A prospective study of surgical site infections in a tertiary care hospital

Background: Among the Health care associated infections (HAI), surgical site infections (SSI) previously termed as post-operative wound infections are one of the most common HAI in low and middle income countries. Increase in SSI is associated with increased morbidity, as well as mortality due to emergence of antimicrobial resistant pathogens. Understanding the pathogens implicated in causing the SSIs and their antimicrobial sensitivity place a good role in reducing the mortality and morbidity.Methods: A prospective study was conducted at a tertiary care hospital to all the patients admitted in Department of surgery, Orthopedics and Gynecology and Obstetrics for six months from January 2016 to June 2016. The demographic data, inclusion criteria and exclusion criteria, risk factors, clinical history, laboratory data with gram stain, culture results and antibiotic sensitivity of the isolates were collected.Results: Two hundred patients were recruited in the study and the prevalence of SSI in the study was 3.83%. Patients who underwent emergency operations and diabetics were at higher risk of acquiring SSI. The most commonly isolated pathogens in the study were Staphylococcus aureus, Escherichia coli, and Pseudomonas aeruginosa. Pseudomonas aeruginosa was most common isolate from orthopedic cases of SSI, Escherichia coli was most common isolate from intestinal surgeries and Staphylococcus aureus from LSCS. Increased rate of isolation of MRSA and ESBL strains were observed in the study.Conclusions: Study clearly explains the various causes and risk factors associated in development of SSI. The study guides in the type of the organism isolated and possible antibiotic of choice in treatment and management of SSI. The prevalence of SSI was 3.83%, which is comparable with some of the studies and lower than many of the studies.

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A prospective study on risk factors for development of surgical site infections at a tertiary care hospital: a two years study

International Surgery Journal ◽

10.18203/2349-2902.isj20180113 ◽

2018 ◽

Vol 5 (2) ◽

pp. 460

Author(s):

Vakamudi Prakash ◽

Ramalinga Reddy Rachamalli ◽

Jithendra Kandati ◽

Sreeram Satish

Keyword(s):

Risk Factors ◽

Staphylococcus Aureus ◽

Nosocomial Infections ◽

Antibiotic Susceptibility ◽

Tertiary Care Hospital ◽

Tertiary Care ◽

Surgical Site Infections ◽

Care Hospital ◽

Multiple Factors ◽

The Common

Background: Surgical site infections (SSI) are the second most common Nosocomial infections after urinary tract infections accounting to 20-25% of Nosocomial infections worldwide. Based on the depth of the infections, SSI is classified by CDC as superficial incisional, deep incisional and organ/space. The development of SSI is dependent upon multiple factors like class of wound, immune status, type of surgery, type of anesthesia; surgical techniques etc and are interplay of multiple factors. Objective of the present study was conducted in identifying the predictors, risk factors and incidence rates of SSI at a tertiary care hospital. The study also identifies the causative bacterial pathogens and their antibiotic susceptibility patternMethods: A prospective cross-sectional study was conducted for a period of two years by department of general surgery involving all patients who underwent surgery, and pre-operative, intra operative and risk factors of the cases were collected using standardized data collection form. Specimens from the infected wounds were collected and processed for isolation of pathogens. Antibiotic susceptibility of pathogens was done using standard guidelines.Results: The incidence of SSI in present study was 25.34% with 81.58% superficial SSI and 18.42% deep SSI. Laparotomy was the common procedure and 63.2% of cases were females and 41-60 years was the most common age group. Staphylococcus aureus, Klebsiella pneumoniae and Escherichia coli were the common pathogens and were sensitive to carbapenems, vancomycin and linezolid. Significant association was observed with presence of pre-morbid analysis, presence of drain, use of povidone iodine alone and development of SSI.Conclusions: In present study the incidence of SSI was significantly high in this hospital and associated with premorbid illness, duration of surgery, presence of drain and use of drain at site of surgery. Staphylococcus aureus was the common pathogen and incidence of MRSA is higher than many other reports. A continuous monitoring and surveillance of patients with a predefined protocol will help in early identification of cases with risk of development of SSI. A feedback of appropriate data to surgeons is highly recommended to reduce the SSI rate in developing countries.

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