Is Cutibacterium acnes early surgical site infection rate related to the duration of antibiotic prophylaxis in adolescent idiopathic scoliosis surgery?

Background. Surgical site infections are the third (14%-16%) most frequent cause of nosocomial infections among hospitalized patients. They still form a large health problem and result in increased antibiotic usage, increased associated costs, and prolonged hospitalization and contribute to increased patient morbidity and mortality. Therefore, studies on surgical site infections and surgical antibiotic prophylaxis contribute to identifying surgical site infection rate and risk factor associated with it as well as for identifying the gap in surgical antibiotic prophylaxis practice. Objective. To assess surgical antibiotic prophylaxis practice and surgical site infection among surgical patients. Method. A hospital-based prospective observational study was conducted in 68 patients who underwent major surgery in Dessie Referral Hospital adult surgical wards between March 24 and April 25/2017. Descriptive and logistic regression analyses were performed to determine infection rate and risk factors for surgical site infections. Result. Assessment of 68 patients who underwent major surgery revealed an overall surgical site infection rate of 23.4%. Prophylactic antibiotics were administered for 59 operations; of these, 33 (48.6%) had inappropriate timing of administration. A combination of ceftriaxone and metronidazole 28 (47.46%) was frequently used. Factors associated with surgical site infection were wound class, patient comorbid condition, duration of the procedure, the timing of administration, and omitting prophylaxis use. Conclusion. This study indicated a higher rate of surgical site infection and also revealed that wound class, preexisting medical condition, prolonged duration of surgery, omitting of prophylaxis use, and inappropriate timing of administration were highly associated with surgical site infection.

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An intraoperative irrigation regimen to reduce the surgical site infection rate following adolescent idiopathic scoliosis surgery

Annals of The Royal College of Surgeons of England ◽

10.1308/rcsann.2016.0132 ◽

2016 ◽

Vol 98 (5) ◽

pp. 320-323 ◽

Cited By ~ 11

Author(s):

B van Herwijnen ◽

NR Evans ◽

CJ Dare ◽

EM Davies

Keyword(s):

Adolescent Idiopathic Scoliosis ◽

Idiopathic Scoliosis ◽

Surgical Site Infection ◽

Povidone Iodine ◽

High Risk Patient ◽

Scoliosis Surgery ◽

Site Infection ◽

Scoliosis Correction ◽

Vancomycin Powder ◽

Baseline Characteristics

Introduction The aim of this study was to compare the efficacy of a gentamicin antibiotic intraoperative irrigation regimen (regimen A) with a povidone-iodine intraoperative irrigation regimen (regimen B) and to evaluate the ability of adjunctive local vancomycin powder (regimen C) to reduce the surgical site infection (SSI) rate following idiopathic scoliosis correction. Methods This was a retrospective, single centre, two-surgeon cohort study of paediatric scoliosis procedures involving 118 patients under the age of 18 years who underwent correction for idiopathic scoliosis over a period of 42 months. Patients’ baseline characteristics, pseudarthrosis and rates of SSI were compared. Results Baseline characteristics were comparable in all three groups, with the exception of sex distribution. Over a quarter (27%) of patients with regimen B were male compared with 13% and 6% for regimens A and C respectively. Patients were mostly followed up for a minimum of 12 months. The SSI rate for both superficial and deep infections was higher with regimen A (26.7%) than with regimens B and C (7.0% and 6.3% respectively). The SSI rates for regimens B and C were comparable. No patients developed complications related to vancomycin toxicity, metalwork failure or pseudarthrosis. Conclusions Wound irrigation with a povidone-iodine solution reduces SSIs following adolescent idiopathic scoliosis surgery. The direct application of vancomycin powder to the wound is safe but does not reduce the SSI rate further in low risk patients. Additional studies are needed to elucidate whether it is effective at higher doses and in high risk patient groups.

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Faculty Opinions recommendation of Operating room ventilation with laminar airflow shows no protective effect on the surgical site infection rate in orthopedic and abdominal surgery.

