ABDOMINAL SURGICAL SITE INFECTION OCCURRENCE AND RISK FACTORS

Dr. Nitin Nangare, Dr. Vipin Tewani

Abstract


Introduction: Surgical site infections(SSI) remain a signicant problem following an operation and the third most
frequently reported nosocomial infections.
Objective: The current study was undertaken to identify occurrence of SSI and risk factors associated with it, and the common organisms
isolated and its antibiotic sensitivity and resistance.
Material and Methods: The prospective study was carried out on 100 surgeries. Infected samples from patients were collected by following all
aseptic precautions and were processed without delay by the standard microbiological techniques.
Results and Conclusions: The overall infection rate was 14%. The SSI rate was 0% in clean surgeries, 6.0% in clean contaminated ones, 23.80%
in contaminated ones and 40% in dirty surgeries. Male patients are affected more(18.2%) than the female patients(5.9%).The SSI rate increased
with increasing age and it also increased signicantly with increasing duration of preoperative hospitalization. The SSI rate was signicantly
higher in emergency surgeries as compared to elective surgeries. The Infection rate was signicantly higher as the duration of surgery increased.
The most commonly isolated organism from surgical site infections was pseudomonas(42.85%),followed by klebsiella spp(28.5%) and other
bacteria. Most of the organisms which were isolated were multidrug resistant. The high rate of resistance to many antibiotics underscored the
need for a policy that could promote a more rational use of antibiotics.


Keywords


Abdominal surgical site infections, surgical site infections, pseudomonas, risk factors for SSI.

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References


David J. Leaper. 2004. “Surgical infection.” Bailey & Love’s short practice of surgery, 25thedition, p 32-48.

Schwartz SI, Comshires G, Spencer FC, Dally GN, Fischer J, Galloway AC: Principles of surgery. 9th edition. Chapter 6 “surgical infections” NY: McGraw-Hill companies; 2010.

Richard T, Ethridge, Mimi Leon and Linda G. Philips: “wound healing”. Sabiston Text book of Surgery, 18th edition, p 191-216.

Alicia J. Mangram, MD; Teresa C. Horan, MPH, CIC; Michele L. Pearson, MD; Leah Christine Silver, BS; guideline for prevention of surgical site infection, vol. 20 no. 4 infection control and hospital epidemiology 1999, p250-264.

Seyd Mansour Razavi, Mohammad Ibrahimpoor, Ahmad Sabouri Kashani and Ali Jafarian “Abdominal surgical site infections: incidence and risk factors at an Iranian teaching hospital”, BMC Surgery 2005, 5:2doi:10.1186/1471-2482-5-2.

Leung JM, Dzankic S: Relative importance of preoperative health status versus intraoperative factors in predicting postoperative adverse outcomes in geriatric surgical patients. J Am Geriatr Soc 2001, 49:1080-1085.

Lipska MA, Bissett IP, Parry BR, and Merrie AE: Anastomotic leakage after lower gastrointestinal anastomosis: men are at a higher risk. ANZ J Surg 2006, 76:579-585.

Detsky AS, Baker JP, O'Rourke K, Johnston N, Whitwell J, Mendelson RA, and Jeejeebhoy KN: Predicting nutrition-associated complications for patients undergoing gastrointestinal surgery. JPEN J Parenter Enteral Nutr 1987, 11:440-446.

Wu GH, Liu ZH, Wu ZH, Wu ZG: Perioperative artificial nutrition in malnourished gastrointestinal cancer patients. World J Gastroenterol 2006, 12:2441-2444.

Schiesser M, Muller S, Kirchhoff P, Breitenstein S, Schafer M, Clavien PA: Assessment of a novel screening score for nutritional risk in predicting complications in gastro-intestinal surgery. Clin Nutr 2008 , 27:565-570.

Beattie AH, Prach AT, Baxter JP, Pennington CR: A randomised controlled trial evaluating the use of enteral nutritional supplements postoperatively in malnourished surgical patients. Gut 2000 , 46:813-818.

Reilly HM: Screening for nutritional risk. Proc Nutr Soc 1996 , 55:841-853.

Buzby GP, Williford WO, Peterson OL, Crosby LO, Page CP, Reinhardt GF, Mullen JL: A randomized clinical trial of total parenteral nutrition in malnourished surgical patients: the rationale and impact of previous clinical trials and pilot study on protocol design. Am J Clin Nutr 1988, 47:357-365.

Kondrup J, Rasmussen HH, Hamberg O, and Stanga Z: Nutritional risk screening (NRS 2002): a new method based on an analysis of controlled clinical trials. Clin Nutr 2003, 22:321-336.

Braga M, Gianotti L, Vignali A, Carlo VD: Preoperative oral arginine and n-3 fatty acid supplementation improves the immunometabolic host response and outcome after colorectal resection for cancer. Surgery 2002, 132:805-814.

Gil-Egea MJ, Pi-Sunyer MT, Verdaguer A, Sanz F, Sitges-Serra A, Eleizegui LT. Surgical wound infections: prospective study of 4,486 clean wounds. Infect Control 1987;8(7):277-80.

Slaughter MS, Olson MM, Lee JT Jr., Ward HB. A fifteen-year wound surveillance study after coronary artery bypass. Ann Thorac Surg 1993; 56(5):1063-8.

Post S, Betzler M, vonDitfurth B, Schurmann G, Kuppers P, and Herfarth C. Risks of intestinal anastomoses in Crohn’s disease. Ann Surg 1991; 213(1):37-42.

Cruse PJ, Foord R. A five-year prospective study of 23,649 surgical wounds. Arch Surg 1973; 107:206-10.

Ziv Y, Church JM, Fazio VW, King TM, Lavery IC. Effect of systemicsteroids on ileal pouch-anal anastomosis in patients with ulcerative colitis. Dis Colon Rectum 1996; 39(5):504-8.

Pons VG, Denlinger SL, Guglielmo BJ, Octavio J, Flaherty J, Derish PA, et al. Ceftizoxime versus vancomycin and gentamicin in neurosurgical prophylaxis: a randomized, prospective, blinded clinical study. Neurosurgery 1993; 33(3):416-22; discussion 422-3.


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