369. Diabetes Mellitus is Associated with Intraoperative Bactibilia and Postoperative Surgical Site Infections in Elective Cholecystectomy: A Case-Control Study
Session: Poster Session: Bacterial Diseases
Friday, October 7, 2005: 12:00 AM
Room: Exhibit Hall A
Background: Surgical site infections (SSI) are a common complication that follows elective cholecystectomy. We evaluated the role of diabetes in the development of SSI after elective cholecystectomy adjusting for potential confounders.
Methods: A prospective study was conducted from July 2002 to August 2004 and evaluated 48 diabetic patients and 48 age and gender matched controls who underwent elective open or laparoscopic cholecystectomy (n = 33 and n = 15 for both groups respectively). All diabetic patients underwent cholecystectomy under a normoglycemic state. Gallbladder wall and mucosal culture were intraoperatively collected for all subjects and bactibilia was determined. All patients received a single intravenous dose of cefuroxime 1.5 gr during induction of anesthesia. Patients were prospectively assessed for development of SSI for 1 month postoperatively.
Results: 14/48 (29.2 %) diabetic subjects developed a postoperative SSI in contrast to only 1/48 (2.1 %) controls (OR: 19.3, 95% CI : 2.4-151.3). E coli, Klebsiella spp. and Enterococcus spp. were most frequently isolated from the SSI sites. 11/14 (78.6 %) SSI occurring in diabetic subjects were due to Enterococcus spp. and the presence of diabetes was significantly associated with the development of an enterococcal SSI (p= 0.004). Intraoperative bactibilia was noted in 26/48 (54.2 %) diabetic subjects and 13/48 (27.1 %) controls (p= 0.01). The presence of intraoperative bactibilia was associated with SSI (p < 0.001).
Conclusion: The presence of diabetes mellitus is significantly associated with intraoperative bactibilia and the development of postoperative SSI (especially those due to Enterococcus spp.) in patients who undergo elective cholecystectomy. Antimicrobial prophylaxis against enterococci may be appropriate in such patients.
Athanasios Dervisoglou, MD1, Helen Giamarellou, MD, PhD, Prof2, Kyriaki Kanellakopoulou, MD3, Sotirios Tsiodras, MD, MSc, DSci4, Stamatios Pinis, MD1, Stavroula Liveranou, MD1 and  A. Dervisoglou, None; S. Tsiodras, None; K. Kanellakopoulou, None; S. Pinis, None; S. Liveranou, None; H. Giamarellou, None., (1)“Agios Panteleimon” State General Hospital, Xaidari, Greece, (2)4th Dept of Internal Medicine, Athens Medical School, Athens, Greece, (3)4th Department of Internal Medicine, University of Athens Medical School, Athens, Greece., Chaidari,Attica, Greece, (4)4th Dept of Internal Medicine, University of Athens Med. Sch., Metamorfosis, Greece

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