Abstract
Surgical site infections (SSIs) are the second most common nosocomial (hospital-acquired) infections after urinary tract infections. Despite recent advances in aseptic techniques, till now SSI has been considered as a major source of morbidity and mortality in developing countries and continued to represent about one fifth of all healthcare-associated infections. This cross-sectional study was conducted to analyze the pattern & aetiological factors of SSI among patients undergoing surgery at Sir Salimullah Medical College Mitford Hospital, Dhaka, Bangladesh involving 160 admitted patients during the study period. Of all SSIs, 73.0% were superficial and 27.0% were deep infections. Among the risk factors, Hypertension (29.4%), Diabetes Mellitus (24.4%), old age (>60 yr) [19.4%], anaemia (28.7%), and below average nutrition (13.8%) were the most common and had statistically significant relation with SSIs (p<.05). Moreover, incidence of SSIs was significantly higher in patients who required more duration of operation. The most common organism involved in SSI was S. aureas (42.4%), followed by E. coli (27.3%), P. aeruginosa (12.1%), bacteroids (12.1%) and Klebsiella spp. (6.1%). However, Meropenem was the most sensitive drug followed by Ceftriaxone according to culture and sensitivity screening. Gentamycin was 100% sensitive for gram-negative organism only. The incidence of SSIs are about one fifth of the post-surgical cases, where Staphylococcus aureus was the most prevalent organism. Meropenem and Gentamicin were the two most sensitive drugs against infections. BSMMU J 2021; 14(3): 50-56
Highlights
Infection at surgical incision site has always been a burden in clinical practice for years
A series of update has been engraved to the history of analysis and monitoring, subjecting the patterns and aetiology
Majority patients belonged to 51 – 60 years (36.3%), among which 59% were male and 41% were female. (Figure - 1 and Figure - 2) Majority patients were from lower socio-economic class (52.5%). followed by middle class (33.8%) and upper class (13.8%)
Summary
Infection at surgical incision site has always been a burden in clinical practice for years. Numerous studies and analysis have been performed and reported to get to the root of it. A series of update has been engraved to the history of analysis and monitoring, subjecting the patterns and aetiology. Factors for acquiring infection are host factors, surgical factors, environmental factors and nature of microbes.. Among surgical factors the nature and extensibility of operation, site and depth of the wound, logistic used during and after operation and surgeons’ technical skills are remarkable. If host damage is extensive and co-morbidity i.e. diabetes or other immunosuppressive states remain, small inoculums of virulent bacteria can ensure SSI and overwhelming infection occurs. Virulent bacteria of drug resistant nature may be the single factor of an fulminant infection.
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