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Surgical microbiology in risk patients undergoing abdominal surgery
I M Iturburu1, C Emparan, C Ezpeleteta
1Department of General Surgery B, Basurto's Hospital, Bilbao, Spain. iturburu@hbas.osakidetza.net
Introduction:
Incidence of surgical infection is greater among elderly patients undergoing surgery than among the general population, with a serious compromise regarding morbidity and mortality in this group of patients with increased risk.
Aim Of The Study:
To determine the microbiological features of surgical infections in patients over 65 years of age compared with those younger than 65.
Patients And Methods:
Over the past 2 years, 2,064 patients underwent surgery in our Department. One thousand three hundred sixty seven of those patients (66.7%) had 65 years of age or less and 688 (33.3%) were over 65. Patient characteristics regarding the type of surgery (degree of contamination) and the nature and type of the condition requiring surgery are reported. One hundred five hundred sixty two samples were submitted for microbiological study. The microbiological infectious pathogens and their characteristics were determined. The Chi-square test was used for the analysis of potential differences related to the age of the patient.
Results:
The rate of samples sent for microbiological study is higher among patients over 65. In addition, these patients show both quantitative and qualitative differences in their infectious microbiological spectrum, mainly in clean-contaminated, contaminated and dirty surgical procedures. Fungal infections play a significant role in this group of patients.
Conclusions:
Facultative gram-negative bacilli, aerobic gram-positive cocci, and fungi are the main pathogens responsible of surgical infections in elderly patients, compared to all other patients, thus requiring specific antibiotic prophylactic and therapeutic regimes.
Insights
Elderly patients undergoing surgery have a higher incidence of surgical infections with distinct microbiological features, including a significant role of fungal infections. Specific antibiotic strategies are needed for this high-risk group.
Area of Science:
- Surgical Infections
- Geriatric Medicine
- Microbiology
Background:
- Elderly patients exhibit a higher incidence of surgical infections compared to the general population.
- These infections pose significant risks for increased morbidity and mortality in older adults.
Purpose of the Study:
- To compare the microbiological characteristics of surgical infections in patients over 65 years of age with those under 65.
- To identify age-related differences in pathogens causing surgical site infections.
Main Methods:
- A retrospective analysis of 2,064 surgical patients over two years.
- Microbiological analysis of 1,562 samples from surgical infections.
- Statistical comparison using the Chi-square test to evaluate age-related differences.
Main Results:
- Patients over 65 years had a higher rate of samples submitted for microbiological study.
- Significant quantitative and qualitative differences in the infectious microbiological spectrum were observed in elderly patients, particularly in contaminated procedures.
- Fungal infections were notably prevalent in the elderly patient group.
Conclusions:
- Facultative gram-negative bacilli, aerobic gram-positive cocci, and fungi are the primary pathogens in elderly patients' surgical infections.
- These findings underscore the need for tailored antibiotic prophylactic and therapeutic regimens for older surgical patients.
- Age-specific microbiological profiles necessitate distinct clinical management strategies.