Bacteriologic features of surgical site infections following breast surgery

• Published in: The American journal of surgery 2009-10, Vol.198 (4), p.529-531
• Main Authors: Mukhtar, Rita A., M.D, Throckmorton, Alyssa D., M.D, Alvarado, Michael D., M.D, Ewing, Cheryl A., M.D, Esserman, Laura J., M.D., M.B.A, Chiu, Charles, M.D., Ph.D, Hwang, E. Shelley, M.D., M.P.H
• Format: Article
• Language: English
• Subjects: Adult; Aged; Aged, 80 and over; Anti-Bacterial Agents - administration & dosage; Antibacterial agents; Antibiotic Prophylaxis; Antibiotics; Antibiotics. Antiinfectious agents. Antiparasitic agents; Bacteria; Biological and medical sciences; Breast; Breast cancer; Breast surgery; Cancer surgery; Cancer therapies; Cefazolin; Cefazolin - administration & dosage; Drug resistance; Drug Resistance, Bacterial; Female; General aspects; Gram-negative bacteria; Gram-Negative Bacteria - isolation & purification; Gram-Negative Bacteria - metabolism; Gram-Positive Bacteria - isolation & purification; Gram-Positive Bacteria - metabolism; Human infectious diseases. Experimental studies and models; Humans; Infectious diseases; Lumpectomy; Mastectomy; Mastectomy - adverse effects; Mastectomy - methods; Medical sciences; Methicillin; Microorganisms; Middle Aged; Patients; Pharmacology. Drug treatments; Plastic surgery; Prevention; Prophylaxis; Retrospective Studies; Staphylococcus infections; Surgery; Surgical site infections; Surgical Wound Infection - microbiology; Surgical Wound Infection - prevention & control
• ISSN: 0002-9610; 1879-1883
• DOI: 10.1016/j.amjsurg.2009.06.006

Abstract Background Perioperative antibiotic prophylaxis to prevent surgical site infections (SSIs) after breast surgery is common practice. Breast SSIs were investigated to determine bacterial isolates, resistance patterns, and the appropriateness of cefazolin, the authors' institution's current regimen for perioperative antibiotic prophylaxis. Methods A retrospective review of 53 patients with culture-positive breast SSIs between June 1997 and August 2008 identified patient characteristics, bacterial isolates, and microbial resistance patterns. Results Among the 53 patients with positive cultures, 42% (n = 22) had undergone mastectomy, and 34% (n = 18) had undergone lumpectomy. Sixty-three bacterial isolates were identified, with 15% of SSIs being polymicrobial. Of the isolates, 49% (n = 31) were gram-negative bacteria. There was only 1 case of methicillin-resistant Staphylococcus aureus . Eight of 63 (13%) gram-negative isolates were cefazolin resistant. Conclusions Gram-negative SSIs constituted half of the SSIs in this breast surgery cohort. Of all breast isolates, 17.5% were resistant to cefazolin. On the basis of these findings, antibiotic prophylaxis regimens alternative to cefazolin should be considered.