Bhakti Sarang1, Anurag Tiwary2, Anita Gadgil3, Nobhojit Roy4. 1. Department of General Surgery, Terna Medical College & Hospital, New Mumbai, India. Electronic address: sarangbhakti@gmail.com. 2. Department of General Surgery, Padmashree Dr D.Y. Patil Medical College and Hospital, New Mumbai, India. 3. Bhabha Atomic Research Centre Hospital, and World Health Organization Collaborating Centre for Research on Surgical Care Delivery in Low and Middle Income Countries, Mumbai, India. 4. Karolinska Institute, Stockholm, Sweden.
Abstract
OBJECTIVES: Surgical site infections (SSIs) contribute significantly to post-surgical morbidity globally. Antimicrobial stewardship programmes (ASPs) are essential to reduce SSI rates and to curb antimicrobial resistance, especially in low-and-middle-income countries. This prospective study aimed to show the reproducibility of ASP implementation and SSI prevention measures in a semi-private institution with high perioperative prophylactic antimicrobial consumption beyond guidelines. METHODS: The prevalence of SSIs in clean surgeries was analysed in a government hospital adhering to SSI prevention guidelines including antimicrobial prophylaxis (phase 1; n=335) and in a surgical department unit of a semi-private hospital where the same guidelines were subsequently implemented (phase 2; n=235). SSI rates were compared to check the hypothesis that ASPs and infection control policies are reproducible with similar SSI rates. Moreover, antimicrobial prophylaxis costs were compared between units with and without guideline adherence. RESULTS: Among a total of 570 clean surgeries analysed, SSI rates were similar in both phases (6.0% vs. 5.1%; P=0.659). SSI rates were higher in patients aged >50 years in both phases (P=0.0009 and 0.045), whilst there was no difference in SSI rates between diabetics and non-diabetics (P=0.475 and 0.835). The cost of antimicrobial prophylaxis was lower in the guideline-oriented group (US$0.42 vs US$9 per patient; P=0.0042). CONCLUSION: Implementing SSI prevention guidelines, including proper antimicrobial prophylaxis, is feasible and reproducible among different hospital settings, leading to a significant decrease in prophylaxis costs. SSI rates do not differ following the same international standards.
OBJECTIVES: Surgical site infections (SSIs) contribute significantly to post-surgical morbidity globally. Antimicrobial stewardship programmes (ASPs) are essential to reduce SSI rates and to curb antimicrobial resistance, especially in low-and-middle-income countries. This prospective study aimed to show the reproducibility of ASP implementation and SSI prevention measures in a semi-private institution with high perioperative prophylactic antimicrobial consumption beyond guidelines. METHODS: The prevalence of SSIs in clean surgeries was analysed in a government hospital adhering to SSI prevention guidelines including antimicrobial prophylaxis (phase 1; n=335) and in a surgical department unit of a semi-private hospital where the same guidelines were subsequently implemented (phase 2; n=235). SSI rates were compared to check the hypothesis that ASPs and infection control policies are reproducible with similar SSI rates. Moreover, antimicrobial prophylaxis costs were compared between units with and without guideline adherence. RESULTS: Among a total of 570 clean surgeries analysed, SSI rates were similar in both phases (6.0% vs. 5.1%; P=0.659). SSI rates were higher in patients aged >50 years in both phases (P=0.0009 and 0.045), whilst there was no difference in SSI rates between diabetics and non-diabetics (P=0.475 and 0.835). The cost of antimicrobial prophylaxis was lower in the guideline-oriented group (US$0.42 vs US$9 per patient; P=0.0042). CONCLUSION: Implementing SSI prevention guidelines, including proper antimicrobial prophylaxis, is feasible and reproducible among different hospital settings, leading to a significant decrease in prophylaxis costs. SSI rates do not differ following the same international standards.
Authors: James Jin; Salesi Akau Ola; Cheng-Har Yip; Peter Nthumba; Emmanuel A Ameh; Stijn de Jonge; Mira Mehes; Hon Iferemi Waiqanabete; Jaymie Henry; Andrew Hill Journal: World J Surg Date: 2021-07-03 Impact factor: 3.352
Authors: Nehad J Ahmed; Ziyad S Almalki; Abdullah A Alfaifi; Ahmed M Alshehri; Abdullah K Alahmari; Emad Elazab; Alaa Almansour; Abdul Haseeb; Mohamed F Balaha; Amer H Khan Journal: Healthcare (Basel) Date: 2022-03-01