Perception and Role of Indirect and Post-Discharge Surveillance in Predicting Surgical Site Infection in Surgical Patients: An Institutional Experience.

Background: Surgical site infection (SSI) surveillance is a process of observing and reporting of infections following surgery. SSI surveillance studies are few in our country.

Objectives: Present study was conducted to know the perception and role of SSI surveillance. Incidence of surgical site infection, identification of risk factors and bacterial spectrum of surgical wounds during surveillance were also studied.

Methods: Patients who underwent a surgical procedure between July 2022 and June 2023 at our hospital were included. A prospective incidence surveillance for SSI was done to look for any signs of infection and record them in the surveillance form. Wound swabs or pus aspirates were sent for microbiological culture.

Results: A total of 2312 patients underwent surgery during the study period, of whom 61 patients were diagnosed with SSI. The incidence of SSI was 2.6%. SSI was encountered more in female patients (57.3%). Age distribution had a significant association with SSI (P = 0.025). Most operative wounds were clean-contaminated (45.9%). Most SSIs were superficial (91.8%), followed by deep (8.2%). Most patients who developed SSI had a National Nosocomial Infection Surveillance (NNIS) patient risk index of 2 (45.9%). Bacterial growth was observed in 45.9% of cases. Multidrug resistance (MDR) among these isolates was 42.6%.

Conclusion: This study helped to determine predictors of SSI like duration of surgery, type of wound, duration of hospital stays, and NNIS risk index. MDR isolates are now contributing to SSI. The perception of healthcare workers about SSI surveillance was that it was feasible to use and practice. Surveillance helped clinicians to strengthen the existing infection prevention and control practices for the future.