Implications of 2,457 consecutive surgical infections entering year 2000.
OBJECTIVE
To assess the demographics and characteristics of infections in surgical patients to define areas that deserve emphasis in surgical education.


BACKGROUND
As a result of evolving technology and diseases, the complexity of diagnosing and treating infections has increased during the past three decades for all patients, including those treated primarily by surgeons. No comprehensive analysis of these conditions in a single surgical cohort has been recently published.


METHODS
The authors conducted a prospective, observational study of all infections occurring on the general and trauma surgery services at a single university hospital during a 3.5-year period.


RESULTS
The authors identified 2,457 infections: 608 community-acquired, 1,053 occurring on the wards, and 796 occurring in the intensive care unit. Although dependent on patient location, the most common sites were abdomen, lung, and wound; the most common isolates were Staphylococcus epidermidis, Staphylococcus aureus, and Candida albicans; and the most commonly used antibiotics were ciprofloxacin, vancomycin, and metronidazole. The overall death rate was 13%, ranging from 5% after community-acquired infections to 25% after infections acquired in the intensive care unit.


CONCLUSIONS
Most infections treated by surgeons are hospital-acquired. Infections with gram-positive cocci and fungi are common, with pulmonary infections becoming more common. Fluoroquinolones have become important therapeutic agents. Depending on the type of practice, these data should be helpful to direct educational efforts so that surgeons can remain knowledgeable and active in the nonsurgical care of their patients.
Sawyer
R G
RG
Charles O. Strickler Transplant Center, University of Virginia Department of Surgery, Charlottesville, Virginia 22908-0709, USA. rws2k@virginia.edu.
Raymond
D P
DP
Pelletier
S J
SJ
Crabtree
T D
TD
Gleason
T G
TG
Pruett
T L
TL
D000005:Abdomen; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D000890:Anti-Infective Agents / Q000627:therapeutic use; D017714:Community-Acquired Infections / Q000188:drug therapy / Q000453:epidemiology; D003428:Cross Infection / Q000188:drug therapy / Q000453:epidemiology*; D004352:Drug Resistance, Microbial; D005260:Female; D024841:Fluoroquinolones; D013502:General Surgery / Q000193:education*; D006785:Hospitals, University; D006801:Humans; D007362:Intensive Care Units; D008168:Lung; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D013530:Surgical Wound Infection / Q000188:drug therapy / Q000453:epidemiology*; D014193:Trauma Centers; D016896:Treatment Outcome; D014768:Virginia / Q000453:epidemiology
D000900:Anti-Bacterial Agents; D000890:Anti-Infective Agents; D024841:Fluoroquinolones