&lt;p&gt;Evaluation of Surgical Antimicrobial Prophylaxis and Incidence of Surgical Site Infection at Borumeda Hospital, Northeast Ethiopia: Retrospective Cross-Sectional Study&lt;/p&gt;

Moges, Getachew; Belete, Lielet; Mengesha, Yohannes; Ahmed, Solomon

doi:10.2147/dhps.s280442

Cited by 10 publications

(12 citation statements)

References 54 publications

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“…Abdominal surgery, which may involve multiple organs, was a serious stressor. DSSI was an important burden of the laparotomy, and the infections can spread to abdominal organs, and lead to shock, coma, and eventual death (25). DSSI were also notoriously difficult to treat.…”

Section: Discussionmentioning

confidence: 99%

Neutrophil extracellular trap formation index predicts occurrences of deep surgical site infection after laparotomy

Duan¹,

Sun²,

Qu³

et al. 2021

Ann Transl Med

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Background: Deep surgical site infections (DSSIs) are serious complications after laparotomy. Neutrophil extracellular traps (NETs) play a vital role in the development of DSSI. Here, we focused on a new approach to predicting the occurrence of DSSI through the detection of the NET formation index (NFI), and compared its prediction ability with other clinical infection indicators. Methods: Patients who received laparotomy were prospectively enrolled in this study. General information, APACHE II score, SOFA score, and serum infection indicators were recorded. The postoperative abdominal drainage fluid was collected within 3 days after the operation for quantification of the NFI.Results: A total of 92 consecutive patients were included, with 22 patients were diagnosed with DSSI.The NFI in the DSSI group was 32.70%±19.33% while the corresponding index was 10.70%±8.25% in the non-DSSI group (P<0.01). The mean APACHE II and SOFA score had significant differences between the two groups. The NFI was positively correlated with the APACHE II score (P<0.01, r=0.269) and SOFA score (P=0.013, r=0.258). Patients with a high NFI (NFI >13.86%) had a higher risk of developing DSSI.According to the receiver operating characteristic (ROC) curve, the area under the ROC curve (AUC) of the NFI, C-reactive protein (CRP) and procalcitonin (PCT) were 0.912, 0.748 and 0.731, respectively. Conclusions:In this cohort of surgical patients, the quantification of the NFI had a considerable predictive value for early identification of DSSI. The NFI in drainage fluid turned out to be a more sensitive and specific predictor of DSSI than serum infection indicators including CRP and PCT.

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Section: Discussionmentioning

confidence: 99%

Neutrophil extracellular trap formation index predicts occurrences of deep surgical site infection after laparotomy

Duan¹,

Sun²,

Qu³

et al. 2021

Ann Transl Med

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“…1 However, lack of adherence to follow protocol for SAP is among one of the factors for irrational use. 6,7 Bacteria that become resistant to multiple antibiotics are often the result of incorrect or prolonged antibiotic use. 8 30% to 50% of antibiotics prescribed in hospitals are for postsurgical prophylaxis, and almost 30% to 90% of these regimens are unnecessary.…”

Section: Introductionmentioning

confidence: 99%

Protocol based Surgical Antimicrobial Prophylaxis in Endo-Urologic Surgeries: An Attempt to Convince the Surgeons to Follow the Guidelines

Ahmad¹,

Arsalan²,

Chaudhary³

et al. 2023

J. Pure Appl. Microbiol.

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Surgical antibiotic prophylaxis (SAP) prevents infectious complications during surgery by administering an effective antimicrobial agent before surgery. There is, however, lack of adherence to the standard SAP administration protocol. We reviewed 576 surgeries and find that cefuroxime/cefazolin was used as SAP in less than 31% of surgeries followed by ceftriaxone and cefoperazone. In 61% of cases, SAP was continued for more than 24 hours and in 2/3rd more than one SAP was prescribed, we noted the best SAP compliance was for the timing of pre-operative dosage. We then selected a unit of urology and applied the recommended SAP protocol, and monitored the patient’s outcome. All the surgeries were endoscopic urological procedures and our protocol was effective in 97.7% of patients. Out of 89, 78(87.6%) surgeries went uneventful, whereas 11 (12.4%) had post-operative complications. Two out of 89 (2.2%) cases had UTI post-operatively which was considered as surgical site infection. following the EAU guidelines for antibiotic prophylaxis reduced antibiotic use without increasing postoperative infection rates and SAP should be followed as per the standard guidelines in other units also. This small study is a way forward for our HICC team to motivate other surgeons to follow the guidelines and become antimicrobial stewardship champions. Our study demonstrates the feasibility of developing and successfully implementing such protocols.

