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Study of postoperative chest infections with particular emphasis on those caused by Haemophilus influenzae
Abstract:
Fifteen per cent of patients admitted to a male general surgical ward were found to be carrying Haemophilus influenzae. Except for patients with chronic bronchitis, who developed an infection with the same micro-organism, carriage did not predispose patients to postoperative chest infection. Age, heavy smoking, and abdominal surgery increased the likelihood of respiratory infection after operation. H influenzae accounted for 58% of bacterial pathogens isolated from sputum, and most infections occurred within 48 hours of operation. Chemotyping showed that most infections were caused by different strains, and cross infection by H influenzae seemed to be rare. Cefuroxime given during anaesthesia did not prevent postoperative chest infection.
Insights
Most surgical patients carrying Haemophilus influenzae do not develop chest infections, but age, smoking, and surgery type increase risks. Prophylactic antibiotics did not prevent these common postoperative infections.
Area of Science:
- Medical Microbiology
- Surgical Infections
- Respiratory Medicine
Background:
- * *Haemophilus influenzae* (HI) is a common bacterium found in the respiratory tract.
- * Postoperative chest infections are a significant concern in surgical patients.
- * Understanding the role of HI carriage in surgical settings is crucial for infection control.
Purpose of the Study:
- * To investigate the prevalence of *Haemophilus influenzae* carriage in male general surgical patients.
- * To determine if HI carriage predisposes patients to postoperative chest infections.
- * To identify risk factors for developing respiratory infections after surgery and assess the efficacy of prophylactic cefuroxime.
Main Methods:
- * Prospective study involving 15% of patients admitted to a male general surgical ward.
- * Bacterial culture of sputum to identify pathogens.
- * Chemotyping to differentiate *H. influenzae* strains.
- * Analysis of patient demographics, smoking status, and surgical procedures.
Main Results:
- * 15% of patients carried *H. influenzae*; carriage did not increase infection risk except in those with chronic bronchitis.
- * Age, heavy smoking, and abdominal surgery were linked to increased postoperative respiratory infection risk.
- * *H. influenzae* was the most common pathogen (58%) in sputum, with infections typically occurring within 48 hours.
- * Most infections were caused by different strains, suggesting limited cross-infection.
- * Cefuroxime administered during anesthesia did not prevent postoperative chest infections.
Conclusions:
- * *Haemophilus influenzae* carriage is common in surgical patients but rarely causes postoperative chest infections.
- * Risk factors for postoperative respiratory infections include age, smoking, and abdominal surgery.
- * Current prophylactic antibiotic strategies may not effectively prevent *H. influenzae*-related postoperative chest infections.