Surveillance of Surgical Site Infection in General Surgery Department at Sohag University Hospital

Abstract

Background: Surgical site infections (SSI) are the most common nosocomial infections in surgical patients and lead to prolonged hospital stay, readmission to the hospital, and increased morbidity and mortality. Objectives: This study aimed to detect the incidence of SSI and the risk factors, the causative organisms and their antimicrobial susceptibility pattern in general surgery department at Sohag university hospital. Methodology: A prospective SSI surveillance at Sohag University hospital from (January 2017 to June 2017) using the criteria of the Centers for Disease Control. Basic demographic, surgical data and data of possible risk factors were collected from all patients. Patients were followed up for 30 days after surgery. Swabs were collected from cases with signs and symptoms of SSI and cultured on basic microbiological culture media. Isolated colonies were identified microscopically and biochemically. Full identification of the causative organisms and their antibiotic sensitivity were done by Vitek 2 compact automated system. Results: The study included 482 patients and the incidence of SSI infections was (11.2%). Escherichia coli was the most common organism causing SSI and was responsible for (40%) of SSIs followed by Pseudomonas aeruginosa (20%), Staphylococcus aureus (20%), Enterobacter cloacae (10 %) and Klebsiella pneumoniae (10 %). Most of isolated E. coli and Klebsiella were ESBL producers (73.3%). Pseudomonas aeruginosa shows emergence of resistance to tigecycline (25%). All isolated staph. aureus were (MRSA) and (10%) of them were (VRSA). Univariate regression analysis show that older age, urgent operation type, bad patient general condition, contaminated wound type, hypertension, obesity, intake of antibiotic prophylaxis and increased length of hospital stay (days) were risk factors for SSI. The multivariable regression analysis revealed that urgent operations type, bad patient condition, obesity increasing length of hospital stay (days) and intake of antibiotic prophylaxis independent risk factors for the development of a SSI. Conclusion: The study provides a valuable data about SSI in General Surgery Department and highlights risk factors associated with SSI, the causative pathogens and their antibiotic sensitivity in our hospital that can help in updating the antimicrobial prophylaxis policy and reducing the incidence of SSI.

Mupirocin Resistance among Methicillin Resistant Staphylococcus aureus Causing Surgical Site Infections

“…In our study percentage of MRSA causing SSI was 20%, matching with the results of Esmat et al in Sohag, who found that Staphylococcus aureus was responsible for 20% of SSIs; all of which were MRSA 22 . In many American and European hospitals, the percentage of MRSA has ranged from 29% to 35%; while in India it ranged from 30% to 87% 23,24 .…”

Antimicrobial susceptibility pattern and mupirocin resistance among methicillin-resistant Staphylococcus aureus isolated from skin and soft-tissue infection patients attending a tertiary care hospital in North India

“…These findings are similar to a previous study by Srinivasan et al, who reported 80% of MRSA isolates from surgical wards. 17 The MRSA isolated from surgery in this investigation was 27.8%, which corresponds to the findings of Esmat et al, 18 19 As per the latest annual report of INSAR, multidrug resistance among MRSA strains was very common and variable between different centers. 91.8% of isolates were resistant to ciprofloxacin, followed by 75% to erythromycin, 39.2% to cotrimoxazole, 35.8% to clindamycin, and 15.1% to tetracycline.…”

Could Training Programs Eliminate Hospital Environmental Surfaces Contamination with Multidrug Resistant Bacteria

“…Previous studies had reported the increased incidence of MDR in health care associated infections. 31,32 And there are much evidence that hospitalized patients who are colonized or infected with antibiotic resistant organisms can shed these organisms into environment, which becomes a reservoir for subsequent transmission. 33 Dancer highlighted on 2014 the association between HAI rates and environmental bioburden.…”

“…A total of 660 samples were collected in the current study in the three times of evaluation; 220 samples in each time: Seventy swabs from ORs surfaces were collected from 9 sites; [operating table top surface (10), anesthesia machine surface (10), instruments trolley (8), electro cautery machine (5), sterilizing hand gel pumps (7), the laryngoscope handles (7), Doors handles (12), diathermy (DC) machine surface (6), and electric power switch (5)] One hundred twenty three swabs from other SWs surfaces: 42 swabs from urology department ,39 swabs from orthopedics , 26 swabs from general surgery and 16 swabs from gynecology department, these samples were collected from 6 sites: [Doors handles (11), bed side table's surface (28), bed linen (24), bed ledges and arms (31), curtains edges (15), and solutions holders (14)].…”