Multidrug-Resistant Gram-Negative Bacteria in Surgical Site Infections: Antimicrobial Resistance and Preventive Measures

Multidrug-resistant (MDR) gram-negative bacteria (GNB) are responsible for high mortality and morbidity in health care settings worldwide. They have been declared as priority pathogens by the WHO for their continuously escalating antimicrobial resistance. Nevertheless, data associated with MDR GNB in health care–associated infections are insufficient. Surgical site infections (SSIs) are among the most commonly occurring health care–associated infections. Such infections are particularly common when bacteria from a patient’s normal microflora are transferred to the surgical sites during surgical procedures. SSIs affect approximately 0.5%–3% of patients undergoing surgery, resulting in prolonged hospital stays compared with patients without SSIs. SSIs result in severe problems and lead to a heavy economic burden. Most SSIs can be avoided if suitable preventive measures are employed. Novel findings support the dedicated usage of oral preoperative surgical antimicrobial prophylaxis for specific surgeries based on sites/organs. Immediate interventions are sought to control the transmission of MDR GNB typically found in hospital settings. The present narrative review aims to describe MDR GNB in SSIs in different sites. Antimicrobial resistance epidemiology and preventive measures for SSIs are also discussed. Different intrinsic and extrinsic factors and control measures are elaborated for curbing SSIs.