Microbiology of Incisional Surgical Site Infection

Journal of Surgical Sciences Pub Date : 2019-10-27 DOI:10.3329/jss.v17i1.43699

Krisna Rani Majumder, S. Mubin, Md Ibrahim Siddique, M Nur E Elahi

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引用次数: 1

Abstract

Background: Bacteria responsible for causing lncisional Surgical Site Infection (ISSI) along with their resistance pattern changes over time due to various factors and are a matter of regular scrutiny. Proper understanding of this will help both surgeon and microbiologist to formulate an effective guideline to combat overall SSI. Objectives: To evaluate responsible microorganisms and their resistance pattern causing ISSI following elective gastrointestinal surgery in our perspective. Methods: Prospective data were collected on 1122 surgical patients admitted in the surgery department in BSMMU from January 201 O to June 2012 having elective gastrointestinal surgery. Patients operated were followed in the post operative period till discharge and if any ISSI noted, swab from the site of infection was sent for culture and sensitivity reporting using standard bacteriological techniques. Antibiotics were given accordingly. Results: In this series 1122 wounds were studied of which183(16.31%) cases had ISSI.Wound infection rates, according to clinical wound types were 10.45%, 14.49%, 49% for clean-contaminated,contaminated and dirty wounds respectively. The figures of ISSI according to SSI types were 76.77% for Superficial SSI and 26.23% for Deep SSI.The figures of ISSI according to SSI types were 76.77% for Superficial SSI and 26.23% for Deep SSI. Causative microorganisms were revealed in 74.87% positive cultures. 5.8% wounds had polymicrobial etiology. The common causative organisms were Escherichia coli 55.5%,Staphylococcus aureus 22.6%, Pseudomonas spp. 9.5% and Klebsiella spp. 6.6%.AII were 100% sensitive to Meropenem. Next to this Escherichia coli and Klebsiellaspp. were mostly sensitive to Ceftriaxone 62.5% and 100% respectively, Staphylococcus aureus to Doxicycline 75% and Pseudomonas spp. to Ceftazidime 93.7%. Comparison with previously done national and international studies revealed alarming increase in resistance pattern of causative bacterial isolates. Conclusion: To date no national or in house SSI prevention policy or surveillance guideline exists. Lack of our attention in this issue along with inept, irrational use of antibiotics is definitely adding causative organisms to gain increasing resistance pattern. Before surgical care centers are overwhelmed with SSls by resistant organisms caution must be taken from all level. Journal of Surgical Sciences (2013) Vol. 17 (1) : 18-24

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切口手术部位感染的微生物学研究

背景:引起切口手术部位感染(ISSI)的细菌及其耐药模式随着时间的推移而变化，由于各种因素，这是一个定期审查的问题。正确理解这一点将有助于外科医生和微生物学家制定有效的指导方针，以对抗整体SSI。目的:从我们的角度评估选择性胃肠手术后ISSI的致病微生物及其耐药模式。方法:收集2011年1月至2012年6月在BSMMU外科收治的1122例择期胃肠手术患者的前瞻性资料。术后随访患者至出院，如果发现任何ISSI，则使用标准细菌学技术从感染部位取拭子进行培养和敏感性报告。因此给予抗生素。结果:本组共研究伤口1122例，其中183例(16.31%)为内伤。按临床创面类型划分，清洁、污染、脏创面感染率分别为10.45%、14.49%、49%。按SSI类型划分，浅表SSI占76.77%，深层SSI占26.23%。按SSI类型划分，浅表SSI占76.77%，深层SSI占26.23%。阳性培养物检出病原菌74.87%。5.8%的伤口有多微生物病因。常见病原菌为大肠杆菌55.5%、金黄色葡萄球菌22.6%、假单胞菌9.5%、克雷伯氏菌6.6%。所有患者对美罗培南均100%敏感。接下来是大肠杆菌和克雷伯氏杆菌。其中对头孢曲松最敏感的分别为62.5%和100%，金黄色葡萄球菌对多西环素最敏感75%，假单胞菌对头孢他啶最敏感93.7%。与先前进行的国家和国际研究比较显示，致病细菌分离株的耐药模式惊人地增加。结论:到目前为止，没有国家或国内的SSI预防政策或监测指南。我们对这个问题缺乏关注，加上抗生素的不合理使用，肯定会增加致病微生物，从而获得越来越多的耐药性。在外科护理中心被耐药生物淹没之前，必须从各个层面采取谨慎措施。外科杂志(2013)Vol. 17 (1): 18-24

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Journal of Surgical Sciences

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审稿时长

6 weeks