Prevalence Of Surgical Site Infection Research Articles

Lower bleeding volume contributes to decreasing surgical site infection in radical cystectomy: A propensity score-matched comparison of open versus robot-assisted radical cystectomy.

To compare the incidence of surgical site infections (SSI) between robot-assisted and open radical cystectomies and investigate the risk factors for SSI after radical cystectomies. Consecutive patients who underwent radical cystectomy between July 2008 and December 2022 were retrospectively reviewed. The prevalence and characteristics of SSI after open and robot-assisted radical cystectomies were compared, and the risk factors for SSI were investigated using propensity score matching. This study enrolled 231 patients (open: 145, robot-assisted: 86). In the robot-assisted group, urinary diversion was performed using an intracorporeal approach. SSI occurred in 34 (open: 28, robot-assisted: 6) patients, and the incidence was significantly lower in the robot-assisted group (19.3% vs. 7.0%, p = 0.007). After propensity score matching cohort (open: 34, robot-assisted: 34), increased bleeding volume, blood transfusion, and delayed postoperative oral feeding were significantly associated with SSI. Only increased bleeding volume remained a significant risk factor in the multivariate regression analysis (odds ratio, 1.13 [per 100 mL increase]; 95% confidence interval: 1.02-1.25; p = 0.001). The cutoff bleeding volume for predicting SSI was 1630 mL with an area under the receiver operating characteristic curve, sensitivity, and specificity of 0.773, 0.73, and 0.75, respectively. The incidence of SSI after robot-assisted radical cystectomy was significantly lower than that after the open procedure. However, decreased bleeding volume, which was significantly associated with robot-assisted procedures, was an independent and more significant factor for reducing SSI after radical cystectomy than the differences of the surgical procedure even after propensity score matching.

Prevalence of and risk factors for surgical site infections after pancreaticoduodenectomy: a systematic review and meta-analysis.

Surgical site infections (SSIs) are one of the most common complications after pancreaticoduodenectomy (PD); however, the global prevalence and risk factors for SSIs after PD remain unknown. To investigate the prevalence of and risk factors for SSIs after PD. The PubMed, Embase, Cochrane Library, Web of Science, and Science Direct databases were systematically searched from inception to 1 December 2022. Observational studies reporting adjusted odds ratios (ORs) and 95% confidence intervals (CIs) of risk factors for SSIs in patients undergoing PD were included. Two independent reviewers in teams performed data extraction, risk of bias assessment, and level of evidence analysis. The pooled results were estimated using a random-effects model. The I 2 statistic and Q χ 2 statistic were used to assess heterogeneity. Funnel plots, Egger's regression test, and the trim-and-fill method were used to determine publication bias. The primary outcomes were identifying risk factors for SSIs after PD. The secondary outcomes were the pooled prevalence rates of SSIs. A total of 98704 patients from 45 studies were included, and 80% of the studies were considered high quality. The estimated pooled prevalence of SSIs was 23% (0.19-0.27, I 2=97%). The prevalence of SSIs was found to be higher in Japan and lower in USA. Preoperative biliary stenting, higher body mass index (BMI), longer operation time, postoperative pancreatic fistula, soft pancreatic texture, perioperative blood transfusion, and cardiac disease were identified as significant risk factors for the development of SSIs after PD. Additionally, broad-spectrum antibiotics were a significant protective factor against SSIs. Subgroup analysis and sensitivity analysis showed that the results were robust. The prevalence of SSIs remains high and varies widely among regions. It is necessary to take effective preventive measures and carry out more prospective studies to further verify these results.

Prevalence of Surgical Site Infection After Hip Arthroplasty; a Systematic Review and Meta-Analysis.

