Characteristics of microorganisms cultured from infected wounds post-hysterectomy.
OBJECTIVE
To characterize organisms causing wound infection following abdominal hysterectomy.


METHODS
All patients who underwent an abdominal hysterectomy (December 2002-January 2006) and developed abdominal wall wound infection proven by a positive culture were included in the study. Patient information was collected from the computerized files. The isolated microorganisms were characterized for antibiotics susceptibility.


RESULTS
Sixty-eight (68/620, 10.96%) patients had positive wound cultures. Of 100 isolated microorganisms, 44 were resistant to cefonicid (prophylactic treatment) and 15 were resistant to combined ampicillin, gentamicin and metronidazole (empirical treatment). Major co-morbidities (including diabetes mellitus, hypertension, past malignancies, renal, cardiovascular and pulmonary diseases, hypothyroidism or anemia), were found to be significantly associated with pseudomonal infection (P<.008).


CONCLUSIONS
A significant portion of pathogens causing post-hysterectomy abdominal wall wound infection are resistant to the prophylactic treatment, and some are resistant to the empirical treatment. Further studies are necessary to evaluate the effectiveness of various prophylactic regimens with better coverage of Enterococcus fecalis, as well as the effectiveness of empirical treatment active against the resistant Enterobacteriaceae group.
Yerushalmy
Anat
A
Department of Obstetrics and Gynecology, Tel Aviv Sourasky Medical Center, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
Reches
Adi
A
Lessing
Joseph B
JB
Schechner
Vered
V
Carmeli
Yehuda
Y
Grisaru
Dan
D
D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D019072:Antibiotic Prophylaxis; D015790:Cefonicid / Q000627:therapeutic use; D024881:Drug Resistance, Bacterial; D013293:Enterococcus faecalis / Q000187:drug effects; D005260:Female; D006801:Humans; D007044:Hysterectomy / Q000009:adverse effects*; D008826:Microbial Sensitivity Tests; D008875:Middle Aged; D012189:Retrospective Studies; D013530:Surgical Wound Infection / Q000188:drug therapy / Q000382:microbiology*
D000900:Anti-Bacterial Agents; D015790:Cefonicid