Srivastav Sharad, Khurana Surbhi, Mukhopadhyay Chiranjay, Myatra Sheila N, Katyal Sonal, Katoch Omika, Mittal Samarth, Trikha Vivek, Sharma Vijay, Farooque Kamran, Kumar Subodh, Sagar Sushma, Gupta Amit, Bhat Shyamasunder N, S S Prasad, Divatia Jigeeshu Vasishtha, Puri Ajay, Nayak Prakash, Gulia Ashish, Deshmukh Anuja, Thiagarajan Shivakumar, Biswas Sanjay, Walia Kamini, Malhotra Rajesh, Mathur Purva
Department of Laboratory Medicine, Jai Prakash Narayan Apex Trauma Center, All India Institute of Medical Sciences, New Delhi, India.
Department of Microbiology, Kasturba Medical College, Manipal Academy of Higher Education, Manipal, Karnataka, India.
Indian J Med Res. 2024 Nov;160(5):428-437. doi: 10.25259/IJMR_369_2024.
Background & objectives Surgical site infections (SSIs) are among the most prevalent healthcare-associated infections (HCAIs). They cause significant morbidity, leading to excess health expenditures and increased length of hospital stay. Despite a high population burden, data on post-discharge SSIs is lacking from low-and middle-income countries (LMICs). There is no existing surveillance system of SSIs in India that covers the post-discharge period. Therefore, we proposed a multicentric analysis to estimate the proportion and identify the risk factors associated with SSIs occurring during hospital stay and after discharge. Methods SSI Surveillance was conducted in three hospitals in different parts of India according to the Centers for Disease Control and Prevention (CDC) guidelines (30 days-6 months). An indigenous database was developed for data entry and analysis. Logistic regression analysis was performed to test for an association between SSI and potential risk factors. Results A total of 161 out of 3090 patients acquired SSI, resulting in a 5.2 per cent SSI incidence. Debridement surgery, which was carried out with either an amputation, open reduction internal fixation surgery (ORIF), or closed reduction internal fixation (CRIF) surgery, had the highest SSI rate (54.2%). Clean, polluted wound class and surgeries lasting longer than 120 minutes were substantially linked to an increased risk of SSI. Interpretation & conclusions Post-discharge surveillance helped with the detection of 66 per cent of SSI cases. Combination surgeries were seen to increase the risk of SSIs in patients.
背景与目的 手术部位感染（SSIs）是最常见的医疗相关感染（HCAIs）之一。它们会导致严重的发病情况，造成额外的医疗支出并延长住院时间。尽管人口负担沉重，但低收入和中等收入国家（LMICs）缺乏出院后手术部位感染的数据。印度目前没有涵盖出院后时期的手术部位感染监测系统。因此，我们提出进行一项多中心分析，以估计住院期间和出院后发生的手术部位感染的比例，并确定与之相关的风险因素。方法 根据美国疾病控制与预防中心（CDC）指南（30天至6个月），在印度不同地区的三家医院开展手术部位感染监测。开发了一个本地数据库用于数据录入和分析。进行逻辑回归分析以检验手术部位感染与潜在风险因素之间的关联。结果 3090名患者中共有161人发生了手术部位感染，手术部位感染发生率为5.2%。清创手术，即与截肢、切开复位内固定手术（ORIF）或闭合复位内固定（CRIF）手术同时进行的手术，手术部位感染率最高（54.2%）。清洁-污染伤口类别以及持续时间超过120分钟的手术与手术部位感染风险增加显著相关。解读与结论 出院后监测有助于发现66%的手术部位感染病例。联合手术被认为会增加患者发生手术部位感染的风险。
