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Le TAT, Sohn AH, Nguyen PT, Vo TCM, Vo VN, Tran Nguyen TH, Ewald B, Dibley M. Microbiology of Surgical Site Infections and Associated Antimicrobial Use Among Vietnamese Orthopedic and Neurosurgical Patients. Infect Control Hosp Epidemiol 2016; 27:855-62. [PMID: 16874647 DOI: 10.1086/506400] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2004] [Accepted: 01/17/2005] [Indexed: 11/03/2022]
Abstract
Objectives.To determine the pathogens associated with surgical site infections (SSIs) and describe patterns of antimicrobial use and resistance in orthopedic and neurosurgical patients in a large university hospital in Vietnam.Design.Prospective cohort study.Setting.Cho Ray Hospital, Ho Chi Minh City, Vietnam.Patients.All patients who had operations during a 5-week study period.Results.Of 702 surgical patients, 80 (11.4%) developed an SSI. The incidence of SSI among orthopedic patients was 15.2% (48 of 315), and among neurosurgical patients it was 8.3% (32 of 387). Postoperative bacterial cultures of samples from the surgical sites were performed for 55 (68.8%) of the 80 patients with SSI; 68 wound swab specimens and 10 cerebrospinal fluid samples were cultured. Of these 78 cultures, 60 (76.9%) were positive for a pathogen, and 15 (25%) of those 60 cultures yielded multiple pathogens. The 3 most frequently isolated pathogens were Pseudomonas aeruginosa (29.5% of isolates), Staphylococcus aureus (11.5% of isolates), and Escherichia coli (10.3% of isolates). Ninety percent of S. aureus isolates were methicillin resistant, 91% of P. aeruginosa isolates were ceftazidime resistant, and 38% of E. coli isolates were cefotaxime resistant. All but 1 of the 702 patients received antimicrobial therapy after surgery, and the median duration of antimicrobial therapy was 11 days. Commonly used antimicrobials included aminopenicillins and second- and third-generation cephalosporins. Two or, more agents were given to 634 (90%) of the patients, and most combination drug regimens (86%) included an aminoglycoside.Conclusions.Our data indicate that the incidence of SSI is high in our study population, that the main pathogens causing SSI are gram-negative bacteria and are often resistant to commonly used antimicrobials, that the use of broad-spectrum antimicrobials after surgery is widespread, and that implementation of interventions aimed at promoting appropriate and evidence-based use of antimicrobials are needed in Vietnam.
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Affiliation(s)
- Thi Anh Thu Le
- Infection Control Department, Cho Ray Hospital, Ho Chi Minh City, Vietnam.
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Banke IJ, von Eisenhart-Rothe R, Mühlhofer HML. [Epidemiology and prevention of prosthetic joint infection]. DER ORTHOPADE 2015; 44:928, 930-3. [PMID: 26526936 DOI: 10.1007/s00132-015-3187-8] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
BACKGROUND Prosthetic joint infection (PJI) is challenging for patients and orthopedic surgeons and represents a great economic burden to the health care system. The growing number of primary and revision arthroplasty procedures in an aging society with demographic changes will increase the number of PJIs in the future. AIM This article presents an overview of the epidemiology and prevention of PJI. METHOD A selective literature review was performed focusing on evidence-based epidemiology, risk factors, and prevention of PJI. RESULTS The total number of primary arthroplasty and septic revision procedures is increasing. The incidence of PJI is constant, although surgical techniques have improved over the years, with a multitude of possible preventive procedures for use before surgical treatment. This is most likely due to the increasing comorbidities and individual risk factors of the patient. Both endogenous and exogenous risk factors are known to be associated with PJI. Endogenous risk factors include diabetes, obesity, immunosuppression, oncological diseases, rheumatoid arthritis, previous or chronic infections, and bacteriuria. Exogenous risk factors include the extended duration of the operation, blood transfusion, and hypothermia. However, the facilities in the operating theatre or the use of iodine-impregnated incision drape seem to have no influence on the incidence of PJI. PROSPECT The increasing number of arthroplasty procedures and the static incidence of PJI will result in an increase in the total number of PJIs in the next few years. In particular, the costs to the health care system of the treatment of PJI will emphasize further the need for the prevention of PJI. Individual risk factors should be optimized before arthroplasty requiring a close cooperation between the general practitioner and the orthopedic specialist.
