Evaluation of Surgical Site Infections in Cancer Patients Following Major Oncologic Procedures

Background: Surgical site infections (SSIs) are an important cause of morbidity and mortality for cancer patients undergoing major oncologic procedures, but we have limited data on incidence, risk factors, and outcomes in this patient population. Objectives: This study aimed to evaluate the medical and surgical characteristics, risk factors, microbiological milieu, antibiotic susceptibility, and postoperative outcomes of surgical site infections (SSIs) among a cohort of cancer patients undergoing major oncologic surgery. Materials and Methods: A prospective, observational study was carried out in 128 cancer patients undergoing major surgery at the Department of General Surgery, JIMSH, Kolkata, India. Data collection included patient demographics, comorbidities, previous treatment, type of surgery, invasive device usage, and administration of prophylactic antibiotics. Wound cultures were performed for identification of pathogens and testing of antibiotic susceptibility. Statistical analysis was completed to identify risk factors for SSIs and postoperative mortality. Results: A total of 128 post-operative surgical patients, 71 (55.5%) patients developed SSIs. The SSI patients tended to be older (mean age 49.6 years vs 43.2 years), more common in males, and they represented a significant risk with prolonged hospitalization, intra-operational blood loss, and invasive devices usage. Gram-negative bacteria were recovered from over 81.8% of the cultures, with Pseudomonas aeruginosa and Escherichia coli being the most common; 48% of the isolates were multidrug-resistant pathogens (resistant to antibiotics). Patients that developed SSIs had significantly increased mortality (43.7% vs 3.5%) and increased duration of stay. Additionally, the use of routine antibiotic prophylaxis differed between the two groups. Conclusion: SSIs continue to pose significant challenges in cancer surgical procedures, involving multidrugresistant pathogens, increased length of stay, and increased mortality. Reducing the risk of SSIs is complex and requires individualized prophylaxis approaches, high-quality perioperative management, and improved infection prevention measures that will help to reduce overall SSIs in this patient population.