Deep surgical site infections following double-dose perioperative antibiotic prophylaxis in adult obese orthopedic patients

AbstractA questionnaire survey was sent to a random sample of the Spanish network of National Health System public acute-care hospitals. Of responding institutions (representing 25% of Spanish hospital beds), nearly 75% had active surveillance programs for the prevention and control of surgical-site infections (SSIs), but only 20% performed postdischarge surveillance. Overall, perioperative antibiotic prophylaxis (PAP) was used in 84% of all surgical procedures. For 77% of procedures, there were written guidelines for the choice and use of PAR Cefazolin was the most commonly used antibiotic (38%). Duration of PAP was shorter than 24 hours in 75% of procedures, and only a single dose was given in 52% of procedures. PAP was commonly used in breast (52%) and inguinal hernia repair (69%) procedures, as well as in laparoscopic abdominal surgery (86%). In summary, the use of PAP in Spanish hospitals is adequate, but improvements can be made in the frequency of prolonged PAP and in the use of broad-spectrum antibiotics. Surveillance systems for SSI, including postdischarge follow-up, also should be improved.

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Single-center Experience with Perioperative Antibiotic Prophylaxis and Surgical Site Infections in Kidney Transplant Recipients

10.21203/rs.3.rs-429312/v1 ◽

2021 ◽

Author(s):

Agata Ostaszewska ◽

Piotr Domagala ◽

Michał Zawistowski ◽

Edyta Karpeta ◽

Michal Wszola ◽

...

Keyword(s):

Risk Factors ◽

Antibiotic Prophylaxis ◽

Kidney Transplant ◽

Immunosuppressive Treatment ◽

Surgical Site Infections ◽

Individual Risk ◽

Transplant Recipients ◽

Kidney Transplant Recipients ◽

Retrospective Case ◽

Perioperative Antibiotic Prophylaxis

Abstract Background Infections in kidney transplant recipients are particularly challenging owing to the immunosuppressive treatment, usually long history of chronic illness, comorbidities and prior exposures to antibiotics. Among the most common complications early after surgery are surgical site infections. The aim of this study was to identify risk factors and evaluate epidemiological data regarding surgical site infections. Moreover, we were able to compare the current results with historical data from our institution when different perioperative antibiotic prophylaxis was practiced. Methods We conducted a retrospective case-control study in a group of 254 deceased donor renal graft recipients transplanted in a single Central European institution. We evaluated epidemiological findings and resistance patterns of pathogens causing surgical site infections. We used multivariable logistic regression to determine risk factors for surgical site infections. Results We revealed no differences in baseline characteristics between patients with and without surgical site infections. Ten surgical site infections (3.9%) were diagnosed (six superficial incisional, two deep incisional, and two organ/space). Eight species (19 strains) were identified, most of which were multi-drug resistant (63%). The most common was extended-spectrum β-lactamase producing Klebsiella pneumoniae (26%). We showed that statistically significant differences were present between reoperated and non-reoperated patients (adjusted odds ratio: 6.963, 95% confidence interval: 1.523–31.842, P = .012). Conclusions Reoperation is an individual risk factor for surgical site infection after kidney transplantation. According to our experience, cefazolin-based prophylaxis can be safe and is associated with relatively low prevalence of surgical site infections.

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Perioperative Antibiotic Prophylaxis: Knowledge and Attitudes among Resident Physicians in Italy

Antibiotics ◽

10.3390/antibiotics9060357 ◽

2020 ◽

Vol 9 (6) ◽

pp. 357

Author(s):

Concetta Paola Pelullo ◽

Angela Pepe ◽

Francesco Napolitano ◽

Nicola Coppola ◽

Gabriella Di Giuseppe

Keyword(s):

Antibiotic Prophylaxis ◽

Multiple Logistic Regression Analysis ◽

Surgical Site Infections ◽

Knowledge Score ◽

National Guidelines ◽

Online Questionnaire ◽

Perioperative Antibiotic Prophylaxis ◽

Knowledge And Attitudes ◽

Adequate Knowledge ◽

Resident Physicians

The aim of this study is to evaluate knowledge and attitudes on the perioperative antibiotic prophylaxis (PAP) among surgery and anesthesiology resident physicians in Italy. A Web-based national survey of Italian surgery and anesthesiology resident physicians was conducted between March 2018 and January 2019. Participants completed a questionnaire and three case vignettes for each specialty. Of the 1282 resident physicians selected, 466 completed the online questionnaire for a response rate of 36.3%. More than half of the sample were female (52.9%), and the mean age was 30 years. A total of 36.3% of the participants had an adequate knowledge score about PAP. Multiple logistic regression analysis showed that resident physicians in general surgery compared to those in anesthesiology, those who agreed that PAP must be performed within 60 min before surgical incision, and those who were aware regarding the availability about the availability of national guidelines on PAP, were significantly more likely to have adequate knowledge about PAP. Moreover, 14% of participants were very concerned that patients may contract surgical site infections during hospitalization. These findings should be useful to promote educational intervention specifically targeted for surgery and anesthesiology resident physicians organizing training course on PAP, to improve the correct antibiotic use and to prevent healthcare-associated infections.

