BACTERIOLOGICAL PROFILE AND ANTIBIOTIC SUSCEPTIBILITY PATTERN OF SURGICAL SITE INFECTIONS AT A TERTIARY CARE CENTRE IN SOUTH KERALA
Main Article Content
Keywords
Surgical site infection, Healthcare associated infection, Clean and clean-contaminated wounds, Staphylococcus aureus, Standard Antimicrobial Prophylaxis
Abstract
Background: Among health care associated infections, Surgical site infections (SSIs) constitute to be a major concern, by increasing hospital cost, net morbidity and mortality related to surgical interventions. The etiological agents pertaining to these infections vary from hospital to hospital, depending on the endemic flora in a system.
Methodology: A prospective study on clean & clean-contaminated post operative wounds of 280 patients at Sree Gokulam Medical College in one year was conducted, to study the prevalence rate of surgical site infections, the bacteriological profile of organisms and their susceptibility pattern. A minimum of two samples were collected, one at the time of the first dressing and the second in evidence of any infection; for bacteriological culture and sensitivity. All data was analysed by SPSS software.
Results: The SSI rate was 7.5% with 5.4% in clean and 31.8% in clean-contaminated wounds. Staphylococcus aureus (61.8%; with 66.7% MRSA) was most frequently isolated, followed by Escherichia coli (14.3%). Others were Enterobacter cloacae (9.5%), Pseudomonas aeruginosa (4.8%), Klebsiella pneumoniae (4.8%) and Streptococcus agalactiae (4.8%).
Conclusion: The infection rate amongst clean and clean-contaminated surgeries was 7.5%, which required intervention. The most frequently isolated strain was Staphylococcus aureus (61.8%) with clear predominance of MRSA. The gram-negative isolates were mostly multi-drug resistant, with predominance in. members of Enetrobacteriaceae.
References
2. Subrata Roy et al. Bacterial profile of Post-Operative Wound Infection, Asian Journal of Biomedical and Pharmaceutical Sciences2016; 6(53): 44-46.
3. Ramani Bai JT. Hospital infection – Present scenario. Proceedings of the fourth triennial conference of the academy of clinical Microbiologists and pre-conference seminar on changing trends in hospital infections. August 22nd & 23rd 2008 (18-23)
4. 2016 National and State Healthcare-Associated Infections Progress Report. Centers for disease control and prevention (CDC) Health care associated infection (HCAI) updated 2016.
5. Lilani SP, Jangale N, Chowdhary A, Daver GB. Surgical site infection in clean and clean-contaminated cases. Indian Journal of Medical Microbiology 2005; 23(4):249-252
6. Anvikar AR, Deshmukh AB, Karyakarte RP, Damle AS, Patwardhan NS, Malik AK, et al. A one year prospective study of 3280 surgical wounds. Indian J Med Microbiology. 1999; 17:129-32.
7. Gaynes RP, Culvar TC, Edwards SR, Richards C, Telson JS. Surgical site infection [SSI], rate in the United States 1992-1998. The National Nosocomial Surveillance System Basic SSI risk index. Infect Control Hosp Epidemiology. 2006; 27:1401-1404.
8. Damani N. Manual of Infection Prevention and Control. Oxford: UP Oxford;2011.
9. Akthter MS, Verma R, Madhukar KP et al. Incidence of surgical site infection in post-operative patients at a tertiary care centre, India. J of wound care 2016;25(4):210-7.
10. Singh S, Chakravarthy M, Rosenthal VD et al. Surgical site infections in six cities in India: findings of the INICC (International Nosocomial Infection Control Consortium). Intern Health 2014;7(5):354-9.
11. Bernstein J. The Silent Epidemic. http://www. huffingtonpost.com/james-bernsteinmd/ the-silentepidemic_b_3006709.html.2013.
12. Shanthi, J., Shankar T, Balagurunathan R. The scenario of post-operative wound infection from a government hospital in South India. Journal of Microbiology and Biotechnology Research. 2012; 02(03): 396-401.
13. Edward S. Wong. Surgical site infections. In: C. Glen Mayhall, editors. Hospital Epidemiology and Infection control. 2nd ed. Philadelphia: Lippincott Williams & Wilkins; 1999. Pp189-210
14. P. Preethishree, Rekha Rai, K. Vimal kumar. Aerobic Bacterial Profile of Post-Operative Wound Infections and their Antibiotic Susceptibility Pattern. International Journal of Current Microbiology and Applied Sciences 2017;6(9): 396-411.
15. Verma, A.K., Kapoor AK, Bhargava A. Antimicrobial susceptibility pattern of bacterial isolates from surgical wound infections in tertiary care hospital in Allahabad, India. Internet Journal of Medical Update. 2012; 07(01): 27-34.