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“…Furthermore, a report from a meta-analysis study indicated that the estimated pooled occurrence of SSI in Ethiopia was 12.3% 11 . From an estimated 30–50% of the antimicrobials used for surgical prophylaxis in hospitals, 30–90% were inappropriate 17 . The use of surgical antimicrobial prophylaxis before any surgery in an appropriate way is an important measure to prevent SSI.…”

Section: Introductionmentioning

confidence: 99%

“…However inappropriate use of antimicrobial agents like inappropriate selection, timing, and duration are associated with an increase in the worldwide emergence of antimicrobial resistance, a major public health problem, and has a significant impact on treatment and outcomes. Moreover, there will be also increased risks of occurrence of surgical site infections, and adverse drug reactions thus strongly calling for the evaluation of SAP 15 , 17 .…”

Section: Introductionmentioning

confidence: 99%

Surgical site infection and antimicrobial prophylaxis prescribing profile, and its determinants among hospitalized patients in Northeast Ethiopia: a hospital based cross-sectional study

Habteweld,

Yimam,

Tsige

et al. 2023

Sci Rep

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The inappropriate use of surgical antimicrobial prophylaxis is a common cause for increased risk of morbidity and mortality from surgical site infection in patients who underwent surgical procedures. The study aimed to evaluate surgical antimicrobial prophylaxis prescribing patterns, Surgical Site Infection (SSI), and its determinants in the surgical ward of Debre Berhan Comprehensive Specialized Hospital, northeast Ethiopia. A prospective cross-sectional study was conducted from October 1st 2022 to January 31st, 2023. Data collected from patient medical record cards and patient interviews were entered and analyzed using SPSS V26.0. The determinants of surgical site infection were determined from the multivariable logistic regression. P-value ≤ 0.05 was considered statistically significant. Ceftriaxone (70.5%) followed by a combination of ceftriaxone with metronidazole (21.90%) was the most frequently used prophylactic antibiotic. One hundred fifty-nine (78%) of patients were exposed to inappropriately used prophylactic antimicrobials and 62.2% of these were exposed to inappropriately selected antibiotics. One hundred twenty-six (61.9%) patients developed Surgical Site Infection (SSI). Duration of procedure longer than an hour and inappropriate use of antimicrobial prophylaxiswere the independent predictors for the occurrence of surgical site infections. Patients whose operation was lasted in longer than an hour were 3.39 times more likely to develop SSI compared to those whose operation was completed in less than an hour, AOR = 3.39 (95% CI: 1.24–9.30). Similarly, controlling the effect of other covariate variables, individuals who were given inappropriate antimicrobial prophylaxis were 6.67 times more likely to develop SSI compared to those given appropriate prophylaxis, AOR = 6.67 (95% CI: 1.05–42.49). The high rate of SSI requires due attention from clinicians as well as health policymakers. Duration of surgical procedure greater than an hour and inappropriate antimicrobial prophylaxis use was the independent predictor of surgical site infections.

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<p>Evaluation of Surgical Antimicrobial Prophylaxis and Incidence of Surgical Site Infection at Borumeda Hospital, Northeast Ethiopia: Retrospective Cross-Sectional Study</p>

Cited by 10 publications

References 54 publications

Neutrophil extracellular trap formation index predicts occurrences of deep surgical site infection after laparotomy

Neutrophil extracellular trap formation index predicts occurrences of deep surgical site infection after laparotomy

Protocol based Surgical Antimicrobial Prophylaxis in Endo-Urologic Surgeries: An Attempt to Convince the Surgeons to Follow the Guidelines

Surgical site infection and antimicrobial prophylaxis prescribing profile, and its determinants among hospitalized patients in Northeast Ethiopia: a hospital based cross-sectional study

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