Trends of Surgical Site Infection as Healthcare Associated Infection in Tertiary Care Hospital, Western India

Surgical site infections are the third most common healthcare associated infection.

The aim of this study was to assess incidence of SSI, identify risk factors, causative aerobic bacteria and their antibiotic susceptibility patterns.

In this study, 300 patients who underwent various surgeries were included and various risk factors were studied. Infected cases were identified using Centre for Disease Control (CDC) definition for surgical site infections. Wound swabs and discharges were received and processed using standard microbiological methods. Culture and sensitivity were performed using CLSI (clinical and laboratory standard Institute) 2013 guidelines.

26 (8.66%) patients developed postoperative wound infection in different general surgical wards. The commonly isolated pathogens were E.coli (34.61%), Pseudomonas aeruginosa (19.23%) and Staphylococcus aureus (11.53%). Resistance Pattern of Gram negative isolates showed >93% to cephalosporins except cefepime (62.5%), 25% to amikacin and 37.5% to imipenem. ESBL production was detected in 50% isolates of gram negative organisms. Pseudomonas aeruginosa isolates were 100% resistant to ceftazidime, 60% to amikacin, 20% to levofloxacin and 20% to imipenem. Staphylococcus aureus exhibited resistance to amikacin (40%), levofloxacin (20%) and vancomycin (0%). 66.67% of isolates were Methicillin resistant staphylococcus aureus(MRSA).

Periodic surveillance of SSI and a higher degree of collaboration between surgeons and microbiologists will guide the Infection Control Committee in laying down strict guidelines to decrease SSI incidence in our setup, which is an indicator of Quality of health care in a given system.