000 0001 2183 9444</institution-id>
<institution-id institution-id-type="GRID">grid.10824.3f</institution-id>
<institution>Department of Surgery, College of Health Sciences,</institution>
<institution>Obafemi Awolowo University,</institution>
</institution-wrap>
Ile-Ife, Nigeria</aff>
<aff id="Aff20"><label>20</label>
<institution-wrap><institution-id institution-id-type="ISNI">0000 0000 9679 3586</institution-id>
<institution-id institution-id-type="GRID">grid.268355.f</institution-id>
<institution>Division of Clinical and Administrative Sciences, College of Pharmacy,</institution>
<institution>Xavier University of Louisiana,</institution>
</institution-wrap>
New Orleans, LA USA</aff>
<aff id="Aff21"><label>21</label>
<institution-wrap><institution-id institution-id-type="ISNI">0000 0000 9075 106X</institution-id>
<institution-id institution-id-type="GRID">grid.254567.7</institution-id>
<institution>Department of Medicine, Division of Infectious Diseases,</institution>
<institution>University of South Carolina School of Medicine,</institution>
</institution-wrap>
Columbia, SC USA</aff>
<aff id="Aff22"><label>22</label>
<institution-wrap><institution-id institution-id-type="ISNI">0000 0004 0419 1043</institution-id>
<institution-id institution-id-type="GRID">grid.414177.0</institution-id>
<institution>General Surgery Department,</institution>
<institution>Bakirkoy Dr Sadi Konuk Training and Research Hospital,</institution>
</institution-wrap>
Instanbul, Turkey</aff>
<aff id="Aff23"><label>23</label>
<institution-wrap><institution-id institution-id-type="ISNI">0000 0000 9375 4688</institution-id>
<institution-id institution-id-type="GRID">grid.414556.7</institution-id>
<institution>Unit of Prevention and Infection Control, Center of Hospital Epidemiology,</institution>
<institution>São João Hospital Centre,</institution>
</institution-wrap>
Porto, Portugal</aff>
<aff id="Aff24"><label>24</label>
Infection Control Committee, Prontobaby Hospital da Criança, Rio de Janeiro, Brazil</aff>
<aff id="Aff25"><label>25</label>
<institution-wrap><institution-id institution-id-type="ISNI">0000 0004 0397 9648</institution-id>
<institution-id institution-id-type="GRID">grid.412688.1</institution-id>
<institution>Department of Surgery,</institution>
<institution>University Hospital Center,</institution>
</institution-wrap>
Zagreb, Croatia</aff>
<aff id="Aff26"><label>26</label>
<institution-wrap><institution-id institution-id-type="ISNI">0000 0001 2221 2926</institution-id>
<institution-id institution-id-type="GRID">grid.17788.31</institution-id>
<institution>Trauma and Acute Care Surgery Unit,</institution>
<institution>Hadassah Hebrew University Medical Center,</institution>
</institution-wrap>
Jerusalem, Israel</aff>
<aff id="Aff27"><label>27</label>
<institution-wrap><institution-id institution-id-type="ISNI">000000041936877X</institution-id>
<institution-id institution-id-type="GRID">grid.5386.8</institution-id>
<institution>Department of Surgery,</institution>
<institution>Weill Cornell Medicine,</institution>
</institution-wrap>
New York, NY USA</aff>
<aff id="Aff28"><label>28</label>
Department of General Surgery, Hospital San Juan de Dios de La Serena, La Serena, Chile</aff>
<aff id="Aff29"><label>29</label>
<institution-wrap><institution-id institution-id-type="ISNI">0000 0001 2177 007X</institution-id>
<institution-id institution-id-type="GRID">grid.415490.d</institution-id>
<institution>Academic Department of Surgery,</institution>
<institution>Queen Elizabeth Hospital,</institution>
</institution-wrap>
Birmingham, UK</aff>
<aff id="Aff30"><label>30</label>
Department of Microbiology National Reference Laboratory Cheikh Khalifa Ibn Zaid Hospital, Mohammed 6th University of Health Sciences, Casablanca, Morocco</aff>
<aff id="Aff31"><label>31</label>
<institution-wrap><institution-id institution-id-type="ISNI">0000 0004 4657 1992</institution-id>
<institution-id institution-id-type="GRID">grid.410370.1</institution-id>
<institution>Department of Pathology and Laboratory Medicine,</institution>
<institution>VA Boston HealthCare System,</institution>
</institution-wrap>
Boston, MA USA</aff>
<aff id="Aff32"><label>32</label>
<institution-wrap><institution-id institution-id-type="ISNI">0000 0004 0367 5222</institution-id>
<institution-id institution-id-type="GRID">grid.475010.7</institution-id>
<institution>Department of Pathology and Laboratory Medicine,</institution>
<institution>Boston University School of Medicine,</institution>
</institution-wrap>
Boston, MA USA</aff>
<aff id="Aff33"><label>33</label>
<institution-wrap><institution-id institution-id-type="ISNI">0000 0000 8816 6945</institution-id>
<institution-id institution-id-type="GRID">grid.411048.8</institution-id>
<institution>Department of Surgery,</institution>
<institution>Hospital Clínico Universitario,</institution>
</institution-wrap>
Santiago de Compostela, Spain</aff>
<aff id="Aff34"><label>34</label>
<institution-wrap><institution-id institution-id-type="ISNI">0000 0004 1760 058X</institution-id>
<institution-id institution-id-type="GRID">grid.464574.0</institution-id>
<institution>Hospital Epidemiology and Infectious Diseases,</institution>
<institution>Hospital Universitario Dr Jose Eleuterio Gonzalez,</institution>
</institution-wrap>
Monterrey, Mexico</aff>
<aff id="Aff35"><label>35</label>
<institution-wrap><institution-id institution-id-type="GRID">grid.417007.5</institution-id>
<institution>Department of Emergency,</institution>
<institution>Umberto I Hospital,</institution>
</institution-wrap>
Rome, Italy</aff>
<aff id="Aff36"><label>36</label>
<institution-wrap><institution-id institution-id-type="ISNI">0000 0004 1781 1790</institution-id>
<institution-id institution-id-type="GRID">grid.448741.a</institution-id>
<institution>Department of Pharmacology,</institution>
<institution>Pushpagiri Institute of Medical Sciences and Research Centre,</institution>
</institution-wrap>
Thiruvalla, Kerala India</aff>
<aff id="Aff37"><label>37</label>
Department of General Surgery, Kuala Krai Hospital, Kuala Krai, Kelantan Malaysia</aff>
<aff id="Aff38"><label>38</label>
<institution-wrap><institution-id institution-id-type="ISNI">0000000086837370</institution-id>
<institution-id institution-id-type="GRID">grid.214458.e</institution-id>
<institution>Division of Acute Care Surgery, Department of Surgery,</institution>
<institution>University of Michigan,</institution>
</institution-wrap>
Ann Arbor, MI USA</aff>
<aff id="Aff39"><label>39</label>
<institution-wrap><institution-id institution-id-type="GRID">grid.416200.1</institution-id>
<institution></institution>
<institution>Niguarda Hospital,</institution>
</institution-wrap>
Milano, Italy</aff>
<aff id="Aff40"><label>40</label>
Department of General Surgery, Health Sciences University, Samsun Training and Research Hospital, Samsun, Turkey</aff>
<aff id="Aff41"><label>41</label>
<institution-wrap><institution-id institution-id-type="ISNI">0000 0000 8580 3777</institution-id>
<institution-id institution-id-type="GRID">grid.6190.e</institution-id>
<institution>Department of Internal Medicine and Infectious Diseases,</institution>
<institution>University of Cologne,</institution>
</institution-wrap>
Cologne, Germany</aff>
<aff id="Aff42"><label>42</label>
<institution-wrap><institution-id institution-id-type="ISNI">0000 0000 9792 1228</institution-id>
<institution-id institution-id-type="GRID">grid.265021.2</institution-id>
<institution>Department of Surgery, Tianjin Nankai Hospital, Nankai Clinical School of Medicine,</institution>
<institution>Tianjin Medical University,</institution>
</institution-wrap>
Tianjin, China</aff>
<aff id="Aff43"><label>43</label>
Department General Surgery, Kipshidze Central University Hospital, Tbilisi, Georgia</aff>
<aff id="Aff44"><label>44</label>
<institution-wrap><institution-id institution-id-type="ISNI">0000 0004 1795 3510</institution-id>
<institution-id institution-id-type="GRID">grid.418062.9</institution-id>
<institution>Department of Digestive Surgery,</institution>
<institution>Cannes Hospital,</institution>
</institution-wrap>
Cannes, France</aff>
<aff id="Aff45"><label>45</label>
<institution-wrap><institution-id institution-id-type="ISNI">0000 0004 0626 3303</institution-id>
<institution-id institution-id-type="GRID">grid.410566.0</institution-id>
<institution>Department of Critical Care Medicine,</institution>
<institution>Ghent University Hospital,</institution>
</institution-wrap>
Ghent, Belgium</aff>
<aff id="Aff46"><label>46</label>
<institution-wrap><institution-id institution-id-type="GRID">grid.430529.9</institution-id>
<institution>School of Pharmacy, Faculty of Medical Sciences,</institution>
<institution>The University of the West Indies,</institution>
</institution-wrap>
St. Augustine, Trinidad and Tobago</aff>
<aff id="Aff47"><label>47</label>
Eric Williams Medical Sciences Complex, Uriah Butler Highway, Champ Fleurs, Trinidad and Tobago</aff>
<aff id="Aff48"><label>48</label>
Department of Surgery, Versilia Hospita, Lido di Camaiore, Italy</aff>
<aff id="Aff49"><label>49</label>
Department of Surgery, University Hospital of Trauma, Tirana, Albania</aff>
<aff id="Aff50"><label>50</label>
<institution-wrap><institution-id institution-id-type="GRID">grid.444534.6</institution-id>
<institution>School of Pharmacy and Biomedicine,</institution>
<institution>Mongolian National University of Medical Sciences,</institution>
</institution-wrap>
Ulaanbaatar, Mongolia</aff>
<aff id="Aff51"><label>51</label>
<institution-wrap><institution-id institution-id-type="ISNI">0000 0001 2171 2558</institution-id>
<institution-id institution-id-type="GRID">grid.5842.b</institution-id>
<institution>Department of Microbiology, Bicêtre Hospital,</institution>
<institution>Paris-Sud University,</institution>
</institution-wrap>
La Kremlin-Bicêtre, France</aff>
<aff id="Aff52"><label>52</label>
Department of Surgery, John Peter Smith Health Network, Fort Worth, Texas USA</aff>
<aff id="Aff53"><label>53</label>
<institution-wrap><institution-id institution-id-type="GRID">grid.414827.c</institution-id>
<institution>Sudan National Public Health Laboratory,</institution>
<institution>Federal Ministry of Health,</institution>
</institution-wrap>
Khartoum, Sudan</aff>
<aff id="Aff54"><label>54</label>
<institution-wrap><institution-id institution-id-type="ISNI">0000 0004 0593 1832</institution-id>
<institution-id institution-id-type="GRID">grid.415277.2</institution-id>
<institution>Department of Medicine, Infectious Disease Division,</institution>
<institution>King Fahad Medical City,</institution>
</institution-wrap>
Riyadh, Saudi Arabia</aff>
<aff id="Aff55"><label>55</label>
<institution-wrap><institution-id institution-id-type="ISNI">0000 0004 0458 8737</institution-id>
<institution-id institution-id-type="GRID">grid.224260.0</institution-id>
<institution>Department of Surgery,</institution>
<institution>Virginia Commonwealth University,</institution>
</institution-wrap>
Richmond, VA USA</aff>
<aff id="Aff56"><label>56</label>
Department of Surgery, Clinica Foianini, Santa Cruz, Bolivia</aff>
<aff id="Aff57"><label>57</label>
Department of Abdominal Surgery, Vladimir City Clinical Hospital of Emergency Medicine, Vladimir, Russia</aff>
<aff id="Aff58"><label>58</label>
Department of Surgery, Bharati Vidyapeeth Deemed University Medical College and Hospital, Sangli, Maharashtra India</aff>
