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Septic complications in relation to factors influencing the gastric microflora in patients undergoing gastric surgery
S Sjöstedt1, P Levin, A S Malmborg
1Department of Surgery, Huddinge University Hospital, Karolinska Institute, Sweden.
Abstract:
Postoperative septic complications and micro-organisms found in primary infections were studied in 750 gastric operations performed between 1972 and 1986. The overall rate of primary infections was 23%. The infection rates were related to the diagnosis and to factors that could influence the colonization of the stomach. No significant differences in the rates of postoperative infections were found between patients who had received preoperative antibiotic prophylaxis and those who had not. In all groups of patients, aerobic and anaerobic gram-positive and gram-negative bacteria and yeasts were isolated in primary infections. Enterobacteriaceae, enterococci and Bacteroides fragiis were more frequent in patients with gastric bleeding or carcinoma.
Insights
This study investigated postoperative septic complications in 750 gastric surgeries. Preoperative antibiotic prophylaxis did not significantly alter infection rates, which were linked to diagnosis and stomach colonization factors.
Area of Science:
- Gastrointestinal Surgery
- Infectious Disease Epidemiology
- Microbiology
Background:
- Postoperative septic complications are a significant concern following gastric surgery.
- Understanding the microbial causes of primary infections is crucial for effective management.
- Factors influencing gastric colonization may impact infection risk.
Purpose of the Study:
- To analyze the incidence of postoperative septic complications in gastric operations.
- To identify the microorganisms responsible for primary infections after gastric surgery.
- To evaluate the impact of preoperative antibiotic prophylaxis on infection rates.
Main Methods:
- Retrospective analysis of 750 gastric operations performed between 1972 and 1986.
- Data collection on postoperative septic complications and identified microorganisms.
- Comparison of infection rates between patients with and without preoperative antibiotic prophylaxis.
Main Results:
- An overall primary infection rate of 23% was observed.
- Infection rates correlated with specific diagnoses and factors affecting gastric colonization.
- No significant difference in infection rates was found with or without preoperative antibiotic prophylaxis.
- Aerobic and anaerobic bacteria, along with yeasts, were common in primary infections.
- Enterobacteriaceae, enterococci, and Bacteroides fragilis were more prevalent in patients with gastric bleeding or carcinoma.
Conclusions:
- Preoperative antibiotic prophylaxis showed no significant benefit in reducing postoperative infection rates in this gastric surgery cohort.
- Diagnosis and factors influencing gastric colonization are key determinants of infection risk.
- A broad spectrum of microorganisms, including specific bacteria like Enterobacteriaceae, enterococci, and Bacteroides fragilis, are implicated in gastric surgery infections.