Occurrence, associated risk factors, and treatment of surgical site infections in Pakistan

Abstract

Globally, surgical site infections are one of the common infections which lead to a large amount of mortality and morbidity in postsurgical care. The risk for surgical site infection is multidimensional which includes mainly; patient, surgery, and hospital-related factors. This study is aimed to determine the burden of SSIs along with contributed risk factors. A prospective observational cross-sectional study was conducted in one of the largest public-sector hospitals in Pakistan. A total of 412 patients were recruited in the study with full consent and monitored for 30 days after surgery with direct and indirect surveillance. Overall, in seven different surgical procedures the incidence (29.8%) rate of SSI was observed; in appendectomy ( n = 17, 4.1%), exploratory laparotomy ( n = 51, 12.6%), laparoscopic cholecystectomy ( n = 12, 2.90%), mesh repair ( n = 17, 4.01%), thyroidectomy (5, 1.2%), transurethral resection of the prostate ( n = 11, 2.6%), and transurethral resection of the bladder (10, 2.4%). The average SSI rate in every single procedure was about 18 (4.27%) per surgical procedure out of 123 (29.85%) SSI cases. Types of SSI identified were superficial, deep incisional and organ/space ( n = 76, 18.4%, n = 23, 5.5%, and n = 24, 5.7%). Incidence of SSIs during admission, at readmission, and post-surveillance cases were ( n = 50, 12.1%, n = 25, 6.0% and n = 48, 11.6%). Associated risk factors found contributed to the incidence of SSI ( p < 0.05). Pre-operative ( n = 348, 84.5%) and 6 (1.5%) surgical patients did not received the post-operative antibiotics. The P. aeruginosa ( n = 15, 12.1%) and S. aureus (13, 10.5%). Cefoperazone and sulbactam were the most prescribed antibiotics. Associated risk factors and treatment outcomes of surgical patients have a direct association with the incidence of SSI. Hospital-based antimicrobial stewardship, implementation of surgical guidelines, patient care, and education are needed to develop at wards level in hospitals.

Epidemiology and Risk Factors of Post Operative Site Infections in Surgical Patients: A Systematic Review

“…In contrast to our finding, a study was done by Khan UF in Pakistan (a part of the South-east Asian WHO region) have reported a slightly higher proportion of SSI (29.8%) among the patients who undergone seven different surgical procedures [43]. This emphasizes the importance of proper implementation of SSI preventive measures in these countries so that the additional burdens faced by the COVID-19 pandemic can be reduced.…”

Exploring Undergraduate Pharmacy Students Perspectives Towards Antibiotics Use, Antibiotic Resistance, and Antibiotic Stewardship Programs Along With the Pharmacy Teachers’ Perspectives: A Mixed-Methods Study From Pakistan

“…A WHO (world health organization) report revealed that out of a total of 67% of antibiotics used in the community about 30% are used irrationally by healthcare providers ( Koivusalo and Mackintosh, 2008 ). There is a direct link between the use of antibiotics and ABR and their use in the community ( Khan et al, 2020a ; Khan et al, 2021 ; Malik et al, 2021 ).…”

Effectiveness of Pharmacist-Led Brief Educational Intervention for Adherence to the Antibiotics for Lower Respiratory Tract Infections (EATSA) in Post-Conflict Rural Areas of Pakistan: Study Protocol for a Randomized Controlled Trial

“…These determinants lead to the inappropriate use of antibiotics and, ultimately, antibiotics resistance is a likely the result of this misuse. Hence, there is an utmost need to engage the community and all stakeholders, including the local people, to stop the irrational use of antibiotics [24,[43][44][45][46][47][48].…”