Updated Microflora in Surgical Site Infections at Surgical Floor

Abstract

Background: Mostly bacterial infections are treatable with oral and injectable antibiotics, but surgical site infections (SSI's) are an important root cause of post-surgical mortality and morbidity. We have undertaken this study in our department to find out the bacterial micro flora isolated from surgical site infections of clean and clean contaminated wounds and their antimicrobial susceptibility at Surgical Unit I, JHL. Methods: It was a descriptive case series study carried out at Surgical Unit I, Department of Surgery Jinnah Hospital Lahore/Allama Iqbal Medical College. Total 60 cases were selected who developed surgical site wound infections within 30 days postoperatively. Patients with clean and clean contaminated wounds were included and those with dirty and contaminated wounds were excluded. Patient having diabetes, chronic liver disease, on immunosuppressant drugs were also not included. Wound swabs were taken from surgical site infected patients for microbiological analysis and drug sensitivity. Swabs were transported to the microbiology laboratory of JHL. Their culture and sensitivity report was recorded in a predesigned proforma. Results: A total 60 patients were included who developed SSI post-operatively within 30 days. The age range of patients was 18–70 years, with mean age of the patients 38.5 year. There were 38(63.33%) female and 22(36.66%) male patients. There were 28(46.66%) elective operations and 32 (53.33%) emergency operations. Our study patients who developed SSI postoperaticely were discharged from the hospital and were managed on OPD basis, while no patient died due to SSI. Amongst the positive growth cultures, the most common pathogenic micro flora isolated was Eschericia Coli with an overall incidence of 18(30%) followed by Staphylococcus aureus in 14(23.33%) cases. Meropenem was 100% effective against all E. coli isolates and all MRSA positive 8(13.33%) cases showed sensitivity to vancomycin. Conclusion: In our study patients who had SSI, Escherichia coli was the most common bacterial pathogen isolated from wounds and high resistance to antibiotics was observed amongst various microbial flora thereby regular antimicrobial susceptibility tests and antibiograms should be carried out in SSIs. Keywords: Surgical Site Infections (SSIs), clean-contaminated, anti-microbial susceptibility, cultures.