Spectrum of Pathogens in Surgical Site Infections after Sarcoma Resection in the Peri-Pelvic and Pelvic Region. Distinct Location, Distinct Infection?

Area of Science:

• Oncology
• Infectious Diseases
• Surgical Research

Background:

• Soft tissue sarcomas (STS) frequently occur in the peri-pelvic region.
• Surgical site infections (SSI) are a common and problematic complication following STS resection, particularly in the peri-pelvic area.
• Current peri-operative antibiotic prophylaxis recommendations for pelvic STS resection are lacking.

Purpose of the Study:

• To determine the incidence rate of SSI after peri-pelvic and pelvic STS resection.
• To analyze the microbial spectrum of SSI in this anatomical region.
• To provide data for potential revision of antibiotic prophylaxis guidelines.

Main Methods:

• Retrospective monocentric study.
• Evaluation of 366 patients who underwent surgery for peri-pelvic or pelvic STS.
• Analysis of recorded SSI and microbial spectrum.

Main Results:

• A significant SSI rate of 23.2% (85/366 patients) was observed, requiring an average of 2.21 revisions per case.
• Polymicrobial infections accounted for 36.5% of cases.
• The most frequent bacteria included coagulase-negative staphylococci (31.5%), Enterococcus species (13.3%), and Escherichia coli (7.7%). Gram-negative (30.8%) and anaerobic (25.9%) bacteria were also prevalent.

Conclusions:

• The bacterial spectrum of SSI following STS resection in the peri-pelvic region is distinct.
• Existing peri-operative antibiotic prophylaxis recommendations may not be optimal for this site.
• Tailoring antibiotic prophylaxis to the identified microbial spectrum is recommended.