Epidemiology of surgical site infections in Nigeria: A systematic review and meta-analysis

Olowo-Okere, Ahmed; Ibrahim, Y. K. E.; Olayinka, Busayo Olalekan; Ehinmidu, JO

doi:10.4103/npmj.npmj_72_19

Cited by 21 publications

(26 citation statements)

References 35 publications

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“…This high resistance rate is similar to earlier report made by Pondei et al [12] in Okolobiri. Of interest is that 27 (96.43%) of the 28 Pseudomonas showed high susceptibility towards penicillin derivatives (Pipracillin/Tazobactum) which corroborates already reported study conducted in western Nigeria [17], despite that 11 (39.29%) of this organism showed resistant to the aminoglycosides (Gentamycin and Streptomycin). Thus, the present study suggested the inclusion of Pipracillin/Tazobactum into the management of Pseudomonas identified wound infection therapy.…”

Section: Discussionsupporting

confidence: 87%

“…In the present study, rate of recovery of bacterial population from wound infection was 83.08%, that is similar to other studies conducted earlier [2,9,12,13], and the frequency of wound infection was slightly more common in males (56.15%) than in females (43.85%). This is in support with studies done earlier in a tertiary hospital (Niger Delta University Teaching Hospital, Okolobiri) situated in a semi-urban area of the Yenagoa [12], in different parts of Nigeria [17,18] and in Nagpur, India [2]. Conventionally, this might be supported by the fact that males are dominants in occupations where trauma is regular, namely, commercial (tricycle) riders, industry and farming.…”

Section: Discussionsupporting

confidence: 86%

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Identification and antimicrobial susceptibility profile of bacterial pathogens isolated from wound infections in a tertiary hospital, Bayelsa, South southern, Nigeria

Abdu

Egbagba

Fente

2019

Trop J Pathol Microbiol

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Introduction: Infected wounds in particular, those associated with antimicrobial resistant microorganisms constitute a significant source of physical, psychological, and economic burden to patients in particular, and the society at large in terms of the huge resources spent in treating such wounds as well as time/days lost at workplaces leading to increased morbidity and mortality globally. The present study sought to investigate and identify the common bacteria associated with wound infections and their antibiotic sensitivity pattern. Material and Methods: A total of 130 wound samples were collected by doctors in ward using Sterile Swab Sticks over a period of 6 months from February-July 2019. Pathogenic bacteria were isolated, identified and their antibiotic susceptibility tests were performed. Results: Among 130 cases, 108 (83.08%) were culture positive for bacterial pathogens, while 22 (16.92%) were bacteriologically sterile (Negative). Rate of infection was high in males (56.15%) than females (43.85%). Of the 108-culture positive, 164 isolates were recovered of which 28 (17.07) were anaerobes, while 136 were aerobes of which 106 (64.64%) were Gram-negative species and 30 (18.29%) Gram-negative species. The predominant isolates among the facultative aerobes, were Pseudomonas aeruginosa 28 (17.07%), followed by E. coli 19 (11.58%), Klebsiella pneumonia 17 (10.37%) while the least were amongst Morganella morgani, Providencia rettgeri and Serretia marcescens with 2 (1.22%) individually. Among the Gram-positive, Staphylococcus aureus 10 (6.10%) were most common, followed by Enterococcus spp 4 (2.44%), Coagulase negative staphylococcus (CoNS) 4 (2.44%) while the least were amongst Streptococcus Group B, Streptococcus Group C, Streptococcus Group G with 2 (1.22%) separately. Amongst the anaerobes, Bacterioides fragilis 16 (9.75%) is the most common, followed by Peptostreptococcus spp., and Prevotella spp with 4 (2.44%) each, while Fusobacterium spp and Veillonella spp were the least, 2 (1.22%) each. Amikacin and nitrofurantoin are the most efficacious for managing wound infections, with all the isolates being susceptible to them. Resistance was moderate to Levofloxacin (49.39%). On the other hand, resistance were above average among Ciprofloxacin (96.34%), Cloxacillin (94.51%), Ceftriaxone (91.46%), Ceftazidine (91.46%), Cefotaxime (87.20%), Erythromycin (59.15%), Ofloxacin (58.54%) and Chloramphenicol (51.22%). The least resistance shown to Gentamicin (16.46%), Streptomycin (16.46%), Imipenem (7.93%), Metronidazole (7.93%), and Piperacillin-tazobactam (7.93%). Conclusion: Antibiotic susceptibility test is suggested prior to administration of antibiotics for successful treatment and intermittent monitoring is also encouraged to check emerging multidrug resistant trends as a guide to health authorities.

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Section: Discussionsupporting

confidence: 87%

Section: Discussionsupporting

confidence: 86%

Identification and antimicrobial susceptibility profile of bacterial pathogens isolated from wound infections in a tertiary hospital, Bayelsa, South southern, Nigeria

Abdu

Egbagba

Fente

2019

Trop J Pathol Microbiol

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“…Similarly, we found that those who had diabetes mellitus were significantly associated with SSIs. This finding supported by other studies conducted in Yemen [63], Nigeria [57], India [64], and Tanzania [17]. Previous studies have shown that patients with pre-existing illnesses, such as diabetes mellitus are at high risk of developing SSI due to their low immunity and that may slow the healing process [65].…”

Section: Note: Weights Are From Random Effects Analysissupporting

confidence: 80%

“…This finding indicates that SSIs are highly prevalent in hospital patients and reflects inadequate implementation of infection prevention in Ethiopia. Hence, a multifactorial approach is required to manage SSIs, with emphasis being placed on adequate antibiotic prophylaxis, aseptic wound care, and treatment adherence.Our estimated prevalence of SSIs among post-operative patients in Ethiopia is in line with systematic review and meta-analysis studies done in Nigeria 14.5%[57] and 14.8% in Sub-Saharan Africa[58]. However, this result was substantially higher than studies conducted in China was 4.5%[59] and 5.4% in Algeria[60].…”

