Impact of the COVID-19 pandemic on surgical site infections: a multi-center study evaluating incidence, pathogen distribution, and antimicrobial resistance patterns

Abstract Background Surgical site infections (SSIs) are among the most significant concerns in healthcare settings, presenting challenges in patient management and healthcare outcomes. The emergence of the COVID-19 pandemic has further complicated the landscape of infectious disease epidemiology, im...

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Main Authors: Şiran Keske, Elif Sargın Altunok, Emel Azak, Ezgi Gülten, Tuğba Arslan Gülen, Çiğdem Ataman Hatipoğlu, Ali Asan, Derya Korkmaz, Bahar Kaçmaz, Yeşim Kızmaz, Ayşe Batırel, Fethiye Akgül, Derya Yapar, Zehra Çağla Karakoç, Ayşe Serra Özel, Tuğba Yanık Yalçın, Deniz Özer, Özge Eren Korkmaz, Ahmet Şahin, Muhammed Fatih Karaşın, Tuba Turunç, Mehtap Aydın, Neşe Demirtürk, Alpay Azap, Önder Ergönül
Format: Article
Language:English
Published: BMC 2025-07-01
Series:Antimicrobial Resistance and Infection Control
Online Access:https://doi.org/10.1186/s13756-025-01542-5
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author Şiran Keske
Elif Sargın Altunok
Emel Azak
Ezgi Gülten
Tuğba Arslan Gülen
Çiğdem Ataman Hatipoğlu
Ali Asan
Derya Korkmaz
Bahar Kaçmaz
Yeşim Kızmaz
Ayşe Batırel
Fethiye Akgül
Derya Yapar
Zehra Çağla Karakoç
Ayşe Serra Özel
Tuğba Yanık Yalçın
Deniz Özer
Özge Eren Korkmaz
Ahmet Şahin
Muhammed Fatih Karaşın
Tuba Turunç
Mehtap Aydın
Neşe Demirtürk
Alpay Azap
Önder Ergönül
author_facet Şiran Keske
Elif Sargın Altunok
Emel Azak
Ezgi Gülten
Tuğba Arslan Gülen
Çiğdem Ataman Hatipoğlu
Ali Asan
Derya Korkmaz
Bahar Kaçmaz
Yeşim Kızmaz
Ayşe Batırel
Fethiye Akgül
Derya Yapar
Zehra Çağla Karakoç
Ayşe Serra Özel
Tuğba Yanık Yalçın
Deniz Özer
Özge Eren Korkmaz
Ahmet Şahin
Muhammed Fatih Karaşın
Tuba Turunç
Mehtap Aydın
Neşe Demirtürk
Alpay Azap
Önder Ergönül
author_sort Şiran Keske
collection DOAJ
description Abstract Background Surgical site infections (SSIs) are among the most significant concerns in healthcare settings, presenting challenges in patient management and healthcare outcomes. The emergence of the COVID-19 pandemic has further complicated the landscape of infectious disease epidemiology, impacting the distribution and resistance characteristics of pathogens responsible for SSIs. Understanding these dynamics is essential for improving infection prevention and treatment strategies. Methods This retrospective multi-center study included 17 hospitals in Turkey, analyzing SSI cases from January 2019 to January 2023. The study was divided into three phases: pre-pandemic (January 2019 - March 2020), early pandemic (March 2020 - January 2022), and late pandemic (January 2022 - January 2023). We assessed demographic and clinical characteristics, pathogen distributions, and resistance rates, focusing on multidrug-resistant (MDR) pathogens. Results A total of 2,058 patients with SSIs were included. The SSI rate increased from 0.79% in 2019 to 0.87% in 2020, then decreased to 0.46% in 2021 and 0.50% in 2022. The most prevalent pathogens were E. coli (21.9%) and K. pneumoniae (14.6%). Resistance to meropenem in K. pneumoniae rose from 23% pre-pandemic to 33% post-pandemic, while ceftazidime-avibactam resistance surged from 6 to 43%. P. aeruginosa showed increased quinolone resistance from 18 to 27%, with colistin resistance rising to 13% in the late pandemic phase. Conclusions This study highlights the significant impact of the COVID-19 pandemic on SSIs in Turkey, revealing concerning trends in antibiotic resistance among key pathogens. Ongoing surveillance and enhanced infection control measures are essential to address these challenges and improve patient outcomes in the post-pandemic era.
