Table 14.
Percentage of Pathogens Reported from Adult Abdominala Surgical Site Infections (SSIs) that Tested Nonsusceptibleb (NS) to Selected Antimicrobial Agents, by Procedure Closure Technique, 2015–2017
| Pathogen, Antimicrobial | Primary Closurec | Non-primary Closured | ||||
|---|---|---|---|---|---|---|
| No. Reported | % Tested | % NSb | No. Reported | % Tested | % NSb | |
| Staphylococcus aureus | 5,909 | 284 | ||||
| OX/CEFOX/METH (MRSA) | 94.4 | 55.8 | 95.4 | 64.2* | ||
| Enterococcus faecium | 3,584 | 358 | ||||
| Vancomycin (VRE) | 96.1 | 53.1 | 94.4 | 61.5* | ||
| Enterococcus faecalis | 7,584 | 469 | ||||
| Vancomycin (VRE) | 92.9 | 3.4 | 92.5 | 4.1 | ||
| Selected Klebsiella spp | 4,591 | 303 | ||||
| ESC | 82.4 | 14.3 | 85.8 | 21.5* | ||
| Carbapenems (CRE) | 72.7 | 3.5 | 74.3 | 8.0* | ||
| MDR | 93.6 | 6.4 | 93.4 | 12.7* | ||
| Escherichia coli | 15,302 | 1,076 | ||||
| ESC | 81.7 | 18.5 | 84.9 | 19.3 | ||
| Carbapenems (CRE) | 73.5 | 0.6 | 73.8 | 1.8* | ||
| FQ | 94.7 | 34.7 | 94.1 | 36.0 | ||
| MDR | 92.8 | 7.8 | 92.6 | 9.4 | ||
| Enterobacter spp | 3,471 | 220 | ||||
| Cefepime | 71.7 | 7.3 | 75.0 | 13.9* | ||
| Carbapenems (CRE) | 76.4 | 5.4 | 81.4 | 7.3 | ||
| MDR-2 | 93.3 | 2.6 | 95.9 | 4.7 | ||
| Pseudomonas aeruginosa | 4,405 | 382 | ||||
| Aminos | 96.6 | 6.8 | 97.4 | 8.6 | ||
| ESC-2 | 95.4 | 12.3 | 95.5 | 21.9* | ||
| FQ-2 | 96.0 | 12.3 | 96.6 | 16.8* | ||
| Carbapenems-2 | 78.2 | 11.2 | 79.3 | 19.5* | ||
| PIP/PIPTAZ | 89.9 | 9.6 | 86.1 | 15.5* | ||
| MDR-3 | 96.6 | 5.5 | 96.6 | 9.8* | ||
| Acinetobacter spp | 118 | 18 | ||||
| Carbapenems-2 | 81.4 | 32.3 | 72.2 | … | ||
| MDR-4 | 93.2 | 33.6 | 94.4 | … | ||
Note. Selected Klebsiella spp, K. oxytoca and K. pneumoniae; OX/CEFOX/METH, oxacillin, cefoxitin, or methicillin; MRSA, methicillin-resistant Staphylococcus aureus; VRE, vancomycin-resistant Enterococcus; ESCs, extended-spectrum cephalosporins (cefepime, cefotaxime, ceftazidime, or ceftriaxone); CRE, carbapenem-resistant Enterobacteriaceae (imipenem, meropenem, doripenem, or ertapenem); MDR, multidrug-resistant (NS to 1 drug in at least 3 of the following classes: ESCs, FQs, AMINOs, carbapenems (R only), PIPTAZ); MDR-2, multidrug-resistant (NS to 1 drug in at least 3 of the following classes: cefepime, FQs, AMINOs, carbapenems (R only), PIPTAZ); FQs, fluoroquinolones (ciprofloxacin, levofloxacin, or moxifloxacin); AMINOs, aminoglycosides (amikacin, gentamicin, or tobramycin); ESCs-2, extended-spectrum cephalosporins (cefepime or ceftazidime); FQs-2, fluoroquinolones (ciprofloxacin or levofloxacin); PIP, piperacillin; PIPTAZ, piperacillin/tazobactam; Carbapenems-2, imipenem, meropenem, or doripenem; MDR-3, multidrug-resistant (NS to 1 drug in at least 3 of the following classes: ESCs-2, FQs-2, AMINOs, carbapenems-2, PIP/PIPTAZ); MDR-4, multidrug-resistant (NS to 1 drug in at least 3 of the following classes: ESCs-2, FQs-2, AMINOs, carbapenems-2, PIP/PIPTAZ, ampicillin/sulbactam).
Statistically significantly different than %NS among SSIs following primarily closed procedures; P < .05.
Consists of appendix surgery, bile duct, liver, or pancreatic surgery, liver transplant, gallbladder surgery, colon surgery, gastric surgery, herniorrhaphy, small bowel surgery, spleen surgery, exploratory laparotomy, and rectal surgery.
MRSA, VRE, and CRE data are presented as %R (ie, includes only those pathogens that tested resistant). All other phenotypes are shown as %NS (ie, includes pathogens that tested intermediate or resistant). This metric is only calculated when at least 20 isolates have been tested.
Primary closure technique is defined as the closure of a surgical wound in which the skin level has been closed, by any means, during the original surgery. In this table, 79% of primary closure abdominal SSI pathogens are from colon procedures.
Non-primary closure technique is defined as the closure of a surgical wound in which the skin level has been left completely open. In this table, 87% of non-primary closure abdominal SSI pathogens are from colon procedures.