Surgical site infection in abdominal surgery: a prospective Kenyatta National hospital study.

SUMMARY

A Six- month prospective surveillance study of surgical site infections (SSI), an indicator of healthcare quality, was conducted at the department of general surgery at Kenyatta National Hospital. Surgical Site Infections were classified according to American Centre for Disease Control (CDC) criteria and identified by active bedside surveillance and post discharge follow up.

This study showed that the overall SSI rates in abdominal surgery was 22.4%. Of these, 25 % were superficial SSI’s, 37.5% deep incisional and 37.5 % Organ or space. The mean time to diagnose SSI was 7 days postoperatively. Emergency operations had higher infection rates of 75 % compared to elective procedures 25%.

Staphylococcus aureus has the highest incidence of SSI , 44.4% followed by E. coli, 17.5%.

About 50 % of organisms cultured are single colonies while the rest are mixed colonies, usually two pathogens.

No protocol of antibiotic prophylaxis was observed in emergency procedures and indiscriminate use of these was observed in the postoperative period.

The use of cephalosporins as antimicrobial prophylaxis is relatively low due to hospital restriction policy where as the resistance patterns to the commonly used antibiotics, penicillin and aminoglycoside (gentamicin) is fairly high. There’s a need for Senior House Officers to prescribe prophylactic antibiotics in the preoperative period considering that the bulk of the general surgical operations are in abdominal surgery.

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