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Perioperative Antibiotic Prophylaxis to Prevent Surgical Site Infections in Solid Organ Transplantation

Transplantation Journal ◽

10.1097/tp.0000000000001848 ◽

2018 ◽

Vol 102 (1) ◽

pp. 21-34 ◽

Cited By ~ 37

Author(s):

Judith A. Anesi ◽

Emily A. Blumberg ◽

Lilian M. Abbo

Keyword(s):

Antibiotic Prophylaxis ◽

Organ Transplantation ◽

Solid Organ Transplantation ◽

Surgical Site Infections ◽

Solid Organ ◽

Perioperative Antibiotic Prophylaxis

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Single-center Experience with Perioperative Antibiotic Prophylaxis and Surgical Site Infections in Kidney Transplant Recipients

10.21203/rs.3.rs-429312/v2 ◽

2021 ◽

Author(s):

Agata Ostaszewska ◽

Piotr Domagala ◽

Michał Zawistowski ◽

Edyta Karpeta ◽

Michal Wszola ◽

...

Keyword(s):

Risk Factors ◽

Antibiotic Prophylaxis ◽

Kidney Transplant ◽

Immunosuppressive Treatment ◽

Surgical Site Infections ◽

Individual Risk ◽

Transplant Recipients ◽

Kidney Transplant Recipients ◽

Retrospective Case ◽

Perioperative Antibiotic Prophylaxis

Abstract Background: Infections in kidney transplant recipients are particularly challenging owing to the immunosuppressive treatment, usually long history of chronic illness, comorbidities and prior exposures to antibiotics. Among the most common complications early after surgery are surgical site infections. The aim of this study was to identify risk factors and evaluate epidemiological data regarding surgical site infections. Moreover, we were able to compare the current results with historical data from our institution when different perioperative antibiotic prophylaxis was practiced.Methods: We conducted a retrospective case-control study in a group of 254 deceased donor renal graft recipients transplanted in a single Central European institution. We evaluated epidemiological findings and resistance patterns of pathogens causing surgical site infections. We used multivariable logistic regression to determine risk factors for surgical site infections.Results: We revealed no differences in baseline characteristics between patients with and without surgical site infections. Ten surgical site infections (3.9%) were diagnosed (six superficial incisional, two deep incisional, and two organ/space). Eight species (19 strains) were identified, most of which were multi-drug resistant (63%). The most common was extended-spectrum β-lactamase producing Klebsiella pneumoniae (26%). We showed that statistically significant differences were present between reoperated and non-reoperated patients (adjusted odds ratio: 6.963, 95% confidence interval: 1.523-31.842, P = .012).Conclusions: Reoperation is an individual risk factor for surgical site infection after kidney transplantation. According to our experience, cefazolin-based prophylaxis can be safe and is associated with relatively low prevalence of surgical site infections.

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Perioperative Antibiotic Prophylaxis Has No Effect on Time to Positivity and Proportion of Positive Samples: a Cohort Study of 64Cutibacterium acnesBone and Joint Infections

Journal of Clinical Microbiology ◽

10.1128/jcm.01576-17 ◽

2017 ◽

Vol 56 (2) ◽

Cited By ~ 2

Author(s):

Alexia Anagnostopoulos ◽

Daniel A. Bossard ◽

Bruno Ledergerber ◽

Patrick O. Zingg ◽

Annelies S. Zinkernagel ◽

...

Keyword(s):

Antibiotic Prophylaxis ◽

Joint Infection ◽

Surgical Site Infections ◽

Content Type ◽

Perioperative Antibiotic Prophylaxis ◽

Perioperative Prophylaxis ◽

Joint Infections ◽

Time To Positivity ◽

Cutibacterium Acnes ◽

Perioperative Antibiotics

ABSTRACTIf a bone or joint infection is suspected, perioperative antibiotic prophylaxis is frequently withheld until intraoperative microbiological sampling has been performed. This practice builds upon the hypothesis that perioperative antibiotics could render culture results negative and thus impede tailored antibiotic treatment of infections. We aimed to assess the influence of antibiotic prophylaxis within 30 to 60 min before surgery on time to positivity of microbiological samples and on proportion of positive samples inCutibacterium acnesbone and joint infections. Patients with at least one sample positive forC. acnesbetween January 2005 and December 2015 were included and classified as having an “infection” if at least 2 samples were positive; otherwise they were considered to have a sample “contamination.” Kaplan-Meier curves were used to illustrate time to culture positivity. We found 64 cases with aC. acnesinfection and 46 classified as having aC. acnescontamination. Application of perioperative prophylaxis significantly differed between the infection and contamination groups (72.8% versus 55.8%;P< 0.001). Within the infection group, we found no difference in time to positivity between those who had or had not received a perioperative prophylaxis (7.07 days; 95% confidence interval [CI], 6.4 to 7.7, versus 7.11 days; 95% CI, 6.8 to 7.5;P= 0.3). Also, there was no association between the proportion of sample positivity and the application of perioperative prophylaxis (71.6% versus 65.9%;P= 0.39). Since perioperative prophylaxis did not negatively influence the microbiological yield inC. acnesinfections, antibiotic prophylaxis can be routinely given to avoid surgical site infections.

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