Archive \ Volume.13 2022 Issue 1

Epidemiology and Risk Factors of Post Operative Site Infections in Surgical Patients: A Systematic Review

, , , , , , , , ,

Abstract

Surgical site infection (SSI) is one of the most common and serious hospital-acquired infections all over the world. The SSI can lead to an increase in morbidity, mortality, and increase in the duration of hospital stay among patients. The present systematic review was planned to find the epidemiological features, prevalence, causative organisms, and predisposing risk factors for the development of postoperative infections among surgical patients of all the six WHO regions. Initially, 281 articles were identified through specified databases. Finally, 18 articles that fulfilled all inclusions and exclusion criteria are included. For the risk factors assessment, p-values, odds ratio were considered. In general, the occurrence rate of SSI ranges from 2% to 17.8%. Regarding causative organisms, three microorganisms are commonly reported in most of the studies were Staphylococcus aureus, Klebsiella pneumonia, and E.Coli. Among the different procedures reviewed, incidence and prevalence rates were higher among emergency surgical procedures and lower among obstetrics and gynecology procedures. Longer preoperative duration of stays in hospital decreased Hb and serum albumin level, comorbid conditions such as diabetes, hypertension are potential risk factors for the development of SSI. The occurrence rate of SSI among post-operative patients is very high, especially in developing countries. This leads to a double burden on the healthcare delivery settings during the COVID-19 pandemic. It is essential to include a strict infection control policy, fair usage of antibiotics practices to be implemented. It is also recommended to control comorbid conditions before planning for elective surgery.


Downloads: 353
Views: 3118

How to cite:
Vancouver
Salahuddin M, Muddebihal F, Thirunavukkarasu A, Alanazi AAZ, Alrashdi AMS, Alrashidi AM, et al. Epidemiology and Risk Factors of Post Operative Site Infections in Surgical Patients: A Systematic Review. Arch Pharm Pract. 2022;13(1):31-6. https://doi.org/10.51847/ZOIxqqgVc6
APA
Salahuddin, M., Muddebihal, F., Thirunavukkarasu, A., Alanazi, A. A. Z., Alrashdi, A. M. S., Alrashidi, A. M., Alanazi, W. O. H., Alruwaili, A. H. R., Alruwaili, A. F. J., & Alruwaili, K. N. (2022). Epidemiology and Risk Factors of Post Operative Site Infections in Surgical Patients: A Systematic Review. Archives of Pharmacy Practice, 13(1), 31-36. https://doi.org/10.51847/ZOIxqqgVc6

Download Citation
References

1.        Lewis SS, Moehring RW, Chen LF, Sexton DJ, Anderson DJ. Assessing the relative burden of hospital-acquired infections in a network of community hospitals. Infect Control Hosp Epidemiol. 2013;34(11):1229-30.

2.        Sheikhi MA, Rahmani H. Inflammatory statuses of non-smoker mustard lung patient candidate for coronary artery bypass grafting surgery. Int J Pharm Res Allied Sci. 2016;5(3):194-5.

3.        Hite GJ, Mishvelov AE, Melchenko EA, Vlasov AA, Anfinogenova OI, Nuzhnaya CV, et al. Holodoctor Planning Software Real-Time Surgical Intervention. Pharmacophore. 2019;10(2):1-2.

4.        Berríos-Torres SI, Umscheid CA, Bratzler DW, Leas B, Stone EC, Kelz RR, et al. Surgical Perspective: Centers for Disease Control and Prevention Guideline for the Prevention of Surgical Site Infection 2017. JAMA Surg. 2017;152(8):784-91. doi:10.1001/jamasurg.2017.0904

5.        Weiser TG, Haynes AB, Molina G, Lipsitz SR, Esquivel MM, Uribe-Leitz T, et al. Size and distribution of the global volume of surgery in 2012. Bull WHO. 2018; 94(3):201-9.

6.        Global guidelines on the prevention of surgical site infection [Internet]. 2016 [cited 2021 Jan 11]. Available from: https://www.who.int/gpsc/ssi-prevention-guidelines/en/

7.        Khairy GA, Kambal AM, Al-Dohayan AA, Al-Shehri MY, Zubaidi AM, Al-Naami MY, et al. Surgical Site Infection in a Teaching Hospital: A Prospective Study. J Taibah Univ Med Sci. 2017;6(2):114-20.

