Dinda Victor, Gunturu Revathi, Kariuki Sam, Hakeem Abdi, Raja Asad, Kimang'a Andrew
Department of Medical laboratory science, School of Health sciences, Masinde Muliro University of Science and Technology.
Ethiop J Health Sci. 2013 Jul;23(2):141-9.
In low income countries, surgical site infections (SSIs) are costly and impose a heavy and potentially preventable burden on both patients and healthcare providers. This study aimed to determine the occurrence of SSI, pathogens associated with SSI, the antibiogram of the causative pathogens and specific risk factors associated with SSI at the hospital.
Two hundred and sixty-eight respondents admitted for general surgical procedures (other than neurological and cardiothoracic surgeries) at the Aga Khan University Hospital were eligible to take part in the study. Post-surgery patients were observed for symptoms of infection. Follow ups were done through the consulting clinics, breast clinic and casualty dressing clinic by a team of surgeons. In cases of infection, pus swabs were collected for culture.
SSI incidence rate was 7.0%, pathogens isolated from SSI included gram negative enteric bacilli and S. aureus which was the most prevalent bacterial isolate. Only one isolate of MRSA was found and all staphylococci were susceptible to Vancomycin. Preoperative stay ≥ 2 days and wound class were the risk factors associated with SSI.
The SSI incidence rates (7.0%) observed in this study were relatively lower than the ones documented in other studies in Kenya. S. aureus is the most prevalent pathogen associated with SSI. Similar to findings from other studies done in the region; prolonged hospital stay and dirty wounds were the risks associated with postsurgical sepsis at the hospital.
在低收入国家,手术部位感染(SSIs)成本高昂,给患者和医疗服务提供者带来沉重且可能可预防的负担。本研究旨在确定该医院手术部位感染的发生率、与手术部位感染相关的病原体、致病病原体的抗菌谱以及与手术部位感染相关的特定风险因素。
在阿迦汗大学医院接受普通外科手术(不包括神经外科和心胸外科手术)的268名受访者有资格参与本研究。对术后患者进行感染症状观察。由一组外科医生通过咨询门诊、乳腺门诊和急诊换药门诊进行随访。对于感染病例,采集脓液拭子进行培养。
手术部位感染发生率为7.0%,从手术部位感染中分离出的病原体包括革兰氏阴性肠道杆菌和金黄色葡萄球菌,金黄色葡萄球菌是最常见的细菌分离株。仅发现1株耐甲氧西林金黄色葡萄球菌(MRSA),所有葡萄球菌对万古霉素敏感。术前住院时间≥2天和伤口类别是与手术部位感染相关的风险因素。
本研究观察到的手术部位感染发生率(7.0%)相对低于肯尼亚其他研究记录的发生率。金黄色葡萄球菌是与手术部位感染相关的最常见病原体。与该地区其他研究结果相似;延长住院时间和伤口污染是该医院术后败血症的相关风险因素。