scholarly journals Incidence and risk factors of surgical site infection following colorectal surgery in Iran: a prospective cohort study

Author(s):  
Siamak Rajaei ◽  
Masoud Mohammadi ◽  
Mohammad Hosein Taziki Balajelini ◽  
Reza Afghani ◽  
Mehrshad Zare ◽  
...  

Abstract Background Surgical site infection (SSI) after colorectal surgery remains a significant problem for its negative clinical outcomes. The aim of this study was to determine the incidence of SSI after colorectal surgery in 5-Azar hospital of Gorgan, Golestan province, Iran and to further evaluate the related risk factors. Methods A prospective design was applied. Patients in the 5-Azar hospital of Gorgan, Golestan province, Iran was prospectively monitored for SSI after colorectal surgery. The demographic and perioperative characteristics were collected, and the main outcome were SSI within postoperative 30 days. Univariate analyses were used to identify risk factors. Results A total of 240 patients were enrolled in the study and the overall SSI rate was 23.3% (56 patients). Univariate analyses indicated that corticosteroids use (Risk Ratio (RR) = 3, 95% CI: 1.62–5.54), segmental resection with anastomosis (RR = 2.28, 95% CI: 1.12–4.63), anemia (RR = 4.52, 95% CI: 3.11–6.59), diabetics (RR = 2.68, 95% CI: 1.73–4.14), and opium use (RR = 1.87, 95% CI: 1.17–2.99) are risk factors for SSI. Conclusions SSI still seems to be a problem in colon surgery despite the observance of scientific principles. There are some risk factors for SSI that can be prevented.

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Xufei Zhang ◽  
Zhiwei Wang ◽  
Jun Chen ◽  
Peige Wang ◽  
Suming Luo ◽  
...  

Abstract Purposes Surgical site infection (SSI) after colorectal surgery is a frequent complication associated with the increase in morbidity, medical expenses, and mortality. To date, there is no nationwide large-scale database of SSI after colorectal surgery in China. The aim of this study was to determine the incidence of SSI after colorectal surgery in China and to further evaluate the related risk factors. Methods Two multicenter, prospective, cross-sectional studies covering 55 hospitals in China and enrolling adult patients undergoing colorectal surgery were conducted from May 1 to June 30 of 2018 and the same time of 2019. The demographic and perioperative characteristics were collected, and the main outcome was SSI within postoperative 30 days. Multivariable logistic regressions were conducted to predict risk factors of SSI after colorectal surgery. Results In total, 1046 patients were enrolled and SSI occurred in 74 patients (7.1%). In the multivariate analysis with adjustments, significant factors associated with SSI were the prior diagnosis of hypertension (OR, 1.903; 95% confidence interval [CI], 1.088–3.327, P = 0.025), national nosocomial infection surveillance risk index score of 2 or 3 (OR, 3.840; 95% CI, 1.926–7.658, P < 0.001), laparoscopic or robotic surgery (OR, 0.363; 95% CI, 0.200–0.659, P < 0.001), and adhesive incise drapes (OR, 0.400; 95% CI, 0.187–0.855, P = 0.018). In addition, SSI group had remarkably increased length of postoperative stays (median, 15.0 d versus 9.0d, P < 0.001), medical expenses (median, 74,620 yuan versus 57,827 yuan, P < 0.001), and the mortality (4.1% versus 0.3%, P = 0.006), compared with those of non-SSI group. Conclusion This study provides the newest data of SSI after colorectal surgery in China and finds some predictors of SSI. The data presented in our study can be a tool to develop optimal preventive measures and improve surgical quality in China.


Author(s):  
Santiago Olguín Joseau ◽  
Natalia Paola Bollati ◽  
Santiago Reimondez ◽  
Franco Signorini ◽  
Alejandro Mario Rossini ◽  
...  

