BACTERIOLOGICAL PROFILE AND ANTIMICROBIAL SUSCEPTIBILITY PATTERN OF SURGICAL SITE INFECTIONS IN A TEACHING HOSPITAL

B. S. V. V. SUBHASHINI

doi:10.22159/ijcpr.2024v16i4.5032

Authors

B. S. V. V. SUBHASHINI Department of Microbiology, Andhra Medical College, Visakhapatnam-530002, Andhra Pradesh, India https://orcid.org/0000-0003-0382-1413

DOI:

https://doi.org/10.22159/ijcpr.2024v16i4.5032

Keywords:

Surgical site infection, Antibiogram, Antimicrobial resistance, Hospital infection control

Abstract

Objective: Surgical site infections (SSI) are defined as infections occurring within 30 or 90 d after surgical operation or within 1 y, if an implant is left in place after procedure and affecting either incision or deep tissues at the operation site. SSI is one of the quality indicators of the healthcare system. Due to advent of newer antibiotics and emergence of multidrug-resistant bacteria, SSI requires reappraisal of the microbiological flora and in vitro antibiotic sensitivity pattern. The aim of the present study is to determine the incidence etiology of SSI, and determine their Antibiogram.

Methods: Cross-sectional study conducted for a period of three months from January 2024 to March 2024. A total of fifty swabs/pus specimens from various types of surgical sites suspected to be infected on clinical grounds were collected from the post-operative wards of surgical departments and processed in Microbiology laboratory. Isolation and identification of bacterial agents were done as per standard protocols. Antimicrobial susceptibility testing was performed by Kirby-Bauer’s disc diffusion method.

Results: Out of 50 samples, 32 were culture-positive. 87.50% showed monomicrobial growth and 12.50% showed polymicrobial growth. Analysis of bacterial profile shows Staphylococcus aureus (27.77%) was the predominant isolate, followed by Pseudomonas aeruginosa (19.44%) and Escherichia coli (19.44%). Antibiogram of gram-positive isolates showed sensitivity to Teicoplanin, Vancomycin, and linezolid, whereas gram-negative isolates were sensitive to Meropenem, Piperacillin-tazobactam and levofloxacin.

Conclusion: Status of SSI is the main quality indicators of hospital infection control and prevention measures. Continuous surveillance on etiology and antibiogram of SSI is necessary to monitor antimicrobial resistance and guide in empirical treatment.

Downloads

Download data is not yet available.

References

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.

CDC. NHSN surveillance definitions for specific types of infections; 2013. p. 1-90.

Garner JS. CDC guideline for prevention of surgical wound infections, 1985. Supersedes guideline for prevention of surgical wound infections published in 1982. (Originally published in November 1985). Infect Control. 1986;7(3):193-200. doi: 10.1017/s0195941700064080, PMID 3633903.

Patil R, Chunchanur SK, Nagarathnamma T. Bacteriological profile and antibiogram of superficial incisional surgical site infections at a tertiary Care Hospital. Int J Curr Res. 2015;7:18566-9.

Owens CD, Stoessel K. Surgical site infections: epidemiology, microbiology and prevention. J Hosp Infect. 2008;70Suppl 2:3-10. doi: 10.1016/S0195-6701(08)60017-1, PMID 19022115.

Evans HL, Sawyer RG. Preventing bacterial resistance in surgical patients. Surg Clin North Am. 2009;89(2):501-19. doi: 10.1016/j.suc.2008.09.011, PMID 19281897.

Sonawane J, Kamath N, Swaminathan R, Dosani K. Bacterial profile of surgical site infections and their antibiograms in a Tertiary Care Hospital in Navi Mumbai. Bombay Hosp J. 2010;52(3).

Laboratory methods and strategies for antimicrobial susceptibility testing. In: Tille PM, editor. Bailey and Scott’s diagnostic microbiology. 13th ed. Amsterdam: Elsevier; 2014. p. 168-92.

CLSI. Performance Standards for antimicrobial Susceptibility Testing CLSI Document mis. 26th ed. Wayne, PA: Clinical and laboratory Standards Institute; 2016.

Performance standards of antimicrobial disc susceptibility tests, M 100-S22 CLSI. Vol. 32(1, Jan); 2012.

Mackie, McCartney. Practical medical microbiology. 14th ed Colloe JG, editor. G. Fraser: BP Marmion, Anthony Simmons; Churchill livingstone; Medical division of Person Professional limited; 2015.

Surgical site infection. Prevention and treatment of surgical site infection. NICE clinical guideline 74. National institute for Health and clinical Excellence; 2008.

Emori TG, Gaynes RP. An overview of nosocomial infections, including the role of the microbiology laboratory. Clin Microbiol Rev. 1993;6(4):428-42. doi: 10.1128/CMR.6.4.428, PMID 8269394.

Nichols RL. Current strategies for prevention of surgical site infections. Curr Infect Dis Rep. 2004;6(6):426-34. doi: 10.1007/s11908-004-0061-y, PMID 15538979.

