Thursday January 23, 2020

Surgical Infections More Common in Low-Income Countries, Study Finds

Overall, about one in 10 patients developed a surgical site infection. But in low-income countries, that rate rose to nearly one in four

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Infections at the site of surgery are the most common complications after operations.
Infections at the site of surgery are the most common complications after operations. Wikimedia Commons
  • Infections at the site of surgery are the most common complications after operations
  • Overall, about one in 10 patients developed a surgical site infection. But in low-income countries, that rate rose to nearly one in four
  • More than 1,500 health care providers took part in the research

Surgeries in low-income countries had higher rates of infections than those in higher-income countries, according to a new study published in The Lancet Infectious Diseases.

The authors said their report provided a starting point for making surgery safer.

Infections at the site of surgery are the most common complications after operations. These infections raise the cost of procedures that are already expensive. And they often make recovery longer and more painful.

Also Read: Tips That Will Help In Recovery From Surgery

The study looked at more than 12,000 gastrointestinal surgeries at 343 hospitals in 66 countries.

Marked difference

Overall, about one in 10 patients developed a surgical site infection. But in low-income countries, that rate rose to nearly one in four.

The study noted that hospitals in low-income countries gave patients more antibiotics than elsewhere, both before and after surgery. Wikimedia Commons
The study noted that hospitals in low-income countries gave patients more antibiotics than elsewhere, both before and after surgery. Wikimedia Commons

That’s after taking into account factors such as the patient’s health, the type of surgery and the condition being treated.

Other elements that could have been behind the difference included the kinds of facilities available in low-income countries, or how long it took to get patients to a hospital, said study co-author Ewen Harrison at the University of Edinburgh.

“If you’re in rural sub-Saharan Africa and you’re run over by a car, it may be a number of days before you can get to a hospital,” he said. “During that time, the infection can get into wounds.”

Drug resistance

Another component could have been the availability of effective antibiotics, Harrison said.

Antibiotics were nearly always given before surgery to prevent infection. But overall, about one in five surgical site infections were resistant to these antibiotics. The rate was higher in low-income countries — one in three — but the authors cautioned that they did not have enough data to draw firm conclusions.

Also Read: Study: Partial Dose of Yellow Fever Vaccine Provides Protection

Resistance generally develops faster the more antibiotics are used. The study noted that hospitals in low-income countries gave patients more antibiotics than elsewhere, both before and after surgery.

“That may be completely appropriate if the patients are needing the antibiotics,” Harrison said. “But that may also be an area where the unnecessary use of antibiotics could be reduced in order to reduce drug resistance.”

Antibiotics were nearly always given before surgery to prevent infection. Wikimedia Commons
Antibiotics were nearly always given before surgery to prevent infection. Wikimedia Commons

The authors’ next plan is to test different skin-cleaning techniques, antibiotic-impregnated stitches, and other simple, low-cost methods to reduce surgical site infections in low-income countries.

More than 1,500 health care providers took part in the research. Harrison said the study organizers “crowdsourced” their participants, using social media to recruit young surgeons-in-training around the world.

“They are really the driving force behind the change that we hope to happen,” he said.

Next Story

Gene Expression Signature in Blood May Predict Onset of Tuberculosis

This blood test may predict onset of tuberculosis

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Blood Test
Gene expression signatures in blood could be used to predict tuberculosis at a very early stage. PIxabay

Researchers, including one of Indian-origin, have revealed a blood test could predict the onset of tuberculosis three to six months before people become unwell, a finding which could help better target antibiotics and save countless lives. This test is a must for a healthy lifestyle.

For the findings, published in the journal Lancet Respiratory Medicine, researchers at University College London sought to identify which, if any, gene expression signatures in blood could be used to predict the disease at a very early stage and before symptoms

Gene expression signatures are single or combined measurements of levels of specific gene products and are being tested in a range of diseases to aid diagnosis, prognosis or prediction of the response to treatment.

Some are already being used to support the management of cancers, but none have reached the clinic in infectious diseases, such as tuberculosis (TB).

“Our findings establish the gene signatures in blood which show most promise for identifying people who are at risk of disease,” said study author Mahdad Noursadeghi, Professor at University College London.

Blood Test
The emergence of gene expression signature blood tests, which can aid diagnosis and early treatment, provides real hope for the management of infectious diseases. Pixabay

“Future development of a blood test based on these findings could make an important contribution to efforts to reduce the impact and spread of this deadly infection,” Noursadeghi added.

For this study, researchers initially conducted a systematic review of published gene signatures found to be present in blood samples from people with TB, compared to healthy individuals.

From this, 17 candidate gene expression signatures for TB were identified, and tested in more than 1,100 blood samples in published data sets from South Africa, Ethiopia, The Gambia, and the UK. Scientists analysed samples from people who had no TB symptoms at the time they gave blood. Those people were then followed up to identify which participants developed TB in the subsequent months.

Researchers found that eight of these signatures, including measurement of expression of a single gene, could predict the diagnosis of TB within three to six months, which falls within the accuracy required by the World Health Organisation (WHO) for new diagnostic tests.

This accuracy was achieved, by revealing the patients’ immune responses to bacteria before the symptoms of the disease develop. “The emergence of gene expression signature tests, which can aid diagnosis and early treatment, provides real hope for the management of infectious diseases,” said Indian-origin researcher and the study’s lead author Rishi Gupta.

Also Read- Premature Menopause More Likely to Increase Health Problems After 60

“In this study we identify multiple signatures to identify the onset of tuberculosis, which is extremely encouraging, potentially providing multiple targets for early detection,” Gupta added.

Further development of these tests could help identify people who will benefit most from preventative antibiotic treatment, in order to reduce the occurrence of tuberculosis, the researchers said. (IANS)