Abstract

Background: Surgical site infection is one of the major predictive factors for morbidity and mortality. The advancement in the asepsis and antibiotic protocols may have reduced its incidences in the developed countries, but it still remains a condition needing close attention by the treating surgeon in avoiding an undesirable catastrophe. Methods: A cross-sectional prospective study was conducted on all the patients who underwent major surgical procedures during the period between Jan 2010 and Dec 2010. Pre-operative factors, intraoperative and post operative variables were collected. Culture specimens from the infected surgical wounds were tested for type of growth and susceptibility testing was done using disc diffusion technique. Results: A total of 638 patients underwent major surgical procedures during the above mentioned study period. Surgical site infection was detected in 91 (14%) patients. Out of these patients, 83 (91%) and 8(9%) had superficial and deep surgical site infection respectively. Staphylococcus aureus was the predominant organism in 31cases (28.5%); of which 8 (25%) were Methicillin Resistant Staphylococcus aureus. This was followed by Escherichia coli (17.8%), Pseudomonas (16%) and Klebsiella (14.2%). Among the Escherichia coli and Klebsiella pneumoniae isolates, 30% and 37.5% were Extended Spectrum Beta Lactamases producers respectively. Presence of co-morbid illness, use of iodine alone on skin during preparation of parts, duration of surgery ≥ 3 hours and cigarette smoking were significant factors for prediction of surgical site infection. Conclusion: Surgical site infection is common among patients admitted in surgical wards, with comorbid illness, use of drain, iodine alone in skin preparation, prolonged duration of the operation and cigarette smoking. Prevention strategies focused on factors associated with SSI are necessary in order to reduce the rate of SSI in our setting.