Prevalence of Post-operative Surgical site infection in a district Hospital of western Rajasthan India
Abstract
Wound infection is the second commonest complication of wound healing. This study was carried out on 250 post-operative cases operated at a district hospital of western Rajasthan, India with the aim the aim to find out prevalence of post-operative surgical site infection and its causing organism. After taking personal information and detailed clinical, operative and post-operative history of these cases, swab from post-operative wound was taken and sent for culture and sensitivity test in Microbiology. Association was inferred with Chi-square test. Post operative surgical site infection rate was found 11.6 % which was found significantly more in intestinal surgeries than the other. Most common causative organism for infection was Staphylococci cases followed by Streptococci, E. Coli and Klebsella. Out of total 11.6% infected cases, majority (8.8%) of patients had infection with more than one organism only 2.8% were having single organism.
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Introduction
Wound infection is the second commonest nosocomial infection1 and causes patient discomfort, prolonged hospital stay, more days off work, increased cost of therapy and the cost of an operation increase by 300% to 400%. 2 An important requirement in the prevention of SSI is the availability of correct and recent data i.e. surgical audit and wound surveillance.
The discovery of the antimicrobial agents also enables us to perform surgery in many conditions that were previously thought to be impossible in the pre-antibiotic era due to the risk of infection. 3 Infection in a wound is a manifestation of disturbed host-bacteria equilibrium that is in favour of bacteria. The absolute prevention of surgical wound infection seems to be an impossible goal.
A recent prevalence study found that SSIs were the most common healthcare-associated infection, accounting for 31% of all HAIs among hospitalized patients4 . The CDC healthcare-associated infection (HAI) prevalence survey found that there were an estimated 157,500 surgical site infections associated with inpatient surgeries in 20115 .
While advances have been made in infection control practices, including improved operating room ventilation, sterilization methods, barriers, surgical technique, and availability of antimicrobial prophylaxis, SSIs remain a substantial cause of morbidity, prolonged hospitalization, and death. SSI is associated with a mortality rate of 3%, and 75% of SSI associated deaths are directly attributable to the SSI. 6 .
Surveillance of SSI with feedback of appropriate data to surgeons has been shown to be an important component of strategies to reduce SSI risk7-10
Conclusion
In this study, post-operative wound infection rate was found 11.6%. In majority of cases, causative agent found in post-operative infected wound was Staphylococci followed with Streptococci, E. Coli, and Klebsella. Maximum infection rate was found in Intestinal surgery followed by in Appendicectomy, Hysterectomy, Inguinal hernia etc. This variation in infection rate as per type of operation was found significant.