Predictors of Surgical site infections among patients undergoing open urological surgery at a Tertiary hospital, Tanzania: A cross sectional study

Manyahi, Joel; Kibwana, Upendo; Sensa, Victor Patrick; Yongolo, S; Lyamuya, Eligius

doi:10.21203/rs.2.10745/v1

Cited by 2 publications

(1 citation statement)

References 21 publications

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“…7 Studies in Tanzania have reported high surgical site infection (SSI) rates ranging from 21.3% to 48.0% among patients undergoing surgery, including CS. [8][9][10][11][12][13] These rates are 5-18 times higher than rates in high-income countries.…”

Section: Introductionmentioning

confidence: 99%

Reducing surgical site infections and mortality among obstetric surgical patients in Tanzania: a pre-evaluation and postevaluation of a multicomponent safe surgery intervention

Ernest¹,

Hellar²,

Varallo³

et al. 2021

BMJ Glob Health

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IntroductionDespite ongoing maternal health interventions, maternal deaths in Tanzania remain high. One of the main causes of maternal mortality includes postoperative infections. Surgical site infection (SSI) rates are higher in low/middle-income countries (LMICs), such as Tanzania, compared with high-income countries. We evaluated the impact of a multicomponent safe surgery intervention in Tanzania, hypothesising it would (1) increase adherence to safety practices, such as the WHO Surgical Safety Checklist (SSC), (2) reduce SSI rates following caesarean section (CS) and (3) reduce CS-related perioperative mortality rates (POMRs).MethodsWe conducted a pre-cross-sectional/post-cross-sectional study design to evaluate WHO SSC utilisation, SSI rates and CS-related POMR before and 18 months after implementation. Our interventions included training of inter-professional surgical teams, promoting use of the WHO SSC and introducing an infection prevention (IP) bundle for all CS patients. We assessed use of WHO SSC and SSI rates through random sampling of 279 individual CS patient files. We reviewed registers and ward round reports to obtain the number of CS performed and CS-related deaths. We compared proportions of individuals with a characteristic of interest during pre-implementation and post implementation using the two-proportion z-test at p≤0.05 using STATA V.15.ResultsThe SSC utilisation rate for CS increased from 3.7% (5 out of 136) to 95.1% (136 out of 143) with p<0.001. Likewise, the proportion of women with SSI after CS reduced from 14% during baseline to 1% (p=0.002). The change in SSI rate after the implementation of the safe surgery interventions is statistically significant (p<0.001). The CS-related POMR decreased by 38.5% (p=0.6) after the implementation of safe surgery interventions.ConclusionOur findings show that our intervention led to improved utilisation of the WHO SSC, reduced SSIs and a drop in CS-related POMR. We recommend replication of the interventions in other LMICs.

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Section: Introductionmentioning

confidence: 99%

Reducing surgical site infections and mortality among obstetric surgical patients in Tanzania: a pre-evaluation and postevaluation of a multicomponent safe surgery intervention

Ernest¹,

Hellar²,

Varallo³

et al. 2021

BMJ Glob Health

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Surveillance of Surgical Site Infections in Post-operative Patients and Bacterial Susceptibility in Tanzania

Karuhanga,

Madoshi,

Machang’u

2024

EMJ Microbiol Infect Dis

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Surgical site infections (SSI) are infections occurring within 30 days of the post-operative procedure. They are common post-operative morbid complications that may cause death if not treated timely. The common causes of SSI include infectious bacteria, such as Staphylococcus aureus, Pseudomonas aeruginosa, Escherichia coli, and some Enterobacteriaceae. This was a cross-sectional study conducted at St. Francis Referral Hospital, Ifakatra, Tanzania over a period of 12 months to investigate the causes of SSI and antimicrobial susceptibility of the causal agents. The study included consenting patients who developed post-operative wound infections during the study period. Identification of infecting micro-organisms and their antimicrobial susceptibility was done at St Francis Referral Hospital Laboratory. Antibiotic susceptibility tests of the isolates were performed by the Kirby–Bauer (K–B 1966) disc diffusion test, and extended spectrum β-lactamase producing Gram-negative species were tested by using the modified double disc synergy test. A total of 130 patients developed post-operative wound infection. Third and fourth decades were the most affected age groups; females were the dominant group with a 1:1.4 male: female ratio. Out of the 130 specimens, 121 isolates were obtained, and nine specimens were negative for culture. P. aeruginosa was the most commonly isolated agent (42.1%), followed by S. aureus (19.8%), while the least were Streptococcus spp. at 0.8%. The isolates showed the highest resistance to ampicillin (91.7%), and least to ciprofloxacin (1.7%). P. aeruginosa was highly resistant to both amoxicillin + clavulanic acid (98%), and to ampicillin (98.0%). Extended spectrum β-lactamase E. coli producers were 68.4%. The bacteria causing SSI require continuous monitoring to obtain data that will support local and national guidelines in the battle against antimicrobial resistance, and improve therapeutic outcomes following surgical interventions.

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Predictors of Surgical site infections among patients undergoing open urological surgery at a Tertiary hospital, Tanzania: A cross sectional study

Cited by 2 publications

References 21 publications

Reducing surgical site infections and mortality among obstetric surgical patients in Tanzania: a pre-evaluation and postevaluation of a multicomponent safe surgery intervention

Reducing surgical site infections and mortality among obstetric surgical patients in Tanzania: a pre-evaluation and postevaluation of a multicomponent safe surgery intervention

Surveillance of Surgical Site Infections in Post-operative Patients and Bacterial Susceptibility in Tanzania

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