Multiple Drug-resistant Organism are the main pathogens of colorectal surgery site infection after colorectal surgery: A retrospective study

Abstract Background: This study investigates the incidence, disease burden, and risk factors of surgical site infections (SSIs), particularly Multiple Drug-Resistant Organism (MDRO) Infection after colorectal surgery, to provide evidence for the prevention and control of the SSIs after colorectal surgery. Methods: The study included patients undergoing colorectal surgery between January 1, 2020, and December 31, 2021 at Xiangya Hospital Central South University. Data about demographic information, length of hospital stay, cost of hospitalization, underlying diseases, invasive procedures, and antimicrobial use were gathered via Epidata3.1. A multivariate logistic regression model is used to examine the independent risk factors of SSIs and Multidrug organism infections. Results: The study included a total of 2297 colorectal surgery patients; 94 patients experienced SSIs following an operation, including superficial incision infection in 18 cases, deep incision infection in 12 cases, and organ compartment infection in 64 cases. In the infection group, 44 cases have multidrug-resistant pathogens, 10 cases have sensitive pathogens, and 40 cases do not have any identifiable pathogens. The pathogen of SSIs in this study is primarily Escherichia coli. It had high cefazolin and cefuroxime resistance, but low resistance to imipenem and piperacillin tazobactam. The median length of stay and hospital costs in the infection group are 27.5 (day) and 85716.96 (yuan), while these figures are 15 (day) and 56318.06 (yuan) in the control group, respectively. All P-values are <0.001. Low preoperative albumin levels, prior use of broad-spectrum antibiotics, preoperative ICU admission, mechanical ventilation, tracheal intubation, central venous catheterization, and blood transfusion are all shown in univariate analysis to be statistically significant risk factors between infection and control group, while mechanical ventilation is shown in multi-factor logistic regression analysis to be the independent risk factor for SSIs. Univariate analysis reveals preoperative hyperglycemia, preoperative ICU admission, mechanical ventilation, and tracheal intubation are all statistically significant risk factors between the MDRO group and NMDR group. Multi-factor logistic regression analysis demonstrates that mechanical ventilation is the independent risk factor for MDRO infection. Conclusion: The disease burden of SSIs after colorectal surgery is comparatively high, and mechanical ventilation is the independent risk factor for SSIs. MDRO were the most common pathogens of SSIs.