Pattern of antibiotics use, incidence and predictors of surgical site infections in a Tertiary Care Teaching Hospital

Halawi, Ezaedin; Assefa, Tamrat; Hussen, Sadikalmahdi

doi:10.1186/s13104-018-3643-8

Cited by 29 publications

(34 citation statements)

References 26 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…According to recent evidence, the risk factors for SSI are multifactorial and complex. For instance, pre-existing illness [16][17][18], wound contamination [13,15,19], American Society of Anaesthesiologists (ASA) score III or IV [13,20], non-use of prophylactic antibiotics [21], presence of hypovolemic [22], longer duration of operation [16,17,21], longer preoperative hospital stay [16,21], postoperative hospital stay [16,19], advanced age [16,21], alcohol use [19,23], previous surgery [23], use of drain [17], use of iodine alone in skin preparation [17], smoking [17,18], absence of wound care [18], and hair removal inside operating room [20] were factors associated with SSIs.…”

Section: Introductionmentioning

confidence: 99%

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

Shiferaw

Aynalem

Akalu

et al. 2019

Preprint

View full text Add to dashboard Cite

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.

show abstract

Section: Introductionmentioning

confidence: 99%

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

Shiferaw

Aynalem

Akalu

et al. 2019

Preprint

View full text Add to dashboard Cite

show abstract

“…2,5,6 In the present study, 19.6% (95% CI: 19-20.2) of patients developed SSIs, which is consistent with other previous study conducted by Tekie et al (18%), 31 Sievert et al (19.1%), 32 Nobandegani et al (20%), 33 and Halawi et al (20.6%). 34 The finding is higher than studies conducted by Lubega et al (16.4%), 35 Fisha et al (9.9%), 36 and Alamrew et al (11.1%). 25 The higher prevalence of SSI in our setting could be due to the lack of adequate infection control systems, poor practices, and inappropriate use of antibiotics.…”

Section: Discussionmentioning

confidence: 57%

<p>Surgical Site Infections and Prophylaxis Antibiotic Use in the Surgical Ward of Public Hospital in Western Ethiopia: A Hospital-Based Retrospective Cross-Sectional Study</p>

Kefale¹,

Tegegne²,

Degu³

et al. 2020

IDR

View full text Add to dashboard Cite

Objective: Surgical site infection (SSI) is one of the leading causes of hospital-acquired infection among hospitalized patients. It causes significant health problems and results in an extended length of hospital stay, increased cost, and increased patient morbidity and mortality. To prevent the development of SSI, surgical antibiotic prophylaxis (SAP) administration before surgery is an evidence-based practice. Therefore, this study aimed to assess the prevalence of SSIs and surgical antibiotic prophylaxis practice, and identifying the gap in practicing prophylactic surgical antibiotic use. Methods: A retrospective cross-sectional study design was conducted on randomly selected 281 participants who fulfilled the inclusion criteria. Appropriateness of surgical antibiotic prophylaxis was assessed by clinical pharmacists based on the standard treatment guideline. Descriptive and multivariate logistic regression analyses were performed in SPSS version 25. Statistical significance was set at p <0.05. Results: The overall prevalence of SSI was 19.6% (95% CI: 19-20.2). Majority of surgical patients (88.6%) got surgical antibiotic prophylaxis. Ceftriaxone and metronidazole (45.4%), and ceftriaxone (33.3%) were the most frequently used prophylactic antibiotics. Presence of comorbidity (AOR=9.18, 95% CI: 5.17-17.9, p<0.001), contaminated (AOR=6.01, 95% CI: 1.77-16.8, p=0.019) and dirty (AOR=7.20, 95% CI: 1.23-12.1, p=0.029) wound classes, devoid of prophylactic antibiotics (AOR=6.63, 95% CI: 0.89-19.3, p=0.006), the timing of prophylactic antibiotic administration between 1 hour and 2 hours before incision (AOR=8.2, 95% CI: 4.34-18.1, p=0.001), and 48 hours duration of surgical antimicrobial prophylaxis (AOR=7.20, 95% CI: 1.23-28.17, p=0.027) were significantly associated with the development of SSIs. Conclusion: The prevalence of SSI was relatively high despite most surgical patients were given prophylactic antibiotics. The presence of comorbidity, contaminated and dirty wound classes, devoid of prophylactic antibiotics, administering prophylactic antibiotics between 1 hour and 2 hours before incision, and 48 hours duration of surgical antibiotic prophylaxis were significantly associated with SSIs.

