SURGICAL SITE INFECTION AND PATTERN OF ANTIBIOTIC USE IN A TERTIARY CARE HOSPITAL IN PESHAWAR
Abstract
Background: Surgical site infection (SSI) is most common complication following surgicalprocedures. 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
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.
Downloads
Published
How to Cite
Issue
Section
License
Journal of Ayub Medical College, Abbottabad is an OPEN ACCESS JOURNAL which means that all content is FREELY available without charge to all users whether registered with the journal or not. The work published by J Ayub Med Coll Abbottabad is licensed and distributed under the creative commons License CC BY ND Attribution-NoDerivs. Material printed in this journal is OPEN to access, and are FREE for use in academic and research work with proper citation. J Ayub Med Coll Abbottabad accepts only original material for publication with the understanding that except for abstracts, no part of the data has been published or will be submitted for publication elsewhere before appearing in J Ayub Med Coll Abbottabad. The Editorial Board of J Ayub Med Coll Abbottabad makes every effort to ensure the accuracy and authenticity of material printed in J Ayub Med Coll Abbottabad. However, conclusions and statements expressed are views of the authors and do not reflect the opinion/policy of J Ayub Med Coll Abbottabad or the Editorial Board.
USERS are allowed to read, download, copy, distribute, print, search, or link to the full texts of the articles, or use them for any other lawful purpose, without asking prior permission from the publisher or the author. This is in accordance with the BOAI definition of open access.
AUTHORS retain the rights of free downloading/unlimited e-print of full text and sharing/disseminating the article without any restriction, by any means including twitter, scholarly collaboration networks such as ResearchGate, Academia.eu, and social media sites such as Twitter, LinkedIn, Google Scholar and any other professional or academic networking site.