<aff id="Aff59"><label>59</label>
<institution-wrap><institution-id institution-id-type="ISNI">0000000103426662</institution-id>
<institution-id institution-id-type="GRID">grid.10251.37</institution-id>
<institution>Department of General Surgery, Mansoura Faculty of Medicine,</institution>
<institution>Mansoura University,</institution>
</institution-wrap>
Mansoura, Egypt</aff>
<aff id="Aff60"><label>60</label>
<institution-wrap><institution-id institution-id-type="GRID">grid.414012.2</institution-id>
<institution>Sixth Department of Internal Medicine,</institution>
<institution>Hygeia General Hospital,</institution>
</institution-wrap>
Athens, Greece</aff>
<aff id="Aff61"><label>61</label>
<institution-wrap><institution-id institution-id-type="ISNI">0000 0001 2155 0800</institution-id>
<institution-id institution-id-type="GRID">grid.5216.0</institution-id>
<institution>Second Department of Surgery,</institution>
<institution>Aretaieion University Hospital, National and Kapodistrian University of Athens,</institution>
</institution-wrap>
Athens, Greece</aff>
<aff id="Aff62"><label>62</label>
<institution-wrap><institution-id institution-id-type="ISNI">0000 0001 2369 4728</institution-id>
<institution-id institution-id-type="GRID">grid.20515.33</institution-id>
<institution>Center for Global Health, Mito Kyodo General Hospital,</institution>
<institution>University of Tsukuba,</institution>
</institution-wrap>
Mito, Ibaraki Japan</aff>
<aff id="Aff63"><label>63</label>
University Department for Tumours, Sestre Milosrrdnice UHC, Zagreb, Croatia</aff>
<aff id="Aff64"><label>64</label>
<institution-wrap><institution-id institution-id-type="ISNI">0000 0001 2177 007X</institution-id>
<institution-id institution-id-type="GRID">grid.415490.d</institution-id>
<institution>General and Upper GI Surgery,</institution>
<institution>Queen Elizabeth Hospital,</institution>
</institution-wrap>
Birmingham, UK</aff>
<aff id="Aff65"><label>65</label>
Peruvian Navy Medical Center, Lima, Peru</aff>
<aff id="Aff66"><label>66</label>
<institution-wrap><institution-id institution-id-type="ISNI">0000 0001 2198 9354</institution-id>
<institution-id institution-id-type="GRID">grid.415169.e</institution-id>
<institution>Department of Gastrointestinal Surgery,</institution>
<institution>Santa Casa Hospital,</institution>
</institution-wrap>
Campo Grande, Brazil</aff>
<aff id="Aff67"><label>67</label>
<institution-wrap><institution-id institution-id-type="ISNI">0000 0001 0723 4123</institution-id>
<institution-id institution-id-type="GRID">grid.16463.36</institution-id>
<institution>Trauma and Trauma ICU, Inkosi Albert Luthuli Central Hospital and Department of Surgery,</institution>
<institution>University of KwaZulu-Natal,</institution>
</institution-wrap>
Durban, South Africa</aff>
<aff id="Aff68"><label>68</label>
<institution-wrap><institution-id institution-id-type="ISNI">0000 0000 8584 9230</institution-id>
<institution-id institution-id-type="GRID">grid.411067.5</institution-id>
<institution>Department of General and Thoracic Surgery,</institution>
<institution>University Hospital Giessen,</institution>
</institution-wrap>
Giessen, Germany</aff>
<aff id="Aff69"><label>69</label>
<institution-wrap><institution-id institution-id-type="GRID">grid.440525.2</institution-id>
<institution>Department of Surgery, Faculty of Medicine,</institution>
<institution>University of Parakou,</institution>
</institution-wrap>
BP 123 Parakou, Benin</aff>
<aff id="Aff70"><label>70</label>
<institution-wrap><institution-id institution-id-type="ISNI">0000000109457005</institution-id>
<institution-id institution-id-type="GRID">grid.4793.9</institution-id>
<institution>Fourth Surgical Department, General Hospital G. Papanikolaou, Medical School,</institution>
<institution>Aristotle University of Thessaloniki,</institution>
</institution-wrap>
Thessaloniki, Greece</aff>
<aff id="Aff71"><label>71</label>
<institution-wrap><institution-id institution-id-type="ISNI">0000 0001 1498 7262</institution-id>
<institution-id institution-id-type="GRID">grid.412176.7</institution-id>
<institution>Department of General Surgery,</institution>
<institution>Erzincan University, Faculty of Medicine,</institution>
</institution-wrap>
Erzincan, Turkey</aff>
<aff id="Aff72"><label>72</label>
Department of Pharmacy, Lebanese, International University, Beirut, Lebanon</aff>
<aff id="Aff73"><label>73</label>
<institution-wrap><institution-id institution-id-type="ISNI">0000 0001 2174 8913</institution-id>
<institution-id institution-id-type="GRID">grid.412888.f</institution-id>
<institution>Drug Applied Research Center,</institution>
<institution>Tabriz University of Medical Sciences,</institution>
</institution-wrap>
Tabriz, Iran</aff>
<aff id="Aff74"><label>74</label>
<institution-wrap><institution-id institution-id-type="ISNI">0000 0004 1936 9801</institution-id>
<institution-id institution-id-type="GRID">grid.22903.3a</institution-id>
<institution>Division of Infectious Diseases,</institution>
<institution>American University of Beirut,</institution>
</institution-wrap>
Beirut, Lebanon</aff>
<aff id="Aff75"><label>75</label>
<institution-wrap><institution-id institution-id-type="ISNI">0000 0004 1936 8972</institution-id>
<institution-id institution-id-type="GRID">grid.25879.31</institution-id>
<institution>Department of Surgery Philadelphia VA Medical Center, Perelman School of Medicine,</institution>
<institution>University of Pennsylvania,</institution>
</institution-wrap>
Philadelphia, PA USA</aff>
<aff id="Aff76"><label>76</label>
<institution-wrap><institution-id institution-id-type="GRID">grid.415285.f</institution-id>
<institution>Department of Microbiology,</institution>
<institution>Gandhi Medical College,</institution>
</institution-wrap>
Bhopal, India</aff>
<aff id="Aff77"><label>77</label>
<institution-wrap><institution-id institution-id-type="ISNI">0000 0001 2166 9385</institution-id>
<institution-id institution-id-type="GRID">grid.7149.b</institution-id>
<institution></institution>
<institution>Clinic for Emergency Surgery, Medical Faculty University of Belgrade,</institution>
</institution-wrap>
Belgrade, Serbia</aff>
<aff id="Aff78"><label>78</label>
<institution-wrap><institution-id institution-id-type="ISNI">0000 0001 2162 9631</institution-id>
<institution-id institution-id-type="GRID">grid.5522.0</institution-id>
<institution>Third Department of General Surgery,</institution>
<institution>Jagiellonian University Medical College,</institution>
</institution-wrap>
Krakow, Poland</aff>
<aff id="Aff79"><label>79</label>
Department of Abdominal Surgery, Regional Hospital of Tienen, Tienen, Belgium</aff>
<aff id="Aff80"><label>80</label>
<institution-wrap><institution-id institution-id-type="ISNI">0000 0004 1772 5665</institution-id>
<institution-id institution-id-type="GRID">grid.416132.3</institution-id>
<institution>Department of Internal Medicine,</institution>
<institution>Royal Hospital,</institution>
</institution-wrap>
Muscat, Oman</aff>
<aff id="Aff81"><label>81</label>
Department of Emergency Surgery, City Hospital, Mozyr, Belarus</aff>
<aff id="Aff82"><label>82</label>
<institution-wrap><institution-id institution-id-type="ISNI">0000 0004 0620 0548</institution-id>
<institution-id institution-id-type="GRID">grid.11194.3c</institution-id>
<institution>Department of Pharmacology and Therapeutics, College of Health Sciences,</institution>
<institution>Makerere University,</institution>
</institution-wrap>
Kampala, Uganda</aff>
<aff id="Aff83"><label>83</label>
<institution-wrap><institution-id institution-id-type="ISNI">0000 0004 0647 3378</institution-id>
<institution-id institution-id-type="GRID">grid.412480.b</institution-id>
<institution>Department of Internal Medicine,</institution>
<institution>Seoul National University Bundang Hospital,</institution>
</institution-wrap>
Seongnam, Republic of Korea</aff>
<aff id="Aff84"><label>84</label>
<institution-wrap><institution-id institution-id-type="ISNI">0000 0004 0639 0054</institution-id>
<institution-id institution-id-type="GRID">grid.412040.3</institution-id>
<institution>Department of Internal Medicine,</institution>
<institution>National Cheng Kung University Hospital,</institution>
</institution-wrap>
Tainan, Taiwan</aff>
<aff id="Aff85"><label>85</label>
<institution-wrap><institution-id institution-id-type="ISNI">0000 0004 0372 2033</institution-id>
<institution-id institution-id-type="GRID">grid.258799.8</institution-id>
<institution>Department of Primary Care and Emergency Medicine,</institution>
<institution>Kyoto University Graduate School of Medicine,</institution>
</institution-wrap>
Kyoto, Japan</aff>
<aff id="Aff86"><label>86</label>
Department of Surgery n. 2, Higher educational institutions of Ukraine Bukovina State Medical University, Chernivtci City, Ukraine</aff>
<aff id="Aff87"><label>87</label>
<institution-wrap><institution-id institution-id-type="ISNI">0000 0004 1936 9609</institution-id>
<institution-id institution-id-type="GRID">grid.21613.37</institution-id>
<institution>Section of Critical Care Medicine and Section of Infectious Diseases, Department of Medicine, Medical Microbiology and Pharmacology/Therapeutics,</institution>
<institution>University of Manitoba,</institution>
</institution-wrap>
Winnipeg, MB Canada</aff>
<aff id="Aff88"><label>88</label>
<institution-wrap><institution-id institution-id-type="ISNI">0000 0004 0633 6808</institution-id>
<institution-id institution-id-type="GRID">grid.414410.4</institution-id>
<institution></institution>
<institution>Hospital Central Dr Ignacio Morones Prieto,</institution>
</institution-wrap>
San Luis Potosi, Mexico</aff>
<aff id="Aff89"><label>89</label>
<institution-wrap><institution-id institution-id-type="ISNI">0000 0001 2168 186X</institution-id>
<institution-id institution-id-type="GRID">grid.134563.6</institution-id>
<institution>Department of Surgery, Division of Trauma,</institution>
<institution>University of Arizona,</institution>
</institution-wrap>
Tucson, AZ USA</aff>
<aff id="Aff90"><label>90</label>
<institution-wrap><institution-id institution-id-type="ISNI">0000 0004 0470 5454</institution-id>
<institution-id institution-id-type="GRID">grid.15444.30</institution-id>
<institution>Department of Surgery,</institution>
<institution>Yonsei University College of Medicine,</institution>
</institution-wrap>
Seoul, South Korea</aff>
<aff id="Aff91"><label>91</label>
<institution-wrap><institution-id institution-id-type="GRID">grid.449754.f</institution-id>
<institution></institution>
<institution>Texas Tech University, Health Sciences Center School of Pharmacy,</institution>
</institution-wrap>
Abilene, TX USA</aff>
<aff id="Aff92"><label>92</label>
Abdominal Center, University Hospital Meilahti, Helsinki, Finland</aff>
<aff id="Aff93"><label>93</label>
<institution-wrap><institution-id institution-id-type="ISNI">0000 0001 2314 964X</institution-id>
<institution-id institution-id-type="GRID">grid.41156.37</institution-id>
<institution>Department of Surgery, Inling Hospital,</institution>
<institution>Nanjing University School of Medicine,</institution>
</institution-wrap>
Nanjing, China</aff>
<aff id="Aff94"><label>94</label>
<institution-wrap><institution-id institution-id-type="ISNI">0000 0001 2355 7002</institution-id>
