Ashish Pathak1, Erika A Saliba2, Shailendra Sharma3, Vijay Kumar Mahadik4, Harshada Shah5, Cecilia Stålsby Lundborg6. 1. Global Health/IHCAR, Department of Public Health Sciences, Karolinska Institutet, Stockholm, Sweden; Department of Paediatrics, Ruxmaniben Deepchand Gardi Medical College, Ujjain, Madhya Pradesh, India; Department of Women and Children's Health, International Maternal and Child Health Unit, Uppsala University, Uppsala, Sweden. 2. Global Health/IHCAR, Department of Public Health Sciences, Karolinska Institutet, Stockholm, Sweden. Electronic address: erika.saliba@ki.se. 3. Department of Surgery, Ruxmaniben Deepchand Gardi Medical College, Ujjain, Madhya Pradesh, India. 4. Ruxmaniben Deepchand Gardi Medical College, Ujjain, Madhya Pradesh, India. 5. Department of Microbiology, Ruxmaniben Deepchand Gardi Medical College, Ujjain, Madhya Pradesh, India. 6. Global Health/IHCAR, Department of Public Health Sciences, Karolinska Institutet, Stockholm, Sweden.
Abstract
BACKGROUND: Surgical site infections (SSI) are among the most commonly reported health care-associated infections; however, there is a paucity of data on SSI from India. This study aimed to determine the incidence of SSI and explore its associated factors at a teaching hospital in India. METHODS: Direct and indirect surveillance methods, based on Centers for Disease Control and Prevention guidelines, were used to define SSI. Patients were followed up for 30 days postsurgery. Prescribing and resistance data were collected. RESULTS: The SSI rate among the 720 patients investigated was 5%. Risk factors for SSI identified were as follows: severity of disease (P = .001), presence of drains (P = .020), history of previous hospitalization (P = .003), preoperative stay (P = .005), wound classification (P < .001), and surgical duration (P < .001). Independent risk factors identified included wound classification (odds ratio = 4.525; P < .001) and surgical duration (odds ratio = 2.554; P = .015). Most patients (99%) were prescribed antibiotics. Metronidazole (24.5%), ciprofloxacin (11%), and amikacin (9%) were the most commonly prescribed antibiotics. Most commonly isolated bacteria were Staphylococcus aureus (n = 14), of which 34% were methicillin-resistant Staphylococcus aureus, and Pseudomonas aeruginosa (n = 6), which showed resistance to ceftazidime (70%), ciprofloxacin (63%), and gentamicin (57%). CONCLUSION: Incidence of SSI at the hospital was lower than reported in many low- and middle-income countries, although higher than reported in most high-income countries. Targeted implementation strategies to decrease incidence of preventable SSI are needed to further improve quality and safety of health care in this hospital and similar hospitals elsewhere.
BACKGROUND: Surgical site infections (SSI) are among the most commonly reported health care-associated infections; however, there is a paucity of data on SSI from India. This study aimed to determine the incidence of SSI and explore its associated factors at a teaching hospital in India. METHODS: Direct and indirect surveillance methods, based on Centers for Disease Control and Prevention guidelines, were used to define SSI. Patients were followed up for 30 days postsurgery. Prescribing and resistance data were collected. RESULTS: The SSI rate among the 720 patients investigated was 5%. Risk factors for SSI identified were as follows: severity of disease (P = .001), presence of drains (P = .020), history of previous hospitalization (P = .003), preoperative stay (P = .005), wound classification (P < .001), and surgical duration (P < .001). Independent risk factors identified included wound classification (odds ratio = 4.525; P < .001) and surgical duration (odds ratio = 2.554; P = .015). Most patients (99%) were prescribed antibiotics. Metronidazole (24.5%), ciprofloxacin (11%), and amikacin (9%) were the most commonly prescribed antibiotics. Most commonly isolated bacteria were Staphylococcus aureus (n = 14), of which 34% were methicillin-resistant Staphylococcus aureus, and Pseudomonas aeruginosa (n = 6), which showed resistance to ceftazidime (70%), ciprofloxacin (63%), and gentamicin (57%). CONCLUSION: Incidence of SSI at the hospital was lower than reported in many low- and middle-income countries, although higher than reported in most high-income countries. Targeted implementation strategies to decrease incidence of preventable SSI are needed to further improve quality and safety of health care in this hospital and similar hospitals elsewhere.
Authors: Edin Mujagic; Walter R Marti; Michael Coslovsky; Savas D Soysal; Robert Mechera; Marco von Strauss; Jasmin Zeindler; Franziska Saxer; Alexandra Mueller; Christoph A Fux; Christoph Kindler; Lorenz Gurke; Walter P Weber Journal: World J Surg Date: 2018-12 Impact factor: 3.352
Authors: Hang Cheng; Brian Po-Han Chen; Ireena M Soleas; Nicole C Ferko; Chris G Cameron; Piet Hinoul Journal: Surg Infect (Larchmt) Date: 2017 Aug/Sep Impact factor: 2.150
Authors: Rafael Lima Rodrigues de Carvalho; Camila Cláudia Campos; Lúcia Maciel de Castro Franco; Adelaide De Mattia Rocha; Flávia Falci Ercole Journal: Rev Lat Am Enfermagem Date: 2017-12-04