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publishDate 2025-07-01
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series Antimicrobial Resistance and Infection Control
spelling doaj-art-7bdd2318b4bb40cbb79ba8da64b7b4eb2025-08-20T03:42:00ZengBMCAntimicrobial Resistance and Infection Control2047-29942025-07-011411710.1186/s13756-025-01542-5Impact of the COVID-19 pandemic on surgical site infections: a multi-center study evaluating incidence, pathogen distribution, and antimicrobial resistance patternsŞiran Keske0Elif Sargın Altunok1Emel Azak2Ezgi Gülten3Tuğba Arslan Gülen4Çiğdem Ataman Hatipoğlu5Ali Asan6Derya Korkmaz7Bahar Kaçmaz8Yeşim Kızmaz9Ayşe Batırel10Fethiye Akgül11Derya Yapar12Zehra Çağla Karakoç13Ayşe Serra Özel14Tuğba Yanık Yalçın15Deniz Özer16Özge Eren Korkmaz17Ahmet Şahin18Muhammed Fatih Karaşın19Tuba Turunç20Mehtap Aydın21Neşe Demirtürk22Alpay Azap23Önder Ergönül24Infectious Diseases and Clinical Microbiology, Koç University School of MedicineInfectious Diseases and Clinical Microbiology, University of Health Sciences, Kartal Dr. Lutfi Kirdar City HospitalFaculty of Medicine, Infectious Diseases and Clinical Microbiology, Kocaeli UniversityInfectious Diseases and Clinical Microbiology, Ankara University School of MedicineInfectious Diseases and Clinical Microbiology, University of Health Sciences, Adana City Training and Research HospitalInfectious Diseases and Clinical Microbiology, University of Health Sciences, Ankara Training and Research HospitalInfectious Diseases and Clinical Microbiology, University of Health Sciences, Bursa Yuksek Ihtisas Training and Research HospitalFaculty of Medicine, Infectious Diseases and Clinical Microbiology, Afyonkarahisar Health Sciences UniversityInfectious Diseases and Clinical Microbiology, VKV American HospitalInfectious Diseases and Clinical Microbiology, University of Health Sciences, Koşuyolu High Specialization Education and Research HospitalInfectious Diseases and Clinical Microbiology, University of Health Sciences, Kartal Dr. Lutfi Kirdar City HospitalInfectious Diseases and Clinical Microbiology, Batman Training and Research HospitalFaculty of Medicine, Infectious Diseases and Clinical Microbiology, Hitit UniversityFaculty of Medicine, Infectious Diseases and Clinical Microbiology, Istinye UniversityInfectious Diseases and Clinical Microbiology, University of Health Sciences, Umraniye Training and Research HospitalFaculty of Medicine, Infectious Diseases and Clinical Microbiology, Baskent UniversityFaculty of Medicine, Infectious Diseases and Clinical Microbiology, Manisa Celal Bayar UniversityEpidemiology, Dokuz Eylül UniversityInfectious Diseases and Clinical Microbiology, Gaziantep Dr. Ersin Arslan Training and Research HospitalFaculty of Medicine, Infectious Diseases and Clinical Microbiology, Kocaeli UniversityInfectious Diseases and Clinical Microbiology, University of Health Sciences, Adana City Training and Research HospitalInfectious Diseases and Clinical Microbiology, University of Health Sciences, Umraniye Training and Research HospitalFaculty of Medicine, Infectious Diseases and Clinical Microbiology, Afyonkarahisar Health Sciences UniversityInfectious Diseases and Clinical Microbiology, Ankara University School of MedicineInfectious Diseases and Clinical Microbiology, Koç University School of MedicineAbstract Background Surgical site infections (SSIs) are among the most significant concerns in healthcare settings, presenting challenges