Antibiotic Use, Incidence and Risk Factors for Orthopedic Surgical Site Infections in a Teaching Hospital in Madhya Pradesh, India

Skender, Kristina; Machowska, Anna; Singh, Vivek; Goel, Varun; Marothi, Yogyata; Lundborg, Cecilia Stålsby; Sharma, Megha

doi:10.3390/antibiotics11060748

Cited by 5 publications

(6 citation statements)

References 41 publications

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“…This has also been seen in the literature. It shows that male sex is a significant risk factor for SSIs [6,11]. Most of the SSIs are related to lower limb surgeries which can also be observed in other studies [10].…”

Section: Discussionsupporting

confidence: 69%

“…In a study conducted in an orthopaedic centre in the United States, the incidence was 2.55% [10]. Another Indian study among 1205 orthopaedic patients showed an incidence of 7.6% [6].…”

Section: Discussionmentioning

confidence: 99%

“…The most common cause of SSIs in recent years is due to Staphylococcus aureus [4]. Also, Staphylococcus aureus is the most common causative organism for orthopaedic implant-associated infections, which is very difficult to treat due to high levels of antibiotic resistance and limited treatment options [5,6].…”

Section: Introductionmentioning

confidence: 99%

“…The presence of a national surveillance system and guidelines on antibiotic use for infections based on the local antibioticresistant pattern and the common causative organisms is essential in preventing SSIs. Continuous auditing of the causative organisms and the resistance pattern will help in formulating local as well as national guidelines to prevent and treat SSIs [6].…”

Section: Introductionmentioning

confidence: 99%

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Prevalence of surgical site infections and antibiotic resistance pattern in a Tertiary care Orthopaedic unit

Sivakumaran Gobinath,

Thanabalasingam Satheeskumar,

Sivarajah Ushjenthan

et al. 2024

GSC Adv. Res. Rev.

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Introduction: Surgical site infections (SSIs) in orthopaedic surgeries pose a significant risk to outcomes. These infections ranging from superficial to periprosthetic joint complications result from various factors including patient-related conditions and environmental factors. Staphylococcus aureus, with increasing antibiotic resistance, is a predominant cause. Perioperative antibiotic prophylaxis recommended by the WHO is crucial. Establishing national surveillance considering local antibiotic resistance and continuous auditing are essential for formulating effective guidelines to prevent and manage SSIs. Methods: This is a retrospective study conducted at a tertiary care hospital from December 2022 to November 2023 at the orthopaedic unit. The study population was all the patients who had surgical site infections following clean orthopaedic surgeries during the study period. An institutional-level ethical clearance was obtained. Results: This retrospective study conducted at a tertiary orthopaedic unit in Jaffna, Sri Lanka, aimed to investigate surgical site infections (SSI) following clean orthopaedic surgeries. Analyzing data from 1676 surgeries over one year, the study identified 83 culture-proven SSIs, yielding an annual incidence of 4.95%. The majority of SSIs occurred in males (62.7%) and were associated predominantly with lower limb surgeries (83.1%). Contrary to global trends, Pseudomonas emerged as the most common causative organism (31.3%). Discussion: Notably, the study revealed significant variations in antibiotic sensitivity patterns among isolated organisms. While Pseudomonas exhibited sensitivity to a wide range of antibiotics, coliforms displayed resistance to several agents. This emphasizes regional and institutional differences in antibiotic resistance patterns. Conclusion: Continuous large-scale institutional audits are crucial for shaping effective antibiotic policies. The study underscores the dynamic nature of SSI aetiology, emphasizing the need for tailored preventive measures based on regional data.

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Section: Discussionsupporting

confidence: 69%

“…In a study conducted in an orthopaedic centre in the United States, the incidence was 2.55% [10]. Another Indian study among 1205 orthopaedic patients showed an incidence of 7.6% [6].…”

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Prevalence of surgical site infections and antibiotic resistance pattern in a Tertiary care Orthopaedic unit

Sivakumaran Gobinath,

Thanabalasingam Satheeskumar,

Sivarajah Ushjenthan

et al. 2024

GSC Adv. Res. Rev.