One of the worrisome complications of hip arthroplasty is surgical site infection (SSI). This study aimed to investigate the prevalence of SSI after hip arthroplasty. A comprehensive and systematic exploration was conducted across various international electronic databases, including Scopus, PubMed, and Web of Science, alongside Persian electronic databases such as Iranmedex and the Scientific Information Database (SID). This search strategy entailed the utilization of Medical Subject Headings-derived keywords such as "Prevalence," "Surgical wound infection," "Surgical site infection," and "Arthroplasty," spanning from the earliest records up to January 1, 2024. Each study's weight was assigned based on its inverse variance. A forest plot visualization was used to assess the studies' heterogeneity. Data on sample size and SSI frequency were compiled for each study to calculate the overall effect size. The study encompassed a cumulative participant cohort of 1,070,638 hip arthroplasty procedures drawn from seventeen selected studies. Notably, the female gender constituted 59.10% of the overall participant demographic. The aggregate SSI among patients undergoing hip arthroplasty was estimated to be 1.9% (95% CI: 1.3% to 2.8%; I2=99.688%; P<0.001). The results of the meta-regression analysis unveiled a statistically significant correlation between the prevalence of SSIs after hip arthroplasty and the year of publication (Coefficient=-0.0020; 95% CI: -0.0021 to -0.0018; Z=-19.39, P<0.001). The study findings indicated a prevalence rate of 1.9% for SSI following hip arthroplasty. This prevalence underscores the importance of vigilance in infection prevention and management strategies within orthopedic surgery. However, it is essential to acknowledge the variability in SSI prevalence observed across diverse studies, which can be attributed to multifaceted factors, notably variances in patient populations and associated risk factors.

To assess the level of knowledge regarding surgical site infections among medical students at Jazan University, Saudi Arabia

Objective: This study aimed to assess the knowledge levels of medical students at Jazan University, Saudi Arabia, regarding surgical site infection (SSI) and its related factors. Methods: A cross-sectional study was conducted among medical students at Jazan University using a validated online questionnaire that was distributed to the participants via social media platforms. Results: The majority of participants (91.7%) demonstrated poor knowledge regarding SSIs, with only a small proportion (8.3%) exhibiting good knowledge. While no significant differences were observed based on age or study year. A marginally significant association was found between gender and knowledge levels. Participants who had previously studied the surgery module demonstrated higher levels of knowledge compared to those who had not. Areas of least knowledge included the appropriate timing for administering prophylactic antibiotics, the prevalence of SSIs, and wound classification. Conclusion: The study highlighted significant gaps in knowledge among medical students at Jazan University regarding SSIs and related preventive measures. Targeted educational interventions and focused training programs are warranted to address these deficiencies and enhance overall knowledge levels among medical students. Improving understanding and awareness of key concepts related to SSI prevention and management is essential for mitigating the burden of SSIs and improving patient outcomes in healthcare settings.

Plating versus Intramedullary Nailing of OTA/AO 43C1 and C2 Intra-articular Distal Tibia Fractures: A Propensity Score and Multivariate Analysis.

To compare rates of loss of reduction, nonunion, and infection in intra-articular distal tibia fractures (IADTF) treated with limited open reduction internal fixation and intramedullary nailing (IMN) as compared to open reduction internal fixation with plate and screws (PF). Retrospective Review. Level-I academic trauma center. 110 patients, age ≥ 18 with operatively treated OTA/AO 43C1 and C2 IADTF between 2013-2021. Loss of reduction, surgical site infection (SSI), nonunion, and patient-reported outcomes (PROs). 110 patients met the inclusion criteria (IMN 33, PF 77). There was no loss of reduction reported. 17 nonunions (15% overall; IMN 4/33, PF 13/77) and 13 SSIs (12% overall; IMN 2/33, PF11/77) were identified. Despite several risk factors being identified for nonunion and SSI in bivariate analysis, only open fracture remained significant as a risk factor for both nonunion (OR 0.09 for closed fracture, 95% CI 0.02-0.56, p=0.009) and SSI (OR 0.07 for closed fracture, 95% CI 0.06-0.26, p=0.012) in the multivariate model. Propensity scoring based on presurgical variables was significantly different between patients that received IMN vs PF (p=0.03); however, logistic regression incorporating the propensity score revealed no significant association with nonunion and SSI. Adjusting for the propensity score, there remained no association comparing IMN versus PF with nonunion and SSI (p=0.54 and p=0.17, respectively). There was also no difference in PROs between IMN and PF (Physical function: p=0.25, Pain interference: p=0.21). Overall nonunion and SSI prevalence in our cohort was 15% and 12%, respectively, in operatively treated OTA/AO 43C1 and C2 IADTF. An open fracture is a significant risk factor for nonunion and SSI. Metaphyseal fixation via IMN or PF in IADTF did not affect the loss of reduction, nonunion, SSI, and PROs. Therapeutic Level III. See Instructions for Authors for a complete description of levels of evidence.

Late and Persistent Symptoms Suggestive of Surgical Site Infections After Cesarean Section: Results from a Prospective Cohort Study in Rural Rwanda.

