Specific National Surveillance Program for Organ Space Infections after Colonic Surgery

Background: The present study aimed to analyze risk factors and management strategies for organ space infections (OSI) specifically after colonic resections. Methods: This was a retrospective analysis of all consecutive colonic resections performed between February 2012 and October 2017 in a single-center quality-improvement project. All OSIs were assessed prospectively by an independent national surveillance program (www.swissnoso.ch) and classified according to the U.S. Centers for Disease Control and Prevention (CDC) criteria (infection involves organ and spaces other than the incision), including anastomotic leaks. Risk factors for OSI were identified by univariable and multivariable analysis. Results: The study cohort included 1,263 patients (731 elective and 532 emergency colectomies). One hundred fifty-three patients (12%) were found to have an OSI, which occurred at median POD 8 [interquartile range 4–14]. Treatment strategies consisted of surgical management in 85 cases (56%), percutaneous drainage in 36 cases (24%), and antibiotic treatment alone in 32 patients (21%). Independent risk factors for OSI were emergency surgery (odds ratio [OR] 2.06; 95% confidence interval [CI] 1.35–3.16), operation duration >180 minutes (OR 2.10; 95% CI 1.29–3.40), and open surgery (OR 2.51; 95% CI 1.73–3.65). Conclusions: Organ space infections after colonic surgery were more frequent after open emergency surgery and occurred early in the post-operative course. Invasive management was required in 79% of cases.