Microbiological Particularities of Surgical Site Infections in Oncologic Orthopedic Surgery Compared to Non- Oncologic Surgery-Single Center Experience and Literature Review

Thierry Rod-Fleury and Ilker Uçkay

Department of Orthopedic Surgery, Geneva University Hospitals, Switzerland
Department of Infectiology and Infection Control, Balgrist University Hospital, Switzerland

^*Correspondance to: Ilker Uckay 

 PDF  Full Text DOI: 10.25107/2474-1647.2443

Abstract

Purpose: Tumor orthopedic surgery has higher incidences of Surgical Site Infections (SSI) than non-oncologic surgery. However, their epidemiologic microbiology is rarely published.
Methods: In our large tertiary composite database of orthopedic infections, we compare SSIs in adult oncologic patients to adult non-oncologic patients.
Results: Among 2752 different first episodes of orthopedic infections in adults, only 14 (0.5%) concerned SSI at the site of prior oncologic surgery. Oncologic patients had no more prior antibiotic therapy (before intraoperative samplings) than non-oncologic patients, but they witnessed significantly more SSIs due to enterococci, Gram-negative pathogens, or infections due to multiresistant skin commensals. In contrast, the proportion of classic orthopedic pathogens such as Staphylococcus aureus or streptococci was not different from the control group. We couldn’t link the germs to prior oncologic treatment, nor to the length of perioperative surgical antibiotic prophylaxis.
Conclusion: The microbiology of orthopedic SSI in adult oncologic patients is significantly different than in non-oncologic patients. Retrospectively, the standard antibiotic prophylaxis is inadequate for the involved pathogens. More studies are needed to tailor a specific perioperative prophylaxis in terms of choice of the agents, rather than of duration of the standard prophylaxis. Type of study/Level of evidence: III, Retrospective study.

Keywords

Microbiology; Orthopedic surgery; Oncology; Comparative epidemiology

Cite the article

Rod-Fleury T, U�kay I. Microbiological Particularities of Surgical Site Infections in Oncologic Orthopedic Surgery Compared to Non-Oncologic Surgery-Single Center Experience and Literature Review. Clin Surg. 2019; 4: 2443.