Microbiology and Antimicrobial Resistance of Surgical Site Infection After Inflammatory Bowel Disease Surgery: Prophylaxis–Spectrum Discordance in a Retrospective Cohort from Saudi Arabia

Background/Objectives: Surgical site infection (SSI) after surgery for inflammatory bowel disease (IBD) has not been described microbiologically in the Arabian Peninsula, where extended-spectrum beta-lactamase (ESBL) prevalence is high and prophylaxis remains largely cephalosporin-based. We described the microbiology of SSI after IBD surgery and the extent to which recovered microorganisms were expected to be covered by the prophylaxis administered.

Methods

We retrospectively studied consecutive gastrointestinal operations for IBD at a tertiary center in Jeddah, Saudi Arabia (April 2014 to November 2025). Of 118 eligible operations, 8 performed through a dirty/infected wound were reported separately, leaving a primary cohort of 110 operations in 91 patients. The primary outcome was deep incisional or organ/space SSI by CDC/NHSN criteria; models used cluster-robust standard errors for repeated operations. The microbiological analysis was exploratory.