Surgical Site Infection after Breast Surgery: Retrospective Analysis of 5-year Postoperative Data from a Single Center in Poland

Purpose: Surgical site infection (SSI) is a significant complication of non-reconstructive and reconstructive breast. This study aimed to assess SSI after breast surgery over 5 years in a single center in Poland. The microorganisms responsible for SSI and their antibiotic susceptibility were determined. Materials/methods: Data of 2129 patients acquired over 5 years postoperatively by the [center] were analyzed. Results: SSI was diagnosed in 132 patients (6.2%) and was an early infection in most cases (65.2%). The incidence of SSI was highest in patients who underwent subcutaneous amputation with simultaneous reconstruction using an artificial prosthesis (14.6%) and breast reconstruction via the TRAM flap method (14.3%). Gram-positive bacteria were responsible for SSI in most cases (72.1%), and these were mainly Staphylococcus strains (53.6%). These strains were 100% susceptible to all beta-lactam antibiotics (except penicillin), but were less susceptible to macrolides and lincosamides. Conclusions: SSI is a serious problem, and attention should be focused on its prevention. Reconstruction using an artificial prosthesis or via the TRAM flap method is connected to increased SSI incidence. Further studies are required to prevent SSI following breast surgery.

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Surgical Site Infection after Breast Surgery: A Retrospective Analysis of 5-Year Postoperative Data from a Single Center in Poland

Medicina ◽

10.3390/medicina55090512 ◽

2019 ◽

Vol 55 (9) ◽

pp. 512 ◽

Cited By ~ 2

Author(s):

Anna Palubicka ◽

Radoslaw Jaworski ◽

Marcin Wekwejt ◽

Beata Swieczko-Zurek ◽

Michal Pikula ◽

...

Keyword(s):

Surgical Site Infection ◽

Breast Surgery ◽

Surgical Oncology ◽

Tram Flap ◽

Site Infection ◽

Single Center ◽

Beta Lactam ◽

Beta Lactam Antibiotics ◽

Simultaneous Reconstruction ◽

Artificial Prosthesis

Background and Objectives: Surgical site infection (SSI) is a significant complication of non-reconstructive and reconstructive breast surgery. This study aimed to assess SSI after breast surgery over five years in a single center in Poland. The microorganisms responsible for SSI and their antibiotic susceptibilities were determined. Materials and Methods: Data from 2129 patients acquired over five years postoperatively by the Department of Surgical Oncology, Medical University of Gdansk in Poland were analyzed. Results: SSI was diagnosed in 132 patients (6.2%) and was an early infection in most cases (65.2%). The incidence of SSI was highest in patients who underwent subcutaneous amputation with simultaneous reconstruction using an artificial prosthesis (14.6%), and breast reconstruction via the transverse rectus abdominis muscle (TRAM) flap method (14.3%). Gram-positive bacteria were responsible for SSI in most cases (72.1%), and these were mainly Staphylococcus strains (53.6%). These strains were 100% susceptible to all beta-lactam antibiotics (except penicillin) but were less susceptible to macrolides and lincosamides. Conclusions: SSI is a serious problem, and attention should be focused on its prevention. Reconstruction using an artificial prosthesis or via the TRAM flap method is connected to increased SSI incidence. Further studies are required to prevent SSI following breast surgery.

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256 Do Non-Beta-lactam antibiotics increase risk for surgical site infection after cesarean: a retrospective chart review

American Journal of Obstetrics and Gynecology ◽

10.1016/j.ajog.2020.12.278 ◽

2021 ◽

Vol 224 (2) ◽

pp. S169-S170

Author(s):

Ariana L. Lewis ◽

Amanda M. Murray ◽

Luke A. Newton ◽

Shawna A. Mattathil ◽

Diana A. Rascon

Keyword(s):

Surgical Site Infection ◽

Chart Review ◽

Retrospective Chart Review ◽

Site Infection ◽

Beta Lactam ◽

Beta Lactam Antibiotics ◽

Increase Risk

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890. Incidence and Microbiology of Surgical Site Infection (SSI) after Breast Surgery

Open Forum Infectious Diseases ◽

10.1093/ofid/ofaa439.1078 ◽

2020 ◽

Vol 7 (Supplement_1) ◽

pp. S479-S479

Author(s):

Farah Tanveer ◽

Dima Youssef ◽

Mamta Youssef ◽

Susanna Szpunar ◽

Michelle Flood

Keyword(s):

