Incidence and root causes of surgical site infections after gastrointestinal surgery at a public teaching hospital in Sudan

Abstract

Background Surgical site infections (SSIs) are common healthcare-associated infections and associated with prolonged hospital stays, additional financial burden, and significantly hamper the potential benefits of surgical interventions. Causes of SSIs are multi-factorials and patients undergoing gastrointestinal tract procedures carry a high risk of bacterial contamination. This study aimed to determine the prevalence, associated factors, and causing microorganisms of SSIs among patients undergoing gastrointestinal tract surgeries. Methods A hospital based, cross-sectional study conducted at Soba University Hospital in Khartoum, Sudan. We included all patients from all age groups attending the gastrointestinal tract surgical unit between 1st September and 31st December 2017. We collected data about the socio-demographic characteristics, risk factors of SSI, and isolated microorganisms from patients with SSIs. A Chi-square test was conducted to determine the relationship between the independent categorical variables and the occurrence of SSI. The significance level for all analyses was set at p < .05. Results A total of 80 participants were included in the study. The mean age was 51 +/- 16 years and most of the patients (67.5%) did not have any chronic illness prior to the surgical operation. Most of them (46.3%) of them underwent large bowel surgery. Twenty-two patients (27.5%) developed SSI post operatively and superficial SSI was the most common type of SSIs (81.8%). Occurrence of SSI was found to be associated with long operation time (p > .001), malignant nature of the disease (p > .001), intra-operative blood loss (p > .001), and intra-operative hypotension (p = .013). The most prevalent microorganism isolated from SSI patients was E coli (47.8%), followed by Enterococcus fecalis (13.0%) and combined Pseudomonas aeruginosa + E coli infection (13.0%). Conclusions The results showed a high prevalence of SSIs among patients attending the gastrointestinal tract surgical unit and the most prevalent microorganism isolated from them was E coli. Measures should be taken to reduce the magnitude of SSI by mitigating the identified associated factors.

Closure of Emergency Midline Laparotomy over Subcutaneous Closed Suction Drain to Mitigate Incisional Surgical Site Infection, Dehiscence and Hernia: A Prospective Comparative Study

“…The current literature shows wide range of variability regarding the rates of laparotomy related ISSI (21)(22)(23)(24) . Thus, the rate of ISSI in our study was almost similar to study (25) and relatively close to others which reported ISSI rate of 22.6% (21) and 21% (22) . However, our results were obviously lower than Sumi et al (23) (36.2%) and higher than Zaidi and co-workers (13.8%) (26) .…”

Diagnosis and Management of Surgical Site Infections: Narrative Review

“…This is significant because blood loss is linked to poor tissue oxygenation, which contributes to the development of SSI. Also, as previously observed [29,30], intraoperative hypotension is closely linked to SSI, and this is due to the inadequate wound perfusion caused by intra-operative hypotension [27].…”

“…Another study found that 26.1 percent of patients who had severe intra-operative blood loss had wound infection [27,28]. There is a significant link between SSI and intra-operative blood loss of more than 500 ml.…”

Current Insights: The Impact of Gut Microbiota on Postoperative Complications in Visceral Surgery—A Narrative Review

“…Overall, Staphylococcus aureus is one of the most common microbes being found in SSI, followed by typical gut commensals such as Escherichia coli and Enterococcus faecalis [2,100]. In visceral surgery, Gram negative bacilli as well as facultative anaerobes are the most common origin of SSI [4,10,11,[101][102][103]. Most of the pathogens are normal inhabitants of the human body making it debatable why some patients develop SSI and others not.…”