SHUPYK NATIONAL HEALTHCARE UNIVERSITY OF UKRAINE, KYIV, UKRAINE; INSTITUTE OF PEDIATRICS, OBSTETRICS AND GYNECOLOGY OF THE NATIONAL ACADEMY OF MEDICAL SCIENCES OF UKRAINE, KYIV, UKRAINE.
NATIONAL CANCER INSTITUTE, KYIV, UKRAINE.
Pol Merkur Lekarski. 2023;51(4):299-305. doi: 10.36740/Merkur202304101.
Aim: To determine the current prevalence of surgical site infections (SSIs) after gynecological surgeries and antimicrobial resistance of causing pathogens in Ukraine.
Materials and Methods: Multicenter prospective observational cohort study was conducted from January 2020 to December 2022 in nine hospitals from eight regions of Ukraine. Definitions of HAIs were adapted from the Centers for Disease Control and Prevention's National Healthcare Safety Network. Antibiotic susceptibility was done by the disc diffusion test as recommended by EUCAST.
Results: A total 12.2% (420/3450) patients who undergoing gynecological surgeries were found to have SSIs. The difference in SSI rates between the three subgroups by route of surgery was not statistically significant, being 12.0% for the abdominal group,11.1% for the vaginal group, and 12.5% for the combined group. The most common causing pathogens of SSIs was Escherichia coli, Pseudomonas aeruginosa, Enterobacter spp., Streptococcus spp., and Klebsiella pneumoniae. Many Gram-negative pathogens isolated from SSI cases were found to be multidrug resistant.
Conclusions: This study showed that SSIs remains the common complication after gynecological procedures in Ukraine. Best practices should be established and followed to reduce the risk of SSIs associated with gynecologic surgery. Optimizing the antibiotic prophylaxis and empirical antimicrobial therapy may reduce the burden of SSIs in gynecological surgeries, but prevention is the key element.
旨在确定乌克兰妇科手术后手术部位感染(SSI)的当前流行率以及导致病原体的抗菌药物耐药性。
材料和方法:这项多中心前瞻性观察性队列研究于 2020 年 1 月至 2022 年 12 月在乌克兰 8 个地区的 9 家医院进行。HAI 的定义改编自疾病控制与预防中心的国家医疗保健安全网络。抗生素敏感性通过 EUCAST 推荐的纸片扩散试验进行。
结果:总共发现 3450 例接受妇科手术的患者中有 12.2%(420 例)发生 SSI。手术途径的三个亚组之间的 SSI 发生率差异无统计学意义,腹部组为 12.0%,阴道组为 11.1%,联合组为 12.5%。SSI 的最常见病原体是大肠埃希菌、铜绿假单胞菌、肠杆菌属、链球菌属和肺炎克雷伯菌。从 SSI 病例中分离出的许多革兰氏阴性病原体被发现具有多药耐药性。
结论:本研究表明,SSI 仍然是乌克兰妇科手术后的常见并发症。应建立和遵循最佳实践,以降低与妇科手术相关的 SSI 风险。优化抗生素预防和经验性抗菌治疗可能会降低妇科手术中 SSI 的负担,但预防是关键因素。