8.        Al-Mulhim FABaragbah MASadat-Ali MAlomran ASAzam MQ. Prevalence of surgical site infection in orthopedic surgery: a 5-year analysis. Int Surg. 2019;99(3):264-8. doi:10.9738/INTSURG-D-13-00251.1

9.        Amer M, Alnawar YMH, Sendi FJE. Appraisal of Awareness of Surgical Staff about Surgical Site infection at Selected Surgical Units, Saudi Arabia. Int J Sci Res (IJSR). 2017;6(1):2362-5.

10.      Al-Kenani NS, Alsultan AS, Alosfoor MA, Bahkali MI, Al-Mohrej OA. Incidence and predictors of surgical site infections following foot and ankle surgery. J Musculoskelet Surg Res. 2017;1:6-9.

11.      Almuneef M, Memish Z, Balkhy H, Hijazi O, Cunningham G, Francis C. Rate, risk factors and outcomes of catheter-related bloodstream infection in a paediatric intensive care unit in Saudi Arabia. J Hosp Infect. 2016;62(2):207-13.

12.      Robson MC. Wound infection. A failure of wound healing caused by an imbalance of bacteria. Surg Clin North Am. 2007;77(3):637-50.

13.      Olsen M, Tian F, Wallace A, Nickel K, Warren D, Fraser V, et al. Impact of Surgical Site Infections following common Ambulatory Procedures on Healthcare Costs. Value Health. 2015;18(3):A234.

14.      Badia JM, Casey AL, Petrosillo N, Hudson PM, Mitchell SA, Crosby C. Impact of surgical site infection on healthcare costs and patient outcomes: a systematic review in six European countries. J Hosp Infect. 2017;96(1):1-15.

15.      Cheadle WG. Surgical Site Infection: Still a Common Problem. JAMA Surg. 2013;148(2):189.

16.      Hamid H, Abid Z, Amir A, Rehman TU, Akram W, Mehboob T. Current Burden on Healthcare Systems in low- and middle-income countries: Recommendations for Emergency Care of COVID-19. Drugs Ther Perspect. 2020;36(10):466-8.

17.      Miller IF, Becker AD, Grenfell BT, Metcalf CJE. Disease and Healthcare Burden of COVID-19 in the United States. Nat Med [Internet]. 2020;26(8):1212-7. Available from: https://www.nature.com/articles/s41591-020-0952-y

18.      Hassan RS, Osman SO, Aabdeen MA, Mohamed WE, Hassan RS, Mohamed SO. Incidence and root causes of surgical site infections after gastrointestinal surgery at a public teaching hospital in Sudan. Patient Saf Surg. 2020;14(1):1-7.

19.      Bhattacharya S, Pal K, Jain S, Chatterjee SS, Konar J. Surgical site infection by methicillin resistant staphylococcus aureus–On decline?. J Clin Diagn Res. 2016;10(9):DC32.

20.      Korol E, Johnston K, Waser N, Sifakis F, Jafri HS, Lo M, et al. A Systematic Review of Risk Factors Associated with Surgical Site Infections among Surgical Patients. Khan A, editor. PLoS ONE. 2013;8(12):e83743. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3867498/

21.      Catania VD, Boscarelli A, Lauriti G, Morini F, Zani A. Risk Factors for Surgical Site Infection in Neonates: a Systematic Review of the Literature and Meta-Analysis. Front Pediatr. 2019 Mar 29 [cited 2019 Jun 12];7. Available from: https://www.frontiersin.org/articles/10.3389/fped.2019.00101

22.      Hegy A, Alshaalan S, Alkuraya H, Aljabbab N, Alruwaili H, Alanazi N. Surgical Site infection: a Systematic Review. Int J Med Dev Ctries. 2021 [cited 2021 Aug 3];730-7. Available from: https://ijmdc.com/fulltext/51-1605163946.pdf

23.      Subramanyam R, Schaffzin J, Cudilo EM, Rao MB, Varughese AM. Systematic Review of Risk Factors for Surgical Site Infection in Pediatric Scoliosis Surgery. Spine J. 2015;15(6):1422-31.

24.      Purba AKR, Setiawan D, Bathoorn E, Postma MJ, Dik J-WH, Friedrich AW. Prevention of Surgical Site Infections: a Systematic Review of Cost Analyses in the Use of Prophylactic Antibiotics. Front Pharmacol. 2018;9:776.

25.      Lubega A, Joel B, Justina Lucy N. Incidence and Etiology of Surgical Site Infections among Emergency Postoperative Patients in Mbarara Regional Referral Hospital, South Western Uganda. Surg Res Pract. 2017;2017:1-6.

