Year: 2016
Type: article
Study design: Observational Study
Abstract: Background. Many organisms have been implicated in post-operative SSIs following breast reconstruction. We report on the microbial species encountered after breast reconstructive surgery at a large tertiary care cancer center. Methods. From 1 January 2013 to 30 October 2015, patients with culture proven superficial or deep incisional SSIs based on NHSN criteria were identified through the infection control surveillance system and categorized by procedure code (CPT code). Preoperative bathing with chlorhexidine and pre-op cefazolin (clindamycin versus fluoroquinolone in PCN allergic patients) are standard of care. Patient demographic information, reconstruction characteristics, microbiological data and postsurgical antibiotic prophylaxis were reviewed (table). Epidemiologically related infections due to the same species were molecularly characterized to evaluate common source infections. Results. During the 22 month study period, 2340 patients underwent surgery, 69 (2.95%) developed culture proven SSI. All the patients were female. Overall infection rates in biologic versus prosthetic reconstruction were not significantly different (29 versus 21 per 1000 procedures). Gram-positives (MSSA, 44.9%; MRSA 11.6%) were most common. Among Gram negatives, PSAE was the dominant organism. CONS although common was mostly found in polymicrobial culture. The majority of monomicrobial infections were caused by MSSA. No common sources were identified by PFGE characterization of temporally related MRSA and PSAE isolates. Cephalosporin Clindamycin Levofloxacin None specified Conclusion. The rate of culture proven infection among our cohort of over 2300 patents was 2.95%. Gram-positive organisms accounted for the majority of SSIs following breast reconstructive surgery. Among Gram negatives, Pseudomonas was the most common organism. Genotyping of organisms from temporally related infections identified sporadic strains without evidence of clonal spread. Disclosures. All authors: No reported disclosures
Source: Open Forum Infectious Diseases
Institution: Memorial Sloan Kettering Cancer Center
Language: English
Subfield: Surgery
Field: Medicine
Domain: Health Sciences
Open Access status: gold
Estimated APC paid: $4,053
OpenAlex ID: W2561794607