in patient management and healthcare outcomes. The emergence of the COVID-19 pandemic has further complicated the landscape of infectious disease epidemiology, impacting the distribution and resistance characteristics of pathogens responsible for SSIs. Understanding these dynamics is essential for improving infection prevention and treatment strategies. Methods This retrospective multi-center study included 17 hospitals in Turkey, analyzing SSI cases from January 2019 to January 2023. The study was divided into three phases: pre-pandemic (January 2019 - March 2020), early pandemic (March 2020 - January 2022), and late pandemic (January 2022 - January 2023). We assessed demographic and clinical characteristics, pathogen distributions, and resistance rates, focusing on multidrug-resistant (MDR) pathogens. Results A total of 2,058 patients with SSIs were included. The SSI rate increased from 0.79% in 2019 to 0.87% in 2020, then decreased to 0.46% in 2021 and 0.50% in 2022. The most prevalent pathogens were E. coli (21.9%) and K. pneumoniae (14.6%). Resistance to meropenem in K. pneumoniae rose from 23% pre-pandemic to 33% post-pandemic, while ceftazidime-avibactam resistance surged from 6 to 43%. P. aeruginosa showed increased quinolone resistance from 18 to 27%, with colistin resistance rising to 13% in the late pandemic phase. Conclusions This study highlights the significant impact of the COVID-19 pandemic on SSIs in Turkey, revealing concerning trends in antibiotic resistance among key pathogens. Ongoing surveillance and enhanced infection control measures are essential to address these challenges and improve patient outcomes in the post-pandemic era.https://doi.org/10.1186/s13756-025-01542-5
spellingShingle Şiran Keske
Elif Sargın Altunok
Emel Azak
Ezgi Gülten
Tuğba Arslan Gülen
Çiğdem Ataman Hatipoğlu
Ali Asan
Derya Korkmaz
Bahar Kaçmaz
Yeşim Kızmaz
Ayşe Batırel
Fethiye Akgül
Derya Yapar
Zehra Çağla Karakoç
Ayşe Serra Özel
Tuğba Yanık Yalçın
Deniz Özer
Özge Eren Korkmaz
Ahmet Şahin
Muhammed Fatih Karaşın
Tuba Turunç
Mehtap Aydın
Neşe Demirtürk
Alpay Azap
Önder Ergönül
Impact of the COVID-19 pandemic on surgical site infections: a multi-center study evaluating incidence, pathogen distribution, and antimicrobial resistance patterns
Antimicrobial Resistance and Infection Control
title Impact of the COVID-19 pandemic on surgical site infections: a multi-center study evaluating incidence, pathogen distribution, and antimicrobial resistance patterns
title_full Impact of the COVID-19 pandemic on surgical site infections: a multi-center study evaluating incidence, pathogen distribution, and antimicrobial resistance patterns
title_fullStr Impact of the COVID-19 pandemic on surgical site infections: a multi-center study evaluating incidence, pathogen distribution, and antimicrobial resistance patterns
title_full_unstemmed Impact of the COVID-19 pandemic on surgical site infections: a multi-center study evaluating incidence, pathogen distribution, and antimicrobial resistance patterns
title_short Impact of the COVID-19 pandemic on surgical site infections: a multi-center study evaluating incidence, pathogen distribution, and antimicrobial resistance patterns
title_sort impact of the covid 19 pandemic on surgical site infections a multi center study evaluating incidence pathogen distribution and antimicrobial resistance patterns
url https://doi.org/10.1186/s13756-025-01542-5
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