Introduction: Morbidity and mortality were associated with increased surgical site infections (SSIs). Besides, it is a financial problem and has a negative impact on patient quality of life (QoL). Aim of study: It was to evaluate the impact of surgical site infection at Obstetric Department on healthcare costs and patient outcomes. Methods: Retrospective descriptive design was used for nine months survey, from October 2018 to Jun 2019. It included all the infected cases at a certain period, conducted through patient’s files and infection control surveillance at Kasr Al Ainy Obstetric Emergency Hospital. Results: SSI rate was around 0.7% per month, with an average length of stay (LOS) of 21 days which affected the patient outcomes. Total cost for antibiotics ranged from 400 to 7800 Egyptian Pounds per patient. Most common pathogens were Acinetobacter baumannii and Escherichia coli (E. coli) found in the environment and food. The most antibiotics used were Flagyl (metronidazole), Rocephin (ceftriaxone) and Unasyn (Ampicillin/Sulbactam). Conclusions: Surgical site infections have bad health and economic impacts. Environmental sanitation, safety measures for intravenous (IV) solutions, corrective department design, implementation of policies and procedures for infection control are highly recommended.
| [1] | Horan, T., Gaynes, R., Martone, W., Jarvis, W., & Emori, T. (1992). CDC Definitions of Nosocomial Surgical Site Infections, 1992: A Modification of CDC Definitions of Surgical Wound Infections. Infection Control & Hospital Epidemiology, 13(10), 606-608.View Article |
| [2] | J.M. Bahia at al. (2017). Impact of surgical site infection on healthcare costs and patient outcomes: a systematic review in six European countries. Journal of Hospital Infection 96. 1e15.View Article PubMed |
| [3] | Ban KA, Minei JP, Laronga C, Harbrecht BG, Jensen EH, Fry DE, Itani KM, Dellinger EP, Ko CY, Duane TM 2017. American College of Surgeons and Surgical Infection Society: Surgical Site Infection Guidelines, J Am Coll Surg. 224(1): 59-74.View Article PubMed |
| [4] | A.E. González-Vélez a, M. Romero-Martínb, R. Villanueva-Orbaiz b, C. Díaz-Agero-Pérezc, A. Robustillo-Rodelac, V. Monge-Jodra 2016. The cost of infection in hip arthroplasty: A matched case-control study. Rev Esp Cir Ortop Traumatol. 60(4): 227-233.View Article |
| [5] | Tanner J, Dumville JC, Norman G, Fortnam M. (2016). Surgical hand antisepsis to reduce surgical site infection. Cochrane Database of Systemic, Issue 1. Art. No.: CD004288.View Article |
| [6] | Leaper, David; Ousey, Karen (2015). Evidence update on prevention of surgical site infection Current Opinion in Infectious Diseases: April 2015 - Volume 28 - Issue 2 - p 158-163.View Article PubMed |
| [7] | Berríos-Torres SI, Umscheid CA, Bratzler DW, et al 2017: Centers for Disease Control and Prevention Guideline for the Prevention of Surgical Site Infection, JAMA Surg. 2017; 152(8): 784-791.View Article PubMed |
| [8] | Ansari S, Hassan M, Barry H D, et al. (June 02, 2019) Risk Factors Associated with Surgical Site Infections: A Retrospective Report from a Developing Country. Cureus 11(6): e4801.View Article |
| [9] | McNeil, S. A., Nordstrom-Lerner, L., Malani, P. N., Zervos, M., & Kauffman, C. A. (2001). Outbreak of Sternal Surgical Site Infections Due to Pseudomonas aeruginosa Traced to a Scrub Nurse with Onychomycosis. Clinical Infectious Diseases, 33(3), 317-323.View Article PubMed |
| [10] | ODOM-FORREN, J. (2006). Preventing surgical site infections. 36(6), 59-63.View Article PubMed |
| [11] | Ariyo, P., Zayed, B., Riese, V., Anton, B., Latif, A., Kilpatrick, C., . . . Berenholtz, S. (2019). Implementation strategies to reduce surgical site infections: A systematic review. Infection Control & Hospital Epidemiology, 40(3), 287-300.View Article PubMed |
| [12] | Webster J., Osborne S. (2015). Preoperative bathing or showering with skin antiseptics to prevent surgical site infection. Cochrane Database of Systematic, Issue 2. Art. No.: CD004985.View Article |
| [13] | Dumville JC, Gray TA, Walter CJ, Sharp CA, Page T, Macefield R, Blencowe N, Milne TKG, Reeves BC, Blazeby J. (2016). Dressings for the prevention of surgical site infection. Cochrane Database of Systematic Reviews, Issue 12. Art. No.: CD003091.View Article PubMed |
| [14] | McDermott K.W., et al. (2017). Overview of Operating Room Procedures during Inpatient Stays in U.S. Hospitals. HCUP Statistical Brief #233. Agency for Healthcare Research and Quality, Rockville, MD. Available from: https://www.hcup- us.ahrq.gov/reports/statbriefs/sb233-Operating-Room-Procedures-United-States- 2014.jsp. |
| [15] | Najjia N. Mahmoud, Guiping Yang, and William B. Saunders. (2009). Impact of Surgical Site Infections on Length of Stay and Costs in Selected Colorectal Procedures Published Online: 27 De2009.Surgical Infections VOL. 10, NO. 6.View Article PubMed |
| [16] | Abu Sheasha, Ghada & Yassine, Omaima & Anwar, Medhat & Bedwani, Ramez. (2017). Cost of surgical site infection in Egyptian University Hospital: Informing a decision to implement an infection control program using simulation. Operations Research for Health Care. 18.View Article |
| [17] | Taghreed Adam, David B Evans and Christopher JL Murray. (2003). Econometric estimation of country-specific hospital costs Cost Effectiveness and Resource Allocation, 1 http://www.resource-allocation.com/content/1/1/3.View Article PubMed PubMed |
| [18] | De Silva, P. M., & Kumar, A. (2019). Signal Transduction Proteins in Acinetobacter baumannii: Role in Antibiotic Resistance, Virulence, and Potential as Drug Targets. Frontiers in Microbiology, 10, 49.View Article PubMed PubMed |
| [19] | Brazier, Y. (2017, December 11). "E. coli infection: Symptoms, causes, and treatment." Medical News Today. Retrieved from https://www.medicalnewstoday.com/articles/68511.php. |
| [20] | Podschun, R., & Ullmann, U. (1998). Klebsiella spp. as nosocomial pathogens: epidemiology, taxonomy, typing methods, and pathogenicity factors. Clinical microbiology reviews, 11(4), 589-603.View Article PubMed PubMed |
| [21] | Sun, Y., Wang, H., Tang, Y., Zhao, H., Qin, S., Xu, L., Zhang, F. (2018): Incidence and risk factors for surgical site infection after open reduction and internal fixation of ankle fracture: A retrospective multicenter study. Medicine, 97(7), e9901.View Article PubMed PubMed |