Related Experiment Video
Updated: Mar 7, 2026
Growing a Cystic Fibrosis-Relevant Polymicrobial Biofilm to Probe Community Phenotypes
Published on: April 19, 2024
[Spectrum of pathogens in postoperative complications of visceral surgery : The problem of multidrug resistance]
A Kramer1, J Pochhammer2, P Walger3
1Institut für Hygiene und Umweltmedizin, Universitätsmedizin Greifswald, Walther-Rathenau-Str. 49a, 17495, Greifswald, Deutschland. kramer@uni-greifswald.de.
Abstract:
In general surgery the etiology of surgical site infections has not significantly changed over the last 30 years. Gram-positive bacteria, e.g. coagulase negative staphylococci (CNS), Staphylococcus aureus and Enterococcus spp. as well as Gram-negative bacteria, e.g. Escherichia coli, Enterobacter spp., Klebsiella spp. and Pseudomonas aeruginosa, are the most common findings. Although in general surgery 10% of the S. aureus causing postoperative wound infections were methicillin resistant (MRSA), no cases of multidrug-resistant Gram-negative (MRGN) bacteria were reported. Yeasts (particularly Candida spp.) are rarely the pathogen causing surgical site infections (≤3%) and concomitant risk factors are typical (e.g. diabetes, chemotherapy, immunosuppression and malnutrition). Viruses are rarely the cause of surgical site infections. Transmission can occur by HBV, HCV or HIV positive surgical staff or in organ transplantations and postoperative reactivation of persistent infections is possible (especially for HBV, HCV, CMV, EBV and HIV). The principles for prevention of surgical site infections are dealt with as consequences of preoperative colonization by MRSA, methicillin-sensitive S. aureus (MSSA) and MRGN and reviewed with respect to screening, perioperative antibiotic prophylaxis and decolonization. In nosocomial peritonitis, the selection of antibiotics should consider previous antibiotic treatment. A single intra-abdominal detection of Candida spp. usually does not require antimycotic treatment in postoperatively stable and immunocompetent patients but is recommended in severe community-acquired or nosocomial peritonitis. Viral infections can be avoided by screening of organ donors and serological surveillance of surgery personnel.
Insights
Surgical site infections (SSIs) remain dominated by Gram-positive and Gram-negative bacteria, with methicillin-resistant Staphylococcus aureus (MRSA) present. Prevention strategies focus on screening and antibiotic prophylaxis for common pathogens.
Area of Science:
- Surgical infections
- Microbiology
- Infectious disease prevention
Background:
- Etiology of surgical site infections (SSIs) in general surgery has remained consistent over 30 years.
- Common pathogens include Gram-positive bacteria (e.g., Staphylococcus aureus, Enterococcus spp.) and Gram-negative bacteria (e.g., Escherichia coli, Pseudomonas aeruginosa).
- Methicillin-resistant Staphylococcus aureus (MRSA) accounts for 10% of S. aureus SSIs, while multidrug-resistant Gram-negative (MRGN) bacteria have not been reported.
Purpose of the Study:
- To review the etiology and prevention principles of surgical site infections.
- To discuss the role of specific pathogens including yeasts and viruses in SSIs.
- To outline strategies for managing SSIs, particularly concerning antibiotic resistance and prophylaxis.
Main Methods:
- Review of established knowledge on surgical site infection etiology.
- Analysis of pathogen prevalence, including antibiotic-resistant strains.
- Discussion of prevention methods such as screening, antibiotic prophylaxis, and decolonization.
Main Results:
- Gram-positive and Gram-negative bacteria are the primary causes of SSIs.
- Yeasts (Candida spp.) and viruses are rare causes, often associated with specific risk factors or transmission routes.
- Prevention principles address preoperative colonization by resistant organisms (MRSA, MRGN) and perioperative management.
Conclusions:
- Surgical site infection etiology is largely unchanged, with persistent challenges from antibiotic-resistant bacteria.
- Prevention strategies are crucial, focusing on preoperative screening, appropriate antibiotic prophylaxis, and decolonization.
- Management of peritonitis and viral infections requires specific considerations, including donor screening and personnel surveillance.
Related Concept Videos
01:26Healthcare Associated Infections I: Iatrogenic, Exogenic and Endogenic
HAIs significantly increase the cost of health care. Extended stays in healthcare institutions, increased disability, increased costs of medications, including specialized antibiotics, and prolonged recovery times add to the patient's expenses and the healthcare institution and funding bodies.
01:30Development of Antibiotic Resistance
01:31Defense Against Bacterial Pathogens
Phagocytes
Phagocytes are the frontline soldiers of the immune system. They include neutrophils and macrophages. Neutrophils are the most abundant type of white blood cell and are quickly mobilized to the site of infection. Macrophages are larger cells that patrol...
01:21Inflammatory Bowel Disease V: Surgical Management
Here are some common surgical interventions for IBD:
01:26Factors Affecting the Risk of Infection
The integrity and count of the white blood cells help the body resist pathogens and fight infection. When impaired, it reduces the body's resistance to pathogens. The acidic pH levels of the gastrointestinal, genitourinary tracts, and skin...
01:25Urinary Tract Infection II: Pathophysiology