Evaluation of Bacterial Profiles and Antibiotic Susceptibility in Orthopedic Patients With Surgical Site Infections After Implant Surgery

评估骨科患者植入手术后手术部位感染的细菌谱和抗生素敏感性

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Abstract

INTRODUCTION: Surgical site infections (SSIs) are a significant concern for surgeons and a leading cause of poor patient outcomes, increased morbidity, extended hospital stay, and higher costs. SSIs are of particular concern in orthopedic implant surgeries because biofilms on implants protect bacteria. This study aimed to evaluate the incidence rate of SSIs in orthopedic implant patients, identify associated risk factors, and analyze the types of bacteria causing these infections. METHODS AND MATERIALS: This study was a prospective analysis of 1,282 patients who underwent orthopedic implant surgery at the Orthopedic Department over a period of more than one year. It examined various parameters, including the type of surgery, surgical site, associated risk factors, and duration of surgery. It also explored the correlation between the development of SSIs, the time to development, and the associated risk factors. RESULTS: Of the 1282 orthopedic patients followed up, 98 developed SSI. Thus, the incidence rate was 7.64%. Patients undergoing emergency surgery are more likely to develop infections than those undergoing elective surgery. About 65% of all SSIs were caused by the most prevalent infectious agent, Staphylococcus aureus, which infected 23 subjects (22.54%), followed by Escherichia coli in 16 subjects (15.68%), Klebsiella pneumoniae in 14 subjects (13.72%), and Acinetobacter baumannii in 13 subjects (12.74%). The most important risk factor was diabetes, which affected 26 participants with the highest prevalence (26.5%), followed by 16 subjects who used tobacco (16.3%). A further significant risk factor for higher rates of SSIs was longer operation times. CONCLUSION: Our analysis highlights the urgent need for a comprehensive antibiotic policy for patients undergoing implant surgery, given the prevalence of common bacteria and the significant risk factors associated with SSIs. To address this critical issue, we propose a level 1 multicenter study to develop standardized guidelines for antibiotic administration in these patients. This approach ensures optimal treatment outcomes and enhances patient safety.

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