Background: Women in low-resource settings will likely develop late surgical site infections (SSIs), diagnosed after post-operative day (POD) 10. We measured SSI prevalence and predictors of late and persistent SSIs-suggestive symptoms among women who delivered via cesarean section (c-section). Patients and Methods: Women who underwent c-sections at Kirehe District Hospital (KDH) between September 2019 and February 2020 were prospectively enrolled. Data were collected on POD1, POD11, and POD30. Logistic regression identified factors associated with persistent and late SSI symptoms. Results: In total, 808 women were study enrolled. Of these, 646 women physically attended the POD11 clinic visit follow-up, while 671 received the POD30 telephone-based follow-up review. Thirty-three (5.0%) women were diagnosed with an SSI on POD11, and 39 (5.3%) had an SSI diagnosis during POD11 to POD30, giving a cumulative prevalence of 10.3% late SSI rate. Of 671, 400 (59.9%) reported at least one SSI-associated symptom between POD11 and POD30. The reported symptoms included pain (56.6%), fever (19.4%), or incision drainage (16.6%). Of these, 200 women reported still having at least one of these symptoms on POD30. Of the 400 women with late SSI symptoms, 232 (58.0%) did not seek care, and of these, 80 (48.5%), 59 (35.8%), and 15 (8.9%) could not afford transport fare, did not believe symptoms were severe for a medical visit, and were not able to travel, respectively. Lower odds of late SSI-suggestive symptoms were reported among women with health insurance (adjusted odds ratio [aOR], 0.06; p = 0.013), whereas higher late SSI-suggestive symptoms odds were among women with wealthier socioeconomic status (aOR, 2.88; p = 0.004). Conclusions: Women in rural Rwanda are at risk of late and persistent SSI-suggestive symptoms. Financial barriers and the perception that their symptoms were not serious enough for the medical visit need education on early care seeking and interventions to mitigate financial barriers for optimizing perinatal care.

961. Prevalence of Surgical Site Infections and Bacteremia in Pediatric Patients Receiving Extracorporeal Membrane Oxygentaion

Abstract Background Extracorporeal membrane oxygenation (ECMO) is a well-known type of advanced life support used in critically ill patients with serious heart and/or lung problems. ECMO treatment is associated with multiple life-threatening complications. The objectives of this study were to identify the prevalence of surgical site infections (SSI) and bloodstream infections (BSI) along with the associated risk factors and outcomes in patients on ECMO. Methods In this retrospective study, clinical charts of patients were reviewed from January 2012 to April 2023. All admitted pediatric patients 14 years or less who received ECMO treatment were enrolled. Mann-Whitney and Fisher exact tests were used to assess mortality-related risk factors. Results A total of 165 patients were included in the study, 79 (47.88%) females and 86 (52.12%) males, with a median age of 4 [IQR 0.8-24] months. BSI were found in 33 (20%) of them, 10 (30.30%) were gram-positive, 25 (75.75%) were gram-negative, and 6 (18.18%) were fungi. Furthermore, 33 (20%) developed SSI. The overall mortality rate in this study is (50.30%) with a median duration from ECMO procedure initiation to death being 11 [IQR: 5-26] days. Most of mortalities (78.31%) were noticed in infants aged ≤24 months. Compared with patient with neither SSI nor BSI, patients with SSI and BSI had a higher mortality rates of 19 (22.89%) and 16 (19.28%) respectively. Additionally, other noted complications were mediastinitis 4 (2.42%), sternal osteomyelitis 2 (1.21%), infective endocarditis 4 (2.42%). Younger age and thrombocytopenia were found to be a mortality related risk factors (P value 0.04 and 0.01 respectively). Conclusion Our study found a high rate of bacteremia and SSI in pediatric patients receiving ECMO. Younger age, thrombocytopenia were the potential risk factors associated with higher mortality rates in this group. Disclosures All Authors: No reported disclosures

Prevalence of surgical site wound infection after spine surgery in nasal colonization of methicillin-resistant Staphylococcus aureus: A meta-analysis.

