Profile Of Surgical Site Infections Research Articles

Bacteriological profile of surgical site infections and their antimicrobial susceptibility pattern at a tertiary care hospital, Western Gujarat

Bacteriological profile of surgical site infections and their antimicrobial susceptibility pattern at a tertiary care hospital, Western Gujarat

A study on clinico-demographic and microbiological profile of surgical site infection (SSI) in a tertiary care hospital, Kolkata: An alarming trend

The Centres for Disease Control and Prevention (CDC) estimates surgical site infections SSI is major contributor of healthcare associated infections (HAI). Multidrug resistant (MDR) Gram-negative bacilli are emerging pathogens. This study aimed to determine the magnitude of SSI and identify predominant pathogens with their antimicrobial susceptibility patterns. It is a hospital-based descriptive cross-sectional study including 2070 suspected SSI specimens from 25809 surgeries between 1July 2021 to 30 June 2023. Organisms’ identification and AST was done by both conventional and automated methods. Data was collected and analysed on MS-Excel sheet with various charts and tables. In our study SSI rate was 6.3%, much higher than previous study (2.83%) from this institution. SSI rate was highest in plastic surgery (8.2%). Major pathogens of SSI were Gram-negative bacilli e.g., (26.34%), (25.59%) and (74.69%) was predominant among Gram-positive cocci. Gram-negative bacilli including enterobacterales and non-fermenter and showed resistance to major classes of broad- spectrum antibiotics. Methicillin resistance (MRSA) was 43.9%, which indicates need to improve infection control practices. Our study showed significant higher proportion of SSI as compared to previous studies from the same institute with alarming number of isolated MDR Gram-negative bacilli. So, this study focusses the need of robust infection control practices and strict implementation of antimicrobial stewardship to overcome challenges of antimicrobial resistance.

Aerobic Bacteriological Profile of Surgical Site Infections and their Antibiogram

Aerobic Bacteriological Profile of Surgical Site Infections and their Antibiogram

Orthopedic postoperative infection profile and antibiotic sensitivity of 2038 patients across 24 countries – Call for region and institution specific surgical antimicrobial prophylaxis

PurposeImproper utilization of surgical antimicrobial prophylaxis frequently leads to increased risks of morbidity and mortality.This study aims to understand the common causative organism of postoperative orthopedic infection and document the surgical antimicrobial prophylaxis protocol across various institutions in to order to strengthen surgical antimicrobial prophylaxis practice and provide higher-quality surgical care. MethodsThis multicentric multinational retrospective study, includes 24 countries from five different regions (Asia Pacific, South Eastern Africa, Western Africa, Latin America, and Middle East). Patients who developed orthopedic surgical site infection between January 2021 and December 2022 were included. Demographic details, bacterial profile of surgical site infection, and antibiotic sensitivity pattern were documented. Results2038 patients from 24 countries were included. Among them 69.7 % were male patients and 64.1 % were between 20 and 60 years. 70.3 % patients underwent trauma surgery and instrumentation was used in 93.5 %. Ceftriaxone was the most common preferred in 53.4 %. Early SSI was seen in 55.2 % and deep SSI in 59.7 %. Western Africa (76 %) and Asia-Pacific (52.8 %) reported a higher number of gram-negative infections whereas gram-positive organisms were predominant in other regions. Most common gram positive organism was Staphylococcus aureus (35 %) and gram-negative was Klebsiella (17.2 %). Majority of the organisms showed variable sensitivity to broad-spectrum antibiotics. ConclusionOur study strongly proves that every institution has to analyse their surgical site infection microbiological profile and antibiotic sensitivity of the organisms and plan their surgical antimicrobial prophylaxis accordingly. This will help to decrease the rate of surgical site infection, prevent the emergence of multidrug resistance and reduce the economic burden of treatment.

Risk assessment and pathogen profile of surgical site infections in traumatic brain injury patients undergoing emergency craniotomy: A retrospective study.

