Literature DB >> 31642991

Successful perioperative infection control measures after gastroenterological surgery reduced the number of cases of methicillin-resistant Staphylococcus aureus or Clostridioides (Clostridium) difficile infection to almost zero over a 30-year period: a single-department experience.

Shinya Kusachi1, Manabu Watanabe2, Koji Asai2, Takaharu Kiribayashi2, Toru Niitsuma2, Hironobu Nishimuta2, Yoshihisa Saida2.   

Abstract

PURPOSE: To investigate changes in the incidence of postoperative infections in the surgical department of a teaching hospital.
METHODS: During the 30-year period from September 1987 to August 2017, 11,568 gastroenterological surgical procedures were performed in our surgical department. This 30-year period was divided into seven periods (A-G), ranging from 2 to 7 years each and based on the infection control methods used in each period. We then compared the rates of incisional surgical site infection (SSI) and organ/space SSI; remote infection (RI) including respiratory tract infection (RTI), intravascular catheter-related infection, and urinary tract infection (UTI); and antibiotic-associated colitis caused by methicillin-resistant Staphylococcus aureus (MRSA) enteritis or Clostridioides (Clostridium) difficile-associated disease (CDAD) among the seven periods.
RESULTS: In periods B (September 1990-August 1997) and E (November 2004-July 2007), when a unique antibiotic therapy devised in our department was in use, MRSA was isolated from only 0.3% and 0.4% of surgical patients, respectively, and these rates were significantly lower than those in the other periods (p < 0.05). The rate of CDAD increased during period F (August 2007-July 2014), but in period G (August 2014-August 2017), restrictions were placed on the use of antibiotics with a strong anti-anaerobic action and, in this period, the rate of CDAD was only 0.04%, which was significantly lower than that in period F (p < 0.05).
CONCLUSIONS: Limiting the use of antibiotics that tend to disrupt the intestinal flora may reduce the rates of MRSA infection and CDAD after gastroenterological surgery.

Entities:  

Keywords:  C. difficile; MRSA; Post-operative infection; SSI; Tazobactam/piperacillin

Year:  2019        PMID: 31642991     DOI: 10.1007/s00595-019-01899-2

Source DB:  PubMed          Journal:  Surg Today        ISSN: 0941-1291            Impact factor:   2.549


  18 in total

1.  Influence of various antimicrobial agents on the intestinal flora in an intestinal MRSA-carrying rat model.

Authors:  Masahiro Takahata; Yoko Sugiura; Satoshi Ameyama; Akira Yotsuji; Junichi Mitsuyama; Yoshinobu Sumiyama; Shinya Kusachi
Journal:  J Infect Chemother       Date:  2004-12       Impact factor: 2.211

2.  Twenty years of countermeasures against postoperative methicillin-resistant Staphylococcus aureus infections.

Authors:  Shinya Kusachi; Jiro Nagao; Yoshihisa Saida; Manabu Watanabe; Yoichi Nakamura; Koji Asai; Yasushi Okamoto; Yoichi Arima; Ryohei Watanabe; Masashi Uramatsu; Tomoaki Saito; Takaharu Kiribayashi; Junko Sato
Journal:  Surg Today       Date:  2011-05-01       Impact factor: 2.549

Review 3.  Comorbidities, Exposure to Medications, and the Risk of Community-Acquired Clostridium difficile Infection: a systematic review and meta-analysis.

Authors:  Luis Furuya-Kanamori; Jennifer C Stone; Justin Clark; Samantha J McKenzie; Laith Yakob; David L Paterson; Thomas V Riley; Suhail A R Doi; Archie C Clements
Journal:  Infect Control Hosp Epidemiol       Date:  2015-02       Impact factor: 3.254

Review 4.  Pharmacokinetic/pharmacodynamic parameters: rationale for antibacterial dosing of mice and men.

Authors:  W A Craig
Journal:  Clin Infect Dis       Date:  1998-01       Impact factor: 9.079

Review 5.  Effect of antimicrobial agents on the ecological balance of human microflora.

Authors:  A Sullivan; C Edlund; C E Nord
Journal:  Lancet Infect Dis       Date:  2001-09       Impact factor: 25.071

Review 6.  Antibiotics and hospital-acquired Clostridium difficile infection: update of systematic review and meta-analysis.

Authors:  Claudia Slimings; Thomas V Riley
Journal:  J Antimicrob Chemother       Date:  2013-12-08       Impact factor: 5.790

Review 7.  Clostridium difficile-associated diarrhea and colitis.

Authors:  D N Gerding; S Johnson; L R Peterson; M E Mulligan; J Silva
Journal:  Infect Control Hosp Epidemiol       Date:  1995-08       Impact factor: 3.254

8.  Strategy of antibiotic rotation: long-term effect on incidence and susceptibilities of Gram-negative bacilli responsible for ventilator-associated pneumonia.

Authors:  Didier Gruson; Gilles Hilbert; Frederic Vargas; Ruddy Valentino; Nam Bui; Sabine Pereyre; Christianne Bebear; Cecile-Marie Bebear; Georges Gbikpi-Benissan
Journal:  Crit Care Med       Date:  2003-07       Impact factor: 7.598

9.  Prophylactic antibiotics given within 24 hours of surgery, compared with antibiotics given for 72 hours perioperatively, increased the rate of methicillin-resistant Staphylococcus aureus isolated from surgical site infections.

Authors:  Shinya Kusachi; Yoshinobu Sumiyama; Jiro Nagao; Yoichi Arima; Yuichi Yoshida; Hidenori Tanaka; Yoichi Nakamura; Yoshihisa Saida; Manabu Watanabe; Ryohei Watanabe; Junko Sato
Journal:  J Infect Chemother       Date:  2008-02-24       Impact factor: 2.211

Review 10.  2016 WSES guidelines on acute calculous cholecystitis.

Authors:  L Ansaloni; M Pisano; F Coccolini; A B Peitzmann; A Fingerhut; F Catena; F Agresta; A Allegri; I Bailey; Z J Balogh; C Bendinelli; W Biffl; L Bonavina; G Borzellino; F Brunetti; C C Burlew; G Camapanelli; F C Campanile; M Ceresoli; O Chiara; I Civil; R Coimbra; M De Moya; S Di Saverio; G P Fraga; S Gupta; J Kashuk; M D Kelly; V Koka; H Jeekel; R Latifi; A Leppaniemi; R V Maier; I Marzi; F Moore; D Piazzalunga; B Sakakushev; M Sartelli; T Scalea; P F Stahel; K Taviloglu; G Tugnoli; S Uraneus; G C Velmahos; I Wani; D G Weber; P Viale; M Sugrue; R Ivatury; Y Kluger; K S Gurusamy; E E Moore
Journal:  World J Emerg Surg       Date:  2016-06-14       Impact factor: 5.469

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