Advertisement

Surgery Today

, Volume 44, Issue 4, pp 685–689 | Cite as

Incidence and risk factors of surgical site infection in general surgery in a developing country

  • Emine AlpEmail author
  • Ferhan Elmali
  • Safiye Ersoy
  • Can Kucuk
  • Mehmet Doganay
Original Article

Abstract

Purpose

To investigate the incidence of surgical site infections (SSIs) according to risk factors, etiological agents, antimicrobial resistance rates of pathogens, and antimicrobial prophylaxis (AMP) in a developing country.

Methods

Prospective surveillance of SSIs was carried out in general surgery (GS) units between May 2005 and April 2009.

Results

SSI was diagnosed in 415 (10.8 %) patients. Cefazolin was used as AMP in 780 (49 %) operations, whereas broad-spectrum antibiotics were used in the remaining operations. AMP was administered for >24 h in 69 and 64 % of the GS patients. The most significant risk factors for SSI after GS were total parenteral nutrition, transfusion, and a drainage catheter. The most common pathogen was Escherichia coli, but all the isolated pathogens were multiresistant.

Conclusion

AMP is effective for reducing the risk of SSI; however, the prolonged use of AMP and broad-spectrum antibiotics may be associated with the emergence of resistant bacterial strains.

Keywords

Surgery Antimicrobial prophylaxis Duration Multidrug resistant Infection Acinetobacter spp 

Notes

Acknowledgments

We thank the Editing Office of Erciyes University for suggestions about English usage.

Conflict of interest

No competing financial interests exist.