Emergency craniotomy in patients with traumatic brain injury poses a significant risk for surgical site infections (SSIs). Understanding the risk factors and pathogenic characteristics of SSIs in this context is crucial for improving outcomes. This comprehensive retrospective analysis spanned from February 2020 to February 2023 at our institution. We included 25 patients with SSIs post-emergency craniotomy and a control group of 50 patients without SSIs. Data on various potential risk factors were collected, including demographic information, preoperative conditions, and intraoperative details. The BACT/ALERT3D Automated Bacterial Culture and Detection System was utilized for rapid bacterial pathogen identification. Statistical analyses included univariate and multivariate logistic regression to identify significant risk factors for SSIs. The study identified Klebsiella pneumoniae, Escherichia coli, and Staphylococcus aureus as the most prevalent pathogens in SSIs. Significant risk factors for SSIs included the lack of preoperative antibiotic use, postoperative drainage tube placement, diabetes mellitus, and the incorporation of invasive procedures, all of which showed a significant association with SSIs in the univariate analysis. The multivariate analysis further highlighted the protective effect of preoperative antibiotics and the increased risks associated with anaemia, diabetes mellitus, postoperative drainage tube placement, and the incorporation of invasive procedures. Our research underscores the critical role of factors like insufficient preoperative antibiotics, postoperative drainage, invasive techniques, anaemia, and diabetes mellitus in elevating the risk of surgical site infections in traumatic brain injury patients undergoing emergency craniotomy. Enhanced focus on these areas is essential for improving surgical outcomes.

Bacterial profile of surgical site infection and antimicrobial resistance patterns in Ethiopia: a multicentre prospective cross-sectional study

BackgroundGlobally, surgical site infections (SSI) are the most commonly reported healthcare-associated infections.MethodsA multicentre study was conducted among patients who underwent surgical procedures at four hospitals located in Northern (Debre Tabor), Southern (Hawassa), Southwest (Jimma), and Central (Tikur Anbessa) parts of Ethiopia. A total of 752 patients clinically studied for surgical site infection were enrolled. The number of patients from Debre Tabor, Hawassa, Jimma, and Tikur Anbessa, hospitals was 172, 184, 193, and 203, respectively. At each study site, SSI discharge culture was performed from all patients, and positive cultures were characterized by colony characteristics, Gram stain, and conventional biochemical tests. Each bacterial species was confirmed using Matrix-Assisted Laser Desorption/Ionization Time-of-Flight Mass Spectrometry (MALDI TOF). An antimicrobial susceptibility test (AST) was done on Mueller–Hinton agar using the disk diffusion method. Logistic regression analysis was used to assess associations of dependent and independent variables. A p-value < 0.05 was considered statistically significant. Data were analysed using STATA 16 software.ResultsAmong 752 wound discharge cultures performed, 65.5% yielded growth. Among these, 57.9% and 42.1% were Gram-negative and Gram-positive isolates, respectively. In this study, a total of 494 bacteria were isolated; Staphylococcus aureus (31%), Escherichia coli (20.7%), and Klebsiella pneumoniae (9.8%) were the most common. Rare isolates (0.8% each) included Raoultella ornithinolytica, Stenotrophomonas maltophilia, Alcalignes faecalis, Pantoea ecurina, Bacillus flexus, and Paenibacillus tylopili. Enterobacteriaceae showed high levels of resistance to most of the tested antibiotics but lower levels of ertapenem (32.9%), amikacin (24.3%), imipenem (20.3%), and meropenem (17.6%) resistance. Multidrug-resistant (MDR) frequency of Enterobacteriaceae at Debre Tabor, Hawassa, Jimma, and Tikur Anbessa hospitals was 84.5%, 96.5%, 97.3%, and 94%, respectively. Ages ≥ 61 years (AOR = 2.83, 95% CI: 1.02–7.99; P 0.046), prolonged duration of hospital stay (AOR = 4.15, 95% CI: 2.87–6.01; P 0.000), history of previous antibiotics use (AOR = 2.83, 95% CI: 1.06–2.80; P 0.028), history of smoking (AOR = 2.35, 95% CI: 1.44–3.83; P 0.001), emergency surgery (AOR = 2.65, 95% CI: 1.92–3.66; P 0.000), and duration of operation (AOR = 0.27, 95% CI: 0.181–0.392; P 0.000) were significant risk factors.ConclusionThe most prevalent isolates from Gram-positive and Gram-negative bacteria across all hospitals were S. aureus and E. coli, respectively. Many newly emerging Gram-negative and Gram-positive bacteria were identified. Variation between hospitals was found for both SSI etiology type and MDR frequencies. Hence, to prevent the emergence and spread of MDR bacteria, standard bacteriological tests and their AST are indispensable for effective antimicrobial stewardship.

Bacteriological Profile of Surgical Site Infection Following Gastrointestinal Surgery and Their Antibiogram.

