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Surgical Site Infections after Spinal Surgery in a Tropical Area: A Prospective Monocentric Observational Study

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  • 1 Orthopaedic and Traumatologic Department, CHU Martinique, Fort-de-France, France;
  • | 2 Pprime Institute, University of Poitiers, Poitiers, France;
  • | 3 Divisions of Clinical Microbiology and Infectious Diseases, Mayo Clinic, Rochester, Minnesota;
  • | 4 Infectious Diseases Department, CHU Martinique, Fort-de-France, France
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ABSTRACT.

To date, no study has described the microbiological profile of surgical site infections (SSIs) after spine surgery in a tropical environment. The main objective of this study is to describe the microbiology and the risk factors of SSI after spinal surgery in a tropical climate. Our hypothesis is that the microbiology of SSIs in tropical areas is different to what is mainly described in temperate countries. As a consequence, the recommendation for antibiotic prophylaxis administered in the operative room, which mainly relays on the literature, might not be adequate in such countries. We included 323 consecutive patients who underwent a spinal intervention between 2017 and 2019, with a 2-year minimum follow-up. Objective ISO criteria were established in accordance with the criteria accepted by the Center of Disease Control in Atlanta. The identification of risk factors for SSI was carried out by uni- and multivariate analysis with a significance threshold of P < 0.05. The incidence of SSI was 7.7%. A total of 54.8% were in favor of a predominantly digestive origin of germs with an average of 1.68 bacteria found by ISO. Inadequate antibiotic prophylaxis was found in 54.8%. Age and body mass index were found to be independent risk factors for SSI. We report here an unusual microbiological profile of SSI with a predominance of gram-negative bacteria and a low proportion of Staphylococcus aureus and Staphylococcus epidermidis.

Author Notes

Address correspondence to Mathieu Severyns, Fort-de-France, France, 97261. E-mail: mathieu.severyns@hotmail.fr

Authors’ addresses: Mathieu Severyns, Orthopaedic and Traumatologic Department, CHU Martinique, Fort-de-France, France, and Pprime Institute, University of Poitiers, Poitiers, France, E-mail: mathieu.severyns@hotmail.fr. François-Xavier Hostalrich and Abdelkrim Benchikh El-Fegoun, Orthopaedic and Traumatologic Department, CHU Martinique, Fort-de-France, France, E-mails: francois-xavier.hostalrich@chu-martinique.com and abdelkrim.bechikh-el-fegoun@chu-martinique.fr. Laure Flurin, Divisions of Clinical Microbiology and Infectious Diseases, Mayo Clinic, Rochester, MN, E-mail: laure.flurin@gmail.com. Tanguy Vendeuvre and Arnaud Germaneau, Pprime Institute, University of Poitiers, Poitiers, France, E-mails: tanguy.vendeuvre@chu-poitiers.fr and arnaud.germaneau@univ-poitiers.fr. Jean-Marie Turmel and André Cabié, Infectious Diseases Department, CHU Martinique, Fort-de-France, France, E-mails: jean-marie.turmel@chu-martinique.fr and andre.cabie@chu-martinique.fr.

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