Surgical Site Infections in a Rural Teaching Hospital of North India

2017 ◽  
Vol 2 (1) ◽  
pp. 11-16
Author(s):  
Rajesh Abbey ◽  
Manjul Mohan ◽  
Nitin Malik ◽  
Rohit Tiwari ◽  
Shashank Nahar
Keyword(s):  
Hospital Stay ◽  
Teaching Hospital ◽  
Tertiary Care ◽  
Antibiotic Sensitivity ◽  
Uttar Pradesh ◽  
Surgical Site Infections ◽  
Control Measures ◽  
North India ◽  
Duration Of Surgery ◽  
Rural Teaching

ABSTRACT Aims and objectives Surgical site infections (SSIs) are one of the most important causes of health care-associated infections. Understanding SSI reduces the social and economic burden of a hospital and society. In this context, we evaluated the various aspects of SSI in our institution, Rohilkhand Medical College & Hospital (RMCH), which is a tertiary care teaching hospital in rural Uttar Pradesh in North India. Materials and methods This prospective study was conducted in the Department of General Surgery, RMCH, Bareilly, Uttar Pradesh, India. A total number of 1,498 patients admitted for surgical procedures with effect from November 1, 2016 to December 31, 2016, formed the subjects of the present study. All operated cases during the above period, including major and minor, emergency and elective, laparoscopic and open procedures were included in the present study. Data so obtained were analyzed statistically. The Centers for Disease Control and Prevention, USA criteria were used for defining the wound. Sample swabs were collected from the first dressing and up to 2 to 4 weeks postoperatively. Samples were processed for aerobic and anaerobic flora, and the antibiotic sensitivity of the isolates was also performed. Results and discussion The SSI rate in the present study was 8.67%. Significantly higher incidence of SSI was detected with increasing age. The SSI rate in case of emergency surgeries was more (27.7%) as compared with routine/elective surgeries (6.3%). The higher incidence (18.75%) of SSI was detected in patients having preoperative hospital stay of more than 7 days, and the maximum incidence (15.7%) was observed in patients having longer postoperative hospital stay of more than 10 days. Dirty wounds had the highest incidence of SSI (53.45%). The incidence of SSI increased with duration of surgery, order of surgery, and with the increasing duration of postoperative drains. Staphylococcus aureus was the commonest isolate (32.30%) followed by Escherichia coli (39%). Conclusion Though the incidence of SSI in the present study was slightly low as compared with similar reports from other institutions of the country, more rational antibiotic policy and more stringent infection control measures are needed. How to cite this article Abbey RK, Mohan M, Malik N, Tiwari R, Nahar S. Surgical Site Infections in a Rural Teaching Hospital of North India. Int J Adv Integ Med Sci 2017;2(1):11-16.

A PROSPECTIVE STUDY OF SURGICAL SITE INFECTION IN A TERTIARY CARE CENTER IN NORTH INDIA

2021 ◽  
pp. 66-68
Author(s):  
Sanjay Gupta ◽  
Avinash Yadav ◽  
Akshay Kumar Bharati
Keyword(s):  
Care Center ◽  
Operative Procedure ◽  
Tertiary Care ◽  
Antibiotic Sensitivity ◽  
Surgical Site Infections ◽  
North India ◽  
Diffusion Method ◽  
Prosthetic Material ◽  
Related Factors ◽  
Class 1

BACKGROUND: Surgical Site Infections (SSI) is dened as an infection related to an operative procedure that occurs at or near the surgical incision within 30 days of the procedure, or within 90 days if prosthetic material is implanted at surgery—is among the most common preventable complication after surgery. OBJECTIVES: To study the incidence and risk factors of SSI in our hospital and to nd out the areas which need concern and methods to reduce SSI. METHODOLOGY: Study was conducted over a period of 1 year. A total of 300 cases of General Surgery presented to our hospital were included in the study. A few host factors, wound factors and surgery related factors that cause SSI were studied. Swabs from infected surgical wounds were sent to the department of Microbiology for pus culture and sensitivity. Antibiotic sensitivity test was done by Kirby-Bauer disc diffusion method. RESULTS: Certain associated factors such as increased duration of surgeries (>2hours) and prolonged drain placement were found to be signicantly associated with occurrence of SSI and the surgeries with class 1 (clean) wound showed minimum risk of infection. Escherichia coli (28.75%) was the commonest pathogen, followed by Pseudomonas aeruginosa (27%) and Staphylococcus aureus (20%) .The incidence of SSI in the hospital is 7%. CONCLUSIONS: The results of the study revealed that in order to decrease the incidence of SSI we need to: a) If possible try to reduce the duration of the surgeries performed b) should give emphasis on drain care c) co-morbidities should be looked for and managed prior to surgery d) a regular monitoring should be done in both emergency and elective operation theatres in order to reduce the risk of SSI.

