Incidence and predictors of surgical site infection in a general surgery department in Algeria

Atif, Mohamed Lamine; Azouaou, A.; Bouadda, N.; Bezzaoucha, A.; Si-Ahmed, M.; Bellouni, R.

doi:10.1016/j.respe.2015.05.003

Cited by 11 publications

(8 citation statements)

References 31 publications

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“…The Previous history of hospitalization was significantly associated with surgical site infection. Indicated in this study patients with the previous history of hospitalization were 4.5 times more likely to develop infection compared to those who had no history [AOR 4.50; 95%Cl (1.44, 14.08)] this was in agreement with a study conducted in India [22]. This might be due to that prior exposure to resistant microorganisms increase the likelihood of the rate of infection [23, 24].…”

Section: Discussionsupporting

confidence: 89%

“…In this study patients who had ≥ 7 days of Preoperative Hospital Stay were 3.88 times more likely to develop surgical site infection compared to those who had less stay [AOR 3.88; 95%Cl (1.46, 10.29)] this is matched with study conducted in India [22], Tunisia [19] and Hawassa [11] this might be due to that global spread of multi-drug resistant infections in health care set-ups and its ubiquitous diagnostic procedures, therapies and microflora have been shown to increase the rate of surgical site infection [23, 24].…”

Section: Discussionmentioning

confidence: 64%

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Magnitude of surgical site infection and its associated factors among patients who underwent a surgical procedure at Wolaita Sodo University Teaching and Referral Hospital, South Ethiopia

2019

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IntroductionSurgical site infections are infections that take place within 30 days of an operative procedure. Worldwide, 23% of patients develop surgical site infections among all surgeries annually with the worst complications causing prolonged hospital stays, increased resistance of microorganisms to antimicrobials, higher health system costs, emotional stress for patients and their families, and substantial economic burdens on hospitals. Therefore, this study was created to assess the magnitude and associated factors of surgical site infection at Wolaita Sodo University Teaching and Referral Hospital.MethodWe conducted a hospital-based cross-sectional study on patients who underwent a surgical procedure in 2018 at Wolaita Sodo University Teaching and Referral Hospital. We applied a systematic random sampling technique to obtain 261 patient records from all records of surgical patients from January 1, 2018, to December 30, 2018. We collected data using a pretested checklist. We used bivariate and multivariate logistic regression analysis to identify factors associated with surgical site infection. We considered a P-value < 0.05 as statistically significant. Summary measures, texts, tables, and figures present the results of the analysis.ResultAmong the 261 patients, 34 or 13% (95% CI = 9.2%, 17.2%) developed surgical site infection. Patients younger than 40 years old [AOR 6.45; 95% CI (1.56, 26.67)], illiterate [AOR 4.25; 95% CI (1.52, 11.84)], with a history of previous hospitalization [AOR 4.50; 95% CI (1.44, 14.08)], with a prolonged preoperative hospital stay (≥ 7 days) [AOR 3.88; 95% CI (1.46, 10.29)], and admitted to the public wing of the ward [AOR 0.24; 95% CI (0.07, 0.79)] possessed factors associated with surgical site infection.ConclusionThe magnitude of surgical site infection in this study was high. Shortening preoperative hospital stays, delivering intravenous antimicrobial prophylaxis before surgery, and giving wound care as ordered would significantly reduce the incidence of surgical site infection.

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Section: Discussionsupporting

confidence: 89%

Section: Discussionmentioning

confidence: 64%

Magnitude of surgical site infection and its associated factors among patients who underwent a surgical procedure at Wolaita Sodo University Teaching and Referral Hospital, South Ethiopia

2019

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“…Our estimated prevalence of SSIs among post-operative patients in Ethiopia is in line with systematic review and meta-analysis studies done in Nigeria 14.5% [57] and 14.8% in Sub-Saharan Africa [58]. However, this result was substantially higher than studies conducted in China was 4.5% [59] and 5.4% in Algeria [60]. This variation could be justified by lack of adequate postoperative care, inadequate infection control, and insufficient trained professionals in Ethiopia.…”

Section: Discussionsupporting

confidence: 86%

“…Hence, a multifactorial approach is required to manage SSIs, with emphasis being placed on adequate antibiotic prophylaxis, aseptic wound care, and treatment adherence.Our estimated prevalence of SSIs among post-operative patients in Ethiopia is in line with systematic review and meta-analysis studies done in Nigeria 14.5%[57] and 14.8% in Sub-Saharan Africa[58]. However, this result was substantially higher than studies conducted in China was 4.5%[59] and 5.4% in Algeria[60]. This variation could be justified by lack of adequate postoperative care, inadequate infection control, and insufficient trained professionals in Ethiopia.Subgroup analysis in this study showed that the pooled prevalence of SSIs among post-operative patients in SNNPR was 17.19% (95% CI: 13.3, 21.09), which was the highest amongst the Ethiopian regions examined, followed by Addis Ababa (14.26%; 95% CI: 9.87, 18.65), whereas the lowest rate was reported in the Amhara Region (9.36%; 95%CI;6.71, 12.0) of the country.…”

supporting

confidence: 82%

Surgical site infection and its associated factors in Ethiopia: A systematic review and meta-analysis

