Surgical Site Infection in A Tertiary Centre In Nigeria

Abstract

Background: Surgical site infection (SSI) previously called wound infection is defined as that infection presenting up to 30 days after a surgical procedure if no prosthesis is placed and up to 1 year if a prosthesis is implanted in the patient.It has been reported to be second only to urinary tract infection as the commonest hospital acquired infection and actually the most commonly encountered form of nosocomial infection in surgical practice. The commonest organisms causing SSI have been reported to be gram positive cocci and gram negative bacilli. Aim: To identify the risk factors of SSI together with the identification of the aetiological bacterial agents. Patients And Methods: This is a 3 year prospective study conducted at the University of Port Harcourt Teaching Hospital (UPTH) between 1st July, 2013 and 30th June, 2016. All patients with SSI were recruited for the study. Data which included age, sex, duration of surgery, type of surgical wound, nature of operation (elective of emergency), body mass index (BMI), site of operation, organisms isolated and associated risk factors ( e.g diabetes) were obtained and recorded on a data sheet. Data were analyzed using the Statistical Package for Social Sciences (SPSS) version 16. Chi square (x2) and Fisher’s exact tests were used to observe associations. P value of ˂ 0.05 was considered statistically significant. Results: There were 32 cases of surgical site infection out of the 350 surgeries within the study period and this constitutes about 9.1%. There were 20 (62.5%) males and 12 females (37.5%) with a male to female ratio of 1.7:1. Their ages ranged from 27 to 65 years with a mean of 40.4±3.7 years and the most commonly affected age group was 21-30 years. Significant risk factors included emergency operation, prolong surgeries ( ˃ 2 hours), dirty wounds and obesity. There was no significant association between SSI and diabetes. Conclusion: The rate of SSI was 9.1% and the identified risk factors were emergency operations, dirty wounds, long duration of surgery (˃ 2 hours) and obesity.The commonest organism isolated was Klebsiella