Surgical Site Infections Causes and the Burden of Staphylococcus Aureus in these Infections with their Antibiotic Susceptibility Pattern
Keywords:
Abdominal surgical patients, Methicillin resistant Staphylococcus aureus, multidrug resistance
Abstract
Background: Surgical site infections (SSI) set hurdles in the healing course of a significant proportion of abdominal surgical patients and thus associated with excessive health care costs. Staphylococcus aureus remains the principal causative agent in these infections. Also the emergence of multidrug resistant bacterial strains further complicates the recovery course of the patients and thus adds burden to both the patients and the surgeon. The intention of this study is to evaluate the etiology of SSI, to establish the incidence of S aureus and to determine their antimicrobial susceptibility pattern in patients with SSI. Methods: A cross section study was done in Aarupadai veedu medical college in patients attending surgery outpatient department for SSI. Purulent material was collected either with syringe or 2 sterile swabs and was sent to the microbiology department. The sample was processed as per standard guidelines, identified and antibiotic susceptibility was done for S.aureus. Result: Among the 63 SSI patients, 50 (79.4%) were culture positive. The most frequently isolated organism was S aureus 23 (36.5%) isolates. Among them methicillin resistant S.Aureus (MRSA) was 9 (39.1%). Both Methicillin sensitive S.aureus (MSSA) and MRSA were all sensitive to linezolid and vancomycin. Majority of the isolates were sensitive to amikacin and clindamicin. Conclusion: Thus our study concludes S. aureus as the foremost etiological agent of SSI, and treatment is further complicated by emerging multidrug resistant MRSA where empirical therapy can be started with clindamicin, amikacin in moderate risk cases and linezolid, vancomycin in high risk cases.References
1. Azoury SC, Farrow NE, Hu QL, Soares KC, Hicks CW, et al. Postoperative Wound Infections – Epidemiology, Risk Factors, Identification And Management. Chronic Wound Care Management and Research. 2015; 2:137-148.
2. Saadatian-Elahi M, Teyssou R, Vanhems P. Staphylococcus aureus, the major pathogen in orthopaedic and cardiac surgical site infections: a literature review. Int J Surg. 2008; 6:238–245.
3. Kontra JM. Reduction of surgical site infections by pre-operative eradication of the staphylococcus aureus carrier state: a paradigm whose time has come. J Lancaster General Health. Spring 2012; 7(1):4-7.
4. Howard RJ,Ravitch MM, Steichen FM. Host against infections.Current problems in surgery. New English Journal of Medicine. 1980;12:1823-1830.
5. B.B Sarkar. Post-operative infections: Physician’s perspectives. Medicine Update. 2012; 22: 67-71.
6. Mangram AJ, Horan TC, Pearson ML, Silver LC, Jarvis WR. Guideline for Prevention of Surgical Site Infection, 1999. Cen¬ters for Disease Control and Prevention (CDC) Hospital In¬fection Control Practices Advisory Committee. Am J Infect Control 1999; 27:97-132.
7. Razavi M, Shepard DS, Suaya JA, Stason WB (2014) Postoperative Staphylococcus aureus Infections in Medicare Beneficiaries. PLoS ONE 9(11): 1-10.
8. Krishna S, Divya P, Shafiyabi S. Postoperative surgical wound infections with special reference to methicillin resistant Staphylococcus aureus: an experience from VIMS hospital, Ballari. J Biosci Tech. 2015;6(3):697-702
9. Winn W, Allen S, Janda W, Koneman E, Procop G, Schreckenberger P, et al. Eds. In: Koneman’s Colour Atlas and TextBook of Diagnostic Microbiology. 6th ed. Lippincott, Williams and Wilkins; 2006:643-648.
10. Performance standards for antimicrobial susceptibility testing; 17th informational supplement. CLSI M100-S17. CLSI 2007, Wayne, PA.27 (1).
11. Chahoud J, Kanafani Z, Kanj SS. Surgical site infections following spine surgery: eliminating the controversies in the diagnosis. Front Med. 2014; 1:1-10.
12. Gayathree Naik, Shrinivas Deshpande. A Study on Surgical Site Infections Caused by Staphylococcus Aureus with a Special Search for Methicillin-Resistant Isolates. Journal of Clinical and Diagnostic Research. 2011; 5:502-508.
13. Surange BN, Rai UK: Bacteriological Pattern and their sensitivity to antibiotics in Wound Infections. Ind. J. Path. Micro: 1979; 22; 331-36.
14. Subramanian K.A, Prakash A, Shrinvas, Bhujwal RA. Post-operative wound infection. Ind J Surg 1973; 57-64
15. Kownhar H, Shanker EM, Vignesh R, Sekar R, Velu V, Rao VA: High rate of isolation of S.aureus from Surgical Site Infections in an Indian Hospital; J Antimicrobial Chemotherapy. 2008; 3: 758-760.
