scholarly journals Variation in the Type and Frequency of Postoperative Invasive Staphylococcus aureus Infections According to Type of Surgical Procedure

2010 ◽  
Vol 31 (7) ◽  
pp. 701-709 ◽  
Author(s):  
Deverick J. Anderson ◽  
Jean Marie Arduino ◽  
Shelby D. Reed ◽  
Daniel J. Sexton ◽  
Keith S. Kaye ◽  
...  
Keyword(s):  
Staphylococcus Aureus ◽  
Surgical Site Infection ◽  
Bloodstream Infection ◽  
Surgical Procedures ◽  
Tertiary Care ◽  
Orthopedic Procedures ◽  
Neurosurgical Procedures ◽  
Site Infection ◽  
Incisional Surgical Site Infection ◽  
Epidemiological Characteristics

Objective.To determine the epidemiological characteristics of postoperative invasive Staphylococcus aureus infection following 4 types of major surgical procedures.Design.Retrospective cohort study.Setting.Eleven hospitals (9 community hospitals and 2 tertiary care hospitals) in North Carolina and Virginia.Patients.Adults undergoing orthopedic, neurosurgical, cardiothoracic, and plastic surgical procedures.Methods.We used previously validated, prospectively collected surgical surveillance data for surgical site infection and microbiological data for bloodstream infection. The study period was 2003 through 2006. We defined invasive S. aureus infection as either nonsuperficial incisional surgical site infection or bloodstream infection. Nonparametric bootstrapping was used to generate 95% confidence intervals (CIs). P values were generated using the Pearson x2 test, Student t test, or Wilcoxon rank-sum test, as appropriate.Results.In total, 81,267 patients underwent 96,455 procedures during the study period. The overall incidence of invasive S. aureus infection was 0.47 infections per 100 procedures (95% CI, 0.43–0.52); 227 (51%) of 446 infections were due to methicillin-resistant S. aureus. Invasive S. aureus infection was more common after cardiothoracic procedures (incidence, 0.79 infections per 100 procedures [95% CI, 0.62–0.97]) than after orthopedic procedures (0.37 infections per 100 procedures [95% CI, 0.32–0.42]), neurosurgical procedures (0.62 infections per 100 procedures [95% CI, 0.53–0.72]), or plastic surgical procedures (0.32 infections per 100 procedures [95% CI, 0.17¬0.47]) (P < .001). Similarly, S. aureus bloodstream infection was most common after cardiothoracic procedures (incidence, 0.57 infections per 100 procedures [95% CI, 0.43–0.72]; P < .001, compared with other procedure types), comprising almost three-quarters of the invasive S. aureus infections after these procedures. The highest rate of surgical site infection was observed after neurosurgical procedures (incidence, 0.50 infections per 100 procedures [95% CI, 0.42–0.59]; P < .001, compared with other procedure types), comprising 80% of invasive S. aureus infections after these procedures.Conclusion.The frequency and type of postoperative invasive S. aureus infection varied significantly across procedure types. The highest risk procedures, such as cardiothoracic procedures, should be targeted for ongoing preventative interventions.

Importance of Methicillin-Resistant Staphylococcus aureus Eradication in Carriers to Prevent Postoperative Methicillin-Resistant Staphylococcus aureus Surgical Site Infection

2011 ◽  
Vol 77 (1) ◽  
pp. 27-31 ◽  
Author(s):  
Walter E. Pofahl ◽  
Keith M. Ramsey ◽  
Delores L. Nobles ◽  
M. Kathy Cochran ◽  
Claudia Goettler
Keyword(s):  
Staphylococcus Aureus ◽  
Surgical Site Infection ◽  
Methicillin Resistant Staphylococcus Aureus ◽  
Tertiary Care ◽  
Carrier State ◽  
Care Hospital ◽  
Site Infection ◽  
Improvement Project ◽  
Methicillin Resistant ◽  
Rapid Polymerase Chain Reaction