Surgical site infection is one of the common complication following abdominal surgery. It causes great morbidity and mortality, further increasing prevalence of multidrug resistant bacteria have made its management very challenging. The current study aims to identify causative agent responsible for surgical site infection and their antibiotic resistance patterns. This study was conducted among patients developing surgical site infection following gastrointestinal surgery in Tribhuvan university teaching hospital over a period of one year. The samples were collected and processed according to standard methods. The bacterial pathogens with their antimicrobial susceptibility were determined and resistant pattern like methicillin resistant Staphylococcus aureus and extended spectrum beta lactamase were further detected. A total of 832 patients had under gone gastrointestinal surgery during the study period. Among them, 162 cases (19.5%) developed surgical site infection and 125 cases showed growth in culture. A total of 160 aerobic bacteria were isolated; Escherichia coli (29.9%) was the commonest organism with 40.8% being extended spectrum beta lactamase producer and 47.4% of Staphylococcus aureus were methicillin resistant. About 75.9% (85/112) of gram negative bacteria and 60.4% (29/48) gram positive bacteria were multi drug resistant. The burden of multi drug resistant bacteria causing surgical site infection is high which needs to be addressed timely. Good surveillance of bacterial antibiogram and rational antimicrobial use is necessary to reduce emergence and spread of resistant bacteria.

Bacteriological Profile of Surgical Site Infection: A Descriptive Study at Deido District Hospital in Douala, Cameroon

Background: Surgical site infection (SSI) is defined as infections occurring within 30 days after a surgical operation, or within one year if an implant is left in place after the procedure. Surgical site infection is classified by the american center for disease control (CDC) into superficial incisional surgical site infections SSI, deep incisional SSI and organ/space SSI.&#x0D; Objectives: The objectives of this study were to determine the prevalence of post-surgical site infections, assess the risk factors, determine the various and most microorganisms encountered and study the antibiotic sensitivity in post-surgical site infection after post-surgical site infection in Deido district hospital Douala.&#x0D; Materials and Methods: we conducted a 3 months hospital based prospective study on general surgery, obstetric and gynecologic records admission at the Deido district Hospital Douala from February 1st 2020 to April 30th 2020. We included available files of the general surgery, obstetrics and gynecology. We excluded paediatrics and medical. The study was approved by the institutional ethic review board of the faculty of health sciences of the university of Bamenda.&#x0D; Results: We had 133 of post-surgical patients in general surgery, obstetric and gynecologic. The prevalence of post-surgical site infection was 32,3% (43/133). Male gender aged 50-60 years were more affected than female to developed SSI. Diabetes mellitus and immunodepression by the human immuno deficiency virus had respective prevalence of 48.1 and 81,8% and increased hosptal stay after operation. Peritonitis with perforation was the most involved (14%). The identified germs were Staphylococcus aureus (11,3%), followed by Escherichia coli (8%), Pseudomonas aeruginosa (3,8%) and pseudomonas spp (3%). Staphylococcus aureus was sensible to vancomycin (73,33%), netilmicin, amikacin (6o%). Escherichia coli was sensible to gentamycin, ciprofloxacin, augmentin with a prevalence of 63,64%. Pseudomonas aeruginosa was sensible to pristinacine (80%) and amikacin (60%). Pseudomonas spp was sensible to netilmicin, amikacin (75%) followed by gentamicin, levofloxacin and ofloxacin (50%).&#x0D; Conclusion: The prevalence of Post-surgical site infection was high, the clinical spectrum and bacterial sensitivity was diverse.

Bacterial causes and antibiotics susceptibility profile of surgical site infection following cesarean section

Backround: Surgical site infection (SSI) is defined as an infection occurring within 30 days after a surgical operation and affecting either incision or deep tissues at the operation site. The aim of this study was to examine the incidence, identify bacterial agents and determine their antibiotics sensitivity of SSI following cesarean section (CS). Methods: This retrospective cohort study included women who undervent Misgav-Ladach method CS after which a SSI developed during the period from 01 January 2019 to 31 December 2019 at the Clinic for Gynecology and Obstetrics, University Clinical Center Tuzla. Results: During the observed period we recorded 3345 deliveries, out of which 946 (28.3%) were by cesarean section, and out of which 50 (5.28%) was with SSI. The most commonly isolated bacteria from SSI were: Escherichia coli; Enterococcus faecalis; Staphylococcus aureus; Klebsiella pneumoniae. Fluoroquinolnes had the highest antibacterial activity against gram-positive pathogenes isolated. Staphylococcus aureus isolates is highly resistant to penicilline (100%). Conclusions: The prevalence of SSI following cesarean section was high and Enterococccus faecalis and Escherichia coli was the commonest pathogens isolated.

