Surgical Site Infections - A Hospital Havoc: Retrospective Study of Surgical Site Infections in Tertiary Health Care Centre in North East India

2018 ◽  
Vol 3 (01) ◽  
Author(s):  
V Singh ◽  
A B Khyriem, W V Lyngdoh ◽  
C J Lyngdoh
Keyword(s):  
Surgical Site Infection ◽  
Multiple Drug Resistance ◽  
Surgical Site Infections ◽  
Multidrug Resistant ◽  
Multiple Drug ◽  
Site Infection ◽  
Retrospective Case ◽  
Acinetobacter Baumanii ◽  
Health Care Centre ◽  
North East

Objectives - Surgical site infections (SSI) has turn out to be a major problem even in hospital with most modern facilities and standard protocols of pre -operative preparation and antibiotic prophylaxis. Objective of this study is to know the prevalence of surgical site infection among the postoperative patients and to identify the relationship between SSI and etiological pathogens along with their antimicrobial susceptibility at North Eastern Indira Gandhi Regional Institute of Health and Medical Sciences (NEIGRIHMS), Shillong. Methods - A retrospective case study conducted at NEIGRIHMS, among patients admitted to the surgical departments during the period between January 1st and December 31st 2016. Swabs from the surgical sites were collected under sterile conditions and standard bacteriological tests were performed for identification and appropriate statistical methods were employed to look for association between SSI and etiological pathogens. Results - Out of the 1284 samples included in the study, 192 samples showed evidence of SSI yielding an infection rate of 14.9%. The most commonly isolated bacteria were: Escherichia coli, Acinetobacter baumanii and Staphylococcus aureus, of the gram negative isolates 6.2% were multidrug resistant of which 19% were carbapenem resistant. Conclusion - SSI with multiple drug resistance strains and polymicrobial etiology reflects therapeutic failure. The outcome of the SSI surveillance in our hospital revealed that in order to decrease the incidence of SSI we would have to: a) incorporate a proper antibiotic stewardship  b) conduct periodic surveillance to keep a check on SSI d) educate medical staffs regarding the prevention of surgical site infection.

scholarly journals Multidrug-Resistant Orthopaedic Surgical Site Infections Treated with Linezolid in Four Dogs

VCOT Open ◽  
2020 ◽  
Vol 03 (02) ◽  
pp. e72-e76
Author(s):  
Po-Yen Chou ◽  
Jin Yoon ◽  
Rebecca A. Hersh-Boyle ◽  
Denis J. Marcellin-Little
Keyword(s):  
Side Effects ◽  
Surgical Site Infection ◽  
Adverse Drug Events ◽  
Clinical Signs ◽  
Surgical Site Infections ◽  
Site Infection ◽  
Case Review ◽  
Retrospective Case ◽  
Drug Concentrations ◽  
Linezolid Therapy

Abstract Objective This study aimed to report the adverse drug events and treatment outcome of systemic linezolid therapy to manage multi-drug resistant orthopaedic surgical site infection in dogs. Materials and Methods Retrospective case review of four dogs that received linezolid to treat surgical site infections after orthopaedic surgery. Reevaluations consisted of a clinical examination or a telephone interview. Results Serum drug concentrations varied. All dogs showed a temporary resolution of clinical signs of surgical site infection. Two dogs that received linezolid at the previously reported dose developed drug-associated side effects. The side effects were anorexia, nausea, vomiting and regenerative anaemia. All side effects resolved after the discontinuation of linezolid. Surgical site infection recurred in two dogs 52 and 177 days after discontinuing linezolid respectively. Clinical significance Adverse drug events occurred in dogs receiving oral linezolid at the dosage of 10 to 20 mg/kg. Oral linezolid therapy failed to resolve deep orthopaedic surgical site infections in two out of four dogs. As a tertiary antimicrobial, linezolid should only be used in carefully selected cases while monitoring for drug-associated side effects.

scholarly journals Epidemiological Characteristics and Predisposing Factors for Surgical Site Infections Caused by Bacterial Pathogens Exhibiting Multidrug-Resistant Patterns

Antibiotics ◽  
2021 ◽  
Vol 10 (6) ◽  
pp. 622
Author(s):  
Abdikarim Hussein Mohamed ◽  
Hussein Ali Mohamud ◽  
Ebubekir Arslan
Keyword(s):  
Multidrug Resistance ◽  
Antimicrobial Resistance ◽  
Surgical Site Infection ◽  
Surgical Site Infections ◽  
Antibiotic Use ◽  
Multidrug Resistant ◽  
Site Infection ◽  
Antimicrobial Sensitivity ◽  
Study Results ◽  
Epidemiological Characteristics

