BACTERIOLOGICAL PROFILE OF SURGICAL SITE INFECTIONS AND THEIR ANTIBIOGRAM: A STUDY IN A TERTIARY CARE HOSPITAL
DOI:
https://doi.org/10.22159/ajpcr.2024v17i11.51864Keywords:
Post-operative wound, Antimicrobial resistance, MRSA, Nosocomial infectionAbstract
Objective: To ascertain the frequency of surgical site infection (SSI) occurrences and the prevalence of aerobic bacterial infections associated with their antibiogram.
Methods: For 1 year, a tertiary care hospital affiliated with Government Medical College, Amritsar, served as the site of this cross-sectional study. Pus aspirates were aseptically taken from 86 consecutive individuals suspected of having SSI using a sterile surgical syringe with a needle and sterile cotton surgical swabs. The specimens were cultivated and placed in an incubator at 37°C for 24 h. The individual strains were then identified using traditional techniques. The Kirby–Bauer’s Disc Diffusion Method was employed to conduct antimicrobial susceptibility testing.
Results: Among 1021 patients, 86 were clinically suspected of SSI, and 64 were culture-positive. The incidence of SSI was 8.42%. The most common organisms were Klebsiella pneumoniae 34% (17/50) and Escherichia coli 32% (16/50), whereas Staphylococcus aureus 100% (14/14) was the only organism found among Gram-positive cocci. The antimicrobial Profile of Gram-positive isolates showed maximum sensitivity to linezolid (100%), followed by erythromycin (85.7%). The antimicrobial profile of lactose fermenters revealed maximum sensitivity to polymyxin (100%). Antibiogram of Proteus species showed maximum sensitivity to meropenem (100%) and ceftazidime tazobactam (100%). Non-fermenters showed 100% polymyxin and 80% sensitivity to aztreonam.
Conclusion: Our study has revealed significant findings. The incidence of SSI was found to vary between 8% and 12% in our tertiary care center. K. pneumoniae 26.5% (17/64) and E. coli 25% (16/64) were the most common organisms isolated. S. aureus 21.2% (14/64) was the only organism found among Gram-positive cocci. SSI below waist surgery was far more 75% (48/64) than above waist surgery of 25% (16/64).
Downloads
References
Ali S, Birhane M, Bekele S, Kibru G, Teshager L, Yilma Y, et al. Healthcare-associated infection and its risk factors among patients admitted to a tertiary hospital in Ethiopia: Longitudinal study. Antimicrob Resist Infect Control. 2018;7:2. doi: 10.1186/s13756-017- 0298-5, PMID 29312659
Plachouras D, Lepape A, Suetens C. ECDC definitions and methods for the surveillance of healthcare-associated infections in intensive care units. Intensive Care Med. 2018;44(12):2216-8. doi: 10.1007/s00134- 018-5113-0, PMID 29797028
Negi V, Pal S, Juyal D, Sharma MK, Sharma N. Bacteriological profile of surgical site infections and their antibiogram: A study from resource constrained rural setting of Uttarakhand State, India. J Clin Diagn Res. 2015;9(10):DC17-20. doi: 10.7860/JCDR/2015/15342.6698, PMID 26557520
Goma K, Gelany SE, Galal AF. Incidence and risk factors for surgical site infection post-gynecological operations in a tertiary hospital in Egypt: A retrospective study. Int J Reprod Contracept Obstet Gynecol. 2022;11(2):299. doi: 10.18203/2320-1770.ijrcog20220056
Berríos-Torres SI, Umscheid CA, Bratzler DW, Leas B, Stone EC, Kelz RR, et al. Centers for Disease Control and Prevention guideline for the prevention of surgical site infection, 2017. JAMA Surg. 2017;152(8):784- 91. doi: 10.1001/jamasurg.2017.0904, PMID 28467526
Shahane V, Bhawal S, Lele U. Surgical site infections: A one-year prospective study in a tertiary care center. Int J Health Sci (Qassim). 2012;6(1):79-84. doi: 10.12816/0005976, PMID 23267307
Mundhada AS, Tenpe S. A study of organisms causing surgical site infections and their antimicrobial susceptibility in a tertiary care government hospital. Indian J Pathol Microbiol. 2015;58(2):195-200. doi: 10.4103/0377-4929.155313, PMID 25885133
Stefani S, Chung DR, Lindsay JA, Friedrich AW, Kearns AM, Westh H, et al. Meticillin-resistant Staphylococcus aureus (MRSA): Global epidemiology and harmonization of typing methods. Int J Antimicrob Agents. 2012;39(4):273-82. doi: 10.1016/j.ijantimicag.2011.09.030, PMID 22230333
Zimlichman E, Henderson D, Tamir O, Franz C, Song P, Yamin CK, et al. Healthcare-associated infections: A meta-analysis of costs and financial impact on the U.S. health care system. JAMA Intern Med. 2013;173(22):2039-46. doi: 10.1001/jamainternmed.2013.9763, PMID 23999949
Aparna MS, Yadav S. Biofilms: Microbes and disease. Braz J Infect Dis. 2008 Dec;12(6):526-30. doi: 10.1590/s1413-86702008000600016, PMID 19287843
Singh S, Singh SK, Chowdhury I, Singh R. Understanding the mechanism of bacterial biofilms resistance to antimicrobial agents. Open Microbiol J. 2017 Apr 28;11:53-62. doi: 10.2174/1874285801711010053, PMID 28553416
Collee JG, Fraser AG, Marmion BP, Simmons A. Mackie and McCartney Practical Medical Microbiology. Laboratory Control of Antimicrobial Therapy. 14th and 32nd ed., Vol. M100. Performance Standards for Antimicrobial Susceptibility Testing. United Kingdom: Churchill Livingstone. Clinical and Laboratory Standards Institute, 2022; 2011. p. 151-78.
