Background: Methicillin-resistant Staphylococcus aureus (MRSA) infections remain a significant cause of morbidity and mortality. We experienced an increased incidence of MRSA surgical-site infections (MRSA SSIs) at our institution. However, to our knowledge, no studies have evaluated the risk factors and outcomes of MRSA SSIs in cancer patients.
Methods: We conducted a case-control study and identified all patients who had developed MRSA SSIs at our institution from July 1, 2002 to July 30, 2003, and all patients who had undergone surgery by the same surgical team during the same time period but who had not developed MRSA SSIs. Cases and controls were age-matched at 1:2 ratio.
Results: The study included 29 cases and 58 controls. Mean interval between surgery and MRSA SSI onset was 17.8 days (range 3-75 days). Cases were more likely than controls to have progressive cancer (72 versus 38%), have received antibiotics (mainly quinolones) within 24 h of surgery (17 versus 2%), have had ongoing infection (10 versus 0%), and have had longer hospital and intensive care unit stays (11.0 versus 7.8 days and 3.4 versus 1.5 days) (all P < 0.05). In a multivariate logistic regression analysis, significant predictors of MRSA SSI in cancer patients were antibiotics use <24 h of surgery and progressive cancer. No surgical factors (i.e., procedure time or timing of perioperative antibiotics) were associated with increased risk of MRSA SSI.
Conclusions: Several clinical and postoperative factors were associated with increased risk of MRSA SSI in cancer patients, but antibiotic use before surgery (especially quinolones) and progressive cancer were the only independent predictors.
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- * In a multicenter study involving 6,740 patients, a 16.5% incidence of SSIs was observed, with the majority being superficial, and many cases detected after hospital discharge; key risk factors included the type of surgical approach and operation duration.
- * The main pathogens identified were Escherichia coli and Staphylococcus aureus, with significant rates of antibiotic resistance noted, indicating a need for improved preventive measures to reduce complications post-surgery.
Surveillance of surgical site infections in orthopedic prosthetic surgery: a tool for identifying risk factors and improving clinical practice.
J Prev Med Hyg
June 2024
Department of Infectious Diseases, Galliera Hospital, Genoa, Italy.
Introduction: Surgical site infections (SSIs) are among the most frequently encountered complications in prosthetic surgery, and are associated with increased hospitalization, costs and in-hospital mortality. There is no national system for the comprehensive monitoring of the incidence of SSIs.
Methods: All patients undergoing orthopedic prosthetic surgery from April 1 to June 30, 2023 were enrolled.
European Society of Clinical Microbiology and Infectious Diseases/European Committee on infection control clinical guidelines on pre-operative decolonization and targeted prophylaxis in patients colonized by multidrug-resistant Gram-positive bacteria before surgery.
Clin Microbiol Infect
December 2024
Department of Medical Microbiology, University Medical Center Utrecht, Utrecht University, The Netherlands. Electronic address:
Scope: The aim of these guidelines is to provide recommendations for decolonization and perioperative antibiotic prophylaxis (PAP) in multidrug-resistant Gram-positive bacteria (MDR-GPB) adult carriers before inpatient surgery.
Methods: These European Society of Clinical Microbiology and Infectious Diseases/European Committee on Infection Control guidelines were developed following a systematic review of published studies targeting methicillin-resistant Staphylococcus aureus (MRSA), vancomycin-resistant enterococci, methicillin-resistant coagulase-negative Staphylococci, and pan-drug-resistant-GPB. Critical outcomes were the occurrence of surgical site infections (SSIs) caused by the colonizing MDR-GPB and SSIs-attributable mortality.
Perioperative cefazolin prescribing rates following suppression of alerts for non-IgE-mediated penicillin allergies.
Infect Control Hosp Epidemiol
May 2024
Nebraska Medicine, Omaha, NE, USA.
Article Synopsis
- Cefazolin is the preferred antibiotic for preventing surgical site infections (SSIs), but prescribing can be affected by patient-reported penicillin allergies.
- In April 2022, Nebraska Medicine adjusted electronic medical record alerts to reduce unnecessary restrictions on prescribing cefazolin for patients with non-severe penicillin allergies.
- A study found that following this change, the use of cefazolin in patients with documented penicillin allergies rose significantly, with no increase in adverse reactions or complications.
Peptide-AIE Nanofibers Functionalized Sutures with Antimicrobial Activity and Subcutaneous Traceability.
Adv Mater
July 2024
National Engineering Research Center for Tissue Restoration and Reconstruction, South China University of Technology, Guangzhou, 510006, China.
As one of the most widely used medical devices, sutures face challenges related to surgical site infections (SSIs) and lack of subcutaneous traceability. In the present study, a facile and effective approach using peptide-AIE nanofibers (NFs-K18) to create fluorescent-traceable antimicrobial sutures, which have been applied to four commercially available sutures is developed. The functionalized sutures of PGAS-NFs-K18 and PGLAS-NFs-K18 exhibit fluorescence with excellent penetration from 4 mm chicken breasts.
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