Although infrequent, postoperative methicillin-resistant Staphylococcus aureus (MRSA) surgical site infection (SSI) is associated with significant morbidity and cost. Previous studies have identified the importance of MRSA screening to diminish the risk of postoperative MRSA SSI. The current study quantifies the importance of eradication of the MRSA carrier state to prevent MRSA SSI. Beginning February 2007, all admissions to an 800-bed tertiary care hospital were screened for MRSA by nasal swab using rapid polymerase chain reaction-based testing. Patients found to be nasal carriers of MRSA were treated with 2 per cent mupirocin nasal ointment and 4 per cent chlorhexidine soap before surgery. The subset of patients undergoing procedures that are part of the Surgical Care Improvement Project (SCIP) were followed for MRSA SSI (n = 8980). The results of preoperative MRSA screening and eradication of the carrier state were analyzed. Since the initiation of universal MRSA screening, 11 patients undergoing SCIP procedures have developed MRSA SSI (0.12%). Of these, six patients (55%) had negative preoperative screens. Of the five patients with positive preoperative screens, only one received treatment to eradicate the carrier state. In patients who develop MRSA SSI, failure to treat the carrier state before surgery results in MRSA SSI.

scholarly journals Microbiology of Incisional Surgical Site Infection

2019 ◽  
Vol 17 (1) ◽  
pp. 18-24
Author(s):  
Krisna Rani Majumder ◽  
Samia Mubin ◽  
Md Ibrahim Siddique ◽  
M Nur E Elahi
Keyword(s):  
Escherichia Coli ◽  
Staphylococcus Aureus ◽  
Surgical Site Infection ◽  
Gastrointestinal Surgery ◽  
Resistance Pattern ◽  
International Studies ◽  
Site Infection ◽  
Prevention Policy ◽  
Pseudomonas Spp ◽  
Incisional Surgical Site Infection

Background: Bacteria responsible for causing lncisional Surgical Site Infection (ISSI) along with their resistance pattern changes over time due to various factors and are a matter of regular scrutiny. Proper understanding of this will help both surgeon and microbiologist to formulate an effective guideline to combat overall SSI. Objectives: To evaluate responsible microorganisms and their resistance pattern causing ISSI following elective gastrointestinal surgery in our perspective. Methods: Prospective data were collected on 1122 surgical patients admitted in the surgery department in BSMMU from January 201 O to June 2012 having elective gastrointestinal surgery. Patients operated were followed in the post operative period till discharge and if any ISSI noted, swab from the site of infection was sent for culture and sensitivity reporting using standard bacteriological techniques. Antibiotics were given accordingly. Results: In this series 1122 wounds were studied of which183(16.31%) cases had ISSI.Wound infection rates, according to clinical wound types were 10.45%, 14.49%, 49% for clean-contaminated,contaminated and dirty wounds respectively. The figures of ISSI according to SSI types were 76.77% for Superficial SSI and 26.23% for Deep SSI.The figures of ISSI according to SSI types were 76.77% for Superficial SSI and 26.23% for Deep SSI. Causative microorganisms were revealed in 74.87% positive cultures. 5.8% wounds had polymicrobial etiology. The common causative organisms were Escherichia coli 55.5%,Staphylococcus aureus 22.6%, Pseudomonas spp. 9.5% and Klebsiella spp. 6.6%.AII were 100% sensitive to Meropenem. Next to this Escherichia coli and Klebsiellaspp. were mostly sensitive to Ceftriaxone 62.5% and 100% respectively, Staphylococcus aureus to Doxicycline 75% and Pseudomonas spp. to Ceftazidime 93.7%. Comparison with previously done national and international studies revealed alarming increase in resistance pattern of causative bacterial isolates. Conclusion: To date no national or in house SSI prevention policy or surveillance guideline exists. Lack of our attention in this issue along with inept, irrational use of antibiotics is definitely adding causative organisms to gain increasing resistance pattern. Before surgical care centers are overwhelmed with SSls by resistant organisms caution must be taken from all level. Journal of Surgical Sciences (2013) Vol. 17 (1) : 18-24

Self-reported beta-lactam allergy and the risk of surgical site infection: A retrospective cohort study

2020 ◽  
Vol 41 (4) ◽  
pp. 438-443 ◽  
Author(s):  
Philip W. Lam ◽  
Payam Tarighi ◽  
Marion Elligsen ◽  
Keith Gunaratne ◽  
Avery B. Nathens ◽  
...  
Keyword(s):  
Cohort Study ◽  
Surgical Site Infection ◽  
Surgical Procedures ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
Tertiary Care ◽  
Site Infection ◽  
Improvement Program ◽  
Increased Risk ◽  
To Receive

