Bacteriological Profile Of Surgical Site Infections Research Articles

Determining the Frequency, Factors and Bacteriological Profile of Surgical Site Infection in a Tertiary Care Teaching Hospital of Western Uttar Pradesh

Background: Surgical site infections (SSIs) account for nearly 20% to 25% of all Health care associatedinfections (HCAIs) worldwide. SSI rates are reported to range from 2.5% to 41.9% resulting in highmorbidity and mortality. Settings and Design: A prospective study was carried out in a tertiary care teachinghospital of Western Uttar Pradesh to determine the frequency, factors and bacteriological profile of Surgicalsite Infections. Materials and Method: Patients, of all age group, gender and diagnosed as a case of SSI asper CDC clinical criteria were included. The demographic detail, diagnostic criteria, associated risk factorswere noted. Culture and antimicrobial susceptibility pattern was determined. Laboratory and clinical datawere analysed. Observations & Results: Significant determinants of SSIs were; male population, youngand middle age group, hot and humid climate, type II diabetes, prolonged duration of surgery and certainsurgical procedures such as lower segment caesarean section, cholecystectomy, laparotomy etc.The rateof SSI was 2.78% and culture positivity rate was (55.04 %). There was predominance of Gram negativebacteria (76.73%). Coagulase Negative Staphylococci (72.22%) and Pseudomonas aeruginosa (35.48 %)were the predominant bacteria isolated. The clinical isolates showed high level of resistance to variousantimicrobial agents.Conclusions: Knowledge about the factors responsible and the bacteriological profile of SSI will guide theclinicians in choosing the appropriate treatment options which will ultimately reduce the morbidity, cost andlead to better clinical outcome.

Surgical site infection in surgery ward at a tertiary care hospital: the infection rate and the bacteriological profile

Background: Surgical Site Infections (SSI) constitute a major fraction of nosocomial infections and occur in superficial incisional, deep incisional, and organ\space locations. The bacteriological profile of SSI and their antibiotic-susceptibility-pattern; aims towards planning proper treatment of SSI. Objectives: To determine the SSI rate MIS (Minimally Invasive Surgery) vs OS (Open surgery) during the study period, the bacteriological profile of SSI & their antibiotic-susceptibility-pattern, and to build up guidelines for empirical treatment of SSI till antibiotic sensitivity results are procured. Design: Prospective, randomized, hospital based study. Materials and Methods: The study included 784 patients; undergoing either OS or MIS\laparoscopic surgery from May 2009 to April 2011; at surgery department of hospital, among which; 72 cases of SSI was observed. Aspirated secretion\pus\wound swab was obtained from operation site of all the cases and cultured aerobically and an-aerobically using standard microbiological techniques. For control, skin swabs were collected from proposed incision site; prior to surgical draping; and bacterial culture attempted in all the subjects. The isolates were processed as per standard test guidelines. Antibiotic susceptibility tests were done by Kirby-Bauer technique. Results: Rate of SSI was 2.06% vs 16.16% in MIS vs OS. Most predominant pathogen was Staphylococcus aureus, predominantly Oxacillin resistant Staphylococcus aureus (ORSA-56.5%). Superficial SSIs were predominated by S.aureus. Deep SSI was predominated Klebsiella sp. ORSA were highly sensitive to vancomycin and linezolide. All ESBL producing isolates were highly sensitive to imipenem. Conclusions: Multidrugresistant (MDR) bacteria have profound role in SSIs. Empirical antibiotic therapy essentially to be started at clinicians end; before receiving the antibiotic susceptibility test results; may include therapy with amikacin and piperacillintazobactum or amikacin and cefoperazonesulbactum & must be switched over to vancomycin or linezolide when ORSA is the causative agent or, to other suitable antibiotics in case of ESBL producing etiology; strictly; as directed by microbial culture and antibiotic susceptibility test report. Keywords––Antibiotic stewardship, Empirical antibiotic therapy, Minimally invasive surgery, Multidrugresistant bacteria, Open surgery, Oxacillin resistant Staphylococcus aureus, Surgical site infection