Bacteriological Profile of Patients with Intra-Abdominal Sepsis and Superficial Surgical Site Infection Following Emerge
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ORIGINAL ARTICLE
Bacteriological Profile of Patients with Intra-Abdominal Sepsis and Superficial Surgical Site Infection Following Emergency Abdominal Surgery—Is It Concordant? Ridhima Aggarwal 1 & A R Pranavi 1 & Mohsina Subair 1 & Sathasivam SureshKumar 1 & G. S. Sreenath 1 & Sujatha Sistla 2 & T. Mahalakshmy 3 & Vikram Kate 1 Received: 19 July 2018 / Accepted: 5 October 2019 # Association of Surgeons of India 2019
Abstract The rates of surgical site infections (SSI) continue to be reported with great variability, even for the same operation, from different geographical areas. Hence, a hospital-based surveillance of SSI can help in designing effective preventive strategies. This study was done to assess the risk factors, characteristics, and incidence of SSI in patients undergoing emergency gastrointestinal surgery. The study was a case series analysis, enrolling all consecutive patients undergoing emergency gastrointestinal surgery. The patients were examined daily for SSI using ASEPSIS score and during the post-operative period up to 30 days. For patients with SSI, wound swab was taken for culture and sensitivity. Patient and operative characteristics were analyzed for identifying risk factors, and the bacteriological profile and sensitivity pattern of intra-abdominal specimens were analyzed and compared with microbiological profile of SSI. A total of 100 patients were studied. The incidence of SSI was 33%. Age (44.33 ± 18.277 vs. 39.43 ± 16.158; p 0.015) and pre-operative blood transfusion (61.1 vs. 38.9; p 0.012) were found to be significant risk factors for SSI. On multivariate analysis, blood transfusion (p 0.027) and the duration of operation (p 0.005) were found to be independent risk factors. In cases where the isolated organisms were Escherichia coli, Enterococcus faecalis, and Klebsiella pneumoniae, concordance was noted between the intra-abdominal pathogens and the organisms isolated from the SSI. Risk factors for SSI in patients undergoing emergency abdominal surgeries include increasing age, pre-operative blood transfusion, prolonged operating time, intra-operative blood loss, and operative procedures involving bowel resection. Concordance exists between intraabdominal and SSI pathogens. Keywords Surgical site infection . Antibiotic sensitivity . Dirty surgical wound . Emergency abdominal surgery . Laparotomy wound infection
Introduction Surgical site infection (SSI) is an important cause of postoperative morbidity and mortality accounting for a
* Vikram Kate [email protected] 1
Department of Surgery, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Pondicherry 605006, India
2
Department of Microbiology, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Pondicherry 605006, India
3
Department of Preventive and Social Medicine, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Pondicherry 605006, India
significant proportion of nosocomial infections. A noticeably larger incidence of SSI is seen in patie
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