Surgical Site Infections and Antimicrobial Resistance in Kyiv City Hospitals, Ukraine

Abstract

OBJECTIVE: Introduction: Surgical site infections (SSIs) are associated with increased morbidity and mortality. Scant information is available on the SSI in Ukrainian hospitals. The aim: to determine the incidence of SSIs and estimates antimicrobial resistance of the major responsible pathogens in Kyiv city hospitals. PATIENTS AND METHODS: Materials and methods:This study was conducted from January 2011 to December 2013 in 3 hospitals. Definitions of SSIs were adapted from the CDC/NHSN. The identification and antimicrobial susceptibility of cultures were determined, using automated microbiology analyzer. Some antimicrobial susceptibility test used Kirby - Bauer antibiotic testing. RESULTS: Results: Among 9,162 patients, 1,912 (20.9%) SSIs were observed. The high SSI case in appendectomy (29.8 %), gastric, small and large bowel surgeries (28.4 %), cholelithiasis (25.7%), and orthopedic procedures (22.9 %). Low infection rate in excision of dermoid cysts, lipoma (5.3%) and lower segment caesarean structure (6.5%). Staphylococcus aureus were most commonly reported, accounting for 27,8% of all organisms, followed by Escherichia coli (18.4 %), Pseudomonas aeruginosa (11.9 %) and Enterococcus faecalis (11.6 %). The antimicrobial resistance in the isolates associated with SSIs showed, among the Gram-positive bacteria, that 43.8% and 4.7% of CoNS isolates were β-lactam (oxacillin) - and glycopeptide (teicoplanin) - resistant, respectively. Meticillin resistance was reported in 35.7 % of S. aureus isolates. CONCLUSION: Conclusions: SSIs and antimicrobial resistance of the responsible pathogens is an actually problem. One essential step in the prevention of SSIs is to implement a nationalsystem for their surveillance.