Surgical Site Infections in Elective Surgeries: A Study From a Teaching Hospital in South India

BACKGROUNDSurgical Site Infections (SSIs) continue to be a major complication despite the improvements in surgical practice.Infections caused by drug-resistant pathogens are expensive in terms of cost of treatment, morbidity and prolonged hospitalisation.Early detection, treatment and prevention of surgical infections are important, because it may lead to sepsis with substantial morbidity and mortality.The aim of this study is to find out the infection rate in elective surgeries and to identify the pathogens with their antibiotic sensitivity pattern. MATERIALS AND METHODSA prospective study was conducted among 245 post-operative patients admitted in the General Surgery wards of a teaching hospital in south India.Swabs were taken from the surgical sites for bacteriological analysis after 48 hours of surgery.Each case was followed up till a period of one month.Second swab was taken if any wound infection was noticed and antibiotic sensitivity pattern of the pathogens were studied against the commonly used antibiotics. RESULTSAmong the 245 cases studied infection rates were 3% in clean surgeries, 8.3% in clean contaminated and 30% in contaminated types of surgeries.Overall, SSI rate was 4.9%.Staphylococcus aureus (50%) and Escherichia coli (38%) were the major pathogens.37.5% of S. aureus were Methicillin resistant, while 57.1% of the Gram-negative pathogens were resistant to 3 rd generation cephalosporin.Wound colonisation was noticed in 28.2% wound sites, which was predominated by S. aureus (80.5%). CONCLUSIONHigh prevalence of S. aureus and Methicillin Resistant Staphylococcus aureus (MRSA) suggest the recommendations to prevent cross infections by improving hygienic measures including hand washing.Screening of nasal carriage of MRSA in attending health care professionals is to be considered.The reduced susceptibility profile of Gram negative pathogens indicates the limited usefulness of antibiotics for prophylaxis and treatment and so antibiotic policy is to be revised.