Rates and Risk Factors Associated with Surgical Site Infections in a Tertiary Care Center in South-Western Nigeria.

ABSTRACT

Background: Surgical site infections [SSI] are one of the most common nosocomial infections. This study was therefore carried out to determine the incidence and risk factors associated with surgical site infection among patients in a tertiary care center in Western Nigeria. Methods: The study was a 6 months Retrospective cohort study which reviewed case files obtained from the surgical departments. The study was carried out between 23rd January 2012 and 3rd february 2012 at Olabisi Onabanjo University Teaching Hospital, Sagamu, Nigeria. Result: A total of 386 surgical patients were recruited into the study. The overall incidence rate of SSI was 13.0%. The children had the highest infection rate of 22.9%. Factors associated with SSI were Pre-existing Medical Condition [X2=70.76, p=0.00001] Department of Care [X2=11.68, p=0.039] and age[X2=9.50, p=0.05]. There was no statistically significant difference in the SSI rate among the respondents due to Sex [X2=1.74, p=0.187], Operation site [X2=9.01, p=0.109] and Occupation [X2=5.84, p=0.12]. Forty-nine (98.0%) out of the 50 clinical surgical site infections were culture-positive and 20 (40.0%) of them had polymicrobial infection. The most frequently isolated bacteria were Staphyloccocus aureus, 16 [32.7%] and E. Coli 17 [34.7]. Pre-existing medical condition [OR=0.46, C.I=0.36-0.59] and length of post operative stay in the hospital [OR=0.33, C.I=0.21-0.50] were predictors of risk of surgical site infection. Conclusion: The study suggests that pre-existing medical condition and length of post operative stay in the hospital were predictors of risk of surgical site infection. This suggest that home based care of surgical wounds in patients that are ambulatory should be encouraged.