Skip to main content
Top
Published in: BMC Infectious Diseases 1/2012

Open Access 01-12-2012 | Research article

Prevention and treatment of surgical site infection in HIV-infected patients

Authors: Lei Zhang, Bao-Chi Liu, Xiao-Yan Zhang, Lei Li, Xian-Jun Xia, Rui-Zhang Guo

Published in: BMC Infectious Diseases | Issue 1/2012

Login to get access

Abstract

Background

Surgical site infection (SSI) are the third most frequently reported nosocomial infection, and the most common on surgical wards. HIV-infected patients may increase the possibility of developing SSI after surgery. There are few reported date on incidence and the preventive measures of SSI in HIV-infected patients. This study was to determine the incidence and the associated risk factors for SSI in HIV-infected patients. And we also explored the preventive measures.

Methods

A retrospective study of SSI was conducted in 242 HIV-infected patients including 17 patients who combined with hemophilia from October 2008 to September 2011 in Shanghai Public Health Clinical Center. SSI were classified according to Centers for Disease Control and Prevention (CDC) criteria and identified by bedside surveillance and post-discharge follow-up. Data were analyzed using SPSS 16.0 statistical software (SPSS Inc., Chicago, IL).

Results

The SSI incidence rate was 47.5% (115 of 242); 38.4% incisional SSIs, 5.4% deep incisional SSIs and 3.7% organ/space SSIs. The SSI incidence rate was 37.9% in HIV-infected patients undergoing abdominal operation. Patients undergoing abdominal surgery with lower preoperative CD4 counts were more likely to develop SSIs. The incidence increased from 2.6% in clean wounds to 100% in dirty wounds. In the HIV-infected patients combined with hemophilia, the mean preoperative albumin and postoperative hemoglobin were found significantly lower than those in no-SSIs group (P<0.05).

