Download PDF
CC BY-NC-ND 4.0 · South Asian J Cancer 2024; 13(02): 110-113
DOI: 10.1055/s-0043-1763282
Original Article
Head and Neck Cancer

Surgical Site Infection in Head and Neck Cancer Patients: Observations from A Tertiary Care Hospital

Surlu Vidya Rao
1   Department of Hospital Administration, Father Muller Medical College Hospital, Kankanady, Mangalore, Karnataka, India
,
Paul Simon
2   Department of Radiation Oncology, Father Muller Medical College Hospital, Kankanady, Mangalore, Karnataka, India
,
Elroy Saldanha
3   Department of General Surgery, Father Muller Medical College Hospital, Kankanady, Mangalore, Karnataka, India
,
Rekha Boloor
4   Department of Microbiology/Hospital Infection Control, Father Muller Medical College Hospital, Kankanady, Mangalore, Karnataka, India
,
Ramakrishna Pai Jakribettu
4   Department of Microbiology/Hospital Infection Control, Father Muller Medical College Hospital, Kankanady, Mangalore, Karnataka, India
,
Manjeshwar Shrinath Baliga
5   Father Muller Research Centre, Kankanady, Mangalore, Karnataka, India
› Author Affiliations
› Further Information
Also available at
   Permissions and Reprints

Abstract

Zoom Image
Ramakrishna Pai Jakribettu

Background Surgical site infections (SSIs) in head and neck cancer (HNC) patients can significantly affect the outcome of the surgery. Appropriate antimicrobial prophylaxis is needed for prevention of SSI.

Aim To study the causative agents causing SSI among the HNC patients and their drug resistance pattern.

Materials and Methods This was a retrospective study. The antibiotic suspectibility pattern of the aerobic bacteria isolated from the wound infection in the patients underwent surgery for head and neck cancer, admitted from January 2015 to December 2016 were added in the study. The demographic details of patients, pathogens isolated, and their antimicrobial susceptibility were collected, entered into Microsoft Excel, and statistical analysis was done as per percentage of isolates and drug resistance.

Results A total of 130 culture-positive pus samples were included in the study. The majority of the samples were from males (71.5%), one-third of the patients belonged to the sixth decade of their life. Buccal mucosa and tongue were the common cancer in the head and neck region. The common gram-negative pathogens were Klebsiella sp. and Acinetobacter sp. and Staphylococcus aureus and Enterococcus sp. among the gram-positive bacteria. Methicillin-resistant S. aureus isolation rate was noted to be as high as 64.28%. High levels of resistance to aminopenicillins, third generation cephalosporins, co-trimoxazole and fluoroquinolones among the gram-negative pathogens. Anti-MRSA drugs such as vancomycin, linezolid, and teicoplanin resistance was not seen among S. aureus.

Conclusion The resistance pattern among the pathogens isolated from SSI in HNC patients is alarming. So, implementation of strict infection control practices to prevent SSI rather than treating them with high end antimicrobials is the best option.

Keywords

head and neck Cancer - surgical site infection - multi-drug resistance - MRSA


Publication History

Article published online:
09 March 2023

© 2023. MedIntel Services Pvt Ltd. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

Thieme Medical and Scientific Publishers Pvt. Ltd.
A-12, 2nd Floor, Sector 2, Noida-201301 UP, India

 

  • References

  • 1 Bray F, Ferlay J, Soerjomataram I, Siegel RL, Torre LA, Jemal A. Global cancer statistics 2018: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin 2018; 68 (06) 394-424
    CrossrefPubMedGoogle Scholar
  • 2 Pai SI, Westra WH. Molecular pathology of head and neck cancer: implications for diagnosis, prognosis, and treatment. Annu Rev Pathol 2009; 4: 49-70
    CrossrefPubMedGoogle Scholar
  • 3 Nwawolo CC, Ajekigbe AT, Oyeneyin JO, Nwankwo KC, Okeowo PA. Pattern of head and neck cancers among Nigerians in Lagos. West Afr J Med 2001; 20 (02) 111-116
    PubMedGoogle Scholar
  • 4 Tobias JS. Cancer of the head and neck. BMJ 1994; 308 (6934): 961-966
    CrossrefPubMedGoogle Scholar
  • 5 Ologe FE, Adeniji KA, Segun-Busari S. Clinicopathological study of head and neck cancers in Ilorin, Nigeria. Trop Doct 2005; 35 (01) 2-4
    CrossrefPubMedGoogle Scholar
  • 6 Licitra L, Felip E. ESMO Guidelines Working Group. Squamous cell carcinoma of the head and neck: ESMO clinical recommendations for diagnosis, treatment and follow-up. Ann Oncol 2009; 20 (Suppl 4): 121-122
    CrossrefPubMedGoogle Scholar
  • 7 Andry G, Hamoir M, Leemans CR. The evolving role of surgery in the management of head and neck tumors. Curr Opin Oncol 2005; 17 (03) 241-248
    CrossrefPubMedGoogle Scholar
  • 8 Penel N, Fournier C, Lefebvre D, Lefebvre JL. Multivariate analysis of risk factors for wound infection in head and neck squamous cell carcinoma surgery with opening of mucosa. Study of 260 surgical procedures. Oral Oncol 2005; 41 (03) 294-303
    CrossrefPubMedGoogle Scholar
  • 9 Clinical and Laboratory Standards Institute (CLSI). Performance standards for antimicrobial susceptibility testing. 16th Informational Supplement (M100–S16). Wayne, PA: CLSI; 2015
    Google Scholar
  • 10 Avritscher EB, Cooksley CD, Rolston KV. et al. Serious postoperative infections following resection of common solid tumors: outcomes, costs, and impact of hospital surgical volume. Support Care Cancer 2014; 22 (02) 527-535
    CrossrefPubMedGoogle Scholar
  • 11 de Melo GM, Ribeiro KC, Kowalski LP, Deheinzelin D. Risk factors for postoperative complications in oral cancer and their prognostic implications. Arch Otolaryngol Head Neck Surg 2001; 127 (07) 828-833
    PubMedGoogle Scholar
  • 12 Hernaiz-Leonardo JC, Golzarri MF, Cornejo-Juárez P. et al. Microbiology of surgical site infections in patients with cancer: a 7-year review. Am J Infect Control 2017; 45 (07) 761-766
    CrossrefPubMedGoogle Scholar
  • 13 Sumathi BG. Bacterial pathogens of surgical site infections in cancer patients at a tertiary regional cancer centre, south India. Int J Curr Microbiol Appl Sci 2016; 5 (10) 605-616
    CrossrefGoogle Scholar
  • 14 Rolston KV, Nesher L, Tarrand JT. Current microbiology of surgical site infections in patients with cancer: a retrospective review. Infect Dis Ther 2014; 3 (02) 245-256
    CrossrefPubMedGoogle Scholar
  • 15 Zahran WA, Zein-Eldeen AA, Hamam SS, Elsayed Sabal MS. Surgical site infections: problem of multidrug-resistant bacteria. Menoufia Med J 2017; 30: 1005-1013
    CrossrefGoogle Scholar
  • 16 Omar AA, Al-Mousa HH. Surgical site infection complicating breast cancer surgery in Kuwait. ISRN Prev Med 2013; DOI: 10.5402/2013/295783.
    CrossrefPubMedGoogle Scholar
  • 17 Cloke DJ, Green JE, Khan AL, Hodgkinson PD, McLean NR. Factors influencing the development of wound infection following free-flap reconstruction for intra-oral cancer. Br J Plast Surg 2004; 57 (06) 556-560
    CrossrefPubMedGoogle Scholar