The purpose of the meta-analysis was to evaluate and compare the prevalence of surgical site infection (SSI) after spine surgery (SS) in nasal colonization of methicillin-resistant Staphylococcus aureus (MRSA). The results of this meta-analysis were analysed, and the odds ratio (OR) and mean difference (MD) with 95% confidence intervals (CIs) were calculated using dichotomous or contentious random- or fixed-effect models. For the current meta-analysis, 14 examinations spanning from 2014 to 2022 were included, encompassing 18 410 people who were tested for nasal colonization after SS. MRSA-positive had a significantly higher SSI (OR, 3.65; 95% CI, 2.48-5.37, p < 0.001) compared with MRSA-negative in SS subjects. However, no significant difference was found between methicillin-susceptible Staphylococcus aureus and Staphylococcus aureus negative (OR, 0.94; 95% CI, 0.32-2.79, p = 0.91), and Staphylococcus aureus positive and negative (OR, 2.13; 95% CI, 0.26-17.41, p = 0.48) in SS subjects. The examined data revealed that MRSA colonization had a significant effect on SSI; however, methicillin-susceptible Staphylococcus aureus and Staphylococcus aureus had no significant effect on SSI in SS subjects. However, given that some comparisons included a small number of chosen studies, attention should be given to their values.

INCIDENCE AND PREDICTORS OF SURGICAL SITE INFECTION IN MAJOR ABDOMINAL SURGERIES AT A TERTIARY CARE CENTER IN DELHI

Objective: Surgical site infections (SSIs) are the third commonly stated nosocomial infections, with the prevalence rate of 14–16%. In India, the prevalence of SSIs in elective surgeries ranged from 3.83% to 39% and in cases of emergency surgeries, the prevalence ranged from 12.41% to 26.4%. This study was aimed to measure the occurrence of SSIs amid subjects experiencing major abdominal surgeries at tertiary care center in Delhi and to assess the predictors related to occurrence of SSIs in these subjects. Methods: In this cross-sectional study, data were collected over a period of 1 year at the Department of Surgery, Super Specialty Hospital in New Delhi. The, from January 2017 to January 2018. All major gastrointestinal surgeries were considered. Sociodemographic details, clinical history, and surgical details were taken. Results: Out of total 626 patients, 42 (6.7%) developed SSIs. The positive predictors of SSIs in our study were male gender, American Society of Anesthesiology grade of 2 and above, wound class of two and above, longer duration of surgery, emergency surgery, open surgery, laparoscopic converted to open surgery, presence of comorbidities, presence of hypoalbuminemia, and hypoproteinemia. Conclusion: SSIs seems to be a common source of perioperative morbidity and mortality, leading to increased hospital stay and cost of treatment. Proper planning and accordingly managing such case by case scenarios can lead to decreased incidence of SSIs and help reducing burden to the health system.

Effectiveness of Gentamicin Wound Irrigation in Preventing Surgical Site Infection During Lumbar Spine Surgery: A Retrospective Study at a Rural Teaching Hospital in India.

Surgical site infections (SSIs) are an opposing result of surgery and account for the majority of healthcare-related infections worldwide. It is one of the most common complications associated with open-spine surgery and is associated with high rates of mortality and high demand for healthcare resources. Surgical site infections are the result of a variety of reasons, which is why a range of prevention strategies have been proposed. Intraoperative wound irrigation (IOWI) is a simple procedure that involves moving a solution through an open wound to help hydrate the tissue. It is a type of prophylactic wound irrigation. It removes and dilutes bodily fluids, bacteria, and cellular debris. It may also act as a bactericidal agent when used with antibiotics and antiseptics. To evaluate the incidence of SSIin lumbar spine surgeries by comparing IOWI with normal saline containing gentamicin (NS-G) and normal saline (NS) alone. A hospital-based retrospective study was conducted among 40 patients who underwent elective lumbar spine surgery at the Department of Orthopaedics, RL Jalappa Hospital Centre, Kolar, Karnataka, India. Out of the total participants enrolled, 60% were males and 40% were females. There was no statistically significant difference found between mean age, mean BMI, mean hemoglobin level, mean WBC counts, and mean fasting blood sugar (FBS) levels among both groups. The overall prevalence of SSI among patients was 25%. In Group A (NS-G), the prevalence of SSI was 15%, and in Group B (NS), it was 35%. In total, 17.5% of study participants had superficial SSI, while 7.5% had deep SSI. Gentamicin, an aminoglycoside antibiotic, is bactericidal and efficient against gram-positive organisms likeStaphylococcus, the most frequent pathogen causing SSI in spine surgery. During lumbar spine surgery, IOWI with saline and gentamicin before closure is more effective in preventing SSI than simple saline irrigation.

