SURGICAL SITE INFECTIONS AND ITS ASSOCIATED FACTORS AMONG POST OPERATIVE PATIENTS ATTENDING A TERTIARY CARE CENTRE IN SOUTH KERALA
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Keywords
Surgical site infection, Healthcare associated infection, Standard Antimicrobial Prophylaxis
Abstract
Background: Surgical site infections (SSIs) pose to be a major problem among health care associated infection, increasing hospital cost, substantial morbidity & occasional mortality related to surgical operations. In spite of the standard protocols of preoperative preparation & antibiotic prophylaxis along with advanced surgical techniques, the complete elimination of SSIs is not possible. This is due to various factors such as the changing patterns of antibiotic resistance and difficulties in fully effective surveillance measures.
Methodology: A study on clean & clean-contaminated wounds of 280 post-op patients at Sree Gokulam Medical College in one year was conducted to know the prevalence rate of surgical site infections in our hospital, and the various factors associated with an increase in infection rate. Double swabs were taken from the wound site for bacterial culture and sensitivity. All data collected was analysed by SPSS software.
Results: The SSI rate was 7.5% with 5.4% in clean and 31.8% in clean-contaminated wounds. Elective cases (11/238=4.4%) showed a lesser rate than emergency cases (10/21=32.3%); as did longer surgeries (5.0% in cases of 1 – 2 hours and 15.9% in cases > 2 hours). Among patient comorbidities, diabetes mellitus was found to be the most common comorbidity associated with SSI. As part of Standard antimicrobial prophylaxis, Most SSI cases were given cefalexin (20.0%) and cefotaxime (6.9%) as the preoperative antibiotic.
Conclusion: The prevalence of SSI was higher in clean-contaminated wounds, in longer surgeries and in cases operated on an emergency basis. The length of hospital stay had a significant association with SSI directly reflecting on the economic burden it causes in healthcare settings. Standard Antimicrobial prophylaxis played a major role, infection rates were lowest in patients given amoxycillin clavulanate, cefotaxime-metronidazole, and cefaperazone sulbactam-metronidazole preoperatively.
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Dr. Poornima J
Assistant Professor, Department of Microbiology, Sree Uthradam Thirunal Medical Sciences, Vattapara, Thiruvananthapuram, Kerala, India.
Dr. Harshan K.H
Professor & HOD, Department of Microbiology, Mount Zion Medical College, Adoor, Kerala, India.
Dr. Geetha Bai
Retired Professor & HOD, Department of Microbiology, Sree Gokulam Medical College and Research Foundation, Venjaramoodu, Thiruvananthapuram, Kerala, India.