Prevalence, Risk Factors and Microbial Profile of Surgical Site Infection after Cesarean Section in a Tertiary Care Center in Western India

Surgical site infection (SSI) was the predominant complication following cesarean delivery. Risk factors like increased Body Mass Index (BMI), emergency cesarean section (CS), prolonged hospital stay, previous CS, anemia, pre-existing chronic diseases, and failure to use preoperative antibiotic prophylaxis associated with SSI. Surgical site infections are responsible for cost burden, longer hospital stay increased maternal morbidity and mortality. Despite the advance, aseptic measures &amp; control practice SSI was the most common nosocomial infection. To determine the prevalence, risk factors, bacterial profile, and antimicrobial resistance pattern of SSI in women following Cesarean section at tertiary care center western India. Women who developed SSI underwent cesarean delivery enrolled in the present study. Data were collected from patient records. Collection of swab samples, identification of microorganisms, and antimicrobial susceptibility testing was done by standard CLSI guidelines Results: Prevalence of SSI was 14.7% in this study. The risk factors significantly associated with SSI were emergency cesarean delivery, severe anemia, lack of preoperative antibiotics use, high Body Mass Index (BMI), preexisting disease, and previous history of CS, Klebsiella Pneumoniae &amp; Staphylococcus aureus was the most predominant isolates. Imipenem was the most susceptible and Amoxycilline-Clavulanate was the most Resistance antibiotic. Prompt identification of risk factors, microbial agents, and susceptibility patterns of SSIs are beneficial for the selection of appropriate antimicrobial therapy to prevent the emergence of drug resistance, planning to make infection control &amp; antibiotic policy, and taking appropriate steps to prevent risk factors.

Bacteriological profile of surgical site infections in a tertiary care hospital of western Nepal

Introduction: Surgical site infections are one of the most commonly reported nosocomial infections resulting into significant morbidity and mortality. Hospital admission and surgical procedures increase the risk of infection with multidrug resistant pathogens. This study was aimed to determine the bacterial agents associated with surgical site infections and antibiotic resistance patterns of the isolates.&#x0D; Methods: A total of 161 specimens from patients with surgical site infections were included in this study. Isolation, identification and antibiotic susceptibility testing of the isolates was performed by standard microbiological techniques.&#x0D; Results: Out of 161 samples, 94 bacterial isolates were recovered. Gram positive bacteria were isolated in 57.4% (54/94) cases and Staphylococcus aureus was the most common organism (49/54) with 65.3% (32/49) methicillin resistant Staphylococcus aureus isolates. All S. aureus isolates were susceptible to vancomycin. Gram negative bacteria constituted 42.6% (40/94) of total isolates and Escherichia coli was the commonest organism (13/40). Majority of Gram negative isolates were susceptible to amikacin, imipenem and piperacillin-tazobactam. Resistance to imipenem was detected among isolates of E coli, Pseudomonas and Acinetobacter species. &#x0D; Conclusion: Gram positive isolates were more commonly associated with surgical site infections. High percentage of MRSA was detected among the S. aureus isolates but no vancomycin resistant S. aureus. High percentage of Gram negative isolates was susceptible to imipenem, piperacillin-tazobactam, amikacin and gentimicin.

Characterization of surgical site infections in patients undergoing neurosurgery in a public hospital between 2017 and 2019

