A comparative study for the role of preoperative antibiotic prophylaxis in prevention of surgical site infections

Objective.To evaluate the effect of an optimized policy for antibiotic prophylaxis on surgical site infection (SSI) rates in cardiac surgery.Design.Prospective cohort study.Setting.Tertiary medical center in Israel.Methods.SSIs were recorded during a 10-year study period and ascertained through routine surveillance using the National Healthcare Safety Network (NHSN) methodology. Multivariable analyses were conducted to determine which significant covariates, including the administration of preoperative prophylaxis, affected these outcomes.Results.A total of 2,637 of 3,170 evaluated patients were included, and the overall SSI rate was 8.4%. A greater than 50% reduction in SSI rates was observed in the last 4 years of the study. Overall and site-specific infection rates were similar for patients receiving cefazolin or vancomycin. SSIs developed in 206 (8.1%) of the 2,536 patients who received preoperative prophylaxis (within 2 hours of the first incision) compared with 14 (13.9%) of 101 patients who received antibiotic prophylaxis at a different time (P= .04; odds ratio [OR], 1.8; 95% confidence interval [CI], 1.0–3.3). After accounting for covariates, preoperative hospital stay (5 days or more), an NHSN risk category (2 or 3), age (60 years or more), surgeon's role, and the period of measurement were significantly associated with SSIs. Emergency surgery, age, surgeon's role, and nonpreoperative prophylaxis were found to be independent predictors of superficial SSI.Conclusions.We observed a progressive and significant decrease in SSI rates after the implementation of an infection control program that included an optimized policy of preoperative prophylaxis in cardiac surgery.

Download Full-text

A prospective surveillance of surgical site infections: Study for efficacy of preoperative antibiotic prophylaxis

African Journal of Microbiology Research ◽

10.5897/ajmr12.377 ◽

2012 ◽

Vol 6 (12) ◽

Cited By ~ 7

Author(s):

Wassef M. A.

Keyword(s):

Antibiotic Prophylaxis ◽

Surgical Site Infections ◽

Prospective Surveillance ◽

Preoperative Antibiotic Prophylaxis

Download Full-text

The Role of Bacterial Colonization of the Suture Thread in Early Identification and Targeted Antibiotic Treatment of Surgical Site Infections: A Prospective Cohort Study

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph17124416 ◽

2020 ◽

Vol 17 (12) ◽

pp. 4416

Author(s):

Francesco Iovino ◽

Federica Calò ◽

Consiglia Orabona ◽

Alessandra Pizza ◽

Francesca Fisone ◽

...

Keyword(s):

Cohort Study ◽

Antibiotic Prophylaxis ◽

Early Identification ◽

Antimicrobial Prophylaxis ◽

Bacterial Colonization ◽

Surgical Site Infections ◽

Site Infection ◽

Patients At Risk ◽

Suture Thread

Background: The aim of the present study is to investigate the role of the colonization of suture thread to identify patients at risk of developing a surgical site infection (SSI) after clean surgical procedures. Methods: Patients who underwent elective clean surgery procedures at the Surgery Unit of the AOU-University of Campania Luigi Vanvitelli in a 21-month period were prospectively enrolled. For each patient, a synthetic absorbable thread in Lactomer 9-1 was inserted into the surgical site at the end of surgery and microbiologically evaluated after 48 h. Antibiotic prophylaxis was chosen according to international guidelines. Results: A total of 238 patients were enrolled; 208 (87.4%) of them were subjected to clean procedures without the placement of prosthesis, and 30 (12.6%) with prosthesis. Of the 238 patients, 117 (49.2%) underwent an antimicrobial prophylaxis. Overall, 79 (33.2%) patients showed a bacterial colonization of the thread: among the 208 without the implantation of prosthesis, 19 (21.8%) of the 87 with antibiotic prophylaxis and in 58 (47.9%) of the 121 without it; among the 30 patients with the implantation of prosthesis, only two patients showed a colonized thread. The patients with antibiotic prophylaxis developed a colonization of the thread less frequently than those without it (17.9% vs. 47.9%, p < 0.001). SSI was observed in six (2.5%) patients, all of them showing a colonized thread (7.6% vs. 0%, p < 0.001). The bacteria identified in colonized threads were the same as those found in SSIs. Conclusions: Our study presents a new method that is able to precociously assess patients who have undergone clean procedures who may develop SSI, and identify the microorganism involved.

Download Full-text