Skip to main content
SpringerLink
Log in

Bacteriological Profile of Patients with Intra-Abdominal Sepsis and Superficial Surgical Site Infection Following Emergency Abdominal Surgery—Is It Concordant?

  • Original Article
  • Published:
Indian Journal of Surgery Aims and scope Submit manuscript

Abstract

The rates of surgical site infections (SSI) continue to be reported with great variability, even for the same operation, from different geographical areas. Hence, a hospital-based surveillance of SSI can help in designing effective preventive strategies. This study was done to assess the risk factors, characteristics, and incidence of SSI in patients undergoing emergency gastrointestinal surgery. The study was a case series analysis, enrolling all consecutive patients undergoing emergency gastrointestinal surgery. The patients were examined daily for SSI using ASEPSIS score and during the post-operative period up to 30 days. For patients with SSI, wound swab was taken for culture and sensitivity. Patient and operative characteristics were analyzed for identifying risk factors, and the bacteriological profile and sensitivity pattern of intra-abdominal specimens were analyzed and compared with microbiological profile of SSI. A total of 100 patients were studied. The incidence of SSI was 33%. Age (44.33 ± 18.277 vs. 39.43 ± 16.158; p 0.015) and pre-operative blood transfusion (61.1 vs. 38.9; p 0.012) were found to be significant risk factors for SSI. On multivariate analysis, blood transfusion (p 0.027) and the duration of operation (p 0.005) were found to be independent risk factors. In cases where the isolated organisms were Escherichia coli, Enterococcus faecalis, and Klebsiella pneumoniae, concordance was noted between the intra-abdominal pathogens and the organisms isolated from the SSI. Risk factors for SSI in patients undergoing emergency abdominal surgeries include increasing age, pre-operative blood transfusion, prolonged operating time, intra-operative blood loss, and operative procedures involving bowel resection. Concordance exists between intra-abdominal and SSI pathogens.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

References

  1. Wilson APR, Treasure T, Sturridge MF, Gruneberg RN (1986) A scoring method (ASEPSIS) for postoperative wound infections for use in clinical trials of antibiotic prophylaxis. Lancet 327:311–312

    Article  Google Scholar 

  2. Culver DH, Horan TC, Gaynes RP, Martone WJ, Jarvis WR, Emori TG et al (1991) Surgical wound infection rates by wound class, operative procedure, and patient risk index. Am J Med 91:3B–153S

    Article  Google Scholar 

  3. Watanabe A, Kohnoe S, Shimabukuro R, Yamanaka T, Iso Y, Baba H, Higashi H, Orita H, Emi Y, Takahashi I, Korenaga D, Maehara Y (2008) Risk factors associated with surgical site infection in upper and lower gastrointestinal surgery. Surg Today 38:404–412

    Article  Google Scholar 

  4. Leaper DJ (2010) Risk factors for and epidemiology of surgical site infections. Surg Infect 11(3):283–287

    Article  Google Scholar 

  5. Kenig J, Richter P, Żurawska S, Lasek A, Zbierska K (2012) Risk factors for wound dehiscence after laparotomy - clinical control trial. Pol Przegl Chir 84(11):565–573

    PubMed  Google Scholar 

  6. Cruse PJ (1980) The epidemiology of wound infection: a 10 –year prospective study of 62939 wounds. Surg Clin North Am 60(1):27–40

    Article  CAS  Google Scholar 

  7. Siegman-Igra Y, Rozin R, Simchen E (1993) Determinants of wound infection in gastrointestinal operations: the Israeli study of surgical infections. J Clin Epidemiol 46(2):133–140

    Article  CAS  Google Scholar 

  8. Belda FJ, Aguilera L, García de la Asunción J, Alberti J, Vicente R, Ferrándiz L et al (2005) Supplemental perioperative oxygen and the risk of surgical wound infection: a randomized controlled trial. JAMA 294(16):2035–2042

    Article  CAS  Google Scholar 

  9. Di Leo A, Piffer S, Ricci F, Manzi A, Poggi E, Porretto V et al (2009) Surgical site infections in an Italian surgical ward: a prospective study. Surg Infect 10:533–538

    Article  Google Scholar 

  10. Poon JT, Law WL, Wong IW, Ching PT, Wong LM, Fan JK et al (2009) Impact of laparoscopic colorectal resection on surgical site infection. Ann Surg 249(1):77–81

    Article  Google Scholar 

  11. Mundhada AS, Tenpe S (2015) A study of organisms causing surgical site infections and their antimicrobial susceptibility in a tertiary care government hospital. Indian J Pathol Microbiol 58(2):195–200

    Article  Google Scholar 

  12. Boueil A, Guégan H, Colot J, D’Ortenzio E, Guerrier G (2015) Peritoneal fluid culture and antibiotic treatment in patients with perforated appendicitis in a Pacific Island. Asian J Surg S1015-9584(15):00035–00034

    Google Scholar 

  13. Singh AV, Mishra B, Thakur A (2009) Multidrug-resistant Gram-negative bacteria in postoperative infections. J Indian Med Assoc 107(3):148–150 163

    PubMed  Google Scholar 

  14. Manolakaki D, Velmahos G, Kourkoumpetis T, Chang Y, Alam HB, De Moya MM et al (2010) Candida infection and colonization among trauma patients. Virulence. 1(5):367–375

    Article  Google Scholar 

  15. Beldi G, Bisch-Knaden S, Banz V, Mühlemann K, Candinas D et al (2009) Impact of intraoperative behavior on surgical site infection. Am J Surg 198:157–162

    Article  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Surgery, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Pondicherry, 605006, India

    Ridhima Aggarwal, A R Pranavi, Mohsina Subair, Sathasivam SureshKumar, G. S. Sreenath & Vikram Kate

  2. Department of Microbiology, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Pondicherry, 605006, India

    Sujatha Sistla

  3. Department of Preventive and Social Medicine, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Pondicherry, 605006, India

    T. Mahalakshmy

Authors
  1. Ridhima Aggarwal
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. A R Pranavi
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Mohsina Subair
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Sathasivam SureshKumar
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. G. S. Sreenath
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Sujatha Sistla
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. T. Mahalakshmy
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Vikram Kate
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Vikram Kate.

Ethics declarations

Conflict of Interest

The authors declare that they have no conflict of interest.

Additional information

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Aggarwal, R., Pranavi, A.R., Subair, M. et al. Bacteriological Profile of Patients with Intra-Abdominal Sepsis and Superficial Surgical Site Infection Following Emergency Abdominal Surgery—Is It Concordant?. Indian J Surg 82, 905–911 (2020). https://doi.org/10.1007/s12262-019-01997-y

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s12262-019-01997-y

Keywords

Search

Navigation