Background: Surgical site infections (SSIs) are
considered as result of the healthcare quality in hospitals. Objective: to
study SSI at Saint Jean de Dieu Hospital Tanguieta (SJDHT), prior to the
implementation of a permanent monitoring system. Method: transversal, and
descriptive study with prospective data collection was performed from 1 July to
31janvier 2017 in the department of general surgery of SJDHT. The hospital
lacks in a microbiology unit. All patients who underwent surgery during this
period were included and the monitoring lasted one month. SSIs diagnostic was
carried out according to WHO criteria as described in the Practical Guide for
the Prevention of Nosocomial Infections published in 2002. Statistical tests (χ-square and Student’s t-test) were
applied and p<0.05 were statistically significant. Results: Of 343 patients recorded,
105 (30.6%) had SSI. Their age averaged 40.3 years and the sex-ratio
(men/women) was 2.8. The emergency surgery resulted in a 50.0% rate of SSI (p =
0.00). The SSI rate for clean and clean-contaminated surgery was 6.3% against
94.6% for infected surgery (p = 0.00). The SSI rates were 100% and 66.7% for
NNISS = 2 and NNISS = 1 (p = 0.00), respectively. Superficial SSI rate was
13.3%, while deep SSI and organ/space SSI were 46.7% and 40%, respectively. The
hospital stay of patients with SSI was three times longer than the length of
patients without SSI (p = 0.00). Conclusion: SSIs are real burden at SJDHT. Appropriate
measures must be adopted to reduce its prevalence.
References
[1]
Walter, P.W., Marcel, Z., Stefan, R., et al. (2008) Economic Burden of Surgical Site Infections at a European University Hospital. Infection Control & Hospital Epidemiology, 29, 623-629.
[2]
Satyanarayana, V., Prashanth, H.V., Basavaraj, B. and Kavyashree, A.N. (2011) Study of Surgical Site Infections in Abdominal Surgeries. Journal of Clinical and Diagnostic Research, 29, 935-939.
[3]
Aiken, A.M., Wanyoro, A.K., Mwangi, J., et al. (2013) Evaluation of Surveillance for Surgical Site Infections in Thika Hospital, Kenya. Journal of Hospital Infection, 83, 140-145. https://doi.org/10.1016/j.jhin.2012.11.003
[4]
Allegranzi, B., Bagheri Nejad, S., Combescure, C., et al. (2011) Burden of Endemic Health-Care-Associated Infection in Developing Countries: Systematic Review and Meta-Analysis. The Lancet, 377, 228-241. https://doi.org/10.1016/S0140-6736(10)61458-4
[5]
Bagheri Nejad, S., Allegranzi, B., Syed, S.B., et al. (2011) Health-Care-Associated Infection in Africa: A Systematic Review. Bulletin of the World Health Organization, 89, 757-765. https://doi.org/10.2471/BLT.11.088179
[6]
Monahan, M., Jowett, S., Pinkney, T., et al. (2020) Surgical Site Infection and Cost in Low- and Middle-Income Countries: A Systematic Review of Economic Burden. PLOS ONE, 15, e0232960. https://doi.org/10.1371/journal.pone.0232960
[7]
Hodonou, M.A., Allodé, S.A., Tobome, S.R., Hounkponou, A.F., et al. (2017) Epidemiological Aspects of Surgical Site Infections in an Income Country: The Case of Regional Hospital Center, Borgou (Benin). International Journal of Medical Research and Health Sciences, 6, 29-33.
[8]
Horan, T.C. andrus, M. and Dudeck, M.A. (2008) CDC/NHSN Surveillance Definition of Healthcare-Associated Infection and Criteria for Specific Types of Infections in the Acute Care Setting. American Journal of Infection Control, 36, 309-332. https://doi.org/10.1016/j.ajic.2008.03.002
[9]
Altemeier, W.A., Burke, J.F., Puitt, B.A. and Sandusky, W.R. (1984) Manual on Control of Infection in Surgical Patients. 2rd Edition, JB Lippincott, Philadelphia, 29 p.
[10]
Culver, D.H., Horan, T.C., Gaynes, R.P., et al. (1991) Surgical Wound Infection Rates by Wound Class, Operative Procedure, and Patient Risk Index. The American Journal of Medicine, 91, S152-S157. https://doi.org/10.1016/0002-9343(91)90361-Z
[11]
World Health Organization (2008) Prévention des infections nosocomiales: guide pratique. 2nd. ed., Organisationmondiale de la Santé. https://apps.who.int/iris/handle/10665/69751
[12]
Horan, T.C., Gaynes, R.P., Martone, W.J., et al. (1992) CDC Definitions of Nosocomial Surgical Site Infections, 1992: A Modification of CDC Definitions of Surgical Wound Infections. Infection Control & Hospital Epidemiology, 13, 606-608. https://doi.org/10.2307/30148464
[13]
NIHR Global Research Health Unit on Global Surgery (2021) Reducing Surgical Site Infection in Low-Income and Middle-Income Countries (FALCON): A Pragmatic, Multicentre, Stratified, Randomized Controlled Trial. The Lancet, 398, 1687-1699.
[14]
Umesh, S.K., Fereirra, A.M.A., Kulkarni, M.S. and Motghare, D.D. (2008) A Prospective Study of Surgical Site Infections in a Teaching Hospital in Goa. Indian Journal of Surgery, 70, 120-124. https://doi.org/10.1007/s12262-008-0031-y
[15]
Hernandez, K., Elizabeth, R., Carlos, S., et al. (2005) Incidence of and Risk Factors for Surgical-Site Infections in a Peruvian Hospital. Infection Control & Hospital Epidemiology, 26, 473-477. https://doi.org/10.1086/502570
[16]
Surveillance des infections du site opératoire dans les établissements de santéfrançais. Résultats 2016. Saint-Maurice (Fra) :Santépublique France, février 2018, 223 p. https://www.invs.santepubliquefrance.fr/
[17]
van der Kooi, T.I., Manniën, J., Wille, J.C. and van Benthem, B.H.B. (2010) Prevalence of Nosocomiol Infections in the Netherlands, 2007-2008: Results of the First Four National Studies. Journal of Hospital Infection, 75, 168-172. https://doi.org/10.1016/j.jhin.2009.11.020
[18]
Oni, A.A., Ewete, A.F., Gbadja, A.T., et al. (2006) Nosocomial Infections: Surgical Site Infection in UCH Ibadan (Nigeria). Nigerian Journal of Surgical Research, 8, 19-23. https://doi.org/10.4314/njsr.v8i1.54850
[19]
Akoko, L.O., Mwanga, A.H., Fredrick, F. and Mbambati, N.M. (2012) Risk Factors of Surgical Site Infection at Muhimbili National Hospital, Dar es Salaam, Tanzania. East and Central African Journal of Surgery, 17, 12-17.
[20]
Rosenthal, R., Weber, P., Marti, W.R., et al. (2010) Surveillance of Surgical Site Infection by Surgeons: Biaised Underreporting or Useful Epidemiological Data? Journal of Hospital Infection, 75, 178-182. https://doi.org/10.1016/j.jhin.2009.10.028
[21]
Hodonou, M.A., Hounkponou, F., Allodé, S.A., Tobome, S.R., et al. (2016) Aspects Bactériologiques des Inections du site opératoire au Centre Hospitalier Départemental du Borgou à Parakou (Bénin). European Scientific Journal, 12, 353-360. https://doi.org/10.19044/esj.2016.v12n9p353
