Current status of post-operative infections due to antimicrobial-resistant bacteria after digestive tract surgery in Japan: Japan Postoperative Infectious Complications Survey in 2015 (JPICS'15)

Surg Today. 2020 Jan;50(1):56-67. doi: 10.1007/s00595-019-01857-y. Epub 2019 Aug 9.


Purpose: We herein report the findings of the Japan Postoperative Infectious Complication Survey in 2015 (JPICS'15), which evaluated the rate of post-operative infections and colonization due to antimicrobial-resistant (AMR) bacteria after digestive tract surgery.

Methods: This survey by the Japan Society of Surgical Infection included patients undergoing digestive tract surgery at 28 centers between September 2015 and March 2016. Data included patient background characteristics, type of surgery, contamination status, and type of post-operative infections, including surgical site infections (SSIs), remote infections (RIs), and colonization.

Results: During the study period, 7,565 surgeries (of 896 types) were performed; among them, 905 cases demonstrated bacteria after digestive tract surgery. The survey revealed that post-operative infections or colonization by AMR bacteria occurred in 0.9% of the patient cohort, constituting 7.5% of post-operative infections, including 5.6% of SSIs and 1.8% of RIs. Extended-spectrum β-lactamase-producing Enterobacteriaceae and methicillin-resistant Staphylococcus aureus were the predominant AMR bacteria isolated from patients after digestive tract surgery. Patients infected with AMR bacteria had a poor prognosis.

Conclusion: Our results reveal that 7.5% of the post-operative infections were due to AMR bacteria, indicating the need for antibacterial coverage against AMR bacteria in patients with critical post-operative infections.

Keywords: Digestive tract surgery; Post-operative infection; Remote infection; Surgical site infection.

MeSH terms

  • Adult
  • Aged
  • Anti-Bacterial Agents / administration & dosage
  • Antibiotic Prophylaxis
  • Bacterial Infections / epidemiology*
  • Bacterial Infections / microbiology*
  • Cohort Studies
  • Digestive System Surgical Procedures / adverse effects*
  • Drug Resistance, Bacterial
  • Enterobacteriaceae / isolation & purification
  • Female
  • Humans
  • Japan / epidemiology
  • Male
  • Methicillin-Resistant Staphylococcus aureus / isolation & purification
  • Middle Aged
  • Postoperative Complications / epidemiology*
  • Postoperative Complications / microbiology*
  • Postoperative Complications / prevention & control
  • Prognosis
  • Surgical Wound Infection / epidemiology*
  • Surgical Wound Infection / microbiology*
  • Time Factors


  • Anti-Bacterial Agents