Severe rapidly progressing multi‑resistant polymicrobial surgical site infection after elective abdominoplasty: a case report

Adverse events following elective cosmetic surgery can raise concerns about patient safety, particularly in facilities with variable oversight of infection‑prevention practices. Severe early‑onset postoperative infections caused by multidrug‑resistant organisms may indicate system‑level failures in sterile processing or infection control protocols. We report a rapidly progressing polymicrobial multidrug‑resistant surgical site infection in a previously healthy woman seven days after elective abdominoplasty with liposuction and lipofilling. The patient experienced early clinical deterioration requiring multiple emergency debridements, intensive care admission, prolonged antimicrobial therapy, negative‑pressure wound management, and eventual skin grafting. Microbiology revealed evolving multidrug‑resistant Pseudomonas aeruginosa, ESBL‑producing Enterobacterales, Staphylococcus epidermidis, and Klebsiella species. The severity, early onset, and unusual microbiological profile raised concerns for a possible sterilization or infection‑control breach at the original surgical facility. Early severe postoperative infections following elective procedures may signal underlying system failures rather than isolated clinical complications. Strengthening sterile processing oversight, improving infection‑control auditing, and ensuring timely escalation of care are critical to preventing similar events and safeguarding patient safety.