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

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.

Author(s):  
V Singh ◽  
A B Khyriem, W V Lyngdoh ◽  
C J Lyngdoh

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.


2020 ◽  
Vol 22 (1) ◽  
pp. 15-20
Author(s):  
Md Abul Hossan ◽  
Md Ariful Islam ◽  
Tapas Chakraborty ◽  
Firoz Ahmed Khan ◽  
Md Mozharul Islam

Surgical site infection after thyroid surgery is a less common incidence. Prophylactic antibiotic before surgery and empirical antibiotic therapy after surgery is a common practice in our country. But international guidelines do not suggest antibiotic in clean surgical procedure. Aim: To compare the incidence of surgical site infection after thyroid surgery with and without empirical antibiotic therapy. Method: It was a cross sectional study, done from July 2010 to December 2010 in 3 medical college hospitals in Dhaka city. Total 100 cases were included in this study, 50 cases for study in which only single prophylactic antibiotic used half an hour before operation, 50 cases for control in which 7 days antibiotic used per orally in addition to prophylaxis. Result: Among 100 cases male were 24 & female 76 (M: F= 1:3.2). Oldest patient was 56 yrs & youngest 21yrs. 47% patient operated for solitary thyroid nodule, 35% multinodular goiter & only 6% diffuse goiter. 47% patient was done hemithyroidectomy & only 7% total thyroidectomy. All the operations were completed within 2 hours where 40% within one hour. No surgical site infections were found in both study and control cases. Conclusion: There is no statistical difference between routine antibiotic use and no use of antibiotic after thyroid surgery. Bangladesh J Otorhinolaryngol; April 2016; 22(1): 15-20


Author(s):  
Nahit Ata ◽  
Mehmet Kulhan ◽  
Nur Gozde Kulhan ◽  
Can Turkler ◽  
Ahmet Bilgi ◽  
...  

OBJECTIVE: Antibiotic prophylaxis is one of the most important steps to reduce surgical site infections. First-generation cephalosporin (cefazolin) is used prophylactically in the majority of operations. Rifamycin is a broad-spectrum semisynthetic antibiotic that is bactericidal against gram (+) and gram (˗) microorganisms. To the best of our knowledge, there are no studies on the use of rifamycin in antibiotic prophylaxis. In this study, we aimed to analyze whether there is a difference between the use of only cefazolin and only rifamycin in terms of surgical site infections. STUDY DESIGN: One hundred patients were included in this case-control study during the last quarter period of 2017. These patients (n=100) were divided into two groups according to their antibiotic use; 50 patients who received only 1 g cefazolin constituted Group 1, 50 patients who received only 250 mg topical rifamycin over the incision line based on surgeon’s preference constituted Group 2. RESULTS: The use of prophylactic topical rifamycin reduced the incidence of wound infection. compared with cefazolin. Surgical site infection was detected in 5 (10%) of the patients who received cefazolin, whereas surgical site infection was not observed in patients who received rifamycin (p=0.022). CONCLUSIONS: The use of topical rifamycin is effective but does not imply that systemic antibiotics should replace prophylaxis. The use of rifamycin would aid in systemic antibiotic prophylaxis.


2019 ◽  
Vol 6 (3) ◽  
pp. 843
Author(s):  
K. Saravanan ◽  
T. Uma Maheswari

Background: Surgical site infections (SSI) are one of the most common postoperative complications leading to increased morbidity which also an important factor of increased hospital stays and increased healthcare cost. The use of prophylactic antibiotics may benefit the patients in preventing the surgical site infection. Aim of the study was to study the single dose prophylactic antibiotic use in preventing surgical site infection in elective surgery.Methods: Patients were included from the list of elective surgery. Patient with comorbid was excluded. The patient was handled as per NICE guideline for prevention of surgical site infection and treatment 2017. Prophylactic antibiotic injection cefuroxime 1500mg administered intravenously 30 minutes before surgery, at the site of the incision.Results: In 110 patients included in the study, 46% of patients were in 35 to 45 years, male were higher in number. 20% of patients underwent hernioplasty followed by cholecystectomy 18.3%. 9% of SSI was recorded in this study. 4 cases in cholecystectomy, 3 cases in hernioplasty, each 1 case in appendicectomy, Hydrocele and ventral hernia mesh repair. The most common bacteria isolated from the samples were Staphylococcus aureus.Conclusions: In uncomplicated surgeries, single dose antibiotics before 30 minutes of surgery may benefit in preventing SSI.


2021 ◽  
Vol 108 (Supplement_2) ◽  
Author(s):  
H Mistry ◽  
B Woolner ◽  
A John

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.


2000 ◽  
Vol 44 (10) ◽  
pp. 2777-2783 ◽  
Author(s):  
P. L. Winokur ◽  
A. Brueggemann ◽  
D. L. DeSalvo ◽  
L. Hoffmann ◽  
M. D. Apley ◽  
...  

