SURGICAL SITE INFECTION RELATED RISK FACTORS AND USAGE OF ANTIBIOTICS IN TWO DIFFERENT TERTIARY CARE HOSPITALS OF DHAKA CITY, BANGLADESH

  • Forhad Monjur Department of Clinical Pathology, Institute of Child Health and Shishu Sasthya Foundation Hospital, 6/2, Barabagh, Mirpur-2, Dhaka-1216, Bangladesh.
  • Farhana Rizwan Department of Pharmaceutical Technology, Jadavpur University, Kolkata-32, India and Department of Pharmacy, East West University, Aftabnagar, Dhaka, Bangladesh.
  • Nobo Krishna Ghosh Department of Paediatric Medicine, Institute of Child Health and Shishu Sasthya Foundation Hospital, 6/2, Barabagh, Mirpur-2, Dhaka-1216, Bangladesh.

Abstract

Objective: Surgical site infection (SSI) is the most common complications following surgical procedures. The aim of the study was to assess the risk factors for SSI and the antibiotic treatment pattern following post-operative infection.

Methods: This retrospective study has been considered the data of 156 surgical patients from two tertiary care hospitals in Dhaka city of Bangladesh.

Result: The majority (31.4%) of the surgical patients came from the age group 40 to 49 years. A total of 8 SSI cases were discovered, 5 cases (8.9%) from Hospital-1, which was relatively higher (3%) than Hospital-2. Wound class contaminated†was found in 6 cases, and the ratio is almost 1:3 or 75%. The duration of surgery within 90–120 min for 50% of SSI patients (4/8). Most frequent types of surgery were colorectal surgery (56.4%, 88/156), followed by various grades of fistula (24.4%, 38/156). The prophylaxis antibiotic was ceftriaxone, used by 77 (49.4%) cases. Commonly used antibiotic was ciprofloxacin, administered in 33 (21.2%) patients as a single therapy. Third-generation cephalosporins (cefixime, ceftriaxone, and cefuroxime) were found at the drug of choice in combination with gentamicin/metronidazole/nitazoxanide or amikacin.

Conclusion: This study tried to give a little overview of SSI in different hospital settings, whereas improvement of preventive measures, early detection, and management of SSI is the main concern of nowadays. Further research should be done to get the detail by considering all the relevant factors of SSI.

Keywords: Surgical site infection, Prophylaxis antibiotics, Post-operative antibiotics.

Author Biographies

Forhad Monjur, Department of Clinical Pathology, Institute of Child Health and Shishu Sasthya Foundation Hospital, 6/2, Barabagh, Mirpur-2, Dhaka-1216, Bangladesh.

Dr. Forhad Monjur,

M.B.B.S.; D.C.P.; M.C.P.S.; M. PH.

Associate Professor and Head,

Department of Clinical Pathology,

Institute of Child Health and Shishu Sasthya Foundation Hospital,

6/2, Barabagh, Mirpur-2, Dhaka-1216, Bangladesh.

Phone: +88-02-8023894-5; +88-02-8061831, Mobile: +880-1978134520, Fax: +88-02-8617372.

Email: monjur_forhad@yahoo.com; forhadmojur@gmail.com.

Farhana Rizwan, Department of Pharmaceutical Technology, Jadavpur University, Kolkata-32, India and Department of Pharmacy, East West University, Aftabnagar, Dhaka, Bangladesh.

Farhana Rizwan,

B.PHARM, M.PHARM;

Ph. D Candidate, Department of Pharmaceutical Technology, Jadavpur University, Kolkata, India.

Assistant Professor, Department of Pharmacy, East West University, Aftabnagar, Dhaka, Bangladesh.

Nobo Krishna Ghosh, Department of Paediatric Medicine, Institute of Child Health and Shishu Sasthya Foundation Hospital, 6/2, Barabagh, Mirpur-2, Dhaka-1216, Bangladesh.

Dr. Nobo Krishna Ghosh

M.B.B.S.; D.C.H.; F.C.P.S.

Department of Paediatric Medicine, Institute of Child Health and Shishu Sasthya Foundation Hospital, 6/2, Barabagh, Mirpur-2, Dhaka-, Bangladesh.