<institution-id institution-id-type="GRID">grid.4367.6</institution-id>
<institution>Division of Infectious Diseases, Division of Emergency Medicine,</institution>
<institution>Washington University School of Medicine,</institution>
</institution-wrap>
St. Louis, MO USA</aff>
<aff id="Aff95"><label>95</label>
<institution-wrap><institution-id institution-id-type="ISNI">0000 0004 1937 1135</institution-id>
<institution-id institution-id-type="GRID">grid.11951.3d</institution-id>
<institution>Clinical Microbiology and Infectious Diseases, School of Pathology, Faculty of Health Sciences,</institution>
<institution>University of the Witwatersrand,</institution>
</institution-wrap>
Johannesburg, South Africa</aff>
<aff id="Aff96"><label>96</label>
<institution-wrap><institution-id institution-id-type="ISNI">0000 0001 2289 5077</institution-id>
<institution-id institution-id-type="GRID">grid.412213.7</institution-id>
<institution>Department of Surgery,</institution>
<institution>Universidad Nacional de Asuncion,</institution>
</institution-wrap>
Asuncion, Paraguay</aff>
<aff id="Aff97"><label>97</label>
<institution-wrap><institution-id institution-id-type="ISNI">0000 0000 9024 6397</institution-id>
<institution-id institution-id-type="GRID">grid.412581.b</institution-id>
<institution>Department for Traumatology and Orthopedic Surgery, Cologne Merheim Medical Center (CMMC),</institution>
<institution>University of Witten/Herdecke (UW/H),</institution>
</institution-wrap>
Cologne, Germany</aff>
<aff id="Aff98"><label>98</label>
<institution-wrap><institution-id institution-id-type="ISNI">0000 0001 2162 9631</institution-id>
<institution-id institution-id-type="GRID">grid.5522.0</institution-id>
<institution>Second Department of General Surgery,</institution>
<institution>Jagiellonian University Medical College,</institution>
</institution-wrap>
Krakow, Poland</aff>
<aff id="Aff99"><label>99</label>
<institution-wrap><institution-id institution-id-type="ISNI">0000 0000 8914 5257</institution-id>
<institution-id institution-id-type="GRID">grid.12984.36</institution-id>
<institution>Health Research Program, Institute of Economic and Social Research,</institution>
<institution>University of Zambia,</institution>
</institution-wrap>
Lusaka, Zambia</aff>
<aff id="Aff100"><label>100</label>
<institution-wrap><institution-id institution-id-type="GRID">grid.477264.4</institution-id>
<institution></institution>
<institution>Clinical Research Center, Fundacion Valle del Lili,</institution>
</institution-wrap>
Cali, Colombia</aff>
<aff id="Aff101"><label>101</label>
<institution-wrap><institution-id institution-id-type="GRID">grid.417374.2</institution-id>
<institution>First Department of Surgery,</institution>
<institution>Tzaneion General Hospital,</institution>
</institution-wrap>
Piraeus, Greece</aff>
<aff id="Aff102"><label>102</label>
Service of General Surgery, Hospital Complex of Jaén, Jaén, Spain</aff>
<aff id="Aff103"><label>103</label>
<institution-wrap><institution-id institution-id-type="ISNI">0000 0004 1771 1642</institution-id>
<institution-id institution-id-type="GRID">grid.412572.7</institution-id>
<institution>Department of Surgery,</institution>
<institution>Post-Graduate Institute of Medical Sciences,</institution>
</institution-wrap>
Rohtak, India</aff>
<aff id="Aff104"><label>104</label>
Servicio de Anestesia y Reanimación, Hospital Universitario La Paz Madrid, Madrid, Spain</aff>
<aff id="Aff105"><label>105</label>
<institution-wrap><institution-id institution-id-type="ISNI">0000 0004 0500 5353</institution-id>
<institution-id institution-id-type="GRID">grid.412963.b</institution-id>
<institution>Department of Surgery, Radiology,</institution>
<institution>University Hospital of the West Indies,</institution>
</institution-wrap>
Kingston, Jamaica</aff>
<aff id="Aff106"><label>106</label>
<institution-wrap><institution-id institution-id-type="GRID">grid.415696.9</institution-id>
<institution>Infectious Diseases Division, Department of Medicine,</institution>
<institution>Prince Mohamed Bin Abdulaziz Hospital, Ministry of Health,</institution>
</institution-wrap>
Riyadh, Saudi Arabia</aff>
<aff id="Aff107"><label>107</label>
<institution-wrap><institution-id institution-id-type="ISNI">0000 0004 1936 8227</institution-id>
<institution-id institution-id-type="GRID">grid.25073.33</institution-id>
<institution>Departments of Medicine, Clinical Epidemiology and Biostatistics, and Pathology and Molecular Medicine,</institution>
<institution>McMaster University,</institution>
</institution-wrap>
Hamilton, ON Canada</aff>
<aff id="Aff108"><label>108</label>
Second Surgical Clinic, Emergency Hospital of Craiova, Craiova, Romania</aff>
<aff id="Aff109"><label>109</label>
Department of Microbiology, Tribhuvan University Teaching Hospital, Institute of Medicine, Kathmandu, Nepal</aff>
<aff id="Aff110"><label>110</label>
Department of Surgery, University of Colorado, Denver Health Medical Center, Denver, CO USA</aff>
<aff id="Aff111"><label>111</label>
Department of Surgery, Onandjokwe Hospital, Ondangwa, Namibia</aff>
<aff id="Aff112"><label>112</label>
<institution-wrap><institution-id institution-id-type="ISNI">0000 0004 1936 9094</institution-id>
<institution-id institution-id-type="GRID">grid.40263.33</institution-id>
<institution>Infectious Diseases Division,</institution>
<institution>Warren Alpert Medical School of Brown University, Rhode Island Hospital,</institution>
</institution-wrap>
Providence, RI USA</aff>
<aff id="Aff113"><label>113</label>
<institution-wrap><institution-id institution-id-type="ISNI">0000000086837370</institution-id>
<institution-id institution-id-type="GRID">grid.214458.e</institution-id>
<institution>Department of Surgery,</institution>
<institution>University of Michigan,</institution>
</institution-wrap>
Ann Arbor, MI USA</aff>
<aff id="Aff114"><label>114</label>
Department of Surgery, Emergency Hospital of Bucharest, Bucharest, Romania</aff>
<aff id="Aff115"><label>115</label>
<institution-wrap><institution-id institution-id-type="ISNI">0000 0004 0517 2741</institution-id>
<institution-id institution-id-type="GRID">grid.418653.d</institution-id>
<institution></institution>
<institution>Clinic for General Surgery, Clinical Centre,</institution>
</institution-wrap>
Nis, Serbia</aff>
<aff id="Aff116"><label>116</label>
Center of Anti-Infective Research and Development, Hartford, CT USA</aff>
<aff id="Aff117"><label>117</label>
<institution-wrap><institution-id institution-id-type="ISNI">0000 0004 0411 3985</institution-id>
<institution-id institution-id-type="GRID">grid.460946.9</institution-id>
<institution>Department of Surgery,</institution>
<institution>King Abdullah University Hospital,</institution>
</institution-wrap>
Irbid, Jordan</aff>
<aff id="Aff118"><label>118</label>
<institution-wrap><institution-id institution-id-type="ISNI">0000 0001 2295 7397</institution-id>
<institution-id institution-id-type="GRID">grid.8271.c</institution-id>
<institution>Department of Surgery and Critical Care,</institution>
<institution>Universidad del Valle, Fundación Valle del Lili,</institution>
</institution-wrap>
Cali, Colombia</aff>
<aff id="Aff119"><label>119</label>
<institution-wrap><institution-id institution-id-type="ISNI">0000 0001 1503 7226</institution-id>
<institution-id institution-id-type="GRID">grid.5808.5</institution-id>
<institution>Intensive Care Medicine Department,</institution>
<institution>Centro Hospitalar São João, University of Porto,</institution>
</institution-wrap>
Porto, Portugal</aff>
<aff id="Aff120"><label>120</label>
<institution-wrap><institution-id institution-id-type="GRID">grid.461024.5</institution-id>
<institution>Department of Microbiology,</institution>
<institution>Grande International Hospital,</institution>
</institution-wrap>
Dhapasi, Kathmandu, Nepal</aff>
<aff id="Aff121"><label>121</label>
<institution-wrap><institution-id institution-id-type="ISNI">0000 0004 0576 9812</institution-id>
<institution-id institution-id-type="GRID">grid.419014.9</institution-id>
<institution>Department of Surgery,</institution>
<institution>Santa Casa de Sao Paulo School of Medical Sciences,</institution>
</institution-wrap>
São Paulo, Brazil</aff>
<aff id="Aff122"><label>122</label>
<institution-wrap><institution-id institution-id-type="ISNI">0000 0001 1216 0093</institution-id>
<institution-id institution-id-type="GRID">grid.412700.0</institution-id>
<institution>Department of General and Emergency Surgery,</institution>
<institution>University Hospital Kraków,</institution>
</institution-wrap>
Kraków, Poland</aff>
<aff id="Aff123"><label>123</label>
<institution-wrap><institution-id institution-id-type="ISNI">0000 0001 0723 2494</institution-id>
<institution-id institution-id-type="GRID">grid.411087.b</institution-id>
<institution>Department of Surgery,</institution>
<institution>University of Campinas,</institution>
</institution-wrap>
Campinas, Brazil</aff>
<aff id="Aff124"><label>124</label>
<institution-wrap><institution-id institution-id-type="ISNI">0000 0001 0698 4037</institution-id>
<institution-id institution-id-type="GRID">grid.416850.e</institution-id>
<institution>Laboratory of Clinical Microbiology, Department of Infectious Diseases,</institution>
<institution>Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán,</institution>
</institution-wrap>
Mexico City, Mexico</aff>
<aff id="Aff125"><label>125</label>
<institution-wrap><institution-id institution-id-type="ISNI">0000 0004 0622 4662</institution-id>
<institution-id institution-id-type="GRID">grid.411449.d</institution-id>
<institution>Fourth Department of Internal Medicine and Infectious Diseases Unit,</institution>
<institution>National and Kapodstrian University-Medical School, Attikon University General Hospital,</institution>
</institution-wrap>
Athens, Greece</aff>
<aff id="Aff126"><label>126</label>
John Farman Intensive Care Unit, University Hospitals, NHS Foundation Trust, Cambridge, UK</aff>
<aff id="Aff127"><label>127</label>
Infectious and Tropical Diseases Department, University Hospital of Nancy, and EA 4360 APEMAC, Lorraine University, Nancy, France</aff>
<aff id="Aff128"><label>128</label>
Department of General and Emergency Surgery, Riga East University Hospital ‘Gailezers’, Riga, Latvia</aff>
<aff id="Aff129"><label>129</label>
<institution-wrap><institution-id institution-id-type="ISNI">0000 0004 0465 2778</institution-id>
<institution-id institution-id-type="GRID">grid.461067.2</institution-id>
<institution>Department of Trauma,</institution>
<institution>Hospital Santo Tomas,</institution>
</institution-wrap>
Panama, Panama</aff>
<aff id="Aff130"><label>130</label>
<institution-wrap><institution-id institution-id-type="ISNI">0000 0001 2113 8111</institution-id>
<institution-id institution-id-type="GRID">grid.7445.2</institution-id>
<institution>National Institute for Health Research, Health Protection Research Unit in Healthcare Associated Infections and Antimicrobial Resistance,</institution>
<institution>Imperial College London,</institution>
</institution-wrap>
Hammersmith Campus, London, UK</aff>
<aff id="Aff131"><label>131</label>
Emergency Post-operative Department, Otavio de Freitas Hospital and Hosvaldo Cruz Hospital, Recife, Brazil</aff>
<aff id="Aff132"><label>132</label>
Department of General Surgery, Jesenice General Hospital, Jesenice, Slovenia</aff>
