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C. difficile infections correlated with surgical site infections
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PHILADELPHIA — Incident 90-day surgical site infections correlated strongly with Clostridium difficile infections among inpatient surgical procedures, according to research data presented at IDWeek 2014.
To examine the association between postoperative surgical site infection (SSI) and C. difficile infection (CDI), Mohammed Saeed, MBChB, MPH, Margaret A. Olsen, PhD, MPH, and Erik R. Dubberke, MD, all from the Washington University School of Medicine in St. Louis, conducted a retrospective cohort study of 1,429,451 hospitalizations (1,362,084 patients) identified in 2009 using the longitudinal State Inpatient Database from California, New York and Florida. Surgeries were categorized into three groups based on SSI percentage.
Mohammed Saeed
Margaret A. Olsen
“In this study, we compared the incidence of SSI after a variety of different surgical procedures with the incidence of CDI after those procedures,” Olsen told Healio.com/Gastroenterology. “The rationale for the study was the question, ‘What is posing the risk for CDI in these patients?’”
SSIs and CDIs occurred in 4.1% and 0.9% of all hospitalizations, respectively. Surgeries with less than 4% SSI percentage had a median CDI percentage of 0.7%; those with 4% to 10% SSI percentage had a median CDI percentage of 1.8%; and those procedures linked to more than 10% SSI percentage had a median CDI percentage of 3.1%. The correlation coefficient between SSI and CDI percentage was 0.57, and the five surgeries with the highest percentage of CDI were above-knee amputation (13.1% SSI; 7.7% CDI), heart transplant (6.1% SSI; 6.4% CDI), knee and leg amputation (15.6% SSI; 6.1% CDI), liver transplant (11.7% SSI; 5.8% CDI) and colon/other bowel (22.1% SSI; 4.8% CDI).
“What we found was a direct correlation between the incidence of SSI and the incidence of CDI,” Olsen said. “The higher the incidence of SSI, the higher the risk of CDI in these patients, suggesting that the majority of the CDI infections that result are due to preceding SSIs that are treated with antibiotics, putting the patients then at risk for their symptomatic CDI.”– by Adam Leitenberger
For more information:
Saeed M. Abstract 1028. Presented at: IDWeek; Oct. 8-12, 2014; Philadelphia.
Disclosure: Dubberke and Olsen report financial ties with Pfizer and Sanofi Pasteur. Dubberke reports additional ties to Merck, Optimer, Rebiotix and ViroPharma. Saeed reports no relevant financial disclosures.