scholarly journals Three-port versus four-port laparoscopic cholecystectomy: a comparative study at a tertiary care centre in North India

2018 ◽  
Vol 5 (2) ◽  
pp. 426
Author(s):  
Peeyush Kumar ◽  
Anil K. S. Rana
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Return To Work ◽  
Hospital Stay ◽  
Tertiary Care ◽  
Gall Stone ◽  
North India ◽  
Duration Of Hospital Stay ◽  
Conversion Rates ◽  
Significant Difference ◽  
Duration Of Surgery

Background: Improvement of Laparoscopic Cholecystectomy (LC) technique in terms of reduction in size and number of ports is being tried to improve patient satisfaction and outcome. Present study was conducted to evaluate and compare the safety outcome and advantages of three-port and four-port LC. Methods: This prospective study included 90 patients presenting with symptomatic gall stone disease or gall bladder polyp more than 1cm at base. Patients with jaundice and choledocholithiasis were excluded. Patients were divided into two groups: A and B, who underwent three-port and four-port LC respectively. Outcomes of the two groups were assessed and compared in terms of duration of surgery, intra-operative and post-operative variables including rate and nature of complications, conversion rates, post-operative pain, duration of hospital stay, return to work and cosmetic outcome.Results: Statistically significant difference was found between the two groups in terms of Visual Analogue Score for pain at 6 and 24 hours, analgesic requirement, duration of hospital stay and return to work; all being less in the three- port LC group. Cosmetic outcome as perceived by patients was also better in the three-port group. Results of other variables were comparable in the two groups. Conclusions: Three-port procedure is safe and appears to be more cost effective than four-port LC. If LC is performed by an experienced surgeon, it can be started with three ports, if required, a fourth port can be inserted. 

scholarly journals Incisional surgical site infections in obstetric and gynecological procedures in a tertiary care hospital in Northern India

2020 ◽  
Vol 9 (12) ◽  
pp. 4946
Author(s):  
Savita Chandra ◽  
Shodashi Saxena
Keyword(s):  
Risk Factors ◽  
Hospital Stay ◽  
Tertiary Care ◽  
Antibiotic Sensitivity ◽  
Surgical Site Infections ◽  
Current Status ◽  
Care Hospital ◽  
Incisional Surgical Site Infection ◽  
The Impact ◽  
Microbial Spectrum

Background: To find the incidence of incisional surgical site infection (ISSI) in obstetric and gynecological procedures, the risk factors, the microbial spectrum, the antibiotic sensitivity and the impact on the hospital stay. Methods: A prospective observational study was done under the department of obstetrics and gynecology, Era’s Lucknow medical college and hospital. All consecutive patients who underwent caesarean section, vaginal delivery with episiotomy, laparotomy, and hysterectomy were included in this study. Laparoscopic surgeries were excluded. Results; In this series of 646 surgeries, 6.18% developed ISSI. In the category of major surgeries, the ISSI rate was 8.89%. Amongst the 185 episiotomies 1.6% gaped. Anemia, diabetes mellitus, excess body weight, emergency or elective surgery, rapid built up of hemoglobin with blood transfusion, previous caesarean scar and tobacco intake were the risk factors identified. Coagulase negative staphylococcus was the dominant microbe. Antibiotic sensitivity to linezolid was found in 50% of the ISSI cases followed by amikacin, clindamycin and some others. The mean hospital stay was 13 days while the maximum was 26 days.Conclusions: The study established the current status of incisional surgical site infections, identified the risk factors, the microbial spectrum, the antibiotic sensitivity and the need for further studies using a preventive approach. 

Epidemiology and clinical outcome of ventilator-associated events at a tertiary care hospital from North India

2020 ◽  
pp. 004947552098245
Author(s):  
Pooja Kumari ◽  
Priya Datta ◽  
Satinder Gombar ◽  
Deepak Sharma ◽  
Jagdish Chander
Keyword(s):  
Mechanical Ventilation ◽  
Tertiary Care Hospital ◽  
Late Onset ◽  
Tertiary Care ◽  
Control Measures ◽  
North India ◽  
Ventilator Associated Pneumonia ◽  
Care Hospital ◽  
Infection Control Measures ◽  
Utilisation Rate

The aim of our study was to determine the incidence, microbiological profile, risk factors and outcomes of patients diagnosed with ventilator-associated events in our tertiary care hospital. In this prospective study, intensive care patients put on mechanical ventilation for >48 h were enrolled and monitored daily for ventilator-associated event according to Disease Centre Control guidelines. A ventilator-associated event developed in 33/250 (13.2%); its incidence was 3.5/100 mechanical ventilation days. The device utilisation rate was 0.86, 36.4% of patients had early and 63.6% late-onset ventilator-associated pneumonia whose most common causative pathogen was Acinetobacter sp. (63.6%). Various factors were significantly associated with a ventilator-associated event: male gender, COPD, smoking, >2 underlying diseases, chronic kidney disease and elevated acute physiological and chronic health evaluation II scores. Therefore, stringent implementation of infection control measures is necessary to control ventilator-associated pneumonia in critical care units.

