Clinical and bacteriological profile of surgical site infections (ssis) from a tertiary care centre

Author: 
Kumari Neha Singh, Kanne Padmaja, Sukanya Sudhaharan and Vijay D.Teja

Introduction: Surgical site infection (SSI) is a health care associated infection (HCAI) that occurs at or near the incision site within 30 days of surgery or within one year if an implant was placed, and the infection develops after surgery leading to morbidity and mortality.
Objectives: a) To study the prevalence, risk factors and microbiological profile of SSI in our hospital.
Materials and methods: A retrospective study was undertaken for a period of 2 years from March 1st 2019 to March 31st 2021 at Nizams Institute of Medical Sciences, Hyderabad Telangana. Data was collected from the medical records of the patients who have undergone surgeries from various departments .The clinical samples included in the study were pus, wound swabs, and tissues which were processed as per standard microbiological methods.
Results: Among 2,115 surgeries, a total of 185(8.74%) SSIs were observed, of which 148 (80%) were elective and 37(20%) had undergone emergency surgeries. Majority of the patients were in the age group of 40-60 years (40%). Infections from Orthopedic surgeries were 66/185(36%), Surgical gastroenterology 34/185 (18%),Neurosurgery 13/185(7%), Cardiothoracic surgery 34/185(18%), and Plastic surgery were 38/185 (20%). As per CDC wound classification 55/185(30%) were clean, 45/185(24%) were clean contaminated, 73/185(40%) were contaminated and 12/185(6%) were Dirty wounds.
Mono microbial growth was observed in 150 /185 (81%) patients and growth of two organisms was observed in 10/185 (5.4%)of patients which makes a total of 160/185 culture positives. Poly microbial growth was observed in 25/185 (13.5%) of the SSI cases as the sample was not collected properly and repeat sample was not sent for these patients. But still all 185 cases were analysed as clinically they were symptomatic and responded to antibiotics empirically. The predominant organism isolated was Escherichia coli 48 (30%) followed by Staphylococcus aureus 39 (24.3%) of which 28 (71.7%) were Methicillin Resistant Staphylococcus aureus (MRSA) and 11(28.2%) were Methicillin sensitive Staphylococcus aureus (MSSA). Multidrug resistant organisms (MDROs) observed were 44(24%) of this ESBL producers were 24(13%).
Conclusion: The post operative complications of SSIs can be controlled by implementation of strict infection control practices during and after surgery and also by rational use of antimicrobial therapy that helps to limit the spread of multidrug resistance and occurrence of SSIs.

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DOI: 
http://dx.doi.org/10.24327/ijcar.2022.1421.0315
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