Postoperative infection rate and clinical outcome after oncosurgery for endometrial carcinoma in a patient population with high prevalence of multidrug-resistant organism colonization and multiple comorbidities

Abstract

To the Editor-Surgical site infection (SSI) among patients undergoing oncosurgery for cancer can increase the chances of morbidity and mortality, delay discharge from the hospital, increase healthcare costs, and affect subsequent management of cancers (through the delay of chemotherapy or radiotherapy). 1 The challenges of SSI are greater in low-and middle-income countries because of resource constraints and due to endemicity of multidrug-resistant gram-negative bacteria (MDR-GNB), which colonizes and infects patients in significant numbers. 2-4 SSI rates are also influenced by preoperative comorbidities. [5][6][7] In the current study, we report the impact of significant MDR-GNB colonization and concurrent comorbidity on SSI and long-term surgical outcomes.The current retrospective study was conducted among patients operated for endometrial cancer in an oncology center in eastern India between 2011 and 2016. In total, 150 patients underwent gynecological oncosurgery during this period. Most patients in the study population were of postmenopausal age (median age, 58 years; range, 34-81 years; interquartile range [IQR], 54-64 years). Most patients were overweight or obese (median body mass index, 30 kg/ m 2 ; IQR, 26-33 kg/m 2 ; range, 14-48 kg/m 2 ). Of the 150 patients, 113 (75%) had 1 or more comorbidities (eg, asthma, diabetes, hypertension, hypothyroidism). Hypertension was the most common comorbidity, affecting 86 of 150 patients, followed by diabetes mellitus in 61 of 150 patients (40.6%) and hypothyroidism in 42 of 150

Predictive factors of surgical site infection after hysterectomy for endometrial carcinoma: a retrospective analysis

“…Besides, 46 strains of pathogenic bacteria were isolated from patients with SSI, which are mainly gram-negative bacteria, among which Escherichia coli, Klebsiella pneumoniae and Staphylococcus aureus were more common. The findings of the distribution of SSI pathogenic bacteria in previous studies [ 27 , 28 ] are consistent with our results. There is no significant difference in the distribution of pathogens at the surgical site of endometrial carcinoma and other gynecological surgical sites, which may be associated with the same characteristics of colonizing pathogens at the same surgical site [ 29 ].…”

“…For the patients with diabetes, especially those with poor blood sugar control, have reduced body defenses and reduced ability to resist the invasion of foreign pathogenic microorganisms, which can increase risks of SSI [ 30 ]. Previous studies [ 27 , 28 ] have reported that patients with higher BMI ​​have thicker subcutaneous fat tissue, poor blood flow to adipose tissue, and are prone to fat liquefaction, with are associated with the development of SSI. We have not found the relationship between BMI and SSI, which may be related to the fact that the sample size is small, future studies with larger sample size are needed.…”

The Relationship Between Preoperative Glycosylated Hemoglobin Levels and Postoperative Wound Complications in Diabetic Patients Undergoing Hysterectomy

“…There are many studies in the literature with different opinions on the relationship between BMI and the development of SSI. Some previous studies have reported that patients with higher BMI have thicker subcutaneous adipose tissue, poorer blood supply to the adipose tissue, and are prone to fat necrosis, which is associated with the development of SSI (32,33). In contrast to the results of these studies, Shi et al found no association between BMI and SSI in their study (19).…”