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Surgical Revision Promotes Presence of Enterococcus spp. in Abdominal Superficial Surgical Site Infections

  • Original Article
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Journal of Gastrointestinal Surgery

Abstract

Background

Superficial surgical site infections (SSSIs) are a major reason for morbidity after abdominal surgery. Microbiologic isolates of SSSIs vary widely geographically. Therefore, knowledge about the specific bacterial profile is of paramount importance to prevent SSSI.

Methods

We performed a subgroup analysis of the microbiological isolates from patients with SSSI after abdominal surgery that were included in our institutional wound register. We aimed at identifying predominant strains as well as risk factors that would predispose for SSSI with certain bacteria.

Results

A total of 494 patients were eligible for analysis. Of those 313 had received wound swaps, with 268 patients yielding a bacterial isolate. Enterobacterales (31.7%) and Enterococcus spp. (29.5%) were found as main bacteria in SSSI, with 62.3% of the wounds being polymicrobial. As risk factors for changes in bacterial isolates, we identified operative revision (OR 3.032; 95%CI 1.734–5.303) in multivariate analysis. Enterococcus spp. showed a significant increase in patients after revision surgery (p<0.001). Antibiotic therapy was neither influential on bacterial changes nor on the presence of Enterococcus spp. in SSSI.

Conclusion

Our study accentuates the high frequency of Enterococcus spp. in SSSI after abdominal surgery, while identifying surgical revision as major risk factor. The results urge vigilance in the treatment of patients with surgical revisions to include Enterococcus spp. in the prevention and treatment strategies.

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Acknowledgements

We appreciate the support of our wound care specialists who have supported this study and who are eager in supplying the best care possible for our SSI patients.

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Authors and Affiliations

  1. Department of Visceral, Transplant, Thoracic and Vascular Surgery, University Hospital of Leipzig, Liebigstraße 20, 04103, Leipzig, Germany

    Matthias Mehdorn, Woubet Tefera Kassahun, Uwe Scheuermann, Linda Groos, Dorina Buchloh, Boris Jansen-Winkeln & Ines Gockel

  2. Institute for Medical Microbiology and Virology, University Hospital of Leipzig, Leipzig, Germany

    Norman Lippmann

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  1. Matthias Mehdorn
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Matthias Mehdorn and Woubet Tefera Kassahun contributed equally to this work and are both considered to be first authors.

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Mehdorn, M., Kassahun, W.T., Lippmann, N. et al. Surgical Revision Promotes Presence of Enterococcus spp. in Abdominal Superficial Surgical Site Infections. J Gastrointest Surg 26, 444–452 (2022). https://doi.org/10.1007/s11605-021-05170-3

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