title: Does antimicrobial homogeneity index influence surgical site infection? A 10-year study in lung, breast, and general surgery.
abstract: To address whether hospital antimicrobial use influences surgical site infection (SSI), we investigated factors including antimicrobial homogeneity index (AHI), an indicator of prescription diversity, with a retrospective study during 120 months for patients undergoing lung, breast, and general surgery (n = 4,510). We analyzed the odds ratios of background factors for SSI and the correlation between AHI and drug susceptibility in isolates of SSI. A total of 243 cases of SSI (5.4%) occurred. Factors that significantly contributed for SSI were operative time [odds ratio (OR), 1.78; 95% confidence interval (CI), 1.33-2.39; P < 0.001], American Society of Anesthesiologists' score (OR, 1.68, 95% CI, 1.23-2.28; P < 0.001), endoscopic use (OR, 0.10, 95% CI, 0.04-0.24; P < 0.001), lung and breast surgery versus general surgery (OR, 0.12, 95% CI, 0.06-0.22; P < 0.001), increased AHI (OR, 0.72, 95% CI, 0.55-0.95; P = 0.020), and older age (OR, 2.08, 95% CI, 1.39-3.11; P < 0.001). AHI showed a positive correlation coefficient (CC, P < 0.05) with susceptibility to ampicillin (CC = +0.327), cefotaxime (CC = +0.142), imipenem/cilastatin (CC = +0.101), and sulbactam/cefoperazone (CC = +0.145). AHI, which has been described to help prevent drug resistance, was associated with increased susceptibility in microbes of SSI. This finding in part may explain that increase in AHI reduced SSI.
authors.affiliation: Department of Chest Surgery, Shimonoseki City Central Hospital, 1-13-1 Koyo-cho, Shimonoseki 750-8520, Japan. yoshidaj@uicalumni.org
authors.forename: Junichi
authors.initials: J
authors.lastname: Yoshida
authors.forename: Mayumi
authors.initials: M
authors.lastname: Oyama
authors.forename: Koichi
authors.initials: K
authors.lastname: Furugaki
authors.forename: Toshiyuki
authors.initials: T
authors.lastname: Ishimitsu
authors.forename: Masahiro
authors.initials: M
authors.lastname: Shinohara
authors.forename: Eiji
authors.initials: E
authors.lastname: Miyatake
authors.forename: Kenichi
authors.initials: K
authors.lastname: Matsuo
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000890:Anti-Infective Agents / Q000008:administration & dosage*; D001419:Bacteria / Q000187:drug effects; D001940:Breast / Q000601:surgery; D006801:Humans; D016015:Logistic Models; D008168:Lung / Q000601:surgery; D055624:Methicillin-Resistant Staphylococcus aureus / Q000302:isolation & purification; D008826:Microbial Sensitivity Tests; D008875:Middle Aged; D010818:Practice Patterns, Physicians'; D012189:Retrospective Studies; D013203:Staphylococcal Infections / Q000453:epidemiology; D013530:Surgical Wound Infection / Q000453:epidemiology / Q000382:microbiology*
chemical_list: D000890:Anti-Infective Agents