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Microbiological Profile of Surgical Site Infections Post Laparotomy and Neurosurgery: A Prospective Observational
Ashish Agrawal1, Suryakant Tiwari2, Ashutosh K Srivastava3
1Department of Microbiology, Chhindwara Institute of Medical Sciences, Chhindwara, Madhya Pradesh, India.
Background:
Surgical site infections (SSIs) are among the most common postoperative complications, significantly impacting morbidity, hospital stay, and healthcare costs. Identifying the microbiological spectrum and resistance patterns is essential for effective management.
Material And Methods:
This prospective observational study was conducted in a tertiary care hospital in Central India among 78 patients who developed SSIs following elective neurosurgical and laparotomy procedures. Pus/wound swab samples were collected aseptically and processed using standard culture methods. Isolates were identified, and antibiotic susceptibility testing was performed as per CLSI guidelines.
Results:
Among 78 samples, 62.8% showed growth. E. coli (21.8%) and S. aureus (19.2%) were the most common isolates. Concomitant infections included UTI (46.5%), BSI (51.2%), and VAP (7%). E. coli showed 82.3% sensitivity to piperacillin-tazobactam and 53% to amikacin. S. aureus was 100% sensitive to vancomycin and linezolid. Klebsiella and Pseudomonas showed 75% and 42.8% sensitivity to piperacillin-tazobactam, respectively. Acinetobacter showed 50% sensitivity to meropenem.
Conclusion:
Gram-negative organisms, particularly E. coli and Klebsiella, were the leading SSI pathogens, with significant resistance to cephalosporins and carbapenems. The high MRSA prevalence highlights the need for stringent infection control and targeted antibiotic stewardship.
Insights
Surgical site infections (SSIs) are often caused by Gram-negative bacteria like E. coli. Understanding pathogen resistance patterns is crucial for effective treatment and infection control in surgical patients.
Area of Science:
- Microbiology
- Infectious Diseases
- Surgical Infections
Background:
- Surgical site infections (SSIs) are a significant postoperative complication.
- They increase patient morbidity, hospital stays, and healthcare expenses.
- Identifying causative agents and their antibiotic resistance is key for management.
Purpose of the Study:
- To determine the microbiological profile of SSIs.
- To analyze antibiotic resistance patterns of common SSI pathogens.
- To inform treatment strategies and infection control measures.
Main Methods:
- Prospective observational study in a tertiary care hospital.
- Involved 78 patients undergoing elective neurosurgery or laparotomy.
- Collected pus/swab samples for culture, identification, and antibiotic susceptibility testing (AST) per CLSI guidelines.
Main Results:
- 62.8% of samples showed microbial growth.
- Most common isolates were E. coli (21.8%) and S. aureus (19.2%).
- E. coli exhibited high sensitivity to piperacillin-tazobactam (82.3%), S. aureus to vancomycin (100%). Significant resistance to cephalosporins and carbapenems was observed in Gram-negative bacteria.
Conclusions:
- Gram-negative bacteria, especially E. coli and Klebsiella, are predominant SSI pathogens.
- High prevalence of Methicillin-resistant Staphylococcus aureus (MRSA) necessitates strict infection control.
- Targeted antibiotic stewardship is vital given observed resistance patterns.