Ramesh A, Dharini R. Surgical site infections in a teaching Hospital. Clinico Microbiological and Epidemiological profile. Int J Biol Med Res. 2012;3(3):2050-3.

Rijal JAM, Baidya R. Bacteriological study of the postoperative wound samples and antibiotic susceptibility pattern of the isolates in Band B hospital. JSM Microbiol. 2015;3(1):1019.

Patil R, Chunchanur SK, Nagarathnamma T. Bacteriological profile and antibiogram of superficial incisional surgical site infections at a tertiary Care Hospital. Int J Curr Res. 2015;7:18566-9.

Hemalatha V, Padma M, Sekar U, Vinodh TM, Arunkumar AS. Detection of Amp C beta-lactamases production in Escherichia coli and Klebsiella by an inhibitor-based method. Indian J Med Res. 2007;126(3):220-3. PMID 18037717.

Jain DA, Bhatawadekar DS, Modak DM. Bacteriological profile of surgical site infection from a Tertiary Care Hospital, From Western India. Indian J Appl Res. 2011;4(1):397-400. doi: 10.15373/2249555X/JAN2014/120.

Bandaru NR, Ranga Rao A, Vijayananda Prasad K, Rama Murthy DVSS. A prospective study on the postoperative wound infections in a teaching hospital of rural set up. J Clin Diagn Res. 2012;6(7):1266-71.

Malone DL, Genuit T, Tracy JK, Gannon C, Napolitano LM. Surgical site infections: reanalysis of risk factors. J Surg Res. 2002;103(1):89-95. doi: 10.1006/jsre.2001.6343, PMID 11855922.

Goswami NN, Trivedi HR, Goswami AP, Patel TK, Tripathi CB. Antibiotic sensitivity profile of bacterial pathogens in postoperative wound infections at a tertiary care hospital in Gujarat, India. J Pharmacol Pharmacother. 2011;2(3):158-64. doi: 10.4103/0976-500X.83279, PMID 21897707.

Selvaraj S, Rathinam TVP, Chandrahausan A, Srinivasan S, Venkatesan V. A study on the post-surgical wound infections in a tertiary care hospital in Kanchipuram. J Evol Med Dent Sci. 2016;05(22):2278-4802.

Ravinder Reddy B, Vani J, Gade PS, Kurkure SV. Trends in surgical site infections in general surgery at a Tertiary Hospital. J Med Allied Sci. 2012;2(1):19-22.

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.

Lilani SP, Jangale N, Chowdhary A, Daver GB. Surgical site infection in clean and clean-contaminated cases. Indian J Med Microbiol. 2005;23(4):249-52. doi: 10.1016/S0255-0857(21)02530-5, PMID 16327121.

Moro ML, Morsillo F, Tangenti M, Mongardi M, Pirazzini MC, Ragni P. Rates of surgical-site infection: an international comparison. Infect Control Hosp Epidemiol. 2005;26(5):442-8. doi: 10.1086/502565, PMID 15954481.

Setty NK, Nagaraja M, Nagappa D, Laxmipathy Naik RM, Giriyaiah C, Gowda N. A study on surgical site infections (SSI) and associated factors in a Government Tertiary Care Teaching Hospital in Mysore, Karnataka. Int J Med Public Health. 2014;4(2):171-5. doi: 10.4103/2230-8598.133126.

Saleem M, Subha TV, Balamurugan R, Kaviraj M, Gopal R. Bacterial profile and antimicrobial susceptibility pattern of surgical site infections. Indian J Appl Res. 2015;5(10).

Sonawane J, Kamath N, Swaminathan R, Dosani K. Bacterial profile of surgical site infections and their antibiograms in a Tertiary Care Hospital in Navi Mumbai. Bombay Hosp J. 2010;52(3).

Jain K, Chavan NS, Jain SM. Bacteriological profile of postsurgical wound infection along with special reference to MRSA in Central India, Indore. Int J Intg Med Sci. 2014;1(1):9-13.

Reba Kanungo AA, Aantha Kumar A, Kumar, S Badrinath. Detection of ESBL produces-among surgical wound infections and Burns patients in JIPMER. IJMM. 2000;18(4):160-5.

Datta P, Thakur A, Mishra B, Gupta V. Prevalence of clinical strains resistant to various beta-lactams in a tertiary care hospital in India. Japan J Infect Dis. 2004;57(4):146-9. PMID 15329445.

Garner JS. CDC guideline for prevention of surgical wound infections, 1985. Supersedes guideline for prevention of surgical wound infections published in 1982. (Originally published in November 1985). Infect Control. 1986;7(3):193-200. doi: 10.1017/s0195941700064080, PMID 3633903.

Nichols RL. Current strategies for prevention of surgical site infections. Curr Infect Dis Rep. 2004;6(6):426-34. doi: 10.1007/s11908-004-0061-y, PMID 15538979.

Priya KS, Muthulakshmi K, Kamalraj M. Comparison of biofilm production among MRSA strains isolated from Surgical Site Infection. JMSCR. 2017;5:18304-9.