Surgical site infection; evaluation of causative organisms involved

Wound infection can be defined as invasion of organisms through tissues following a breakdown of local and systemic host defenses. The basic principles of wound care and antisepsis introduced during the past century improved surgery dramatically. Evaluation of causative organisms which evolved in the surgical site infection [elective abdominal surgery] at surgical unit of Liaquat university hospital Jamshoro. This prospective observational study was contains 103 patients undergoing elective, abdominal surgery were included in this study. Surgical wound categories i.e. clean, clean contaminated, were included. Prophylactic antibiotics were given in all cases. Primary closure of wounds was employed in all cases. Follow up period was 30 days postoperatively. All cases were evaluated for postoperative fever, redness and swelling of wound margins, collection and discharge of pus. Cultures were taken from all the cases with any of the above findings. The mean age of the patient was 37 years with male to female ratio of 1:5:1. The overall rate of wound infection was 13.04%. Most frequently involved pathogen was E.col 33.33% followed by Staph Aureus 20%, Klebsiella 20%, proteus 13.33%, Pseudomonas 6.66% and no organism was isolated in 6.66% cases. Most effective antibiotics were cephalosporins, quinolones and aminoglycosides' whereas septran, erythromycin and tetracycline's were ineffective. Surgical wound infections are quite common. Time of postoperative hospital stay was twice longer in infected case. Male sex, old age, anemia, longer duration of operation and wound class were significant risk factors. Most common organims are found in this study E-Coli, Kllebcella and Staph Aureus, these are mostly sensitive to cephalosporins, quinolones and aminoglycosides

Pattern of microbes associated to acute appendicitis at Liaquat University Hospital

To identify the most common of causative microbes associate to acute appendicitis and choice of different antibiotics according to sensitivity. Observational and Prospective Study. This was carried out in the Department of Surgery, Liaquat University Hospital, Hyderabad from January 2009 to January 2010. In this study patients various cultures obtained at the time of appendectomy was sent under sterile conditions for isolation of organisms and their sensitivity were sent to university hospital. the condition of the appendix regarding catarrhal inflammation, perforation and gangrene were noted on the preformed. Cultures were sent from the appendix wall and peri appendix peritoneal fluid for aerobics and anaerobic cultures. Total number of 100 culture reports of the patients who underwent open appendectomy was enrolled in this study irrespective of sex. The Pipracillin + Amikacin was the most effective [41.8%, n= 55] antibiotic followed by Ceftazidime + Amikacin, the second commonest effective antibiotic in 17 patients [30.9%]. We conclude that the most common isolated organisms of the aerobes were found sensitive against cephalosporins. Pipracillin tazobactum and Quinolones are the most sensitive antimicrobial to most of the pathogens isolated in our study