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Kim, Kim, Jeong, Han, Choi, Kim, Choi, Im, Yeom, Park, Song, Choi, Peck, Kang, Kim, Kim, Lee, Park, Kim, Choi, and Kim: Comparison of the Incidence and Clinical Characteristics of Gram-positive and Gram-negative Surgical Site Infections after Gastric Surgery
Original Article
Infection & Chemotherapy

Infection & Chemotherapy 2012; 44(1): 11-16.

Published online: 29 February 2012

DOI: https://doi.org/10.3947/ic.2012.44.1.11

Comparison of the Incidence and Clinical Characteristics of Gram-positive and Gram-negative Surgical Site Infections after Gastric Surgery

Hye Won Kim1, Chang Oh Kim1, Su Jin Jeong1, Sang Hoon Han1, Jun Yong Choi1, Min-Ja Kim2, Young-Hwa Choi3, Seung Guan Im3, Joon-Sup Yeom4, Yoon-Soo Park5, Young Goo Song6, Hee-Jung Choi7, Kyong Ran Peck8, Cheol-In Kang8, Hyo-Youl Kim9, Young-Keun Kim9, Seung Soon Lee10, Dae-Won Park11, Yeon-A Kim12, Suk-Hoon Choi13, June Myung Kim1

1Department of Internal Medicine, Yonsei University Collegeof Medicine, Severance Hospital, Seoul, Korea.

2Department of Internal Medicine, University College of Medicine, Anam Hospital, Seoul, Korea.

3Department of Pulmonary and Critical Care Medicine, Ajou University School of Medicine, Ajou University Hospital, Suwon, Korea.

4Department of Internal Medicine, Sungkyunkwan University School of Medicine, Kangbuk Samsung Hospital, Seoul, Korea.

5Department of Internal Medicine, Gachon University School of medicine, Gil Medical Center, Incheon, Korea.

6Department of Internal Medicine, Yonsei University College of Medicine, Gangnam Severance Hospital, Seoul, Korea.

7Department of Internal Medicine, Ewha Womans University School of Medicine, Mok-Dong Hospital, Seoul, Korea.

8Department of Internal Medicine, Sungkyunkwan University School of Medicine, Samsung Medical Center, Seoul, Korea.

9Department of Internal Medicine, Yonsei University Wonju College of Medicine, Wonju Christian Hospital, Wonju, Korea.

10Department of Internal Medicine, Hallym University College of Medicine, Sacred Heart Hospital, Anyang, Korea.

11Department of Internal Medicine, Korea University College of Medicine, Ansan Hospital, Ansan, Korea.

12Department of Internal Medicine, Konyang University College of Medicine, Konyang University Hospital, Daejeon, Korea.

13Department of Internal Medicine, Hanil General Hospital, Seoul, Korea.

Correspondence to June Myung Kim, M.D., Ph.D. Department of Internal Medicine, Yonsei University College of Medicine, 50 Yonsei-ro, Seodaemun-gu, Seoul 120-752, Korea. Tel: +82-2-2228-1946, Fax: +82-2-393-6884, jmkim@yuhs.ac

Received 17 October 2011       Revised 15 December 2011       Accepted 6 January 2012

Copyright © 2012 by The Korean Society of Infectious Diseases and Korean Society for Chemotherapy

(open-access):

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Background

Surgical site infection (SSI) is prominent among the total incidence of healthcare-associated infections, and is a major contributing factor in the trend of increasing medical costs. There have been numerous efforts to analyze the conditions and causes of SSI for the purpose of prevention. In this study of SSI development after gastric surgery, we evaluated the prevalence of specific pathogens and compared the clinical characteristics observed between gram-positive (GPB) and gram-negative bacteria (GNB).

Materials and Methods

We conducted a retrospective study of patients who developed SSI within 30 days after gastric surgery at 13 clinics in Korea, between January 2007 and December 2008. Only those cases of SSI which included confirmed pathogen were included in this study.

Results

Among the 121 patients who developed SSI, GPB were observed in 32 patients and 36 cases, and GNB were isolated in 32 patients and 36 cases. Methicillin resistant Staphylococcus aureus (MRSA) was the most frequently isolated pathogen in this analysis. There were no differences observed between the GPB and GNB group in terms of baseline characteristics, patient or procedure related risk factors, or factors associated with prophylactic antibiotics.

Conclusions

In the previous studies of the occurrence of SSI after gastric surgery, it was reported that the majority of observed pathogens were enteric GNB. Further studies of the incidence of SSI after gastric surgery, particularly those related to MRSA infection, are necessary.

Keywords: Surgical site infection, Gastric surgery, Pathogens, Gram-positive bacteria, Gram-negative bacteria

Figures and Tables

Table 1
Causative Microorganism of Surgical Site Infection after Gastric Surgery
ic-44-11-i001

The data were expressed as number of isolates/total number of isolates (%).

aKlebsiella oxytoca, Raoultella ornithinolytica, Proteus mirabilis, Citrobacter braakii.

Table 2
Baseline Characteristics and Patient Related Risk Factors for Surgical Site Infection
ic-44-11-i002

GI, gastrointestinal; MRSA, methicillin resistant Staphylococcus aureus; ASA, American society of anesthesiologists; SSI, surgical site infection.

aNumeric variables, presented as mean±standard deviation. All other data presented as number (%).

bP-value was calculated by two-sample Student's t-test.

cP-value was calculated by Chi-square test.

dP-value was calculated by Fisher's exact test.

Table 3
Procedure Related Risk Factors of Surgical Site Infection
ic-44-11-i003

NNIS, National nosocomial infections surveillance system; RBC, Red blood cell.

T75, 75th percentile of the average duration for the procedure, 3 hour for gastric surgery.

aNumeric variables, presented as mean±standard deviation. All other data were presented as number (%).

bP-value was calculated by Fisher's exact test.

cP-value was calculated by Chi-square test.

dP-value was calculated by two-sample Student's t-test.

Table 4
Factors Associated with Gram Positive and Negative Infection according to Systemic Prophylactic Antibiotics
ic-44-11-i004

The data were expressed as number (%).

aP-value was calculated by Fisher's exact test.

bP-value was calculated by Chi-square test.

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ORCID iDs

Joon-Sup Yeom
https://orcid.org/http://orcid.org/0000-0001-8940-7170

Young-Keun Kim
https://orcid.org/http://orcid.org/0000-0002-2120-6265

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