Shiferaw

Aynalem

Akalu

et al. 2019

Preprint

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Background: Despite being a preventable complication of surgical procedures, surgical site infections (SSIs) continue to threaten public health with significant impacts on the patients and the health-care human and financial resources. With millions affected globally, there issignificant variation in the primary studies on the prevalence of SSIs in Ethiopia. Therefore, this study aimed to estimate the pooled prevalence of SSI and its associated factors among postoperative patients in Ethiopia. Methods:PubMed, Scopus, Psyinfo, African Journals Online, and Google Scholar were searched for studies that looked at SSI in postoperative patients. A funnel plot and Egger's regression test were used to determine publication bias. The I 2 statistic was used to check heterogeneity between the studies. DerSimonian and Laird random-effects model was applied to estimate the pooled effect size, odds ratios (ORs), and 95% confidence interval (CIs) across studies. The subgroup analysis was conducted by region, sample size, and year of publication.Sensitivity analysis was deployed to determine the effect of a single study on the overall estimation. Analysis was done using STATA™ Version 14 software. Result:A total of 24 studies with 13,136 study participants were included in this study.The estimated pooled prevalence of SSI in Ethiopia was 12.3% (95% CI: 10.19, 14.42). Duration of surgery > 1 hour (AOR = 1.78; 95% CI: 1.08 -2.94), diabetes mellitus (AOR = 3.25; 95% CI:1.51-6.99), American Society of Anaesthesiologists score >1 (AOR = 2.51; 95% CI: 1.07-5.91), previous surgery (AOR = 2.5; 95% CI: 1.77-3.53), clean-contaminated wound (AOR = 2.15; 95% CI: 1.52-3.04), and preoperative hospital stay > 7 day (AOR = 5.76; 95% CI: 1.15-28.86), were significantly associated with SSI. Conclusion:The prevalence of SSI among postoperative patients in Ethiopia remains high with a pooled prevalence of 12.3% in 24 extracted studies. Therefore, situation based interventions and region context-specific preventive strategies should be developed to reduce the prevalence of SSI among postoperative patients.

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“…Surveillance: clinical records review type Direct 92 Akhter et al (2016), Al-Mulhim et al (2014), Ali et al (2009), Alvarez-Moreno et al (2014), Ameh et al (2009), Atif et al (2015), Austin et al (2004), Bannura et al (2016), Bellusse et al (2015), Bercion et al (2007), Bibi et al (2015), Buang and Haspani (2012), Cao et al (2017), Ikeanyi et al (2013), da Cunha et al (2011, da Silva Pinto et al (2015), De Nardo et al (2016, Ding et al (2014), Ding et al (2016), Dreher et al (2017), Duerink et al (2006), Ee et al (2014), El Beltagy et al (2010), Farouk et al (2015), Farsky et al (2011), Fehr et al (2006), Freitas et al (2000), Galal and El-Hindawy 2011 The study type and follow-up time of surveillance after the index procedure (postoperative) expressed in months were also recorded, as were any explicit description of a post-discharge surveillance period and the frequencies of SSI at each stage. The final variable evaluated was whether the procedures included the placement of some type of artificial implant, in all or at least some of the surgeries.…”

Section: Topic Number Referencementioning

confidence: 99%

Surgical site infection in elective clean and clean-contaminated surgeries in developing countries

Curcio

Cané

Fernández³

et al. 2019

International Journal of Infectious Diseases

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Background: Surgical site infection (SSI) is both the most frequently studied healthcare-associated infection and the most common healthcare-associated infection in the developing world. A systematic review and meta-analysis was conducted to evaluate the relative size of this burden and to estimate the prevalence of SSI in clean and clean-contaminated surgeries in a large sample of countries in the developing world. Methods: A systematic search of the MEDLINE/PubMed, Scopus, and LILACS databases was conducted to identify studies providing the prevalence of SSI in elective clean and clean-contaminated surgeries in 39 countries or regions around the world. Data of interest were limited to publications from January 2000 to December 2017. Studies with information on the number of cases of SSI and number of total elective clean and clean-contaminated surgeries during the same period were included in this evaluation. Studies lacking clear definition of the total number of exposed patients were excluded. Results: Based on the combined data from the 99 articles evaluated in this analysis, the overall prevalence of SSI in elective clean and clean-contaminated surgeries was estimated to be 6% (95% confidence interval (CI) 5-7%). This increased to 15% (95% CI 6-27%) when considering only those reports with post-discharge surveillance data. The overall prevalence of SSI in Africa/Middle East, Latin America, Asia, and China was 10% (95% CI 6-15%), 7% (95% CI 5-10%), 4% (95% CI 4-5%), and 4% (95% CI 2-6%), respectively. Significant variability in the data was confirmed by both the funnel plot and the Egger test (p = 0.008). Conclusions: Although the data are variable, it is clear that the incidence of SSI in the developing world is higher than that in the developed world.

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Incidence and predictors of surgical site infection in a general surgery department in Algeria

Cited by 11 publications

References 31 publications

Magnitude of surgical site infection and its associated factors among patients who underwent a surgical procedure at Wolaita Sodo University Teaching and Referral Hospital, South Ethiopia

Magnitude of surgical site infection and its associated factors among patients who underwent a surgical procedure at Wolaita Sodo University Teaching and Referral Hospital, South Ethiopia

Surgical site infection and its associated factors in Ethiopia: A systematic review and meta-analysis

Surgical site infection in elective clean and clean-contaminated surgeries in developing countries

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