García Prado María E, Matia Elisa Cordero, Ciuro Felipe Pareja, Díez-Canedo Juan Serrano, Sousa Martín José M, Porras López Francisco M, de la Casa Angel Cantos, Cisneros Herreros José M
Servicio Enfermedades Infecciosas, Hospital Universitario Virgen del Rocío, Avda, Manuel Siurot s/n, Seville, Spain.
Transplantation. 2008 Jun 27;85(12):1849-54. doi: 10.1097/TP.0b013e3181735407.
Surgical site infection (SSI) is an important cause of morbidity after orthotopic liver transplantation (OLT). Perioperative antibiotic prophylaxis is one of the main modifiable risk factors. We prospectively investigated the epidemiology, risk factors, and prognosis of SSI in a cohort of 167 OLT. Two different schedules of antibiotic SSI prophylaxis were compared. Fifty-six episodes of SSI were included (0.34 episodes/patient). The SSI incidence among patients who received cefazolin and amoxicillin-clavulanate did not differ. Bacteria caused all episodes. The most common pathogen was Escherichia coli (21.25%), among which 47% were extended-spectrum beta-lactamase producers. The only risk factor for SSI was antibiotic therapy before OLT. Patients with SSI had a longer hospital and intensive care unit stay (P<0.05), but survival did not differ. In conclusion, SSI has a high incidence despite antibiotic perioperative prophylaxis; therefore, an integral perspective of SSI and a multifactorial approach other than antimicrobial prophylaxis are needed to prevent it.
手术部位感染（SSI）是原位肝移植（OLT）术后发病的重要原因。围手术期抗生素预防是主要的可改变危险因素之一。我们前瞻性地调查了167例OLT患者队列中SSI的流行病学、危险因素和预后。比较了两种不同的抗生素SSI预防方案。纳入了56例SSI病例（0.34例/患者）。接受头孢唑林和阿莫西林-克拉维酸的患者中SSI发生率无差异。所有病例均由细菌引起。最常见的病原体是大肠埃希菌（21.25%），其中47%是超广谱β-内酰胺酶产生菌。OLT前使用抗生素治疗是SSI的唯一危险因素。发生SSI的患者住院和重症监护病房停留时间更长（P<0.05），但生存率无差异。总之，尽管围手术期使用了抗生素预防，SSI的发生率仍很高；因此，需要对SSI有一个整体的认识，并采取除抗菌预防以外的多因素方法来预防它。