Surgical Site Infection ◽

Breast Surgery ◽

Tissue Expander ◽

Empiric Therapy ◽

Site Infection ◽

Gram Positive ◽

Historical Cohort ◽

Gram Negative ◽

Tissue Expanders ◽

Student’S T

Abstract Background Surgical site infection (SSI) after breast surgery is much more common than expected after a clean surgical procedure. Although breast SSIs are primarily Gram-positive; recent literature shows an increase in Gram-negative infections. We assessed the risk factors and microbiology of SSI following breast surgery at our institution. Methods We conducted a historical cohort study of all (³ 18 y) females who had surgery from 1/1/2014-3/31/2019 and subsequent SSI within 90 days of the procedure. Two controls, matched for surgery type, were selected per case. Data were collected on demographic and clinical characteristics, surgery type, microbiology and antibiotics. Data were analyzed using the χ 2 test, Student’s t-test and multivariable logistic regression with a forward likelihood ratio algorithm. Results After excluding patients with limited data, we reviewed 284 charts: 95 of 132 cases and 189 controls. The 90-day incidence of SSI was 3.5 % (132/3755). Cases were younger than controls: 53.9 ± 12.4 years vs. 58.3± 13.7 years, respectively, p=0.02. Controls had more comorbidities: 1.8 ± 1.3 vs. 1.4 ± 0.7,respectively, p=0.001. Tissue expanders were placed in 65 (70%) cases versus 11 (5.8%) controls (p < 0.0001). After controlling for age, BMI, comorbidities and post-operative antibiotics, only tissue expanders were associated with infection (OR=35.1, p< 0.0001, 95% CI: 16.6, 74.0). Microbiological data were available for 84 cases. Gram-positive organisms accounted for 45 (53.6%) infections and Gram-negative organisms accounted for 39 (46.4%) infections. Over 72% of African Americans (p= 0.014), 76.5% of patients with diabetes (p=0.005) and 57.1 % with tissue expanders (p= 0.02) had Gram-negative infections. The table shows the multivariable predictors of Gram-negative infection. Tissue expander removal was required in 61.5% of patients with Gram-negative infections compared to 39% with Gram-positive infections. Predictors of Gram-negative SSI after breast surgery Conclusion Patients with tissue expanders had a higher incidence of SSI after breast surgery; removal was often required in Gram-negative infections. Diabetes and post-operative antibiotics were significant predictors of Gram-negative infection. Knowledge of local epidemiology is a key factor in deciding empiric therapy for SSI. Disclosures All Authors: No reported disclosures

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The negative pressure therapy with PICO as a prevention of surgical site infection in high risk patients undergoing breast surgery

Annals of Oncology ◽

10.1093/annonc/mdz098.011 ◽

2019 ◽

Vol 30 ◽

pp. iii42

Author(s):

T. Fogacci ◽

F. Cattin ◽

D. Samorani

Keyword(s):

High Risk ◽

Surgical Site Infection ◽

Negative Pressure ◽

Breast Surgery ◽

Site Infection ◽

Negative Pressure Therapy ◽

Pressure Therapy ◽

High Risk Patients ◽

Risk Patients

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Use of Diagnosis Codes and/or Wound Culture Results for Surveillance of Surgical Site Infection after Mastectomy and Breast Reconstruction

Infection Control and Hospital Epidemiology ◽

10.1086/652155 ◽

2010 ◽

Vol 31 (05) ◽

pp. 544-547 ◽

Cited By ~ 21

Author(s):

Margaret A. Olsen ◽

Victoria J. Fraser

Keyword(s):

Surgical Site Infection ◽

Claims Data ◽

Breast Surgery ◽

International Classification Of Diseases ◽

Site Infection ◽

Wound Culture ◽

Diagnosis Codes ◽

Classification Of Diseases ◽

Major Breast

We compared surveillance of surgical site infection (SSI) after major breast surgery by using a combination of International Classification of Diseases, Ninth Revision, Clinical Modification diagnosis codes and microbiology-based surveillance. The sensitivity of the coding algorithm for identification of SSI was 87.5%, and the sensitivity of wound culture for identification of SSI was 78.1%. Our results suggest that SSI surveillance can be reliably performed using claims data.

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Efficacy of Non-Beta-lactam Antibiotics for Prevention of Cesarean Delivery Surgical Site Infections

American Journal of Perinatology Reports ◽

10.1055/s-0039-1685503 ◽

2019 ◽

Vol 09 (02) ◽

pp. e167-e171 ◽

Cited By ~ 3

Author(s):

Benjamin Harris ◽

Maeve Hopkins ◽

Margaret Villers ◽

Jeremy Weber ◽

Carl Pieper ◽

...

