Surgical Site Infections in a Tertiary Hospital in Egypt: Bacterial Isolates and Antibiotic Sensitivity Profiles

Background Surgical Site Infections (SSIs) are among the most common and costly postoperative complications, significantly impacting patient recovery and healthcare systems. Their burden is especially pronounced in low- and middle-income countries due to limited resources and inconsistent infection control practices. Objective To investigate the prevalence, microbial aetiology, and antimicrobial resistance patterns of SSIs in Al-Azhar University Hospital, Assiut, Egypt. Methods A prospective surveillance study was conducted on 90 patients undergoing general, gynaecological, urological, orthopaedic, and neurosurgical procedures. Patients were monitored for up to 90 days postoperatively. Wound swabs were collected, cultured, and analysed using both conventional microbiological methods and the automated VITEK-2 system (bioMérieux, France). Antibiotic susceptibility was assessed via the Kirby-Bauer disk diffusion method (Thermo Fisher Scientific, Basingstoke, UK) and VITEK-2. Results The most frequently isolated pathogen was Staphylococcus aureus (31.1%), followed by Escherichia coli and coagulase-negative staphylococci (16.7% each). High resistance rates were observed for ampicillin and gentamicin. Notably, a strong concordance was found between disc diffusion and VITEK-2 results (e.g., κ = 1 for ciprofloxacin and ampicillin; p<0.001). Patients with diabetes exhibited significantly longer hospital stays and were more likely to be admitted to the vascular surgery department. Conclusion SSIs continue to pose a major challenge in surgical care at Al-Azhar University Hospitals. The dominance of multidrug-resistant pathogens underscores the urgent need for improved infection control protocols and the rational use of antibiotics tailored to local resistance profiles.