Infection and Drug Resistance (Jan 2023)

Does the Microflora of Surgery Site Infection Change After Prophylactic Use of Vancomycin Powder in the Spine Surgery

  • Hu W,
  • Wang H,
  • Wu X,
  • Shi X,
  • Ma H,
  • Zhang K,
  • Gao Y

Journal volume & issue
Vol. Volume 16
pp. 105 – 113

Abstract

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Weiran Hu,1,2,* Hongqiang Wang,1,2,* Xiaonan Wu,1,3 Xinge Shi,1,2 Haohao Ma,1,2 Kai Zhang,1,2 Yanzheng Gao1,2 1Department of Spine and Spinal Cord Surgery, Henan Provincial People’s Hospital, Zhengzhou, People’s Republic of China; 2Department of Spine and Spinal Cord Surgery, People’s Hospital of Zhengzhou University, Zhengzhou, People’s Republic of China; 3Department of Spine and Spinal Cord Surgery, People’s Hospital of Henan University, Zhengzhou, People’s Republic of China*These authors contributed equally to this workCorrespondence: Yanzheng Gao, Department of Spine and Spinal Cord Surgery, Henan Provincial People’s Hospital, No. 7, Wei Wu Road, Zhengzhou, 450003, People’s Republic of China, Email [email protected] Design: Retrospective cohort study.Objective: This study aimed to investigate the characteristics of microflora in patients with deep spinal surgical site infection (SSI) after prophylactic use of vancomycin powder (VP).Methods: A retrospective analysis was performed on patients after spinal surgery. Patients were grouped according to whether VP use and only patients with deep SSI were included in this study. General information of the patients, the dose of vancomycin, bacterial culture results, drug sensitivity test results, and SSI treatment methods were recorded. The differences of microflora between the two groups were analyzed, and the sensitivity of bacteria in the +VP group to antibiotics was analyzed.Results: The infection rate in the +VP group was 4.9% (56/1124) vs 6.3% (93/1476) in the No-VP group (P 1g SSIs was higher (59.0% vs 32.4%, P < 0.05). In the +VP SSIs, all of the GNB cultured were sensitive to meropenem, and linezolid covered most of the GPB cultured.Conclusion: Local use of vancomycin powder can reduce the incidence of SSI, but this may lead to changes in the bacterial flora. Once the SSI occurs, the case of GNB infection may be increased. The more dose of VP cannot decrease SSI but may increase the rate of GNB in the +VP SSIs. Once infections still occur after VP use, antibiotics covering GNB may be added. These findings may help guide choice of empiric antibiotics while awaiting culture data.Keywords: surgery site infection, microflora, spine, vancomycin

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