Post-operative surgical site infection surveillance in general surgery departments

Nurgül CERAN, İlknur ERDEM, Seyfi ÖZYÜREK, Asuman İNAN, Meliha KESİKBAŞ, Seniha AKÇAY, Paşa GÖKTAŞ, Emin KARAGÜL, Derya ÖZTÜRK

Abstract

Between July 2006 and January 2007, in surgical clinics in our hospital, an active surveillance study has been performed in order to determine the frequ-ency,species, infectious agents and antimicrobial sensitivity of these agents in postoperative surgical site infections. In 98(%3.7) of 2637 operated patients developed postoperative surgical site infection between these dates. The classification of 2637 operations wounds; 1080(40.6%) were clean,722(27.3%) were clean-contaminated, 520 (19.7%) were contaminated and 315(11.9%) were dirty-infected wounds. The surgical site infection rate was 1.3% for clean wounds, 4.1% for clean-contaminated wounds, 4.8% for contaminated wounds, 10.4% for dirty infected wounds. The surgical site infections were superficial incisional in 41(41.8%), deep incisio-nal in 48(48.9%) and organ-space infections in 9(9.1%) patients.ln fifeteen (15.4%) of 98 patients cultures were negative, while the cultures were positive in 83(84.6%) patients. 109 microorganisms has been isolated in the cultures. The microorganism most frequently isolated was Escherichia coli with a rate of 26.6%. This was followed by Staphylococcus aureus (25.5%), Enterobacter sp.(15.5%) ,Pseudo-monas aeroginosa (10%) and Enterococcus sp.(10%), in order of frequency. While the antibiotic sensitivity of isolated Gram negative bacilli were showing difference; were found 78.6% of S.aureus as methicillin resistant (MRSA).

Özet

Hastanemiz genel cerrahi kliniklerinde postoperatif ceerahi alan infeksiyonlarının (CAİ) sıklığı, infeksiyon etkenleri ve bu etkenlerin antimikrobiyal duyarlılıklarını ortaya koymak amacıyla Temmuz 2006-Ocak 2007 tarihleri arsında aktif sürveyans çalışması yapılmıştır.Bu süre içinde öpere edilen 2637 hastanın 98 (%3.7)'inde postoperatif CAİ'u gelişti. 2637 operasyonun, 1080(%40.6)'i temiz, 722 (%27.3)'si temiz-kontamine, 520 (%19.7)'si kontamine, 315(%11.9)'i kirli infekte yara grubundaydı. Temiz operasyonlarda %1.3, temiz-kontamine operasyonlarda %4.1, kontamine operasyonlarda %4.8, kirli-infekte operasyonlarda ise %10.4 oranında CAİ geliştiği saptandı. Gelişen CA-İ'nın 41(%41.8)'i yüzeyel insizyonel, 48(%48.9)'i derin insizyonel, 9(%9.1)'u organ-boşluk infeksiyonları şeklindeydi. 98 hastanın 15(% 15.4)'inde kültür negatif kalırken, 83(%84,6) hastanın kültüründen 109 mikroorganizma izole edildi, %26.6'lık oranla en sık izole edilen etken Escherichia coli olup; bunu sırasıyla Staph-ylococcus aureus (%25.6), Enterobacter sp (%15.5), Pseudomonas aeroginosa (%10) ve Enterococcus sp.(%10) izlemekteydi. Gram negatif basiller değişik antibiyotiklere farklı direnç oranları gösterirken, S.au-reus'ların %78.6'sı metisiline dirençli bulundu.