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Abstract
BackgroundSurgical Site Infections (SSI) are the most reported health acquired infection and common surgical complication in both developed and developing countries. In developing countries such as Rwanda, there is a paucity of published reports on the pattern of SSI, therefore this study aimed at assessing the incidence, risk factors and the antibiotic profile of pathogens responsible of SSI.MethodsThis prospective study included 294 patients admitted between October 10, 2017 and February 12, 2018 to the surgical department of the University Teaching Hospital of Kigali. Patients data were collected using a structured and pretested questionnaire in English version. Regular follow-up was maintained until at least 30 days postoperatively. Samples were collected from suspected wounds and identified using different bacteria culture media. Data were analyzed using Statistical Package for the Social Sciences (SPSS) software word version 20.0. P-value < 0.05 was considered statistically significant.ResultsThe overall incidence of SSI was 10.9%. The associated risk factors were found to be an increased age, ASA class, wound classification, skills and experience of the surgeon, longer duration of surgery (> 2 h), prolonged duration of hospital stay, blood transfusion and emergency surgery. The most common pathogens isolated were Klebsiella ssp (55%), followed by Escherichia coli (15%) and Proteus ssp (12%), Acinectobacter (9%), Staphylococcus aureus (6%) and coagulase-negative staphylococci (3%).The pathogens revealed different levels of antibiotic resistance; amoxy-clavilinic acid (98.8%), gentamicin (92.6%), ciprofloxacin (78.1%) and ceftriaxone (53.3%). On the other hand, Amikacin and imipinem were the only two most effective antibiotics for all isolated pathogens with 100% sensitivity.ConclusionSSI incidence rate was revealed to be within acceptable international ranges. However, multi drug resistance was seen in half of the isolates leaving clinicians with few choices of drugs for the treatment of patients with SSI. Periodic surveillance of bacteria and antibiotic susceptibility coupled with the implementation of strict protocol for antibiotic administration and operative room regulations are important to minimize the burden of SSI with resistant bacteria pathogens.
Highlights
Surgical Site Infections (SSI) are the most reported health acquired infection and common surgical complication in both developed and developing countries
SSI is a type of hospital-acquired infection (HAI) that arises following surgery and it is related to the surgical site [3]
The aim of the study was to establish the burden of SSI, its risk factors, the etiological bacterial agents associated with SSI and their antimicrobial susceptibility pattern as well as the outcome in patients after surgery in orthopedic and general surgery at University Teaching Hospital of Kigali known as CHUK
Summary
Surgical Site Infections (SSI) are the most reported health acquired infection and common surgical complication in both developed and developing countries. SSI is a type of hospital-acquired infection (HAI) that arises following surgery and it is related to the surgical site [3]. SSI may result in increased morbidity and mortality, prolonged hospital stay, increased hospital readmissions even reoperation and healthcare costs [5, 6]. It has been reported by numerous studies that diverse surgical specialties were associated with elevated costs next to the development of an SSI in United Kingdom [7,8,9]. Fan Y.et al, 2014 reported 4.5% to be an average incidence of SSI in mainland China from 2001 to 2012 and abdominal surgery to be the most common surgical procedure
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