Surgical site infections in thyroid and parathyroid surgery in Japan: An analysis of the Japan Nosocomial Infections Surveillance database from 2013 to 2020

Abstract

Surgical site infections (SSIs) after thyroid surgery are rare complications, with incidence rates of 0.3%-1.6%. Using a Japanese database, we conducted exploratory analyses on the incidence of SSIs, investigated the incidence of SSIs by the National Nosocomial Infections Surveillance risk index, and identified the causative bacteria of SSIs. SSIs occurred in 50 (0.7%) of 7388 thyroid surgery cases. Risk index-0 patients had the lowest incidence rate of SSIs (0.41%). The incidence of SSIs in risk index-1 patients was 3.05 times the incidence of SSIs in risk index-0 patients. The rate of SSI occurrence for risk index-2 patients was 4.22 times the rate of SSI occurrence for risk index-0 patients. Thirty-one bacterial species were identified as the cause of SSIs in thyroid surgery cases, of which 12 (38.7%) SSIs were caused by Staphylococcus aureus and Staphylococcus epidermidis. Of the nine SSIs caused by Staphylococcus aureus, 55.6% (five cases) were attributed to methicillin-resistant Staphylococcus aureus.Therefore, routine prophylactic antibiotic administration should be avoided, while the target for administration should be narrowed, according to the SSI risk. Administration of prophylactic antibiotics, such as 2 g piperacillin or 1 g cefazolin, is considered appropriate.

Histopathological Patterns and Early Postoperative Complications among Patients with Surgically Treated Thyroid Diseases at Bugando Medical Centre, Mwanza, Tanzania

“…In this study as well as other studies [42] [45], thyroid surgery performed for malignant neoplastic lesion was found to be is associated with increased risk of postoperative complications. Malignant pathology is associated with increased vascularity, immunosuppression, and poor wound healing predisposing this to increased risk of postoperative complications [45].…”

“…Thyroid surgery is considered a clean procedure with a very low incidence of SSIs. The presence of SSIs due to thyroid surgery is a rare complication; however, it is associated with increased morbidity and mortality, increased length of hospital stay, higher readmission rates and increased hospital costs [42]. In this Int.…”

“…Females outnumbered males by a female to male ratio of 11:1. The median age of patients was 44 [IQR,[35][36][37][38][39][40][41][42][43][44][45][46][47][48][49][50][51][52][53][54] years old, the youngest was 14 years old and the oldest was 76 years old. Colloid goiter was the most common non-neoplastic lesion accounting for 34 (44.7%) patients.…”

Appropriateness of perioperative antibiotics in thyroid surgery

“…19 An analysis of the Japan Nosocomial Infections Surveillance database from 2013 to 2020 for SSI in thyroid and parathyroid surgery recommend antibiotics for patients with poor general condition and prolonged operative time. 20 In contrary to the recommendations, many centers in Nepal and India, antibiotics are being prescribed for various duration following thyroidectomy. [4][5][6] In an international survey among endocrine surgeons, the patterns of antibiotic use varied widely among European, American and Asian surgeons.…”