Background: Surgical site infection is the most common kind of nosocomial infection in developed and developing countries. Objectives: Our aim was to identify the prevalence of factors predisposing to multidrug resistance and the antimicrobial susceptibility profile of pathogens. Method: This retrospective study enrolled 10,878 patients who underwent operations in 2018–2020. Pathogens were identified using eosin methylene blue agar. Mueller–Hinton agar was used to assess antimicrobial sensitivity and resistance. In total, 382 patients with confirmed surgical site infection (SSI), whose culture showed growth, were included in the study. Results: The prevalence of SSI in the current study was 3.5%. Escherichia coli was the predominant pathogen (35.8%), followed by Staphylococcus aureus (21.8%). Antibiotic use, chronic renal failure, diabetes, and emergency operations were found to increase the likelihood of multidrug resistance (OR = 6.23, CI = 1.443–26.881, p = 0.014; OR = 5.67, CI = 1.837–19.64, p = 0.02; OR = 2.54, CI = 1.46–7.35, p = 0.03; OR = 1.885, CI = 1.067–3.332, p = 0.002, respectively). The pathogens showed different levels of antimicrobial resistance against ceftriaxone (72.7%), ciprofloxacin (46.6%), and gentamicin (34%). Antimicrobial resistance of about 1–3.4% was exhibited by linezolid, tigecycline, and teicoplanin. Conclusion: The study presented significantly increased multidrug-resistant (MDR) Enterobacteriaceae pathogens isolated from surgical sites. They involve significant morbidity and mortality rates and increased health-related costs.

scholarly journals Case-Control Study of Pediatric Cardiothoracic Surgical Site Infections

2008 ◽  
Vol 29 (1) ◽  
pp. 76-79 ◽  
Author(s):  
Galit Holzmann-Pazgal ◽  
Diane Hopkins-Broyles ◽  
Angela Recktenwald ◽  
Melinda Hohrein ◽  
Patricia Kieffer ◽  
...  
Keyword(s):  
Surgical Site Infection ◽  
Case Control Study ◽  
Unit Length ◽  
Operative Procedure ◽  
Significant Risk ◽  
Surgical Site Infections ◽  
Case Control ◽  
Site Infection ◽  
Retrospective Case ◽  
Control Study

A retrospective case-control study was performed to determine the risks and outcomes associated with pediatric cardiothoracic surgical site infection. Undergoing more than 1 cardiothoracic operative procedure, having preoperative infection, and undergoing surgery on a Monday were significant risk factors. Cardiothoracic surgical site infection increased hospital and pediatric intensive care unit length of stay. Deep surgical site infection significantly increased mortality.

scholarly journals Surgical site infections in emergency abdominal surgeries in a tertiary care hospital of North-East India

2020 ◽  
Vol 8 (12) ◽  
pp. 4278
Author(s):  
Sufil Gogoi ◽  
Sajeed Ahmed ◽  
Kalyan J. Dutta
Keyword(s):  
Surgical Site Infection ◽  
General Surgery ◽  
Tertiary Care ◽  
Surgical Site Infections ◽  
Care Hospital ◽  
Site Infection ◽  
Klebsiella Species ◽  
Female Ratio ◽  
Strict Adherence ◽  
North East

Background: Most of the emergency abdominal surgeries are either contaminated or dirty, they carry a higher rate of complications, aided by lack of optimization of the patient before surgery as opposed to elective surgeries. Complications related to surgical site encompasses a majority and may be aggravated by pre-existing co-morbid conditions. Seroma, hematoma, wound dehiscence, surgical site infection (SSI) are some of the major complications of surgical wounds. A prospective study was carried out in Department of General Surgery, Assam Medical College and Hospital (AMCH), Dibrugarh, Assam to find out the incidence of surgical site infection (SSI), clinical presentations and causative organisms including their antibiogram.Methods: Total 280 patients undergoing emergency abdominal surgeries in Department of General Surgery, AMCH from June 2017 to May 2018 were included in the study. Preoperative, intraoperative and post-operative details were collected, recorded and analysed. In case of SSI, wound swab was taken for culture and sensitivity and antibiotics tailored accordingly. Regular follow-up for at least 30 days post-operatively was maintained.Results: The incidence of SSI was 21.43%, with male: female ratio being 1.22:1. SSI was highest in the age group above 50 years; 33.33%, and with co-morbidities. SSI seen highest in class 4 wounds (55%). Commonest clinical features were erythema, tenderness, edema around the wound in superficial SSI and deep SSI. Organ space SSI was associated with fever, trachycardia and leucocytosis. The most common isolates were Staphylococcus aereus (55%), Escherichia coli (21.67%), Pseudomonas aeruginosa (11.67%), Klebsiella species (3.3%).  Conclusions: To reduce the incidence of SSI, strict adherence to antisepsis protocol specially during intraoperative and postoperative is of paramount importance in emergency surgeries.

