title: Evaluation of antimicrobial prophylaxis against postoperative infection after spine surgery: Limit of the first generation cephem.
abstract: In our department, first-generation cephem (CEZ) are generally administered for 2 days as antimicrobial prophylaxis (AMP) for spinal surgery. However, the incidence of surgical site infection (SSI) has recently increased, particularly cases involving coagulase-negative Staphylococci (CNS) as an etiologic agent. The objective was to elucidate the problems with the current AMP and the risk factors of SSI through a retrospective investigation of affected cases. The subjects were patients who underwent spine surgery at our department between August 2007 and June 2013. The subjects were divided into those who developed SSI (S group) and who did not develop SSI (non-SSI (N) group), patients who developed CNS infection in the S group was subdivided as C group, and the risk factors were investigated. The significance of each factor was analyzed using cross tabulation, and multivariate logistic regression analyses were performed with 22 of the investigation factors as explanatory variables. The incidence of SSI was 2.55%, and the etiologic agent was CNS in 17 patients. Upon comparison between the S and N groups, the presence of 3 or more underlying diseases and blood loss were extracted as significant risk factors. Upon comparison between the C and N groups, emergency surgery and intra- and postoperative steroid administration were extracted as significant risk factors, in addition to the presence of 3 or more underlying diseases and blood loss. The effect of the current AMP using first generation cephem is limited, and reconsideration of the protocol may be necessary.
authors.affiliation: Department of Orthopaedic Surgery, Toho University School of Medicine, Tokyo, Japan.
authors.forename: Yasuaki
authors.initials: Y
authors.lastname: Iida
authors.affiliation: Department of Orthopaedic Surgery, Toho University School of Medicine, Tokyo, Japan.
authors.forename: Yasuhiro
authors.initials: Y
authors.lastname: Inoue
authors.affiliation: Department of Orthopaedic Surgery, Toho University School of Medicine, Tokyo, Japan.
authors.forename: Keiji
authors.initials: K
authors.lastname: Hasegawa
authors.affiliation: Department of Orthopaedic Surgery, Toho University School of Medicine, Tokyo, Japan.
authors.forename: Shintaro
authors.initials: S
authors.lastname: Tsuge
authors.affiliation: Department of Orthopaedic Surgery, Toho University School of Medicine, Tokyo, Japan.
authors.forename: Yuichirou
authors.initials: Y
authors.lastname: Yokoyama
authors.affiliation: Department of Orthopaedic Surgery, Toho University School of Medicine, Tokyo, Japan.
authors.forename: Kazumasa
authors.initials: K
authors.lastname: Nakamura
authors.affiliation: Department of Orthopaedic Surgery, Toho University School of Medicine, Tokyo, Japan.
authors.forename: Ryoichi
authors.initials: R
authors.lastname: Fukano
authors.affiliation: Department of Orthopaedic Surgery, Toho University School of Medicine, Tokyo, Japan.
authors.forename: Ryo
authors.initials: R
authors.lastname: Takamatsu
authors.affiliation: Department of Orthopaedic Surgery, Toho University School of Medicine, Tokyo, Japan.
authors.forename: Akihito
authors.initials: A
authors.lastname: Wada
authors.affiliation: Department of Orthopaedic Surgery, Toho University School of Medicine, Tokyo, Japan. Electronic address: drkan@med.toho-u.ac.jp.
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Takahashi
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000890:Anti-Infective Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D019072:Antibiotic Prophylaxis / Q000706:statistics & numerical data*; D002648:Child; D005260:Female; D006801:Humans; D015994:Incidence; D007564:Japan / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D019637:Orthopedic Procedures / Q000009:adverse effects*; D012189:Retrospective Studies; D012307:Risk Factors; D013131:Spine / Q000601:surgery*; D013530:Surgical Wound Infection / Q000188:drug therapy* / Q000453:epidemiology / Q000517:prevention & control; D055815:Young Adult
chemical_list: D000890:Anti-Infective Agents
keywords: Antimicrobial prophylaxis; Methicillin-resistant coagulase-negative staphylococci; Spine surgery; Surgical site infection