Risk Factors for Sepsis in Abdominal Surgery: A Clinical Experience

Introduction: Postoperative sepsis is a severe complication with increasing incidence in recent decades. However, data on its prevalence and risk factors in abdominal surgery remain limited. Aims: This study aimed to investigate the clinical and microbiological characteristics of sepsis in patients undergoing abdominal surgery, focusing on risk factor identification to enhance prevention strategies and optimize empirical treatment. Objective: The objective of this study was to identify the associated factors and microbiology of sepsis in patients who underwent abdominal surgery between 2019 and 2021 at a hospital in Loja, Ecuador. Materials and Methods: A retrospective case series analysis was conducted on 1, 502 adult patients. Chi-square/Fisher’s exact test and odds ratios were applied for inferential analysis. Results and Discussion: Sepsis occurred in 5.8% of patients and was significantly associated with age ≥65 years, comorbidities, emergency procedures, contaminated/dirty surgeries, laparoscopic approach, ICU admission, and mortality. Lower sepsis rates were observed in patients with gallbladder/biliary tract pathology and appendicitis/peritonitis. Escherichia coli and Klebsiella pneumoniae were the predominant isolates in clinical samples and rectal swabs, frequently exhibiting multidrug resistance and beta-lactamase production. Conclusion: Sepsis in abdominal surgery is linked to multiple clinical and surgical factors, particularly multidrug-resistant bacteria. These findings emphasize the need for early risk stratification, perioperative infection control, and antimicrobial stewardship programs to tailor empirical treatment. The high prevalence of resistant bacteria highlights the urgency of reinforcing microbiological surveillance and optimizing antibiotic prophylaxis. Implementing these strategies in clinical practice could improve patient outcomes and reduce the economic burden of sepsis management.