Introdução: As infecções de sítio cirúrgico em pacientes submetidos a procedimentos neurológicos contribuem para o desenvolvimento e complicações, pois constituem séria ameaça à segurança do paciente. Objetivo: Caracterizar o perfil das infecções de sítio cirúrgico em pacientes submetidos a neurocirurgias em um hospital-escola do Paraná. Método: Estudo retrospectivo, de fonte documental, quantitativo, realizado no período de janeiro de 2017 a dezembro de 2019. Os dados foram coletados e organizados em tabelas e analisados por meio de estatística descritiva. Resultados: Foram notificadas 439 infecções de sítio cirúrgico e, destas, 10,0% (n = 44) fizeram parte da amostra. Houve predomínio do sexo masculino, 72,7% (n = 32), e a média de idade dos participantes foi de 31,2 anos. O tempo médio de internação foi de 82,5 dias. O implante de derivação ventricular peritoneal ou externa foi o procedimento cirúrgico realizado em 40,9% (n = 18) dos pacientes e, segundo o potencial de contaminação, 100,0% das cirurgias foram classificadas como limpas. Foram 68,1% (n = 30) de infecções clinicamente definidas como infecção de sítio cirúrgico de órgão cavidade, prevalecendo em 33 (75,0%) casos. O microrganismo prevalente foi Pseudomonas spp., com 42,9% (n = 6). Para o desfecho dos casos, 29,5% (n = 13) dos pacientes desenvolveram outras infecções, 93,1% (n = 41) tiveram alta hospitalar e 6,8% (n = 3) dos pacientes evoluíram a óbito. Conclusões: As infecções de sítio cirúrgico influenciam diretamente a saúde do paciente neurológico, sendo necessária a implementação de estratégias que visem reduzir as estatísticas e promovam a segurança do paciente.

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 &amp; 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 infections in human immunodeficiency virus positive patients and their correlation with CD4 count

Background: The CD4 count is like a snapshot of how well the immune system is functioning. The progressive failure of the immune system caused by the human immunodeficiency virus (HIV) can increase the possibility of developing surgical site infections (SSI) after surgery. Study about the incidence of SSI and their correlation with CD4 count in HIV positive patients has not been done in India. The present study was aimed to find the incidence and microbiological profile of SSI among HIV positive patients, and the correlation between SSI and CD4 count.Methods: One hundred forty-six HIV positive patients &gt;18 years of age scheduled for surgery were included. CD4 count of each patient was noted. The primary outcome measure was the incidence of SSI, whereas secondary outcome measures were the correlation of SSI with CD4 count and microbiological profile of infective material. Intergroup comparison of categorical, and continuous variables was done using the chi-square test/Fisher’s exact test and unpaired ‘t’ test respectively.Results: The incidence of SSI in HIV positive patients was 14/146 (9.6%). The incidence of SSI was significantly higher among patients with CD4 count &lt;200 (60.0%) as compared to patients with CD4 count &gt;500 (0.9 %). Mean±SD of CD4 count in patients without SSI and with SSI was 712.5±238.9 and 330.1±118.1 (cells/mm3) respectively (p&lt;0.001). Klebsiella pneumoniae was the most common organism isolated in this study.Conclusions: SSI is frequent in HIV positive patients whose CD4 count is &lt;200 cells/mm3.

English

BACKGROUND Surgical site infections (SSI) represent a significant hurdle in the recovery and return to normalcy of patients. When considering abdominal surgeries in particular, SSI and its complications have been identified as one of the most important causes for postoperative morbidity. Treatment of SSI’s ideally begins with prevention and this can be done with the identification of risk factors. This allows for appropriate stratification and institution of steps to safeguard the patient against the development of SSI in the pre-surgical period. The objectives of the study were to compare the incidence, severity and microbiological profile of surgical site infections following emergency and elective abdominal surgeries. METHODS This study was a prospective observational study, conducted from December 2017 to May 2019 at Father Muller Medical College Hospital, Mangalore, among patients who underwent laparotomy (regardless of indication) in either an elective or emergency setting. Patients who had SSI were then stratified using the ASEPSIS wound scoring system and the Southampton wound assessment scale. The type of SSI was further documented in each patient. Other parameters such as duration of stay in the hospital, microbiological profile, interventions performed etc. were also recorded in the study. RESULTS 150 patients were enrolled in the study (84 female and 66 male), 23 patients (incidence of 15.33 %) developed an SSI (7 elective cases and 16 emergency cases), whereas 127 did not. Of the organisms cultured, the most common was found to be coagulase negative staphylococcus (CoNS, 7 cases) followed by E. coli (4 cases). CONCLUSIONS The following factors were found to significantly contribute to the development of SSI - nature of the surgery, i.e. elective vs. emergency (P-value 0.040), class of wound (Pvalue 0.001), underlying malignancy (P-value 0.030) and a concomitant urinary tract infection (UTI) (P-value 0.045). The following factors were not found to contribute to the development of a SSI - sex of the patient (P-value 0.108), age of the patient (Pvalue 0.699), presence of diabetes mellitus (DM) (P-value 0.816), chronic kidney disease (CKD) (P-value 0.904) and acute respiratory infection (ARI) (P-value 0.909).

