STUDY OF CLINICO BACTERIOLOGY OF POST OPERATIVE WOUND INFECTION

Introduction: Globally, surgical site infections (SSI) are known to be most common nosocominal infections in hospitalized patients after urinary tract infection. There are many studies which showed surgical site infection rates are reported globally as it range from 2.5% to 41.9% resulting in high morbidity and mortality. Surgical infections are those which caused infection as a result of a surgical procedure or those that require surgical intervention as part of their treatment which are characterized by breaking of anatomic defense mechanisms and are associated with greater morbidity, significant mortality, and increased cost of care. Though increasing the advance technology in surgical sciences post operative wound infection remains one of the common complications which surgeons encounter. If this problem is not evaluated and treated in timely then it can have significant sequel. The cutaneous or mucosal barrier, entrance of microbes into the host tissue is the initial requirement for infection. In SSI patient stays in hospital may be double the length of time and also increase the costs of health care. The main extra cost may be related to re-operation, extra nursing care and interventions, and drug treatment costs. AIM: The main aim of this study was to estimate the frequency of SSI with reference to factors contributing to it and the antimicrobial susceptibility pattern in surgery wards. Material and Methods: For this study patients were included as they were admitted in the surgical wards and the surgical emergencies that underwent surgical procedure in this hospital. The surgical procedures were classified as planned (elective) surgeries, emergency surgeries and clean, clean-contaminated surgeries, contaminated and dirty patients were divided accordingly. The discharged of infected wound were collected in sterilized container or the pus swab were collected aseptically procedure and send to microbiology laboratory for further process. By consulting with microbiologist the result were recorded. Result: On the base of surgeries were done total 452 cases were preformed. Out of 452 cases there were 132 cases in emergency out of which 29 get infected and in 320 elective cases 20 got infected. The overall rate of surgical site infection (SSI) was 10.8%. The occurrence of SSI in emergency cases (22%) was found to be higher compared to elective cases (6.3%). Out of total cases send for the culture and sensitivity, organism cultured gram negative organism predominate and and commonest was Escherchia coli, followed by Klebsiella, Pseudomonas and Staphylococcus aureus. E.coli and Klebsiella from emergency cases showed resistance to ciprofloxacin (83%) and ceftraixone (83%) and elective cases showed resistance of 70 % to ciprofloxacin and 40% to ceftriaxone. Therefore it was found that occurrence of SSI is significantly more in emergency cases. Conclusion: In this study rate of surgical site infection (SSI) was 10.8% whereas in clean 5.6%, in Clean and Contaminated 7.3% , in contaminated 21.2% and in dirty 25.9%. In gram negative bacteria E.coli were most commonly isolated bacteria followed by Pseudomonas and Klebsiella and in gram positive bacteria Staphylococcus aereus were most common isolated bacteria. Therefore antibiotics sensitive to the gram negative and pram positive bacteria should be initiative for establishing improved hospital antimicrobial policy and antimicrobial prescribing guidelines. Keywords: Surgical Site Infection, Post-operative wound infections, Antimicrobial resistance

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Reduction of Surgical-site Infections in Neurosurgery – The Advantage of Antiseptics Combined with a Sterile Surface

European Neurological Review ◽

10.17925/enr.2009.04.02.116 ◽

2009 ◽

Vol 4 (2) ◽

pp. 116

Author(s):

Patrick J Parks ◽

Georges K Nohra ◽

◽

Keyword(s):

Surgical Site Infection ◽

Surgical Site Infections ◽

Bacterial Density ◽

High Morbidity ◽

Site Infection ◽

Operative Site ◽

Hospitalised Patients ◽

Concomitant Reduction

Surgical-site infections remain a significant contributor to hospital-acquired infections despite continued efforts to reduce their occurrence. Infection at the operative site is associated with high morbidity, mortality and prolonged hospitalisation. Typically, in neurosurgical cases the infection rate varies between 1 and 4%. The rise in antimicrobial resistance makes pre-operative methods to reduce surgical-site infection even more important. This is essential since hospitalised patients tend to have a higher frequency of resistant organisms, and the rise in methicillin-resistantStaphylococcus aureus(MRSA) infections has made antibiotic prophylaxis of this highly virulent organism more difficult. In this article we consider the role of pre-operative antisepsis, which aims to reduce bacterial density in the operative site, and the development of a sterile surface concept as part of an approach to reduce surgical-site infection in a neurosurgical setting. The risk of surgical-site infection is proportional to residual bacteria at the wound site, so a reduction in skin bacterial density will be associated with a concomitant reduction in surgical-site infection. The cumulativein vitroandin vivoevidence related to wound contamination and extensive clinical experience with implanted neurosurgical devices illustrate the utility of using 3M™Ioban™2 as part of an infection prevention regimen within neurosurgery.

