Keywords : SSI
A one year cross sectional study on Surgical Site Infections (SSI), associated risk factors and antimicrobial sensitivity patterns in a government tertiary care teaching hospital, Egmore Chennai
European Journal of Molecular & Clinical Medicine,
2023, Volume 10, Issue 4, Pages 804-811
Surgical Site Infections (SSI) is one of the most commonly reported nosocomial infection which has an adverse impact on the hospital as well as on the patient.
Objectives:
To study the prevalence of Surgical Site Infections.
To identify the risk factors associated with the development of SSIs.
To identify the etiological pathogens and their antimicrobial susceptibility
Methodology: We conducted a one year cross sectional study on SSI in
IOG. 152 post lscs cases who developed SSI were included in the study. Factors like age, duration of surgery, co-morbidities, type of skin suture, pathogen and their antimicrobial sensitivity associated with SSI and their outcomes were studied. Swabs were collected from the infected surgical wounds and processed by the conventional microbiological methods. Antimicrobial susceptibility was done by Kirby-Bauer disc diffusion method and interpretation done by CLSI guidelines 2020.
Results: Among the 6650 cases of LSCS done in our hospital in the year 2021, 152 cases developed surgical site infection. Of which 67% of the population comprise of the age group 18-30 yrs, anemia, diabetes, hypetension were the predominant risk factors associated with SSI. About 37% of the cases needed wound resuturing remaining 63% of the cases were medically managed. The common pathogen encountered with SSI were E. coli, Klebsiella and MRSA. Around 82% of the organism were sensitive to Amikacin and 48% of them were sensitive to Gentamycin, about 43% of the pathogen were resistant to Ampicillin.
Conclusions: The overall prevelance of SSI in our hospital was 2.28% in the year 2021. Early diagnosis and prompt treatment of risk factors like anemia, diabetes and hypertension may prevent SSI and improve outcomes in infected cases. Decrease in the duration of surgery, decreases the incidence of SSI. Empirical use of antibiotics based on the common organism encountered and their sensitivity patters improves the outcome of SSI. Peroidic surveillance of SSI and measures to prevent it to be done on regular basis
Prospective Comparative Study of Complications of Laparotomy Wound in Elective and Emergency Surgery
European Journal of Molecular & Clinical Medicine,
2023, Volume 10, Issue 1, Pages 4194-4199
Background: Postoperative wound complications are of common occurrence. The incidence of postoperative wound infections ranging from <2% to 38%. Based on NNIS (National Nosocomial Infections Surveillance) system reports, surgical site infections are the third most frequently reported nosocomial infections among hospitalized patient, Aim is to compare the complications of laparotomy wound in elective and emergency surgery and to study the various determinants affecting it.
Obstetric and gynecological surgeries: risk factors, bacteriological profile, and antibiogram in patients with surgical site infection
European Journal of Molecular & Clinical Medicine,
2023, Volume 10, Issue 3, Pages 155-165
To determine the S.S.I. risk variables. should be familiar with S.S.I.'s bacteriological profile. To research the microorganisms obtained from wounds' antibiograms. To understand their post-operative effects.
Method: After consultation with the institute's ethical review board, a prospective observational study was conducted by Department of Obstetrics and Gynaecology, Rangaraya Medical College, Kakinada, Andhra Pradesh, India, from June 2021 to May 2022. The microbiology lab provided a sterile swab to collect pus or discharge from the injury site for culture and sensitivity testing. 5731 surgeries were done in130 patients (22.68%) had surgical site infections (S.S.I.).
Result: 83 (63.86%) of 130 patients developed S.S.I. between 6-10 days, followed by 33 (25.38%) before 6 days. Staph. aureus was the most frequent organism, followed by E. Coli in 30 (23.08%), Klebsiella in 17 (13.08%), Pseudomonas in 11 (8.46%), Citrobacter in 4 (3.08%), and Acinetobacter in 2 (1.54%). 50 (38.46%) were sensitive to Piperacillin + Tazobactum, 42 (32.32%) were sensitive to Cefoperazone +Sulbactum, 18 (13.84%) were sensitive to meropenem, Gentamycin was 8 (6.15%), Amikacin was 6 (4.61%), Clindamycin was 3 (2.32%), Linezolid was 2 (1.53%), and 1 case was only sensitive to Levofloxacin.
Conclusion: Reducing the incidence of postoperative infections in women has the potential to lower both healthcare expenses and the severity of their complications. This is feasible if the bacteriological profile and antibiotic sensitivity of the hospital's most common organism are recognized, and if the patient's risk factors for S.S.I. are identified and classified. It is possible that our S.S.I. analysis will reveal pervasive species and sensitivity trends among the sample population and the organization under examination.