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Affiliation(s)
- I J Banke
- Klinik für Orthopädie und Sportorthopädie, Klinikum rechts der Isar der TU München, Ismaninger Str. 22, 81675, München, Deutschland.
| | - R von Eisenhart-Rothe
- Klinik für Orthopädie und Sportorthopädie, Klinikum rechts der Isar der TU München, Ismaninger Str. 22, 81675, München, Deutschland
| | - H M L Mühlhofer
- Klinik für Orthopädie und Sportorthopädie, Klinikum rechts der Isar der TU München, Ismaninger Str. 22, 81675, München, Deutschland
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Jeong SJ, Ann HW, Kim JK, Choi H, Kim CO, Han SH, Choi JY, Peck KR, Kang CI, Yeom JS, Choi YH, Lim SK, Song YG, Choi HJ, Yoon HJ, Kim HY, Kim YK, Kim MJ, Park YS, Kim JM. Incidence and risk factors for surgical site infection after gastric surgery: a multicenter prospective cohort study. Infect Chemother 2013; 45:422-30. [PMID: 24475356 PMCID: PMC3902821 DOI: 10.3947/ic.2013.45.4.422] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2013] [Revised: 08/22/2013] [Accepted: 10/23/2013] [Indexed: 12/31/2022] Open
Abstract
Background Surgical site infection (SSI) is a potentially morbid and costly complication of surgery. While gastrointestinal surgery is relatively common in Korea, few studies have evaluated SSI in the context of gastric surgery. Thus, we performed a prospective cohort study to determine the incidence and risk factors of SSI in Korean patients undergoing gastric surgery. Materials and Methods A prospective cohort study of 2,091 patients who underwent gastric surgery was performed in 10 hospitals with more than 500 beds (nine tertiary hospitals and one secondary hospital). Patients were recruited from an SSI surveillance program between June 1, 2010, and August 31, 2011 and followed up for 1 month after the operation. The criteria used to define SSI and a patient's risk index category were established according to the Centers for Disease Control and Prevention and the National Nosocomial Infection Surveillance System. We collected demographic data and potential perioperative risk factors including type and duration of the operation and physical status score in patients who developed SSIs based on a previous study protocol. Results A total of 71 SSIs (3.3%) were identified, with hospital rates varying from 0.0 - 15.7%. The results of multivariate analyses indicated that prolonged operation time (P = 0.002), use of a razor for preoperative hair removal (P = 0.010), and absence of laminar flow in the operating room (P = 0.024) were independent risk factors for SSI after gastric surgery. Conclusions Longer operation times, razor use, and absence of laminar flow in operating rooms were independently associated with significant increased SSI risk after gastric surgery.
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Affiliation(s)
- Su Jin Jeong
- Department of Internal Medicine, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
| | - Hea Won Ann
- Department of Internal Medicine, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
| | - Jae Kyung Kim
- Department of Internal Medicine, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
| | - Heun Choi
- Department of Internal Medicine, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
| | - Chang Oh Kim
- Department of Internal Medicine, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
| | - Sang Hoon Han
- Department of Internal Medicine, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
| | - Jun Yong Choi
- Department of Internal Medicine, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
| | - Kyong Ran Peck
- Division of Infectious Diseases, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Cheol-In Kang
- Division of Infectious Diseases, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Joon-Sup Yeom
- Department of Internal Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Young Hwa Choi
- Department of Pulmonary and Critical Care Medicine, Ajou University Hospital, Ajou University School of Medicine, Suwon, Korea
| | - Seung-Kwan Lim
- Department of Pulmonary and Critical Care Medicine, Ajou University Hospital, Ajou University School of Medicine, Suwon, Korea
| | - Young Goo Song
- Department of Internal Medicine, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
| | - Hee Jung Choi
- Department of Internal Medicine, Mokdong Hospital, Ewha Womans University School of Medicine, Seoul, Korea
| | - Hee Jung Yoon
- Division of Infectious Diseases, Department of Intermal Medicine, Eulji University College of Medicine, Daejeon, Korea
| | - Hyo-Youl Kim
- Department of Internal Medicine, Wonju Christian Hospital, Yonsei University Wonju College of Medicine, Wonju, Korea
| | - Young-Keun Kim
- Department of Internal Medicine, Wonju Christian Hospital, Yonsei University Wonju College of Medicine, Wonju, Korea
| | - Min Ja Kim
- Division of Infectious Diseases, Department of Internal Medicine, Anam Hospital, Korea University College of Medicine, Seoul, Korea
| | - Yoon Seon Park
- Department of Internal Medicine, National Health Insurance Corporation Ilsan Hospital, Goyang, Korea
| | - June Myung Kim
- Department of Internal Medicine, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
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Jeong SJ, Kim CO, Han SH, Choi JY, Kim MJ, Choi YH, Lim SK, Yeom JS, Park YS, Song YG, Choi HJ, Peck KR, Kang CI, Kim HY, Kim YK, Lee SS, Park DW, Kim YA, Choi SH, Kim JM. Risk factors for surgical site infection after gastric surgery: A multicentre case–control study. ACTA ACUST UNITED AC 2012; 44:419-26. [DOI: 10.3109/00365548.2011.652159] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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