<aff id="Aff133"><label>133</label>
<institution-wrap><institution-id institution-id-type="ISNI">0000 0001 2157 2938</institution-id>
<institution-id institution-id-type="GRID">grid.17063.33</institution-id>
<institution>Trauma and Acute Care Service, St Michael’s Hospital,</institution>
<institution>University of Toronto,</institution>
</institution-wrap>
Toronto, Canada</aff>
<aff id="Aff134"><label>134</label>
<institution-wrap><institution-id institution-id-type="ISNI">0000 0000 9320 7537</institution-id>
<institution-id institution-id-type="GRID">grid.1003.2</institution-id>
<institution>Burns, Trauma and Critical Care Research Centre,</institution>
<institution>The University of Queensland,</institution>
</institution-wrap>
Brisbane, Queensland Australia</aff>
<aff id="Aff135"><label>135</label>
<institution-wrap><institution-id institution-id-type="ISNI">0000 0001 2168 1229</institution-id>
<institution-id institution-id-type="GRID">grid.9224.d</institution-id>
<institution>Unidad Clínica Intercentros de Enfermedades Infecciosas, Microbiología y Medicina Preventiva, Hospitales Universitarios Virgen Macarena y Virgen del Rocío-IBiS and Departamento de Medicina,</institution>
<institution>Universidad de Sevilla,</institution>
</institution-wrap>
Seville, Spain</aff>
<aff id="Aff136"><label>136</label>
<institution-wrap><institution-id institution-id-type="ISNI">0000 0001 0726 0380</institution-id>
<institution-id institution-id-type="GRID">grid.35371.33</institution-id>
<institution>General Surgery Department,</institution>
<institution>Medical University, University Hospital St George,</institution>
</institution-wrap>
Plovdiv, Bulgaria</aff>
<aff id="Aff137"><label>137</label>
<institution-wrap><institution-id institution-id-type="GRID">grid.414766.6</institution-id>
<institution></institution>
<institution>JPS Health Network,</institution>
</institution-wrap>
Texas, TX USA</aff>
<aff id="Aff138"><label>138</label>
Hospital Center Tondela Viseu, Tondela, Portugal</aff>
<aff id="Aff139"><label>139</label>
<institution-wrap><institution-id institution-id-type="ISNI">0000 0001 1011 3808</institution-id>
<institution-id institution-id-type="GRID">grid.255464.4</institution-id>
<institution>Department of Aeromedical Services for Emergency and Trauma Care,</institution>
<institution>Ehime University Graduate School of Medicine,</institution>
</institution-wrap>
Ehime, Japan</aff>
<aff id="Aff140"><label>140</label>
<institution-wrap><institution-id institution-id-type="ISNI">0000 0004 1936 9932</institution-id>
<institution-id institution-id-type="GRID">grid.412587.d</institution-id>
<institution>Department of Surgery,</institution>
<institution>University of Virginia Health System,</institution>
</institution-wrap>
Charlottesville, VA USA</aff>
<aff id="Aff141"><label>141</label>
<institution-wrap><institution-id institution-id-type="ISNI">0000 0004 1937 0722</institution-id>
<institution-id institution-id-type="GRID">grid.11899.38</institution-id>
<institution>Department of Surgery,</institution>
<institution>University of Sao Paulo,</institution>
</institution-wrap>
Ribeirao Preto, Brazil</aff>
<aff id="Aff142"><label>142</label>
Unit of Hospital Pharmacy, Macerata Hospital, Macerata, Italy</aff>
<aff id="Aff143"><label>143</label>
<institution-wrap><institution-id institution-id-type="ISNI">0000 0004 1767 2903</institution-id>
<institution-id institution-id-type="GRID">grid.415131.3</institution-id>
<institution>Department of Pharmacology,</institution>
<institution>Postgraduate Institute of Medical Education and Research,</institution>
</institution-wrap>
Chandigarh, India</aff>
<aff id="Aff144"><label>144</label>
<institution-wrap><institution-id institution-id-type="GRID">grid.240988.f</institution-id>
<institution>Department of General Surgery,</institution>
<institution>Tan Tock Seng Hospital,</institution>
</institution-wrap>
Tan Tock Seng, Singapore</aff>
<aff id="Aff145"><label>145</label>
<institution-wrap><institution-id institution-id-type="ISNI">0000 0004 1936 9932</institution-id>
<institution-id institution-id-type="GRID">grid.412587.d</institution-id>
<institution>Office of Hospital Epidemiology/Infection Prevention and Control,</institution>
<institution>University of Virginia Health System,</institution>
</institution-wrap>
Charlottesville, VA USA</aff>
<aff id="Aff146"><label>146</label>
<institution-wrap><institution-id institution-id-type="ISNI">0000 0004 1937 1127</institution-id>
<institution-id institution-id-type="GRID">grid.412434.4</institution-id>
<institution>Department of Surgery, Faculty of Medicine,</institution>
<institution>Thammasat University Hospital, Thammasat University,</institution>
</institution-wrap>
Pathum Thani, Thailand</aff>
<aff id="Aff147"><label>147</label>
<institution-wrap><institution-id institution-id-type="ISNI">0000 0004 0627 2891</institution-id>
<institution-id institution-id-type="GRID">grid.412835.9</institution-id>
<institution>Department of Gastrointestinal Surgery,</institution>
<institution>Stavanger University Hospital,</institution>
</institution-wrap>
Stavanger, Norway</aff>
<aff id="Aff148"><label>148</label>
<institution-wrap><institution-id institution-id-type="ISNI">0000 0004 1936 7443</institution-id>
<institution-id institution-id-type="GRID">grid.7914.b</institution-id>
<institution>Department of Clinical Medicine,</institution>
<institution>University of Bergen,</institution>
</institution-wrap>
Bergen, Norway</aff>
<aff id="Aff149"><label>149</label>
Department of Emergency Surgery and Critical Care, Centro Medico Imbanaco, Cali, Colombia</aff>
<aff id="Aff150"><label>150</label>
<institution-wrap><institution-id institution-id-type="ISNI">0000 0001 2166 9094</institution-id>
<institution-id institution-id-type="GRID">grid.412519.a</institution-id>
<institution>Department of Surgery, School of Medicine,</institution>
<institution>Pontifícia Universidade Católica do Rio Grande do Sul (PUCRS),</institution>
</institution-wrap>
Porto Alegre, Brazil</aff>
<aff id="Aff151"><label>151</label>
Department of Surgery, North Estonia Medical Center, Tallinn, Estonia</aff>
<aff id="Aff152"><label>152</label>
Department of Molecular Biology, Tran Hung Dao Hospital, No 1, Tran Hung Dao Street, Hai Ba Trung Dist, Hanoi, Vietnam</aff>
<aff id="Aff153"><label>153</label>
Department of Infectious Diseases, John Peter Smith Health Network, Fort Worth, Texas USA</aff>
<aff id="Aff154"><label>154</label>
<institution-wrap><institution-id institution-id-type="ISNI">0000 0001 0941 3192</institution-id>
<institution-id institution-id-type="GRID">grid.8142.f</institution-id>
<institution>Institute of Infectious Diseases,</institution>
<institution>Catholic University,</institution>
</institution-wrap>
Rome, Italy</aff>
<aff id="Aff155"><label>155</label>
<institution-wrap><institution-id institution-id-type="ISNI">0000 0000 9100 9940</institution-id>
<institution-id institution-id-type="GRID">grid.411798.2</institution-id>
<institution>First Department of Surgery—Department of Abdominal, Thoracic Surgery and Traumatology,</institution>
<institution>General University Hospital,</institution>
</institution-wrap>
Prague, Czech Republic</aff>
<aff id="Aff156"><label>156</label>
<institution-wrap><institution-id institution-id-type="ISNI">0000 0000 8988 2476</institution-id>
<institution-id institution-id-type="GRID">grid.11598.34</institution-id>
<institution>Department of Surgery,</institution>
<institution>Medical University of Graz,</institution>
</institution-wrap>
Graz, Austria</aff>
<aff id="Aff157"><label>157</label>
<institution-wrap><institution-id institution-id-type="ISNI">0000 0004 0444 9382</institution-id>
<institution-id institution-id-type="GRID">grid.10417.33</institution-id>
<institution>Department of Surgery,</institution>
<institution>Radboud University Nijmegen Medical Center,</institution>
</institution-wrap>
Nijmegen, The Netherlands</aff>
<aff id="Aff158"><label>158</label>
<institution-wrap><institution-id institution-id-type="ISNI">0000 0001 0663 9479</institution-id>
<institution-id institution-id-type="GRID">grid.9679.1</institution-id>
<institution>Department of Surgery,</institution>
<institution>Medical School University of Pécs,</institution>
</institution-wrap>
Pécs, Hungary</aff>
<aff id="Aff159"><label>159</label>
<institution-wrap><institution-id institution-id-type="ISNI">0000 0001 2165 8627</institution-id>
<institution-id institution-id-type="GRID">grid.8664.c</institution-id>
<institution>Department of Urology, Pediatric Urology and Andrology,</institution>
<institution>Medical Faculty of the Justus Liebig University Giessen,</institution>
</institution-wrap>
Giessen, Germany</aff>
<aff id="Aff160"><label>160</label>
<institution-wrap><institution-id institution-id-type="ISNI">0000 0004 1759 700X</institution-id>
<institution-id institution-id-type="GRID">grid.13402.34</institution-id>
<institution>State Key Laboratory for Diagnosis and Treatment of Infectious Diseases,</institution>
<institution>The First Affilliated Hospital, Zhejiang University,</institution>
</institution-wrap>
Zhejiang, China</aff>
<aff id="Aff161"><label>161</label>
<institution-wrap><institution-id institution-id-type="ISNI">0000 0004 1756 1461</institution-id>
<institution-id institution-id-type="GRID">grid.454210.6</institution-id>
<institution>Trauma and Emergency Surgery Department,</institution>
<institution>Chang Gung Memorial Hospital,</institution>
</institution-wrap>
Taoyuan City, Taiwan</aff>
<aff id="Aff162"><label>162</label>
<institution-wrap><institution-id institution-id-type="ISNI">0000 0004 0522 8258</institution-id>
<institution-id institution-id-type="GRID">grid.413303.6</institution-id>
<institution>Department of Antibiotics and Infection Control,</institution>
<institution>Rudolfstiftung Hospital,</institution>
</institution-wrap>
Vienna, Austria</aff>
<aff id="Aff163"><label>163</label>
Infection Control Unit, Angers University, CHU d’Angers, Angers, France</aff>
<aff id="Aff164"><label>164</label>
<institution-wrap><institution-id institution-id-type="ISNI">0000 0004 1936 8606</institution-id>
<institution-id institution-id-type="GRID">grid.26790.3a</institution-id>
<institution>Division of Trauma and Surgical Critical Care, DeWitt Daughtry Family Department of Surgery,</institution>
<institution>University of Miami,</institution>
</institution-wrap>
Miami, FL USA</aff>
<aff id="Aff165"><label>165</label>
<institution-wrap><institution-id institution-id-type="ISNI">0000 0004 1936 9000</institution-id>
<institution-id institution-id-type="GRID">grid.21925.3d</institution-id>
<institution>Department of Surgery,</institution>
<institution>University of Pittsburgh,</institution>
</institution-wrap>
Pittsburgh, PA USA</aff>
<aff id="Aff166"><label>166</label>
<institution-wrap><institution-id institution-id-type="ISNI">0000 0004 0435 165X</institution-id>
<institution-id institution-id-type="GRID">grid.16872.3a</institution-id>
<institution></institution>
<institution>VU University Medical Center,</institution>
</institution-wrap>
Amsterdam, The Netherlands</aff>
<aff id="Aff167"><label>167</label>
Department of General Surgery, Maggiore Hospital, Parma, Italy</aff>
</contrib-group>
<pub-date pub-type="epub"><day>1</day>
<month>8</month>
<year>2017</year>
</pub-date>