Conclusions

SSI is frequent in HIV-infected patients. And suitable perioperative management may decrease the SSIs incidence rate of HIV-infected patients.
Literature
1.
go back to reference Mangram AT, Horan M: Pearson:Guideline for prevention of surgical site infection,1999. Infect Control Hosp Epidemio. 1999, 20: 247-278.CrossRef Mangram AT, Horan M: Pearson:Guideline for prevention of surgical site infection,1999. Infect Control Hosp Epidemio. 1999, 20: 247-278.CrossRef
2.
go back to reference Evans R, The American Academy of Orthopaedic Surgeons Patient Safety Committee: Surgical site infection prevention and control: an emerging paradigm. J Bone Joint Surg Am. 2009, 91: 2-9.CrossRefPubMed Evans R, The American Academy of Orthopaedic Surgeons Patient Safety Committee: Surgical site infection prevention and control: an emerging paradigm. J Bone Joint Surg Am. 2009, 91: 2-9.CrossRefPubMed
3.
go back to reference Kirkland K, Briggs J, Trivette S, Wilkinson W, Sexton D: The impact of surgical site infections in the 1990s: attributable mortality, excess length of hospitalization, and extra costs. Infect Control Hosp Epidemiol. 1999, 20: 725-730. 10.1086/501572.CrossRefPubMed Kirkland K, Briggs J, Trivette S, Wilkinson W, Sexton D: The impact of surgical site infections in the 1990s: attributable mortality, excess length of hospitalization, and extra costs. Infect Control Hosp Epidemiol. 1999, 20: 725-730. 10.1086/501572.CrossRefPubMed
4.
go back to reference McGarry S, Engemann J, Schmader K, Sexton D, Kaye K: Surgical site infection due to Staphylococcus aureus among elderly patients: mortality, duration of hospitalization, and cost. Infect Control Hosp Epidemiol. 2004, 25: 461-467. 10.1086/502422.CrossRefPubMed McGarry S, Engemann J, Schmader K, Sexton D, Kaye K: Surgical site infection due to Staphylococcus aureus among elderly patients: mortality, duration of hospitalization, and cost. Infect Control Hosp Epidemiol. 2004, 25: 461-467. 10.1086/502422.CrossRefPubMed
5.
go back to reference Palmer S, Parker M, Hollingworth W: The cost and implications of reoperation after surgery for fracture of the hip. J Bone Joint Surg Br. 2000, 82: 864-866. 10.1302/0301-620X.82B6.9974.CrossRefPubMed Palmer S, Parker M, Hollingworth W: The cost and implications of reoperation after surgery for fracture of the hip. J Bone Joint Surg Br. 2000, 82: 864-866. 10.1302/0301-620X.82B6.9974.CrossRefPubMed
6.
go back to reference Pollard T, Newman J, Barlow N, Price J, Willett K: Deep wound infection after proximal femoral fracture: consequences and costs. J Hosp Infect. 2006, 63: 133-139. 10.1016/j.jhin.2006.01.015.CrossRefPubMed Pollard T, Newman J, Barlow N, Price J, Willett K: Deep wound infection after proximal femoral fracture: consequences and costs. J Hosp Infect. 2006, 63: 133-139. 10.1016/j.jhin.2006.01.015.CrossRefPubMed
7.
go back to reference Edwards P, Lipp A, Holmes A: Preoperative skin antisepsis for preventing surgical wound infections after clean surgery (review). Cochrane Database Syst Rev. 2004, 3: CD003949-PubMed Edwards P, Lipp A, Holmes A: Preoperative skin antisepsis for preventing surgical wound infections after clean surgery (review). Cochrane Database Syst Rev. 2004, 3: CD003949-PubMed
8.
go back to reference Humphreys H: Preventing surgical site infection. Where now?. J Hosp Infect. 2009, 73: 316-322. 10.1016/j.jhin.2009.03.028.CrossRefPubMed Humphreys H: Preventing surgical site infection. Where now?. J Hosp Infect. 2009, 73: 316-322. 10.1016/j.jhin.2009.03.028.CrossRefPubMed
10.
go back to reference Ruiz-Perez I, Olry de Labry-Lima A, López-Ruz MA: Clinical status, adherence to HAART and quality of life in HIV-infected patients receiving antiretroviral treatment. Enferm Infecc Microbiol Clin. 2005, 23: 581-585. 10.1157/13081565.CrossRefPubMed Ruiz-Perez I, Olry de Labry-Lima A, López-Ruz MA: Clinical status, adherence to HAART and quality of life in HIV-infected patients receiving antiretroviral treatment. Enferm Infecc Microbiol Clin. 2005, 23: 581-585. 10.1157/13081565.CrossRefPubMed
11.
go back to reference Mocroft A, Vellaa S, Benfield TL, Chiesi A, Miller V, Garqalianos P: Changing patterns of mortality across Europe in patients infected with HIV-1. EuroSIDA Study Group. Lancet. 1998, 352: 1725-1730. 10.1016/S0140-6736(98)03201-2.CrossRefPubMed Mocroft A, Vellaa S, Benfield TL, Chiesi A, Miller V, Garqalianos P: Changing patterns of mortality across Europe in patients infected with HIV-1. EuroSIDA Study Group. Lancet. 1998, 352: 1725-1730. 10.1016/S0140-6736(98)03201-2.CrossRefPubMed
12.
go back to reference Palella FJ, Delaney KM, Moorman AC: Declining morbidity and mortality among patients with advanced human immunodeficiency virus infection HIV Outpatient Study Investigators. N Engl J Med. 1998, 338: 853-860. 10.1056/NEJM199803263381301.CrossRefPubMed Palella FJ, Delaney KM, Moorman AC: Declining morbidity and mortality among patients with advanced human immunodeficiency virus infection HIV Outpatient Study Investigators. N Engl J Med. 1998, 338: 853-860. 10.1056/NEJM199803263381301.CrossRefPubMed
13.