16. Prasanna Gupta et al, A study of post-operative wound infection among post surgical patients at Calicut medical college, Kerala, India., Journal of Evolution of Medical and Dental Sciences2012;1(4): 582–588
17. Kokate Sandeep Bhaskar Rao, Rahangdale Vaishali, Vyankatesh Jagannath Katkar, Study of Bacteriological Profile of Post Operative Wound Infections in Surgical Wards in a Tertiary Care Hospital International journal of contemporary medical research 2017;4(1): 77-83
18. Bangal, V.B., Borawake SK, Shinde KK, Gavhane SP. Study of surgical site infections following gynaecological surgery at tertiary care teaching hospital in Rural India. International Journal of Biomedical Research. 2014; 05(02): 113-16
19. Vikrant Negi, Shekhar Pal, Deepak Juyal et al. Bacteriological Profile of Surgical Site Infections and Their Antibiogram: A Study From Resource Constrained Rural Setting of Uttarakhand State, India. Journal of Clinical and Diagnostic Research. 2015; 9(10):17-20
20. Mangram AJ, Horan TC, Pearson ML, Silver LC, Jarvis WR. Guideline for Prevention of Surgical Site Infection, 1999. Centers for Disease Control and Prevention (CDC) Hospital Infection Control Practices Advisory Committee. Am J Infect Control 1999; 27:97-132.
21. European Centre for Disease Control and Prevention, HAI case definitions for use in hospitals, Field epidemiology manual 2017;1(4):1-5.
22. Horan TC, Gaynes RP, Martone WJ et al, CDC definitions of nosocomial surgical site infections; A modification of CDC definitions of surgical wound infections. Journal Infection control Hosp. epidemiology1992; 13:606-608
23. Slashing SSI CDC classification of surgical wounds. www.cdc.gov/hicpac/SSI/table7-8-9-10-SSI.html. 2018
24. F. Charles Brunicardi, Dana K. Anderson, Timothy R. Billar et al, Schwartz’s Principles of Surgery 2015; 10 (6): 147 – 149
25. Gupta P. A study of post-operative wound infection among post surgical patients at Calicut medical college, Kerala, India., Journal of Evolution of Medical and Dental Sciences 2012;1(4):582-8.
26. Negi V, Pal S, Juyal D, et al. Bacteriological Profile of Surgical Site Infections and Their Antibiogram: A Study From Resource Constrained Rural Setting of Uttarakhand State, India. Journal of Clinical and Diagnostic Research 2015;9(10):17-20.
27. Roy S. Bacterial profile of Post-Operative Wound Infection. Asian Journal of Biomedical and Pharmaceutical Sciences 2016;6(53):44-6.
28. Kumar A, Rai A. Prevalence of surgical site infection in general surgery in a tertiary care centre in India. International Surgery Journal 2017;4(9):3101-6.
29. Patnaik N, Mallick B, Kar A. Aerobic Bacteriological Profile of Surgical Site Infection with Special Reference to MRSA at Hitech Medical College and Hospital, Bhubaneswar. International Journal of Current Microbiology and Applied Sciences 2019;8(2):309-14.
30. Jain K, Chavan NS, Jain SM. Bacteriological profile of post-surgical wound infection along with special reference to MRSA in central India, Indore. International Journal of Integrative Medical Sciences 2014;1(1):9-13.
31. Jenkins PJ, Clement ND, Gaston P, et al. Invasive group B streptococcal disease in an orthopaedic unit. Journal of Hospital Infection 2010;76(3):231-3.
32. Shahane V, Bhawal S, Lele MU. Surgical site infections: A one-year prospective study in a tertiary care centre, International Journal of Health Sciences 2012;6(1):79-84.
33. Bansal D, Singh RR, Kulwant S, et al. Bacteriological profile and antimicrobial susceptibility in surgical site infection in elective abdominal surgeries. International Surgery Journal 2016;3(4):1879-82.
Article Sidebar
Article Details
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
All articles published in JPTCP are licensed under Copyright Creative Commons Attribution-NonCommercial 4.0 International License.
Dr. Poornima J.
Assistant Professor, Department of Microbiology, Sree Uthradom Thirunal Medical Sciences, Vattappara, Thiruvananthapuram, Kerala, India.
Dr. Harshan K.H.
Associate Professor, Department of Microbiology, Mount Zion Medical College, Adoor, Enadimangalam, Kerala, India.
Dr. Geetha Bhai
Retired Professor & HOD, Department of Microbiology, Sree Gokulam Medical College and Research Foundation, Venjaramoodu, Thiruvananthapuram, Kerala, India.