<pub-date pub-type="pmc-release"><day>1</day>
<month>8</month>
<year>2017</year>
</pub-date>
<pub-date pub-type="collection"><year>2017</year>
</pub-date>
<volume>12</volume>
<elocation-id>34</elocation-id>
<history><date date-type="received"><day>19</day>
<month>5</month>
<year>2017</year>
</date>
<date date-type="accepted"><day>24</day>
<month>7</month>
<year>2017</year>
</date>
</history>
<permissions><copyright-statement>© The Author(s). 2017</copyright-statement>
<license license-type="OpenAccess"><license-p><bold>Open Access</bold>
This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (<ext-link ext-link-type="uri" xlink:href="http://creativecommons.org/licenses/by/4.0/">http://creativecommons.org/licenses/by/4.0/</ext-link>
), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (<ext-link ext-link-type="uri" xlink:href="http://creativecommons.org/publicdomain/zero/1.0/">http://creativecommons.org/publicdomain/zero/1.0/</ext-link>
) applies to the data made available in this article, unless otherwise stated.</license-p>
</license>
</permissions>
<abstract id="Abs1"><sec><title>Background</title>
<p id="Par1">Antimicrobial Stewardship Programs (ASPs) have been promoted to optimize antimicrobial usage and patient outcomes, and to reduce the emergence of antimicrobial-resistant organisms. However, the best strategies for an ASP are not definitively established and are likely to vary based on local culture, policy, and routine clinical practice, and probably limited resources in middle-income countries. The aim of this study is to evaluate structures and resources of antimicrobial stewardship teams (ASTs) in surgical departments from different regions of the world.</p>
</sec>
<sec><title>Methods</title>
<p id="Par2">A cross-sectional web-based survey was conducted in 2016 on 173 physicians who participated in the AGORA (Antimicrobials: A Global Alliance for Optimizing their Rational Use in Intra-Abdominal Infections) project and on 658 international experts in the fields of ASPs, infection control, and infections in surgery.</p>
</sec>
<sec><title>Results</title>
<p id="Par3">The response rate was 19.4%. One hundred fifty-six (98.7%) participants stated their hospital had a multidisciplinary AST. The median number of physicians working inside the team was five [interquartile range 4–6]. An infectious disease specialist, a microbiologist and an infection control specialist were, respectively, present in 80.1, 76.3, and 67.9% of the ASTs. A surgeon was a component in 59.0% of cases and was significantly more likely to be present in university hospitals (89.5%, <italic>p</italic>
< 0.05) compared to community teaching (83.3%) and community hospitals (66.7%). Protocols for pre-operative prophylaxis and for antimicrobial treatment of surgical infections were respectively implemented in 96.2 and 82.3% of the hospitals. The majority of the surgical departments implemented both persuasive and restrictive interventions (72.8%). The most common types of interventions in surgical departments were dissemination of educational materials (62.5%), expert approval (61.0%), audit and feedback (55.1%), educational outreach (53.7%), and compulsory order forms (51.5%).</p>
</sec>
<sec><title>Conclusion</title>
<p id="Par4">The survey showed a heterogeneous organization of ASPs worldwide, demonstrating the necessity of a multidisciplinary and collaborative approach in the battle against antimicrobial resistance in surgical infections, and the importance of educational efforts towards this goal.</p>
</sec>
<sec><title>Electronic supplementary material</title>
<p>The online version of this article (doi:10.1186/s13017-017-0145-2) contains supplementary material, which is available to authorized users.</p>
</sec>
</abstract>
<kwd-group xml:lang="en"><title>Keywords</title>
<kwd>Antibiotics</kwd>
<kwd>Infections</kwd>
<kwd>Surgery</kwd>
<kwd>Antimicrobial stewardship</kwd>
</kwd-group>
<custom-meta-group><custom-meta><meta-name>issue-copyright-statement</meta-name>
<meta-value>© The Author(s) 2017</meta-value>
</custom-meta>
</custom-meta-group>
</article-meta>
</front>
<body><sec id="Sec1"><title>Background</title>
<p id="Par6">Antimicrobial Stewardship Programs (ASPs) have been promoted to optimize antimicrobial usage and patient outcomes and reduce the emergence of antimicrobial-resistant organisms. However, the best strategies for an ASP are not definitively established and are likely to vary based on local culture, policy and routine clinical practice, and probably limited resources in middle-income countries [<xref ref-type="bibr" rid="CR1">1</xref>
, <xref ref-type="bibr" rid="CR2">2</xref>
]. Many hospitals remain without formal programs and those that do continue to struggle with gaining acceptance across service lines [<xref ref-type="bibr" rid="CR3">3</xref>
]. Moreover, identifying optimal efforts to impact system change has been challenging [<xref ref-type="bibr" rid="CR4">4</xref>
].</p>
<p id="Par7">Restriction strategies may be effective at controlling use but raise issues of prescriber autonomy and require a large personnel commitment. Encouraging multidisciplinary collaboration within health systems to ensure that prophylactic, empirical, and targeted use of antimicrobial agents results in optimal patient outcomes is mandatory in the current era of antimicrobial resistance.</p>
<p id="Par8">A panel of experts from the Surgical Infection Society (SIS) and World Society of Emergency Surgery (WSES) has recently published a review with the aim of defining the role of surgeons within the ASPs. The panel proposed that the best means of improving antimicrobial stewardship in surgical units worldwide should involve collaboration among various specialties within institutions including prescribing clinicians and pharmacists [<xref ref-type="bibr" rid="CR5">5</xref>
].</p>
<p id="Par9">In 2016, a multidisciplinary task force from 79 different countries joined a global project to develop a consensus on the rational use of antimicrobials for patients with intra-abdominal infections (IAIs). The project has been termed AGORA (Antimicrobials: A Global Alliance for Optimizing their Rational Use in Intra-Abdominal Infections) [<xref ref-type="bibr" rid="CR1">1</xref>
].</p>
<p id="Par10">Recently the <italic>Global Alliance for Infections in Surgery</italic>
was founded and experts from 87 countries worldwide joined the highly diverse and skilled International Advisory Board. This alliance, promoted by the WSES, includes an interdisciplinary group of hospital administrators, epidemiologists, infection control specialists, infectious disease specialists, microbiologists, clinical pharmacologists and hospital pharmacists, surgeons, and intensivists. The mission of this alliance is to educate healthcare providers promoting the standards of care in managing infections in surgery worldwide [<xref ref-type="bibr" rid="CR6">6</xref>
]. Therefore, this study was conducted to evaluate the structure and resources of antimicrobial stewardship teams (ASTs) in surgical departments from different regions of the world.</p>
</sec>
<sec id="Sec2"><title>Methods</title>
<p id="Par11">We conducted a cross-sectional electronic survey evaluating the structure and resources of ASTs in surgical departments. The survey was designed by a multidisciplinary team of investigators including an epidemiologist, a surgeon, an infectious diseases physician, a pharmacologist, and a microbiologist. The questionnaire was piloted among five physicians for face and content validity.</p>
<p id="Par12">The 24-item self-administered questionnaire collected information from multidisciplinary experts—mostly physicians—about characteristics and composition of the hospital team, implementation of local procedures, availability of antimicrobial use monitoring and surveillance systems, presence of an ASP, and related interventions (Additional file <xref rid="MOESM1" ref-type="media">1</xref>
). An electronic invitation with a link to the survey was sent to 831 physicians: 173 physicians who participated in the AGORA project [<xref ref-type="bibr" rid="CR1">1</xref>
], and a large number (658) of international experts in the fields of antimicrobial stewardship, infection control, and infections in surgery identified after a thorough investigation using the PubMed database. The survey was Internet-based (using <ext-link ext-link-type="uri" xlink:href="http://www.docs.google.com">http://www.docs.google.com</ext-link>
). Participation was voluntary but not anonymous; however, the confidentiality of respondents and their choices was ensured. No incentives were provided to the respondents. The study was open for 6 weeks between September 30 and November 11, 2016. Reminders were sent to all those who had not replied after 1 and 3 weeks. Due to the characteristics of the survey, a response rate ranging between 15 and 25% was expected.</p>
<p id="Par13">Data were entered in an Excel database (Microsoft Corporation, Redmond, Washington, USA) and analyzed using Stata 11.0 software package (StataCorp, College Station, TX). Descriptive analyses included medians and interquartile ranges (IQR) for continuous variables or frequency (%) for categorical variables The two-sided chi-square or Fisher’s exact test was used for categorical variables, as appropriate. All tests were two-sided, and <italic>p</italic>
values of 0.05 or lower were considered statistically significant.</p>
</sec>
<sec id="Sec3"><title>Results</title>
<sec id="Sec4"><title>Baseline data: coverage, response rate, working setting, and professional profile</title>
<p id="Par14">A total of 161 (19.4%) of the 831 experts who were contacted by email completed the survey after two reminders. One incomplete survey was excluded from the study. In two cases the participants were from the same institution and only one survey was considered. One hundred fifty-eight responses were included in our analysis. Participants work settings and professional profiles are summarized in Table <xref rid="Tab1" ref-type="table">1</xref>
.<table-wrap id="Tab1"><label>Table 1</label>
<caption><p>Participants’ working settings and professional profiles</p>
</caption>
<table frame="hsides" rules="groups"><thead><tr><th>Characteristics</th>
<th>African region<break></break>
<italic>n</italic>
= 8</th>
<th>Eastern- Mediterranean region <italic>n</italic>
= 13</th>
<th>European region<break></break>
<italic>n</italic>
= 67</th>
<th>Region of Americas<break></break>
<italic>n</italic>
= 47</th>
<th>South-East Asia region<break></break>
<italic>n</italic>
= 8</th>
<th>Western Pacific region <italic>n</italic>
= 15</th>
<th>Total<break></break>
<italic>n</italic>
= 158</th>
</tr>
</thead>
<tbody><tr><td colspan="8">Type of hospital, n (%)</td>
</tr>
<tr><td>- University hospital</td>
<td>5 (62.5)</td>
<td>6 (46.1)</td>
<td>50 (74.6)</td>
<td>35 (74.5)</td>
<td>6 (75.0)</td>
<td>12 (80.0)</td>
<td>114 (72.1)</td>
</tr>
<tr><td>- Community teaching hospital</td>
<td>2 (25.0)</td>
<td>3 (23.1)</td>
<td>14 (20.9)</td>
<td>9 (19.1)</td>
<td>1 (12.5)</td>
<td>1 (6.7)</td>
<td>30 (19.0)</td>
</tr>
<tr><td>- Community hospital</td>
<td>0</td>
<td>2 (15.4)</td>
<td>3 (4.5)</td>
<td>1 (2.1)</td>
<td>1 (12.5)</td>
<td>2 (13.3)</td>
<td>9 (5.7)</td>
</tr>
<tr><td>- Other</td>
<td>1 (12.5)</td>
<td>2 (15.4)</td>
<td>0</td>
<td>2 (4.3)</td>
<td>0</td>
<td>0</td>