AbstractObjective:To assess whether a self-reported β-lactam allergy is associated with an increased risk of surgical site infection (SSI) across a broad range of procedures and to determine whether this association is mediated by the receipt of an alternate antibiotic to cefazolin.Design:Retrospective cohort study.Participants:Surgical procedures sampled by an institutional National Surgical Quality Improvement Program database over an 18-month period (January 2017 to June 2018) from 7 surgical specialties.Setting:Tertiary-care academic hospital.Results:Of the 3,589 surgical procedures included in the study, 369 (10.3%) were performed in patients with a reported β-lactam allergy. Those with a reported β-lactam allergy were significantly less likely to receive cefazolin (38.8% vs 95.5%) or metronidazole (20.3% vs 26.1%) and were more likely to receive clindamycin (52.0% vs 0.2%), gentamicin (3.5% vs 0%), or vancomycin (2.2% vs 0.1%) than those without allergy. An SSI occurred in 154 of 3,220 procedures (4.8%) in patients without reported allergy and 27 of 369 (7.3%) with reported allergy. In the multivariable regression model, a reported β-lactam allergy was associated with a statistically significant increase in SSI risk (adjusted odds ratio [aOR], 1.61; 95% confidence interval [CI], 1.04–2.51; P = .03). This effect was completely mediated by receipt of an alternate antibiotic to cefazolin (indirect effect aOR, 1.68; 95% CI, 1.17–2.34; P = .005).Conclusions:Self-reported β-lactam allergy was associated with an increased SSI risk mediated through receipt of alternate antibiotic prophylaxis. Safely increasing use of cefazolin prophylaxis in patients with reported β-lactam allergy can potentially lower the risk of SSIs.

scholarly journals A Study on the Prevalence and Source of Staphylococci and Methicillin-resistant Staphylococcus aureus Causing Superficial Incisional Surgical Site Infection

2021 ◽  
Vol 9 (1) ◽  
pp. 114-121
Author(s):  
Kameran M. Ali ◽  
Bahrouz M. A. Al-Jaff
Keyword(s):  
Staphylococcus Aureus ◽  
Surgical Site Infection ◽  
Antibiotic Susceptibility ◽  
Methicillin Resistant Staphylococcus Aureus ◽  
Hospital Environment ◽  
Site Infection ◽  
Methicillin Resistant ◽  
Resistance To Antibiotics ◽  
Incisional Surgical Site Infection ◽  
Rapd Pcr

Staphylococcus aureus and coagulase-negative staphylococci (CoNS) are common causatives of superficial incisional surgical site infection (SSI). The source of the pathogens is still not fully diagnosed whether it is endogenous or exogenous particularly with regard to the extent of its resistance to antibiotics. Therefore, this study is designed to determine the rate of infection, the source of pathogens, and the extent of their resistance to antibiotics. For this purpose, pre-, intra- and post-operative swabs from the nasal and skin of patients undergoing surgeries and samples from the hospital environment have been collected and processed for isolation and identification of staphylococci. Bacterial analysis and antibiotic susceptibility profiles of the isolates are assessed by unweighted pair group method with arithmetic mean (UPGMA) analysis based on random amplified polymorphic DNA-polymerase chain reaction (RAPD-PCR) and disc diffusion test for antibiotics susceptibility profile. The microbiological and PCR results indicate that SSIs are found in 113/512 (22.07%), Staphylococcus spp. rated 67/512 (13.09%) of infections. Further analysis indicates that S. aureus, CoNS, and both of them were causes SSI with different rates 41/67 (61.2%), 23/67 (34.3%), and 3/67 (4.5%), respectively. Results of RAPD-PCR for 70 isolates reveal that 52/70 (74.28%) of SSIs are from endogenous source, followed by 10/70 (14.29%) and 8/70 (11.43%) from hospitals acquired and undetermined sources, respectively. Moreover, results of antibiotic susceptibility test reveal that 24/44 (54.5%) of isolates belong to methicillin-resistant Staphylococcus aureus; from both endogenous and exogenous sources with 13/24 (54.17%) and 11/24 (45.83%), respectively.

Surgical site infection in colorectal surgeries: Experience in tertiary care hospital

2015 ◽  
Vol 12 ◽  
pp. S11
Author(s):  
Afshan Anjum Wani ◽  
Nisar Ahmad Chowdri ◽  
Fazal Q. Parray ◽  
Rouf A. Wani
Keyword(s):  
Surgical Site Infection ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Care Hospital ◽  
Site Infection
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