The spread of drug-resistant bacteria is significantly increasing the challenges of preventing surgical infection in poor countries, according to a global analysis by a British research team.
This is creating an “urgent need” to tackle surgical infection in these low income countries, according to the study published in The Lancet Infectious Diseases.
It also raises questions about antibiotic use and whether inappropriate use is worsening problems in some regions, according to the researchers.
Experts at the universities of Birmingham, Edinburgh and Warwick worked together on the project, analysing records of more than 12,000 patients from 66 countries undergoing gastrointestinal surgery.
They found that patients in low income countries were 60% more likely than those in high and middle-income countries to develop an operation following an infection.
Overall 22% of infections were antibiotic resistant – varying from 17% in wealthy western countries to 36% in low income African countries.
Researcher Ewan Harrison, from Edinburgh, said: “The level of antibiotic resistance is higher than we would have expected. It’s something we should be concerned about and we need to come up with a strategy to deal with it.
“So even though there are higher levels of antibiotic resistance in other countries that does mean something for the UK as well.”
Professor Dion Morton, from Birmingham, said: “Countries with a low Human Development Index carry a disproportionately greater burden of surgical infections than countries with a middle or high Human Development Index.
“In view of World Health Organisation recommendations on measures for surgical site infection prevention that highlight the absence of high-quality evidence for interventional research, urgent, pragmatic, randomised trials are needed to assess measures aiming to reduce this preventable complication.”
Surgical site infection after gastrointestinal surgery in high-income, middle-income, and low-income countries: a prospective, international, multicentre cohort study. Lancet Infectious Diseases 14 February 2018 [abstract]
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