A Case Study – Surgical Site Infection of Open Fracture Grade II Caused by Pseudomonas aeruginosa

Introduction: Surgical Site Infections (SSI) are the third most commonly reported nosocomial infections which has an adverse impact on the hospital as well as on the patient. SSI a hospital acquired infection among surgery patients, which in turn delays normal recovery process and increases hospital length of stay and health care costs. Case study: A 34-years-old woman underwent ORIF surgical procedure on 22/3/2023 and developed symptoms like oozing of pus from surgical site on fifth day of post-surgery, fever spikes on same day, increase of pain at surgical site. She was treated with linezolid-600mg-BD a day intravenously and Meropenem-1gm-BD a day intravenously. After 10 days she made eventful recovery and got discharged. Microbiology Examination and Diagnosis: Pus sample collected from surgical site gave rise to growth of Pseudomonas aeruginosa on mac cockney agar medium. Pseudomonas aeruginosa of this particular sample showed resistance to most of the antibiotics that were tested. Discussion: Patient’s conditions like duration of operative procedure (>2 hours), immune-compromised condition like type II Diabetes, obesity, antibiotic prophylaxis and class of wound all these factors becomes risk factors for developing SSI. Conclusion: These infections are more common in elderly patients, patients undergoing emergency surgeries, longer surgical duration (>2 hours), and patients with a high ASA index. In order to decrease incidence of SSI we would have to: a) decrease the duration of the surgeries performed b) focus on regular and intensive drain care c) if a patient has any conditions that can complicate the surgical procedure rule out them first with proper management d) conduct periodic surveillance to keep a check on SSI.