Bacteriological profile of surgical site infection and associated risk factors in obstetrics and Gynecology patient

Surgical site infections (SSI) are the second most common cause of nosocomial infections in obstetrics and gynecology patient. It has been estimated that SSI develops in at least 2% of hospitalized patients undergoing operative procedure. Knowledge of the most likely causative organisms and antibiotic sensitivity or resistance pattern will be of great help in managing the patients. Patients in the Obstetrics and Gynecology department, who had developed signs and symptoms of SSI were included in this study. Surgical sites were considered to be infected according to the set of clinical criteria recommended by CDC definition 1992. When infection was clinically suspected, the exudate was collected from the depth of the wound using two sterile cotton swabs one for preparing smear and another for culture. All the specimens collected were transported immediately to the laboratory for further processing. The samples collected were processed by conventional method according to CLSI guidelines. A total of 300 cases were examined for SSI and 25 were found to be clinically infected with the rate of incidence of infection 8.33%. The commonest organism was klebsiella, Pseudomonas 61.5% followed by staphylococcus 15.3%. Keywords: Surgical site infection, Gram negative bacilli, Risk factors.

Bacteriological profile of surgical site infections and their antibiogram

Surgical site infection (SSI) is one of the most common postoperative complications that is encountered in the clinical and surgical practice and it is also the most important cause of significant postoperative morbidity and mortality. The study puts in an effort to determine the incidence of surgical site infections in clean, clean contaminated and contaminated surgeries in our setting along with the factors related to patient and surgical procedures influencing the rate of postoperative surgical wound infections and determine bacteriological profile with antimicrobial susceptibility patterns of the isolates.

English

English

Bacteriological Profile of Patients with Intra-Abdominal Sepsis and Superficial Surgical Site Infection Following Emergency Abdominal Surgery—Is It Concordant?

The rates of surgical site infections (SSI) continue to be reported with great variability, even for the same operation, from different geographical areas. Hence, a hospital-based surveillance of SSI can help in designing effective preventive strategies. This study was done to assess the risk factors, characteristics, and incidence of SSI in patients undergoing emergency gastrointestinal surgery. The study was a case series analysis, enrolling all consecutive patients undergoing emergency gastrointestinal surgery. The patients were examined daily for SSI using ASEPSIS score and during the post-operative period up to 30 days. For patients with SSI, wound swab was taken for culture and sensitivity. Patient and operative characteristics were analyzed for identifying risk factors, and the bacteriological profile and sensitivity pattern of intra-abdominal specimens were analyzed and compared with microbiological profile of SSI. A total of 100 patients were studied. The incidence of SSI was 33%. Age (44.33 ± 18.277 vs. 39.43 ± 16.158; p 0.015) and pre-operative blood transfusion (61.1 vs. 38.9; p 0.012) were found to be significant risk factors for SSI. On multivariate analysis, blood transfusion (p 0.027) and the duration of operation (p 0.005) were found to be independent risk factors. In cases where the isolated organisms were Escherichia coli, Enterococcus faecalis, and Klebsiella pneumoniae, concordance was noted between the intra-abdominal pathogens and the organisms isolated from the SSI. Risk factors for SSI in patients undergoing emergency abdominal surgeries include increasing age, pre-operative blood transfusion, prolonged operating time, intra-operative blood loss, and operative procedures involving bowel resection. Concordance exists between intra-abdominal and SSI pathogens.

A Prospective Study of Surgical Site Infections in a Medical College Hospital

Background: Surgical site infections (SSI) are an important post-operative complication. Knowledge about its risk factors is essential. The present study was conducted to find the profile of surgical site infection among patients admitted in surgical ward of SKMCH, Muzaffarpur.Subjects and Methods:The present cross-sectional study included 322 patients undergoing surgery. Clinical details, onset of SSI and microbiological profile were noted.Results:Mean age of the cases was 43.7 years. 61.2% of these were males. 11.8% of the cases suffered from surgical site infection. Of the emergency surgeries, 20.2% had SSI while 8.1% elective surgery cases had SSI. 36.1% of the cases with dirty wound had SSI while only 5.2% of the cases with clean wound had such infection. S. aureus was the most common organism isolated (57.9%) followed by Pseudomonas (39.5%) and Klebsiella (23.7%).Conclusion: Incidence of SSI is higher in cases of emergency surgery and in dirty wounds.