Key result
Surgical site infections affect ~30% of post-operative patients in Pakistan.
Why the study?
Surgical site infections cause significant mortality and morbidity in postsurgical care, with risk factors spanning patient, surgery, and hospital-related domains, but their burden and associated factors in Pakistan were not well defined.
Cross-Sectional (n=412)
No
There is a high burden of surgical site infections (29.8%) following common surgical procedures in a public-sector hospital in Pakistan, highlighting the need for antimicrobial stewardship and implementation of surgical guidelines.
High SSI incidence (29.8%) in one Pakistani center warrants targeted local surveillance; leaves open whether rates and risk factors generalize nationally or inform prevention.
Globally, surgical site infections are one of the common infections which lead to a large amount of mortality and morbidity in postsurgical care. The risk for surgical site infection is multidimensional which includes mainly; patient, surgery, and hospital-related factors. This study is aimed to determine the burden of SSIs along with contributed risk factors. A prospective observational cross-sectional study was conducted in one of the largest public-sector hospitals in Pakistan. A total of 412 patients were recruited in the study with full consent and monitored for 30 days after surgery with direct and indirect surveillance. Overall, in seven different surgical procedures the incidence (29.8%) rate of SSI was observed; in appendectomy ( n = 17, 4.1%), exploratory laparotomy ( n = 51, 12.6%), laparoscopic cholecystectomy ( n = 12, 2.90%), mesh repair ( n = 17, 4.01%), thyroidectomy (5, 1.2%), transurethral resection of the prostate ( n = 11, 2.6%), and transurethral resection of the bladder (10, 2.4%). The average SSI rate in every single procedure was about 18 (4.27%) per surgical procedure out of 123 (29.85%) SSI cases. Types of SSI identified were superficial, deep incisional and organ/space ( n = 76, 18.4%, n = 23, 5.5%, and n = 24, 5.7%). Incidence of SSIs during admission, at readmission, and post-surveillance cases were ( n = 50, 12.1%, n = 25, 6.0% and n = 48, 11.6%). Associated risk factors found contributed to the incidence of SSI ( p < 0.05). Pre-operative ( n = 348, 84.5%) and 6 (1.5%) surgical patients did not received the post-operative antibiotics. The P. aeruginosa ( n = 15, 12.1%) and S. aureus (13, 10.5%). Cefoperazone and sulbactam were the most prescribed antibiotics. Associated risk factors and treatment outcomes of surgical patients have a direct association with the incidence of SSI. Hospital-based antimicrobial stewardship, implementation of surgical guidelines, patient care, and education are needed to develop at wards level in hospitals.
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Khan et al. (2020) conducted a cross-sectional in Surgical site infections (n=412). Surgical procedures and associated risk factors was evaluated on Incidence of surgical site infection (SSI). Among 412 surgical patients in Pakistan, the overall incidence of surgical site infections was 29.8% at 30 days post-surgery.
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