Successful perioperative infection control measures after gastroenterological surgery reduced the number of cases of methicillin-resistant Staphylococcus aureus or Clostridioides (Clostridium) difficile infection to almost zero over a 30-year period: a single-department experience
Purpose To investigate changes in the incidence of postoperative infections in the surgical department of a teaching hospital. Methods During the 30-year period from September 1987 to August 2017, 11,568 gastroenterological surgical procedures were performed in our surgical department. This 30-year...
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Published in | Surgery today (Tokyo, Japan) Vol. 50; no. 3; pp. 258 - 266 |
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Main Authors | , , , , , , |
Format | Journal Article |
Language | English |
Published |
Singapore
Springer Singapore
01.03.2020
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Subjects | |
Online Access | Get full text |
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Summary: | Purpose
To investigate changes in the incidence of postoperative infections in the surgical department of a teaching hospital.
Methods
During the 30-year period from September 1987 to August 2017, 11,568 gastroenterological surgical procedures were performed in our surgical department. This 30-year period was divided into seven periods (A–G), ranging from 2 to 7 years each and based on the infection control methods used in each period. We then compared the rates of incisional surgical site infection (SSI) and organ/space SSI; remote infection (RI) including respiratory tract infection (RTI), intravascular catheter-related infection, and urinary tract infection (UTI); and antibiotic-associated colitis caused by methicillin-resistant
Staphylococcus aureus
(MRSA) enteritis or
Clostridioides (Clostridium) difficile
-associated disease (CDAD) among the seven periods.
Results
In periods B (September 1990–August 1997) and E (November 2004–July 2007), when a unique antibiotic therapy devised in our department was in use, MRSA was isolated from only 0.3% and 0.4% of surgical patients, respectively, and these rates were significantly lower than those in the other periods (
p
< 0.05). The rate of CDAD increased during period F (August 2007–July 2014), but in period G (August 2014–August 2017), restrictions were placed on the use of antibiotics with a strong anti-anaerobic action and, in this period, the rate of CDAD was only 0.04%, which was significantly lower than that in period F (
p
< 0.05).
Conclusions
Limiting the use of antibiotics that tend to disrupt the intestinal flora may reduce the rates of MRSA infection and CDAD after gastroenterological surgery. |
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Bibliography: | ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23 |
ISSN: | 0941-1291 1436-2813 |
DOI: | 10.1007/s00595-019-01899-2 |