Recently, the global prevalence of extended spectrum beta-lactamases (ESBL)-producing Enterobacteriaceae has been increasing, with significant implications for community-acquired and healthcare-associated infections. Although antimicrobial prophylaxis is a standard practice for preventing postoperative infections, ESBL-producing bacteria are frequently not covered by current regimens. This study aimed to assess the prevalence of ESBL carriage among patients scheduled for gastrointestinal and genitourinary tract surgeries. We conducted an observational analysis at the Lebanese American University Medical Center-Rizk Hospital in Lebanon from February 4, 2013, to July 15, 2014. The study population included 126 patients, with 23.8% ESBL carriers. Higher carriage was observed with the higher age group. In the bivariate analysis, smoking and recent antibiotic use showed a significant difference for ESBL carriage, similarly for the previous admission and the length or type of hospitalization. After the multivariate analysis, only smoking status remained a significant factor. No patients developed surgical site infection. The ESBL carriage rate in our institution is high compared with international prevalence. Smoking remained the main risk factor. Despite this, none of the recruited patients who underwent gastrointestinal or genitourinary tract surgeries developed surgical site infections. Therefore, it is suggested that infections with ESBL-producing organisms can be multifactorial and not only related to colonization alone. To explore risk factors, further larger studies are warranted.
Farra et al. (Fri,) studied this question.