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“…In abdominal surgery, the antibiotics often given are cefotaxime, metronidazole, cefradine, and amoxicillin/clavulanate. In orthopedic surgery, the antibiotic often prescribed is amikacin [23].…”

Section: Figure 1 Number Of Publications By Yearmentioning

confidence: 99%

Trends of research on antibiotic prophylaxis and surgical site infection: A bibliometric review based on VOS viewer by Scopus database

Adzillina¹,

Sundari²

2023

World J. Adv. Res. Rev.

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Studies on prophylactic antibiotics and surgical site infection have been widely carried out by researchers, with various focuses and approaches. However, still more needs to be done using a bibliometric study approach. The study used 711 Scopus databases and a wide variety of bibliometric indicators such as publication trends, citations, and author keywords. Bibliometric graphic visualization using VOSviewer software is also presented. The results show that there are 200 concepts divided into four research themes’ the latest topics agreed to adverse events, postoperative operations, and prescriptions. Meanwhile, issues and topics still need to be addressed related to oral drug administration, clinical practice, and guideline adherence. The bibliometric study helps provide a comprehensive and in-depth view of antibiotic prophylaxis and surgical site infection-themed research to researchers interested in discovering new knowledge and topics in this field.

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Ten-year trends of antibiotic prescribing in surgery departments of two private sector hospitals in Central India: a prospective observational study

Skender,

Machowska,

Dhakaita

et al. 2024

BMC Public Health

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Background Inappropriate antibiotic use contributes to the global rise of antibiotic resistance, prominently in low- and middle-income countries, including India. Despite the considerable risk of surgical site infections, there is a lack of antibiotic prescribing guidelines and long-term studies about antibiotic prescribing in surgery departments in India. Therefore, this study aimed to analyse 10 years’ antibiotic prescribing trends at surgery departments in two tertiary-care hospitals in Central India. Methods Data was prospectively collected from 2008 to 2017 for surgery inpatients in the teaching (TH-15,016) and the non-teaching hospital (NTH-14,499). Antibiotics were classified based on the World Health Organization (WHO) Access Watch Reserve system and analysed against the diagnoses and adherence to the National List of Essential Medicines India (NLEMI) and the WHO Model List of Essential Medicines (WHOMLEM). Total antibiotic use was calculated by DDD/1000 patient days. Time trends of antibiotic prescribing were analysed by polynomial and linear regressions. Results The most common indications for surgery were inguinal hernia (TH-12%) and calculus of the kidney and ureter (NTH-13%). The most prescribed antibiotics were fluoroquinolones (TH-20%) and 3rd generation cephalosporins (NTH-41%), and as antibiotic prophylaxis, norfloxacin (TH-19%) and ceftriaxone (NTH-24%). Access antibiotics were mostly prescribed (57%) in the TH and Watch antibiotics (66%) in the NTH. Culture and susceptibility tests were seldom done (TH-2%; NTH-1%). Adherence to the NLEMI (TH-80%; NTH-69%) was higher than adherence to the WHOMLEM (TH-77%; NTH-66%). Mean DDD/1000 patient days was two times higher in the NTH than in the TH (185 vs 90). Overall antibiotic prescribing significantly increased in the TH (β1 =13.7) until 2012, and in the NTH (β2 =0.96) until 2014, and after that decreased (TH, β2= -0.01; NTH, β3= -0.0005). The proportion of Watch antibiotic use significantly increased in both hospitals (TH, β=0.16; NTH, β=0.96). Conclusion Total antibiotic use decreased in the last three (NTH) and five years (TH), whereas consumption of Watch antibiotics increased over 10 years in both hospitals. The choice of perioperative antibiotic prophylaxis was often inappropriate and antibiotic prescribing was mostly empirical. The results of this study confirmed the need for antibiotic prescribing guidelines and implementation of antimicrobial stewardship programs.

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Antibiotic Use, Incidence and Risk Factors for Orthopedic Surgical Site Infections in a Teaching Hospital in Madhya Pradesh, India

Cited by 5 publications

References 41 publications

Prevalence of surgical site infections and antibiotic resistance pattern in a Tertiary care Orthopaedic unit

Prevalence of surgical site infections and antibiotic resistance pattern in a Tertiary care Orthopaedic unit

Trends of research on antibiotic prophylaxis and surgical site infection: A bibliometric review based on VOS viewer by Scopus database

Ten-year trends of antibiotic prescribing in surgery departments of two private sector hospitals in Central India: a prospective observational study

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