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Current status of post-operative infections due to antimicrobial-resistant bacteria after digestive tract surgery in Japan: Japan Postoperative Infectious Complications Survey in 2015 (JPICS’15)

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Abstract

Purpose

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.

Methods

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.

Results

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.

Conclusion

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.

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Acknowledgements

We would like to extend our deep appreciation to the participants of this survey. The participating institutions and chief participants were follows: Department of Gastroenterological Surgery, Fukuoka University (S. Takeno), Division of Surgery, Fujinomiya City General Hospital (T. Okumura), Department of Digestive Surgery, Nihon University School of Medicine (O. Aramaki), Department of Surgery, Nippon Medical School Tama-Nagayama Hospital (H. Maruyama), Institute of Gastroenterology, Nippon Medical School Musashikosugi Hospital (M. Watanabe), Department of Surgery, Nippon Medical School (H. Kanno), Department of Surgery, Toho University Omori medical center (T. Maeda), Department of Surgery, Toho University Sakura Medical Center (M. Nagashima), Department of Surgery, The Jikei University School of Medicine (M. Kanehira), Department of Surgery, Osaka Rosai Hospital (M. Murakami), Department of Hepato-Biliary-Pancreatic Surgery, Osaka City University Graduate School of Medicine (S. Kubo), Gastroenterological Surgery, Chiba Cancer Center (Y. Nabeya), Department of Gastroenterological and General Surgery, School of Medicine, Showa University (A. Fujimori), Japanese Red Cross Ogawa Hospital (K. Shimura), Department of Surgery, Teine Keijinkai Hospital (M. Takada), Department of Surgery, Jiaikai Imamura hospital (S. Hokita), Sapporo General City Hospital (K. Yamamoto), Department of Surgery 1, School of Medicine, University of Occupational and Environmental Health (T. Tamura), Department of Gastroenterological, Breast and Endocrine Surgery, Yamaguchi University Graduate School of Medicine (S. Takeda), Department of Innovative Surgery and Surgical Techniques Development, Mie University Graduate School of Medicine (M. Kobayashi), Departments of Surgery, Saiseikai Niigata Daini Hospital (A. Kuwabara), Department of Surgery, Keio University School of Medicine (K. Tokizawa), Department of Surgery, Kyoto-Katsura Hospital (R. Nishitai), Department of Digestive Surgery, Tsushimi Hospital (T. Yamamoto), Department of Infection Control and Prevention, Aichi Medical University Hospital (Y. Kato), Department of Surgery, Mazda Hospital (S. Akagi), Department of Gastroenterological Surgery, Kawasaki Saiwai Hospital (K. Narita).

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Authors and Affiliations

  1. Department of Clinical Infectious Diseases, Aichi Medical University Hospital, 1-1 Yazakokarimata, Nagakute, 480-1195, Aichi, Japan

    Mao Hagihara, Yukiko Kato, Yuka Yamagishi & Hiroshige Mikamo

  2. Department of Surgery, Ohashi Medical Center, Toho University, Tokyo, Japan

    Shinya Kusachi & Toru Niitsuma

  3. Department of Infection Prevention and Control, Hyogo College of Medicine, Hyogo, Japan

    Yoshio Takesue

  4. Toho University, Tokyo, Japan

    Yoshinobu Sumiyama

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  1. Mao Hagihara
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Correspondence to Hiroshige Mikamo.

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Hagihara, M., Kusachi, S., Kato, Y. et al. Current status of post-operative infections due to antimicrobial-resistant bacteria after digestive tract surgery in Japan: Japan Postoperative Infectious Complications Survey in 2015 (JPICS’15). Surg Today 50, 56–67 (2020). https://doi.org/10.1007/s00595-019-01857-y

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