scholarly journals Neurosurgical Post‐Operative Wound Infections: A retrospective study on surgical site infections for quality improvement

2020 ◽  
Vol 17 (4) ◽  
pp. 1039-1046
Author(s):  
Brian Fiani ◽  
Alessandra Cathel ◽  
Kasra J. Sarhadi ◽  
Jordan Cohen ◽  
Javed Siddiqi
Keyword(s):  
Quality Improvement ◽  
Retrospective Study ◽  
Surgical Site Infections ◽  
Wound Infections ◽  
Operative Wound

scholarly journals Bacteriological study of post-operative wound infections with special reference to MRSA and ESBL in a tertiary care hospital

2019 ◽  
Vol 6 (6) ◽  
pp. 1700
Author(s):  
Rashmi Basavantsing Rajput ◽  
Anjana Telkar ◽  
Ansh Chaudhary ◽  
Bhupendra Chaudhary
Keyword(s):  
Staphylococcus Aureus ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Surgical Site Infections ◽  
Care Hospital ◽  
Wound Infections ◽  
Bacterial Isolates ◽  
E Coli ◽  
Esbl Producers ◽  
Operative Wound

Background: Surgical site infections are known to be one of the most common causes of nosocomial infections worldwide and raises an important public health concern.Methods: A prospective observational study was conducted across 12 months (July 2018-June 2019) in a tertiary care hospital. The present study includes 50 pus samples from clinically suspected cases of post-operative wound infections from various surgical wards which were inoculated in Department of Microbiology. The phenotypic identification of different bacterial isolates especially MRSA and ESBL producers along with their antimicrobial susceptibility testing was interpreted according to CLSI guidelines.Results: Out of 50 samples, 44 showed positive culture. The infections were more common in emergency situations, age group of 20-30 years and in females. The most common bacterial isolates were Staphylococcus aureus (43.18%) followed by E. coli (22.72%), Klebsiella (15.9%), CONS (13.63%) and Pseudomonas (4.54%). Out of 19 Staphylococcus aureus 9 were MRSA and these gram-positive bacteria were highly sensitive to Linejolid and Clindamycin. In gram negative group 22.72% of E. coli and 15.9% of Klebsiella were ESBL producers who were susceptible mainly to Aztreonam, Linezolid or Cefoxitine.Conclusions: Post-operative wound or surgical site infections is the most important factor responsible for significant morbidity, mortality, prolonged hospitalization and additional cost to treatment in surgical patients. Marked resistance of isolates to commonly used antibiotics indicates the need of judicious use of these drugs to prevent the emergence of multi-drug resistant strains.

scholarly journals Prevention of spinal fusion post-operative wound infections in pediatric patients with scoliosis: a quality improvement initiative

2021 ◽  
Author(s):  
Elizabeth Partridge ◽  
Dean Blumberg ◽  
Rolando F. Roberto
Keyword(s):  
Quality Improvement ◽  
Spinal Fusion ◽  
Infection Rate ◽  
Neuromuscular Scoliosis ◽  
Quality Improvement Intervention ◽  
Quality Improvement Initiative ◽  
Evidence Based ◽  
Wound Infections ◽  
Deep Wound ◽  
Operative Wound

Abstract Purpose Post-operative wound infections increase patient morbidity and mortality as well as the length of hospital stay, with a profound personal and institutional cost. The aim of this study was to decrease post-operative infections through development of a surgical antibiotic prophylaxis policy based on institution-specific risk factors and microbiology data. Methods We conducted a retrospective review of deep wound infections at our institution over a 5-year period (2014–2018). 399 spinal fusion procedures were performed with a 2.5% post-operative infection rate. Patients with neuromuscular scoliosis were six times more likely to develop deep wound infections (7.6%) compared to patients with congenital and idiopathic scoliosis (combined rate of 1.25%). The microbiology data revealed that polymicrobial, extended spectrum beta-lactamase (ESBL) gram negative organisms predominated in patients with neuromuscular scoliosis. Based on these findings, we implemented an evidence-based quality improvement intervention: all patients with neuromuscular scoliosis undergoing spinal fusion were given a single 15 mg/kg dose of amikacin, in addition to our standard practice of perioperative cefazolin plus vancomycin with intra-operative betadine wash and vancomycin powder application. This intervention was put into practice in January 2019. Results Since the implementation of our quality improvement initiative, the overall post-operative infection rate decreased to 1.1% (2 infections in 176 cases). Ninety-eight percent of the 43 neuromuscular scoliosis patients who underwent spinal fusion in the post-intervention time frame have remained infection free. Conclusion Examination of post-operative infection and microbiology data at the institution level can guide the development of institution specific, evidence-based quality improvement initiatives that reduce post-operative wound infections.

scholarly journals Antibiotic susceptibility patterns of bacteria isolates in post-operative wound infections among patients attending Mama Lucy Kibaki Hospital, Kenya