<td>5 (3.2)</td>
</tr>
<tr><td colspan="8">Hospital setting, n (%)</td>
</tr>
<tr><td>- Urban</td>
<td>5 (62.5)</td>
<td>10 (76.9)</td>
<td>65 (97.0)</td>
<td>44 (93.6)</td>
<td>6 (75.0)</td>
<td>14 (93.3)</td>
<td>144 (91.1)</td>
</tr>
<tr><td>- Suburban</td>
<td>3 (37.5)</td>
<td>3 (23.1)</td>
<td>2 (3.0)</td>
<td>1 (2.1)</td>
<td>2 (25.0)</td>
<td>0</td>
<td>11 (7.0)</td>
</tr>
<tr><td>- Rural</td>
<td>0</td>
<td>0</td>
<td>0</td>
<td>2 (4.3)</td>
<td>0</td>
<td>1 (6.7)</td>
<td>3 (1.9)</td>
</tr>
<tr><td colspan="8">Hospital inpatient beds, n (%)</td>
</tr>
<tr><td>- ≤100</td>
<td>0</td>
<td>2 (15.4)</td>
<td>3 (4.5)</td>
<td>1 (2.1)</td>
<td>0</td>
<td>0</td>
<td>6 (3.8)</td>
</tr>
<tr><td>- 101–500</td>
<td>3 (37.5)</td>
<td>5 (38.5)</td>
<td>15 (22.4)</td>
<td>10 (21.3)</td>
<td>2 (25.0)</td>
<td>3 (20.0)</td>
<td>38 (24.1)</td>
</tr>
<tr><td>- 501–1000</td>
<td>3 (37.5)</td>
<td>5 (38.5)</td>
<td>27 (40.3)</td>
<td>28 (59.6)</td>
<td>3 (37.5)</td>
<td>1 (6.7)</td>
<td>67 (42.4)</td>
</tr>
<tr><td>- ≥ 1000</td>
<td>2 (25.0)</td>
<td>1 (7.7)</td>
<td>22 (32.8)</td>
<td>8 (17.0)</td>
<td>3 (37.5)</td>
<td>11 (73.3)</td>
<td>47 (29.7)</td>
</tr>
<tr><td colspan="8">Profession, n (%)</td>
</tr>
<tr><td>Epidemiologist</td>
<td>1 (12.5)</td>
<td>0</td>
<td>2 (3.0)</td>
<td>1 (2.1)</td>
<td>0</td>
<td>0</td>
<td>4 (2.5)</td>
</tr>
<tr><td>Hospital administrator</td>
<td>0</td>
<td>0</td>
<td>0</td>
<td>0</td>
<td>0</td>
<td>0</td>
<td>0</td>
</tr>
<tr><td>Clinical pharmacologist</td>
<td>0</td>
<td>1 (7.7)</td>
<td>0</td>
<td>4 (8.5)</td>
<td>1(12.5)</td>
<td>1 (6.7)</td>
<td>7 (4.4)</td>
</tr>
<tr><td>Hospital pharmacist</td>
<td>0</td>
<td>0</td>
<td>1 (1.5)</td>
<td>1 (2.1)</td>
<td>1 (12.5)</td>
<td>1 (6.7)</td>
<td>4 (2.5)</td>
</tr>
<tr><td>Infection control specialist</td>
<td>0</td>
<td>0</td>
<td>1 (1.5)</td>
<td>1 (2.1)</td>
<td>0</td>
<td>0</td>
<td>2 (1.3)</td>
</tr>
<tr><td>Infectious diseases specialist</td>
<td>0</td>
<td>4 (30.8)</td>
<td>10 (14.9)</td>
<td>10 (21.3)</td>
<td>0</td>
<td>5 (33.3)</td>
<td>29 (18.4)</td>
</tr>
<tr><td>Intensivist</td>
<td>1 (12.5)</td>
<td>0</td>
<td>5 (7.5)</td>
<td>2 (4.3)</td>
<td>0</td>
<td>1 (6.7)</td>
<td>9 (5.7)</td>
</tr>
<tr><td>Microbiologist</td>
<td>3 (37.5)</td>
<td>3 (23.1)</td>
<td>1 (1.5)</td>
<td>1 (2.1)</td>
<td>3 (37.5)</td>
<td>0</td>
<td>11 (7.0)</td>
</tr>
<tr><td>Surgeon</td>
<td>3 (37.5)</td>
<td>5 (38.5)</td>
<td>44 (65.7)</td>
<td>24 (51.1)</td>
<td>3 (37.5)</td>
<td>6 (40.0)</td>
<td>85 (53.8)</td>
</tr>
<tr><td>Other</td>
<td>0</td>
<td>0</td>
<td>3 (4.5)</td>
<td>3 (6.4)</td>
<td>0</td>
<td>1 (6.7)</td>
<td>7 (4.4)</td>
</tr>
</tbody>
</table>
</table-wrap>
</p>
<p id="Par15">The response rate was similar to that of previous studies promoted by WSES [<xref ref-type="bibr" rid="CR1">1</xref>
, <xref ref-type="bibr" rid="CR7">7</xref>
, <xref ref-type="bibr" rid="CR8">8</xref>
].</p>
<p id="Par16">As in the other WSES studies [<xref ref-type="bibr" rid="CR1">1</xref>
, <xref ref-type="bibr" rid="CR7">7</xref>
, <xref ref-type="bibr" rid="CR8">8</xref>
], participants were not homogeneously distributed across all geographic regions of the world due to the difficulty in recruiting participants in some areas of the world. However all geographic regions were represented in the survey.</p>
</sec>
<sec id="Sec5"><title>Characteristics of the team</title>
<p id="Par17">One hundred fifty-six (98.7%) participants stated their hospital had a multidisciplinary AST. Ninety participants (90/156, 57.7%) declared they were currently members of the team, with no difference in frequency between different WHO regions. The median number of physicians working inside the team was five [IQR 4–6]. Characteristics of the team are in Table <xref rid="Tab2" ref-type="table">2</xref>
.<table-wrap id="Tab2"><label>Table 2</label>
<caption><p>Characteristics of the team in 156 hospitals</p>
</caption>
<table frame="hsides" rules="groups"><thead><tr><th>Characteristics</th>
<th><italic>n</italic>
(%)</th>
</tr>
</thead>
<tbody><tr><td colspan="2">Components</td>
</tr>
<tr><td>- Epidemiologist</td>
<td>64 (41.0)</td>
</tr>
<tr><td>- Hospital administrator</td>
<td>73 (46.8)</td>
</tr>
<tr><td>- Clinical pharmacologist</td>
<td>8 (5.1)</td>
</tr>
<tr><td>- Hospital pharmacist</td>
<td>95 (60.9)</td>
</tr>
<tr><td>- Infection control specialist</td>
<td>106 (67.9)</td>
</tr>
<tr><td>- Infectious disease specialist</td>
<td>125 (80.1)</td>
</tr>
<tr><td>- Intensivist</td>
<td>76 (48.7)</td>
</tr>
<tr><td>- Microbiologist</td>
<td>119 (76.3)</td>
</tr>
<tr><td>- Surgeon</td>
<td>92 (59.0)</td>
</tr>
<tr><td>- Other</td>
<td>11 (7.1)</td>
</tr>
<tr><td>- Infectious disease specialist AND hospital pharmacologist/pharmacist</td>
<td>87 (55.8)</td>
</tr>
<tr><td colspan="2">Frequency of meetings</td>
</tr>
<tr><td>- More than once a week</td>
<td>15 (9.6)</td>
</tr>
<tr><td>- Once a week</td>
<td>26 (16.7)</td>
</tr>
<tr><td>- Twice a month</td>
<td>13 (8.3)</td>
</tr>
<tr><td>- Once a month</td>
<td>58 (37.2)</td>
</tr>
<tr><td>- Less than once a month</td>
<td>27 (17.3)</td>
</tr>
<tr><td>- Only as necessary</td>
<td>17 (10.9)</td>
</tr>
</tbody>
</table>
</table-wrap>
</p>
<p id="Par18">One hundred thirty-five (135/158, 85.4%) participants had at least one surgeon with an interest or skills in surgical infections within the surgical department of their hospital; a surgeon was significantly more likely to be present in university hospitals (89.5%, two-sided chi-square test <italic>p</italic>
< 0.05) compared to community teaching hospitals (83.3%) and community hospitals (66.7%).</p>
</sec>
<sec id="Sec6"><title>Implementation of protocols and monitoring systems</title>
<p id="Par19">Implementation of protocols and monitoring systems in 158 hospitals are reported in Table <xref rid="Tab3" ref-type="table">3</xref>
.<table-wrap id="Tab3"><label>Table 3</label>
<caption><p>Implementation of protocols and monitoring systems in 158 hospitals</p>
</caption>
<table frame="hsides" rules="groups"><thead><tr><th rowspan="2">Implementation of protocols and monitoring systems</th>
<th rowspan="2">All hospital wards<break></break>
<italic>n</italic>
(%)</th>
<th colspan="2">Some hospital wards, including surgical wards<break></break>
<italic>n</italic>
(%)</th>
<th rowspan="2">Some hospital wards, not including surgical wards<break></break>
<italic>n</italic>
(%)</th>
<th rowspan="2">No hospital wards<break></break>
<italic>n</italic>
(%)</th>
</tr>
<tr><th>Every surgical wards</th>
<th>Some surgical wards</th>
</tr>
</thead>
<tbody><tr><td>- SAP protocol</td>
<td>NA</td>
<td char="(" align="char">124 (78.5)</td>
<td>28 (17.7)</td>
<td>NA</td>
<td>6 (3.8)</td>
</tr>
<tr><td>- TIS protocol</td>
<td>NA</td>
<td char="(" align="char">70 (44.3)</td>
<td>60 (38.0)</td>
<td>NA</td>
<td>28 (17.7)</td>
</tr>
<tr><td>- UAMS</td>
<td>84 (53.2)</td>
<td colspan="2">45 (28.5)</td>
<td>9 (5.7)</td>
<td>20 (12.7)</td>
</tr>
<tr><td>- RDSR</td>
<td>104 (65.8)</td>
<td colspan="2">26 (16.5)</td>
<td>7 (4.4)</td>
<td>21 (13.3)</td>
</tr>
</tbody>
</table>
<table-wrap-foot><p><italic>SAP</italic>
Surgical antimicrobial prophylaxis, <italic>TIS</italic>
therapy for infections in surgery, <italic>UAMS</italic>
used antimicrobial monitoring system, <italic>RDSR</italic>
resistance data systematic report</p>
</table-wrap-foot>
</table-wrap>
</p>
<p id="Par20">The vast majority of respondents (152/158, 96.2%) stated that their hospitals have a protocol for pre-operative prophylaxis. The protocol covered all surgical wards in 124 (78.5%) cases. A protocol for antimicrobial treatment of surgical infections was available in 130 (82.3%) hospitals; however, only 70 (44.3%) had it available in every surgical ward. One hundred twenty-eight (81.0%) hospitals had both a protocol for peri-operative prophylaxis and for antimicrobial treatment of surgical infections available, while four (4/158, 2.5%) hospitals lacked both.</p>
<p id="Par21">Among 130 surgical wards implementing a protocol for antimicrobial treatment of surgical infections, 97 (74.6%) participants stated it included interventions to reduce the duration of therapy, 88 (67.7%) interventions to switch selected antimicrobials from intravenous-to-oral therapy, 78 (60.0%) interventions for alternative dosing strategies based on pharmacokinetics and pharmacodynamics, with significant difference between community hospitals (11.1%, two-sided Fischer’s exact test <italic>p</italic>
< 0.05) compared to university (57.0%) and community teaching (60.0%) hospitals. Thirty-five (26.9%) participants reported the use of biological markers - such as procalcitonin to decrease antimicrobial use in critically ill patients.</p>
</sec>
<sec id="Sec7"><title>Implementations of ASPs and related interventions</title>
<p id="Par22">One hundred fifty-five (155/158, 98.1%) participants declared their hospital had an ASP running.</p>
<p id="Par23">Our survey showed that 30 (19.4%) hospitals have developed persuasive interventions, 17 (11.0%) restrictive interventions and 108 (69.7%) both of them.</p>
<p id="Par25">Twenty-three surgical departments (23/136, 16.9%) have developed persuasive interventions, 14 (10.3%) restrictive interventions and 99 (72.8%) both of them.</p>
<p id="Par26">The most common types of interventions in surgical departments were dissemination of educational materials (62.5%), expert approval (61.0%), audit and feedback (55.1%), educational outreach (53.7%), and compulsory order forms (51.5%).</p>
<p id="Par27">Types of ASPs and related interventions in surgical departments and in all hospital wards are described in detail in Table <xref rid="Tab4" ref-type="table">4</xref>
.<table-wrap id="Tab4"><label>Table 4</label>
<caption><p>Difference in type of ASPs and related implemented types of interventions in surgical departments and non-surgical departments</p>
</caption>
<table frame="hsides" rules="groups"><thead><tr><th>Characteristics</th>
<th>Surgical departments, <italic>n</italic>
= 136<break></break>
<italic>n</italic>
(%)</th>
<th>Other departments, <italic>n</italic>
= 19<break></break>
<italic>n</italic>
(%)</th>
<th><italic>P</italic>
value</th>
<th>Total, <italic>n</italic>
= 155<break></break>
<italic>n</italic>
(%)</th>
</tr>
</thead>
<tbody><tr><td colspan="5">Type of ASPs</td>
</tr>
<tr><td>- Persuasive interventions</td>
<td>23 (16.9)</td>
<td>7 (36.8)</td>
<td>0.06<sup>a</sup>
</td>
<td>30 (19.4)</td>
</tr>
<tr><td>- Restrictive interventions</td>
<td>14 (10.3)</td>
<td>3 (15.8)</td>
<td>0.44<sup>a</sup>
</td>
<td>17 (11.0)</td>
</tr>
<tr><td>- Both</td>
<td>99 (72.8)</td>
<td>9 (47.4)</td>
<td><0.05</td>
<td>108 (69.7)</td>
</tr>
<tr><td colspan="5">Type of interventions</td>
</tr>
<tr><td>- Dissemination of educational materials</td>
<td>85 (62.5)</td>
<td>8 (42.1)</td>
<td>0.15</td>
<td>93 (60.0)</td>
</tr>
<tr><td>- Reminders</td>
<td>56 (41.2)</td>
<td>8 (42.1)</td>
<td>1.00</td>
<td>64 (41.3)</td>
</tr>
<tr><td>- Audit and feedback</td>
<td>75 (55.1)</td>
<td>4 (21.1)</td>
<td><0.05</td>
<td>79 (51.0)</td>
</tr>
<tr><td>- Educational outreach</td>
<td>73 (53.7)</td>
<td>10 (52.6)</td>
<td>1.00</td>
<td>83 (53.6)</td>
</tr>
<tr><td>- Other persuasive interventions</td>
<td>23 (16.9)</td>
<td>3 (15.8)</td>
<td>1.00<sup>a</sup>
</td>
<td>26 (16.8)</td>
</tr>
<tr><td>- Compulsory order form</td>
