caa a22 4500 445834757 CHVBK 20180317145327.0 cr unu---uuuuu 170323e20110801xx s 000 0 eng 10.1007/s00586-011-1906-3 doi (NATIONALLICENCE)springer-10.1007/s00586-011-1906-3 Individualized antibiotic prophylaxis reduces surgical site infections by gram-negative bacteria in instrumented spinal surgery [Elektronische Daten] [Susana Núñez-Pereira, F. Pellisé, D. Rodríguez-Pardo, C. Pigrau, J. Sánchez, J. Bagó, C. Villanueva, E. Cáceres] Purpose: Surgical site infection (SSI) can be a challenging complication after posterior spinal fusion and instrumentation (PSFI). An increasing rate of SSI by gram-negative bacteria (GNB) has been observed. Current guideline recommendations have not been effective for preventing infection by these microorganisms. Methods: Retrospective cohort study comparing two consecutive groups of patients undergoing PSFI at a single institution. Cohort A includes 236 patients, operated between January 2006 and March 2007, receiving standard preoperative antibiotic prophylaxis with cefazolin (clindamycin in allergic patients). Cohort B includes 223 patients operated between January and December 2009, receiving individualized antibiotic prophylaxis and treatment based on preoperative urine culture. Cultures were done 3-5days before surgery in patients meeting one of the following risk criteria for urinary tract colonization: hospitalization longer than 7days, indwelling catheter, neurogenic bladder, history of urinary incontinence, or history of recurrent urinary tract infection. Results: Twenty-two (9.3%) patients in cohort A developed SSI, 68.2% due to GNB. 38 (17%) patients in cohort B were considered at risk for GNB colonization; preoperative urine culture was positive in 14 (36%). After adjusted antibiotic prophylaxis, 15 (6.27%) patients in cohort B developed SSI, 33.4% due to GNB. A statistically significant reduction in GNB SSI was seen in cohort B (Fisher's exact test, p=0.039). Conclusion: Higher preoperative GNB colonization rates were found in patients with neurogenic bladder or indwelling catheters. Preoperative bacteriological screening, treatment for bacteriuria, and individualized antibiotic prophylaxis were effective for reducing GNB SSI. Springer-Verlag, 2011 Antibiotic prophylaxis nationallicence Surgical site infection nationallicence Gram-negative bacteria nationallicence Urinary tract infection nationallicence Spine surgery nationallicence Núñez-Pereira Susana German Scoliosis Center Bad Wildungen, Im Kreuzfeld 4, 34537, Bad Wildungen, Germany aut Pellisé F. Spine Unit, Hospital Vall d'Hebron, Passeig Vall d'Hebron 119-129, 08035, Barcelona, Spain aut Rodríguez-Pardo D. Infectious Diseases Department, Hospital Vall d'Hebron, Passeig Vall d'Hebron 119-129, 08035, Barcelona, Spain aut Pigrau C. Infectious Diseases Department, Hospital Vall d'Hebron, Passeig Vall d'Hebron 119-129, 08035, Barcelona, Spain aut Sánchez J. Preventive Medicine Department, Hospital Vall d'Hebron, Passeig Vall d'Hebron 119-129, 08035, Barcelona, Spain aut Bagó J. Spine Unit, Hospital Vall d'Hebron, Passeig Vall d'Hebron 119-129, 08035, Barcelona, Spain aut Villanueva C. Spine Unit, Hospital Vall d'Hebron, Passeig Vall d'Hebron 119-129, 08035, Barcelona, Spain aut Cáceres E. Universitat Autònoma de Barcelona, Barcelona, Spain aut European Spine Journal Springer-Verlag 20(2011-08-01), 397-402 0940-6719 20<397 2011 20 586 https://doi.org/10.1007/s00586-011-1906-3 text/html Onlinezugriff via DOI 1 research-article jats NATIONALLICENCE 856 40 https://doi.org/10.1007/s00586-011-1906-3 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Núñez-Pereira Susana German Scoliosis Center Bad Wildungen, Im Kreuzfeld 4, 34537, Bad Wildungen, Germany aut NATIONALLICENCE 700 1- Pellisé F. Spine Unit, Hospital Vall d'Hebron, Passeig Vall d'Hebron 119-129, 08035, Barcelona, Spain aut NATIONALLICENCE 700 1- Rodríguez-Pardo D. Infectious Diseases Department, Hospital Vall d'Hebron, Passeig Vall d'Hebron 119-129, 08035, Barcelona, Spain aut NATIONALLICENCE 700 1- Pigrau C. Infectious Diseases Department, Hospital Vall d'Hebron, Passeig Vall d'Hebron 119-129, 08035, Barcelona, Spain aut NATIONALLICENCE 700 1- Sánchez J. Preventive Medicine Department, Hospital Vall d'Hebron, Passeig Vall d'Hebron 119-129, 08035, Barcelona, Spain aut NATIONALLICENCE 700 1- Bagó J. Spine Unit, Hospital Vall d'Hebron, Passeig Vall d'Hebron 119-129, 08035, Barcelona, Spain aut NATIONALLICENCE 700 1- Villanueva C. Spine Unit, Hospital Vall d'Hebron, Passeig Vall d'Hebron 119-129, 08035, Barcelona, Spain aut NATIONALLICENCE 700 1- Cáceres E. Universitat Autònoma de Barcelona, Barcelona, Spain aut NATIONALLICENCE 773 0- European Spine Journal Springer-Verlag 20(2011-08-01), 397-402 0940-6719 20<397 2011 20 586 Metadata rights reserved Springer special CC-BY-NC licence nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-springer