IMR Press / EJGO / Volume 42 / Issue 4 / DOI: 10.31083/j.ejgo4204112
Open Access Original Research
Microbiological characteristics of early and late infectious complications following total pelvic exenteration due to cervical cancer recurrence—the significance of infections in long-term outcomes
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1 Department of Microbiology, The Franciszek Lukaszczyk Oncology Centre in Bydgoszcz, 85-796 Bydgoszcz, Poland
2 2nd Department of Obstetrics and Gynecology, Centre of Postgraduate Medical Education, Bielanski Hospital, 01-809 Warsaw, Poland
Eur. J. Gynaecol. Oncol. 2021 , 42(4), 742–751; https://doi.org/10.31083/j.ejgo4204112
Submitted: 10 May 2021 | Revised: 15 June 2021 | Accepted: 21 June 2021 | Published: 15 August 2021
Abstract

Objective: We analysed microbiological results of early and late infectious complications following total pelvic exenteration (TPE) due to cervical cancer recurrence and evaluated the significance of infections in patient survival. Methods: A retrospective study was conducted on 13 out of 31 patients who had undergone TPE due to cervical cancer, from February 2013 to January 2018. Results: Early and late infections occurred in 7 (53.8%) patients and 6 (46.1%) patients, respectively. Superficial and deep surgical site infections (SSIs) were the only ones that appeared as early infections. Late infections, besides SSIs (4/13; 30.8%), also included urinary infections (2/13; 15.4%). The most frequently isolated microorganisms were Enterococcus spp. (9/28; 32.1%) and Escherichia coli (6/28; 21.4%). There was no resistance to vancomycin, teicoplanin and linezolid among Enterocccus spp. Among gram-negative rods, there was no resistance to meropenem and imipenem. We found three ESBL (extended-spectrum ß-lactamase) producers. Patients diagnosed with early deep SSIs had a shortened median overall survival (5.0 months vs. 11.5 months, P = 0.03). Patient survival was neither related to the occurrence of early superficial infections nor to late infections. Conclusions: Our results suggest that early, especially early deep, SSI may worse the prognosis of patients after TPE. The time of infection management after the operation should be especially intensified within 1 month after TPE.

Keywords
Cervical cancer recurrence
Total pelvic exenteration
Post-operative infections
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