go back to reference Needham DM, Hogg RS, Yip B: The impact of antiretroviral therapy on AIDS survival observed in a province-wide drug treatment program. Int J STD AIDS. 1998, 9: 370-372.PubMed Needham DM, Hogg RS, Yip B: The impact of antiretroviral therapy on AIDS survival observed in a province-wide drug treatment program. Int J STD AIDS. 1998, 9: 370-372.PubMed
14.
go back to reference Teng T, Shao Y: Scientific approaches to AIDS prevention and control in china. Adv Dent Res. 2011, 23: 10-12. 10.1177/0022034511398871.CrossRefPubMed Teng T, Shao Y: Scientific approaches to AIDS prevention and control in china. Adv Dent Res. 2011, 23: 10-12. 10.1177/0022034511398871.CrossRefPubMed
15.
go back to reference Broder S: The development of antiretroviral therapy and its impact on the HIV-1/AIDS pandemic. Antiviral Res. 2010, 85: 1-18. 10.1016/j.antiviral.2009.10.002.CrossRefPubMed Broder S: The development of antiretroviral therapy and its impact on the HIV-1/AIDS pandemic. Antiviral Res. 2010, 85: 1-18. 10.1016/j.antiviral.2009.10.002.CrossRefPubMed
16.
go back to reference Grulich AE, van Leeuwen MT, Falster MO: Incidence of cancers in people with HIV/AIDS compared with immunosuppressed transplant recipients: A meta-analysis. Lancet. 2007, 370: 59-67. 10.1016/S0140-6736(07)61050-2.CrossRefPubMed Grulich AE, van Leeuwen MT, Falster MO: Incidence of cancers in people with HIV/AIDS compared with immunosuppressed transplant recipients: A meta-analysis. Lancet. 2007, 370: 59-67. 10.1016/S0140-6736(07)61050-2.CrossRefPubMed
17.
go back to reference Slaven EM, Lopez F, Weintraub SL: The AIDS patient with abdominal pain: A new challenge for the emergency physician. Emerg Med Clin North Am. 2003, 21: 987-1015. 10.1016/S0733-8627(03)00070-1.CrossRefPubMed Slaven EM, Lopez F, Weintraub SL: The AIDS patient with abdominal pain: A new challenge for the emergency physician. Emerg Med Clin North Am. 2003, 21: 987-1015. 10.1016/S0733-8627(03)00070-1.CrossRefPubMed
18.
go back to reference Gaynes RP, Culver DH, Horan TC: Surgical site infection (SSI) rates in the United States, 1992–98: the National Nosocomial Infections Surveillance System basic SSI risk index. Clin Infect Dis. 2001, 33: S69-S77. 10.1086/321860.CrossRefPubMed Gaynes RP, Culver DH, Horan TC: Surgical site infection (SSI) rates in the United States, 1992–98: the National Nosocomial Infections Surveillance System basic SSI risk index. Clin Infect Dis. 2001, 33: S69-S77. 10.1086/321860.CrossRefPubMed
19.
go back to reference Drapeau CM, Pan A, Bellacosa C: Surgical site infections in HIV-infected patients: results from an Italian prospective multicenter observational study. Infection. 2009, 37: 455-460. 10.1007/s15010-009-8225-1.CrossRefPubMed Drapeau CM, Pan A, Bellacosa C: Surgical site infections in HIV-infected patients: results from an Italian prospective multicenter observational study. Infection. 2009, 37: 455-460. 10.1007/s15010-009-8225-1.CrossRefPubMed
20.
go back to reference Brian Mawalla, Mshana Stephen E, Chalya Philipo L, Imirzalioqlu C, Mahalu W: Predictors of surgical site infections among patients undergoing major surgery at Bugando Medical Centre in Northwestern Tanzania. BMC Surg. 2011, 11: 21-10.1186/1471-2482-11-21.CrossRef Brian Mawalla, Mshana Stephen E, Chalya Philipo L, Imirzalioqlu C, Mahalu W: Predictors of surgical site infections among patients undergoing major surgery at Bugando Medical Centre in Northwestern Tanzania. BMC Surg. 2011, 11: 21-10.1186/1471-2482-11-21.CrossRef
21.
go back to reference Petrosillo N, Drapeau CM, Nicastri E, Martini L, Lppolito G, Moro ML: Surgical site infections in Italian Hospitals: a prospective multicenter study. BMC Infect Dis. 2008, 8: 34-10.1186/1471-2334-8-34.CrossRefPubMedPubMedCentral Petrosillo N, Drapeau CM, Nicastri E, Martini L, Lppolito G, Moro ML: Surgical site infections in Italian Hospitals: a prospective multicenter study. BMC Infect Dis. 2008, 8: 34-10.1186/1471-2334-8-34.CrossRefPubMedPubMedCentral
Metadata
Title
Prevention and treatment of surgical site infection in HIV-infected patients
Authors
Lei Zhang
Bao-Chi Liu
Xiao-Yan Zhang
Lei Li
Xian-Jun Xia
Rui-Zhang Guo
Publication date
01-12-2012
Publisher
BioMed Central
Published in
BMC Infectious Diseases / Issue 1/2012
Electronic ISSN: 1471-2334
DOI
https://doi.org/10.1186/1471-2334-12-115

Other articles of this Issue 1/2012

BMC Infectious Diseases 1/2012 Go to the issue
Obesity Clinical Trial Summary

At a glance: The STEP trials

A round-up of the STEP phase 3 clinical trials evaluating semaglutide for weight loss in people with overweight or obesity.

Developed by: Springer Medicine

Highlights from the ACC 2024 Congress

Year in Review: Pediatric cardiology

Watch Dr. Anne Marie Valente present the last year's highlights in pediatric and congenital heart disease in the official ACC.24 Year in Review session.

Year in Review: Pulmonary vascular disease

The last year's highlights in pulmonary vascular disease are presented by Dr. Jane Leopold in this official video from ACC.24.

Year in Review: Valvular heart disease

Watch Prof. William Zoghbi present the last year's highlights in valvular heart disease from the official ACC.24 Year in Review session.

Year in Review: Heart failure and cardiomyopathies

Watch this official video from ACC.24. Dr. Biykem Bozkurt discuss last year's major advances in heart failure and cardiomyopathies.