 

References

1. Tang R, Chen HH, Wang YL, Changchien CR, Chen JS, Hsu KC, et al. Risk factors for surgical site infection after elective resection of the colon and rectum: A single-center prospective study of 2,809 consecutive patients. Ann Surg 2001;234:181-9.
2. Basavaraj B, Satyanarayana V, Jyotirmoy A. A retrospective study of the pattern of antimicrobial prophylaxis and surgical site infection in abdominal surgeries in a tertiary care hospital. Natl J Basic Med Sci 2013;3:221-6.
3. Cheng K, Li J, Kong Q, Wang C, Ye N, Xia G, et al. Risk factors for surgical site infection in a teaching hospital: A prospective study of 1,138 patients. Patient Prefer Adherence 2015;9:1171-7.
4. Song L, Ji M, Gefei W, Meng W, Xiuwen W, Kun G, et al. Risk factors for postoperative surgical site infections in patients with Crohn’s disease receiving definitive bowel resection. Sci Rep 2017;7:1-6.
5. Bishnu RG, Hom PP, Ravi SP, Chandrasekhara TS, Pranav KS. Surgical site infection and antibiotics use pattern in a tertiary care hospital in Nepal. J Pak Med Assoc 2008;58:141-51.
6. Rajeshwari, Nagabhusan H. Drug utilization study in postoperative patients in obstetrics and gynecology ward of a tertiary care hospital. Int J Basic Clin Pharm 2016;2016:329-4.
7. Awad SS. Adherence to surgical care improvement project measures and postoperative surgical site infections. Surg Infect (Larchment) 2012;13:234-7.
8. Kirkland KB, Briggs JP, Trivette SL, Wilkinson WE, Sexton DJ. The impact of surgical-site infections in the 1990s: Attributable mortality, excess length of hospitalization, and extra costs. Infect Control Hospital Epidemiol 1999;20:725-30.
9. Hunt TK. Surgical postoperative wound Infections: An overview. Am J Med 1981;70:712-8.
10. Raut A, Cherian T, Chauhan S, Pawar A. Antibiotic utilization pattern at the surgery department of a tertiary care hospital. Asian J Pharm Clin Res 2017;10:131-4.
11. Devesh KJ, Mohd R, Preeti K, Yogesh J. Evaluation of a prescription pattern of antibiotics for surgical prophylaxis in a secondary care hospital. Int J Basic Clin Pharmacol 2017;6:1969-76.
12. Classen DC, Evans RS, Pestotnik SL, Horn SD, Menlove RL, Burke JP, et al. The timing of prophylactic administration of antibiotics and the risk of surgical-wound infection. N Engl J Med 1992;326:281-6.
13. Chuang SC, Lee KT, Chang WT, Wang SN, Kuo KK, Chen JS, et al. Risk factors for wound infection after cholecystectomy. J Formos Med Assoc 2004;103:607-2.
14. MihirKumar B, Ashley S, Nawaz S, Surekha G, Padmaa MP. Assessment of two or more antibiotic regimens versus one or no antibiotic regimen in postoperative surgery. Int J Pharm Pharm Sci 2017;9:188-1.
15. Pankaj G, Manish S, Bhushan SW, Vijay MB, Dilip SG, Dhirendra DW, et al. Role of antibiotics on surgical site infection in cases of open and laparoscopic cholecystectomy: A comparative observational study. J Surg Tech Case Rep 2014;6:1-4.
16. Stone HH, Hooper CA, Kolb LD, Geheber CE, Dawkins EJ.Antibiotic prophylaxis in gastric, biliary and colonic surgery. Ann Surg 1976;184:443-2.
17. Kala P, Jamuna RR, Sangeeta R. Prescription pattern of prophylactic antimicrobial agents used in preoperative patients at a tertiary care teaching hospital. Int J Pharm Pharm Sci 2018;10:128-1.
18. Heethal J. Pattern of antimicrobial use in cesarean section in a tertiary care hospital in rural south India. Int J Pharm Biomed Res 2010;1:57-61.
19. Tamanna FT, Ahmed Z. Bacteriological study of postoperative abdominal wound infection-a case study. Bangladesh J Med Sci 2013;12:86-90.
20. Cruse PJ, Foord R. The epidemiology of wound infection: A 10-year prospective study of 62939 wounds. Surg Clin North Am 1980;60:27-40.
21. Public Health Laboratory Services. Incidences of surgical wound infection in england and wales: A report of public health laboratory service. Lancet 1960;2:658.
22. Patric P, Simon M, David A, Jean-Marie H, Yvs F. Risk factors for postoperative infectious complications in non-colorectal abdominal surgery. A multivariate analysis based on a prospective multicenter study of 4718 patients. Arch Surg 2003;138:314-24.
23. John JE, Yehuda C, Sara EC, Vance GF, Melissa ZB, Sharon LT, et al. Adverse clinical and economic outcomes attributable to methicillin resistance among patients with Staphylococcus aureus surgical site infection. Clin Infect Diseases 2003;36:592-8
Statistics
252 Views | 366 Downloads
Citatons
How to Cite
Monjur, F., F. Rizwan, and N. K. Ghosh. “SURGICAL SITE INFECTION RELATED RISK FACTORS AND USAGE OF ANTIBIOTICS IN TWO DIFFERENT TERTIARY CARE HOSPITALS OF DHAKA CITY, BANGLADESH”. Asian Journal of Pharmaceutical and Clinical Research, Vol. 11, no. 8, Aug. 2018, pp. 184-8, doi:10.22159/ajpcr.2018.v11i8.25878.
Section
Original Article(s)