Abstract | PURPOSE:
Surgical site infection (SSI) can be a challenging complication after posterior spinal fusion and instrumentation (PSFI). An increasing rate of SSI by gram-negative bacteria (GNB) has been observed. Current guideline recommendations have not been effective for preventing infection by these microorganisms. METHODS: Retrospective cohort study comparing two consecutive groups of patients undergoing PSFI at a single institution. Cohort A includes 236 patients, operated between January 2006 and March 2007, receiving standard preoperative antibiotic prophylaxis with cefazolin ( clindamycin in allergic patients). Cohort B includes 223 patients operated between January and December 2009, receiving individualized antibiotic prophylaxis and treatment based on preoperative urine culture. Cultures were done 3-5 days before surgery in patients meeting one of the following risk criteria for urinary tract colonization: hospitalization longer than 7 days, indwelling catheter, neurogenic bladder, history of urinary incontinence, or history of recurrent urinary tract infection. RESULTS: Twenty-two (9.3%) patients in cohort A developed SSI, 68.2% due to GNB. 38 (17%) patients in cohort B were considered at risk for GNB colonization; preoperative urine culture was positive in 14 (36%). After adjusted antibiotic prophylaxis, 15 (6.27%) patients in cohort B developed SSI, 33.4% due to GNB. A statistically significant reduction in GNB SSI was seen in cohort B (Fisher's exact test, p = 0.039). CONCLUSION:
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Authors | Susana Núñez-Pereira, F Pellisé, D Rodríguez-Pardo, C Pigrau, J M Sánchez, J Bagó, C Villanueva, E Cáceres |
Journal | European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society
(Eur Spine J)
Vol. 20 Suppl 3
Pg. 397-402
(Aug 2011)
ISSN: 1432-0932 [Electronic] Germany |
PMID | 21789528
(Publication Type: Journal Article)
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Chemical References |
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Topics |
- Adolescent
- Adult
- Aged
- Aged, 80 and over
- Anti-Bacterial Agents
(therapeutic use)
- Cohort Studies
- Equipment Contamination
- Female
- Gram-Negative Bacterial Infections
(epidemiology, prevention & control, urine)
- Humans
- Incidence
- Male
- Middle Aged
- Preoperative Care
(methods)
- Retrospective Studies
- Spinal Fusion
(instrumentation)
- Surgical Wound Infection
(epidemiology, prevention & control, urine)
- Urinalysis
(methods)
- Urinary Tract Infections
(epidemiology, prevention & control)
- Urine
(microbiology)
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