Prevalence, pattern, sensitivity and resistance to antibiotics of different bacteria isolated from port site infection in low risk patients after elective laparoscopic cholecystectomy for symptomatic cholelithiasis at tertiary care hospital of Kashmir

Abstract

The aim of this study was to determine specific pattern of port site microbial colonisation, sensitivity and resistance to different antibiotics of bacteria isolated from port site infection (PSI) in low risk patients after elective laparoscopic cholecystectomy in surgical wards at tertiary care hospital of Kashmir. This is a prospective study. The study included 675 consecutive patients of postoperative PSI after elective laparoscopic cholecystectomy for symptomatic cholelithiasis over a period of 12 months. Culture swabs were taken from port sites with signs of PSI and transported to the microbiology laboratory. The positive swab cultures were subjected to antibiotic susceptibility test. The data obtained was analysed by using appropriate statistical analytical tests. The incidence of PSI after elective laparoscopic cholecystectomy is 6·7%. The commonest organism responsible for PSI is pseudomonas, 19 (42·2%) cases. Most of the strains of organisms isolated were resistant to commonly used antibiotics in the hospital,pseudomonas was found 100% resistant to the combination of ampicillin + sulbactum and ceftriaxone and it was sensitive to imipenem, amikacin and vancomycin in 89·47,57 and 52·63% of cases respectively. Our study will be helpful in choosing effective empirical prophylactic antibiotic therapy in cases of elective laparoscopic cholecystectomy and will have a great impact on morbidity and mortality in them because of PSI.

Port Site Infections Following Laparoscopic Cholecystectomy

“…The incidence of port site infection following laparoscopic surgery are less than that of open procedure because laparoscopic surgery is minimally invasive and have less impact on immune system. 17 Incidence of port site infection in our study was 3.92% which was less than some studies [18][19][20][21][22] & more than some other studies. 7,[23][24][25] .Population , sterilization technique & environmental factors may be responsible for the difference among these studies.…”

Role of prophylactic antibiotics in elective laparoscopic cholecystectomy: A systematic review and meta-analysis

“…Full texts of 63 articles were reviewed and assessed for eligibility, and 34 studies including 28 RCTs and 3 prospective and 3 retrospective trials were included in this meta-analysis. Twenty-nine full-text articles555657585960616263646566676869707172737475767778798081828384 were excluded because of the following reasons: inclusion criteria not met,83 inappropriate intervention,5557707784 inappropriate comparator,565859 insufficient data reported, 606163656667686971727374757678808182 and data duplication 6264. The procedure for the study selection is summarized in the PRISMA flow diagram (Fig.…”

Effect of Cefazolin Prophylaxis on Postoperative Infectious Complications in Elective Laparoscopic Cholecystectomy: A Prospective Randomized Study

“…However the aim of antimicrobial prophylaxis is not to completely eradicate microorganisms from the tissue, but to reduce the number of microorganisms to such an extent that the defense mechanism of the host can effectively prevent infection by the contaminating microorganisms (15). Whether or not antibiotic prophylaxis has any effect on the occurrence of postoperative infections in LC remains controversial (1-7, 9-11). Several studies conclude that the use of prophylactic antibiotics in LC leads to a significant decrease in infectious complications (9, 10, 16).…”

“…Due to its low infection rate and because the use of prophylactic antibiotics does not further decrease the rate of wound infections or other postoperative infections, many investigators believe that antimicrobial prophylaxis may be unnecessary for LC patients (1-8). However, prophylactic antibiotic use in LC remains popular, and many surgeons believe that it decreases the incidence of postoperative infections (9-11). Cefazolin (a first-generation cephalosporin) has some favorable pharmacokinetic properties, including sufficient distribution to the gallbladder wall and a high concentration in bile.…”