Leela Rani Kasukurthy1 , Madhumati Bathala2
BACKGROUND All postoperative surgical infections occurring in an operative site are termed Surgical Site Infections (SSIs). SSI is a common form of nosocomial infection and is a common complication associated with surgery. They are responsible for increasing cost, length of hospital stay, morbidity and mortality. Surgical site infection is a major public health problem worldwide. We wanted to determine the incidence of SSI rates, bacteriological profile, and the resistant pattern in a tertiary care centre. METHODS This prospective study was conducted in a tertiary care centre in Bangalore in the Department of Microbiology over a period of 6 months. 180 patients with surgical site infections were studied. Wound swabs and pus samples were collected and processed as per standard microbiological techniques. Antimicrobial testing was done using Vitek 2K automated method. MRSA, ESBL types of resistance among the isolates were detected and characterized as per CLSI guidelines. RESULTS Among 1734 patients, 180 (10.3%) patients developed surgical site infections (SSI). SSIs were more frequent in the age group of 36 - 45 years. Males were more likely to get SSIs. Diabetes mellitus was the commonest comorbid condition seen in SSI cases. Pre-operative waiting period beyond 7 days, not receiving prophylactic antibiotics, dirty and contaminated surgeries were the other contributory factors for SSIs. Gram negative bacilli were the predominant isolates in SSIs. Klebsiella pneumoniae was the most frequent isolate followed by E. coli. MRSA (Methicillin Resistant Staphylococcus aureus) was the predominant isolate in Gram positive bacteria. These strains demonstrated extensive antibiotic resistance to the drugs tested. CONCLUSIONS Minimizing postoperative wound infections relies on adequate asepsis, efforts to decrease the duration of surgery without compromising the patient’s safety and beneficial outcome. Implementation of an effective infection control programme and judicious use of antibiotic prophylaxis reduces the incidence of SSIs in the hospital.
