Prevalence of surgical site infections and antibiotic resistance pattern in a Tertiary care Orthopaedic unit

Abstract

Introduction: Surgical site infections (SSIs) in orthopaedic surgeries pose a significant risk to outcomes. These infections ranging from superficial to periprosthetic joint complications result from various factors including patient-related conditions and environmental factors. Staphylococcus aureus, with increasing antibiotic resistance, is a predominant cause. Perioperative antibiotic prophylaxis recommended by the WHO is crucial. Establishing national surveillance considering local antibiotic resistance and continuous auditing are essential for formulating effective guidelines to prevent and manage SSIs. Methods: This is a retrospective study conducted at a tertiary care hospital from December 2022 to November 2023 at the orthopaedic unit. The study population was all the patients who had surgical site infections following clean orthopaedic surgeries during the study period. An institutional-level ethical clearance was obtained. Results: This retrospective study conducted at a tertiary orthopaedic unit in Jaffna, Sri Lanka, aimed to investigate surgical site infections (SSI) following clean orthopaedic surgeries. Analyzing data from 1676 surgeries over one year, the study identified 83 culture-proven SSIs, yielding an annual incidence of 4.95%. The majority of SSIs occurred in males (62.7%) and were associated predominantly with lower limb surgeries (83.1%). Contrary to global trends, Pseudomonas emerged as the most common causative organism (31.3%). Discussion: Notably, the study revealed significant variations in antibiotic sensitivity patterns among isolated organisms. While Pseudomonas exhibited sensitivity to a wide range of antibiotics, coliforms displayed resistance to several agents. This emphasizes regional and institutional differences in antibiotic resistance patterns. Conclusion: Continuous large-scale institutional audits are crucial for shaping effective antibiotic policies. The study underscores the dynamic nature of SSI aetiology, emphasizing the need for tailored preventive measures based on regional data.