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confidence: 87%

Surgical site infection and its associated factors in Ethiopia: A systematic review and meta-analysis

Shiferaw

Aynalem

Akalu

et al. 2019

Preprint

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Background: Despite being a preventable complication of surgical procedures, surgical site infections (SSIs) continue to threaten public health with significant impacts on the patients and the health-care human and financial resources. With millions affected globally, there issignificant variation in the primary studies on the prevalence of SSIs in Ethiopia. Therefore, this study aimed to estimate the pooled prevalence of SSI and its associated factors among postoperative patients in Ethiopia. Methods:PubMed, Scopus, Psyinfo, African Journals Online, and Google Scholar were searched for studies that looked at SSI in postoperative patients. A funnel plot and Egger's regression test were used to determine publication bias. The I 2 statistic was used to check heterogeneity between the studies. DerSimonian and Laird random-effects model was applied to estimate the pooled effect size, odds ratios (ORs), and 95% confidence interval (CIs) across studies. The subgroup analysis was conducted by region, sample size, and year of publication.Sensitivity analysis was deployed to determine the effect of a single study on the overall estimation. Analysis was done using STATA™ Version 14 software. Result:A total of 24 studies with 13,136 study participants were included in this study.The estimated pooled prevalence of SSI in Ethiopia was 12.3% (95% CI: 10.19, 14.42). Duration of surgery > 1 hour (AOR = 1.78; 95% CI: 1.08 -2.94), diabetes mellitus (AOR = 3.25; 95% CI:1.51-6.99), American Society of Anaesthesiologists score >1 (AOR = 2.51; 95% CI: 1.07-5.91), previous surgery (AOR = 2.5; 95% CI: 1.77-3.53), clean-contaminated wound (AOR = 2.15; 95% CI: 1.52-3.04), and preoperative hospital stay > 7 day (AOR = 5.76; 95% CI: 1.15-28.86), were significantly associated with SSI. Conclusion:The prevalence of SSI among postoperative patients in Ethiopia remains high with a pooled prevalence of 12.3% in 24 extracted studies. Therefore, situation based interventions and region context-specific preventive strategies should be developed to reduce the prevalence of SSI among postoperative patients.

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“…Surgical site infection (SSI) is among the most common problems for patients who undergo operative procedures and represents the second most common type of healthcare-associated infection (HAI). [12] SSIs are the most common reason for readmission after surgery and account for nearly 20% of unplanned readmissions. [3] They are associated with increased morbidity, mortality, readmission, reoperation, limitation of the quality of life, loss of daily wages, prolonged hospital stays, and consequently increased health care costs, which may be considerably higher in drug-resistant organisms.…”

Section: Introductionmentioning

confidence: 99%

Staphylococcus aureus: A predominant cause of surgical site infections in a rural healthcare setup of Uttarakhand

Pal

Sayana

Joshi

et al. 2019

J Family Med Prim Care

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Introduction:Surgical site infections (SSIs) represent the second most common type of healthcare-associated infections and remain a relatively common postoperative complication and the most common reason for readmission after surgery. SSIs have dire implications for the surgeon, patient, and institution which often require prolonged treatment, impose an economic burden and double the risk of patient mortality. Staphylococcus aureus is currently the most common cause of SSIs causing as many as 37% of cases of SSIs in community hospitals with methicillin-resistant S. aureus (MRSA) of particular concern.Materials and Methods:This cross-sectional study was conducted from January 2014 to December 2014 in a rural tertiary care hospital of Pauri Garhwal district of Uttarakhand state, India. Samples were collected using sterile cotton swabs from 269 patients clinically diagnosed with SSIs and were processed as per standard microbiological techniques. Antimicrobial susceptibility testing was done using a modified Kirby-Bauer disc diffusion method.Results:Out of 1294 patients, 269 (20.8%) were found to have SSIs and samples were collected from them. Out of a total of 269 samples, 258 (95.9%) yielded bacterial growth and 267 bacterial isolates were obtained. S. aureus (45.3%) was the commonest organism followed by Escherichia coli (13.9%), Pseudomonas aeruginosa (6.7%), and Proteus species (4.9%). Antimicrobial profile of S. aureus revealed maximum sensitivity to rifampicin, linezolid, teicoplanin, vancomycin, and amikacin whereas ampicillin, cefazolin, and gentamicin were found to be least sensitive.Conclusion:S. aureus played a predominant role in the etiology of SSIs in this hospital with MRSA being a major concern as the treatment options for such resistant strains are limited. Reduction in SSI rates can lead to both better clinical outcomes for patients and cost savings for hospitals. Adherence to strict infection control measures, maintenance of proper hand hygiene and optimal preoperative, intraoperative, and postoperative patient care can surely reduce the incidence of SSIs. A multifaceted approach involving the surgical team, microbiologist, and the infection control team is required to provide quality surgical services.

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Epidemiology of surgical site infections in Nigeria: A systematic review and meta-analysis

Cited by 21 publications

References 35 publications

Identification and antimicrobial susceptibility profile of bacterial pathogens isolated from wound infections in a tertiary hospital, Bayelsa, South southern, Nigeria

Identification and antimicrobial susceptibility profile of bacterial pathogens isolated from wound infections in a tertiary hospital, Bayelsa, South southern, Nigeria

Surgical site infection and its associated factors in Ethiopia: A systematic review and meta-analysis

Staphylococcus aureus: A predominant cause of surgical site infections in a rural healthcare setup of Uttarakhand

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