<td>70 (51.5)</td>
<td>7 (36.8)</td>
<td>0.34</td>
<td>77 (49.7)</td>
</tr>
<tr><td>- Expert approval</td>
<td>83 (61.0)</td>
<td>5 (26.3)</td>
<td><0.05</td>
<td>88 (56.8)</td>
</tr>
<tr><td>- Restriction by removal</td>
<td>41 (30.1)</td>
<td>2 (10.5)</td>
<td>0.13</td>
<td>43 (27.7)</td>
</tr>
<tr><td>- Review and make changes</td>
<td>36 (26.5)</td>
<td>1 (5.3)</td>
<td><0.05<sup>a</sup>
</td>
<td>37 (23.9)</td>
</tr>
<tr><td>- Other restrictive interventions</td>
<td>10 (7.4)</td>
<td>3 (15.8)</td>
<td>0.20<sup>a</sup>
</td>
<td>13 (8.4)</td>
</tr>
</tbody>
</table>
<table-wrap-foot><p>All <italic>p</italic>
values were calculated using two-sided chi-square test unless otherwise noted</p>
<p><italic>ASP</italic>
antimicrobial stewardship program</p>
<p><sup>a</sup>
Calculated using two-sided Fisher’s exact test</p>
</table-wrap-foot>
</table-wrap>
</p>
<p id="Par28">Six (6/41, 14.6%) surgical departments implementing a formulary restriction do not perform any monitoring system of used antimicrobials, and 4 (4/41, 9.8%) do not carry out any systematic reports about resistance data. Furthermore, 6 (7/70, 10.0%) surgical departments using a compulsory order form do not perform any monitoring system of used antimicrobials, and 11 (11/70, 15.7%) do not carry out any systematic reports about resistance data.</p>
<p id="Par29">One hundred twenty-five (125/158, 79.1%) participants stated their hospital had carried out structural interventions to improve ASPs in the last 5 years. Sixty-nine (43.7%) changed from paper to computerized records, 74 (46.8%) implemented rapid laboratory testing, 32 (20.3%) introduced computerized decision support systems, 69 (43.7%) introduced organization of quality monitoring mechanisms and 29 (18.4%) implemented other structural interventions.</p>
<p id="Par30">Characteristics of the implementation of protocols, monitoring systems, and ASPs interventions in surgical departments are detailed in Table <xref rid="Tab5" ref-type="table">5</xref>
.<table-wrap id="Tab5"><label>Table 5</label>
<caption><p>Implementation of protocols, monitoring systems and ASPs interventions in surgical departments related to working setting and team components</p>
</caption>
<table frame="hsides" rules="groups"><thead><tr><th>Variables</th>
<th>PAP protocol implemented <italic>n</italic>
. (%), p</th>
<th>TIS protocol implemented <italic>n</italic>
. (%), <italic>p</italic>
</th>
<th>Monitoring system of used antimicrobials <italic>n</italic>
. (%), p</th>
<th>Resistance data systematic reports <italic>n.</italic>
(%), <italic>p</italic>
</th>
<th>ASP implemented<break></break>
<italic>n</italic>
. (%), <italic>p</italic>
</th>
<th>Structural intervention <italic>n</italic>
. (%), <italic>p</italic>
</th>
</tr>
</thead>
<tbody><tr><td colspan="7">Number of bed</td>
</tr>
<tr><td> Less than 100, <italic>n</italic>
= 6</td>
<td>5 (83.3) 1.00<sup>a</sup>
</td>
<td>4 (66.7) 0.29<sup>a</sup>
</td>
<td>4 (66.7) 0.30<sup>a</sup>
</td>
<td>4 (66.7) 0.29<sup>a</sup>
</td>
<td>3 (50.0) 0.58<sup>a</sup>
</td>
<td>3 (50.0) 0.10<sup>a</sup>
</td>
</tr>
<tr><td> 101–500, <italic>n</italic>
= 38</td>
<td>37 (97.4) 1.00<sup>a</sup>
</td>
<td>32 (84.2) 0.57</td>
<td>29 (76.3) 0.80</td>
<td>30 (78.9) 1.00</td>
<td>32 (84.2) 0.75</td>
<td>22 (57.9) <0.05<sup>a</sup>
</td>
</tr>
<tr><td> 501–1000, <italic>n</italic>
= 67</td>
<td>62 (92.5) 0.08<sup>a</sup>
</td>
<td>53 (79.1) 0.49</td>
<td>53 (79.1) 0.62</td>
<td>56 (83.6) 0.87</td>
<td>56 (83.6) 0.75</td>
<td>58 (86.6) <0.05<sup>a</sup>
</td>
</tr>
<tr><td> More than 1000, <italic>n</italic>
= 47</td>
<td>47 (100.0) 0.18<sup>a</sup>
</td>
<td>40 (85.1) 0.71</td>
<td>42 (89.4) 0.16</td>
<td>39 (83.0) 1.00</td>
<td>39 (83.0) 1.00</td>
<td>41 (87.2) 0.16</td>
</tr>
<tr><td colspan="7">Hospital setting</td>
</tr>
<tr><td> Urban, <italic>n</italic>
= 144</td>
<td>140 (97.2) 0.09</td>
<td>118 (81.9) 1.00<sup>a</sup>
</td>
<td>119 (82.6) 0.29<sup>a</sup>
</td>
<td>122 (84.7) <0.05<sup>a</sup>
</td>
<td>120 (83.3) 0.40<sup>a</sup>
</td>
<td>97 (67.4) 0.17<sup>a</sup>
</td>
</tr>
<tr><td> Suburban and rural, <italic>n</italic>
= 14</td>
<td>12 (85.7) 0.09</td>
<td>12 (85.7) 1.00<sup>a</sup>
</td>
<td>11 (78.6) 0.29<sup>a</sup>
</td>
<td>9 (64.3) <0.05<sup>a</sup>
</td>
<td>10 (71.4) 0.40<sup>a</sup>
</td>
<td>9 (64.3) 0.17<sup>a</sup>
</td>
</tr>
<tr><td colspan="7">Type of hospital</td>
</tr>
<tr><td> University hospital, <italic>n</italic>
= 114</td>
<td>110 (96.5) 0.67<sup>a</sup>
</td>
<td>92 (80.7) 0.55</td>
<td>94 (82.5) 0.84</td>
<td>98 (86.0) 0.08</td>
<td>92 (80.7) 0.84</td>
<td>95 (83.3) <0.05</td>
</tr>
<tr><td> Community teaching hospital, <italic>n</italic>
= 30</td>
<td>29 (96.7) 1.00<sup>a</sup>
</td>
<td>27 (90.0) 0.33</td>
<td>27 (90.0) 0.60</td>
<td>24 (80.0) 0.92</td>
<td>26 (86.7) 0.77<sup>a</sup>
</td>
<td>22 (73.3) 0.54</td>
</tr>
<tr><td> Community hospital, <italic>n</italic>
= 9</td>
<td>8 (88.9) 0.30<sup>a</sup>
</td>
<td>8 (88.9) 1.00<sup>a</sup>
</td>
<td>7 (77.8) 0.67<sup>a</sup>
</td>
<td>5 (55.6) 0.05<sup>a</sup>
</td>
<td>9 (100.0) 1.00<sup>a</sup>
</td>
<td>3 (33.3) <0.05<sup>a</sup>
</td>
</tr>
<tr><td> Other, <italic>n</italic>
= 5</td>
<td>5 (100.0) 1.00<sup>a</sup>
</td>
<td>3 (60.0) 0.21<sup>a</sup>
</td>
<td>3 (60.0) <0.05<sup>a</sup>
</td>
<td>4 (80.0) 0.21<sup>a</sup>
</td>
<td>4 (80.0) 0.52<sup>a</sup>
</td>
<td>4 (80.0) 1.00<sup>a</sup>
</td>
</tr>
<tr><td colspan="7">Components of the team</td>
</tr>
<tr><td> Epidemiologist, <italic>n</italic>
= 64</td>
<td>62 (96.9) 1.00<sup>a</sup>
</td>
<td>53 (82.8) 1.00</td>
<td>52 (81.3) 1.00</td>
<td>59 (92.2) <0.05</td>
<td>52 (81.3) 1.00</td>
<td>53 (82.8) 0.46</td>
</tr>
<tr><td> Infection control specialist, <italic>n</italic>
= 106</td>
<td>103 (97.2) 0.40<sup>a</sup>
</td>
<td>90 (84.9) 0.31</td>
<td>91 (85.8) 0.08</td>
<td>89 (84.0) 0.57</td>
<td>89 (84.0) 1.00</td>
<td>82 (77.4) 0.79</td>
</tr>
<tr><td> Hospital administrator, <italic>n</italic>
= 73</td>
<td>71 (97.3) 0.69<sup>a</sup>
</td>
<td>65 (89.0) 0.06</td>
<td>61 (83.6) 0.71</td>
<td>61 (83.6) 0.86</td>
<td>63 (86.3) 0.29</td>
<td>59 (80.8) 0.49</td>
</tr>
<tr><td> Hospital pharmacologist, <italic>n</italic>
= 95</td>
<td>94 (98.9) <0.05<sup>a</sup>
</td>
<td>80 (84.2) 0.57</td>
<td>80 (84.2) 0.42</td>
<td>82 (86.3) 0.16</td>
<td>83 (87.4) 0.29</td>
<td>79 (83.2) 0.08</td>
</tr>
<tr><td> Hospital pharmacist, <italic>n</italic>
= 8</td>
<td>7 (87.5) 0.27<sup>a</sup>
</td>
<td>6 (75.0) 0.43<sup>a</sup>
</td>
<td>7 (87.5) 0.55<sup>a</sup>
</td>
<td>5 (62.5) 0.15<sup>a</sup>
</td>
<td>7 (87.5) 0.36<sup>a</sup>
</td>
<td>3 (37.5) <0.05<sup>a</sup>
</td>
</tr>
<tr><td> Infectious diseases specialist, <italic>n</italic>
= 125</td>
<td>120 (96.0) 1.00<sup>a</sup>
</td>
<td>100 (80.0) v0.23</td>
<td>104 (83.2) 0.47</td>
<td>103 (82.4) 1.00</td>
<td>107 (85.6) 0.15<sup>a</sup>
</td>
<td>95 (76.0) 0.50</td>
</tr>
<tr><td> Intensivist, <italic>n</italic>
= 76</td>
<td>74 (97.4) 0.68<sup>a</sup>
</td>
<td>65 (85.5) 0.41</td>
<td>66 (86.8) 0.16</td>
<td>63 (82.9) 1.00</td>
<td>66 (86.8) 0.80</td>
<td>60 (78.9) 1.00</td>
</tr>
<tr><td> Microbiologist, <italic>n</italic>
= 119</td>
<td>119 (100.0) 0.64<sup>a</sup>
</td>
<td>98 (82.4) 1.00</td>
<td>96 (80.7) 0.75</td>
<td>100 (84.0) 0.44</td>
<td>98 (82.4) 0.82</td>
<td>91 (76.5) 0.46</td>
</tr>
<tr><td> Surgeon, <italic>n</italic>
= 92</td>
<td>88 (95.7) 1.00<sup>a</sup>
</td>
<td>80 (87.0) 0.11</td>
<td>77 (83.7) 0.56</td>
<td>77 (83.7) 0.73</td>
<td>76 (82.6) 0.70</td>
<td>70 (76.1) 0.61</td>
</tr>
<tr><td> Other, <italic>n</italic>
= 11</td>
<td>11 (100.0) 1.00<sup>a</sup>
</td>
<td>9 (81.8) 1.00<sup>a</sup>
</td>
<td>11 (100.0) 0.22<sup>a</sup>
</td>
<td>10 (90.9) 0.69<sup>a</sup>
</td>
<td>10 (90.9) 1.00<sup>a</sup>
</td>
<td>8 (72.7) 0.70<sup>a</sup>
</td>
</tr>
</tbody>
</table>
<table-wrap-foot><p>All <italic>p</italic>
values were calculated using two-sided chi-square test unless otherwise noted</p>
<p><italic>PAP</italic>
pre-operative antimicrobial prophylaxis, <italic>TIS</italic>
therapy for infections in surgery, <italic>ASP</italic>
antimicrobial stewardship program</p>
<p><sup>a</sup>
Calculated using two-sided Fisher’s exact test. <italic>ASP</italic>
antimicrobial stewardship program</p>
</table-wrap-foot>
</table-wrap>
</p>
</sec>
</sec>
<sec id="Sec8"><title>Discussion</title>
<p id="Par31">Antimicrobial stewardship programs (ASP) are a key strategy to curb the spread of antibiotic resistance [<xref ref-type="bibr" rid="CR3">3</xref>
, <xref ref-type="bibr" rid="CR9">9</xref>
]. The best strategies for an ASP are not definitively established and are likely to vary based on local routine clinical practice [<xref ref-type="bibr" rid="CR7">7</xref>
], despite several guidelines on the topic [<xref ref-type="bibr" rid="CR9">9</xref>
, <xref ref-type="bibr" rid="CR10">10</xref>
].</p>
<p id="Par32">Successful ASPs should focus on collaboration between healthcare professionals in order to share knowledge and best practices. It is essential for an ASP to have at least one member who is an infectious diseases specialist. Pharmacists with advanced training or longstanding clinical experience in infectious diseases are also key actors for the design and implementation of the stewardship program interventions [<xref ref-type="bibr" rid="CR11">11</xref>
]. Infection control specialists and hospital epidemiologists should coordinate efforts on monitoring and preventing healthcare-associated infections and in analyzing and reporting “real-time” data to prevent infections, improve antimicrobial use, and minimize secondary spread of resistance. Microbiologists should actively guide the proper use of tests and the flow of laboratory results. Being involved in providing surveillance data on antimicrobial resistance, they should provide periodic reports on antimicrobial resistance data allowing the multidisciplinary team to determine the ongoing burden of antimicrobial resistance in the hospital. Moreover, timely and accurate reporting of microbiology susceptibility test results allows selection of more appropriate targeted therapy, and may help reduce broad-spectrum antimicrobial use.</p>
<p id="Par33">Surgeons with adequate knowledge in surgical infections and surgical anatomy when involved in ASPs may audit antibiotic prescriptions, provide feedback to the prescribers and integrate best practices of antimicrobial use among surgeons, and act as champions among colleagues. Although many surgeons are aware of the problem of antimicrobial resistance, most underestimate it in their own hospital [<xref ref-type="bibr" rid="CR1">1</xref>
]. Very few studies have been published on the role of ASPs in general surgical departments. In 2015, Cakmakci [<xref ref-type="bibr" rid="CR12">12</xref>
] suggested that the engagement of surgeons in ASPs might be crucial to their success. In 2013, however, Duane et al. showed poor compliance of surgical services with ASP recommendations [<xref ref-type="bibr" rid="CR13">13</xref>
]. Surgeons need to take part in addressing the global issue of antimicrobial resistance. Failure to do so will be catastrophic to patients and programs [<xref ref-type="bibr" rid="CR3">3</xref>
].</p>
<p id="Par34">Infections are the main factors contributing to mortality in intensive care units (ICU) [<xref ref-type="bibr" rid="CR14">14</xref>
].</p>
