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Positive Bacterial Culture Results at a Dermatologic Surgery Center: A Single-Site Retrospective Review
Jessica B Dietert1, James Ko2, Eva A Hurst2
1Snyder Dermatology, Austin, Texas.
Background:
Typical prophylactic coverage of suspected cutaneous surgical-site infections (SSIs) predominantly covers gram-positive bacteria. Data regarding the frequency of infection with unusual bacteria, not covered by prophylaxis, are not available.
Objective:
A retrospective 10-year review of culture-positive infections at a single academic site was performed.
Materials And Methods:
All positive bacterial culture results at the Washington University Center for Dermatologic and Cosmetic Surgery between October 31, 2007, and October 31, 2017, were collected and analyzed.
Results:
Coagulase-negative staphylococcus accounted for 20.8% of positive culture results. Staphylococcus aureus caused 45.4% of infections. The remaining 33.8% were due to non-S. aureus bacteria, most frequently with Pseudomonas aeruginosa (10.8%). Numerous other gram-negative organisms and unusual gram-positive organisms were cultured. The lower extremity and ear were the only sites more likely to be infected with non-S. aureus bacteria. Smokers and immunosuppressed individuals were not more likely to have an SSI with non-S. aureus bacteria.
Conclusion:
A significant proportion of all SSIs with positive culture results was due to bacteria that are not sensitive to beta-lactam prophylaxis. Broader coverage for suspected SSI should be considered, particularly on the lower extremity and ear.
