Background: This study aims to study the incidence, microbial aetiology and antimicrobial susceptibility of surgical site infections (SSIs) at a private tertiary care hospital in Mumbai, India, and compare it with previously published data from the same institute as well as literature. Methods: This is a prospective observational study done over 6 years (January 2013–December 2018) at a 750-bed private multi-specialty hospital in Mumbai, India, among all patients undergoing clean and clean-contaminated surgeries. Standard guidelines for preventing, diagnosing and classifying SSIs were followed. The incidence rates of SSI (overall and specialty specific), microbial aetiology and antibiotic susceptibility of SSI were calculated and expressed as percentages. Results: A total of 55,553 patients underwent clean and clean-contaminated surgeries during the study period. The overall SSI rate was 1.0% (555 cases). The SSI rate in clean surgeries was 0.97% and in clean-contaminated surgeries was 1.03%. Sixty-five per cent of SSIs were due to Gram-negative bacilli, 30% were due to Gram-positive cocci and 4% were due to Candida. Klebsiella pneumoniae (19%), Escherichia coli (17%), Pseudomonas aeruginosa (13%), Staphylococcus aureus(12%) and Enterococcus (10%) were the top five organisms. The overall susceptibility rate of the Gram-negative isolates to beta-lactam–beta-lactamase inhibitor combinations was 60% and carbapenems was 73%. The prevalence of methicillin resistance in S. aureus was 44% and coagulase-negative Staphylococcus was 84%. The crude mortality rate was 1%. Conclusions: Although the SSI rate is comparable to established international benchmarks, the predominance of multidrug-resistant Gram-negative organisms is a matter of serious concern.


中文翻译：

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在印度孟买的一家私立三级保健医院，多重耐药革兰氏阴性菌主要是手术部位感染的原因


背景：本研究旨在研究印度孟买一家私立三级医疗医院手术部位感染 (SSI) 的发病率、微生物病因和抗菌药物敏感性，并将其与同一研究所先前发表的数据和文献进行比较。方法：这是一项前瞻性观察研究，历时 6 年（2013 年 1 月至 2018 年 12 月）在印度孟买的一家拥有 750 个床位的私立多专科医院进行，所有患者均接受清洁和清洁污染手术。遵循了预防、诊断和分类 SSI 的标准指南。计算 SSI 的发生率（整体和专业特异性）、微生物病因和 SSI 的抗生素敏感性并以百分比表示。结果：在研究期间，共有 55,553 名患者接受了清洁和清洁污染的手术。总体 SSI 率为 1.0%（555 例）。清洁手术的 SSI 率为 0.97%，清洁污染手术的 SSI 率为 1.03%。65% 的 SSI 由革兰氏阴性杆菌引起，30% 由革兰氏阳性球菌引起，4% 由念珠菌引起。肺炎克雷伯菌(19%)、大肠杆菌(17%)、铜绿假单胞菌(13%)、金黄色葡萄球菌(12%) 和肠球菌(10%) 是排名前五的生物。革兰氏阴性菌株对 β-内酰胺-β-内酰胺酶抑制剂组合的总体敏感性为 60%，碳青霉烯为 73%。金黄色葡萄球菌的甲氧西林耐药率为 44%，凝固酶阴性葡萄球菌为 84%。粗死亡率为1%。结论：虽然 SSI 率与既定的国际基准相当，但多重耐药革兰氏阴性生物的优势是一个令人严重关切的问题。