<p>Introducción: La infección de sitio quirúrgico (ISQ) es la infección intrahospitalaria más frecuente en los pacientes quirúrgicos con una incidencia entre 5-30%. Objetivos: Identificar los factores de riesgo para ISQ en cirugía colónica en nuestra población. Los objetivos secundarios son determinar la incidencia y tipo de ISQ, así como la incidencia de dehiscencia de anastomosis (DA). Materiales y métodos: Estudio de casos-controles de pacientes intervenidos de colectomía entre 2010-2014 en el Hospital Privado Universitario de Córdoba y Hospital Raúl Ferreyra. Se incluyeron las intervenciones convencionales y laparoscópicas, con seguimiento de 30 días, pacientes entre 20 y 85 años y con ASA I-III. Se excluyeron las cirugías de urgencia y las resecciones recto-anales. Se definió ISQ a aquella que ocurre dentro de 30 días. Resultados: Se incluyeron 238 pacientes. Se diagnosticó ISQ en 27,7% (n=66) de los pacientes de los cuales 12,2% fue superficial, 4,6% profunda y 10,9% de órgano/espacio. El análisis multivariado demostró que la ISQ se asocia con sexo masculino (odds ratio [OR] 3,15; IC95%:1,43-6,92; p=0,004), quimioterapia neoadyuvante (OR 6,72; IC95%:1,48-30,93; p=0,01), conversión (OR 3,32; IC95%:1,13-9,77; p=0,02), reintervención dentro de 30 días postquirúrgicos (OR 12,34; IC95%:2,65-57,37, p=0,001) y DA (OR 12,83; IC95%:2,97- 55,5; p=0,001). La DA presenta una incidencia del 9,6%, de los cuales el 91% presentó ISQ y todas fueron de órgano/espacio. Conclusión: Sexo masculino, quimioterapia neoadyuvante, conversión, reintervención dentro de 30 días postquirúrgicos y DA son factores de riesgo para ISQ en nuestra población. Estos resultados deben ser considerados para implementar medidas preventivas para ISQ.</p>


2014 ◽  
Vol 15 (3) ◽  
pp. 256-261 ◽  
Author(s):  
Masanori Watanabe ◽  
Hideyuki Suzuki ◽  
Satoshi Nomura ◽  
Kentaro Maejima ◽  
Naoto Chihara ◽  
...  

2021 ◽  
Author(s):  
Miho Shibamura-Fujiogi ◽  
Jennifer Ormsby ◽  
Mark Breibart ◽  
Benjamin Warf ◽  
Thomas Sandora ◽  
...  

Abstract Background Infection is a major complication following cerebral spinal fluid (CSF) diversion procedures for hydrocephalus. However, their pediatric risk factors for surgical site infection (SSI) are currently not well defined. Because SSI prevention bundle is increasingly introduced, the purpose of this study was to evaluate risk factors associated with SSIs following CSF diversion surgeries under SSI bundle at a single quaternary care pediatric hospital.Methods We performed a retrospective cohort study of patients undergoing CSF diversion procedures from 2017 to 2019. SSIs were identified prospectively through continuous surveillance. We performed univariate analyses to determine an association between SSIs and patient demographics, comorbidities and perioperative factors, with subsequent multivariate logistic regression analyses to identify independent risk factors for SSI.Results We identified a total of 561 CSF diversion procedures with an overall SSI rate of 3.6%. In univariate analyses, older age, number of previous shunt revisions and comorbid cardiac disease were significantly associated with SSI. In multivariate analyses, history of brain tumor (OR2.75, 95%CI 1.03-7.33, P=0.04) and cardiac comorbidities (OR9.47, 95%CI 2.15-41.73, P=0.003) were significantly associated with SSIs. When endoscopic third ventriculostomy was excluded, only cardiac disease was independently associated with SSI. Cardiac diseases associated with SSI included single ventricle disease with palliative repair and valvulopathy with underlying connective tissue diseases. Conclusion This study showed that comorbid conditions (cardiac disease, brain tumor) were more important than perioperative factors as risk factors for SSI in pediatric patients undergoing CSF diversion procedures. Further investigation is needed to define the mechanisms behind these associations.


2020 ◽  
Author(s):  
Yu Zhang ◽  
Hui-Quan Gan ◽  
Jing-Fang Zhou ◽  
Ya-Jie Gong ◽  
Liu-Yi Li ◽  
...  

