Prevalence of surgical site infections and antimicrobial sensitivity pattern in patients attending a Tertiary Care Hospital in South India: A prospective study

Abstract

Background: Nosocomial infections account for 1.7 million cases every year costing between $35.7 billion and $45 billion of losses to the system and surgical site infections (SSIs) were responsible for 77' of the death of patients. This study aims to analyse the factors involved and thereby reduce them. Materials and Methods: Ninety-six patients undergoing both emergency and elective procedures in the surgery department during a period of 1 month were selected and followed up pre-operatively, intraoperatively, post-operatively and till 30 days after surgery. Results: The prevalence rate of SSI was 41.6' with women (52') and patients of the age group of 41–60 years (30') being affected more. Alcohol, smoking, tobacco use, diabetes, hypertension, tuberculosis, duration of surgery hospital stay and the American Society of Anesthesiologists classification proved to be important factors in the prevalence rate. Emergency surgeries had twice the rate than electives. Staphylococcus aureus (22') and Escherichia coli (22') followed by Pseudomonas aeruginosa (18') and Proteus mirabilis (17') were the organisms isolated. All S. aureus isolates were methicillin sensitive but erythromycin resistant. E. coli isolates were sensitive to the antibiotics except for cefotaxime and ampicillin (41.6'). Pseudomonas showed resistance to bacitracin (80') and ampicillin (90'), and all were sensitive to ceftazidime. The Proteus species were all resistant to cefotaxime. Conclusion: The high prevalence rate in the study can be reduced by following a systematic approach during pre-operative workup of the patient with proper pre-operative hair removal and smoking cessation at least 1 month before surgery and post-operative monitoring and educating the patient.