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Persistent Postoperative Hyperglycemia as a Risk Factor for Operative Treatment of Deep Wound Infection After Spine Surgery

Neurosurgery ◽

10.1093/neuros/nyz405 ◽

2019 ◽

Vol 87 (2) ◽

pp. 211-219

Author(s):

Zach Pennington ◽

Daniel Lubelski ◽

Erick M Westbroek ◽

A Karim Ahmed ◽

Peter G Passias ◽

...

Keyword(s):

Diabetes Mellitus ◽

Risk Factor ◽

Surgical Site Infection ◽

Wound Infection ◽

Glucose Control ◽

Surgical Site Infections ◽

Operative Management ◽

Diabetic Patients ◽

Site Infection ◽

Glucose Levels

Abstract BACKGROUND Surgical site infections (SSIs) affect 1% to 9% of all spine surgeries. Though previous work has found diabetes mellitus type 2 (DM2) to increase the risk for wound infection, the influence of perioperative hyperglycemia is poorly described. OBJECTIVE To investigate perioperative hyperglycemia as an independent risk factor for surgical site infection. METHODS We retrospectively identified patients undergoing operative management of SSIs occurring after spinal surgery for degenerative pathologies. These patients were individually matched to controls based upon age, surgical invasiveness, ICD-10CM, race, and sex. Cases and controls were compared regarding medical comorbidities (including diabetes), postoperative hyperglycemia, and operative time. RESULTS Patients in the infection group were found to have a higher BMI (33.7 vs 28.8), higher prevalence of DM2 (48.5% vs 14.7%), and longer inpatient stay (8.8 vs 4.3 d). They also had higher average (136.6 vs 119.6 mg/dL) and peak glucose levels (191.9 vs 153.1 mg/dL), as well as greater variability in glucose levels (92.1 vs 58.1 mg/dL). Multivariable logistic regression identified BMI (odds ratio [OR] = 1.13), diabetes mellitus (OR = 2.12), average glucose on the first postoperative day (OR = 1.24), peak postoperative glucose (OR = 1.31), and maximal daily glucose variation (OR = 1.32) as being significant independent predictors of postoperative surgical site infection. CONCLUSION Postoperative hyperglycemia and poor postoperative glucose control are independent risk factors for surgical site infection following surgery for degenerative spine disease. These data suggest that, particularly among high-risk diabetic patients, strict perioperative glucose control may decrease the risk of SSI.

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Magnitude of Surgical Site Infection and Its Associated Factors Among Patients Who Underwent a Surgical Procedure at Debre Tabor General Hospital, Northwest Ethiopia

10.21203/rs.3.rs-123625/v1 ◽

2020 ◽

Author(s):

Mequanint Bezie Walelign ◽

Tadesse Wuletaw Demissie ◽

Abaynew Honelign Desalegn

Keyword(s):

Surgical Site Infection ◽

General Hospital ◽

Surgical Procedure ◽

Surgical Site Infections ◽

Northwest Ethiopia ◽

P Value ◽

Age Group ◽

Site Infection ◽

Co Morbidity ◽

Debre Tabor

Abstract Background: Surgical site infections are the commonest nosocomial infections and responsible for considerable morbidity and mortality as well as increased hospitalizations and treatment cost related to surgical operations. The aim of this study was to determine the magnitude and factors associated with surgical site infections at the surgical ward of Debre Tabor General Hospital, Northwest Ethiopia.Method: Institution based cross-sectional study was conducted on patients who underwent a surgical procedure at Debre Tabor General Hospital in 2020. The sample size was determined using the single population proportion formula. Data were entered and analyzed using SPSS version 21 software. Bivariate and multivariate logistic regressions analysis were employed. The odds ratio and its 95% confidence interval were taken to test the association between the dependent and independent variables. A P-value of less than 0.05 will be considered statistically significant.Result: In this study, a total of 191 patients have participated in the study yielding a response rate of 100%. The mean age of the respondents was 2.5 (SD ±0.68) years. The most age group 115(60.2%) resides at the age group greater than 40 years. More than one half(62.3) of the surgical clients were females. Most of the clients were farmers(32.5%) and unable to read and write(41.9) based on the occupation. The magnitude of surgical site infection in this study was found to be 11.5% (95% CI: 7.8%, 15.9%). The factors existence of comorbidity and antibiotic prophylaxis was given were found to be significantly associated with the magnitude of surgical site infection.Conclusion: The magnitude of surgical site infection in this study was high. Proper management of patients with co-morbidity especially those with diabetes mellitus, proper administration of anesthesia, and delivering intravenous antimicrobial prophylaxis before surgery as ordered would significantly reduce the incidence of surgical site infection.

