Surgical Revision Promotes Presence of Enterococcus spp. in Abdominal Superficial Surgical Site Infections

Kassahun, Woubet Tefera; Lippmann, Norman; Scheuermann, Uwe; Groos, Linda; Buchloh, D; Jansen-Winkeln, Boris; Gockel, Ines

doi:10.1007/s11605-021-05170-3

Cited by 3 publications

(4 citation statements)

References 28 publications

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“…Furthermore, the surgical procedure can serve as a vector for introducing infectious agents as evidenced by a study indicating the development of certain bacterial species in SSIs following surgical revisions. 36 To overcome the above issues, colonization, and fecal contamination, some SSI bundles include changing gloves and trays before perineal wound closure. 35,37 Based on these results, when performing perineal wound closure, our institution changed gloves, trays, and protective clothing as new.…”

Section: Discussionmentioning

confidence: 99%

“…This risk factor can be attributed to the potential for fecal contamination and skin contamination from adjacent skin bacterial colonies during perineal surgery. Furthermore, the surgical procedure can serve as a vector for introducing infectious agents as evidenced by a study indicating the development of certain bacterial species in SSIs following surgical revisions 36 . To overcome the above issues, colonization, and fecal contamination, some SSI bundles include changing gloves and trays before perineal wound closure 35,37 .…”

Section: Discussionmentioning

confidence: 99%

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Influence of additional prophylactic oral antibiotics during mechanical bowel preparation on surgical site infection in patients receiving colorectal surgery

Lee,

Lee

et al. 2024

World j. surg.

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BackgroundProphylactic antibiotics (PAs) are standard for preventing surgical site infections (SSIs) post‐colorectal surgery. This study aims to compare the effect of additional empiric oral antibiotics (OAs) alongside routine PAs to identify SSI risk factors.MethodsA retrospective observatory analysis was conducted from January 2019 to December 2022 at Asan Medical Center, Seoul, Korea. The cohort was divided into two groups: PA given 1 h before surgery and discontinued within 24 h, and OA administered empiric OAs during mechanical bowel preparation in addition to PA.ResultsFrom a total of 6736 patients, 3482 were in the PA group and 3254 in the OA group. SSI incidence showed no significant intergroup difference (p = 0.374) even after propensity score matching (p = 0.338). The multivariable analysis revealed male sex [odds ratio (OR): 2.153, 95% confidence interval (CI): 1.626–2.852, and p = 0.001], open surgery (OR: 3.335, 95% CI: 2.456–4.528, and p = 0.001), dirty wound (OR: 2.171, 95% CI: 1.256–3.754, and p = 0.006), and an operation time of more than 145 min (OR: 2.110, 95% CI: 1.324–3.365, and p = 0.002) as SSI risk factors. In rectal surgery subgroup, OA demonstrated a protective effect against SSI (OR: 0.613, 95% CI: 0.408–0.922, and p = 0.019) and in laparoscopic approach (OR: 0.626, 95% CI: 0.412–0.952, and p = 0.028).ConclusionsOA did not affect SSI incidence in colorectal surgeries. Male sex, open surgery, dirty wounds, and longer operation time were risk factors for SSI. However, for rectal and laparoscopic surgery, OA was a protective factor for SSI.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Influence of additional prophylactic oral antibiotics during mechanical bowel preparation on surgical site infection in patients receiving colorectal surgery

Lee,

Lee

et al. 2024

World j. surg.

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“…Colonization of intestine with drug resistant enterococci in patients act as a possible source for dissemination of organisms to hospital environment, healthcare workers and to other patients [7]. Moreover, repeated surgery of the gastrointestinal tract, prolonged hospitalization is some of the factors to promote infection by Enterococcus spp [8]. Thus, all previous findings show, isolation of drug resistant or susceptible enterococci from surgical site infection depends on various factors like intestinal colonization, dissemination to the environment, infection control practices and many more.…”

Section: Discussionmentioning

confidence: 99%

“…Moreover, repeated surgery of the gastrointestinal tract, prolonged hospitalization are some of the factors to promote infection by Enterococcus spp. [8]. In case of surgical site infection, the role of Enterococci spp.…”

