Matthias Mehdorn1, Woubet Tefera Kassahun2, Norman Lippmann3, Uwe Scheuermann2, Linda Groos2, Dorina Buchloh2, Boris Jansen-Winkeln2, Ines Gockel2. 1. Department of Visceral, Transplant, Thoracic and Vascular Surgery, University Hospital of Leipzig, Liebigstraße 20, 04103, Leipzig, Germany. Matthias.mehdorn@medizin.uni-leipzig.de. 2. Department of Visceral, Transplant, Thoracic and Vascular Surgery, University Hospital of Leipzig, Liebigstraße 20, 04103, Leipzig, Germany. 3. Institute for Medical Microbiology and Virology, University Hospital of Leipzig, Leipzig, Germany.
Abstract
BACKGROUND: Superficial surgical site infections (SSSIs) are a major reason for morbidity after abdominal surgery. Microbiologic isolates of SSSIs vary widely geographically. Therefore, knowledge about the specific bacterial profile is of paramount importance to prevent SSSI. METHODS: We performed a subgroup analysis of the microbiological isolates from patients with SSSI after abdominal surgery that were included in our institutional wound register. We aimed at identifying predominant strains as well as risk factors that would predispose for SSSI with certain bacteria. RESULTS: A total of 494 patients were eligible for analysis. Of those 313 had received wound swaps, with 268 patients yielding a bacterial isolate. Enterobacterales (31.7%) and Enterococcus spp. (29.5%) were found as main bacteria in SSSI, with 62.3% of the wounds being polymicrobial. As risk factors for changes in bacterial isolates, we identified operative revision (OR 3.032; 95%CI 1.734-5.303) in multivariate analysis. Enterococcus spp. showed a significant increase in patients after revision surgery (p<0.001). Antibiotic therapy was neither influential on bacterial changes nor on the presence of Enterococcus spp. in SSSI. CONCLUSION: Our study accentuates the high frequency of Enterococcus spp. in SSSI after abdominal surgery, while identifying surgical revision as major risk factor. The results urge vigilance in the treatment of patients with surgical revisions to include Enterococcus spp. in the prevention and treatment strategies.
BACKGROUND: Superficial surgical site infections (SSSIs) are a major reason for morbidity after abdominal surgery. Microbiologic isolates of SSSIs vary widely geographically. Therefore, knowledge about the specific bacterial profile is of paramount importance to prevent SSSI. METHODS: We performed a subgroup analysis of the microbiological isolates from patients with SSSI after abdominal surgery that were included in our institutional wound register. We aimed at identifying predominant strains as well as risk factors that would predispose for SSSI with certain bacteria. RESULTS: A total of 494 patients were eligible for analysis. Of those 313 had received wound swaps, with 268 patients yielding a bacterial isolate. Enterobacterales (31.7%) and Enterococcus spp. (29.5%) were found as main bacteria in SSSI, with 62.3% of the wounds being polymicrobial. As risk factors for changes in bacterial isolates, we identified operative revision (OR 3.032; 95%CI 1.734-5.303) in multivariate analysis. Enterococcus spp. showed a significant increase in patients after revision surgery (p<0.001). Antibiotic therapy was neither influential on bacterial changes nor on the presence of Enterococcus spp. in SSSI. CONCLUSION: Our study accentuates the high frequency of Enterococcus spp. in SSSI after abdominal surgery, while identifying surgical revision as major risk factor. The results urge vigilance in the treatment of patients with surgical revisions to include Enterococcus spp. in the prevention and treatment strategies.
Authors: K Furukawa; M Onda; H Suzuki; H Maruyama; Y Akiya; M Ashikari; K Maezawa; A Tokunaga; T Tajiri; N Tanaka; K Yamasita Journal: Surg Today Date: 1999 Impact factor: 2.549
Authors: Sandra I Berríos-Torres; Craig A Umscheid; Dale W Bratzler; Brian Leas; Erin C Stone; Rachel R Kelz; Caroline E Reinke; Sherry Morgan; Joseph S Solomkin; John E Mazuski; E Patchen Dellinger; Kamal M F Itani; Elie F Berbari; John Segreti; Javad Parvizi; Joan Blanchard; George Allen; Jan A J W Kluytmans; Rodney Donlan; William P Schecter Journal: JAMA Surg Date: 2017-08-01 Impact factor: 14.766