Peri Operative Infections Flashcards
What are the most common pathogens responsible for peri-operative infections?
Staphylococcus aureus (including MRSA), coagulase-negative staphylococci, Enterococcus spp., Escherichia coli, Klebsiella spp., Pseudomonas aeruginosa, Acinetobacter spp., Enterobacter spp., Streptococcus spp.
What is the classification of surgical wounds?
Clean: hernia repair, breast biopsy; Clean-contaminated: cholecystectomy, elective bowel resection; Contaminated: emergency bowel resection; Dirty/Infected: perforation or abscess.
When is antibiotic prophylaxis recommended in surgery?
Clean surgeries with prosthesis/implant, clean-contaminated surgeries, contaminated surgeries, surgeries on dirty or infected wounds.
Why should antibiotic prophylaxis not be routinely used in clean non-prosthetic surgeries?
Due to risks of adverse events, Clostridium difficile-associated disease, resistance, and drug hypersensitivity.
What are the signs and symptoms of surgical site infections (SSI)?
Heat, redness, pain, swelling, systemic signs like fever or raised white blood cell count.
What is the rationale for antibiotic prophylaxis in surgery?
Assess patient history, evaluate the procedure type, select appropriate antibiotics, administer at the correct timing and dose, monitor, and adjust as needed.
Which antibiotic is commonly used for clean surgeries?
Cefazolin.
What combination of antibiotics is used for colorectal surgeries?
Cefazolin and metronidazole.
What pathogens are significant in abdominal surgeries?
Enterococcus spp., including Enterococcus faecalis and Enterococcus faecium.
What are patient-specific factors for developing a prophylactic plan?
Medical history, type of surgery, allergies, comorbidities, weight, and renal function.
What factors contribute to postoperative pain?
Type of surgery, preoperative pain, patient expectations, acute pain, psychological factors, age, gender, comorbidities, lifestyle factors like smoking and sleep quality.
What is the antibiotic of choice for MRSA prophylaxis?
Vancomycin or clindamycin.
Why is vancomycin-resistant enterococci (VRE) a concern?
It requires alternative treatments and poses challenges in hospitals due to resistance.
How can healthcare professionals reduce surgical site infections?
Understanding pathogens, using proper antimicrobial prophylaxis, and developing patient-specific plans.
What are common pathogens requiring broader-spectrum antibiotics in GI surgeries?
Gram-negative bacteria.
