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Infectious complications and managements for surgical site infections in genital Paget's disease
Author(s) -
Yamasaki O,
Asagoe K,
Otsuka M,
Oono T,
Iwatsuki K
Publication year - 2007
Publication title -
journal of the european academy of dermatology and venereology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.655
H-Index - 107
eISSN - 1468-3083
pISSN - 0926-9959
DOI - 10.1111/j.1468-3083.2006.02052.x
Subject(s) - medicine , perioperative , incidence (geometry) , staphylococcus aureus , sex organ , surgical wound , surgery , bacteria , biology , physics , optics , genetics
Background Extramammary Paget's disease is an intra‐epidermal carcinoma that occurs preferentially in genital areas. Patients with genital Paget's disease (GPD) sometimes develop severe post‐surgical infections because of this anatomical disadvantage. Objective To study perioperative micro‐organisms and surgical site infection (SSI) in GPD. Methods We examined micro‐organisms isolated from preoperative lesions, necrotic sites and infected wounds in 60 adult patients with GPD who underwent surgery at our hospital between November 1990 and December 2005. Based on the obtained microbiological data, we assessed the incidence, risk factors and treatment of SSI. Results The colonized organisms found in preoperative GPD were Enterobacteriaceae (27.6%), methicillin‐sensitive Staphylococcus aureus (MSSA) (22.4%) and coagulase‐negative staphylococci (CNS) (15.5%), among others . In the postoperative necrotic sites, the frequency of MSSA isolation was reduced to 9.4%, while Pseudomonas aeruginosa and methicillin‐resistant S. aureus (MRSA) both increased in frequency from 3.4% and 0% upon preoperative examination to 18.8% and 9.4%, respectively. The incidence of SSI was 15%. In 7 of 9 SSIs, MRSA and/or P. aeruginosa were isolated. Conclusion We have successfully identified a number of perioperative micro‐organisms in GPD. The present observations may be extremely useful in choosing appropriate antimicrobial agents for use in the surgical treatment of GPD.