mentioning

confidence: 99%

Antibiogram of Enterococcus spp. associated with post-operative wound infections

Shivashankar¹,

Bhat²,

Dhanashree³

2023

Infectious diseases: News, Opinions, Training

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При лечении пациентов в стационарных учреждениях здравоохранения из образцов раневого отделяемого все чаще выделяют энтерококки с множественной лекарственной устойчивостью, обладающие высокой резистентностью к аминогликозидам, β-лактамам и гликопептиду. Основными факторами риска развития устойчивости являются сниженный иммунный статус, длительное пребывание в стационарном лечебном учреждении, лечение антибактериальными препаратами широкого спектра действия, такими как цефалоспорины и ванкомицин.Цель исследования -определение антибактериальной чувствительности штаммов Enterococcus spp., выделенных из образцов гнойного отделяемого больных с послеоперационной раневой инфекцией.Материал и методы. В исследование включены представители 30 видов Enterococcus spp. Штаммы Enterococcus spp. были выделены из биологического материала пациентов с послеоперационными раневыми инфекциями. Изоляты были идентифицированы с помощью стандартных биохимических тестов. Продукцию гемолизина определяли путем посева штаммов Enterococcus spp. на 5% агар с овечьей кровью. Диско-диффузионный тест Кирби-Бауэра использовали для определения чувствительности к антибактериальным средствам. Результаты теста интерпретировали в соответствии с рекомендациями CLSI. Минимальную ингибирующую концентрацию ванкомицина (MIC) определяли методом разведения в агаре.Результаты и обсуждение. Среди 30 изолятов энтерококка 18 (60%) идентифицированы как E. faecalis, по 4 (13%) были E. faecium и E. dispar, по 2 (7%) были E. pseudoavium и E. durans. 11 (61%) штаммов E. faecalis и 2 (7%) штамма E. faecium были положительными на гемолизин. 4 (22%) штамма E. faecalis были высокоустойчивы к стрептомицину. 8 (44%) штаммов E. faecalis и 1 (25%) штамм E. faecium показали устойчивость к гентамицину высокого уровня. Все изоляты энтерококка были чувствительны к ванкомицину при тестировании диско-диффузионным методом и разведении в агаре с MIC ≤2 мкг/мл.Заключение. Своевременное выделение энтерококков и оценка их чувствительности к антибактериальным препаратам позволяет проводить эффективную этиотропную терапию, что способствует снижению летальности у госпитализированных пациентов и ограничивает распространение антибиотикорезистентных штаммов в больницах.Финансирование. Исследование не имело финансовой поддержки. Конфликт интересов. Авторы заявляют об отсутствии конфликта интересов. Вклад авторов. Экспериментальная работа и обзор литературы для рукописи, анализ данных и написание текста -Шивашанкар Ш.Б.К.; экспериментальная работа, анализ данных и написание текста -Бхат Н.Р.; проект исследования, отслеживание экспериментов, анализ данных и рецензирование рукописи -Дханашри Б. Все авторы рассмотрели и одобрили окончательный вариант рукописи. Благодарность. Авторы благодарят сотрудников кафедры микробиологии, декана Медицинского колледжа Кастурба (Мангалор) за поддержку в проведении исследования.

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Rectal colonization is predictive for surgical site infections with multidrug-resistant bacteria in abdominal surgery

Kolbe-Busch

Lippmann

Moulla

et al. 2023

Langenbecks Arch Surg

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Purpose Superficial surgical site infections (SSI) are a common complication after abdominal surgery. Additionally, multidrug-resistant organisms (MDRO) have shown an increasing spread in recent years with a growing importance for health care. As there is varying evidence on the importance of MDRO in different surgical fields and countries as causative agents of SSI, we report our findings of MDRO-caused SSI. Methods We assembled an institutional wound register spanning the years 2015–2018 including all patients with abdominal surgery and SSI only, including demographics, procedure-related data, microbiological data from screenings, and body fluid samples. The cohort was examined for the frequency of different MDRO in screenings, body fluids, and wound swabs and assessed for risk factors for MDRO-positive SSI. Results A total of 138 out of 494 patients in the register were positive for MDRO, and of those, 61 had an MDRO isolated from their wound, mainly multidrug-resistant Enterobacterales (58.1%) followed by vancomycin-resistant Enterococcus spp. (19.7%). As 73.2% of all MDRO-carrying patients had positive rectal swabs, rectal colonization could be identified as the main risk factor for an SSI caused by a MDRO with an odds ratio (OR) of 4.407 (95% CI 1.782–10.896, p = 0.001). Secondly, a postoperative ICU stay was also associated with an MDRO-positive SSI (OR 3.73; 95% CI 1.397–9.982; p = 0.009). Conclusion The rectal colonization status with MDRO should be taken into account in abdominal surgery regarding SSI prevention strategies. Trial registration Retrospectively registered in the German register for clinical trials (DRKS) 19th December 2019, registration number DRKS00019058.

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Surgical Revision Promotes Presence of Enterococcus spp. in Abdominal Superficial Surgical Site Infections

Cited by 3 publications

References 28 publications

Influence of additional prophylactic oral antibiotics during mechanical bowel preparation on surgical site infection in patients receiving colorectal surgery

Influence of additional prophylactic oral antibiotics during mechanical bowel preparation on surgical site infection in patients receiving colorectal surgery

Antibiogram of Enterococcus spp. associated with post-operative wound infections

Rectal colonization is predictive for surgical site infections with multidrug-resistant bacteria in abdominal surgery

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