Prevalence, Knowledge, and Preventive Practices of Surgical Site Infection among Nurses in Selected Hospitals in Owo, Ondo State, Nigeria

Surgical site infection (SSI) is a burden to the patient and family as it extends the number of days spent in the ward post-surgery. This study assessed the perception of factors associated with surgical site infection among nurses in selected hospitals in Ondo State, Nigeria. A cross-sectional design was utilized for the study. A simple random sampling technique was used to select 100 respondents for the study. Data was collected using a self-constructed questionnaire. Data obtained were analyzed with descriptive and inferential statistics using SPSS version 22. Results were summarized using frequency tables and charts. Results showed that the prevalence of surgical site infection among postoperative patients was 47%, with approximately 20% mortality rate. Also, the study showed that 88% of the respondents have high knowledge of SSI. Preventive practices adopted against SSI among respondents were: skin preparation using alcohol (76%), hand washing before wound care (92%), aseptic technique (80%), assessment of surgical site (89%), antibiotics usage (89%) and use of surgical mask (98%); overall, 97% of the respondents showed good level of preventive practice. The study showed a significant relationship between knowledge and preventive practice of SSI among respondents (X2= 20.20, df=4, p &lt; 0.05). Also, there was a significant relationship between the duration of surgery and SSI among postoperative patients (X2 = 18.21, df=3, p &lt; 0.05). The study concludes that SSI is well known among the respondents. However, the identified factors seem to contribute to the increase in SSI among the patients the respondents cared for.

Factors Influencing Prevalence of Surgical Site Infections among Mothers Undergoing Ceaserean Section in Iganga Hospital, Uganda

Caesarean Section as a mode of delivery is the most commonly done surgical procedure in maternity departments all over the world. Surgical site infection complicates about one-third to two-thirds of caesarean sections in low-income countries which is about 9 times higher compared with the high-resource countries. Surgical Site Infection is associated with increased maternal morbidity, prolonged hospital stay and increased medical costs. The development of post-caesarean surgical site infection is hung on a complex interplay of many factors not limited to wound class, immune status, maternal age, hypertensive disorders, ASA classification, number of vaginal examinations, the virulence of the microorganisms, maternal weight, surgical techniques and premature rupture of membrane. The study employed a descriptive cross-sectional and quantitative approach to study the factors influencing the prevalence of surgical site infections among mothers undergoing caesarean section in Iganga Hospital. A sample size of 288 participants were enrolled using a random sampling technique and close-ended questionnaires were employed to obtain the data from participants. Data analysis was done using SPSS version 20 and statistical significance was set at a P-value less than 0.05 at 95% confidence interval. A total of 288 post-caesarean mothers were studied from October – November 2021 in Iganga Hospital. The majority of the participants were married 255(88.8%) and had a secondary level of education 142(49.3%). The mean age of the participants were 25.6 years with 21 as the modal age. The prevalence of surgical site infection among post-caesarean mothers at Iganga Hospital was 20.5% (59 out of 288) and the factors which were statistically influencing the SSI included early rupture of membranes of more than 18 hours (aOR 23.715 95% C.I 5.976-94.117, P 0000) and postoperative haemoglobin (aOR 15.109 95% C.I 3.494-65.333, P 0.000) There’s a high burden of SSI among post-caesarean mothers in Iganga Hospital. Earlyrupture of membranes more than 18 hours and post-operative haemoglobin less than 11g/dl are key contributory factors. Aggressive prophylactic and post-operative antibiotic therapy should be considered in mothers with early rupture of membranes and post-operative anaemia. Keywords: Caesarean Section, Maternal morbidity, Surgical Site Infection, Post-caesarean mothers, Vagina examination. IN

Instrument Sterilization and Surgical Site Infections in Low and Middle Income Countries

With the recent surge in oftentimes fatal bacterial resistance, surgical site infections (SSI) are now a prominent topic of scholarly discussion. These infections occur due to unsterile surgical practices infiltrating the operating room, and deadly pathogens with it. The developed world has lowered rates of SSI through scrupulous enforcement of CDC sterilization guidelines while low and middle income countries (LMICs) continue to fall victim to inefficient sterilization. LMICs often don't have the resources to reach these CDC guidelines and as a result endure surgical instrument contamination. Currently, there is a gap in funding and research related to the state of surgical instrument sterilization. This study aims to reveal first hand data regarding the gap in adherence to CDC sterilization guidelines for a variety of LMICs. Data was collected through virtual interviews with surgeons or surgical technologists globally. Interview responses were later scored for adherence to the CDC guidelines and correlated with rates of SSI per country. Results showed that the adequacy of surgical instrument sterilization processes (SP) in hospitals is directly correlated to SSI rates in LMICs. A one tailed test with a flow of SP adherence to SSI prevalence rendered the following strong correlation of R squared=0.772. This relationship demonstrates that investments to improve surgical sterilization processing will likely render lower rates of SSI. Lower SSI rates in LMICs could give rise to an increase in surgical tourism, a decrease in expensive treatments for highly resistant bacteria, and ultimately a decrease in surgical morbidity and mortality.