INFLUENCE OF GENOTYPIC VARIABILITY OF M. TUBERCULOSIS ON THE COURSE OF TUBERCULOSIS WITH MULTIPLE DRUG RESISTANCE

2020 ◽  
pp. 68-71
Author(s):  
V. S. Krutko ◽  
L. H. Nikolaieva ◽  
T. V. Maistat ◽  
O. A. Oparin ◽  
Anton Viktorovych Rohozhyn
Keyword(s):  
Clinical Laboratory ◽  
Multiple Drug Resistance ◽  
Multidrug Resistant ◽  
Multiple Drug ◽  
Genotypic Variability ◽  
Intensive Phase ◽  
Resistant Tuberculosis ◽  
Multidrug Resistant Tuberculosis ◽  
Promising Area ◽  
Infection Source

Tuberculosis is infectious and socially dependent disease, being now one of the most pressing issues in practical health care. As well the usual types of tuberculosis infection, chemoresistant tuberculosis is spreading rapidly in the world. The WHO estimates that about 500,000 people on the planet are infected with M. tuberculosis, which is resistant to standard anti−tuberculosis drugs. The probability of successful treatment decreases with emergence of new genotypes of M. tuberculosis with total resistance. In the modern epidemiology of tuberculosis, it is important to identify genotypes on certain signs, allowing to address issues such as their origin, identification of the infection source, possible routes and factors of transmission, as well as to reveal cases and spread of resistance to anti−tuberculosis drugs. To evaluate the therapy efficiency of multidrug−resistant tuberculosis patients with revealed genotypic variability during treatment, 10 patients with chemoresistant pulmonary tuberculosis having M. tuberculosis genotypic variability were treated. In these patients, the clinical, laboratory and radiological dynamics of disease in intensive phase of treatment were studied. Analysis of treatment results for patients with chemoresistant tuberculosis with genotypic variability of M. tuberculosis was evaluated by the intoxication syndrome dynamics of, the timing of closure of the decay cavities and cessation of bacterial excretion. The study found that the genotypic variability of M. tuberculosis is characterized by the change of less virulent genotypes of M. tuberculosis to more virulent. Signs of intoxication have been shown to change from less virulent M. tuberculosis genotypes to M. tuberculosis Beijing genotypes. Genotypic variability of mycobacteria in hospital suggests that hospitalization in tuberculosis facilities is a risk of exogenous tuberculosis superinfection. Studying the influence of genotypic variability of M. tuberculosis on the course of multidrug−resistant tuberculosis requires more extensive research, being a very relevant and promising area in phthisiology. Key words: Mycobacterium tuberculosis, genotypic variability, VNTR−genotyping, treatment.

58 Use of Abdominal Wall or Sucutaneous Drain to Reduce the Risk of Surgical Site Infections

2021 ◽  
Vol 108 (Supplement_2) ◽  
Author(s):  
H Mistry ◽  
B Woolner ◽  
A John
Keyword(s):  
Surgical Site Infection ◽  
Open Cholecystectomy ◽  
Surgical Site Infections ◽  
Standard Operating Procedure ◽  
Site Infection ◽  
Infection Rates ◽  
Local Evidence ◽  
Audit Data ◽  
The Impact ◽  
To Receive

Abstract Introduction Open abdominal surgery confers potentially greater risk of surgical site infections, and local evidence suggests use of drains can reduce this. Our objectives were: Assessing local rates and risk factors of infections and if use of drains can reduce the rates of infections. Method Retrospectively looking from 01/01/2018 to 31/12/2018, at patients following laparotomy or open cholecystectomy. Data collection on demographics, smoking/alcohol status, heart, respiratory or renal disease or diabetes, steroid use and CEPOD status, as well as use of drain and the outcome of infection using inpatient and online patient records. Results 84 patients included, 25 had drains inserted. There were 13 documented cases of surgical site infection, all of whom had no drain post-op. Other parameters shown to be most prevalent in the patients with a surgical site infection include being current/ex-smoker (8/13), having heart disease (9/13), and elective procedures. Conclusions Aiming to reduce the risk of surgical site infections can improve morbidity and potentially mortality outcomes. Our audit data showed that there appears to be a benefit of inserting intra-abdominal or subcutaneous drains. We will create a standard operating procedure of all patient to receive drains post-op and then re-audit to assess the impact this has on infection rates.