To study the effectiveness of antibiotics administered in a single dosage with those administered over the course of five days in clean surgery
European Journal of Molecular & Clinical Medicine,
2023, Volume 10, Issue 1, Pages 5265-5272
A research comparing the effectiveness of antibiotics administered in a single dosage with those administered over the course of five days in clean surgery.
Material and methods: The Department of General Surgery was responsible for carrying out this research. A total of 200 patients were chosen. At the time of induction or thirty minutes before the skin incision, a single dosage of one gramme (g) of injectable cefotaxime was administered to each and every patient in the research group. They were not given any further antibiotic treatment, either intravenously or orally. In the second group, every single patient was given 1 gramme of cefotaxime intravenously BD for a period of five days. Patients who were either underweight or obese had their dosage modified such that it was proportional to their body weight. Tab. cefixime 200mg BD was administered to patients in the control group who had had laparoscopic cholecystectomy and were expected to be released in two to three days.
Results: It was determined that the majority of patients were admitted for hernioplasty, which accounted for 45% of patients in the study group and 47% of patients in the control group. Laparoscopic cholecystectomy, which accounted for 39% of patients in both groups, was the next most common type of surgery, followed by appendicectomy and other surgeries. The laboratory confirmed that the main growth in the surgical site was E. coli, Staphylococcal aureus, and Streptococcal. This was the case in the control group, in which participants or patients received postoperative 3-4days of conventional antibiotic cover. However, 7 patients displayed organisms from their pus or contaminated wound, albeit in a lesser amount. While a considerable number of patients tested positive for the presence of infections, this connection was not determined to be significant. 93 percent of patients in the study group and 91 percent of patients in the control group did not have wound discharge, according to the distribution of participants among the study and control groups in terms of wound discharge. Seven patients in the study group had wound discharge, while nine patients in the control group did. Although there were more patients in the control group who had wound discharge, this difference did not show any significant association.
A COMPARATIVE STUDY OF EFFECTIVENESS OF SUBCUTANEOUS SALINE IRRIGATION DURING CLOSURE OF EMERGENCY LOWER SEGMENT CAESAREAN SECTION INCISION ON POSTOPERATIVE SURGICAL SITE COMPLICATIONS
European Journal of Molecular & Clinical Medicine,
2022, Volume 9, Issue 7, Pages 8185-8194
Background: Healthcare-associated infections (HAI) are common worldwide and amongst one of them is wound infections which includes surgical site infections (SSI). Studies on unconventional methods of prevention of superficial wound infection, during emergency Lower Segment Caesarean Sections (LSCS)are relatively less in literature.
Aim: The study was conducted with the aim to determine the role of irrigation of subcutaneous tissue of wound with Normal Salineduring closure of emergency LSCS on reducing SSI and decreasing the morbidity
THE ROLE OF SINGLE DOSE ANTIBIOTIC PROPHYLAXIS DURING HERNIA SURGERY: A RANDOMIZED CONTROL TRIAL
European Journal of Molecular & Clinical Medicine,
2021, Volume 8, Issue 4, Pages 1667-1671
Background: This prospective, randomised control experiment was conducted to determine the role of single-dose antibiotic prophylaxis after hernia surgery. This research also provides evidence for determining whether stringent aseptic precautions can reduce antibiotic use.
Materials and Methods: This study included 60 patients with inguinal hernias (direct or indirect) who were admitted to the surgical ward at the Pt. B.D. Sharma Post Graduate Institute of Medical Sciences in Rohtak. Prior to admission, each patient was given a thorough screening as well as a rigorous clinical evaluation that included Haemoglobin, Bleeding time, Clotting time, Urine complete examination, Blood urea, Blood sugar, Serum electrolytes, Chest X-ray and ECG.
Results: The average age of the presenters was 45.88 years old. The majority of the patients, sixteen (26.66 percent), were between the ages of 41 and 50. The youngest patient was an 18-year-old man, while the oldest was an 80-year-old man. Males made up 98.33% (n=59) of the cases, while females made up 1.66 percent (n=1). Lichtenstein's repair was performed in forty patients (66.66%) for indirect inguinal hernias, and Lichtenstein's repair was combined with posterior wall plication in eighteen patients (30%) for direct inguinal and Pantaloons' type hernias. Indirect inguinal hernias accounted for the most occurrences (40), with two having a sliding component.
Conclusion: There is substantial evidence in the international literature to support the claim that prophylactic antibiotic treatment does not reduce the incidence of wound infection. Given the findings of this study, it is possible to conclude that the variations in infection rates are not substantial, and that prophylactic antibiotics do not reduce the rate of SSI in mesh repair of inguinal hernias, and that routine use of prophylactic antibiotics is not indicated.