Rapid emergence of resistant coagulase-negative staphylococci on the skin after antibiotic prophylaxis

Area of Science:

• Surgical Infection Prevention
• Antimicrobial Resistance
• Vascular Surgery

Background:

• Antimicrobial prophylaxis is standard in prosthetic vascular surgery with intravascular devices.
• Prolonged use may foster antimicrobial resistance in bacterial flora.

Purpose of the Study:

• To investigate the impact of different durations of antimicrobial prophylaxis on bacterial resistance patterns in vascular surgery patients.
• To determine if extended prophylaxis contributes to the emergence of resistant bacterial strains.

Main Methods:

• 37 vascular surgery patients received co-amoxyclav (3 days), ofloxacin/metronidazole (3 days), or ofloxacin/metronidazole (1 day).
• 17 control patients received no antibiotics.
• Skin staphylococci susceptibility to cloxacillin and ofloxacin was monitored using molecular typing.

Main Results:

• Groups receiving 3-day prophylaxis showed significant declines in susceptibility to cloxacillin and ofloxacin.
• Molecular typing revealed replacement of susceptible community strains with resistant, hospital-derived strains.
• One-day prophylaxis yielded intermediate resistance levels.

Conclusions:

• Long-term antimicrobial prophylaxis in vascular surgery should be avoided.
• Extended prophylaxis promotes colonization with resistant bacterial strains, increasing antimicrobial resistance.
• Shorter prophylaxis durations may mitigate the development of resistance.