Abstract Background: Surgical site infection (SSI) after colorectal surgery (CRS) remains a significant problem for its negative clinical outcomes. However, it is poorly understood in China . This study aims to investigate the prevalence, risk factors and microbiology of SSI after CRS. Methods: A nationwide prospective multicenter design was applied. Patients in 19 Chinese hospitals from 2015 to 2018 were prospectively monitored for SSI after CRS. Demographic data, hospital characteristics, and potential perioperative risk factors were collected and analyzed, using univariate and multivariate logistic regression models. Results: Among 3,663 study participants, 134(3.66%) episodes of SSI were identified. The prevalence rate of SSI decreased from 5.9 infections per 100 procedures in 2014 to 3.1 infections per 100 procedures in 2017 (prevalence rate ratio [PRR], 0.52; 95% CI, 0.28–0.94). The SSI rates were 1.88, 4.15, 6.27 and 11.58 per 100 operations for the National Nosocomial Infections Surveillance system (NNIS) risk index categories of 0, 1, and 2 or 3, respectively. Escherichia coli (54/134, 40.3%) and Klebsiella pneumoniae (10/134, 7.5%) were the most frequently isolated microorganisms. A high prevalence of antibiotic resistance were observed in our study, with rates of extended spectrum beta-lactamase-producing or carbapenem-resistant Escherichia coli and Klebsiella pneumonia of 50.0%(27/54) and 30.0%(3/10) respectively. Preoperative hospital stay ≥ 48h (OR=2.28, 95% CI: 1.03–5.02) and contaminated or dirty wound (OR=3.38, 95% CI: 1.88–6.06) were significantly associated with increasing risk of SSI after CRS. Conclusion: A statistically significant but modest decrease in the prevalence rate of CRS SSI over the 4-year study period was observed in this study. Noticeably, the relatively high rates of multidrug-resistant pathogens causing SSI after CRS should be alert despite of the small number of isolates identified in our survey.


2013 ◽  
Vol 27 (12) ◽  
pp. 4574-4580 ◽  
Author(s):  
Joseph Drosdeck ◽  
Alan Harzman ◽  
Andrew Suzo ◽  
Mark Arnold ◽  
Mahmoud Abdel-Rasoul ◽  
...  

2021 ◽  
Vol 28 (2) ◽  
pp. 136-141
Author(s):  
Shahfinaz Mehzabin ◽  
Mohmmad Mahbub Elahi ◽  
Debashish Bar ◽  
Banalata Sinha ◽  
Tahmina Akter ◽  
...  

Background: Surgical site infection (SSI) is a common complication following caesarean section (C-section) and mainly responsible for increased maternal morbidity and higher treatment costs. This study will determine the incidence and risk factors of surgical site infections following caesarean section in Dhaka Medical College Hospital (DMCH). Materials and Methods: This is a retrospective observational study which was conducted among patients having post caesarean surgical site infections attending post-natal outdoor clinic of DMCH from January, 2019 to December, 2019. Data were collected in structured questionnaire. Culturebased microbiological methods were used to identify causal agents in postoperative wounds. Results: Overall SSI rate following caesarian section was 4.44%.Patient related risk factors were inadequate antenatal check-up, emergency procedures, malnutrition (22.44%), anaemia (21.46%) associated comorbidity (59.46%), history of rupture membrane >12 hours (40.98%) and had history of prolonged labour pain >12 hours (16.10%).Surgery related risk factors were repeated per vaginal examinations by untrained birth attendant (21.95%) & duration of surgery>1 hour (62.93%). The most common organisms responsible for SSI were Staphylococcus aureus 44(21.46%) and Escherichia coli 31(15.12%). The most sensitive antibiotics were aminoglycosides, cephalosporin & cloxacillin. Conclusion: Most of the risk factors for surgical site infection following caesarean section identified in this study can be modified through intervention. However the microorganisms detected from our patient showed a high degree of resistance for commonly prescribed antimicrobials in our set-up. J Dhaka Medical College, Vol. 28, No.2, October, 2019, Page 136-141


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