Effect of a New Antibiotic Protocol Adopted by ASU Hospitals on Patients with Intra-Medullary Nailing of Femoral and Tibial Diaphyseal Fractures as Regard Post-Operative Infection

Background This study postulated that systemic antibiotic prophylaxis delivered preoperatively in intramedullary nailing of femur and tibia procedures significantly reduces the incidence of infection. Prophylactic antibiotics should be taken IV before skin incision by 30-60 minutes and no need for antibiotics more than 24 hours after operation. This protocol of antibiotics has multiple benefits such as saving a lot of money, decrease the risk of surgical site infection and decrease antibiotic resistance. Aim of the Work To assess the effect of antibiotic choice, duration on prevalence of surgical site infection among patients with intramedullary nailing of femoral and tibial fractures, and identify risk factors. Patients and Methods This study conducted on 50 cases of femoral and tibial fractures admitted from Al-Demerdash University Hospital in the period from June 2019 to December 2020 with age ranged from 18 to 56 years and with mean ± SD of 28.14 ± 10.14. This study was based on the antibiotic protocol adopted by Ain Shams University Hospitals that we give first generation cephalosporin (zinol) for all patient undergoing intramedullary nailing of femur and tibia, 30 – 60 minutes before skin incision and for 24 hours post-operative. Results The results of this study showed 1 case infected postoperative from 50 cases with a percentage of 2%, by this result we found that by studying the risk factors for infection there was no specific risk factor for infection except for obesity and diabetes. By studying of the results of application of our new antibiotic prophylaxis protocol in our hospital (Ain Shams University Hospitals) from the period from 6-2019 to 12-2020 the new protocol have the benefits of the following: Decrease of the total percentage of infection in all orthopedic surgeries in our department to less than 2%, Presence of fixed, known and effective prophylactic antibiotic protocol in our hospital unlike before every surgeon has his opinion about type and dose of antibiotics causing less controversy and confusion among surgeons in the practice of postoperative antibiotic use. Conclusion This study postulated that systemic antibiotic prophylaxis delivered preoperatively in intramedullary nailing of femur and tibia procedures significantly reduces the incidence of infection.

Prevalence of surgical site infection and risk factors in patients after foot and ankle surgery: A systematic review and meta-analysis.

The present systematic review and meta-analysis aimed to determine the prevalence of surgical site infection (SSI) and related factors in patients after foot and ankle surgery. A comprehensive, systematic search was conducted in different international electronic databases, such as Scopus, PubMed, Web of Science and Persian electronic databases such as Iranmedex and Scientific Information Database (SID) using keywords extracted from Medical Subject Headings such as 'Prevalence', 'Surgical wound infection', 'Surgical site infection' and 'Orthopaedics' from the earliest to 1 June 2023. The appraisal tool for cross-sectional studies (AXIS tool) evaluates the quality of the included studies. A total of 10 447 patients undergoing foot and ankle surgery participated in nine studies. The pooled prevalence of SSI in patients who underwent foot and ankle surgery was reported in nine studies was 4.2% (95% CI: 2.4%-7.2%; I2 = 96.793%; p < 0.001). The odds ratio of SSI prevalence in men was higher than that of women and was significant (OR: 1.335; 95% CI: 1.106-1.612; Z = 3.009; p = 0.003). The pooled prevalence of SSI in patients with hindfoot fracture sites reported in five studies was 4.9% (95% CI: 2.6%-8.9%; I2 = 90.768%; p < 0.001). The pooled prevalence of SSI in patients with diabetes mellitus (DM) reported in six studies was 9.1% (95% CI: 5.6%-14.6%; I2 = 73.957%; p = 0.002). The pooled prevalence of SSI in patients with hypertension (HTN) reported in five studies was 5.5% (95% CI: 2.5%-11.6%; I2 = 91.346%; p < 0.001). The pooled prevalence of SSI in patients with tobacco use reported in eight studies was 6.6% (95% CI: 4.1%-10.4%; I2 = 85.379%; p < 0.001). In general, the existing differences in the prevalence of SSI after foot and ankle surgery in different studies can be based on different risk factors such as comorbidities and gender. Therefore, it is suggested to design appropriate interventions to reduce SSI in these patients.