show abstract

“…The articles those fulfill eligibility criteria for this systematic review and meta analysis were conducted on four regions and in the Federal capital city of Ethiopia, Addis Ababa, but no study on SSI was obtained from other regions (Afar, Benishangul-Gumuz, Gambela and Somali). Five studies at South Nations Nationalities and Peoples of Ethiopia national regional state (SNNP) [16,17,[27][28][29]; four studies were conducted in Addis Ababa [15,[30][31][32]; similarly four studies at Tigray national regional state [33][34][35][36]; three studies at Amhara national regional state [37][38][39][40] and lastly two study at Oromia regional state [41,42].…”

Section: Characteristics Of Included Studiesmentioning

confidence: 99%

“…Although in primary studies study variables such as duration of surgery greater than one hour, drinking an alcohol [15,36], chorioaminities [35,38,42], residence [35,42], previous surgery [15,27], HIV [27,35], anemia [28,32], prolonged labor [28,34,35,38], rupture of membrane >12 hour [15,28,32,34,35,42] and duration of surgery > 1hour [15, 27-29, 38, 40] had shown significant association with the SSI, when the odds those associated risk factors of two or more studies become pooled only drinking an alcohol, chorioaminities, residence, previous surgery and rupture of membrane >12 hour were significantly associated with SSI in Ethiopian context.…”

Section: Pooled Effect Of Associated Risk Factors On Ssimentioning

confidence: 99%

“…Similarly, in Ethiopia, variety of studies was conducted to estimate the prevalence of SSIs. However, prevalence of SSIs rate, which shows the prevalence of patients with clinical signs and symptoms of SSI from all patients that undergo surgery, ranges from 3.5% [14] to 20.6 % [15] which showed variation across different geographical settings and different time periods. Likewise, the prevalence culture positive SSI among SSI patients, patients with clinical sign and symptoms of SSI is also ranges from 71.1 % [16] -92% [17].…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Magnitude, bacterial etiology profile and associated factors of surgical site infection in Ethiopia: Systematic review and meta-analysis

Kindu

Zeleke

Tarekegn

et al. 2019

Preprint

View full text Add to dashboard Cite

Background: Surgical site infection is the third most commonly reported nosocomial infection. Different primary studies on Surgical site infection (SSI) were conducted in Ethiopia. However, variation among those studies was seen. This study was aimed to estimate the national prevalence of SSI, its bacterial profile and associated factors of SSI in Ethiopia. Methods: PubMed, Cochrane library, and Google Scholar were searched. A funnel plot and Egger’s regression test were used to see publication bias. I-squared statistic was applied to check heterogeneity of studies. A weighted inverse variance random-effects model was applied to estimate the national prevalence of SSI, its bacterial profile and the effect size of associated factors. The subgroup analysis was conducted by region, study design, and year of study conducted. Result: A total of 18 studies were used for prevalence of SSI, its bacterial profile and associated factors. The pooled prevalence of SSI was 11.58 (95% CI 9.78, 13.38). The pooled prevalence of culture positive SSI infection among patients who develop clinical sign and symptoms of SSI was also 80.42% (95% CI 70.86, 89.99). SSI was majorly caused by S. aureus (28.47%) and E. coli (15.93%). Drinking an alcohol (AOR = 6.28; 95%CI: 2.9–13.3); women’s having chorioaminities (AOR = 8.67; 95%CI: 4.63–16.27); patients living in rural areas (AOR = 3.10; 95%CI: 1.57–6.14); patients who undergo previous surgery (AOR = 3.94; 95%CI: 1.7–7.17) and women’s who had rupture of membrane >12 hour (AOR=5.29; 95%CI: 2.73–10.25) were identified factors of SSI. Conclusions: The prevalence of SSI in Ethiopia was high. This indicates calling for the need of better allocating resources and implementing a program for controlling Surgical site infections in Ethiopia.

show abstract

Pattern of antibiotics use, incidence and predictors of surgical site infections in a Tertiary Care Teaching Hospital

Cited by 29 publications

References 26 publications

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

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

<p>Surgical Site Infections and Prophylaxis Antibiotic Use in the Surgical Ward of Public Hospital in Western Ethiopia: A Hospital-Based Retrospective Cross-Sectional Study</p>

Magnitude, bacterial etiology profile and associated factors of surgical site infection in Ethiopia: Systematic review and meta-analysis

Contact Info

Product

Resources

About