The Role of Bacterial Colonization of the Suture Thread in Early Identification and Targeted Antibiotic Treatment of Surgical Site Infections: A Prospective Cohort Study

Francesco Iovino, Federica Calò, Consiglia Orabona, Alessandra Pizza, Francesca Fisone, Pina Caputo, Alessandra Fusco, Margherita Macera and Nicola Coppola
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Francesco Iovino: Department of Translational Medical Sciences-Division of General Surgery, University of Campania Luigi Vanvitelli, 80131 Naples, Italy
Federica Calò: Department of Mental Health and Public Medicine—Infectious Diseases Unit, University of Campania Luigi Vanvitelli, 80131 Naples, Italy
Consiglia Orabona: Department of Translational Medical Sciences-Division of General Surgery, University of Campania Luigi Vanvitelli, 80131 Naples, Italy
Alessandra Pizza: Department of Translational Medical Sciences-Division of General Surgery, University of Campania Luigi Vanvitelli, 80131 Naples, Italy
Francesca Fisone: Department of Translational Medical Sciences-Division of General Surgery, University of Campania Luigi Vanvitelli, 80131 Naples, Italy
Pina Caputo: Department of Experimental Medicine, Section of Microbiology and Clinical Microbiology, University of Campania “Luigi Vanvitelli”, 80131 Naples, Italy
Alessandra Fusco: Department of Experimental Medicine, Section of Microbiology and Clinical Microbiology, University of Campania “Luigi Vanvitelli”, 80131 Naples, Italy
Margherita Macera: Department of Mental Health and Public Medicine—Infectious Diseases Unit, University of Campania Luigi Vanvitelli, 80131 Naples, Italy
Nicola Coppola: Department of Mental Health and Public Medicine—Infectious Diseases Unit, University of Campania Luigi Vanvitelli, 80131 Naples, Italy

IJERPH, 2020, vol. 17, issue 12, 1-9

Abstract: Background: The aim of the present study is to investigate the role of the colonization of suture thread to identify patients at risk of developing a surgical site infection (SSI) after clean surgical procedures. Methods: Patients who underwent elective clean surgery procedures at the Surgery Unit of the AOU-University of Campania Luigi Vanvitelli in a 21-month period were prospectively enrolled. For each patient, a synthetic absorbable thread in Lactomer 9-1 was inserted into the surgical site at the end of surgery and microbiologically evaluated after 48 h. Antibiotic prophylaxis was chosen according to international guidelines. Results: A total of 238 patients were enrolled; 208 (87.4%) of them were subjected to clean procedures without the placement of prosthesis, and 30 (12.6%) with prosthesis. Of the 238 patients, 117 (49.2%) underwent an antimicrobial prophylaxis. Overall, 79 (33.2%) patients showed a bacterial colonization of the thread: among the 208 without the implantation of prosthesis, 19 (21.8%) of the 87 with antibiotic prophylaxis and in 58 (47.9%) of the 121 without it; among the 30 patients with the implantation of prosthesis, only two patients showed a colonized thread. The patients with antibiotic prophylaxis developed a colonization of the thread less frequently than those without it (17.9% vs. 47.9%, p < 0.001). SSI was observed in six (2.5%) patients, all of them showing a colonized thread (7.6% vs. 0%, p < 0.001). The bacteria identified in colonized threads were the same as those found in SSIs. Conclusions: Our study presents a new method that is able to precociously assess patients who have undergone clean procedures who may develop SSI, and identify the microorganism involved.

Keywords: surgical site infection; antibiotic prophylaxis; bacterial colonization (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2020
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