Nosocomial infections: surgical site infection in UCH Ibadan, Nigeria

Surgical wound infection is a good index of Hospital Acquired Infection (HAI). The programme of Surveillance of HAI in University College Hospital (UCH), Ibadan, Nigeria, started in January 1976. The last audit of the programme reported the situation between January 1989 and December 1991, whence the prevalence of HAI was found to be 4.9%. The programme of Surveillance of HAI from year 1995 to 2004 was audited. All wound swabs/biopsies sent for microscopy, culture and sensitivity were analysed. Previous incidence of nosocomial Infection in the environment was obtained from literature. The prevalence of HAI was 3.0%, Surgical Site Infection was the second most prevalent HAI. Surgical Site Infection was responsible for 27.9% of the nosocomial infections recorded. The ratio of Gram Positive to Gram Negative organisms was 1:2.3. Bacterial agents of Surgical Site Infection were Staphylococcus aureus 29.0%, Klebsiella spp 25.3%, Pseudomonas spp 21.7%, Proteus spp 11.7% E. coli 11.3%, Streptococcus pyogenes 0.6% and Enterococcus faecalis 0.3%. A decrease from 4.9% to 3.0% in prevalence rate of HAI was observed, compared with the earlier review as a result of refresher courses in Controls of Hospital Infections. To reduce the menace of Surgical Site Infections, prophylactic antibiotic with short courses of quinolone is advocated as well as adequate wound surveillance and Hospital Workers’ medical care.