Risk Factors for Treatment-Resistant Postoperative Surgical Site Infections

Objective:Surgical site infection(SSI) is the most common complication seen after surgery. The aim of this study was to determine the risk factors that cause resistance to antibiotic treatment for SSI. Methods:All patients’ records who underwent elective gynecologic surgery between 2021-2023 at the Department of Obstetrics and Gynecology, Kocaeli University were scanned. Patients who had positive surgical site culture were enrolled in the study. After antibiotic treatment, cultures were taken from all patients. The demographic, obstetric and perioperative characteristics were compared between culture negative(control group) and culture positive(study group) patients. Results:Patients with positive cultures were included in the study. There was a significant difference in terms of chronic medication between the two groups(p=0.002). The duration of hospitalization before SSI development was also significantly higher in the study group(p=0.017). A significant difference was found between the 2 groups in terms of the number of antibiotics used for the treatment of SSI(p=0.027). The use of multi-antibiotic regimens was more common in the study group. Conclusion:The use of oral antidiabetic drugs and prednisolone was higher and the duration of hospital stay was longer in patients that developed treatment-resistant SSI. The need for multi-antibiotic regimens based on initial culture results was more common in the study group. In order to reduce the incidence of treatment-resistant SSI in patients undergoing planned surgery, a throughout evaluation of the patient is essential. Clinicans should take into consideration the risk of treatment-resistant infection in SSI patients with chronic medication use, long hospital stay, and infections requiring multi-drug regimens.