scholarly journals Longitudinal Trends in All Healthcare-Associated Infections through Comprehensive Hospital-wide Surveillance and Infection Control Measures over the Past 12 Years: Substantial Burden of Healthcare-Associated Infections Outside of Intensive Care Units and “Other” Types of Infection

2015 ◽  
Vol 36 (10) ◽  
pp. 1139-1147 ◽  
Author(s):  
Hajime Kanamori ◽  
David J. Weber ◽  
Lauren M. DiBiase ◽  
Emily E. Sickbert-Bennett ◽  
Rebecca Brooks ◽  
...  
Keyword(s):  
Intensive Care ◽  
Tract Infection ◽  
Intensive Care Units ◽  
Linear Models ◽  
Infection Type ◽  
Tertiary Care ◽  
Surgical Site Infections ◽  
Control Measures ◽  
Healthcare Associated Infections ◽  
Healthcare Associated

OBJECTIVETargeted surveillance has focused on device-associated infections and surgical site infections (SSIs) and is often limited to healthcare-associated infections (HAIs) in high-risk areas. Longitudinal trends in all HAIs, including other types of HAIs, and HAIs outside of intensive care units (ICUs) remain unclear. We examined the incidences of all HAIs using comprehensive hospital-wide surveillance over a 12-year period (2001–2012).METHODSThis retrospective observational study was conducted at the University of North Carolina (UNC) Hospitals, a tertiary care academic facility. All HAIs, including 5 major infections with 14 specific infection sites as defined using CDC criteria, were ascertained through comprehensive hospital-wide surveillance. Generalized linear models were used to examine the incidence rate difference by infection type over time.RESULTSA total of 16,579 HAIs included 6,397 cases in ICUs and 10,182 cases outside ICUs. The incidence of overall HAIs decreased significantly hospital-wide (−3.4 infections per 1,000 patient days), in ICUs (−8.4 infections per 1,000 patient days), and in non-ICU settings (−1.9 infections per 1,000 patient days). The incidences of bloodstream infection, urinary tract infection, and pneumonia in hospital-wide settings decreased significantly, but the incidences of SSI and lower respiratory tract infection remained unchanged. The incidence of Clostridium difficile infection (CDI) increased remarkably. The outcomes were estimated to include 700 overall HAIs prevented, 40 lives saved, and cost savings in excess of $10 million.CONCLUSIONSWe demonstrated success in reducing overall HAIs over a 12-year period. Our data underscore the necessity for surveillance and infection prevention interventions outside of the ICUs, for non–device-associated HAIs, and for CDI.Infect Control Hosp Epidemiol 2015;36(10):1139–1147

A RETROSPECTIVE STUDY OF BLOOD TRANSFUSION PRACTICES IN A TERTIARY CARE HOSPITAL OF NORTH INDIA.

2021 ◽  
pp. 25-29
Author(s):  
Rakesh Kumar Sharma ◽  
Shahid Anjum Awan ◽  
Vijay Sawhney
Keyword(s):  
Blood Transfusion ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Transfusion Practice ◽  
Blood Bank ◽  
Control Measures ◽  
North India ◽  
Care Hospital ◽  
Important Concern ◽  
Life Saving

INTRODUCTION: Blood transfusion is an important concern for the society, as it is life saving for patients with bleeding disorders, accidents, surgeries, inherited/acquired hematological diseases and malignancies. Generally, donors are classied into the following categories: voluntary, family replacement, remunerated or paid donors, and autologous donor. AIMS & OBJECTIVES:To understand the importance of Blood & its safe Transfusion practice in a Teaching Hospital. METHODOLOGY: An Observational study was conducted over a period of 12 months from January 2019 to December 2019 in a 750 –bedded Tertiary Care Hospital of Jammu(UT). OBSERVATIONS: In addition to providing Blood-Transfusion Services to the patients admitted in SMGS Hospital Jammu & Other Associated Hospitals of GMC Jammu, the Blood-Bank is also catering to the needs of Registered Private Nursing Homes & Hospitals of Jammu(UT).This Blood-Bank has exceptionally maintained a record of consuming the whole stock of Blood without wasting even a single pint of blood. DISCUSSION: The Aim of Blood Transfusion Services is to supply good Quality of Blood & its Components to the Patients & avoid any risk to the Donors as well as Recepients. Hence it is extremely essential to institute strict Quality Control Measures RECOMMENDATIONS: Recommended that Upgradation of Blood-Bank is essential to cater with the needs of Additional bed-strength that SMGS Hospital is going to acquire in the coming future.

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