Aim To survey postoperative infections (PI) after digestive surgery. Methods This survey, conducted by the Japan Society of Surgical Infection, included patients undergoing digestive surgery at 28 centers between September 2015 and March 2016. Data collected included patient background characteristics, type of surgery, contamination status, and type of PI, including surgical site infection (SSI), remote infection (RI), and antimicrobial‐resistant (AMR) bacterial infections and colonization. Results Postoperative infections occurred in 10.7% of 6582 patients who underwent digestive surgery (6.8% for endoscopic surgery and 18.7% for open surgery). SSI and RI, including respiratory tract infection, urinary tract infection, antibiotic‐associated diarrhea, drain infection, and catheter‐related bloodstream infection, occurred in 8.9% and 3.7% of patients, respectively. Among all PI, 13.2% were overlapping infections. The most common overlapping infections were incisional and organ/space SSI, which occurred in 4.2% of patients. AMR bacterial infections occurred in 1.2% of patients after digestive surgery and comprised 11.5% of all PI. Rate of AMR bacterial colonization after digestive surgery was only 0.3%. Conclusion Periodic surveillance of PI, including AMR bacteria, is necessary for a detailed evaluation of nosocomial infections.

Background Postoperative infections may be classified as surgical site infections developing within surgical sites or remote infections developing in areas outside the surgical site. Postoperative respiratory tract infections (PRTI) are a type of remote infection, and may be associated with a prolonged hospitalization period and increased medical expenses. The aim of this study is to compare postoperative hospitalization and medical expenses between patients with PRTI and non PRTI after gastrointestinal surgery. Methods We retrospectively analyzed data from a multicenter joint study involving multiple centers affiliated to the Japan Society for Surgical Infection. We used a one-to-one matching analysis to evaluate 86 patients who underwent gastrointestinal surgery between March 1, 2014 and February 29, 2016. Results There was a significant increase in the postoperative hospitalization period among patients with PRTI (38.6 days) compared with patients without PRTI (16.1 days). Furthermore, postoperative medical expenses were significantly higher in patients with PRTI (1388.2 USD) than in those without PRTI (629.4 USD). Conclusions The hospitalization period and medical expenses are known to increase in patients that develop surgical site infections. Our findings show that these parameters also increase in patients with PRTI following gastrointestinal surgery. However, further studies are needed to confirm these results.

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Background: Most surveillance programs for postoperative infection focus on surgical site infections (SSI). However, remote infections, as postoperative infections, are of emerging clinical importance. We investigated the incidence of both SSI and remote infection following colorectal surgery by performing a subanalysis of a multicenter survey after gastrointestinal surgery. Methods: From September 2015 to March 2016, 1724 patients underwent colorectal surgery in 28 affiliated institutions in Japan. We retrospectively recorded patients' age, sex, surgical site, surgical approach, wound classification, performance status at discharge, and postoperative infection status. Results: Postoperative infections occurred in 236 (13.7%) patients; 150 and 86 patients underwent colon and rectal surgeries (postoperative infection incidence: 13.7% and 14.8%), respectively. Laparoscopic surgery was associated with a significantly lower incidence of postoperative infection compared with open surgery for both colon and rectal surgery (p < 0.001). Among all patients with postoperative infections, 211 (89.4%) had single infections, and 25 (10.6%) had multiple infections. SSI and remote infection in patients with single postoperative infections occurred in 143 (60.6%) and 68 (28.8%) patients, respectively. The most common multiple postoperative infections 3 were "incisional and organ/space SSIs", and "organ/space SSI and bacteremia of unknown origin", with three cases each. Conclusions: This study revealed the distribution of the overall prevalence of postoperative infections, including both SSI and remote infections. Considering the substantial influence of remote infections on patients' quality of life and the social burden, prospective periodic surveillance for both SSI and remote infection is necessary for detailed evaluation and prevention.