Is There an Association between Intra-Operative Detection of Pathogens in Subcutaneous Tissue and Surgical Site Infections? Results from a Prospective Study

被引：2

作者：

Strobel, Rahel M. ^{[1
]}

Leistner, Rasmus ^{[2
]}

Leonhardt, Marja ^{[3
]}

Neumann, Konrad ^{[4
]}

Eschlboeck, Sophie M. ^{[1
]}

Lee, Lucas D. G. ^{[1
]}

Seifarth, Claudia ^{[1
]}

Schineis, Christian H. W. ^{[1
]}

Kamphues, Carsten ^{[1
]}

Weixler, Benjamin ^{[1
]}

Beyer, Katharina ^{[1
]}

Lauscher, Johannes C. ^{[1
]}

机构：

[1] Charite Campus Benjamin Franklin, Dept Gen & Visceral Surg, Hindenburgdamm 30, D-12203 Berlin, Germany

[2] Charite Campus Benjamin Franklin, Dept Gastroenterol Rheumatol & Infectiol, Berlin, Germany

[3] Innlandet Hosp Trust, Norwegian Natl Advisory Unit Concurrent Substance, Brumunddal, Norway

[4] Humboldt Univ, Charite Universitatsmed Berlin, Inst Biometry & Clin Epidemiol, Berlin Inst Hlth,Freie Univ Berlin, Berlin, Germany

来源：

SURGICAL INFECTIONS | 2022年 / 23卷 / 04期

关键词：

enterococci; Escherichia coli; surgical site infection; visceral surgery; wound irrigation;

D O I：

10.1089/sur.2021.154

中图分类号：

R51 [传染病];

学科分类号：

100401 ;

摘要：

Background: Surgical site infections (SSIs) are a common complication in visceral surgery. Pathogens causing SSIs vary depending on the type of surgery.Patients and Methods: Within the scope of the Reduction of Postoperative Wound Infections by Antiseptica (RECIPE) trial we analyzed the pathogens cultured in intra-operative, subcutaneous swabs and in swabs from SSI in a single-center, prospective, randomized controlled study. Definition of SSI complied with the criteria of the U.S. Centers for Disease Control and Prevention (CDC).Results: The overall rate of SSI was 28.2% in 393 patients. Colorectal surgery was performed in 68.2% of elective laparotomies. Pathogens were more often detected in intra-operative subcutaneous swabs in patients who developed SSIs than in patients who did not develop SSIs (64.4% vs. 38.0%; p < 0.001). Enterococci were found in 29.1% of intra-operative swabs in patients with SSIs, followed by Escherichia coli in 15.5%. A higher rate of Enterococcus faecium was found in patients with anemia versus those without anemia (9.2% vs. 2.3%; p = 0.006) and in patients who smoked versus those who did not (11.8% vs. 3.6%; p = 0.008). A positive subcutaneous swab (odds ratio [OR], 2.51; 95% confidence interval [CI], 1.47-4.29; p = 0.001), pre-operative anemia (OR, 1.84; 95% CI, 1.08-3.13; p = 0.016), and renal insufficiency (OR, 2.15; 95% CI, 1.01-4.59; p = 0.048) were risk factors for SSIs.Conclusions: There is an association between the intra-operative detection of pathogens in subcutaneous tissue and the development of SSIs in visceral surgery. The most prevalent pathogens causing SSIs were enterococci and Escherichia coli. More efforts are justified to reduce subcutaneous colonization with pathogens, for example by using intra-operative wound irrigation with polyhexanide solution.This trial is registered at www.ClinicalTrials.gov (ID: NCT04055233).

引用

页码：372 / 379

页数：8

共 22 条

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Indian Journal of Surgical Oncology, 2024, 15 : 218 - 224

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