Introduction: Surgical site infection accounts for approximately 38% of hospital-acquired infections globally and is associated with increased length of hospitalization and mortality. The aim of the study was to determine the incidence of surgical site infection, causative organisms and factors which were associated with its occurrence at a central hospital in South Africa. Methods: A retrospective review of records of patients who developed surgical site infection over a 12-months period was conducted. Data were extracted from records of weekly morbidity and mortality meetings of the Department of Surgery. Data retrieved included demographic information, co-morbidities, nature of surgery, class of surgical site infection and microscopy, culture and sensitivity results and overall outcome including the length of hospital stay. Results: During the study period 3 005 surgical procedures were performed of which 46.8% were elective operations. A total of 147 records of patients who developed surgical site infection were found. The mean age of these 147 patients who developed surgical site infection was 47.3±17.21 years. The incidence of reported surgical site infection was 4.8% (147/3 005) with 72.6% (93/147) occurring in males. Nineteen of the 147 cases had to be excluded and thus only 128 patient files were suitable for the study. Of patients who developed surgical site infection, 30.5% (39/128) had diabetes mellitus, 21.9% (28/128) had hypertension and 18.8% (24/128) had both diabetes and hypertension, while 15.6% (20/128) of patients were known to be HIV positive. Sixty-four percent (64.1%: 82/128) of the patients who developed SSI had positive culture results and the two most commonly cultured organisms were E. coli (44%, 36/82) and P. aeruginosa (29.3%, 24/82). Conclusion: The overall rate of occurrence of surgical site infection was 4.8% and most of the infections were diagnosed in male patients. The two most commonly cultured organisms were E. coli and P. aeruginosa. Thirty-one percent who had surgical site infection had diabetes mellitus.
| Published in | Journal of Surgery (Volume 10, Issue 2) |
| DOI | 10.11648/j.js.20221002.17 |
| Page(s) | 83-88 |
| Creative Commons |
This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited. |
| Copyright |
Copyright © The Author(s), 2024. Published by Science Publishing Group |
Surgical Site Infection, Classification, Co-morbidities, Diabetes Mellitus, Gender, HIV
| [1] | Bull AL, Worth LJ, Spelman T, et al (2017) Antibiotic prescribing practices for prevention of surgical site infections in Australia: increased uptake of national guidelines after surveillance and reporting and impact on infection rates. Surg Infect 18: 834–840. |
| [2] | Badia JM, Casey AL, Petrosillo N (2017) Impact of surgical site infection on healthcare costs and patient outcomes: a systematic review in six European countries. J Hosp Infect 96: 1–15. |
| [3] | Berrios-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): 784-791. |
| [4] | Ngaroua, Ngah JE, Bénet T, et al (2016) Incidence of surgical site infections in sub-Saharan Africa: systematic review and meta-analysis]. Pan Afr Med J. 24: 171. |
| [5] | Moeng MS, Sparaco A, Mare I, Naidoo V, Phakathi B, Miller EJ, et al. Clavien-Dindo classifcation of post-operative complications in a South African setting. Wits Journal of Clinical Medicine 2021; 3 (1): 11-18. http://dx.org/10.18772/26180197.2021.v3n1a2. |
| [6] | Nair A, Steinberg WJ, Habib T (2018). Prevalence of healthcare-associated infection at a tertiary hospital in the Northern Cape Province, South Africa. South Afr Fam Pract 60: 162–167. |
| [7] | Eriksen HM, Iversen BG, Aavitsland P (2005) Prevalence of nosocomial infections in hospitals in Norway, 2002 and 2003. J Hosp Infect 60: 40–45. |
| [8] | Harbarth S, Ruef C, Francioli P, et al (1999) Nosocomial infections in Swiss university hospitals: a multi-centre survey and review of the published experience. Swiss-Noso Network. Schweiz Med Wochenschr 129: 1521–1528. |
| [9] | Olowo-Okere A, Ibrahim YKE, Olayinka BO, et al (2019). Epidemiology of surgical site infections in Nigeria: A systematic review and meta-analysis. Niger Postgrad Med J 26: 143–151. |
| [10] | Olowo-Okere A, Ibrahim YKE, Sani AS, et al (2018) Occurrence of Surgical Site Infections at a Tertiary Healthcare Facility in Abuja, Nigeria: A Prospective Observational Study. Med Sci 6: 60. |
| [11] | Billoro BB, Nunemo MH, Gelan SE, et al (2019) Evaluation of antimicrobial prophylaxis use and rate of surgical site infection in surgical ward of Wachemo University Nigist Eleni Mohammed Memorial Hospital, Southern Ethiopia: prospective cohort study. BMC Infect Dis 19: 298. |
| [12] | Dessie W, Mulugeta G, Fentaw S, et al (2016) Pattern of Bacterial Pathogens and Their Susceptibility Isolated from Surgical Site Infections at Selected Referral Hospitals, Addis Ababa, Ethiopia. Int J Microbiol. 2016; 2016: 1–8. |
