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Gram-negative organisms after spine surgery were not reduced with vancomycin powder
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Although vancomycin powder was associated with a reduction in gram-positive organisms in spine deformity reconstruction surgeries, researchers also found a number of gram-negative or polymicrobial organisms postoperatively, according to results.
Owoicho Adogwa, MD, MPH , and colleagues gathered baseline characteristics, operative details, rates of wound infection and microbiological data for 1,200 spine deformity reconstruction surgeries in which crystalline vancomycin powder was used for infection prophylaxis between 2011 and 2013.
Results showed a surgical site infection (SSI) rate of 2.83%. Researchers found 29.41% of patients with a SSI had diabetes. According to results, patients with a SSI had a mean age of 62.08 years and a mean BMI of 30.86 kg/m2.
On average, results showed patients with a SSI received 1.41 g of vancomycin powder and 88% of patients received subfascial drains. Researchers found deep wound infections occurred within 30 days of surgery and accounted for 50% of all SSIs. Cultures were positive for 75% of the SSIs and about half of the identified organisms were gram-negative.
“Vancomycin powder covers gram-positive microbes well,” Adogwa told Healio.com/Orthopedics. “It potentially could self-select for gram-negatives or other polymicrobial agents and perhaps, thinking about strategies to cover the gram-negative microbes in addition to the vancomycin powder, might further decrease infection rates down from 4% to something even lower.” – by Casey Tingle
Disclosures: Adogwa reports no relevant financial disclosures. Please see the full study for a list of all other authors’ relevant financial disclosures.
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