Surgical Site Infection as a Surrogate Marker of Physician Impairment

2009 ◽  
Vol 30 (11) ◽  
pp. 1120-1122 ◽  
Author(s):  
Robert J. Sherertz ◽  
Tobi B. Karchmer
Keyword(s):  
Hepatitis C Virus ◽  
Hepatitis C ◽  
Surgical Site Infection ◽  
Surrogate Marker ◽  
Surgical Site Infections ◽  
Baseline Period ◽  
Site Infection ◽  
Hepatitis C Virus Infection ◽  
Physician Impairment

Our report details an implant-associated outbreak of surgical site infections related to the adverse effects of treatment for hepatitis C virus infection administered to surgeon X. During the 12-month period of this outbreak, 14 (9.5%) of 148 of surgeon X's patients developed a surgical site infection, a rate of SSI that was 8-fold higher than the rate during the 14-month baseline period or the 14-month follow-up period (P = .001), and higher than the rate among peer surgeons (P = .02).

scholarly journals Genomic Characterization of A Multidrug-resistant Citrobacter freundii Strain ZT01-0079 Co-Producing blaNDM-1 and blaSHV-12 using MiSeq and MinION

2020 ◽  
Author(s):  
Tingyan Zhang ◽  
Yanfeng Lin ◽  
Zhonghong Li ◽  
Xiong Liu ◽  
Jinhui Li ◽  
...  
Keyword(s):  
Resistance Genes ◽  
Southern Blotting ◽  
Multiple Drug Resistance ◽  
Carbapenem Resistance ◽  
Multidrug Resistant ◽  
Multiple Drug ◽  
Citrobacter Freundii ◽  
Rapid Spread ◽  
Genomic Characterization

Abstract Background: The emergence of multi-drug resistant Citrobacter freundii poses daunting challenges to the treatment of clinical infections. The purpose of this study was to characterize the genome of a C. freundii strain with an IncX3 plasmid encoding both the blaNDM-1 and blaSHV-12 genes.Methods: Strain ZT01-0079 was isolated from a clinical urine sample. The Vitek2 system was used for identification and antimicrobial susceptibility testing. The presence of blaNDM-1 was detected by PCR and sequencing. Conjugation experiments and Southern blotting were performed to determine the transferability of the blaNDM-1- carrying plasmid. Nanopore and Illumina sequencing were performed to better understand the genomic characteristics of the strain.Results: Strain ZT01-0079 was identified as C. freundii, and the coexistence of blaNDM-1 and multiple drug resistance genes was confirmed. Electrophoresis and Southern blotting showed that blaNDM-1 was located on a ~53kb IncX3 plasmid. The NDM-1-encoding plasmid was successfully transferred at a frequency of 1.68×10−3. Both blaNDM-1 and blaSHV-12 were located on the self-transferable IncX3 plasmid.Conclusion: The rapid spread of the IncX3 plasmid highlights the importance of continuous monitoring of the prevalence of NDM-1-encoding Enterobacteriaceae. Mutations of existing carbapenem resistance genes will bring formidable challenges to clinical treatment.

scholarly journals Study of efficacy of short course peri-operative antibiotics in clean contaminated surgeries

2017 ◽  
Vol 4 (8) ◽  
pp. 2455
Author(s):  
Shivakumar C. R. ◽  
Mohammad Fazelul Rahman Shoeb ◽  
Anil Reddy Pinate
Keyword(s):  
Surgical Site Infection ◽  
Infection Rate ◽  
Surgical Site Infections ◽  
Cost Effective ◽  
Site Infection ◽  
Medical Sciences ◽  
Short Course ◽  
Perioperative Antibiotics ◽  
Clean Contaminated ◽  
Hospital Acquired

Background: Surgical site infection is a one of the most common postoperative complication and causes significant postoperative morbidity and mortality. WHO described Hospital acquired infections as one of the major infectious diseases having huge economic impact. Perioperative antibiotics constitute the bulk of antimicrobial consumption in any hospital. We need to adapt the policies that decrease the incidence of postoperative wound infection.Methods: Patients undergoing elective surgeries for clean contaminated cases for various causes from 15th May 2014 to 15th June 2017 under Surgical 1st Unit of District hospital Gulbarga (Affiliated to Gulbarga Institute of Medical Sciences, Gulbarga) are included in our study. During this period, a total of 216 patients participated, of which 145 were males and 71 were females. Patients received two doses of perioperative antibiotics, first dose before surgery and second dose after surgery, 12 hours apart during this period.Results: In this study, surgical site infection rate is 2.3% in clean-contaminated surgeries.Conclusions: The findings indicate that a short course of perioperative antibiotics where in first dose is given 30 minutes to one hour before surgery and second dose is given 12 hours after surgery are sufficient and efficacious as infection rate is acceptable (1%-3%).Infection rate in our study was 2.3%. It is cost-effective as well for prevention of surgical site infections in clean-contaminated surgeries in Indian surgical setup.

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