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Superficial surgical site infections following stone and non-stone bile duct surgery- A comparative analysis

Northern International Medical College Journal ◽

10.3329/nimcj.v11i2.54061 ◽

2021 ◽

Vol 11 (2) ◽

pp. 458-462

Author(s):

Chishti Tanhar Bakth Choudhury ◽

BH Nazma Yasmeen ◽

Manir Hossain Khan ◽

AHM Towhidul Alam ◽

Shirin Akhter

Keyword(s):

Bile Duct ◽

Surgical Site Infection ◽

Wound Infection ◽

Surgical Site Infections ◽

Stone Disease ◽

P Value ◽

Site Infection ◽

Causative Agents ◽

Group A ◽

Group B

Background : Superficial surgical site infection (SSSI) is a vital issue after biliary surgery. Surgical site infections remain a major cause of illness in the post-operative period. Objectives : The purpose of the present study was to compare the number of wound infection and the causative organism of surgical site infection of patient of stone and non-stone bile duct surgery. Methodology : This cross-sectional study was carried out in the Department of Surgery at Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka from May 2017 to April 2018 for a period of 12 months. Patients presented with biliary disease of stone and non-stone variety were selected as study population. Patients were divided into 2 groups designated as group A and group B. Patients with the biliary stone disease were enrolled in group A and the biliary nonstone disease patients were in the group B. Patients were followed up in the postoperative period up to 2 weeks to find out the incidence of wound infection and its risk factors, causative agents, and some other variables. Certain variables were closely monitored to find the postoperative outcome as these variables were standard parameters in assessment of the outcome of the study. Results : A total number of 50 patients were recruited for this study of which 25 patients were enrolled in group A and the 25 patients were enrolled in group B. Mean age was 42.48 ± 17.21 years in group A and 40.04 ± 21.37 years in group B. The difference was not statistically significant ( p=0.659). Males were predominant in both groups. Male female ratio was 1.77:1 and 1.08:1 in group A and group B respectively. Inflammatory evidence of gall bladder with pericholecystic collection was found in 5 (20%) and 6 (24%) patients in group A and group B. There was evidence of cholangitis in 8 (32%) and 4 (16%) patients in group A and group B respectively. Evidence of inflammation at the wound site, was found in 14 (56%) patients in group A and 7 (28%) patients in group B. There was statistically significant difference between these 2 groups in the incidence of superficial surgical site infection, ( p value is 0.045). Regarding per operative collected bile, we found E. Coli in 4 cases in group A and 3 cases in group B ( p value is 0.408). Klebsiella spp. was found in 1 patient in group A. Wound swab C/S identified E. Coli in 1 patient in group A. Staph aureus was found in 1 and 2 patients in group A and group B respectively ( p value is nonsignificant). Conclusion : In conclusion, there is a difference in the incidence of occurrence of surgical site infection and causative agents after stone and non-stone bile duct surgery. Stone disease has increased chance of wound infection than nonstone disease of bile ducts. Northern International Medical College Journal Vol.11 (2) Jan 2020: 458-462

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Incidence and Risk Factors for Surgical Site Infections Following Oromaxillofacial Oncologic Surgery in Dogs

Frontiers in Veterinary Science ◽

10.3389/fvets.2021.760628 ◽

2021 ◽

Vol 8 ◽

Author(s):

Brittney E. Rigby ◽

Kevin Malott ◽

Scott J. Hetzel ◽

Jason W. Soukup

Keyword(s):

