Fudan University, China
Baochi Liu received his Ph.D. from Zhengzhou University in 2007. He received his B.S.in 1983. He has many Peer-reviewed Publications in reputed journals. His research interest includes general surgery, surgery infection and trauma. He is currently working as a Director and Professor in Department of Surgery, Shanghai Publical Health Clinical Center Affi liated to Fudan University, Shanghai, China.
Objective: To analyze the risk factors aff ecting postoperative infectious complications in HIV-infected patients and explore the rational use of perioperative antibiotics. Methods: Retrospective analysis of 308 HIV-infected patients (male 272, female 36) who were operated at the Shanghai Public Health Clinical Center from Nov 2008 to Apr 2012. Th e patients were divided into postoperative infection and non-infection groups. Age and clinical variables were compared. Th e correlation between the method of surgical incision, surgical site infection (SSI) and postoperative sepsis were analyzed. Prophylactic antibiotics were used for patients with type I and II surgical incisions for no longer than 2 days. Patients with type III surgical incisions were administered antibiotics until infection was controlled. Antiretroviral therapy (ART) were used before operation for patients whose preoperative CD4 counts were <350 cells/μL,For those patients whose preoperative CD4 counts were <200 cells/μL, Sulfamethoxazole and fl uconazole were administered preoperatively as a prophylaxis against Pneumocystis carinii pneumonia and fungal infection. Results: 196 patients developed postoperative infectious complications with 7 mortalities. Preoperative CD4 counts, ratio of CD4/ CD8 cells, hemoglobin level, and postoperative CD4 counts, hemoglobin and albumin levels were risk factors of perioperative infection in HIV-infected patients. Patients with a preoperative CD4 count < 200cell/μl, anemia, or a postoperative CD4 count < 200cell/μl and albumin levels < 35g/L correlated with a higher rate of postoperative infection. Th ere was a signifi cant correlation between SSI and the type of surgical incision. Th e rate of SSI in patients with type I surgical incision was 2% and the patients with type II surgical incision was 38%. All the patients who received type III surgical incisions developed SSI. Patients with SSI were more likely to develop postoperative sepsis. Conclusions: HIV-infected patients are more likely to develop postoperative infectious complications. Rational use of antibiotics in HIV-infected patients could help to reduce the rate of postoperative infectious complications in these patients.