Surgical Site Bacterial Infection in a General Hospital, Al-Jouf Region, Saudi Arabia: A Retrospective Study.

Background Surgical site infection (SSI) is a major healthcare problem with a great impact on patient morbidity, mortality, and healthcare cost all over the world. It accounts for 20% of healthcare-associated infections (HAIs), with higher frequency in low- and middle-income countries where it affects about 30% of the patients undergoing surgery. Aim The current study aims to assess the prevalence of SSI in a general hospital in Sakaka, Al-Jouf region, Saudi Arabia. The types of bacteria causing SSI were also determined. Subjects and methods A retrospective cross-sectional study was done by reviewing the hospital records of patients who got SSI during the period between 2020 and 2022. Data collection was done during 2022 and 2023 after taking ethical approval and permission from the hospital management. Results The numberof patients who underwent surgical procedures during 2020, 2021, and 2022 were 689, 867, and 1119, respectively. Most of the cases were cholecystectomy and appendectomy. The cases that developed surgical site infection after cholecystectomy and/or appendectomy during 2021 and 2022 were 15.45% and 9.29% cases, respectively, and they were mainly associated with appendectomy. A culture and sensitivity test revealed methicillin-resistant Staphylococcus aureus (MRSA)and Klebsiella pneumonia. Nearly all patients have received ciprofloxacin for seven days and improved with treatment. Conclusion The number of cases that developed SSI has decreased gradually due to the application of infection control measures and strict follow-up.

Surgical Site Infection (SSI) Predominance and Causative Factors Association after Caesarean Section at Asella Teaching and Referral Hospital, Ethiopia

Background:: Caesarean Section (CS) is the most commonly performed major obstetrical procedure, accounting for 15% of all deliveries globally. Surgical Site Infection (SSI) is one of the most prevalent infectious complications following CS. This state of health increases maternal morbidity and mortality, as well as hospitalization length and hospital expenses. The goal of this study was to ascertain the prevalence of SSI and the factors that contribute in mothers who had CS at Asella Teaching and Referral Hospital (ATRH). Methods:: From December 2020 to January 2021, an institution-based retrospective cross-sectional study (CSS) was carried out at ATRH. The data were collected from the case records of the mothers who underwent CS by systematic random sampling technique. The collected data was exported to Epi-info version 7 for cleaning and exported to SPSS for further data analysis process. Descriptive and inferential statistics were applied. To identify factors associated with SSI, logistic regression was used to fit data with a P-value of &lt; 0.05 was considered statistically significant in all cases. Results:: The prevalence of SSI was 9.9%. About 28(12%) of SSI were developed during emergency procedures, and 3(3.8%) of them were developed during elective procedures done in the hospital. In this study, SSI was significantly associated with; (pain/tenderness at operation site [AOR=310.04 95%CI (9.58 -10037.68)], arrest of labor [AOR=0.03 95%CI (0-0.49)], skin closure [AOR=46.548 95%CI (1.74-1240.25)], parity [AOR=0.08 95%CI (0.01-0.73)], duration of operation [AOR=0.31 95%CI (0.10 -0.86)] and gestational age [AOR=0.08 95%CI (0.01-0.55)]. Conclusion:: Post-cesarean SSI was found to be high; and pain/tenderness at the operation site, arrest of labor, skin closure, parity, duration of operation and gestational age were significantly associated with SSI and this can be averted by appropriate preoperative, intraoperative and post-operative management. other: Surgical site infection, caesarean section, associated factors, Ethiopia

Impact of control measures including decolonization and hand hygiene for orthopaedic surgical site infection caused by MRSA at a Japanese tertiary-care hospital