2019 ◽  
Author(s):  
Johnstone Amulioto ◽  
Margaret W. Muturi ◽  
Scholastica Mathenge ◽  
Gideon M. Mutua
Keyword(s):  
Staphylococcus Aureus ◽  
Antibiotic Susceptibility ◽  
Surgical Site Infections ◽  
Diffusion Method ◽  
Resistant Bacteria ◽  
Wound Infections ◽  
Gram Negative ◽  
Antibiotic Susceptibility Patterns ◽  
Susceptibility Patterns ◽  
Operative Wound

Abstract Background Surgical site infections accounts for high mortality rates, morbidity and elevated costs of treatment for surgical patients. In recent years, surgical site infections attributed to antibiotic resistant bacteria has been on the rise globally. To effectively formulate a comprehensive treatment protocol for surgical site infection, there is need for knowing the likely causative agents and their antibiograms. In this regard, this study sought to determine the prevalence and antibiotic susceptibility patterns of bacteria isolates from post-operative wound infections among patients attending Mama Lucy Kibaki Hospital.Methods A cross-sectional descriptive study was carried out between October 2018 and March 2019. The study included patients of all age group with surgical site infections following general, obstetrics and gynecological surgeries. Pus swabs were aseptically obtained from 58 consented patients with clinical evidence of surgical site infections. Gram stain, culture, biochemical tests and antibiotic susceptibility tests were done for each pus swab. Antibiotic susceptibility testing was done using Kirby bauer disc diffusion method. Data was analysed using a statistical package for the social sciences (SPSS) version 20.Results An isolation rate of 94.8% was observed. Staphylococcus aureus 28.2% was the preponderant isolate followed by Escherichia coli 15.4% with Methicillin resistant Staphylococcus aureus accounting for 65.4% (n=17) of the total Staphylococcus species . Chloramphenicol was the most sensitive drug to all the bacteria isolates. Ampicillin and Amoxycillin recorded resistance rates >90% against positive and gram negative bacteria respectively. Klebsiella pneumoniae 81.3% and E.coli 74% were the most resistant bacteria.Conclusion Majority of the drugs were resistant to gram negative rods, therefore there is need for continuous monitoring to determine the susceptibility patterns of the most common surgical site infections bacteria isolates which are found in the hospitals.

scholarly journals BACTERIOLOGICAL STUDY OF POST-OPERATIVE WOUND INFECTIONS AND THEIR ANTIBIOGRAMS IN A TERTIARY CARE TEACHING HOSPITAL

2020 ◽  
pp. 18-20
Author(s):  
Prasada Rao Namburi1 ◽  
Sisira D ◽  
Surendra BV
Keyword(s):  
Staphylococcus Aureus ◽  
Pseudomonas Aeruginosa ◽  
Antimicrobial Susceptibility ◽  
Surgical Site Infections ◽  
Etiological Agent ◽  
Wound Infections ◽  
Susceptibility Pattern ◽  
Bacteriological Study ◽  
Postoperative Wound ◽  
Operative Wound

Background: Surgical site infections (SSI) are frequently occurring in postoperative complications. The present study is undertaken to isolate and determine the frequency of distribution of pathogens in post-operative wound infections and the antimicrobial susceptibility pattern of the causative organisms. Methods: This cross-sectional, prospective study was carried out over a period of one year. 250 pus samples from cases of surgical site infections were processed for gram staining, culture, biochemical identification tests, and antimicrobial susceptibility testing. Results: Out of 250 patients of post-operative wound infections, 48 are cultured positive, among which 21 were gram-positive, and 27 were gram-negative. Staphylococcus aureus emerged as the commonest etiological agent 17 (35.42%) followed by Pseudomonas aeruginosa 14 (29.17%), E.coli 6 (12.5%). Amikacin (72.9%) was found to be the most effective antibiotic, and Multidrug resistance was observed with staphylococcus aureus (79.16%) and pseudomonas aeruginosa (83.3%). Conclusions: Staphylococcus aureus is the commonest etiological agent for Postoperative wound infections. Antibiotic susceptibility pattern of various isolates helps in proper selection of antibiotics and in this study, it was found that Amikacin was the most effective antibiotic against postoperative wound infections.  

scholarly journals Prospective study on use of antibiotic prophylaxis on operative wound infections in south Indian population

2018 ◽  
Vol 5 (7) ◽  
pp. 2479
Author(s):  
Chakarala Obula Reddy ◽  
Garisa Chandra Mohana Reddy
Keyword(s):  
Antibiotic Prophylaxis ◽  
Surgical Site Infections ◽  
Purulent Discharge ◽  
South Indian Population ◽  
Wound Infections ◽  
Post Surgery ◽  
South Indian ◽  
Serous Discharge ◽  
Clean Contaminated ◽  
Operative Wound

