Infección de sitio quirúrgico en el Programa de Trasplante Hepático en Uruguay

Introduction: surgical site infection in liver transplant results in high morbimortality for these patients. Objective: to learn about the incidence of surgical site infection, identify the microorganisms involved and the factors that favor it with the purpose of optimizing our prophylactic strategies. Method: cohort study where patients with liver transplant were prospectively included in our national database. Period of study: July 14, 2009 through May 31, 2013. Statistical analysis: we used chi squared test. If the value in the contingency table was lower than or equal to 5 we used the exact Fisher test. Values p < 0,05 were considered significant. Results: sixty-five patients underwent transplant during this period. Relative frequency accumulated for surgical site infection was 12 patients (18.46%); temporal distribution evidences incidence grew in the last 12 months during which seven episodes took place (58%) out of all surgical site infection episodes. Median time for episodes to appear was 17 days. Out of all patients with surgical site infection, 7 evidenced risk factors for multiresistant micro-organisms before transplant. Sixteen micro-organisms were isolated, 12 of them corresponded to gram-negative bacilli: (Klebsiella spp, n = 6), (Acinetobacter baumannii, n = 2), (Enterobacter cloacae, n = 1), (Aeromonas spp, n = 1), (Pseudomonas aeruginosa, n = 1), (E. coli, n = 1). In terms of their resistance profile: ten patients showed a multiresistant and extremely resistant profile. Conclusions: one out of five patients presented surgical site infection in our center, and the incidence of gram-negative, multiresistant and extremely resistant bacilli was high.