Perioperative antimicrobical therapy in gastrointestinal surgery: a study

Background:The aim of this study is to determine surgical wound infection(SWI)rates in surgical patients using the National Nosocomial Infections Surveillance system(NNIS),to monitor current surgical antimicrobial prophylaxis,and to identify possible modifiable risk factors for SWI. Materials and Methods:Main criteria for hospital wards inclusion were more than 20 surgical procedures per week, and use of amoxycillin/clavulanate(Augmentin)among prophylactic options.Each patient operated from December 1st 2005 to July 31th 2006 was sur. veyed for 30 days after surgery.SWI cumulative incidence rates and 95%confidence intervals(95%Cl)were calculated. Results:During the study period,2068 surgical procedures were per- formed in 2050 patients.A total of 147 SWI were diagnosed in 142 patients:82(57.7%)were at superficial incision,31(21.8%)were at deep incision and 42(29.6%)were at organ-space site.Incidence of SWI every 100 operations was 6.4%.About 86.5%of the operated patients received antimicrobial prophylaxis,mainly with amoxicillin/ clavulanate(Augmentin)(28.3%)or with imipenem/cilastatin(Tienam) （11.4%).Pre-operative hospital stay>or=48 h,diabetes,obesity,and HIV/AIDS infection were statistically significantly associated with increased risk of SWI. Conclusions:The SWI rates found are comparable with European studies and can be a benchmark for national incidence data and for inter-and intra-hospital SWI rate comparisons.