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Microbiology of Surgical Site Infections and Associated Antimicrobial Use Among Vietnamese Orthopedic and Neurosurgical Patients

Published online by Cambridge University Press:  21 June 2016

Le Thi Anh Thu ,
Annette H. Sohn ,
Nguyen Phuc Tien ,
Vo Thi Chi Mai ,
Vo Van Nho ,
Tran Nguyen Trinh Hanh ,
Ben Ewald  and
Michael Dibley
Le Thi Anh Thu*
Affiliation:
Infection Control Department, Cho Ray Hospital, Ho Chi Minh City, Vietnam
Annette H. Sohn
Affiliation:
Division of Pediatric Infectious Diseases, University of California, San Francisco
Nguyen Phuc Tien
Affiliation:
Infection Control Department, Cho Ray Hospital, Ho Chi Minh City, Vietnam
Vo Thi Chi Mai
Affiliation:
Infection Control Department, Cho Ray Hospital, Ho Chi Minh City, Vietnam
Vo Van Nho
Affiliation:
Infection Control Department, Cho Ray Hospital, Ho Chi Minh City, Vietnam
Tran Nguyen Trinh Hanh
Affiliation:
Infection Control Department, Cho Ray Hospital, Ho Chi Minh City, Vietnam
Ben Ewald
Affiliation:
Centre for Clinical Epidemiology and Biostatistics, University of Newcastle, New South Wales, Australia
Michael Dibley
Affiliation:
Centre for Clinical Epidemiology and Biostatistics, University of Newcastle, New South Wales, Australia
*
Infection Control Department, Cho Ray Hospital, 201B Nguyen Chi Thanh Street, District 5, Ho Chi Minh City, Vietnam, ([email protected])
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Abstract

Objectives.

To determine the pathogens associated with surgical site infections (SSIs) and describe patterns of antimicrobial use and resistance in orthopedic and neurosurgical patients in a large university hospital in Vietnam.

Design.

Prospective cohort study.

Setting.

Cho Ray Hospital, Ho Chi Minh City, Vietnam.

Patients.

All patients who had operations during a 5-week study period.

Results.

Of 702 surgical patients, 80 (11.4%) developed an SSI. The incidence of SSI among orthopedic patients was 15.2% (48 of 315), and among neurosurgical patients it was 8.3% (32 of 387). Postoperative bacterial cultures of samples from the surgical sites were performed for 55 (68.8%) of the 80 patients with SSI; 68 wound swab specimens and 10 cerebrospinal fluid samples were cultured. Of these 78 cultures, 60 (76.9%) were positive for a pathogen, and 15 (25%) of those 60 cultures yielded multiple pathogens. The 3 most frequently isolated pathogens were Pseudomonas aeruginosa (29.5% of isolates), Staphylococcus aureus (11.5% of isolates), and Escherichia coli (10.3% of isolates). Ninety percent of S. aureus isolates were methicillin resistant, 91% of P. aeruginosa isolates were ceftazidime resistant, and 38% of E. coli isolates were cefotaxime resistant. All but 1 of the 702 patients received antimicrobial therapy after surgery, and the median duration of antimicrobial therapy was 11 days. Commonly used antimicrobials included aminopenicillins and second- and third-generation cephalosporins. Two or, more agents were given to 634 (90%) of the patients, and most combination drug regimens (86%) included an aminoglycoside.

Conclusions.

Our data indicate that the incidence of SSI is high in our study population, that the main pathogens causing SSI are gram-negative bacteria and are often resistant to commonly used antimicrobials, that the use of broad-spectrum antimicrobials after surgery is widespread, and that implementation of interventions aimed at promoting appropriate and evidence-based use of antimicrobials are needed in Vietnam.

Type
Original Articles
Information
Infection Control & Hospital Epidemiology , Volume 27 , Issue 8 , August 2006 , pp. 855 - 862
Copyright
Copyright © The Society for Healthcare Epidemiology of America 2006

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