Keyword(s):

Surgical Site Infection ◽

Cesarean Delivery ◽

Surgical Site Infections ◽

Type I ◽

Site Infection ◽

Beta Lactam ◽

Postpartum Visit ◽

Chi Square ◽

Lower Odds ◽

Logistic Regression Models

Objective To examine the association between perioperative Beta (β))-lactam versus non-β-lactam antibiotics and cesarean delivery surgical site infection (SSI). Study Design Retrospective cohort of women undergoing cesarean delivery from January 1 to December 31, 2014. All women undergoing cesarean after 34 weeks with a postpartum visit were included. Prevalence of SSI was compared between women receiving β-lactam versus non-β-lactam antibiotics. Bivariate analyses were performed using Pearson's Chi-square, Fisher's exact, or Wilcoxon's rank-sum tests. Logistic regression models were fit controlling for possible confounders. Results Of the 929 women included, 826 (89%) received β-lactam prophylaxis and 103 (11%) received a non-β-lactam. Among the 893 women who reported a non-type I (low risk) allergy, 819 (92%) received β-lactam prophylaxis. SSI occurred in 7% of women who received β-lactam antibiotics versus 15% of women who received a non-β-lactam (p = 0.004). β-Lactam prophylaxis was associated with lower odds of SSI compared with non-β-lactam antibiotics (odds ratio [OR] = 0.43; 95% confidence interval [CI] = 0.22–0.83; p = 0.01) after controlling for chorioamnionitis in labor, postlabor cesarean, endometritis, tobacco use, and body mass index (BMI). Conclusion β-Lactam perioperative prophylaxis is associated with lower odds of a cesarean delivery surgical site infection compared with non-β-lactam antibiotics.

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Surgical Site Infection after Liver Transplantation: Single-Center Experience

International Journal of Transplantation Research and Medicine ◽

10.23937/2572-4045.1510037 ◽

2018 ◽

Vol 4 (1) ◽

Author(s):

Softness Kenneth A ◽

ElSabbagh Ahmed ◽

Kroemer Alexander ◽

Hawksworth Jason ◽

Matsumoto Cal S ◽

...

Keyword(s):

Liver Transplantation ◽

Surgical Site Infection ◽

Site Infection ◽

Single Center ◽

Single Center Experience

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Faculty Opinions recommendation of Effect of perioperative oxygen supplementation on 30-day surgical site infection rate in abdominal, gynecologic, and breast surgery: the ISO2 randomized controlled trial.

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

10.3410/f.717953940.793459644 ◽

2012 ◽

Author(s):

David Murdoch

Keyword(s):

Randomized Controlled Trial ◽

Surgical Site Infection ◽

Infection Rate ◽

Breast Surgery ◽

Controlled Trial ◽

Site Infection ◽

Surgical Site Infection Rate ◽

Oxygen Supplementation ◽

Randomized Controlled

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Genomic Overview into the Evolving Epidemiology of Methicillin-Resistant Staphylococcus aureus

Mansoura Veterinary Medical Journal ◽

10.35943/mvmj.2020.21.322 ◽

2020 ◽

Vol 21 (3) ◽

pp. 125-131

Author(s):

Yara El dessouky ◽

Shaimaa Mouftah ◽

Mohamed Elhadidy

Keyword(s):

Staphylococcus Aureus ◽

Methicillin Resistant Staphylococcus Aureus ◽

Human Infection ◽

Emerging Infections ◽

Beta Lactam ◽

Methicillin Resistant ◽

Gram Positive Bacteria ◽

Beta Lactam Antibiotics ◽

Mrsa Strains ◽

Hospital Acquired

Emerging infections represent an enormous challenge to both human and veterinary medicine. Identification of Methicillin-Resistant Staphylococcus aureus (MRSA) in various species and in food has raised concerns about the roles of animals in the epidemiology of MRSA. MRSA are a group of gram-positive bacteria, distinct from other strains of S. aureus in that this pathogen is resistant to methicillin, oxacillin, and all beta-lactam antibiotics. The severity of infections caused by MRSA depends on the strain responsible for the infection and can vary from soft tissue infections to bacteremia and sometimes pneumonia. MRSA strains are divided into clones, based on their genetic makeup. According to the setting of infection, MRSA are divided into three epidemiological types: hospital acquired (HA-MRSA), community acquired (CA-MRSA), and livestock acquired (LA-MRSA) (ie. Transmitted from animal carriers). The epidemiology of HA-MRSA, CA-MRSA, and LA-MRSA is blurred as different recent genetic studies have revealed significant overlap of identical clones between HA-MRSA and CA-MRSA, and the significant increase of human infection caused by LA-MRSA. Furthermore, the animal-human and animal-animal transmission of LA-MRSA has prompted further investigation to study the origin of this epidemiological type and the transmission dynamics. The genetic and virulence profiles of different types of MRSA vary widely, where community acquired and livestock acquired strains are more virulent than hospital acquired strains. This review sheds light on three epidemiological groups of MRSA (HA-MRSA, CA-MRSA, and LA-MRSA), and their most prevalent clonal clusters, that can consequently allow better understanding of their evolution, emergence, transmission, and global dissemination.

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