16. Bhattacharya S, Pal K, Jain S, Chatterjee SS, Konar J. Surgical site infection by methicillin resistant Staphylococcus aureus – on decline? Journal of Clinical and Diagnostic Research. 2016; 10(9):DC32–DC36.
17. Batabyal B, Biswas S, Chakraborty S, Desai P and Sarkar ND, Prevalence and drug sensitivity pattern of Staphylococcus aureus in post-operative Surgical oral & maxillofacial infections. Int. j. life sci. pharma res. 2012; 2(4): 154-158.
18. Ranjan KP, Ranjan N, Gandhi S. Surgical site infections with special reference to methicillin resistant Staphylococcus aureus: experience from a tertiary care referral hospital in North India. Int J Res Med Sci. 2013; 1(2):108-11.
2. Saadatian-Elahi M, Teyssou R, Vanhems P. Staphylococcus aureus, the major pathogen in orthopaedic and cardiac surgical site infections: a literature review. Int J Surg. 2008; 6:238–245.
3. Kontra JM. Reduction of surgical site infections by pre-operative eradication of the staphylococcus aureus carrier state: a paradigm whose time has come. J Lancaster General Health. Spring 2012; 7(1):4-7.
4. Howard RJ,Ravitch MM, Steichen FM. Host against infections.Current problems in surgery. New English Journal of Medicine. 1980;12:1823-1830.
5. B.B Sarkar. Post-operative infections: Physician’s perspectives. Medicine Update. 2012; 22: 67-71.
6. Mangram AJ, Horan TC, Pearson ML, Silver LC, Jarvis WR. Guideline for Prevention of Surgical Site Infection, 1999. Cen¬ters for Disease Control and Prevention (CDC) Hospital In¬fection Control Practices Advisory Committee. Am J Infect Control 1999; 27:97-132.
7. Razavi M, Shepard DS, Suaya JA, Stason WB (2014) Postoperative Staphylococcus aureus Infections in Medicare Beneficiaries. PLoS ONE 9(11): 1-10.
8. Krishna S, Divya P, Shafiyabi S. Postoperative surgical wound infections with special reference to methicillin resistant Staphylococcus aureus: an experience from VIMS hospital, Ballari. J Biosci Tech. 2015;6(3):697-702
9. Winn W, Allen S, Janda W, Koneman E, Procop G, Schreckenberger P, et al. Eds. In: Koneman’s Colour Atlas and TextBook of Diagnostic Microbiology. 6th ed. Lippincott, Williams and Wilkins; 2006:643-648.
10. Performance standards for antimicrobial susceptibility testing; 17th informational supplement. CLSI M100-S17. CLSI 2007, Wayne, PA.27 (1).
11. Chahoud J, Kanafani Z, Kanj SS. Surgical site infections following spine surgery: eliminating the controversies in the diagnosis. Front Med. 2014; 1:1-10.
12. Gayathree Naik, Shrinivas Deshpande. A Study on Surgical Site Infections Caused by Staphylococcus Aureus with a Special Search for Methicillin-Resistant Isolates. Journal of Clinical and Diagnostic Research. 2011; 5:502-508.
13. Surange BN, Rai UK: Bacteriological Pattern and their sensitivity to antibiotics in Wound Infections. Ind. J. Path. Micro: 1979; 22; 331-36.
14. Subramanian K.A, Prakash A, Shrinvas, Bhujwal RA. Post-operative wound infection. Ind J Surg 1973; 57-64
15. Kownhar H, Shanker EM, Vignesh R, Sekar R, Velu V, Rao VA: High rate of isolation of S.aureus from Surgical Site Infections in an Indian Hospital; J Antimicrobial Chemotherapy. 2008; 3: 758-760.
16. Bhattacharya S, Pal K, Jain S, Chatterjee SS, Konar J. Surgical site infection by methicillin resistant Staphylococcus aureus – on decline? Journal of Clinical and Diagnostic Research. 2016; 10(9):DC32–DC36.
17. Batabyal B, Biswas S, Chakraborty S, Desai P and Sarkar ND, Prevalence and drug sensitivity pattern of Staphylococcus aureus in post-operative Surgical oral & maxillofacial infections. Int. j. life sci. pharma res. 2012; 2(4): 154-158.
18. Ranjan KP, Ranjan N, Gandhi S. Surgical site infections with special reference to methicillin resistant Staphylococcus aureus: experience from a tertiary care referral hospital in North India. Int J Res Med Sci. 2013; 1(2):108-11.
Published
03-09-2018
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