Abstract
To address whether hospital antimicrobial use influences surgical site infection (SSI), we investigated factors including antimicrobial homogeneity index (AHI), an indicator of prescription diversity, with a retrospective study during 120 months for patients undergoing lung, breast, and general surgery (n = 4,510). We analyzed the odds ratios of background factors for SSI and the correlation between AHI and drug susceptibility in isolates of SSI. A total of 243 cases of SSI (5.4%) occurred. Factors that significantly contributed for SSI were operative time [odds ratio (OR), 1.78; 95% confidence interval (CI), 1.33–2.39; P < 0.001], American Society of Anesthesiologists’ score (OR, 1.68, 95% CI, 1.23–2.28; P < 0.001), endoscopic use (OR, 0.10, 95% CI, 0.04–0.24; P < 0.001), lung and breast surgery versus general surgery (OR, 0.12, 95% CI, 0.06–0.22; P < 0.001), increased AHI (OR, 0.72, 95% CI, 0.55–0.95; P = 0.020), and older age (OR, 2.08, 95% CI, 1.39–3.11; P < 0.001). AHI showed a positive correlation coefficient (CC, P < 0.05) with susceptibility to ampicillin (CC = +0.327), cefotaxime (CC = +0.142), imipenem/cilastatin (CC = +0.101), and sulbactam/cefoperazone (CC = +0.145). AHI, which has been described to help prevent drug resistance, was associated with increased susceptibility in microbes of SSI. This finding in part may explain that increase in AHI reduced SSI.
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Yoshida, J., Oyama, M., Furugaki, K. et al. Does antimicrobial homogeneity index influence surgical site infection? A 10-year study in lung, breast, and general surgery. J Infect Chemother 17, 825–830 (2011). https://doi.org/10.1007/s10156-011-0270-x
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DOI: https://doi.org/10.1007/s10156-011-0270-x