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Incidence and Etiology of Surgical Site Infections in Appendectomies: A 3-Year Prospective Study
Humberto Guanche Garcell1, Ariadna Villanueva Arias1, Cristobal A Pancorbo Sandoval2
1Infection Control Department, The Cuban Hospital, Hamad Medical Corporation, Qatar.
Objectives:
Surgical site infections (SSIs) constitute a threat, especially in complicated appendicitis, and are commonly due to gram-negative organisms. We sought to describe the incidence of SSIs in appendectomies performed during a three-year period (January 2013 to December 2015) in a community hospital in Qatar, and compare this with external benchmarks.
Methods:
We conducted a longitudinal study at The Cuban Hospital, Qatar. We used the standardized surveillance criteria to define SSI developed by the Centers for Disease Control. Information about age, sex, smoking habits, diabetes mellitus status, body mass index, and the result of bacteriologic studies were collected.
Results:
Of a total 603 patients, 22 (3.6%) cases of SSI were reported, with an infection rate of 13.6%, 4.5%, and 1.0% in 2013, 2014, and 2015, respectively. SSIs were observed more frequently in patients with contaminated/dirty wounds (6.6%). About 65% of isolates from the surgical site were multidrug-resistant organisms (Escherichia coli and Klebsiella spp.).
Conclusions:
This study describes the incidence of SSI in appendectomy, which could be used as a benchmark for the facility improvement program. The high frequency of multidrug-resistant organisms in SSIs requires additional studies focused on evaluating the effectiveness of the current preventive practices with a particular reference to antimicrobial prophylaxis.
Insights
Surgical site infections (SSIs) after appendectomy are a concern. This study in Qatar found a decreasing SSI rate over three years, but a high prevalence of multidrug-resistant organisms necessitates further research into prevention strategies.
Area of Science:
- Infectious Diseases
- Surgical Outcomes
- Public Health Surveillance
Background:
- Surgical site infections (SSIs) pose a significant risk, particularly following appendectomies for complicated appendicitis.
- Gram-negative organisms are frequently implicated in SSIs, highlighting the need for effective antimicrobial strategies.
- Establishing local incidence rates is crucial for benchmarking and improving patient care.
Purpose of the Study:
- To determine the incidence of SSIs in appendectomies performed at a community hospital in Qatar.
- To compare the observed SSI rates with established external benchmarks.
- To identify the microbiological profile of SSIs, focusing on antimicrobial resistance patterns.
Main Methods:
- A longitudinal study was conducted at The Cuban Hospital, Qatar, from January 2013 to December 2015.
- Standardized Centers for Disease Control surveillance criteria were employed to define and identify SSIs.
- Data collected included patient demographics, comorbidities, and microbiological findings of surgical site cultures.
Main Results:
- A total of 603 appendectomies were analyzed, with 22 (3.6%) cases of SSI reported.
- The SSI incidence decreased annually: 13.6% in 2013, 4.5% in 2014, and 1.0% in 2015.
- Higher SSI rates were noted in patients with contaminated/dirty wounds (6.6%), and 65% of isolates were multidrug-resistant organisms (e.g., Escherichia coli, Klebsiella spp.).
Conclusions:
- The study provides valuable SSI incidence data for appendectomies in Qatar, serving as a benchmark for quality improvement initiatives.
- The significant prevalence of multidrug-resistant organisms in SSIs warrants further investigation into the efficacy of current antimicrobial prophylaxis and preventive measures.
- Enhanced surveillance and targeted interventions are essential to mitigate the impact of resistant pathogens in surgical infections.
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