Prevalence, Microbiological Profile, and Risk Factors of Surgical Site Infections in Saudi Patients with Colorectal Cancer

Marwh Gassim Aldriwesh; Abrar Alnodley; Norah Almutairi; Mohammed Algarni; Ayyob Alqarni; Bayan Albdah; Mutaib Mashraqi

doi:10.4103/sjmms.sjmms_3_23

Prevalence, Microbiological Profile, and Risk Factors of Surgical Site Infections in Saudi Patients with Colorectal Cancer

Saudi J Med Med Sci. 2023 Jul-Sep;11(3):208-218. doi: 10.4103/sjmms.sjmms_3_23. Epub 2023 Jul 15.

Authors

Marwh Gassim Aldriwesh^{1

2}, Abrar Alnodley¹, Norah Almutairi¹, Mohammed Algarni^{2

3

4}, Ayyob Alqarni^{2

4

5}, Bayan Albdah⁶, Mutaib Mashraqi⁷

Affiliations

¹ Department of Clinical Laboratory Sciences, College of Applied Medical Sciences, King Saud Bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia.
² King Abdullah International Medical Research Center, Ministry of National Guard-Health Affairs, Riyadh, Saudi Arabia.
³ Department of Oncology, Ministry of National Guard-Health Affairs, Riyadh, Saudi Arabia.
⁴ Department of Medicine, College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia.
⁵ Department of General Surgery, Ministry of National Guard-Health Affairs, Riyadh, Saudi Arabia.
⁶ Department of Biostatistics and Bioinformatics, King Abdullah International Medical Research Center, Riyadh, Saudi Arabia.
⁷ Department of Clinical Laboratory Sciences, College of Applied Medical Sciences, Najran University, Najran, Saudi Arabia.

Abstract

Background: Resection surgery in patients with colorectal cancer (CRC) patients is associated with potential complications, including surgical site infection (SSI).

Objectives: To estimate the prevalence rate of SSI, identify the common pathogens responsible for SSI, and determine potential risk factors for SSI development in a cohort from Saudi Arabia.

Materials and methods: Patients with CRC who underwent bowel resection surgery at King Abdulaziz Medical City, Riyadh, between January 01, 2016, and December 31, 2019, were retrospectively included. Demographics, comorbidities, surgical procedure data, and the results of preoperative laboratory tests were retrospectively collected from medical records through the health information system. The study population was divided into two groups: those who developed SSI and those who did not.

Results: A total of 92 patients with CRC who underwent resection surgery were included, of which 54 (58.7%) were males. The median age was 65 (IQR 55.5-75.0) years. SSI was observed in 25 (27.2%) patients. The most frequently isolated organisms were Escherichia coli and Pseudomonas aeruginosa, followed by Klebsiella pneumoniae, vancomycin-sensitive Enterococcus faecium, and methicillin-resistant Staphylococcus aureus. Three E. coli isolates were producers of extended-spectrum beta-lactamases, and two K. pneumoniae isolates exhibited a multidrug resistance profile. Low preoperative serum albumin level was identified as a significant independent risk factor for developing SSI (AOR = 0.853, 95% CI = 0.748-0.973, P = 0.0181).

Conclusion: The study found a notable prevalence of SSI among the included patients. Gram-negative bacteria were more involved in SSI events and were also associated with drug-resistance patterns. Gut microbiota bacteria were most commonly involved in SSIs. Low preoperative serum albumin levels predicted the development of postoperative SSI, and thus its close monitoring and management before surgery could reduce the SSIs.

Keywords: Antimicrobial resistance; Saudi Arabia; colorectal surgery; hypoalbuminemia; risk factors; surgical site infection.