Risk Factors ◽

Surgical Site Infection ◽

Surgical Procedures ◽

Surgical Procedure ◽

Bacterial Infections ◽

Critical Evaluation ◽

Surgical Site Infections ◽

Tumor Type ◽

Site Infection ◽

Oncologic Surgery

Antibiotic stewardship in veterinary medicine is essential to help prevent resistant bacterial infections. Critical evaluation into the benefits of prophylactic use of antibiotics during veterinary surgical procedures is under reported and additional investigation is warranted. The objectives of this paper were to determine the incidence of surgical site infection in dogs that underwent oromaxillofacial oncologic surgery and to identify risk factors for the development of surgical site infection. In this retrospective cohort study including 226 dogs surgically treated for oromaxillofacial tumors between January 1, 1997 and December 31, 2018, the incidence of surgical site infection was determined to be 7.5%. Univariable logistical regression models were used to evaluate potential risk factors for development of surgical site infections including signalment, tumor type, antibiotic protocol, time under anesthesia, location of surgical procedure (dental suite vs. sterile operating room), specific comorbidities, and surgical margins obtained. Anesthetic events lasting greater than 6 h were significantly associated with development of infection. Signalment, comorbidities, administration of anti-inflammatory and immunosuppressive medications, tumor type, histological margin evaluation, surgical procedure location, and antibiotic protocols were not significant contributors to development of infection. Use of antibiotic therapy in this cohort was not protective against development of infection and may not be routinely indicated for all oromaxillofacial oncologic surgeries despite common promotion of its use and the contaminated nature of the oral cavity. Anesthetic time significantly contributed towards the development of infection and use of perioperative antibiotics for surgical procedures lasting >6 h may be routinely warranted.

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Magnitude of Surgical Site Infection and its Associated Factors among Patients who Underwent a Surgical Procedure at Debre Tabor General Hospital, Northwest Ethiopia

10.21203/rs.3.rs-136000/v1 ◽

2020 ◽

Author(s):

Mequanint Bezie Walelign ◽

Tadesse Wuletaw Demissie ◽

Abaynew Honelign Dessalegn

Keyword(s):

Surgical Site Infection ◽

General Hospital ◽

Surgical Procedure ◽

Surgical Site Infections ◽

Northwest Ethiopia ◽

P Value ◽

Age Group ◽

Site Infection ◽

Co Morbidity ◽

Debre Tabor

Abstract Background: Surgical site infections are commonest nosocomial infections and responsible for considerable morbidity and mortality as well as increased hospitalizations and treatment cost related to surgical operations.Objective: The aim of this study was to determine the magnitude and factors associated with surgical site infections at surgical ward of Debre Tabor General Hospital, Northwest Ethiopia.Method: Institution based cross sectional study was conducted on patients who underwent a surgical procedure at Debre Tabor General Hospital in 2020. The sample size was determined using single population proportion formula. Data were entered and analyzed using SPSS version 21 software. Bivariate and multivariate logistic regressions analysis were employed. Odds ratio and its 95% confidence interval were taken to test the association between the dependent and independent variables. P-value of less than 0.05 will be considered as statistically significant. Result: In this study, a total of 191 patients have participated in the study yielding a response rate of 100%. The mean age of the respondents was 2.5 (SD ±0.68) years. The most age group 115(60.2%) resides at the age group greater than 40 years. More than one half(62.3) of the surgical clients were females. Most of the clients were farmers(32.5%) and un able to read and write(41.9) based on the occupation. The magnitude of surgical site infection in this study was found to be 11.5% (95% CI: 7.8%, 15.9%).The factors existance of comorbidity and antibiotic prophylaxis given were found to be significantly assoiated with magnitude of surgical site infection.Conclusion: The magnitude of surgical site infection in this study was high. Proper management of patients with co-morbidity especially those with diabetes mellitus, proper administration of anesthesia and delivering intravenous antimicrobial prophylaxis before surgery as ordered would significantly reduce the incidence of surgical site infection.

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A study of surgical site infections with and without the use of pre-operative antibiotics

International Surgery Journal ◽

10.18203/2349-2902.isj20194180 ◽

2019 ◽

Vol 6 (10) ◽

pp. 3806

Author(s):

Arun Kumar Gupta ◽

Seema Mittal ◽

Tejinder Singh Dall ◽

Darpan Bansal

Keyword(s):