26.      Torres S, Perdiz LB, Medeiros EA. Incidence of Surgical Site Infection after craniotomy: Comparison between Three Months and Twelve Months of Epidemiological Surveillance. Braz J Infect Dis. 2018;22(5):433-7.

27.      Kumar A, Rai A. Prevalence of Surgical Site Infection in General Surgery in a Tertiary Care Centre in India. Int Surg J. 2017;4(9):3101.

28.      Alshammari LT, Alkatheer SA, AlShoaibi MB, Alomran AA, Almulhim SN, Aljindan RY, et al. Surgical site infections in a tertiary hospital over 10 years. Saudi Med J. 2020;41(9):971-6.

29.      Dessie W, Mulugeta G, Fentaw S, Mihret A, Hassen M, Abebe E. Pattern of Bacterial Pathogens and Their Susceptibility Isolated from Surgical Site Infections at Selected Referral Hospitals, Addis Ababa, Ethiopia. Int J Microbiol. 2016;2016:1-8.

30.      Morikane K, Honda H, Suzuki S. Factors Associated with Surgical Site Infection following Gastric Surgery in Japan. Infect Control Hosp Epidemiol. 2016;37(10):1167-72.

31.      Negi V. Bacteriological Profile of Surgical Site Infections and Their Antibiogram: a Study from Resource-Constrained Rural Setting of Uttarakhand State, India. J Clin Diagn Res. 2015; Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4625239/

32.      Pathak A, Mahadik K, Swami MB, Roy PK, Sharma M, Mahadik VK, et al. Incidence and Risk Factors for Surgical Site Infections in Obstetric and Gynecological Surgeries from a Teaching Hospital in Rural India. Antimicrob Resist Infect Control. 2017;6(1):1-8.

33.      Rouse T, Nascu P, Dawson C, Morris E. Incidence of Surgical Site Infections after Caesarean Sections in a Community Hospital. Can J Infect Control. 2019;34(1):30-4.

34.      Li Z, Li H, Lv P, Peng X, Wu C, Ren J, et al. Prospective Multicenter Study on the Incidence of Surgical Site Infection after Emergency Abdominal Surgery in China. Sci Rep. 2021;11(1):1-10.

35.      Brennfleck FW, Bachmeier T, Simet W, Zeman F, Junger HHG, Schlitt HJ, et al. Surgical Site Infections and Their Economic Significance in Hepatopancreatobiliary surgery: a Retrospective incidence, cost, and Reimbursement Analysis in a German Centre of the Highest Level of Care. Int Wound J. 2020;18(1):17-23.

36.      Alghamdi S, Alawi M, Bokhari R, Bajunaid K, Mukhtar A, Baeesa SS. Risk Factors for Surgical Site Infection following Spinal Surgery in Saudi Arabia. Medicine. 2021;100(17):e25567.

37.      Mekhla FR. Determinants of Superficial Surgical Site Infections in Abdominal Surgeries at a Rural Teaching Hospital in Central India: a Prospective Study. J Family Med Prim Care. 2019;8(7):2258.

38.      Azeze GG, Bizuneh AD. Surgical Site Infection and Its Associated Factors following Cesarean Section in Ethiopia: a cross-sectional study. BMC Res Notes. 2019;12(1):1-6.

39.      Patel S, Thompson D, Innocent S, Narbad V, Selway R, Barkas K. Risk Factors for Surgical Site Infections in Neurosurgery. Ann R Coll Surg Engl. 2019;101(3):220-5.

40.      Carvalho RL, Campos CC, Franco LM, Rocha AD, Ercole FF. Incidence and Risk Factors for Surgical Site Infection in General Surgeries. Rev Lat Am Enfermagem. 2017;25(0). Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5738868/

41.      Zhang X, Wang Z, Chen J, Wang P, Luo S, Xu X, et al. Incidence and risk factors of surgical site infection following colorectal surgery in China: a national cross-sectional study. BMC Infect Dis. 2020;20(1):1-11.

42.      Mirzashahi B, Tonkaboni A, Chehrassan M, Doosti R, Kharazifard MJ. The Role of Poor Oral Health in Surgical Site Infection following Elective Spinal Surgery. Musculoskelet Surg. 2018;103(2):167-71.

43.      Khan FU, Fang Y, Khan Z, Khan FU, Malik ZI, Ahmed N, et al. Occurrence, Associated Risk Factors, and Treatment of Surgical Site Infections in Pakistan. Eur J Inflamm. 2020;18:205873922096054.


Creative Commons License
This work is licensed under a Creative Commons Attribution 4.0 International License.