Incidence and factors associated with surgical site infections in a teaching hospital in Ujjain, India

Pathak, Ashish; Saliba, Erika A.; Sharma, Shailendra; Mahadik, Vijay K.; Shah, Harshada; Lundborg, Cecilia Stålsby

doi:10.1016/j.ajic.2013.06.013

Cited by 54 publications

(51 citation statements)

References 18 publications

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“…The low prevalence of SSIs on clean wounds in this study could be due to more precaution including antibiotic use for most clean wounds in the study setting.This study also identified, in open kept surgical sites, the odds of developing surgical site infection was 5.2 times as compared to close kept surgical site (AOR= 5.189, 95% CI 1.511, 17.821). The result was consistent with Indian study as the open wound is exposed to potential contamination from time of incision and closure(30).The prevalence of SSI in those patients with Malnutrition was more than three folds and malnourished patients were 29.3 times more likely to develop SSIs than well-nourished patients (AOR= 29.351 95% CI 5.711, 150.851). The finding is similar to other studies as Malnutrition is a well-documented risk factor for SSI…”

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confidence: 87%

Surgical site infection prevalence and associated factors in Hawassa University comprehensive specialized hospital, southern Ethiopia.

Deribe

Jemebere

Bekele

2019

Preprint

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Background Surgical site infections (SSIs) continue the main problem in health care facilities, causing the prolonged length of stay, considerable morbidity, mortality, and the extra cost to patients after surgery. The aim of this study was to determine the prevalence of SSIs and explore its associated factors among surgical patients at Hawassa university comprehensive specialized hospital, southern Ethiopia.Methods A hospital-based cross-sectional study design was conducted among post-operative patients on a sample of 281 who were admitted and have had surgery from 1 March – 1 April 2019. Purposive sampling technique and the structured questioner were selected to gather data from the patient's medical record, interview, and observation. EPI Info 3.5.4 was a data entry software and SPSS version 20.0 was selected for analysis. Associations among variables were assessed by binary logistic regression.Result A total of 281 patients have participated and the mean age was 30.3 (±18.9) years. The prevalence of SSIs was (24.6%) (95% CI 19.6 – 29.69). Age less than 15 years AOR = 0.131 (95% CI 0.020, 0.087), having clean surgical wound AOR = 0.006 (95% CI 0.002, 0.024) were significant protective associated factors to SSIs while having open surgical wound AOR =5.189 (95% CI 1.511, 17.821) and malnutrition AOR =29.351 (95% CI 5.711, 150.851) were significant risk associated factors to SSIs.Conclusion The prevalence of SSIs was bigger than the worldwide range between (1.2%) and (5.2%) even higher compared to reports from several developing countries. This needs exceptional attention to reduce the odds of surgical site infection by standardizing patient care and controlling of comorbidities.

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confidence: 87%

Surgical site infection prevalence and associated factors in Hawassa University comprehensive specialized hospital, southern Ethiopia.

Deribe

Jemebere

Bekele

2019

Preprint

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“…In present study, the incidence of SSIs was highest in dirty wound followed by contaminated wounds and the lowest rate was observed in clean wound. This finding is in agreement with previous study in Cameron (10), India (14), Nepal (12) and India (15) In present study, patients who had history of surgical procedures were about three times more likely to develop SSIs compared with patients who had no previous exposure for surgical procedure/s which was in line with other study in Ethiopia (9) in which patients who had history of surgical procedures were 3.64 times more likely to develop SSIs and Brazil (16). We also found prolonged operation is risk factor for SSIs which also in line with previous reports (14), India(4), Rwanda (17), Brazil (11), Indonesia (18) and Finland (19)in which procedures that lasts more than 2 hours prone to develop SSI.…”

Section: Discussionsupporting

confidence: 94%

Surgical site infection and predictors among adults in specialized hospital: prospective observational study

