Rrisk factors, pathogenic bacteria and drug resistance of postoperative surgical site infection in patients with Crohn's disease
10.3760/cma.j.cn113855-20201104-00839
- VernacularTitle:克罗恩病患者术后手术部位感染的危险因素及病原菌和耐药性分析
- Author:
Xiaolong GE
1
;
Weilin QI
;
Wei LIU
;
Haili XU
;
Lingna YE
;
Qian CAO
;
Wei ZHOU
Author Information
1. 浙江大学医学院附属邵逸夫医院普外科，杭州 310016
- Keywords:
Crohn disease;
Gram-positive bacterial infection;
Gram-negative bacterial infections;
Risk factors
- From:
Chinese Journal of General Surgery
2021;36(7):520-524
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To analyze the risk factors for postoperative surgical site infections (SSIs) in patients with Crohn's disease (CD).Methods:This retrospective observational study included CD patients undergoing bowel resection between July 2015 and July 2018. The prevalence and risk factors of SSIs were evaluated. The microbiological evaluation from patients with SSIs was performed by bacterial culture and drug sensitivity test.Results:There were 66 patients suffering SSIs, with 41 incisional SSIs and 32 organ/space SSIs. Multivariate analysis identified the preoperative infliximab therapy ( OR 2.338,95% CI 1.192-4.587, P=0.013), laparoscopic surgery ( OR 0.460,95% CI 0.226-0.936, P=0.013), and preoperative white blood cell ( OR 2.008,95% CI 1.018-3.961, P=0.044) as independent factors for SSIs. Fifty-nine strains of pathogenic bacteria were detected in 66 cases of CD combined with SSIs, including 36 strains of gram-negative bacteria, 5 strains of gram-positive bacteria, and 2 strains of fungi. Escherichia coli and Klebsiella pneumoniae were main G - bacteria, with high resistance to common used antibiotics. Enterococcus faecalis and Enterococcus faecium were main G -. 62.1% of the SSIs grew extended-spectrum β-lactamase (ESBL)-producing pathogens in their bacteria cultures and 37.9% grew non-ESBL microbes. Conclusion:The incidence of SSIs was higher in CD patients. Preoperative infliximab therapy, preoperative white blood cell, and laparoscopic surgery were predictors of SSIs.
