Surgical Site Infection After Laparoscopic Hysterectomy for Benign Gynecological Disease in Ukraine

Abstract

The aim: To obtain the first estimates of the current incidence, and risk factors for Surgical Site Infection (SSI) after laparoscopic hysterectomy, and antimicrobial resistance of responsible pathogens in Ukraine. Materials and methods: We performed a multicenter prospective cohort study was patient-based on surveillance data for SSIs were according to CDC/NHSN methodology. This study included women’s undergoing a laparoscopic hysterectomy in 8 hospitals from different regions of Ukraine from January 2018 to December 2020. Results: A total of 1184 women underwent a laparoscopic hysterectomy and 14.9% SSI were identified within 30 days of the operation. Majority of SSI were deep/organ-space. The deep/organ-space SSI incidence rate was 9.2% in total laparoscopic hysterectomy, 15.2% in laparoscopic-assisted vaginal hysterectomy, and 17% in laparoscopic supracervical hysterectomy. The predominant SSI types were Pelvic abscess or cellulitis (19.1%), Salpingitis (16%), Oophoritis (15.3%), Adnexa utery (14.5%), Vaginal cuff infections (13.7%), Endometritis (11.1%), and Chorioamnionitis (9.9%). 93.8% of SSIs were detected post discharge. The most commonly identified pathogen were Escherichia coli (21.6%), Enterobacter spp. (13.1%), followed by Klebsiella spp. (8,1%), Streptococcus spp. (7%), and Pseudomonas aeruginosa (7%). The overall proportion of extended spectrum beta-lactamase production (ESBL) among Enterobacteriaceae was 17.1% and of methicillin-resistance in S. aureus (MRSA)15.8%. Resistance to third-generation cephalosporins was observed in 13.7% E.coli and 8.5% Klebsiella spp. isolates. Carbapenem resistance was in 9.7% of P.aeruginosa strains. Conclusions: Our study identified high incidence rates of SSI within 30 days surveillance of the laparoscopic hysterectomy in Ukraine, and many cases were caused by pathogens that are resistant to antibiotics.

Оцінка Ризику Хірургічної Інфекції При Оперативних Втручаннях У Гінекологічних Хворих

“…В економічно розвинутих країнах в останні роки післяопераційна хірургічна інфекція (ПХІ) у гінекологічних стаціонарах виникає рідко [1,6,7]. Значно зменшилася кількість ПХІ після широкого впровадження у практику лапароскопічних хірургічних втручань [8]. За даними Hopkins Hospital, частота SSI (surgical site infection, інфекція місця втручання) складає 2,76 випадку на 100 операцій [6].…”