1252. Development of a Surgical Site Infection at a Tertiary Hospital in Colombia: A Clinical and Microbiological Profile

Abstract

BackgroundSurgical site infections (SSIs) are the most common healthcare-associated infections in developing countries, it represents a problem of patient safety and as well as evidence of quality of care. The objective of the study was to estimate the incidence of SSIs in surgical procedures of the surgical service, the microbiological profile and clinical evolution of patients.MethodsDesign: A retrospective, longitudinal cohort study using electronic health record data. Settings: Conducted between January and December of 2017 at tertiary hospital in Medellín, Colombia. Participants: Patients whose primary surgical procedures of gastrointestinal surgeries and abdominal wall hernias were included and followed up for 30 days after discharge. Main outcome measures: demographics, surgical risk scale, surgical procedures data, SSI according to NHSN-CDC criteria, microbiological isolates and clinical outcomes were registered and descriptive measures were obtained.ResultsThere were 546 clinical charts analyzed, 55% were women, the mean age was 47 years (SD: 21), 74% at intermediate or high surgical risk. Antibiotic prophylaxis was administered at least 120 minutes before the incision and the cefazolin + metronidazole scheme was the most frequent to 70% of the patients. The incidence of SSIs was 12% (64/546), 1% superficial incisional SSIs, 3% deep incisional SSIs and 8% organ / space. Among them, 52% were NHSN-2, 55% had dirty wounds and 43% contaminated. E. coli were isolated in 16% (7/10 were BLEE+), S. aureus in 10% (all MRSA−). SSI was more frequent in laparotomy due to intra-abdominal infection in 36%, 20% colectomy, and 19% appendicectomy. The SSIs were treated in 27% with imipenem and 19% imipenem + vancomycin, for a median of 7 days (p25-p75: 7–10); 36% of the patients with SSIs underwent percutaneous drainage, 30% have been reoperated, 34% were unplanned readmission and 9% died, only two death were attributable to SSIs; the median of length of post-procedure stay days was 12 (p25-p75: 7–23) and overall 14 (p25-p75: 8–32).ConclusionThe incidence of SSIs was higher than reported in the literature, perhaps due to the greater complexity and risk of the patients. It is necessary to implement preventive strategies in health personnel in order to reduce their incidence and complications.Disclosures All authors: No reported disclosures.