Aslam Mehran, Raza Muhammad Nabeel, Hurera Abu, Iqbal Areeba, Ilyas Firdous, Irum Tamseela
Department of Emerging Allied Health Sciences, Superior University, Lahore, PAK.
Department of Emerging Allied Health Technology, Superior University, Lahore, PAK.
Cureus. 2025 Jun 6;17(6):e85451. doi: 10.7759/cureus.85451. eCollection 2025 Jun.
Methicillin-resistant (MRSA) significantly contributes to surgical site infections (SSIs) in Pakistan, with high prevalence rates among isolates, leading to increased morbidity and healthcare costs.
This study assessed the effectiveness of infection control strategies in reducing MRSA-related SSIs in Pakistani healthcare facilities, identified implementation barriers, and proposed context-specific recommendations.
A mixed-methods study, conducted from January to March 2025, surveyed 100 healthcare professionals (32% surgeons, 28% nurses, and 18% infection control specialists) across public, private, and rural hospitals in all Pakistani provinces. Quantitative data from a structured questionnaire were analyzed using chi-square tests and logistic regression, while qualitative responses were thematically analyzed using Braun and Clarke's framework.
Quantitatively, only 8% of facilities screened all surgical patients for MRSA, with 46% performing no screening, and 38% achieved 51-70% hand hygiene compliance, correlating with higher MRSA-SSI rates (odds ratio = 3.42, p < 0.001). Qualitatively, key themes included resource scarcity (e.g., "We often share a single dispenser"), staff resistance, and systemic inefficiencies.
Strengthening hand hygiene, selective MRSA screening, and surgical bundles, alongside improved training and resource allocation, can reduce MRSA-SSIs in Pakistan. Tailoring global guidelines to local constraints is essential for effective implementation. These findings guide strategies to enhance surgical safety in resource-limited settings.
耐甲氧西林金黄色葡萄球菌（MRSA）是巴基斯坦手术部位感染（SSIs）的重要病因，其分离株的流行率很高，导致发病率增加和医疗成本上升。
本研究评估了感染控制策略在降低巴基斯坦医疗机构中与MRSA相关的SSIs方面的有效性，确定了实施障碍，并提出了针对具体情况的建议。
一项混合方法研究于2025年1月至3月进行，调查了巴基斯坦所有省份公立、私立和农村医院的100名医疗专业人员（32%为外科医生，28%为护士，18%为感染控制专家）。使用卡方检验和逻辑回归分析来自结构化问卷的定量数据，同时使用布劳恩和克拉克的框架对定性回答进行主题分析。
从数量上看，只有8%的机构对所有手术患者进行了MRSA筛查，46%的机构未进行筛查，38%的机构手部卫生依从率达到51%-70%，这与较高的MRSA-SSI率相关（优势比=3.42，p<0.001）。从质量上看，关键主题包括资源稀缺（如“我们经常共用一个分配器”）、工作人员抵制和系统效率低下。
加强手部卫生、选择性MRSA筛查和手术综合措施，同时改进培训和资源分配，可以降低巴基斯坦的MRSA-SSIs。根据当地限制调整全球指南对于有效实施至关重要。这些发现为在资源有限的环境中提高手术安全性的策略提供了指导。
