Title: Prevalence and Microbial Etiology of Surgical Site Infections Following Major Abdominal Gynecologic Surgeries in a Tertiary Care Center

Authors: Dr Sujatha.T.L, Dr O.Sasikumari

 DOI:  https://dx.doi.org/10.18535/jmscr/v5i1.105

Abstract

Background and Objective- Surgical site infections (SSI) are one of the common healthcare associated infections and account for approximately a quarter of all nosocomial infections.. The risk factors and microbial etiology are different in various situations. Hence a study of the risk factors and microbial pattern associated with Surgical site infections will help  to develop a treatment policy for the institution.

Materials and method- Data was collected during hospital stay and one month post operatively. Data was collected on important study variables including medical history and risk factors by the use of pretested interview schedule. Parameters like socioeconomic status was assessed by Kuppuswamy’s socio economic status scale. Swabs taken from SSI were tested in the Department of Microbiology, Govt. Medical college, Thiruvananthapuram. for culture and sensitivivity.

Results- A total of 1000 cases were studied during the study period and there were 138 cases (13.8%) of surgical site infection following major abdominal gynecologic surgeries. Of the total 138 cases of SSI micro organisms were isolated in 54 cases (31.8%). This included Klebsiella Species 23 cases (42.6%), Staphylococcus aureus 20 cases (37%), MRSA 9 cases (16.7%)  and      E coli. 2 cases( 3.7%)

Low education status, low socio economic status, emergency nature of surgeries, diabetes, urinary tract infection and  premature rupture of membranes for more than 12 hours were significant risk factors

Conclusion - Klebsiellaspp was the most common isolate obtained. Knowledge of microbial etiology and sensitivity pattern would be helpful regarding the use of prophylactic and therapeutic antibiotics.

Keywords- Abdominal surgery, surgical site infection, risk factors, LSCS.

References

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2.      www.cdc.gov/nhsn/PDFs/pscmanual/9pscssicurrent.

3.      Dr. Upendranath, Dr.Ashokkumar Jawaharlal Nehru Medical College, Bhagalpur, Surgical Site Infection in Abdominal Surgeries in a Tertiary Centre, Indian journal of applied research,Vol : 6 | Issue : 3 | March 2016 | ISSN - 2249-555X | IF : 3.919Margaret A. Olsen, PhD, MPH,1 James Higham-Kessler, BA,1 Deborah S. Yokoe, MD,2 Anne M. Butler, MS,1 Johanna Vostok, BS,3 Kurt B. Stevenson, MD, MPH,4 Yosef Khan, MBBS, MPH,4 Victoria J. Fraser, MD,1 and the CDC Prevention Epicenter Program Developing a Risk Stratification Model for Surgical Site Infection after Abdominal Hysterectomy Infect Control Hosp Epidemiol. 2009 Nov; 30(11): 1077–1083.

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5.      Filbert J Mpogoro,1 Stephen E Mshana, corresponding author2 Mariam M Mirambo,1 Benson R Kidenya,3 Balthazar Gumodoka,1 and Can Imirzalioglu Incidence and predictors of surgical site infections following caesarean sections at Bugando Medical Centre, Mwanza, TanzaniaAntimicrob Resist Infect Control. 2014; 3: 25. Published online 2014 Aug 11.  doi:  10.1186/2047-2994-3-25

6.       Stephen E MshanaMariam M Mirambo Filbert J MpogoroBalthazar Gumod-oka, and Can ImirzaliogluI ncidence and predictors of surgical site infections follo-wing caesarean sections at Bugando Medical Centre, Mwanza, Tanzania  Antimicrob Resist InfecControl .2014; 3: 25. Published online 2014 Aug 11. doi:  10.1186/2047-2994-3-25.

Corresponding Author

Dr Sujatha.T.L

Additional Professor

Department of Obstetrics and Gynaecology, SATH, Thiruvananthapuram