Microbiology of surgical site infections

ABSTRACT

Surgical site infections in the Philippines vary in frequency between second and third most common site of nosocomial infections. Most studies were concentrated on postoperative incisional surgical site infections with few reports on postoperative intra-abdominal and soft tissue infections, and practically no studies on other organ/space infections Infection rates varied from hospital to hospital with lowe infection rates reflected by surveillance methods based on microbiology culture reports and higher rates with active surveillance procedures. SLMC reported the lowest surgical wound infection rate at 0.12 percent while Jose Reyes Memorial Medical Center registered the highest rate at 14.4 percent. Postoperative intra-abdominal infection rate in one report was 2.3 percent. (PGH) while two other hospitals had 0.5 percent (STUH) and 1.0 percent (PGH) in another report. Traumatic nosocomial surgical infection rate was 21.43 percent and a superinfection rate in another study of 38.8 percent Majority of the hospitals had predominantly gram-negative organisms as etiologic agents in surgical site infections. In those hospitals where gram-positive organisms were the most fequently isolated organisms, the overall picture still showed that gran negative organisms were still the predominant group of organisms. The predominant gram-positive organisms were S. aureus and epidermidis while the predominant gram-negative organisms were Pseudomonas sp., E. coli, Proteus sp. and Enterobacter sp In the three hospitals where resistance patterns were reported, there was discordance in the results. Where one antibiotic may be useful in one hospital for a particular organism, it may not be an adequate drug for the other hospitals against the same organism. This underscores the fact that hospitals should have their own resistograms compiled by an active infection control committee which would serve as guides for initial antimicrobial therapy in surgical site infections.(Author)