SURGICAL SITE INFECTIONS  A PROSPECTIVE STUDY IN A TEACHING HOSPITAL OF SEMIURBAN SETUP

DR.BANDARU NARASINGA RAO; DR.P.SRIMANNARAYANA; DR.A.RANGA RAO; Dr.D.VIJAYA BHARATHI

Volume : VI, Issue : III, March - 2016

SURGICAL SITE INFECTIONS A PROSPECTIVE STUDY IN A TEACHING HOSPITAL OF SEMIURBAN SETUP

Dr. Bandaru Narasinga Rao, Dr. P. Srimannarayana, Dr. A. Ranga Rao, Dr. D. Vijaya Bharathi

Abstract :

<p>&nbsp;Background: Surgical site infection (SSI) or Surgical wound infection is a type of healthcare&ndash;associated infection in which a wound infection occurs after an invasive (surgical) procedure. Keeping in view the prevalence of the wound infections in our set up, this study was designed to evaluate the frequency, clinical presentation, different aerobic microorganisms which were involved in cases of clean and clean&ndash;contaminated, contaminated and dirty surgeries and their antimicrobial sensitivity pattern. Design and Duration: An observational prospective study from Feuary 2014 to January 2016. Setting: Surgical Units I, II and III of Gayatri Vidya Parishad institute of Health Care and Medical Technology, Madhurawada, Visakhapatnam, Andhra Pradesh, India. Patients: Nine hundred and thirty six patients who under&ndash;went clean and clean&ndash;contaminated, contaminated and dirty surgeries were included. Methodology: The biodata of the patients, together with their clinical features, diagnosis, type of surgery which was performed and the development of any wound infections , the microorganisms isolated and their antimicrobial sensitivity pattern were noted . All the data was analyzed. Results: Out of the 936 patients (544 males and 392 females) in the study, 674 belonged to the clean surgery group, 243 belonged to the clean&ndash;contaminated surgery group, 36 belonged to the contaminated surgery group and 21 belonged to the dirty surgery group. The overall incidence of surgical site infections (SSI) in this study was 7.59%; 32 (4.75%) cases in the clean surgical group, 21(8.64%) cases in the clean&ndash;contaminated group, 7(19.44%) cases in the contaminated group and 11(52.38) cases in the dirty group developed infections. The patients in the age group of more than 51&ndash;60 years were infected more than those in the younger age groups. The incidence of the wound infections was more in the male patients (11.63%) as compared to that in the female patients (7.65%). The common organisms involved in the SSIs were Staphylococcus aureus, Escherichia.coli and Pseudomonas sps. Among Gram positive isolates, Linozolid was the most useful antimicrobial (96.30 to 100%) followed by Gentamycin and Amikacin. The least effective drug was Ciprofloxacin ( 0 to 44.44%) where as in Gram negative group, Gentamycin was the most effective antibiotic ( 91.67 to 100%) followed by Amikacin (77.78 to 100%) and the least effective was again ciprofloxacin ( 0 to 50%) . Conclusion: Meticulous surgical techniques, the duration of the operation, proper sterilization, the judicious use of antibiotics, hygienic operation theatres and ward environments, the control of malnutrition and obesity and the treatment of infective foci and diseases like diabetes help in controlling the morbidity of the surgical wound infections.</p>