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埃塞俄比亚东部哈勒尔市哈勒里地区公立医院术后患者手术部位感染的严重程度、细菌病因、相关因素及分离株的药敏模式

Magnitude of Surgical Site Infections, Bacterial Etiologies, Associated Factors and Antimicrobial Susceptibility Patterns of Isolates Among Post-Operative Patients in Harari Region Public Hospitals, Harar, Eastern Ethiopia.

作者信息

Shakir Anwar, Abate Degu, Tebeje Fikru, Weledegebreal Fitsum

机构信息

Department of Medical Laboratory Sciences, Jugal Regional Hospital, Harar, Ethiopia.

Department of Medical Laboratory Sciences, College of Health and Medical Science, Haramaya University, Harar, Ethiopia.

出版信息

Infect Drug Resist. 2021 Nov 5;14:4629-4639. doi: 10.2147/IDR.S329721. eCollection 2021.

Abstract

BACKGROUND

Surgical site infections (SSIs) are infections that occur one month after a surgical operation or one year after implant surgery and a surgical procedure, either at the injury site or near the injury site. Surgical site infections are still a major global problem, especially in developing countries, where they cause increased morbidity and mortality. There is a dearth of information regarding SSIs in the eastern Ethiopia, particularly in this study area.

OBJECTIVE

This study aimed to assess the prevalence of SSIs, bacterial etiologies, associated factors, and antimicrobial susceptibility patterns of isolates among post-operated patients admitted to public hospitals in the Harari Region, eastern Ethiopia.

METHODS

A cross-sectional study was conducted among 306 patients who had undergone surgery. A pre-tested structured questionnaire was used for assessing the sociodemographic and clinical factors. Following standard microbiological techniques, wound swabs and pus specimens were collected and transported to Harar Health Research and Regional Laboratory for isolation, identification of bacteria, and antibiotic susceptibility test. Data were double entered onto Epi Data version 3.5.1 software and transferred to Statistical Package for the Social Sciences version 20.0 for analysis. P-value < 0.05 was declared as statistical significant.

RESULTS

In this study, the overall prevalence of surgical site infection was 11.8% (95% CI: 8.3-15.4%) and (30.3%) was the most frequent isolate. Both and coagulase negative Staphylococci were 100% resistant to penicillin. Wound with drain (AOR = 24.538; 95% CI: 10.053-59.898), being diabetic patient (AOR = 7.457, 95% CI 2.893-19.221), age >60 years (AOR = 4.139, 95% CI 1.278-13.40), surgical procedure duration of more than 2 hours (AOR = 0.159, 95% CI 0.040, 0.630), being alcohol drinker (AOR = 2.58, 95% CI 1.091-6.102) and having dirty surgical wound (AOR = 9.026; 95% CI: 3.503-23.255) were factors significantly associated with SSIs.

CONCLUSION

In this study, single and multiple drug resistance to the commonly used antibiotics was high. Therefore, intensifying the implementation of infection prevention and patient safety measures and identifying an etiological cause may minimize the burden.

摘要

背景

手术部位感染(SSIs)是指在外科手术一个月后或植入手术及外科手术后一年内,在伤口部位或伤口附近发生的感染。手术部位感染仍是一个重大的全球性问题,尤其是在发展中国家,它们会导致发病率和死亡率上升。在埃塞俄比亚东部,特别是在本研究区域,关于手术部位感染的信息匮乏。

目的

本研究旨在评估埃塞俄比亚东部哈拉里地区公立医院收治的术后患者中手术部位感染的患病率、细菌病因、相关因素以及分离菌株的抗菌药敏模式。

方法

对306例接受过手术的患者进行了横断面研究。使用预先测试的结构化问卷评估社会人口统计学和临床因素。按照标准微生物技术,采集伤口拭子和脓液标本,并送至哈拉尔健康研究与区域实验室进行细菌分离、鉴定和药敏试验。数据双录入Epi Data 3.5.1软件,并转移至社会科学统计软件包20.0进行分析。P值<0.05被视为具有统计学意义。

结果

在本研究中,手术部位感染的总体患病率为11.8%(95%CI:8.3 - 15.4%),[具体细菌名称](30.3%)是最常见的分离菌株。[具体细菌名称]和凝固酶阴性葡萄球菌对青霉素的耐药率均为100%。有引流管的伤口(调整后比值比[AOR]=24.538;95%CI:10.053 - 59.898)、糖尿病患者(AOR = 7.457,95%CI 2.893 - 19.221)、年龄>60岁(AOR = 4.139,95%CI 1.278 - 13.40)、手术时间超过2小时(AOR = 0.159, 95%CI 0.040, 0.630)、饮酒者(AOR = 2.58,95%CI 1.091 - 6.102)以及手术伤口污染(AOR = 9.026;95%CI:3.503 - 23.255)是与手术部位感染显著相关的因素。

结论

在本研究中,对常用抗生素的单药和多药耐药性较高。因此,加强感染预防和患者安全措施的实施并确定病因可能会减轻负担。

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