References

  1. 1.
    Weber WP, Zwahlen M, Reck S, Feder-Mengus C, Misteli H, Rosenthal R, et al. Economic burden of surgical site infections at a European University Hospital. Infect Control Hosp Epidemiol. 2008;29:623–9.PubMedCrossRefGoogle Scholar
  2. 2.
    Allegranzi B, Bagheri Nejad S, Combescure C, Graafmans W, Atter H, Donaldson L, et al. Burden of endemic health-care-associated infection in developing countries: systematic review and meta-analysis. Lancet. 2011;377(9761):228–41.PubMedCrossRefGoogle Scholar
  3. 3.
    Bratzler DW, Houck PM, for the Surgical Infection Prevention Guideline Writers Workgroup. Antimicrobial prophylaxis for surgery: an advisory statement from the National Surgical Infection Prevention Project. Clin Infect Dis. 2004;38:1706–15.PubMedCrossRefGoogle Scholar
  4. 4.
    Mangram AJ, Horan TC, Pearson ML, Silver LC, Jarvis WR. Guideline for prevention of surgical site infection, 1999. Infect Control Hosp Epidemiol. 1999;20:250–78.PubMedCrossRefGoogle Scholar
  5. 5.
    Talbot TR. Surgical site infections and antimicrobial prohylaxis. In: Mandell GL, Bennett JE, Dolin R, editors. Principles and practice of infectious diseases. United States: Churchill Livingstone Elsevier; 2010. p. 3891–904.Google Scholar
  6. 6.
    Horan TC, Andrus M, Dudeck MA. CDC/NHSN surveillance definition of health care-associated infection and criteria for specific types of infections in the acute care setting. Am J Infect Control. 2008;36:309–32.PubMedCrossRefGoogle Scholar
  7. 7.
    Edwards JR, Peterson KD, Mu Y, Banerjee S, Allen-Bridson K, Morrell G, et al. National Healthcare Safety Network (NHSN) report: data summary for 2006 through 2008, issued December 2009. Am J Infect Control. 2009;37:783–805.PubMedCrossRefGoogle Scholar
  8. 8.
    Brandt C, Sohr D, Behnke M, Daschner F, Rüden H, Gastmeier P. Reduction of surgical site infection rates associated with active surveillance. Infect Contr Hosp Epidemiol. 2006;27:1347–51.CrossRefGoogle Scholar
  9. 9.
    Eriksen HM, Chugulu S, Kondo S, Lingaas E. Surgical-site infections at Kilimanjaro Christian Medical Center. J Hosp Infect. 2003;55:14–20.PubMedCrossRefGoogle Scholar
  10. 10.
    Fehr J, Hatz C, Soka I, Kibatala P, Urassa H, Smith T, et al. Risk factors for surgical site infection in a Tanzanian Disrict Hospital: a challenge for the traditional national nosocomial infections surveillance system index. Infect Control Hosp Epidemiol. 2006;27:1401–4.PubMedCrossRefGoogle Scholar
  11. 11.
    Raza MW, Kazi BM, Mustafa M, Gould FK. Developing countries have their own characteristic problems with infection control. J Hosp Infect. 2004;57:294–9.PubMedCrossRefGoogle Scholar
  12. 12.
    Hambraeus A. Lowbury Lecture 2005: infection control from a global perspective. J Hosp Infect. 2006;64:217–23.PubMedCrossRefGoogle Scholar
  13. 13.
    Alexander JW, Solomkin JS, Edwards MJ. Updated recommendations for control of surgical site infections. Ann Surg. 2011;253:1082–93.PubMedCrossRefGoogle Scholar
  14. 14.
    Campbell DA, Henderson WG, Englesbe MJ, Hall BL, O’Reily M, Bratzler D, et al. Surgical site infection prevention: the importance of operative duration and blood transfusion-rates of the first American College of Surgeons-national surgical quality improvement program best practices initiative. J Am Coll Surg. 2008;207:810–20.PubMedCrossRefGoogle Scholar
  15. 15.
    Talbot TR, D’Agata EMC, Brinsko V, Lee B, Speroff T, Schaffner W. Perioperative blood transfusion is predictive of poststernotomy surgical site infection: marker for morbidity or true immunosuppressant? Clin Infect Dis. 2004;38:1378–82.PubMedCrossRefGoogle Scholar
  16. 16.
    Tesfahuengn Z, Asrat D, Woldeamanuel Y, Estifanos K. Bacteriology of surgical site and catheter related urinary tract infectionsamong patients admitted in Mekelle Hospital, Mekelle, Tigray, Ethiopia. Ethiop Med J. 2009;47:117–27.Google Scholar
  17. 17.
    Kobayashi M, Takesue Y, Kitagawa Y, Kusunoki M, Sumiyama Y. Antimicrobial prophylaxis and colon preparation for colorectal surgery: results of a questionnaire survey of 721 certified institutions in Japan. Surg Today. 2011;41:1363–9.PubMedCrossRefGoogle Scholar
  18. 18.
    Prospero E, Barbadoro P, Marigliano A, Martini E, D’Errico MM. Perioperative antibiotic prophylaxis: improved compliance and impact on infection rates. Epidemiol Infect. 2011;139:1326–31.PubMedCrossRefGoogle Scholar
  19. 19.
    McHugh SM, Hill ADK, Humphreys H. Intraoperative technique as a factor in the prevention of surgical site infection. J Hosp Infect. 2011;78:1–4.PubMedCrossRefGoogle Scholar

Copyright information

© Springer Japan 2013

Authors and Affiliations

  • Emine Alp
    • 1
    • 2
    Email author
  • Ferhan Elmali
    • 3
  • Safiye Ersoy
    • 2
  • Can Kucuk
    • 4
  • Mehmet Doganay
    • 1
  1. 1.Department of Infectious Diseases and Clinical Microbiology, Infection Control Committee, Faculty of MedicineErciyes UniversityKayseriTurkey
  2. 2.Infection Control Committee, Faculty of MedicineErciyes UniversityKayseriTurkey
  3. 3.Department of Biostatistics, Faculty of MedicineErciyes UniversityKayseriTurkey
  4. 4.Department of General Surgery, Faculty of MedicineErciyes UniversityKayseriTurkey

Personalised recommendations