Clinical and Laboratory Standards Institute. M100 Ed32 Performance Standards for Antimicrobial Susceptibility Testing. 32nd ed. United States: Clinical and Laboratory Standards Institute; 2022.
Singh B, Hans S, Singh G, Singh J. Study comparing Two Step vs Single Step preoperative antibiotic prophylaxis for prevention of surgical site infection. Int J Sci Res. 2018 May;2(5):43-6.
Narula H, Chikara G, Gupta P. A prospective study on bacteriological Profile and antibiogram of postoperative wound infections in a tertiary care hospital in Western Rajasthan. J Fam Med Prim Care. 2020 Apr;9(4):1927-34. doi: 10.4103/jfmpc.jfmpc_1154_19, PMID 32670942
Mekhla BFR, Borle FR. Determinants of superficial surgical site infections in abdominal surgeries at a Rural Teaching Hospital in Central India: A prospective study. J Fam Med Prim Care. 2019;8(7):2258-63. doi: 10.4103/jfmpc.jfmpc_419_19, PMID 31463239
Shah S, Singhal T, Naik R, Thakkar P. Predominance of multidrug-resistant Gram-negative organisms as cause of surgical site infections at a private tertiary care hospital in Mumbai, India. Indian J Med Microbiol. 2020;38(3 & 4):344-50. doi: 10.4103/ijmm.IJMM_20_284, PMID 33154245
Patel SM, Patel MH, Patel SD, Soni ST, Kinariwala DM, Vegad MM. Surgical site infections: incidence and risk factors in A tertiary Care Hospital, Western India. Natl J Community Med. 2012;3(02):193-6.
Kumar A, Rai A. Prevalence of surgical site infection in general surgery in a tertiary care centre in India. Int Surg J. 2017;4(9):3101-6. doi: 10.18203/2349-2902.isj20173896
Bhave PP, Kartikeyan S, Ramteerthakar MN, Patil NR. Bacteriological study of surgical site infections in a tertiary care hospital at Miraj, Maharashtra state, India. Int J Res Med Sci. 2016;4(7):2630-5. doi: 10.18203/2320-6012.ijrms20161922
Panchalamarri H, Renuka Devi A. Study of aerobic bacteriological profile of surgical site infections and their antibiogram at tertiary Care Center. Int J Curr Microbiol Appl Sci. 2019 Sep;8(9):2667-73. doi: 10.20546/ijcmas.2019.809.308
Sikdar S, Choudhury K, Basu S, Bhattacharjee SG, Deb S, Tabassum N. Surgical site infection: Clinico- bacteriological Profile and antibiogram in a tertiary care hospital in Kolkata. PJMS. 2023;13(2):299-304. doi: 10.18231/j.pjms.2023.058
Khan AS, Sarwat T, Mohan S, Dutta R. Surgical site infection: bacteriological and clinicopathological profile and antibiogram in a Tertiary Care Hospital. J Med Sci Health. 2021;6(3):51-7.
Ba M, Mahesh Kumar S, Patil AB, Pramod G, Uppar A. A study of aerobic bacteriological Profile of surgical site infections in a tertiary care hospital. I.P. Int J Med Microbiol Trop Dis. 2024;6(1):42-7.
Published
How to Cite
Issue
Section
Copyright (c) 2024 Niharika Neha
This work is licensed under a Creative Commons Attribution 4.0 International License.
The publication is licensed under CC By and is open access. Copyright is with author and allowed to retain publishing rights without restrictions.
