Surgical Site Infections : A One Year Prospective Study in a Tertiary Care Center

Varsha Shahane,Upendra Lele,Saikat Bhawal

doi:10.12816/0005976

Abstract

Surgical Site Infections (SSI) is the third most commonly reported nosocomial infection which has an adverse impact on the hospital as well as on the patient. A continuous surveillance is called for, to keep a check on the occurrence of SSI. to study the incidence of SSI in our hospital.to study the risk factors of SSI in our hospital.to identify the areas in our hospital, which need to be strengthened and dealt with proactive measures to curb the incidence of SSI, which is an indicator of health care system in a given set up. We conducted a one year study of SSI in our hospital. 300 cases of Surgery and Obstetrics and Gynaecology were included in the study. A few host factors, wound factors and surgery related factors that cause SSI were studied. Swabs were collected from the infected surgical wounds and processed by the conventional microbiological methods. Antimicrobial susceptibility was done by Kirby-Bauer disc diffusion method. Prolonged surgery (>2hours) and insertion of drain were found to be significantly associated with occurrence of SSI and the clean surgeries showed minimum risk of infection. Escherichia coli (31.25%) was the commonest pathogen, followed by Pseudomonas aeruginosa (25 %) and Staphylococcus aureus 22%. The incidence of SSI in our set up is 6%. THE OUTCOME OF THE SSI SURVEILLANCE IN OUR HOSPITAL REVEALED THAT IN ORDER TO DECREASE THE INCIDENCE OF SSI WE WOULD HAVE TO: a) decrease the duration of the surgeries performed b) focus on regular and intensive drain care c) identify poor risk patients and ensure their proper management d) conduct periodic surveillance to keep a check on SSI.

Highlights

Surgical site infections (SSI) are the third most commonly reported nosocomial infection and they account for approximately a quarter of all nosocomial infections
(2) Antimicrobial susceptibility testing was done by Kirby-Bauer disc diffusion method (3) and interpretation was done according to CLSI guidelines. (4)
(Fig 1) This is in agreement with the SSI incidences in other studies. (6, 7) infection rates varying from 20% to as high as 76.9% have been reported. (8-12)

Summary

Introduction

Surgical site infections (SSI) are the third most commonly reported nosocomial infection and they account for approximately a quarter of all nosocomial infections It has an adverse impact on the hospital as well as on the patient. The present study was aimed at obtaining the incidence of SSI in our set up and to evaluate the risk factors as well as to formulate an antibiotic policy for patients posted for any surgery in our hospital. Surgical Site Infections (SSI) is the third most commonly reported nosocomial infection which has an adverse impact on the hospital as well as on the patient. Conclusions: The outcome of the SSI surveillance in our hospital revealed that in order to decrease the incidence of SSI we would have to: a) decrease the duration of the surgeries performed b) focus on regular and intensive drain care c) identify poor risk patients and ensure their proper management d) conduct periodic surveillance to keep a check on SSI.

Objectives

Methods

Discussion

Conclusion