Dr. Harapriya Kar, Department of Microbiology, MGM Medical College and Hospital, Nerul, Navi Mumbai, Maharashtra, India. E-mail: Harapriya.kar@gmail.com
Abstract
Background: Surgical site wound infection is the infection that occurs after surgery in the part of the body where surgery has taken place. It is the third most common nosocomial infection in hospital population. It is the highest cause of morbidity and mortality. It is worst in the case of orthopedic practice as it is difficult to get rid of bone and joint infection. Therefore, this study is focused on studying the aerobic organisms present in surgical site wound infections of orthopedic patients.
Materials and Methods: In a Tertiary Care Hospital, 200 probable cases of surgical site infections (SSI) in orthopedic patients from August 2019 to July 2020 were studied. The samples were processed aerobically following the standard microbiology procedures. Antibiotic susceptibility testing was done using the Kirby Baeur’s disk diffusion method. The antibiotics were chosen based on the organism isolated, and zone size was measured, results were interpreted following the Clinical and Laboratory Standards Institute guidelines.
Results: Out of 200 probable samples, 16 samples were positive. The incidence was 8%. The most common bacteria isolated were Staphylococcus aureus. Open fracture patients and patients who underwent emergency surgery showed a high incidence of infection as compared to patients who underwent elective surgery. The most effective antibiotic was seen to be Tetracycline and Gentamicin. Multidrug-resistant isolates were only seen in patients with open fracture.
Conclusion: An initiative for improved hospital infection control policy and improved antimicrobial prescribing guidelines should be implemented. Furthermore, pre-operative bathing and screening for methicillin-resistant S. aureus should be mandatory. Proper training to the patient’s relatives in terms of wound dressing should be given so as to avoid SSI.
Keywords: Surgical site infection, antibiotic susceptibility testing, Kirby-Bauer’s disk diffusion.
References
- 1. Global Guidelines for the Prevention of Surgical Site Infection (WHO Guidelines Approved by the Guidelines Review Committee). Geneva: World Health Organization; 2018. Available from: https://www.ncbi.nlm.nih.gov/books/NBK536404 [Last accessed on 2025 Sep 20]. [Google Scholar]
- 2. Borchardt RA, Tzizik D. Update on surgical site infections: The new CDC guidelines. JAAPA 2018;31:52-4. [Google Scholar]
- 3. Alelign D, Tena T, Tadesse D, Tessema M, Seid M, Oumer Y, et al. Bacteriological profiles, antimicrobial susceptibility patterns, and associated factors in patients undergoing orthopedic surgery with suspicion of surgical site infection at Arba minch general hospital in Southern Ethiopia. Infect Drug Resist 2022;15:2427-43. [Google Scholar]
- 4. McNally M, Corrigan R, Sliepen J, Dudareva M, Rentenaar R, IJpma F, et al. What factors affect outcome in the treatment of fracture-related infection? Antibiotics 2022;11:946. [Google Scholar]
- 5. Vatavati SR, Kampli MS. Surgeries and surgical site infection in India: A analysis of health management information system 2019-2020. J Surg Surg Res 2020;6:146-8. [Google Scholar]
- 6. Raoofi S, Kan FP, Rafiei S, Hosseinipalangi Z, Mejareh ZN, Khani S, et al. Global prevalence of nosocomial infection: A systematic review and meta-analysis. PLoS One 2023;18:e0274248. [Google Scholar]
- 7. Keely Boyle K, Rachala S, Nodzo SR. Centers for disease control and prevention 2017 guidelines for prevention of surgical site infections: Review and relevant recommendations. Curr Rev Musculoskelet Med 2018;11:357-69. [Google Scholar]
- 8. Walia K, Ohri VC, Madhumathi J, Ramasubramanian V. Policy document on antimicrobial stewardship practices in India. Indian J Med Res 2019;149:180-4. [Google Scholar]
- 9. Firesbhat A, Tigabu A, Tegene B, Gelaw B. Bacterial profile of high-touch surfaces, leftover drugs and antiseptics together with their antimicrobial susceptibility patterns at University of Gondar comprehensive specialized hospital, Northwest Ethiopia. BMC Microbiol 2021;21:309. [Google Scholar]
- 10. Weinstein MP, Lewis JS 2nd. The clinical and laboratory standards institute subcommittee on antimicrobial susceptibility testing: Background, organization, functions, and processes. J Clin Microbiol 2020;58:e01864-19. [Google Scholar]
- 11. Mohan N, Gnanasekar D, Sowmya TK, Ignatious A. Prevalence and risk factors of surgical site infections in a teaching medical college in the Trichy District of India. Cureus 2023;15:e39465. [Google Scholar]
- 12. Das A, Tripathy SK, Mohapatra I, Poddar N, Pattnaik D, Sayashi S, et al. Microbiological profile and outcome of surgical site infections following orthopedic surgeries in a tertiary care hospital. Cureus 2025;17:e76874. [Google Scholar]