Spectrum of surgical site infection on the surgical floor; Increasing resistance to routine antibiotics

Abstract

Objective: To know the spectrum of surgical site infections in general surgical patients so that specific strategies can be developed to decrease the morbidity caused by these infections.Material and Methods: All the patients who underwent general surgical operations on an emergency basis at the surgical unit of the District headquarters teaching hospital Rawalpindi from 01-01-2016 to 31-12-2017 were evaluated for surgical site infections. Surgical site infections suspected clinically were confirmed by culture and sensitivity. Involved flora and their sensitivity to various antibiotics were also determined.Results: Among 2202 emergency operated patients, two hundred and thirty-seven patients (10.76%) had surgical site infection confirmed on culture and sensitivity (C/S) report. About sixty-five percent of patients were male. Of two hundred and thirty-seven positive patients, the twenty-nine patient underwent laparotomy for penetrating and blunt abdominal trauma. Staph aureus was present in one hundred and forty-five (79.67%) patients. E.coli was the commonest Gram-ve micro-organism (70.95%). Forty-six patients (19.40%) were sensitive to Cefoperazone sodium followed by twenty patients (8.43%) to Piperacillin sodium and twenty-one (8.86%) each to Amikacin and Linezolid.Conclusion: Surgical site infection causes a significant rise in morbidity on the surgical floor. Most of the causative microorganisms are becoming resistant to routine antibiotics. Sensitivity to the broader spectrum of antibiotics like Cefoperazone and Linezolid is increasing.

Occurrence, associated risk factors, and treatment of surgical site infections in Pakistan

“…31 The SSI incidence rate in the thyroidectomy was reported by 10.9% in Nawabsha city. 32 Due to post-surgical complications, the mortality rate was up to 10.6% in Karachi. The Khyber Pakhtunkhwa province hospitals reported SSIs rate from 5.78% to 9.2%.…”

Microbiology and drug sensitivity of Surgical Site Infections in Pakistan: A Systematic Review

“…Inadequate sterilization measures especially at remote public sector hospitals and antibiotic resistance has caused rise in SSI. 11,12 Various studies are published before in which microbiology and drug sensitivity from swabs of SSI are tested. The aim of this systematic review is to gather recent information about microbiology and sensitivity of various antibiotics against the microorganisms isolated in cultures.…”

“…However other factors may be involved as wellThe growing incidence and emergence of Methicillin resistance staph aureus (MRSA) in wounds of SSI is alarming and on the rise. Study conducted by Iqbal M et al12 in Rawalpindi showed 5% of all staph aureus positive cultures were MRSA while 1 % were vancomycin resistant staph aureus (VRSA). This growing incidence is alarming.…”