TO STUDY THE PREVALENCE AND ITS ASSOCIATED RISK FACTORS OF SURGICAL SITE INFECTIONS OF PATIENTS POST SURGERY, UTTAR PRADESH, INDIA
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Keywords
Surgical site infection, Prevalence, risk factors, Microorganisms, Hospital stay
Abstract
Introduction: Surgical site infections (SSI) are a common type of healthcare-associated infections and frequent complication of hospitalization, responsible for prolonged hospital stay, increased intensive care unit admissions, hospital readmissions after surgery, significantly increased costs and delays to adjuvant systemic therapy; they occur in 2 to 5% of patients undergoing surgery .
Aim and Objective: To study the prevalence and its associated risk factors of surgical site infections of the patients at a tertiary care centre.
Material and Methods: This was a cross-sectional study conducted in a hospital setting over the period of 1 year i.e, April 2023 to April 2024 in the Department of Microbiology and Department of Surgery at a tertiary care centre. All surgically treated adult patients of both sexes who were older than 16 years old were included. Patients who received a second surgery at the same location for any reason, patients receiving immunosuppressant medication, people with immunodeficiency diseases, people currently taking antibiotics, and people with infections elsewhere were all disqualified from participating. If there was signs of a wound infection 48 hours.
Results: In the present study a total of 120 patients underwent different types of surgeries. The prevalence of SSIs during the study period was 13.3%. SSIs were more common in abdominal surgeries. It was observed that the ratio of males 64.2% was more as compared to the females 37.2% with maximum number of cases in the age group of 35-44 years of age with 37.5%. Patients who underwent emergency surgery have a higher risk of getting SSI than those who underwent elective surgery . Those with diabetes had a higher risk of getting SSI than those who were non-diabetics. In the present study it was observed that Klebsiella pneumoniae (31.25%) was the most common isolate followed by E.coli (25%), Pseudomonas aeruginosa with 18.75%, S.aureus with 12.5% and least for Staphylococcus epidermitidis and Klebsiella oxytoca with 6.25%. It was also noted that the site of the infection was most common in the superficial site with 68.75%.
Conclusion: Abdominal surgeries were more likely to cause SSIs. Patients who were male, aged 30 years or older, had emergency surgery, had diabetes, and/or had a lengthy hospital stay were more likely to develop SSIs following any type of surgery.
References
2. PradhanGB, AgrawalJ. Comparative study of postoperative wound infection following emergency lower segment caesarean section with and without the topical use off usidicacid.NepalMedCollJ.2009; 11(3):189-91.
3. -Dalhatu A, Olaogun A, Olayinka AT, Ahmed S, Timothy G, Yunusa U. Incidence of Surgical Site Infections (SSIs) among Patients Undergoing Major Surgery at General Hospital Funtua, Katsina State, Nigeria. IOSR Journal of Nursing and Health Science. 2014; 3(3):16–21 .
4. Zelle BA, Stahel PF. Lessons learned for postoperative wound healing: respect the past and embrace the future. Patient Saf Surg. 2019; 13(1):5.
5. Mukagendaneza MJ, Munyaneza E, Muhawenayo E, Nyirasebura D, Abahuje E, Nyirigira J, et al. Incidence, root causes, and outcomes of surgical site infections in a tertiary care hospital in Rwanda: a prospective observational cohort study. Patient Saf Surg. 2019; 13(1):10.
6. Handaya AY, Werdana VAP. Adherence to preoperative hand hygiene and sterile gowning technique among consultant surgeons, surgical residents, and nurses: a pilot study at an academic medical center in Indonesia. Patient Saf Surg. 2019;13(1):11.
7. Gelaw KA, Aweke AM, Astawesegn FH, Demissie BW, Zeleke LB. Surgical site infection and its associated factors following cesarean section: a cross sectional study from a public hospital in Ethiopia. Patient Saf Surg. 2017; 11(1):18
8. Surveillance System basic SSI risk index. Clin Infect Dis. 2001; 33(Supplement 2):S69–77.
9. Mawalla B, Mshana SE, Chalya PL, Imirzalioglu C, Mahalu W. Predictors of surgical site infections among patients undergoing major surgery at Bugando medical Centre in Northwestern Tanzania. BMC Surg. 2011; 11(1):21.
10. Fisha K, Azage M, Mulat G, Tamirat KS. The prevalence and root causes of surgical siteinfections in public versus private hospitals in Ethiopia: a retrospective observational cohort study. Patient Saf Surg. 2019; 13(1):26.
11. Prajapati V, Komal P. Modi, “Study of surgical site infection in patients undergoing caesarean section at tertiary care center, Gujarat”, Int J Reprod Contracept Obstet Gynecol. 2022 ; 11(3):844-848.
12. Hohmann C, Eickhoff C, Radziwill R, Schulz M. Adherence to guidelines for antibiotic prophylaxis in surgery patients in German hospitals: a multicentre evaluation involving pharmacy interns. Infection. 2012; 40(2):131–37.
13. Owens CD, Stoessel K. Surgical site infections: epidemiology, microbiology and prevention. J Hosp Infect. 2008; 70(Suppl 2):3–10.
14. Pradhan GB, Agrawal J. Comparative study of post operative wound infection following emergency lower segment caesarean section with and without the topical use offusidic acid. Nepal Med Coll J. 2009; 11(3):189–91.
15. Golia S, Kamath ASB, Nirmala AR: A study of superficial surgical site infections in a tertiary care hospital at Bangalore. Int J Res Med Sci. 2014, 2:647-52.
16. Iqbal F, Younus S, Asmatullah, Zia OB, Khan N: Surgical site infection following fixation of acetabular fractures. Hip Pelvis. 2017, 29:176-81.
