Published: 2019-10-24

A study of surgical site infections in a tertiary care hospital

Ayush Jain, Anuradha Tolpadi, Bhupendra Chaudhary, Ansh Chaudhary, Ankita Misra


Background: Health care-associated infections remain as an important public health concern. Surgical site infections (SSIs) are known to be one of the most common causes of nosocomial infections worldwide.

Methods: A prospective observational study was conducted across 12 months (May 2018-April 2019) in a tertiary care hospital. The present study includes 223 patients who were undergoing clean and clean contaminated surgery in the hospital. Contaminated and dirty surgeries were excluded. The demographic data of the patient, diagnostic criteria used, associated risk factors, use of prophylactic antimicrobial agents, the type and duration of surgery, clinical evaluation of wound and laboratory data was collected. All the pus samples or wound swabs of clinically suspects of SSI cases received in the Department of Microbiology were inoculated and interpreted according to Centre for Disease Control and Infection guidelines.

Results: The study included 223 patients who underwent surgery in the hospital. Amongst them 9 (4%) developed SSI. The incidence of SSI was 4.03%. There was a direct relationship observed between the occurrence of SSI and certain co-morbid conditions such as diabetes. It was also observed that prolonged surgeries above two hours and females were more predisposed to develop a surgical site infection.

Conclusions: SSIs being one of the most common causes of nosocomial infections. It was also the most important factor responsible for significant morbidity, mortality, unwanted prolonged hospitalization and additional cost of treatment in surgical patients which can be reduced by strictly following the guidelines of infection control along with judicious and rational use of antibiotics.


Antibiotic susceptibility, Diabetes, Infection, Microbiology, Surgery, Wound

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WHO. Surveillance, control and prevention of hospital acquired (nosocomial) infections. Report of an advisory group. 1981 BAC/NIC/81.6.

Avalos BS. Knocking out nosocomial infections. Nursing 2010. 2004;34(11):24-5.

Anusha S, Vijaya LD, Pallavi K, Manavalan R. An epidemiological study of surgical wound infections in a surgical unit of tertiary care teaching hospital. Indian J Pharmacy Practice. 2010;4:8-13.

Kokate SB, Rahangdale V, Katkar VJ. Study of bacteriological profile of post-operative wound infections in surgical wards in a tertiary care hospital. Int J Contemporary Med Res. 2017;4(1):77-83.

Collee JG, Marr W. Specimen collection, culture containers and media In: Collee JG, Fraser AG, Marmion BP, Simmons A, eds. Mackie and McCartney Practical Medical Microbiology. 14th ed. NewYork: Churchill Livingstone; 1996: 95-112.

Collee JG, Miles RS, Watt B. Tests for identification of bacteria. In: Collee JG, Fraser AG, Marmion BP, Simmons A, eds. Mackie and McCartney Practical Medical Microbiology. 14th ed. New York: Churchill Livingstone; 1996: 131-150.

Cockerill FR, Wikler MA, Bush K, Dudley MN, Eliopoulos GM, Hardy DJ, et al. Performance standards for antimicrobial susceptibility testing; twenty- first informational supplement. Clin Lab Stand Institute. 2011;30(1):21-125.

Suljagic V, Jevtic M, Djordjevic B, Jovelic A. Surgical site infections in a tertiary health care center: prospective cohort study. Surg Today. 2010;40:763-71.

Kumar A, Rai A. Prevalence of surgical site infection in general surgery in a tertiary care centre in India. Int Surg J. 2017;4:3101-6.

Communicable Disease Surveillance Centre. NINSS reports on surgical site infection and hospital acquired bacteremia. CDR Weekly. 2000;10:213-6.

Geubbels E, Groot AJM, van den Berg JM, de Boer AS. An operating surveillance system of surgical-site infections in the Netherlands: results of the PREZIES National Surveillance Network. Infect Control Hosp Epidemiol. 2000;21:311-8.

Ward VP, Charlett A, Fagah J, Crawshaw SC. Enhanced surgical site infection surveillance following caesarean section: experience of a multicenter collaborative. J Hosp Infect. 2008;70(2):166-73.

Neumayer L, Hosokawa P, Itani K, El Tamer M, Henderson WG, Khuri SF. Multivariable predictors of postoperative surgical site infection after general and vascular surgery: results from the patient safety in surgery study. J Am Coll Surg. 2007;204:1178-87.

Rao R, Sumathi S, Anuradha K, Venkatesh D, Krishna S. Bacteriology of postoperative wound infections. Int J Pharm Biomed Res. 2013;4:72-6.

Lilani SP, Jangale N, Chowdhary A, Daver GB. Surgical site infection in clean and clean-contaminated cases. Indian J Med Microbiol. 2005;23:249-52.