ABSTRACT Salmonella spp. are important food-borne pathogens that are demonstrating increasing antimicrobial resistance rates in isolates obtained from food animals and humans. In this study, 10 multidrug-resistant, cephalosporin-resistant Salmonellaisolates from bovine, porcine, and human sources from a single geographic region were identified. All isolates demonstrated resistance to cephamycins and extended-spectrum cephalosporins as well as tetracycline, chloramphenicol, streptomycin, and sulfisoxazole. Molecular epidemiological analyses revealed eight distinct chromosomal DNA patterns, suggesting that clonal spread could not entirely explain the distribution of this antimicrobial resistance phenotype. However, all isolates encoded an AmpC-like β-lactamase, CMY-2. Eight isolates contained a large nonconjugative plasmid that could transformEscherichia coli. Transformants coexpressed cephalosporin, tetracycline, chloramphenicol, streptomycin, and sulfisoxazole resistances. Plasmid DNA revealed highly related restriction fragments though plasmids appeared to have undergone some evolution over time. Multidrug-resistant, cephalosporin-resistant Salmonellaspp. present significant therapeutic problems in animal and human health care and raise further questions about the association between antimicrobial resistance, antibiotic use in animals, and transfer of multidrug-resistant Salmonella spp. between animals and man.


2009 ◽  
Vol 30 (11) ◽  
pp. 1120-1122 ◽  
Author(s):  
Robert J. Sherertz ◽  
Tobi B. Karchmer

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).


Food Research ◽  
2021 ◽  
Vol 5 (3) ◽  
pp. 144-151
Author(s):  
P. Vijayalakshmi ◽  
A. Rajani Chowdary ◽  
P. Vidyullatha ◽  
M. Sharon Sushma

The current study aimed to isolate bacteria that harbour various animal food products like meat, chicken and seafoods collected from the abattoir, butcher shops and local seafood market and to determine the antimicrobial resistance pattern of isolated pathogens which are responsible for various foodborne illnesses in human beings. A total of forty raw animal product samples were collected from the abattoir, butcher shops and local seafood market of Visakhapatnam. The samples selected for the study include raw chicken, meat, crab, prawns and different varieties of fish. A classic random sampling technique was employed to collect the study samples. All the samples were processed immediately using standard microbiological protocols. The bacteria isolation and characterization were done by studying morphological characteristics with staining methods, cultural characteristics by isolating and growing the pathogenic microorganisms in various selective and differential culture media. Antimicrobial susceptibility testing was performed by the Kirby -Bauer method by following Clinical and Laboratory Standards Institute (CLSI) guidelines. EDTA-Disc Potentiation Test and Imipenem-EDTA Double disc synergy test are used to detect the metallo beta-lactamase production of isolated pathogens. The highest number of isolates belong to Salmonella species (18), Pseudomonas aeruginosa (18) followed by Vibrio species (14) and few isolates belong to Enterobacter species (4). Majority of the microbial isolates obtained in the current study were multidrug resistant. The isolates from the abattoir environments, slaughterhouses, fish markets were found to exhibit variable resistance pattern to aminoglycosides, macrolides, β-lactams, cephalosporins, quinolone antibiotics used in the present study and at the same time most of them were sensitive to carbapenem antibiotic imipenem. Antimicrobial resistance (AMR) prevents the designing and assessment of effective interventions. If such a link can be established, then the tracking of antibiotic use and consumption data could be furthermore used as a surrogate indicator for the risk of potential antibiotic resistance (ABR) emergence.


2021 ◽  
Vol 56 (1) ◽  
pp. 36
Author(s):  
Norman Hadi ◽  
Hantoro Ishardyanto

Surgical operations on modified radical mastectomy are considered clean procedures by the Centers for Disease Control and Prevention (CDC) wound classification system. Despite this, higher than expected Surgical Site Infection (SSI) rates are reported, varying from 1 % to 26 % across the literature. Some surgeons also prescribe postoperative prophylaxis for postoperative modified radical mastectomy patients to prevent infection despite its lack of proven efficacy. The aim of this study is to analyze the use of oral antibiotics to prevent Surgical Site Infection (SSI) on postoperative modified radical mastectomy patients in Dr. Soetomo General Hospital. This study was double-blinded randomized control trial of 60 postoperative modified radical mastectomy patients (2 groups) during the period of December 2017 to March 2018. Samples were prospectively divided into two groups (random sampling), in group A (n=30) patients received single dose prophylactic antibiotics and continued with oral antibiotics postoperative (Cefadroxil 2 x 500 mg) during 7 days and in group B (n=30) patients received single dose prophylactic antibiotics and continued without postoperative antibiotics (placebo). Both groups were evaluated clinically for surgical site infection up to 30 days. There was no statistically significant difference in both groups {p=1 (p>0.05)}. There was no incidence of surgical site infection in both groups during the 30-day follow-up period (days 3, 7, 14 and 30). There was no difference in the surgical site infection rate among those who received oral postoperative antibiotics prophylactic and without antibiotics (placebo) on postoperative modified radical mastectomy patients in Dr. Soetomo General Hospital. Because of the potential adverse events associated with antibiotic use, further evaluation of this practice is required.


2017 ◽  
Vol 4 (8) ◽  
pp. 2455
Author(s):  
Shivakumar C. R. ◽  
Mohammad Fazelul Rahman Shoeb ◽  
Anil Reddy Pinate

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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