A study of superficial surgical site infections in a tertiary care hospital at Bangalore

Saroj Golia, Asha S. Kamath B, Nirmala AR


Background: All postoperative surgical infections occurring in an operative site are termed surgical site infections (SSI). Superficial incisional surgical site infection occurs within 30 days after the operation and infection involves only skin or subcutaneous tissue of the incision and represents a substantial burden of disease for patients and health services. The study was conducted to know the incidence of surgical site infection in our hospital, risk factors associated with it and the antibiotic susceptibility pattern of the pathogens.

Methods:This prospective study was carried out in the Department of Microbiology at Dr B R AMC for a period of 1 year from Jan 2013to Jan 2014. Samples of SSI received in the Microbiology laboratory were processed and Data collected.

Results:The overall surgical site infection rate in our hospital during the study period is 4.3%. Staphylococcus aureus (S. aureus) was the most common isolate obtained followed by Escherichia coli (E. coli) and Coagulase negative Staphylococcus (CONS). Other organisms isolated were Pseudomonas aeruginosa, Enterococcus, Klebsiella pneumoniae and Proteus mirabilis. Among them, 88.8% of S. aureus and 50% of CONS isolates were methicillin-resistant strains. 80% of E. coli and 100% of Klebsiella species were ESBL producers. 50% of Enterococci were Vancomycin resistant. Risk factors like diabetes mellitus and duration plays a significant role in causing surgical site infection.

Conclusion:Implementation of an effective infection control programme and judicious use of antibiotic prophylaxis reduces the incidence of SSI in the hospital.



Surgical site infection, Wound infection, Incision, Postoperative infection

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PL Nandi, S Soundara Rajan, KC Mak, SC Chan, YP S. Surgical wound infection. Hong Kong Med J. 1999 Mar;5(1):82-6.

Klevens RM, Edwards JR, Richards CL Jr et al. Estimating health care associated infections and deaths in U.S. hospitals, 2002. Public Health Rep. 2007;122:160-6.

Horan TC, Gaynes RP, Martone WJ, Jarvis WR, Emori TG. CDC definitions of nosocomial surgical site infections, 1992: a modification of CDC definitions of surgical wound infections. Infect Control Hosp Epidemiol. 1992;13:606-8.

Mustafa A, Burkhari A, Kakru KD. Incidence of nosocomial wound infection in postoperative patients at a teaching hospital in Kashmir. JK Practitioner. 2004;11:38-40.

Cooper RA. Understanding wound infection, European Wound Management Association (EWMA). In: Cooper RA, eds. Identifying Criteria for Wound Infection. 1st ed. London: MEP Ltd; 2005: 6-9.

Haley RW, Culver DH, Morgan WM, White JW, Emori TG, Hooton TM. Identifying patients at high risk of surgical wound infection. A simple multivariate index of patient susceptibility and wound contamination. Am J Epidemiol. 1985;121(2):206-15.

Aldo Cunha Medeiros, Tertuliano Aires-Neto, George Dantas Azevedo, Maria José Pereira Vilar, Laíza Araújo Mohana Pinheiro, José Brandão-Neto. Surgical site infection in a university hospital in north-east Brazil. Braz J Infect Dis. 2005 Aug;9(4):310-4.

Lawal OO, Adejuyigbe O, Oluwole SF. The predictive value of bacterial contamination at operation in post-operative wound sepsis. Afr J Med Sci. 1990;19(3):173-9.

Demling R, LaLonde C, Saldinger P, Knox J. Multiple-organ dysfunction in the surgical patient: pathophysiology, prevention,and treatment. Curr Probl Surg. 1993;30(4):345-414.

CDC. CDC/NHSN protocol clarifications, 2013. Available at: http://www.cdc.gov/nhsn/pdf/pscmanual/protocol-clarification.pdf.

Anvikar AR, Deshmukh AB, Karyakarte RP, Damle AS, Patwardhan NS, Malik AK, Bichile LK, Bajaj JK, Baradkar VP, Kulkarni JD, Sachdeo SM. A one year prospective study of 3280 surgical wounds. Indian J Med Microbiol. 1999;17:129-32.

Nichols RL. Prevention of infection in high risk gastrointestinal surgery. Am J Med. 1984;76:111-9.

S. K. Sahu., J. S. Shergill., P. K. Sachan., P. Gupta. Superficial incisional surgical site infection in elective abdominal surgeries: a prospective study. Int J Surg. 2011;26(1):1.

SP Lilani, N Janghaley, A Chowdhary, GB Daver. Surgical site infection in clean and clean contaminated cases. Indian J Med Microbiol. 2005;23(4):249-54.

Suchitra Joyce B. and Lakshmidevi N. Surgical site infections: assessing risk factors, outcomes and antimicrobial sensitivity patterns. African J Microbiol Res. 2009 Apr;3(4):175-9.