| [13] | Mawalla B, Mshana SE, Chalya PL, et al (2011) Predictors of surgical site infections among patients undergoing major surgery at Bugando Medical Centre in Northwestern Tanzania. BMC Surg 11: 21. |
| [14] | Gardner EM and Murasko DM, (2002) Age-related changes in Type 1 and Type 2 cytokine production in humans. Biogerontology 3: 271–290. |
| [15] | Latham R, Lancaster AD, Covington JF, et al (2001) The Association of Diabetes and Glucose Control With Surgical-Site Infections Among Cardiothoracic Surgery Patients. Infect Control Hosp Epidemiol 22: 607–612. |
| [16] | Zerr KJ, Furnary AP, Grunkemeier GL, et al (1997) Glucose control lowers the risk of wound infection in diabetics after open heart operations. Ann Thorac Surg 63: 356–361. |
| [17] | Cheadle WG, (2006) Risk factors for surgical site infection. Surg Infect 7: 7-11. |
| [18] | Delgado-Rodríguez M, Medina-Cuadros M, Martínez-Gallego G, et al (1997) Total cholesterol, HDL-cholesterol, and risk of nosocomial infection: a prospective study in surgical patients. Infect Control Hosp Epidemiol 18: 9–18. |
| [19] | Schweizer ML, Cullen JJ, Perencevich EN, et al (2014) Costs Associated with Surgical Site Infections in Veterans Affairs Hospitals. JAMA Surg 149: 575-581. |
| [20] | Vegas AA, Jodra VM, Garcia ML (1993) Nosocomial infection in surgery wards: a controlled study of increased duration of hospital stays and direct cost of hospitalization. Eur J Epidemiol 9: 504–510. |
| [21] | Purba AKR, Setiawan D, Bathoorn E, et al (2018) Prevention of Surgical Site Infections: A Systematic Review of Cost Analyses in the Use of Prophylactic Antibiotics. Front Pharmacol 9: 776. |
| [22] | Whitehouse JD, Friedman ND, Kirkland KB, et al (2002) The Impact of Surgical-Site Infections Following Orthopedic Surgery at a Community Hospital and a University Hospital Adverse Quality of Life, Excess Length of Stay, and Extra Cost. Infect Control Hosp Epidemiol 23: 183–189. |
| [23] | Kang KT, Son DW, Lee SH, et al (2017) Variation of C-Reactive Protein and White Blood Cell Counts in Spinal Operation: Primary Fusion Surgery Versus Revision Fusion Surgery. Korean J Spine 14: 66–70. |
| [24] | Ortega-Deballon P, Radais F, Facy O, et al (2010) C-Reactive Protein Is an Early Predictor of Septic Complications After Elective Colorectal Surgery. World J Surg 34: 808–814. |
| [25] | Vijayan AL, Vanimaya, Ravindran S, et al (2017) Procalcitonin: a promising diagnostic marker for sepsis and antibiotic therapy. J Intensive Care 5: 51-7. |
| [26] | Omar J, Isa S, Ismail TST, et al (2019) Procalcitonin as an Early Laboratory Marker of Sepsis in Neonates: Variation in Diagnostic Performance and Discrimination Value. Malays J Med Sci 26: 61–9. |
| [27] | Medeiros AC, Tertuliano AN, Azevedo GD, et al (2005) Surgical site infection in a university hospital in north east Brazil. Brazilian J Infect Dis 9: 310-314. |
| [28] | Poulsen KB, Bremmelgaard A, Sørensen AI, et al (1994) Estimated costs of postoperative wound infections: A case-control study of marginal hospital and social security costs. Epidemiol Infect 113: 283–295. |
| [29] | Hernaiz-Leonardo JC, Golzarri MF, Ostrosky-Frid M, et al. (2017) Microbiology of surgical site infections in patients with cancer: A 7-year review. Am J Infect Control. 45 (7): 761–766. |
| [30] | Mundhada A and Tenpe S (2015) A study of organisms causing surgical site infections and their antimicrobial susceptibility in a tertiary care Government Hospital. Indian J Pathol Microbiol 58: 195-200. |
| [31] | Owens CD, Stoessel K (2008) Surgical site infections: epidemiology, microbiology and prevention. J Hosp Infect 70: 3–10. |
| [32] | Matinyi S, Enoch M, Akia D, et al (2018) Contamination of microbial pathogens and their antimicrobial pattern in operating theatres of peri-urban eastern Uganda: a cross-sectional study. BMC Infect Dis 18 (1): 460. |
APA Style
Barbakh Mohamed Khaled Eyadah, Muganza Adelin, Luvhengo Thifhelimbilu Emmanuel, Nel Marietha. (2022). Surgical Site Infection at a Central Academic Hospital in Johannesburg: A One-year Audit. Journal of Surgery, 10(2), 83-88. https://doi.org/10.11648/j.js.20221002.17
ACS Style
Barbakh Mohamed Khaled Eyadah; Muganza Adelin; Luvhengo Thifhelimbilu Emmanuel; Nel Marietha. Surgical Site Infection at a Central Academic Hospital in Johannesburg: A One-year Audit. J. Surg. 2022, 10(2), 83-88. doi: 10.11648/j.js.20221002.17
AMA Style
Barbakh Mohamed Khaled Eyadah, Muganza Adelin, Luvhengo Thifhelimbilu Emmanuel, Nel Marietha. Surgical Site Infection at a Central Academic Hospital in Johannesburg: A One-year Audit. J Surg. 2022;10(2):83-88. doi: 10.11648/j.js.20221002.17
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Download@article{10.11648/j.js.20221002.17,
author = {Barbakh Mohamed Khaled Eyadah and Muganza Adelin and Luvhengo Thifhelimbilu Emmanuel and Nel Marietha},
title = {Surgical Site Infection at a Central Academic Hospital in Johannesburg: A One-year Audit},
journal = {Journal of Surgery},
