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Incidence and factors associated with surgical site infections in a teaching hospital in Ujjain, India
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health.
Global Health/IHCAR, Department of Public Health Sciences, Karolinska Institutet, Stockholm, Sweden.
Department of Surgery, Ruxmaniben Deepchand Gardi Medical College, Ujjain, Madhya Pradesh, India.
Ruxmaniben Deepchand Gardi Medical College, Ujjain, Madhya Pradesh, India.
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2014 (English)In: American Journal of Infection Control, ISSN 0196-6553, E-ISSN 1527-3296, Vol. 42, no 1, E11-E15 p.Article in journal (Refereed) Published
Abstract [en]

Background: Surgical site infections (SSI) are among the most commonly reported health care-associated infections; however, there is a paucity of data on SSI from India. This study aimed to determine the incidence of SSI and explore its associated factors at a teaching hospital in India. Methods: Direct and indirect surveillance methods, based on Centers for Disease Control and Prevention guidelines, were used to define SSI. Patients were followed up for 30 days postsurgery. Prescribing and resistance data were collected. Results: The SSI rate among the 720 patients investigated was 5%. Risk factors for SSI identified were as follows: severity of disease (P = .001), presence of drains (P = .020), history of previous hospitalization (P = .003), preoperative stay (P = .005), wound classification (P < .001), and surgical duration (P < .001). Independent risk factors identified included wound classification (odds ratio - 4.525; P <. 001) and surgical duration (odds ratio = 2.554; P = .015). Most patients (99%) were prescribed antibiotics. Metronidazole (24.5%), ciprofloxacin (11%), and amikacin (9%) were the most commonly prescribed antibiotics. Most commonly isolated bacteria were Staphylococcus aureus (n = 14), of which 34% were methicillin-resistant Staphylococcus aureus, and Pseudomonas aeruginosa (n = 6), which showed resistance to ceftazidime (70%), ciprofloxacin (63%), and gentamicin (57%). Conclusion: Incidence of SSI at the hospital was lower than reported in many low-and middle-income countries, although higher than reported in most high-income countries. Targeted implementation strategies to decrease incidence of preventable SSI are needed to further improve quality and safety of health care in this hospital and similar hospitals elsewhere. 

Place, publisher, year, edition, pages
2014. Vol. 42, no 1, E11-E15 p.
Keyword [en]
Health care-associated infections, Antibiotics, Surveillance, Risk factors, Staphylococcus aureus, Pseudomonas aeruginosa, Rural
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Medical and Health Sciences
URN: urn:nbn:se:uu:diva-216725DOI: 10.1016/j.ajic.2013.06.013ISI: 000329165200003OAI: oai:DiVA.org:uu-216725DiVA: diva2:691215

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Available from: 2014-01-27 Created: 2014-01-24 Last updated: 2014-09-25Bibliographically approved

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Pathak, Ashish
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