Current status of postoperative infections after digestive surgery in Japan: The Japan Postoperative Infectious Complications Survey in 2015

Abstract

Aim To survey postoperative infections (PI) after digestive surgery. Methods This survey, conducted by the Japan Society of Surgical Infection, included patients undergoing digestive surgery at 28 centers between September 2015 and March 2016. Data collected included patient background characteristics, type of surgery, contamination status, and type of PI, including surgical site infection (SSI), remote infection (RI), and antimicrobial‐resistant (AMR) bacterial infections and colonization. Results Postoperative infections occurred in 10.7% of 6582 patients who underwent digestive surgery (6.8% for endoscopic surgery and 18.7% for open surgery). SSI and RI, including respiratory tract infection, urinary tract infection, antibiotic‐associated diarrhea, drain infection, and catheter‐related bloodstream infection, occurred in 8.9% and 3.7% of patients, respectively. Among all PI, 13.2% were overlapping infections. The most common overlapping infections were incisional and organ/space SSI, which occurred in 4.2% of patients. AMR bacterial infections occurred in 1.2% of patients after digestive surgery and comprised 11.5% of all PI. Rate of AMR bacterial colonization after digestive surgery was only 0.3%. Conclusion Periodic surveillance of PI, including AMR bacteria, is necessary for a detailed evaluation of nosocomial infections.

Prediction of Postoperative Infection for Patients Undergoing Gastrointestinal Surgery: Findings from Electronic Health Records

“…An observational study in Japan reported a POI incidence of 10.7% in 6582 patients who underwent GI surgery (6.8% for endoscopic surgery and 18.7% for open surgery) in 2015. In addition, the incidence rates of SSI in the biliary tract, pancreas, and esophagus were approximately 32.4%, 31.2%, and 20.1%, respectively, which were remarkably higher than those in other surgical sites [1].…”

“…Bacterial infection was confirmed by bacterial isolation. Bacterial colonization was defined as the presence of low-volume bacteria [1]. Data were collected to determine the infection and colonization status of the following antimicrobial-resistant bacteria: Clostridioides difficile, methicillin-resistant Staphylococcus aureus, and extended-spectrum beta-lactamase-producing Enterobacteriaceae [9][10][11].…”

“…Postoperative infections (POIs), including surgical site infections (SSIs), in patients who undergo gastrointestinal (GI) surgery could lead to morbidity and prolonged hospitalization, which consequently increases medical costs and ultimately increases the risk of mortality [1]. Ohno et al reported that following the occurrence of SSIs after GI surgery, the median time for hospitalization was prolonged to 9 days, and the median medical cost increased to 576,000 Japanese Yen [2].…”

“…Severe sepsis and septic shock have mortality rates of approximately 50%. Severe sepsis and septic shock are as common and lethal as other acute life-threatening conditions that emergency physicians routinely encounter, such as acute myocardial infarction, stroke, and trauma [1,7,8].…”

Postoperative Infection after Colorectal Surgery: Subanalysis of Data from the 2015 Japan Postoperative Infectious Complications Survey

“…To address this need, the Japan Society of Surgical Infection organized the Japan Postoperative Infectious Complications Survey in 2015 to perform a multicenter joint study of the incidence of postoperative infection in digestive surgery. 7 The present report is a subanalysis of these data, for colorectal surgery.…”