Surgical Site Infection ◽

Surgical Site Infections ◽

Site Infection ◽

Medical Sciences ◽

Gram Positive ◽

Gram Negative ◽

Gram Positive Bacteria ◽

Group A ◽

Group B ◽

Clean Contaminated

Background: In spite of advances in infection control, infection still remains the major limitor of surgical horizons. After urinary tract infection, surgical site infection is a main factor contributing to morbidity and mortality.Methods: The present study was carried out in the department of General Surgery and Microbiology at Shri Guru Ram Das Institute of Medical Sciences and Research, Vallah, Sri Amritsar. In this study 100 patients were selected undergoing clean or clean contaminated surgeries out of which 50 patients were not given pre-operative antibiotics (first group) and remaining 50 patients (second group) were given preoperative antibiotics.Results: Sample consisted of 100 patients with mean age of patients was 36.97 years. Total number of males was 57 and females were 43. 25 (50%) of patients who had not received prophylaxis developed SSI (group A) and 28 (56%) patients who received prophylaxis developed SSI (group B). Most common bacteria isolated from SSI was Staphylococcus aureus for both the groups. 10 (52.63%) Gram positive bacteria were isolated from microscopic examination of infected sample (A) and 25 (73.52%) were gram negative bacteria. 25 (73.52%) were Gram positive bacteria in group (b) and 9 (26.47%) were Gram negative isolates.Conclusions: It can be concluded from the present study that there is no need to give antibiotic prophylaxis prior to surgery in order to reduce the incidence of surgical site infection.

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Post-operative surgical site infection among general surgery patients: Rate and risk factors.

The Professional Medical Journal ◽

10.29309/tpmj/2021.28.09.6076 ◽

2021 ◽

Vol 28 (09) ◽

pp. 1276-1281

Author(s):

Shahid Nazir Memon ◽

Shehzada Ameer Ahmed Babar ◽

Sarwat Sultana ◽

Sulhera Khan ◽

Amir Hussain Khan ◽

...

Keyword(s):

Surgical Site Infection ◽

Wound Infection ◽

General Surgery ◽

Surgical Site Infections ◽

High Rate ◽

P Value ◽

Emergency Setting ◽

Site Infection ◽

Emergency Case ◽

Cross Sectional

Objectives: High rate of post-surgical infections are reported with scanty effort for controlling them. The objectives were to evaluate frequency of surgical site infections in patients undergoing general surgery. Study Design: Cross Sectional Observational Study. Setting: Naz Memorial Hospital. Period: March 2019 to March 2020. Material & Methods: This study was conducted in general surgery ward for 1 year. All patients over 18 years admitted in surgery ward either as elective or emergency case were included while patients having any wound infection, operated in other hospital or diabetic foot and all those operated for incision and drainage of abscess were excluded. All patients that were operated during the study period were followed for any wound infection development till one qAqmonth. SPSS was used for data entry and analysis keeping p-value of <0.05 as significant. Results: 75 from 200 patients developed surgical site infection, 46 (61.3%) were operated in emergency. Among 24 contaminated surgeries type, 70.8% were reported having SSI (p-0.05) while from 28 dirty types of surgeries 78.6% of patients had a SSI (p-0.03). 25% were anemic, 21% diabetic while (20%) were reported to be hypertensive, 13 (17%) gave positive history of smoking while 12 (16%) were obese. Conclusion: Higher proportion of surgical site infection was observed in patients undergoing contaminated and dirty type of surgeries. Most patients with SSI were operated in emergency setting and anemia and diabetes were the most common risk factor reported in the infected patients.

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Reduction of Surgical-site Infections in Neurosurgery—The Advantage of Antiseptics Combined with a Sterile Surface

US Neurology ◽

10.17925/usn.2010.06.01.95 ◽

2010 ◽

Vol 06 (01) ◽

pp. 95

Author(s):

Patrick J Parks ◽

Georges K Nohra ◽

◽

Keyword(s):

Surgical Site Infection ◽

Surgical Site Infections ◽

Bacterial Density ◽

High Morbidity ◽

Site Infection ◽

Operative Site ◽

Wound Contamination ◽

Concomitant Reduction

Infection at the operative site is associated with high morbidity, mortality, and prolonged hospitalization. Typically, in neurosurgical cases the infection rate varies between 1 and 4%. The rise in antimicrobial resistance makes pre-operative methods to reduce surgical-site infection even more important. This is essential since hospitalized patients tend to have a higher frequency of resistant organisms, and the rise in methicillin-resistantStaphylococcus aureus(MRSA) infections has made antibiotic prophylaxis of this highly virulent organism more difficult. In this article we consider the role of pre-operative antisepsis, which aims to reduce bacterial density in the operative site, and the development of a sterile surface concept as part of an approach to reduce surgical-site infection in a neurosurgical setting. The risk for surgical-site infection is proportional to residual bacteria at the wound site, so a reduction in skin bacterial density will be associated with a concomitant reduction in surgical-site infection. The cumulativein vitroandin vivoevidence related to wound contamination and extensive clinical experience with implanted neurosurgical devices illustrate the utility of using 3MIoban2 as part of an infection prevention regimen within neurosurgery.

Download Full-text