362. Microbiology of Surgical Site Infections in Cancer Patients: A Seven Year Review
Session: Poster Abstract Session: HAI: Surgical Site Infections
Thursday, October 8, 2015
Room: Poster Hall
Posters
  • Microbiology of SSI in cancer.pdf (1.4 MB)
  • Background:

    Surgical site infections (SSI) are the most common health-care-associated infections in developing countries. Cancer patients are particularly at risk. However there are few reports that fully describe this entity. Our goal is to describe the microbiological spectrum and resistance patterns of the most common bacteria associated with of SSI in cancer patients at a tertiary care center.

    Methods:

    We conducted a retrospective review of microbiologic data from January 2008 to December 2014. Samples from patients that did not meet the criteria for SSI according to CDC guidelines were excluded. Bacteria were identified using an automated microbiology system (BD Phoenix 100) and resistant isolates were confirmed using a disc diffusion method.  

    Results:

    A total of 23,421 surgeries were performed at our Institution during the study period. We identified 1863 SSI, of which 60% were monomicrobial and 40% polymicrobial. Gram negative bacilli (GNB) were found in 56.5% of samples, with Escherichia coli as the most frequent microorganism (27.5%), followed by other GNB (17.7%) and Staphylococcus aureus (16.3%). Extended spectrum beta lactamase (ESBL) producing E. coli increased throughout the study period from 40% in 2008 to 77% in 2014.  Fluoroquinolone resistance also increased in all members of the Enterobacteriaceae family.Methilcillin resistant S. aureus (MRSA) remained stable at 32% throughout the study period. Vancomycin resistant Enterococcus faecium was infrequent and never surpassed 13% of Enterococci isolates.

    Conclusion:
    During the past 7 years, GNB have been responsible for the majority of SSI at our Institution, regardless of the type of surgery performed. E. coli was the most common bacteria involved, with 77% of strains producing ESBL. Fluoroquinolone resistance poses a significant problem when treating SSI empirically and should be taken into account. MRSA is now prevalent in our population but did not increase during the study period. This is one of the largest series of SSI reported in oncology patients.
    Maria Fernanda Golzarri, MD1, Juan Carlos Hernaiz-Leonardo, MD1, Mauricio Ostrosky, Medical Student2, Consuelo Velazquez-Acosta, BS3, Patricia Cornejo-Juarez, MD, MSc1 and Diana Vilar-Compte, MD, MSc1, (1)Infectious Diseases, Instituto Nacional de Cancerología, Mexico City, Mexico, (2)Pecem, Universidad Nacional Autonoma de Mexico, Mexico City, Mexico, (3)Microbiology, Instituto Nacional de Cancerología, Mexico City, Mexico

    Disclosures:

    M. F. Golzarri, None

    J. C. Hernaiz-Leonardo, None

    M. Ostrosky, None

    C. Velazquez-Acosta, None

    P. Cornejo-Juarez, None

    D. Vilar-Compte, None

    Findings in the abstracts are embargoed until 12:01 a.m. PDT, Wednesday Oct. 7th with the exception of research findings presented at the IDWeek press conferences.