Faculty Opinions – Post-Publication Peer Review of the Biomedical Literature ◽

10.3410/f.1158112.618216 ◽

2009 ◽

Author(s):

Peter Wilson ◽

Thomas Haustein

Keyword(s):

Abdominal Surgery ◽

Protective Effect ◽

Surgical Site Infection ◽

Operating Room ◽

Infection Rate ◽

Site Infection ◽

Surgical Site Infection Rate ◽

Room Ventilation

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Nine-year downward trends in surgical site infection rate in southeast France (1995–2003)

Journal of Hospital Infection ◽

10.1016/j.jhin.2007.07.013 ◽

2007 ◽

Vol 67 (2) ◽

pp. 127-134 ◽

Cited By ~ 17

Author(s):

C.M. Couris ◽

M. Rabilloud ◽

R. Ecochard ◽

M.H. Metzger ◽

E. Caillat-Vallet ◽

...

Keyword(s):

Surgical Site Infection ◽

Infection Rate ◽

Site Infection ◽

Surgical Site Infection Rate

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P28.07 Surgical site infection rate: surgeons’ perception vs reality

Journal of Hospital Infection ◽

10.1016/s0195-6701(10)60256-3 ◽

2010 ◽

Vol 76 ◽

pp. S76-S77

Author(s):

S. Vallabhajousula ◽

I. Gunn ◽

S. Cole

Keyword(s):

Surgical Site Infection ◽

Infection Rate ◽

Site Infection ◽

Surgical Site Infection Rate

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Dual antibiotic prevention bundle is associated with decreased surgical site infections

International Journal of Gynecological Cancer ◽

10.1136/ijgc-2020-001515 ◽

2020 ◽

Vol 30 (9) ◽

pp. 1411-1417

Author(s):

Michelle Kuznicki ◽

Adrianne Mallen ◽

Emily Clair McClung ◽

Sharon E Robertson ◽

Sarah Todd ◽

...

Keyword(s):

Surgical Site Infection ◽

Infection Rate ◽

Infection Prevention ◽

Gynecologic Oncology ◽

Site Infection ◽

Surgical Site Infection Rate ◽

Readmission Rates ◽

Optimal Method ◽

Bundle Versus ◽

Exact Test

BackgroundGynecologic oncology surgery is associated with a wide variation in surgical site infection risk. The optimal method for infection prevention in this heterogeneous population remains uncertain.Study DesignA retrospective cohort study was performed to compare surgical site infection rates for patients undergoing hysterectomy over a 1-year period surrounding the implementation of an institutional infection prevention bundle. The bundle comprised pre-operative, intra-operative, and post-operative interventions including a dual-agent antibiotic surgical prophylaxis with cefazolin and metronidazole. Cohorts consisted of patients undergoing surgery during the 6 months prior to this intervention (pre-bundle) versus those undergoing surgery during the 6 months following the intervention (post-bundle). Secondary outcomes included length of stay, readmission rates, compliance measures, and infection microbiology. Data were compared with pre-specified one-sided exact test, Chi-square test, Fisher’s exact test, or Kruskal–Wallis test as appropriate.ResultsA total of 358 patients were included (178 PRE, 180 POST). Median age was 58 (range 23–90) years. The post-bundle cohort had a 58% reduction in surgical site infection rate, 3.3% POST vs 7.9% PRE (−4.5%, 95% CI −9.3% to −0.2%, p=0.049) as well as reductions in organ space infection, 0.6% POST vs 4.5% PRE (−3.9%, 95% CI −7.2% to −0.7%, p=0.019), and readmission rates, 2.2% POST vs 6.7% PRE (−4.5%, 95% CI −8.7% to −0.2%, p=0.04). Gram-positive, Gram-negative, and anaerobic bacteria were all prevalent in surgical site infection cultures. There were no monomicrobial infections in post-cohort cultures (0% POST vs 58% PRE, p=0.04). No infections contained methicillin-resistant Staphylococcus aureus.ConclusionImplementation of a dual antibiotic infection prevention bundle was associated with a 58% reduction in surgical site infection rate after hysterectomy in a surgically diverse gynecologic oncology practice.

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