Multi-drug-resistant organisms are the main pathogens of surgical-site infection after colorectal surgery: a retrospective study

Abstract

Objective

This study aimed to investigate the incidence, disease burden and risk factors of surgical-site infections (SSIs) after colorectal surgery, particularly caused by multi-drug-resistant organism (MDRO) infections, to provide evidence for the control and prevention of SSIs after colorectal surgery.

Methods

This retrospective study included patients who underwent colorectal surgery at Xiangya Hospital, Central South University, between 2020 and 2021. Univariate and multi-variate analyses were performed to identify risk factors.

Results

In total, 2297 patients who had undergone colorectal surgery were included, of which 94 experienced SSIs following surgery. Of the 94 patients, 54 had specific pathogens identified. Furthermore, of these 54 patients, 44 were infected with an MDRO. The main pathogen causing SSIs was Escherichia coli, which was isolated from 43 patients. E. coli isolates showed high levels of resistance to cefazolin and cefuroxime but low resistance to imipenem, piperacillin and tazobactam. Low albumin levels before surgery, prior use of antibiotics, pre-operative intensive care unit (ICU) admission, mechanical ventilation, central venous indwelling catheter and blood transfusion were statistically significant risk factors for SSIs. Prior use of antibiotics and blood transfusion were independent risk factors for SSIs. Pre-operative ICU admission, mechanical ventilation and high pre-operative venous blood glucose levels were statistically significant risk factors for MDRO infection, and pre-operative ICU admission was identified as the only independent risk factor.

Conclusion

MDROs were the most common pathogens of SSIs after colorectal surgery. Prior antibiotic use, blood transfusion and pre-operative ICU admission are key independent risk factors for SSIs and MDRO infections.