Relationship between skin and urine colonization and surgical site infection in the proximal femur fracture: a prospecti
- PDF / 207,371 Bytes
- 5 Pages / 595.276 x 790.866 pts Page_size
- 109 Downloads / 233 Views
ORIGINAL PAPER
Relationship between skin and urine colonization and surgical site infection in the proximal femur fracture: a prospective study Eva Cuchí 1 & Lucía Gómez García 2 & Elena Jiménez 1 & Daniel Haro 3 & Pablo Castillón 3 & Laura Puertas 3 & Alfredo Matamala 3 & Francesc Anglès 3 & Josefa Pérez 1 Received: 7 November 2019 / Accepted: 4 March 2020 # SICOT aisbl 2020
Abstract Purpose Antibiotic prophylaxis is routinely used in the surgical management of proximal femur fractures. The role of bacterial colonization of the skin and urine in the development of deep surgical site infections (SSI) is yet to be elucidated. This study aimed to evaluate the role of previous skin and urine colonization in the development of deep SSI after a proximal femoral fracture surgery. Methods We conducted a prospective observational study in 326 patients > 64 years old, who were scheduled to surgery. Cultures from skin samples of the surgical site and from urine were performed prior to the procedure, and cefazoline was administered as prophylaxis. Results Skin microbiota was isolated in 233 (71.5%) cases; 8 (2.5%) samples were positive for other bacteria, and 85 (26%) were negative. Of 236 urine samples, 168 were negative or contaminated (71.2%), and 68 (28.8%) were positive, being 58/236 for Enterobacterales (24.6%). Acute deep SSI were diagnosed in nine out of 326 patients (2.7%), and two (22%) were infected by Gram-negative bacilli. Of the 9 cases, normal skin microbiota was isolated in 7 (78%), and the remaining two were negative. Seven cases had negative or contaminated urine cultures, and the one with E. coli did not correlate with SSI bacteria. Conclusion In our elderly hip fracture population, most patients harbored normal skin microbiota, and Enterobacterales urine cultures were positive in one-quarter of cases. There was no relationship between skin colonization, urine culture, and deep SSI. We therefore do not believe that our patients would benefit from modifying the current antibiotic prophylaxis. Keywords Proximal femur fracture . Surgical site infection . Microbiota . Antibiotic prophylaxis . Elderly population
Introduction Antibiotic prophylaxis in surgery reduces the proportion of patients that develop a superficial or deep surgical site infection (SSI) compared with non-prophylaxis or placebo populations [1]. The principles of antibiotic prophylaxis have been well established since the early 1960s [2].
* Lucía Gómez García [email protected] 1
Department of Microbiology, Catlab, Barcelona, Spain
2
Infectious Diseases Department, Hospital Universitari Mútua de Terrassa, Universitat de Barcelona, Pza Dr. Robert, 5, 08221 Terrassa, Barcelona, Spain
3
Department of Orthopedic Surgery, Hospital Universitari MútuaTerrassa, Barcelona, Spain
Within the field of Orthopedic Surgery and Traumatology, antibiotics are widely administered prior to surgeries for the implantation of osteosynthesis or prosthesis material. Moreover, due to the fact that the pathogenesis of SSIs in closed fractures is similar in
Data Loading...
