Acta Scientific Microbiology (ISSN: 2581-3226)

Research Article Volume 5 Issue 4

Single Institution’s Postoperative Infections: A Prospective Descriptive Study on Incidence, Risk Factors, Management and Outcome

Lamis H Amer1, Rami Waked1, Ghassan Sleilaty2, Gebrael Saliba1, Elie Haddad1, Marie Chedid1, Nabil Chehata1, Hadi Younes1 and Jacques Choucair1*

1Department of Infectious Diseases, Faculty of Medicine, Saint Joseph University, Beirut, Lebanon

2Department of Biostatistics, Faculty of Medicine, Saint Joseph University, Beirut, Lebanon

*Corresponding Author: Jacques Choucair, Department of Infectious Diseases, Faculty of Medicine, Saint Joseph University, Beirut, Lebanon.

Received: January 31, 2022; Published: March 18, 2022

Abstract

Background: Evaluate the incidence, potential risk factors, management and outcome of postoperative infections.

Methods: This is a prospective study between August 2017 and October 2018 taking place in a Middle Eastern tertiary care center. The sample was collected using infectious disease consultations, and cases specified by doctors and residents of surgery. The definition of the surgical site infection used was the one defined by the Center for Disease Control and Prevention (CDC). The following variables were collected: age, arterial hypertension, diabetes, hyperlipidemia, tobacco smoking, immunosuppression, type of surgery, preoperative antibiotic therapy, the site of infection, the causative organism, the resistance profile of the infective organism, the treatment and the prognosis of the infection.

Results: Escherichia coli (36%) was the most frequent causative bacteria in postoperative infections, followed by Staphylococcus aureus (10%). 65% of the Enterobacteriaceae secrete an extended spectrum beta lactamase (ESBL), and 12.5% of the Staphylococcus aureus were methicillin resistant. The Altemeier score seems to affect the incidence of infections. The antibiotic prophylaxis was well targeted in 90.9%. A targeted postoperative antibacterial treatment was initiated in 86% versus 14% of inappropriate antibiotics. The duration of treatment was appropriate in 72.8% of cases. These postoperative infections had a favorable evolution in 58%, and a recurrence rate of 23%. No potential risk factor was found significant in this study.

Conclusion: Strategies to prevent and decrease such complications must be implemented in every hospital. More studies are needed to determine the frequency and epidemiology of the postoperative infections. Better-targeted management is warranted.

Keywords: Postoperative Infections; Surgical Site Infections; Antibiotic Therapy; Antibiotic Prophylaxis; and Outcome

References

  1. Wenzel RP and Pfaller MA. “Feasible and desirable future targets for reducing the costs of hospital infections”. Journal of Hospital Infection 18 (1991): 94-98.
  2. Horan TC., et al. “Nosocomial infections in surgical patients in the United States, January 1986-June 1992. National Nosocomial Infections Surveillance (NNIS) System”. Infection Control and Hospital Epidemiology 2 (1993): 73-80.
  3. Herwaldt LA., et al. “Prospective Study of Outcomes, Healthcare Resource Utilization, and Costs Associated with Postoperative Nosocomial Infections”. Infection Control and Hospital Epidemiology12 (2006): 1291-1298.
  4. Berríos-Torres SI., et al. “Centers for Disease Control and Prevention Guideline for the Prevention of Surgical Site Infection, 2017”. JAMA Surgery8 (2017): 784-791.
  5. Health (UK) NCC for W and C. “Definitions, surveillance and risk factors”. RCOG Press (2008).
  6. Umscheid CA., et al. “Estimating the proportion of healthcare-associated infections that are reasonably preventable and the related mortality and costs”. Infection Control and Hospital Epidemiology 2 (2011): 101-114.
  7. Horan TC., et al. “CDC/NHSN surveillance definition of health care-associated infection and criteria for specific types of infections in the acute care setting”. American Journal of Infection Control5 (2008): 309-332.
  8. l’Urologie M de. Recommandations de bonnes pratiques cliniques : l’antibioprophylaxie en chirurgie urologique, par le Comité d’infectiologie de l’association française d’urologie (CIAFU) (2018).
  9. National Nosocomial Infections Surveillance (NNIS) report, data summary from October 1986-April 1996, issued May 1996. “A report from the National Nosocomial Infections Surveillance (NNIS) System”. American Journal of Infection Control5 (1996): 380-388.
  10. Alonso-Isa M., et al. “Infección de herida quirúrgica en urología. Análisis de factores de riesgo y microorganismos asociados”. Actas Urológicas Españolas 2 (2017): 109-116.
  11. Alp E., et al. “Incidence and risk factors of surgical site infection in general surgery in a developing country”. Surgery Today4 (2014): 685-689.
  12. Dudeck MA., et al. “National Healthcare Safety Network (NHSN) Report, Data Summary for 2012, Device-associated Module”. American Journal of Infection Control12 (2013): 1148-1166.
  13. Cheng H., et al. “Prolonged Operative Duration Increases Risk of Surgical Site Infections: A Systematic Review”. Surgery Infection6 (2017): 722-735.
  14. Martin ET., et al. “Diabetes and Risk of Surgical Site Infection: A systematic review and meta-analysis”. Infection Control and Hospital Epidemiology1 (2016): 88-99.
  15. Alverdy JC and Prachand V. “Smoking and Postoperative Surgical Site Infection: Where There’s Smoke, There’s Fire”. JAMA Surgery 5 (2017): 484-484.
  16. Durand F., et al. “Smoking is a risk factor of organ/space surgical site infection in orthopaedic surgery with implant materials”. International Orthopaedics 4 (2013): 723-727.
  17. Nichols RL. “Preventing Surgical Site Infections”. Clinical Medicine and Research 2 (2004): 115-118.
  18. Boetto J., et al. “Is hospital information system relevant to detect surgical site infection? Findings from a prospective surveillance study in posterior instrumented spinal surgery”. Orthopaedics and Traumatology: Surgery and Research7 (2015): 845-849.

Citation

Citation: Jacques Choucair., et al. “Single Institution’s Postoperative Infections: A Prospective Descriptive Study on Incidence, Risk Factors, Management and Outcome". Acta Scientific Microbiology 5.4 (2022): 91-97.

Copyright

Copyright: © 2022 Jacques Choucair., et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.




Metrics

Acceptance rate30%
Acceptance to publication20-30 days

Indexed In






News and Events


  • Certification for Review
    Acta Scientific certifies the Editors/reviewers for their review done towards the assigned articles of the respective journals.
  • Submission Timeline for Upcoming Issue
    The last date for submission of articles for regular Issues is December 25, 2024.
  • Publication Certificate
    Authors will be issued a "Publication Certificate" as a mark of appreciation for publishing their work.
  • Best Article of the Issue
    The Editors will elect one Best Article after each issue release. The authors of this article will be provided with a certificate of "Best Article of the Issue"

Contact US