Home E-Weekly February 27, 2018

Surgical Site Infections Often Follow Gastrointestinal Surgery

Published: February 27, 2018

Infection RESIST Researchers found that about one-fifth of SSIs from GI surgery were resistant to pre-op antibiotics.

More than 10% of patients worldwide who underwent gastrointestinal surgeries ended up with surgical site infections (SSI), according to a study published in The Lancet Infectious Diseases.

Patients in 66 countries were surveyed between January and July of 2016 following emergency or elective gastrointestinal surgery. Gallbladder and appendix removal were the most common surgeries performed in the study. Respondents were organized into high-, middle- and low-income countries and tracked to see if they developed an SSI within 30-days of surgery.

The results varied with the country's income status. Patients from 30 high-income countries had fewer instances of SSIs (9%) whereas; patients from 18 low-income countries had 23% of SSIs. On average, patients with SSIs had hospital stays 3 times longer than those without infections.

The study also found that 22% of all the reported SSIs were resistant to the antibiotics given during pre-op. Patients in low-income countries had the highest incidence of resistance (36%) while high-income countries had the lowest rate (17%).

When researchers looked into possible causes of the disparity they found that patients in low-income countries were given antibiotics at a much higher rate pre- and post-op (96% and 86%, respectively) than in high-income countries (88% and 46%, respectively).

"These findings begin to characterize the relationship between surgical site infections and global antimicrobial resistance," says Ewen M. Harrison, MB ChB, PhD, FRCS, National Institute of Health Research Unit on Global Surgery at the University of Edinburgh, United Kingdom. "Worldwide, large amounts of antibiotics were consumed to prevent and treat surgical site infections, yet in a fifth of cases the causative microorganism was resistant to the pre-surgery antibiotics given, and this increased to 1 of 3 cases in low-income countries. This high prevalence illustrates a potentially important area for improvement worldwide."

JoEllen McBride

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