Abstract
BackgroundSurgical site infections (SSI) represent a burden on the health care system especially in developing countries with significant morbidity and mortality. In Egypt, especially in our institution, there is no registry for the SSI rate or the contributing factors with no clear guidelines regarding the regimen of perioperative antibiotic prophylaxis. Our study was conducted to assess the local practice and to calculate the rate and risk factors of SSI.Patients and methodsA prospective registry was established at the Neurosurgery Department, Demerdash teaching hospital Ain Shams University, Cairo, Egypt. All patients who underwent elective neurosurgical procedures were included in this study. Trauma patients were excluded. Patients were followed-up for incident SSI for 1 month postoperatively. SSIs were identified based on CDC criteria and a standardized data collection form predictor variables including patient characteristics, preoperative, intraoperative, and postoperative factors along with the pattern of antimicrobial prophylaxis.ResultsThe study included 248 patients with 1-month postoperative follow-up. An SSI rate of 19% was recorded being mainly in patients below 10 years of age. Postoperative CSF leak was noticed to be the most significant risk factor of SSI in our study (p value < 0.01). Sixty five percent of culture results showed infection with gram-negative bacilli with the predominance of Acinetobacter.ConclusionProlonged use of perioperative antibiotics does not seem to have an added benefit in SSI prevention. Tailoring of the used antibiotic regimen is highly recommended according to the latest antimicrobial prophylaxis guidelines and the local culture and sensitivity results.
Highlights
Surgical site infections (SSIs) are infections related to surgical incision, organs, or space after surgery [1]
According to The center for disease control and prevention (CDC) guidelines published in August 2017, there is no need for additional administration of prophylactic antibiotics after the closure of the incision in the operating room in case of clean and cleancontaminated wounds [1]
The aim of the present study was to construct a registry for SSI to objectively document the local practice, incidence of SSI, the patterns, risk factors of surgical site infections, local microbial prevalence and the pattern of antimicrobial resistance at El-Demerdash teaching hospital Ain Shams University in Cairo, Egypt, between 2016 and 2018
Summary
Surgical site infections (SSIs) are infections related to surgical incision, organs, or space after surgery [1]. In 2010, a World Health Organization (WHO) report stated that up to one-third of patients who had surgeries in low- and Within neurosurgical procedures, the reported incidence of surgical site infection in the last 10 years ranges from 0.8 to 6.6% [5]. Many perioperative risk factors for SSI were reported. Infection rates are lower when the surgery is elective, clean and with patients whose ASA score is lower. Surgical site infections (SSI) represent a burden on the health care system especially in developing countries with significant morbidity and mortality. In Egypt, especially in our institution, there is no registry for the SSI rate or the contributing factors with no clear guidelines regarding the regimen of perioperative antibiotic prophylaxis.
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