INFECȚIILE DE SITUS CHIRURGICAL CAUZATE DE MICROORGANISME REZISTENTE

Summary. Multi-drug resistant organisms (MDR) are emerging and significant cause of surgical site infections (SSI), but clinical outcomes and risk factors associated to MDR organisms SSI (MDR-Os-SSI) have been poorly investigated in general surgery. Aims were to investigate risk factors, clinical outcomes and costs of care of MDR-Os-SSI in general surgery. From January 2018 to December 2019, all the consecutive, unselected patients affected by MDR-Os-SSI were prospectively evaluated. Among 3494 patients operated, 47 presented an MDR-Os-SSI . Two control groups of 47 patients with non-MDR-Os-SSI and without SSI were identified. MDR-Os-SSI were caused in most cases by Gram negative bacilli. MDR-Os-SSI were related to major postoperative complications. Iterative surgery, open abdomen, intensive care, hospital stay, and use of aggressive and expensive therapies were associated to MDR-Os-SSI. At multivariate analysis, only iterative surgery and the need of total parenteral and immune-nutrition were significantly associated to MDR-Os-SSI. The extra-cost of MDR-Os-SSI treatment was 150% in comparison to uncomplicated patients. MDR-OsSSI seems to be associated with major postoperative complications and reoperative surgery, they are demanding in terms of clinical workload and costs of care, they are rare but increasing, and difficult to prevent with current strategies. Key words:Surgery, Complications, Surgical site infections, Multi-drug resistance, Risk factors, Cost of care