Meticillin-resistant Staphylococcus aureus (MRSA) is the most common pathogen in orthopaedic surgical site infections (SSIs). However, few studies have investigated the transmission process of orthopaedic MRSA SSI. To investigate the transmission process of orthopaedic MRSA SSI using epidemiological and molecular analyses and to determine a method to prevent MRSA SSI innosocomial orthopaedic surgery. Active MRSA surveillance, preoperative decolonization and contact precautions for MRSA-positive cases was performed at our institution. Changes in epidemic strains were evaluated and the possibility of transmission from patients in an orthopaedic ward of a Japanese tertiary-care hospital was assessed by genotyping stored MRSA strains. In addition, data on the prevalence of MRSA SSI, MRSA colonization, and use of an alcohol antiseptic agent (mL/patient-days) during 2005-2022 were retrospectively assessed. SCCmec type II strain in the SSI group decreased over time, associated with fewer outbreaks. Even during a period of high infection rates, no cases of transmission-induced SSI from nasal MRSA carriers were identified. The infection rate correlated negatively with the use of an alcohol antiseptic agent (r = -0.82; P < 0.0001). Two cases among five nasal carriers developed MRSA SSI caused by strains different from those related to nasal colonization. The infection control measures for transmission from the hospital reservoirs including strict adherence to hand hygiene and decolonization of carriers is likely to be important for the prevention of orthopaedic MRSA SSI. However, the need for contact precautions for decolonized nasal carriers might be low.

Surgical site infection: Clinico- bacteriological Profile and antibiogram in a tertiary care hospital in Kolkata

Surgical site infections (SSIs) are a major health care associated infections and possess a great challenge to clinicians. It increases duration of hospital stay, associated morbidity and mortality and treatment cost. For prompt and appropriate management, it is necessary to understand the appropriate microbial etiology and its antimicrobial susceptibility pattern. To determine the prevalence of SSI along with its clinico-bacteriological profile and antibiogram and to correlate with the risk factors.A cross-sectional study was conducted in the Department of Microbiology of Nil Ratan Sircar Medical College &amp; Hospital, Kolkata for a period of one year (2020-2021). Post-operative surgical site infections within 30 days after surgery were included in the study. All samples were collected from clinically suspected SSI cases and processed in the lab as per standard laboratory protocol. Vitek®2 compact system (BIOMERIEUX) was used for further identification and antimicrobial susceptibility testing. All Gram negative pathogens resistant to 3rd generation cephalosporins were screened for ESBL and AmpC. Carbapenem resistant isolates were subjected to Carba NP test for carbapenemase production. Out of 6582 surgeries, clinically suspected SSIs were detected in 220 cases. Among these 220 patients, 186 patients were confirmed as SSI in the laboratory, SSI rate being 2.83%. In 62.27% cases, growth was mono-microbial. Growth of gram negative organisms were noted in 58.72% cases and gram positive growth was 38.53%. (57.14%) was the predominant isolates followed by (35.94%). Diabetes mellitus, obesity and using prophylactic antibiotic &amp;#62;2 hours prior to surgery were found to be significantly associated. For gram positive organism, Vancomycin and Linezolid were found to be most susceptible antimicrobials and for gram negative organisms, it was Polymyxin B and Meropenem. Most of the gram negative organisms were ESBL producer (67.97%). Rapidly emerging multi drug resistant organisms are complicating the management of surgical site infection day by day and possessing significant burden to health care system. For implementation of appropriate antimicrobial policy, it is important to identify bacteriological profile and antibiogram in every hospital.

Prevalence of surgical site infections after open reduction and internal fixation for mandibular fractures: a systematic review and meta-analysis

Our study aims to estimate the prevalence of surgical site infections (SSI) following open reduction and internal fixation (ORIF) for mandibular fractures and to determine the effect of potential moderators on it. A systematic literature search (Medline and Scopus databases) was conducted independently by two reviewers. The pooled prevalence with 95% confidence intervals was estimated. Quality assessment as well as outlier and influential analysis were performed. Additionally, subgroup and meta-regression analysis were conducted in order the effect of categorical and continuous variables on the estimated prevalence to be investigated. In total, seventy-five eligible studies (comprising a sum of 5825 participants) were included in this meta-analysis. The overall prevalence of SSI following ORIF for mandibular fractures was estimated as high as 4.2% (95% CI 3.0–5.6%) with significant heterogeneity between studies. One study was identified to be critically influential. In the subgroup analysis, the prevalence was 4.2% (95% CI 2.2–6.6%) among studies conducted in Europe, 4.3% (95% CI 3.1–5.6%) among studies conducted in Asia and higher among those conducted in America (7.3%) (95% CI 4.7–10.3%). It is important for healthcare professionals to be aware of the etiology of these infections, despite the relatively low rate of SSI in these procedures. However, further, well-designed prospective and retrospective studies need to be conducted in order this issue to be fully clarified.