<p id="Par35">Intensivists have a critical role in treating multidrug resistant organisms in ICUs in critically ill patients. They have a crucial role in prescribing antimicrobial agents for our most challenging patients and are at the forefront of a successful ASP [<xref ref-type="bibr" rid="CR15">15</xref>
].</p>
<p id="Par36">Finally, without adequate support from hospital administration, the ASP will be inadequate or inconsistent since the programs do not generate revenue [<xref ref-type="bibr" rid="CR16">16</xref>
]. Engagement of hospital administration has been confirmed as a key factor for both developing and sustaining an ASP [<xref ref-type="bibr" rid="CR17">17</xref>
].</p>
<p id="Par37">In most cases, our survey demonstrated that ASPs do not involve a true multi-disciplinary approach.</p>
<p id="Par38">An infectious diseases specialist and a hospital pharmacist were part of the team in 125 (80.1%) and in 95 (60.9%) cases, respectively. Only 87 (55.8%) teams included both an infectious diseases specialist and a hospital pharmacist. An infection control specialist and a hospital epidemiologist were part of the team in 106 (67.9%) and in 64 (41.0%) cases, respectively. It is possible that in some hospitals, AMS and infection prevention and control team are two separate entities, which collaborate. A microbiologist was part of the team in 119 (76.3%) cases. A surgeon was part of the team in 92 (59.0%) cases and an intensivist in 76 (48.6%) cases. A hospital administrator was part of the team only in 73 (46.8%) cases. Interestingly a surgeon was significantly more likely to be part of the team in university hospitals (89.5%, two-sided chi-square test <italic>p</italic>
< 0.05) compared to community teaching (83.3%) and community non-teaching hospital (66.7%).</p>
<p id="Par39">Strategies of ASPs should be tailored based on individual hospital characteristics and personnel and resources available. The Infectious Diseases Society of America/Society for Healthcare Epidemiology of America (IDSA/SHEA) guidelines identified two core proactive evidence-based strategies and several supplemental strategies for promoting antimicrobial stewardship [<xref ref-type="bibr" rid="CR7">7</xref>
, <xref ref-type="bibr" rid="CR8">8</xref>
]: first, a restrictive strategy based on a proactive strategy of either formulary restriction or a requirement for pre-approval for specific drugs or both, and second, a persuasive strategy of performing prospective audit with intervention and feedback to the prescriber.</p>
<p id="Par40">Our survey showed that 23 (16.9%) surgical departments have developed persuasive interventions, 14 (10.3%) restrictive interventions and 99 (72.8%) both of them. ASP policies should be based on both international/national antibiotic guidelines, and tailored to local microbiology and resistance patterns. Local clinical practice guidelines and algorithms can be an effective way to standardize prescribing practices based on the country’s epidemiology. Standardizing a shared protocol of antimicrobial prophylaxis should represent the first step of any Antimicrobial Stewardship program.</p>
<p id="Par41">One hundred fifty-two (96.2%) participants stated their hospitals have a protocol for surgical antibiotic prophylaxis. Among the 158 hospitals, a protocol for antibiotic prophylaxis is present in all surgical wards in 124 (78.5%) of hospitals while only in some surgical wards in 28 (17.7%) hospitals.</p>
<p id="Par42">A protocol for antibiotic treatment was present in all surgical wards in 70 (44.3%) hospitals, while only in some surgical wards in 60 (38.0%) hospitals. Among 130 hospitals implementing a protocol for antimicrobial treatment of surgical infections, 97 (74.6%) participants stated that it included interventions to reduce the duration of therapy, 88 (67.7%) interventions to switch select antimicrobials from intravenous-to-oral therapy, 78 (60.0%) interventions for alternative dosing strategies based on pharmacokinetic and pharmacodynamic principles, with substantial difference between community hospitals (11.1%, two-sided Fischer’s exact test <italic>p</italic>
< 0.05), university (57.0%) and community teaching (60.0%) ones. Thirty-five (26.9%) participants admitted to the use of biological markers - such as procalcitonin - to decrease antimicrobial use in critically ill patients<bold>.</bold>
</p>
<p id="Par43">In any healthcare setting, a significant amount of time and energy should be spent on infection control. Surveillance studies can help clinicians to identify trends in pathogens incidence and antimicrobial resistance, including identification of emerging pathogens at local level<italic>.</italic>
The survey showed that 130 (83.3%) surgical departments had systematic reports about resistance data.</p>
<p id="Par44">Hospital pharmacists inside the multidisciplinary team should negotiate with hospital administration to obtain adequate and necessary infrastructure to measure antimicrobial use. Regular feedback about antimicrobial consumption can be an important determinant for change for healthcare professionals and policy makers to expedite progress towards prudent use of antimicrobials. The survey showed that 129 (81.6%) surgical departments had an antimicrobial monitoring system.</p>
<p id="Par45">Interestingly, 6 (6/41, 14.6%) surgical departments implementing a formulary restriction do not perform any monitoring system of used antimicrobials, and 4 (4/41, 9.8%) do not carry out any systematic reports about resistance data. Furthermore, 6 (7/70, 10.0%) surgical departments using a compulsory order form do not perform any monitoring system of used antimicrobials, and 11 (11/70, 15.7%) do not carry out any systematic reports about resistance data. In institutions that use restrictive interventions, monitoring overall trends in antimicrobial use and systematic reports about resistance data should be necessary to assess and respond to such shifts in use.</p>
<p id="Par46">The ultimate goal of any stewardship program should be to stimulate a behavioral change in prescribing practices. In this context, education of prescribers is crucial to convince clinicians to use antibiotics judiciously. However, without concurrent interventions education alone is of little value. In this regard, various stewardship interventions have been implemented with the aim of improving adherence to guidelines. Where these interventions have been clinician focused, accumulating evidence suggests that educational interventions are mostly ineffective and result in insignificant changes to overall compliance [<xref ref-type="bibr" rid="CR17">17</xref>
]. It is possible that this might relate to cognitive dissonance, a process in which clinician-focused education fails to engage prescribers effectively, allowing them to ignore the evidence and to continue with their regular habits and practices. Alternative strategies of improving antibiotic management of surgical patients are needed and these may include guidance of clinicians in the institutional process of improvement, which has not as yet been addressed in guidelines [<xref ref-type="bibr" rid="CR17">17</xref>
]. The answer may lie within the principles and imperatives contained with the change of processes in hospitals.</p>
<p id="Par47">It is highly important that faculty in academic medical centers and teaching hospitals focus on fundamental antibiotic stewardship principles in their preclinical and clinical curricula [<xref ref-type="bibr" rid="CR18">18</xref>
].</p>
<p id="Par48">The survey found that dissemination of educational materials and educational outreach were developed respectively in 85 cases (62.5%) and 73 (53.7%) surgical departments.</p>
<p id="Par49">This study has several limitations: with a response rate of just 19.4% we have to consider a response bias, and it is possible that non-participating physicians may have been less interested in ASPs than the participants and therefore it is possible that results are biased towards a better picture than it actually is. Furthermore, the study was conducted in a sample of physicians who participated in the AGORA project, and selecting international experts in the field again potentially resulting in an overrepresentation of hospitals with a considerably active ASP. No stratification or sampling according to medical specialty were pre-planned to ensure that all stakeholders were adequately represented, and finally our questionnaire was self-reported, has not been externally validated, and was evaluated in a single institution. The major strength of the study is its multinational (global) and multidisciplinary approach, to our best knowledge the first in this setting. Thus, our survey provides a benchmark to all interested stakeholders; it can be repeated over time to explore if better uniformity on a global platform of healthcare environments would develop in the future, and may be used to build consensus around the best practices in the field of prevention of surgical infections and rational use of antibiotics in a future project.</p>
</sec>
<sec id="Sec9"><title>Conclusions</title>
<p id="Par50">The results of the survey showed a heterogeneous organization of ASPs worldwide and demonstrated the need for a cohesive approach in order limit the emergence of antimicrobial resistance in surgical infections. Successful ASPs should focus on collaboration between all healthcare professionals in order to gain the wider-possible acceptance, share knowledge and spread best clinical practices. The main bias of the survey is the low response rate.</p>
</sec>
</body>
<back><app-group><app id="App1"><sec id="Sec10"><title>Additional file</title>
<p id="Par57"><media position="anchor" xlink:href="13017_2017_145_MOESM1_ESM.doc" id="MOESM1"><label>Additional file 1:</label>
<caption><p>The international cross-sectional survey. (DOC 56 kb)</p>
</caption>
</media>
</p>
</sec>
</app>
</app-group>
<glossary><title>Abbreviation</title>
<def-list><def-item><term>ASP</term>
<def><p id="Par5">Antimicrobial stewardship program</p>
</def>
</def-item>
</def-list>
</glossary>
<fn-group><fn><p><bold>Electronic supplementary material</bold>
</p>
<p>The online version of this article (doi:10.1186/s13017-017-0145-2) contains supplementary material, which is available to authorized users.</p>
</fn>
</fn-group>
<ack><title>Acknowledgements</title>
<p>Not applicable.</p>
<sec id="FPar1"><title>Funding</title>
<p id="Par51">None.</p>
</sec>
<sec id="FPar2"><title>Availability of data and materials</title>
<p id="Par52">Not applicable.</p>
</sec>
</ack>
<notes notes-type="author-contribution"><title>Authors’ contributions</title>
<p>MS wrote the first draft of the manuscript. All the authors reviewed the manuscript and approved the final draft.</p>
</notes>
<notes notes-type="COI-statement"><sec id="FPar3"><title>Ethics approval and consent to participate</title>
<p id="Par53">Not applicable.</p>
</sec>
<sec id="FPar4"><title>Consent for publication</title>
<p id="Par54">Not applicable.</p>
</sec>
<sec id="FPar5"><title>Competing interests</title>
<p id="Par55">The authors declare that they have no competing interests.</p>
</sec>
<sec id="FPar6"><title>Publisher’s Note</title>
<p id="Par56">Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.</p>
</sec>
</notes>
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