Surgical site infection rates in six cities of India: findings of the International Nosocomial Infection Control Consortium (INICC)

Singh, Sanjeev; Chakravarthy, Murali; Rosenthal, Víctor D.; Myatra, Sheila Nainan; Dwivedy, Arpita; Bagasrawala, Iqbal; Munshi, Nita; Shah, Sweta; Panigrahi, Bishnu; Sood, Sanjeev; Kumar-Nair, Pravin; Radhakrishnan, K.; Gokul, B.N.; Sukanya, R.; Pushparaj, Leema; Pramesh, C S; Shrikhande, S. V.; Gulia, Ashish; Puri, Ajay; Moiyadi, Aliasgar; Divatia, Jigeeshu V.; Kelkar, Rohini; Biswas, Sanjay; Raut, Sandhya; Sampat, Sulochana; Shetty, Suvin; Binu, Sheena; Pinto, Preethi; Arora, Sohini; Kamble, Asmita; Kumari, Neelakshi; Mendonca, Angelina; Singhal, Tanu; Naik, Reshma; Kothari, Vatsal; Sharma, Bindu; Verma, Neeru; Khanna, D.K.; Chacko, Felcy

doi:10.1093/inthealth/ihu089

Cited by 33 publications

(24 citation statements)

References 22 publications

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“…6 However, Indian studies consistently show higher rates of SSIs ranging from 4.2 to 30%. [5][6][7][8][9] This variability in estimates is consistent with the differences in the characteristics of the hospital populations, the underlying diseases, differences in clinical procedures, the extent of the infection control measures, and also the hospital environment. Further, infection with multidrugresistant organisms constitutes a serious threat to surgical patients.…”

Section: Introductionsupporting

confidence: 58%

Surgical Site Infections in a Rural Teaching Hospital of North India

Abbey¹,

Mohan²,

Malik³

et al. 2017

International Journal of Advanced and Integrated Medical Sciences

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Aims and objectives: Surgical site infections (SSIs) are one of the most important causes of health care-associated infections. Understanding SSI reduces the social and economic burden of a hospital and society. In this context, we evaluated the various aspects of SSI in our institution, Rohilkhand Medical College & Hospital (RMCH), which is a tertiary care teaching hospital in rural Uttar Pradesh in North India. Materials and methods:This prospective study was conducted in the Department of General Surgery, RMCH, Bareilly, Uttar Pradesh, India. A total number of 1,498 patients admitted for surgical procedures with effect from November 1, 2016 to December 31, 2016, formed the subjects of the present study. All operated cases during the above period, including major and minor, emergency and elective, laparoscopic and open procedures were included in the present study. Data so obtained were analyzed statistically. The Centers for Disease Control and Prevention, USA criteria were used for defining the wound. Sample swabs were collected from the first dressing and up to 2 to 4 weeks postoperatively. Samples were processed for aerobic and anaerobic flora, and the antibiotic sensitivity of the isolates was also performed. Results and discussion:The SSI rate in the present study was 8.67%. Significantly higher incidence of SSI was detected with increasing age. The SSI rate in case of emergency surgeries was more (27.7%) as compared with routine/elective surgeries (6.3%). The higher incidence (18.75%) of SSI was detected in patients having preoperative hospital stay of more than 7 days, and the maximum incidence (15.7%) was observed in patients having longer postoperative hospital stay of more than 10 days. Dirty wounds had the highest incidence of SSI (53.45%). The incidence of SSI increased with duration of surgery, order of surgery, and with the increasing duration of postoperative drains. Staphylococcus aureus was the commonest isolate (32.30%) followed by Escherichia coli (39%). Conclusion:Though the incidence of SSI in the present study was slightly low as compared with similar reports from other institutions of the country, more rational antibiotic policy and more stringent infection control measures are needed.

