Predictors of surgical site infections (SSIs) among patients undergoing major surgery at general hospital funtua,Katsina State, Nigeria

Dalhatu, Adamu (2014)



Infection has always been a feature of human life, and sepsis in modern surgery continues to be a significant problem for health care practioneers across the globe. Surgical site infection (SSI) continues to be a major source of morbidity and mortality in developing countries despite recent advances in aseptic techniques: Yet, there is paucity from secondary health care centers. This study therefore examines the incidence of SSI, bacteriological pathogens implicated and predictors of surgical site infection at General Hospital Funtua, Katsina State, Nigeria. A cross sectional prospective study was used involving all subjects who underwent major surgery in surgical wards. A non-probabilistic purposive sampling technique was employed to recruit the total sample size of one hundred and twenty seven. After informed written consent for the study , all subjects who met inclusion criteria were consecutively enrolled in to the study. Pre-operative, intra-operative and postoperative data were collected using standardized data collection form based on CDC/WHO criteria .Wound specimens were collected and processed as per standard operative procedure. Data were analyzed using SPSS and STATA. Surgical site infection (SSI) was detected in 28 (22.05%) subjects of whom all had superficial SSI and no evidence of deep/ organ space. Among the 28 subjects with surgical site infection based on clinical criteria, 25 (19.6%) had positive aerobic culture giving rise to 19.6% based on bacteriological criteria. Pseudomonas spp was the predominant organism 11 (39.28%), followed by Staphylococcus spp. 5 (17.85%), and Klbsiella spp. in a decreasing frequency. Results from odds ratio analysis confirmed that, inadequate operating room ventilation and surgical hand scrub for < 2 minutes were found to have an increased risk for SSI by 34, fold. Subjects within the age limit between 21-30 years have increased risk for SSI by 2 fold, and subjects with co-existing illness (fever), have an increased risk for SSI by 4 fold, OR(3.9). Sterilization technique by the use of high level disinfectant and pre morbidity has been found to be an independent predictor of SSI, P-valve < 0.05. The study concluded that predictors for surgical site infections are associated with modifiable risk factors that the surgeons, nursing staffs and hospital management can deal with in a greater details.Prevention strategies focusing onfactors associatedwith surgical site infection is necessary in order to reduce the rate of SSI in our setting.