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2025-02-02

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cc by-nc-nd (c) Flores-Yelamos, Miriam et al., 2025
Please use this identifier to cite or link to this item: https://hdl.handle.net/2445/220335

Oral antibiotic prophylaxis induces changes in the microbiology of surgical site infection after colorectal surgery. A matched comparative study

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https://doi.org/10.1111/codi.70008

Abstract

Aim: Oral antibiotic prophylaxis (OAP) lowers rates of surgical site infection (SSI) and may aid anastomotic healing in colorectal surgery. The aim of this study was to analyse the understudied impact of OAP on SSI microbiology after colorectal surgery. Method: A post hoc analysis was performed on a previous prospective, multicentre study of elective colorectal surgery. For 1000 patients with SSI, this study compared the microbiology of SSIs in procedures without OAP (SSI/OAP-) and with OAP (SSI/OAP+). Results: There were 340 patients in the SSI/OAP- group and 660 in the SSI/OAP+ group. The use of OAP increased the presence of Gram-positive cocci (GPC) (OR 1.542, 95% CI 1.153-2.062) and fungi (OR 2.037, 95% CI 1.206-3.440), but reduced rates of Gram-negative bacteria (GNB) (OR 1.461, 95% CI 1.022-2.088) and anaerobe isolation (OR 0.331, 95% CI 0.158-0.696). Specifically, it led to increases in the isolation of Enterococcus faecium (OR 1.450, 95% CI 0.812-2.591), methicillin-resistant Staphylococcus aureus (OR 2.000, 95% CI 1.043-3.834) and Candida spp. (OR 2.037, 95% CI 1.206-3.440). In colon surgery with OAP, GPC infections were more likely (OR 1.461, 95% CI 1.022-2.088). In rectal surgery, organ/space SSIs had a higher risk of harbouring GPC (OR 1.860, 95% CI 1.153-2.999) and a lower risk of GNB (OR 0.321, 95% CI 0.200-0.515). Conclusion: OAP reduced the presence of anaerobes and GNB in SSIs, but increased the isolation of GPCs and fungi, with E. faecium and Candida being of particular concern. This information should guide empirical antibiotic therapy for postoperative colorectal SSIs in patients who have received preoperative OAP.

Subject

Medicaments antibacterians, Medicina preventiva, Cirurgia colorectal, Còlon

Subject (English)

Antibacterial agents, Preventive medicine, Colorectal surgery, Colon

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Articles publicats en revistes (Infermeria de Salut Pública, Salut mental i Maternoinfantil)
Articles publicats en revistes (Institut d'lnvestigació Biomèdica de Bellvitge (IDIBELL))

Citation

FLORES-YELAMOS, Miriam, et al. Oral antibiotic prophylaxis induces changes in the microbiology of surgical site infection after colorectal surgery. A matched comparative study. Colorectal Disease. 2025. Vol. 27, num. 2. ISSN 1462-8910. [consulted: 15 of August of 2026]. Available at: https://hdl.handle.net/2445/220335

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