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Section: Introductionsupporting

confidence: 58%

Surgical Site Infections in a Rural Teaching Hospital of North India

Abbey¹,

Mohan²,

Malik³

et al. 2017

International Journal of Advanced and Integrated Medical Sciences

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“…18 In our study setting all possible pre, intra and postoperative issues were handled carefully in routine manner to avoid surgical site infection risks. Like many other hospitals, commonly isolated microbes with their varying sensitivity patterns were S. aureus, Enterobacter, E. coli, Klebsiella.…”

Section: Discussionmentioning

confidence: 99%

Exploration of epidemiologic profile and strategic prevention framework for surgical site infection rates in a tertiary care hospital of Bhopal city

Goyal¹,

Kaushal

2018

Int J Community Med Public Health

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Background: Post-operative surgical site infections are deadlock for any successful surgery. This exigency triggers draining of extra resources for management of the quagmire. Methods: This prospective direct surveillance study based on incidence design was undertaken to gauge and estimate the nature of propensity of various surgical site infections in a tertiary care hospital over a period of twelve months. Results: Calculated cumulative SSI rate for the year 2016 was found to be 4.32%. Conclusions: It was concluded that a multidisciplinary approach integrating periodic training sessions on infection control, checklists based routine surveillance & following some benchmark etc. are the linchpin in controlling hospital acquired infections including surgical site infection rates in any clinical setting.

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“…A larger percentage of participants from the control group developed infection compared to the intervention group, but this was not statistically significant. [10] A review of literature by Gagliardi et al revealed several strategies that antibiotic prophylaxis reduce SSI rates. [11] In our study, all patients received cloxacillin 500 mg, which was given sixth hourly one day prior to seven days post-operative.…”

Section: Depilatory Creamsmentioning

confidence: 99%

A Randomised Controlled Trial to Compare the Effects of Two Methods of Preoperative Hair Removal on Surgical Site Infections in Patients Undergoing Elective Tympanoplasty

P¹,

Mathew²,

E³

2018

jemds

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BACKGROUND From time immemorial, ever since the principles of disinfection were being brought into being, it has been noticed that it is the seemingly simple and easy steps that brought giant breakthroughs in infection control. For example, the introduction of alcoholbased handrub by health care workers in a hospital in central India gave a complete reduction in the bacterial flora in the hands. [1] Similarly, preparation of surgical site before skin incision has been the convention. Skin preparation is done by disinfecting the area with a cleaning solution (soap, spirit, povidone-iodine). Staphylococcus aureus is the commonest organism in site infection. Aim-This randomised controlled trial was planned to evaluate which method of pre-operative hair removal, clipping or shaving is less likely to cause surgical site infection. MATERIALS AND METHODSConsenting patients undergoing tympanoplasty were randomised by permuted block randomisation to pre-operative hair removal by shaving or clipping with allocation concealment from the investigator. A blinded assessor used the ASEPSIS scoring method to grade the wound healing. RESULTSOf the 64 patients undergoing tympanoplasty enrolled into the study 62 showed satisfactory healing when graded by the ASEPSIS score and 2 (3.1%) had disturbances of healing, while there were no incidents of mild, moderate or severe surgical site infection. Though both incidents of delayed wound healing were in the group where hair removal was done by shaving. No significance could be attributed to these findings. CONCLUSIONThough two subjects developed disturbances in healing, they could be treated and could go home by the seventh day. There were no patients who had mild, moderate or severe surgical site infection as graded by the ASEPSIS score. This shows that good preoperative preparation and strict enforcement of aseptic precautions can reduce the number of surgical site infections irrespective of the method of hair removal.

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Surgical site infection rates in six cities of India: findings of the International Nosocomial Infection Control Consortium (INICC)

Cited by 33 publications

References 22 publications

Surgical Site Infections in a Rural Teaching Hospital of North India

Surgical Site Infections in a Rural Teaching Hospital of North India

Exploration of epidemiologic profile and strategic prevention framework for surgical site infection rates in a tertiary care hospital of Bhopal city

A Randomised Controlled Trial to Compare the Effects of Two Methods of Preoperative Hair Removal on Surgical Site Infections in Patients Undergoing Elective Tympanoplasty

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