Background: Antibiotic prophylaxis can help to reduce surgical site infections in operative wound infections. Present work was done to study the use of antibiotic prophylaxis on operative wound infection.Methods: A total of 120 patients under went various surgeries in the department of surgery, Fathima Institute of Medical Sciences, Kadapa, Andhra Pradesh utilized for the present study. Out of 120 patients utilized 86 were males and 34 females with elective surgeries and observed from their admission to discharge from the hospital and also followed up all the patients up to fifth week of post-surgery. Surgical wound types were observed and recorded.Results: We have noted clean wound cases were 91, contaminated cases were 5 and clean contaminated were 24 noted. 11 infected cases were observed in clean wound type, 3 infected cases in clean contaminated were observed. 3 patients out of 120 patients had post-operative fever and subsided within 2 days without antibiotics. Out of 91 clean wound cases, 2 patients (2.19%) had post-operative fever, 10 patients (10.9%) developed with serous discharge and purulent discharge was developed in 1 (1.09%) case in present study. Bacteriology revealed 4 cases (4.29%) showed growth of staphylococcus aureus organism, 1 case (1.09%) with pseudomonas organism was noted. 2 cases (8.3%) developed with serous discharge and 1 case (4.16%) with purulent discharge and also growth of E. coli in 1 (4.16%) case was noted in 24 clean contaminated cases in present study.Conclusions: Use of antibiotic prophylaxis has a vital role in pre and post-operative wound infections.

scholarly journals Surgical site infection metrics: Dissecting the differences between the National Health and Safety Network and the National Surgical Quality Improvement Program

2021 ◽  
Vol 1 (1) ◽  
Author(s):  
Alaia M. M. Christensen ◽  
Karen Dowler ◽  
Shira Doron
Keyword(s):  
Quality Improvement ◽  
Health And Safety ◽  
Surgical Site Infections ◽  
Cost Of Care ◽  
Quality Improvement Program ◽  
Surveillance Systems ◽  
Improvement Program ◽  
Surgical Quality ◽  
National Healthcare Safety Network ◽  
Hospital Acquired

Abstract Surgical site infections (SSIs) are associated with readmissions, reoperations, increased cost of care, and overall morbidity and mortality risk. The National Healthcare Safety Network (NHSN) and the National Surgical Quality Improvement Program (NSQIP) have developed an array of metrics to monitor hospital-acquired complications. The only metric collected by both is SSI, but performance as benchmarked against peer hospitals is often discordant between the 2 systems. In this commentary, we outline the differences between these 2 surveillance systems as they relate to this potential for discordance.

scholarly journals Total arterial myocardial revascularization using bilateral internal mammary arteries and the role of postoperative sternal stabilization to reduce wound infections in a large cohort study

2019 ◽  
Vol 29 (2) ◽  
pp. 224-229 ◽  
Author(s):  
Marc Albert ◽  
Ragi Nagib ◽  
Adrian Ursulescu ◽  
Ulrich F W Franke
Keyword(s):  
Retrospective Study ◽  
Wound Infection ◽  
Internal Mammary Artery ◽  
Wound Closure ◽  
Myocardial Revascularization ◽  
Wound Complications ◽  
Wound Infections ◽  
Term Survival ◽  
Mammary Arteries ◽  
Internal Mammary

Abstract OBJECTIVES Total arterial myocardial revascularization using bilateral internal mammary arteries shows improved results for mortality, long-term survival and superior graft patency. It has become the standard technique according to recent guidelines. However, these patients may have an increased risk of developing sternal wound infections, especially obese patients or those with diabetes. One reason for the wound complications may be early sternum instability. This situation could be avoided by using a thorax support vest (e.g. Posthorax® vest). This retrospective study compared the wound complications after bilateral internal mammary artery grafting including the use of a Posthorax vest. METHODS Between April 2015 and May 2017, 1613 patients received total arterial myocardial revascularization using bilateral internal mammary artery via a median sternotomy. The Posthorax support vest was used from the second postoperative day. We compared those patients with 1667 patients operated on via the same access in the preceding 26 months. The end points were the incidence of wound infections, when the wound infection occurred and how many wound revisions were needed until wound closure. RESULTS The demographic data of both groups were similar. A significant advantage for the use of a thorax support vest could be seen regarding the incidence of wound infections (P = 0.036) and the length of hospital stay when a wound complication did occur (P = 0.018). CONCLUSIONS As seen in this retrospective study, the early perioperative use of a thorax stabilization vest, such as the Posthorax vest, can reduce the incidence of sternal wound complications significantly. Furthermore, when a wound infection occurred, and the patient returned to the hospital for wound revision, patients who were given the Posthorax vest postoperatively had a significantly shorter length of stay until wound closure.

Prevention of orthopaedic wound infections: A quality improvement project

2001 ◽  
Vol 21 (4) ◽  
pp. 149-153 ◽  
Author(s):  
Paul Douglas ◽  
Margo Asimus ◽  
Judith Swan ◽  
Allan Spigelman
Keyword(s):  
Quality Improvement ◽  
Quality Improvement Project ◽  
Wound Infections ◽  
Improvement Project
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