Incidence, risk factors and outcomes of surgical site infections among patients admitted to Jimma Medical Center, South West Ethiopia: Prospective cohort study

Abstract

Background Surgical site infections are one of the leading health care–associated infections in developing countries. Despite improvements in surgical technique and the use of best infection prevention strategies, surgical site infections remained the major cause of hospital acquired infections. Therefore, this study aimed to determine incidence, risk factors, and outcomes of surgical site infections among patients admitted to Jimma Medical Center, South West Ethiopia. Methods A hospital based prospective cohort study design was employed to follow adult patients admitted to general surgery ward, orthopaedic ward and gynaecologic/obstetrics ward of Jimma Medical Centre, from April 20 to August 20, 2019. All patients were followed daily before, during and after operation for 30 days to determine the incidence of surgical site infection and other outcomes. Data was entered using EpiData version 4.2 and analyzed using statistical software package for social science version 20.0. To identify the independent predictors of outcome, multiple stepwise backward cox regression analysis was done. Statistical significance was considered at p-value <0.05. Results Of total of 251 participants included to the study, about 126 (50.2%) of them were females. The mean ± SD age of patients was 38 ± 16.30 years. Considerable number of patients 53(21.1%) developed surgical site infections. American Society of Anaesthesiologists score ≥3 [ Adjusted Hazard Ratio (AHR) = 2.26; 95%CI = (1.03–4.93)], postoperative antibiotic prescription [AHR = 3.2; 95%CI = (1.71–6.01)], contaminated-wound [AHR = 7.9; 95%CI = (4.3–14.60)], emergency surgery [AHR = 2.8; 95% CI = (1.16–6.80)], duration of operation ≥ 2 h [AHR = 4; 95% CI = (2.17–7.50)] and comorbidity [AHR = 2.52; 95%CI = (1.28–4.94)] were independent predictors for surgical site infections. Twenty nine (11.6%) patients returned to operation room. The result of the multivariate cox regression analysis showed that SSI [AHR (95% CI) = 7(3.16–15.72)], and incision site [AHR (95% CI) = 2.5(1.14–5.42)] had statistically significant association with re-operation Conclusion The incidence of surgical site infection was high in the study setting. There were significant numbers of contributing factors for the occurrence of surgical site infections. Although no mortality observed during the study period, significant number of patients re-operated. Large multicenter study is urgently needed to confirm the outcome of this study.

Incidence of surgical site infection, bacterial isolate, and their antimicrobial susceptibility pattern among patients who underwent surgery at Dessie Comprehensive Specialized Hospital, Northeast Ethiopia

“…In this study, the rate of clinical SSI (14.5%) was slightly higher than that in similar studies done in Addis Ababa, Ethiopia (9.8%), 32 and Alexandria, Egypt (2.3%), 33 but it was lower than that in other studies performed in the Harari region, Mekelle, and Jimma, Ethiopia. 11 , 23 , 25 , 34 It was also lower than a pooled prevalence report that was conducted in Ethiopia. 35 This difference across studies could be due to the fact that the rate of SSIs varies widely across study periods, between hospitals and between surgeons, suggesting that working practices play a critical role in the prevention of these infections.…”

Assessment of Post-Operative Infection of Acetabular Fracture Fixation: Meta-Analysis

“…Regard pooled analysis DM considered as significant risk factor with Pooled OR 2.31 (1.1-8.63) (Table 7). (6) 16 NA Iqbal et al (9) 14 Staphylococcus aureus 10 Enterococcus faecalis 2 Acinetobacter species 0 Staphylococcus epidermidis 0 Pseudomonas aeruginosa 0 Enterobacter cloacae 2 Escherichia coli 0 Ding et al (12) 56 NA Mardanpour et al (13) 53 NA Misha et al (14) 53 (11) 79 NA 3017 NA ---------Li et al (6) 16 30.9 ±17.4 322 17.5 ±14.9 3.65 0.00** Iqbal et al (9) 14 NA 236 NA ---------Ding et al (12) 56 25.1±3.58 735 17.52±2.36 19.75 0.00** Mardanpour et al (13) 53 NA 735 NA ---------Misha et al (14) 53 NA 198 NA -------- (12) 56 NA 735 NA ---------Mardanpour et al (13)…”

“…NA 735 NA --------- (11) 79 NA 3017 NA ----------------- (13) 53 NA 735 NA ---------------Misha et al (14) 53…”

Identification of Bacterial Isolates and Their Antimicrobial Susceptibility Pattern from Wound/Pus Sample in a Tertiary Care Hospital, Gwalior, India

“…8,9 Infection can be either endogenous or exogenous. 10 The loss of skin integrity due to a variety of reasons creates an environment conducive to the colonization and proliferation of microorganisms. 11 Humidity, heat, and nutrition in the wound attract pathogen from the cutaneous surface, environment, or the patient's own flora, which grow and release various virulence factors, resulting in wound infection.…”