SURGICAL SITE INFECTION AND PATTERN OF ANTIBIOTIC USE IN A TERTIARY CARE HOSPITAL IN PESHAWAR

Waqar Alam Jan, Sajjad Muhammad Khan, Muhammad Jehanzeb, Muazzam Muazzam

Abstract


Background: Surgical site infection (SSI) is most common complication following surgical
procedures. The objective of the study was to collect information on SSI regarding the most frequent
pathogen in cases operated in casualty of Lady Reading Hospital (LRH) Peshawar, and sensitivity of
the isolated pathogens to different antibiotics used. Methods: The study was carried out at surgical ‘B’
unit (SBU) LRH from Jan 1, 2009 till Dec 31, 2009. A total of 100 patients who developed SSI after
being operated for peritonitis following traumatic gut perforations, perforated appendix and enteric
perforation. The patients included presented to casualty, operated in casualty OT and were shifted to the
SBU, LRH. Children and patients operated on the elective list were excluded. Data was collected on
specially designed proforma. Demographic details, details of SSI, culture/sensitivity reports and
antibiotic used for prophylaxis and after C/S report were recorded. Results: Out of a total of 100, 72
had superficial, 20 had organ/space and 8 had deep SSI. Organisms were isolated in 77 cases (77%). E.
coli being most common pathogen (46%), followed by Pseudomonas (23%), mixed growth of Staph.
Aureus or MRSA (13%), MRSA (5%) AND Staph aureus (4%) in descending order. No growth was
reported in 23% of cases. Conclusion: E.coli was the most common organism involved in SSI in SBU
LRH. The incidence of infection with MRSA in our unit is high. Combination of antibiotics like
pipreacillin/Tazobactam, Cefoperazone/Sulbactam, were most effective against the isolated organisms,
except MRSA where Linezolid , vancomycin and Tiecoplanin were effective.
Keywords: Surgical site infection (SSI), antibiotics, drug resistance

Full Text:

PDF

References


Singhal H., Kaur K, Zammit C. Wound infection. 2009.

Retrieved from http://emedicine.medscape.com/article/188988-

overview.

Emori TG, Gaynes RP. An overview of nosocomial infections,

including the role of the microbiology laboratory. Clin Microbiol

Rev 1993;6:428–42.

Haley RW, Schaberg DR, Crossley KB, Von Allmen SD, Mc

Gowan JE Jr. Extracharges and prolongation of stay attributable

to nosocomial infections: aprospective interhospital comparison.

Am J Med 1981;70:51–8.

Mayon-White RT, Ducel G, Kereselidze T. An international

survey of the prevalence of hospital-acquired infection. J Hosp

Infect 1988;11(Suppl A):43–8.

Gaynes RP, Culver DH, Horan TC, Edwards JR, Richards C,

Tolson JS. Surgical site infection (SSI) rate in the United States,

to 1998: the National Nosocomial Surveillance System

basic SSI risk index. Clin Infect Dis 2001;33:S69–77.

Eriksen HM, Chugulu S, Kondo S, Lingaas E. Surgical site

infections at Kilimanjaro Christian Medical Centre. J Hosp Infect

;55:14–20.

Mangram AJ, Horan TC, Pearson ML, Silver LC, Jarvis

WR. Guideline for prevention of surgical site infection 1999.

Hospital Infection Control Practices Advisory Committee. Infect

Control Hosp epidemiol 1999;20(4):250–78.

Kirkland KB, Briggs JP, Trivette SL, Wilkinson WE, Sexton

DJ. The impact of surgical-site infections in the 1990s:

attributable mortality, excess length of hospitalization, and extra

costs. Infect Control Hosp Epidemiol 1999;20(11):725-30.

National Nosocomial Infections Surveillance (NNIS) System

NNIS report, data summary from January 1992 to June 2002,

issued August 2002. Am J Infect Control 2002;30:458–75.

Russell RCG, Williams NS, Bulstrode CJK. Wound infection,

Baileys & Love’s Short Practice of Surgery. (Ed 24th. London;

Arnold; 2004. p.122.

J Ayub Med Coll Abbottabad 2010;22(3)

http://www.ayubmed.edu.pk/JAMC/PAST/22-3/Waqar.pdf 145

National Nosocomial Infections Surveillance (NNIS)

System report, data summary from October 1986‒April 1996,

issued May 1996. A report from the NNIS System. Am J Infect

Control 1996;24:380–8.

Khorvash F, Mostafavizadeh K, Mobasherizadeh S, Behjati M,

Naeini AE, Rostami S, et al. Antimicrobial susceptibility pattern

of microorganisms involved in the pathogenesis of surgical site

infection (SSI); A 1 year of surveillance. Retrieved from:

http://www.ncbi.nlm.nih.gov/pubmed/18983037.

Santos KR, Fonseca LS, Bravo Neto GP, Gontijo Filho PP.

Surgical site infection: Rates, etiology and resistance patterns to

antimicrobials among strains isolated at Rio De Janeiro

University. Infection 1997;25(4):217–20.

Giri BR, Pant HP, Shankar PR, Sreeramareddy CT, Sen PK.

Surgical site infection and Antibiotics use pattern in a tertiary

care hospital in Nepal. J Pak Med Assoc 2008;58(3):148–51.

Cruse PJ, Foord R. The epidemiology of wound infection. A 10-

year prospective study of 62,939 wounds. Surg Clin North Am

;60(1):27–40.


Refbacks

  • There are currently no refbacks.


Contact Number: +92-992-382571

email: [jamc] [@] [ayubmed.edu.pk]