17. Al-Mulhim FA, Baragbah MA, Sadat-Ali M, Alomran AS, Azam MQ: Prevalence of surgical site infection in orthopedic surgery: a 5-year analysis. Int Surg. 2014; 99:264-8.
18. Setty NKH, Nagaraja MS, Nagappa DH, Giriyaiah CS, Gowda NR, Naik RDML: A study on surgical site infections (SSI) and associated factors in a government tertiary care teaching hospital in Mysore, Karnataka. Int J Med Public Health. 2014; 4:171.
19. Vikrant Negi, Shekhar Pal, Deepak Juyal, Munesh Kumar Sharma, and Neelam Sharma. Bacteriological Profile of Surgical Site Infections and Their Antibiogram: A Study From Resource Constrained Rural Setting of Uttarakhand State, India. J Clin Diagn Res. 2015; 9(10): DC17–DC20.
20. Hernandez K, Ramos E, Seas C, Henostroza G, Gotuzzo E: Incidence of and risk factors for surgical-site infections in a Peruvian Hospital. Infect Control Hosp Epidemiol. 2005; 26:473-7.
21. Shanmugam G, Rangam S, Kayalvili K, Sundaram L: Prevalence of surgical site infections and antimicrobial sensitivity pattern in patients attending a Tertiary Care Hospital in South India: a prospective study. J Patient Saf Infect Control. 2017; 5:12-7.
22. Khan AKA, Rashed MR, Banu G. A Study on the Usage Pattern of antimicrobial agents for the prevention of surgical site infections (ssis) in a tertiary care teaching hospital. J Clin Diagn Res. 2013; 7(4):671–74.
23. DeD, SaxenaS ,MehtaG,YadavR,DuttaR.Risk factor analysisandmicrobial etiology ofsurgicalsiteinfectionsfollowinglowersegmentcaesareansection. InternationalJournalofAntibiotics.2013;2013.
24. Mundhada AS, Tenpe S: A study of organisms causing surgical site infections and their antimicrobial susceptibility in a tertiary care government hospital. Indian J Pathol Microbiol. 2015; 58:195-200.
25. Mundhada AS, Tenpe S: A study of organisms causing surgical site infections and their antimicrobial susceptibility in a tertiary care government hospital. Indian J Pathol Microbiol. 2015; 58:195-200.
26. Dessie W, Mulugeta G, Fentaw S, Mihret A, Hassen M, Abebe E: Pattern of bacterial pathogens and their susceptibility isolated from surgical site infections at selected referral hospitals, Addis Ababa, Ethiopia. Int J Microbiol. 2016; 2016:2418902.
27. Kvalvik, S. A., Rasmussen, S., Thornhill, H. F., & Baghestan, E. Risk factors for surgical site infection following cesarean delivery: A hospital-based case-control study. Acta obstetricia et gynecologica Scandinavica.2021;100(12): 2167–2175.
28. Gashaw A , Fantu S , Tarekegn M, “Factor associated with surgical site infection of women who undergone cesarean section in Hawassa University comprehensive specialized hospital southern Ethiopia, retrospective study design” , International Journal of Surgery.2022; 100506.
29. Ahmed MI. Prevalence of nosocomial wound infection among postoperative patients and antibiotics patterns at teaching hospital in Sudan. N Am J Med Sci. 2012; 4(1):29–34.
30. Mulu W, Kibru G, Beyene G, Datie M. Postoperative nosocomial infections and antimicrobial resistance patterns of bacterial isolates among patients admitted at FelegeHiwot Referral Hospital, Bahirdar, Ethiopia. Ethiop J Health Sci. 2012; 22(1):7–18.
31. Chakarborty SP, Mahapatra SK, Bal M, Roy S. Isolation and identification of vancomycin resistant Staphylococcus aureus from postoperative pus sample. Al Ameen J Med Sci. 2011; 4(2):152–68.
32. Masaadeh HA, Jaran AS. Incident of Pseudomonas aeruginosa in post-operative wound infection. Am J Infect Dis. 2009; 5:1–6.
33. Sohn AH, Parvez FM, Vu T, Hai HH, Bich NN, Le Thu TA. Prevalence of surgical-site infections and patterns of antimicrobial use in a large tertiary-care hospital in Ho Chi Minh City, Vietnam. Infect Control Hosp Epidemiol. 2002; 23(7):382–87.
34. Morteza Zaboli Mahdiabadi. Prevalence of surgical site infection and risk factors in patients after knee surgery: A systematic review and meta‐analysis. Int Wound J. 2024 ; 21(2): e14765.
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Anurag Singh
Associate Professor, Department of General Surgery, G.S.V.M. Medical College, Kanpur, Uttar Pradesh, India
Shikha Pandey
Tutor Department of Microbiology, Madhav Prasaad Tripaahi Medical College, Siddharthanagar, Uttar Pradesh, India.
Madhu Yadav
Associate ProfessorDepartment of Microbiology, G.S.V.M. Medical College, Kanpur, Uttar Pradesh, India
Snehanshu Shukla
ProfessorDepartment of Microbiology, Rajarshi Dashrath Autonomous State Medical College, Ayodhya, India.
Nashra Afaq
Research Associate Department of Microbiology, Rama Medical College Hospital and Research Centre, Kanpur, Uttar Pradesh, India.
Mukesh Kumar Patwa
Junior ResidentDepartment of Microbiology, King George Medical University, Lucknow, India.
Komal Tanwar
Junior Resident-Department of Microbiology, Government Medical College, Jammu, India.
Saurabh Singh
Associate Professor, Department of General Surgery, Rama Medical College Hospital and Research Centre, Kanpur, Uttar Pradesh, India.