Department of Clinical Infectious Diseases, Aichi Medical University Hospital, 1-1 Yazakokarimata, Nagakute, 480-1195, Aichi, Japan.
Department of Surgery, Ohashi Medical Center, Toho University, Tokyo, Japan.
Surg Today. 2020 Jan;50(1):56-67. doi: 10.1007/s00595-019-01857-y. Epub 2019 Aug 9.
We herein report the findings of the Japan Postoperative Infectious Complication Survey in 2015 (JPICS'15), which evaluated the rate of post-operative infections and colonization due to antimicrobial-resistant (AMR) bacteria after digestive tract surgery.
This survey by the Japan Society of Surgical Infection included patients undergoing digestive tract surgery at 28 centers between September 2015 and March 2016. Data included patient background characteristics, type of surgery, contamination status, and type of post-operative infections, including surgical site infections (SSIs), remote infections (RIs), and colonization.
During the study period, 7,565 surgeries (of 896 types) were performed; among them, 905 cases demonstrated bacteria after digestive tract surgery. The survey revealed that post-operative infections or colonization by AMR bacteria occurred in 0.9% of the patient cohort, constituting 7.5% of post-operative infections, including 5.6% of SSIs and 1.8% of RIs. Extended-spectrum β-lactamase-producing Enterobacteriaceae and methicillin-resistant Staphylococcus aureus were the predominant AMR bacteria isolated from patients after digestive tract surgery. Patients infected with AMR bacteria had a poor prognosis.
Our results reveal that 7.5% of the post-operative infections were due to AMR bacteria, indicating the need for antibacterial coverage against AMR bacteria in patients with critical post-operative infections.
本研究报告了 2015 年日本术后感染并发症调查(JPICS'15)的结果,该调查评估了消化道手术后由抗菌药物耐药(AMR)细菌引起的术后感染和定植率。
该调查由日本外科感染学会开展,纳入了 2015 年 9 月至 2016 年 3 月间 28 个中心接受消化道手术的患者。数据包括患者的背景特征、手术类型、污染状态以及术后感染类型,包括手术部位感染(SSI)、远处感染(RI)和定植。
在研究期间,共进行了 7565 例(896 种类型)手术;其中 905 例术后有细菌。调查显示,0.9%的患者发生了 AMR 细菌引起的术后感染或定植,占术后感染的 7.5%,包括 5.6%的 SSI 和 1.8%的 RI。从消化道手术后的患者中分离出的主要 AMR 细菌为产超广谱β-内酰胺酶的肠杆菌科和耐甲氧西林金黄色葡萄球菌。感染 AMR 细菌的患者预后较差。
我们的结果表明,7.5%的术后感染是由 AMR 细菌引起的,这表明对于有严重术后感染风险的患者,需要针对 AMR 细菌进行抗菌药物覆盖。