Kebede¹,

Asredaw²

2019

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Introduction: Health-care-associated infection (HAI) is a major global safety issue for patients, health care managers and health-care professionals. One of HAI is surgical site infection (SSI). SSI is refers to an infection that occurs after surgery in the part of the body where surgery took place. It arises following surgery and is specifically related to the surgical site. It is estimated that SSIs account between 10-30% of all HAIs. Objective: The objectives of this study was to quantify the rate of wound infection and identify determinant factors Method: Prospective observational study was conducted from January to June 05/2019. All adult patients who met inclusion criteria were included in the study. The data was obtained either directly from the patient, or by observations or from the patient’s file. All patients were followed daily before, during and after operation for 30 days starting from the date of operation. Wound infection was detected at bedside and post-discharge surveillance. Chi-square test was computed to evaluate adequacy of cells for regression analysis. Independent predictors identified using binary logistic regression analysis and statistical significance was considered at p<0.05. Results: Two hundred eighty patients were included with mean age of 42.5±11 and 157(56.1%) patients were females. Caesarean section is the most common type of surgery. The rate of wound infection was found to be 80 (28.57%). The highest SSI rate was observed in gastrointestinal surgery 28(35.0). More than half of the cases were developed in health institution and patients having clean contaminated wound share the highest number. Majority of patients were undergoing emergency surgery with mean duration of surgery 1.8±0.65 hours. Multivariate analysis revealed that seven variables were significantly associated with the prevalence of wound infection; namely patient’s body mass index (P=0.037), age (P=0.046), history of previous surgery (P=0.04), preoperative hospital stay (p=0.0091), wound class (p=0.01) and history of steroid use (p= 0.027). Conclusion: In this study the rate of wound infection was high with patient’s physical status, duration of surgery, previous steroid use being strong predictor of infection. Life style modification is important to reduce body mass index and health professionals should counsel them.

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“…In India, based upon the various studies prevalence of SSI varies between 5% and 24%. 1 SSI are defined as an infection occurring within 30 days after a surgical operation (or within 1 year if an implant is left in place after procedure) and affecting either incision or deep tissues at the operation site. 2 Despite advances in SSI control practices, like improved operating room ventilation, sterilization methods, use of barriers, surgical technique there has been an alarming rise in low and middle income countries.…”

Section: Introductionmentioning

confidence: 99%

A prospective study of surgical site infections in a tertiary care hospital

2017

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INTRODUCTIONAmong the Health care associated infections (HAI), surgical site infections (SSI) previously termed as postoperative wound infections are one of the most common HAI in low and middle income countries. The prevalence of these infections varies widely ranging from 5-16%. In India, based upon the various studies prevalence of SSI varies between 5% and 24%.1 SSI are defined as an infection occurring within 30 days after a surgical operation (or within 1 year if an implant is left in place after procedure) and affecting either incision or deep tissues at the operation site.2 Despite advances in SSI control practices, like improved operating room ventilation, sterilization methods, use of barriers, surgical technique there has been an alarming rise in low and middle income countries. Increase in SSI is associated with increased morbidity, as well as mortality due to emergence of antimicrobial resistant pathogens. Factors related to development of SSI include patient related factors like smoking, diabetes etc. and also operation ABSTRACT Background: Among the Health care associated infections (HAI), surgical site infections (SSI) previously termed as post-operative wound infections are one of the most common HAI in low and middle income countries. Increase in SSI is associated with increased morbidity, as well as mortality due to emergence of antimicrobial resistant pathogens. Understanding the pathogens implicated in causing the SSIs and their antimicrobial sensitivity place a good role in reducing the mortality and morbidity. Methods: A prospective study was conducted at a tertiary care hospital to all the patients admitted in Department of surgery, Orthopedics and Gynecology and Obstetrics for six months from January 2016 to June 2016. The demographic data, inclusion criteria and exclusion criteria, risk factors, clinical history, laboratory data with gram stain, culture results and antibiotic sensitivity of the isolates were collected. Results: Two hundred patients were recruited in the study and the prevalence of SSI in the study was 3.83%. Patients who underwent emergency operations and diabetics were at higher risk of acquiring SSI. The most commonly isolated pathogens in the study were Staphylococcus aureus, Escherichia coli, and Pseudomonas aeruginosa. Pseudomonas aeruginosa was most common isolate from orthopedic cases of SSI, Escherichia coli was most common isolate from intestinal surgeries and Staphylococcus aureus from LSCS. Increased rate of isolation of MRSA and ESBL strains were observed in the study. Conclusions: Study clearly explains the various causes and risk factors associated in development of SSI. The study guides in the type of the organism isolated and possible antibiotic of choice in treatment and management of SSI. The prevalence of SSI was 3.83%, which is comparable with some of the studies and lower than many of the studies.

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Incidence and factors associated with surgical site infections in a teaching hospital in Ujjain, India

Cited by 54 publications

References 18 publications

Surgical site infection prevalence and associated factors in Hawassa University comprehensive specialized hospital, southern Ethiopia.

Surgical site infection prevalence and associated factors in Hawassa University comprehensive specialized hospital, southern Ethiopia.

Surgical site infection and predictors among adults in specialized hospital: prospective observational study

A prospective study of surgical site infections in a tertiary care hospital

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