Vancomycin Use in Posterior Lumbar Interbody Fusion of Deep Surgical Site Infection

Figures & data

Figure 1 The rate of deep surgical site infection between two group.

Table 1 Demographic and Clinical Characteristics of Lumbar Fusion Patients Treated or Not with Vancomycin Intraoperatively. Factors Included in the Study and Intra-Group Comparison Between the Two Groups

Patient Factors		Control Group		P	Treatment Group		P
		DSSI	Non-DSSI		DSSI	Non-DSSI
Gender	Male, n (%)	8 (61.5%)	148 (42.2%)	0.166	2 (28.6%)	232 (44.6%)	0.641
	Female, n (%)	5 (38.5%)	203 (57.8%)		5 (71.4%)	288 (55.4%)
Age (years)		57.08±8.29	52.82±9.63	0.117	62.29±5.68	56.02±19.58	0.398
Body mass index (kg/m^2)		25.69±1.95	23.20±3.39	0.001*	24.97±4.08	23.28±3.33	0.186
Smoking (yes)		5 (38.5%)	95 (27.1%)	0.366	2 (28.6%)	123 (23.7%)	1.000
Alcohol abuse (yes)		4 (30.8%)	45 (12.8%)	0.063	2 (28.6%)	66 (12.7%)	0.498
Diabetes mellitus (yes)		3 (23.1%)	21 (6.0%)	0.062	1 ((14.3%)	28 (5.4%)	0.848
Hypertension (yes)		5 (38.5%)	84 (23.9%)	0.231	3 (42.9%)	121 (23.3%)	0.444
Hyperuricemia (yes)		1 (7.7%)	23 (6.6%)	1.000	2 (28.6%)	57 (58.2%)	0.387
Urinary tract infection (yes)		2 (15.4%)	23 (6.6%)	0.498	2 (28.6%)	36 (6.9%)	0.143
Preoperative hospital stay (days)		7.85±4.95	5.91±3.04	0.185	6.29±2.69	6.12±3.74	0.909
Number of surgical levels (n)		1.62±0.87	1.35±0.56	0.292	1.43±0.54	1.35±0.57	0.715
Intraoperative blood loss (mL)		442.31±299.20	417.98±270.00	0.751	378.57±186.76	313.82±231.71	0.462
Surgical duration of operation (min)		181.15±38.58	184.15±60.63	0.860	130.00±16.58	161.38±47.22	0.002*
Postoperative drainage volume (mL)		261.62±222.92	438.50±325.88	0.053	572.00±270.19	445.69±464.99	0.474
Number of internal fixations (n)		8.38±1.85	7.80±1.69	0.226	7.29±0.76	7.47±1.91	0.800
Blood transfusion (n)		5 (38.5%))	100 (28.5%)	0.436	5 (71.4%)	127 (24.4%)	0.016*
Postoperative catheter dwell time in dwelling (days)		1.77±1.17	2.55±1.71	0.103	2.86±2.97	2.76±3.41	0.940

Note: *Significantly different at p < 0.05.

Table 2 Effect of Intrawound Vancomycin on the Rate of Deep Surgical Site Infection

		Local Vancomycin Treatment		Total	P	χ^2
		No	Yes
DSSI	Yes	13 (65.0%)	7 (35.0%)	20 (100%)	0.026	4.937
	No	351 (40.30%)	520 (59.70%)	871 (100%)
Rate		13/364 (3.57%)	7/527 (1.33%)	20/891 (2.24%)

Table 3 Microorganisms in the Surgical Site

Infectious Agent	Patients (n)	Control Group	Treatment Group
Escherichia coli	4	1	3
Enterobacter cloacae	1	1	0
Klebsiella pneumoniae	1	1	0
Multidrug-resistant Staphylococcus epidermis	1	1	0
Staphylococcus haemolyticus	1	1	0
Gram-positive coccus	1	0	1
Negative microbial culture	11	8	3

Note: Microbiological culture in 20 patients with surgical site infections after lumbar fusion.

Table 4 Multivariate Logistic Regression Analysis of Risk Factors for Deep Surgical Site Infections

	Risk Factors	OR (95% CI)	B (SE)	Wald (df)	P
Total sample	Vancomycin (0: no, 1: yes)	0.25 (0.087–0.718)	−1.38 (0.54)	6.64 (1)	0.010
	Body mass index (kg/m^2)	1.21 (1.061–1.381)	0.191 (0.07)	8.05 (1)	0.005
	Alcohol abuse (0: no, 1: yes)	5.19 (1.65–16.30)	1.65 (0.58)	7.96 (1)	0.005
	Diabetes mellitus (0: no, 1: yes)	4.23 (1.15–15.55)	1.44 ((0.67)	4.70 (1)	0.030
	Urinary tract infection (0: no, 1: yes)	4.49 (1.25–16.10)	1.50 (0.65)	5.32 (1)	0.021
	Blood transfusion (n)	3.67 (1.135–11.867)	1.30 (0.599)	4.72 (1)	0.030
Control group	Body mass index (kg/m^2)	1.28 (1.061–1.549)	0.25 (0.10)	6.64 (1)	0.010
	Diabetes mellitus (0: no, 1: yes)	9.65 (1.921–48.516)	2.27 (0.82)	7.58 (1)	0.006
	Number of surgical levels (n)	4.17 (1.553–11.193)	1.43 (0.50)	8.03 (1)	0.005
	Postoperative drainage volume (mL)	0.996 (0.992–0.999)	−0.004 (0.002)	5.99 (1)	0.014
Treatment group	Surgical duration (min)	0.97 (0.941–0.996)	−0.032 (0.014)	5.05 (1)	0.025
	Perioperative Blood transfusion (n)	16.75 (2.858–98.164)	2.82 (0.90)	9.76 (1)	0.002