volume = {10},
number = {2},
pages = {83-88},
doi = {10.11648/j.js.20221002.17},
url = {https://doi.org/10.11648/j.js.20221002.17},
eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.js.20221002.17},
abstract = {Introduction: Surgical site infection accounts for approximately 38% of hospital-acquired infections globally and is associated with increased length of hospitalization and mortality. The aim of the study was to determine the incidence of surgical site infection, causative organisms and factors which were associated with its occurrence at a central hospital in South Africa. Methods: A retrospective review of records of patients who developed surgical site infection over a 12-months period was conducted. Data were extracted from records of weekly morbidity and mortality meetings of the Department of Surgery. Data retrieved included demographic information, co-morbidities, nature of surgery, class of surgical site infection and microscopy, culture and sensitivity results and overall outcome including the length of hospital stay. Results: During the study period 3 005 surgical procedures were performed of which 46.8% were elective operations. A total of 147 records of patients who developed surgical site infection were found. The mean age of these 147 patients who developed surgical site infection was 47.3±17.21 years. The incidence of reported surgical site infection was 4.8% (147/3 005) with 72.6% (93/147) occurring in males. Nineteen of the 147 cases had to be excluded and thus only 128 patient files were suitable for the study. Of patients who developed surgical site infection, 30.5% (39/128) had diabetes mellitus, 21.9% (28/128) had hypertension and 18.8% (24/128) had both diabetes and hypertension, while 15.6% (20/128) of patients were known to be HIV positive. Sixty-four percent (64.1%: 82/128) of the patients who developed SSI had positive culture results and the two most commonly cultured organisms were E. coli (44%, 36/82) and P. aeruginosa (29.3%, 24/82). Conclusion: The overall rate of occurrence of surgical site infection was 4.8% and most of the infections were diagnosed in male patients. The two most commonly cultured organisms were E. coli and P. aeruginosa. Thirty-one percent who had surgical site infection had diabetes mellitus.},
year = {2022}
}
TY - JOUR T1 - Surgical Site Infection at a Central Academic Hospital in Johannesburg: A One-year Audit AU - Barbakh Mohamed Khaled Eyadah AU - Muganza Adelin AU - Luvhengo Thifhelimbilu Emmanuel AU - Nel Marietha Y1 - 2022/04/20 PY - 2022 N1 - https://doi.org/10.11648/j.js.20221002.17 DO - 10.11648/j.js.20221002.17 T2 - Journal of Surgery JF - Journal of Surgery JO - Journal of Surgery SP - 83 EP - 88 PB - Science Publishing Group SN - 2330-0930 UR - https://doi.org/10.11648/j.js.20221002.17 AB - Introduction: Surgical site infection accounts for approximately 38% of hospital-acquired infections globally and is associated with increased length of hospitalization and mortality. The aim of the study was to determine the incidence of surgical site infection, causative organisms and factors which were associated with its occurrence at a central hospital in South Africa. Methods: A retrospective review of records of patients who developed surgical site infection over a 12-months period was conducted. Data were extracted from records of weekly morbidity and mortality meetings of the Department of Surgery. Data retrieved included demographic information, co-morbidities, nature of surgery, class of surgical site infection and microscopy, culture and sensitivity results and overall outcome including the length of hospital stay. Results: During the study period 3 005 surgical procedures were performed of which 46.8% were elective operations. A total of 147 records of patients who developed surgical site infection were found. The mean age of these 147 patients who developed surgical site infection was 47.3±17.21 years. The incidence of reported surgical site infection was 4.8% (147/3 005) with 72.6% (93/147) occurring in males. Nineteen of the 147 cases had to be excluded and thus only 128 patient files were suitable for the study. Of patients who developed surgical site infection, 30.5% (39/128) had diabetes mellitus, 21.9% (28/128) had hypertension and 18.8% (24/128) had both diabetes and hypertension, while 15.6% (20/128) of patients were known to be HIV positive. Sixty-four percent (64.1%: 82/128) of the patients who developed SSI had positive culture results and the two most commonly cultured organisms were E. coli (44%, 36/82) and P. aeruginosa (29.3%, 24/82). Conclusion: The overall rate of occurrence of surgical site infection was 4.8% and most of the infections were diagnosed in male patients. The two most commonly cultured organisms were E. coli and P. aeruginosa. Thirty-one percent who had surgical site infection had diabetes mellitus. VL - 10 IS - 2 ER -
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