Ali, Abdurrahman (2017) Incidence of Surgical Site Infection, Predisposing Factors and Associated Costs at Dessie Referral Hospital, Dessie, Ethiopia. Masters thesis, Addis Ababa University.
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Abstract
Background: Surgical wound infection is a prototype of (Hospital Acquired Infection) HAI and constitutes a serious problem. Patients diagnosed with Surgical Site Infection (SSI) face a 2 to 11 times increased in mortality along with prolonged hospital stays, treatment associated risks, pain, suffering, delayed wound healing, revision of surgery, and potential long-term sequelae. The burdens posed by SSIs are also reflected in excess of health care costs. Advances in control of infections have not completely eradicated the problem because of development of resistance. There are very limited data in relation to this agenda particularly cost associated with SSI in Ethiopia as well as Africa. Objective: The aim of this study was to assess the incidence of surgical site infection, predisposing factors and associated costs at Dessie Referral Hospital, Dessie, Ethiopia Methods: A hospital based cross sectional study was conducted from July 22 – October 25, 2016 in Dessie referral hospital. About 338 surgical patients who fulfilled the inclusion criteria were included using consecutive convenient sampling technique. Information regarding sociodemographic status and past medical history of the respondent was collected using pre-structured questionnaire. Two pus swabs were taken when a patient was first presented with clinical evidence of infection. One of the swabs was processed for microscopic examination the other one was inoculated to MacConkey agar, Blood agar and Manitol salt agar following a standard operating procedure. Colony characteristics, Gram’s reaction and biochemical tests were used to differentiate the organisms. Antibiotic susceptibility of the isolated bacteria was determined by Kirby-Bauer disc diffusion technique, following CLSI guideline (CLSI document M100-S24). The data was analyzed by SPSS version 20 and the results were presented by using tables and different graphs. Logistic regression analysis was used to determine the association between dependent and independent variables. Results: out of the 338 patients included in this study 49 (14.5 %) were clinically suspected for SSIs. Forty one out of the 49 (83.7 %) wound swabs were culture positive; hence the overall XI culture confirmed SSI was 12.1 %. More than half of the bacteria isolated were gram negative rods. About 79.2 % of all the isolates were Multi Drug Resistant (MDR). About 66.67 % and 100 % of E. coli and K. pneumonia were Extended Spectrum Beta Lactamase (ESBL) producers respectively. In this study, 55.6 % of the Syaphylococcus species were methicilin resistant (MRSA). Hypertension, ASA score-3, elective surgery and the age group 35-44 years were found to be statistically significant associated factors for SSIs. A more than two times increase of the cost and length of hospital stay was observed as a result of SSI in Dessie Referal Hospital. Conclusion and recommendation: the rate of SSI, MDR, MRSA and ESBL producing bacteria was very high among patients with SSI. A hospital based survey should be conducted on a regular basis, evidence based information should be given to the surgical team in order to reduce the rate of SSIs and the use of some drugs should be limited due to a high degree of resistance.
| Item Type: | Thesis (Masters) |
|---|---|
| Uncontrolled Keywords: | SSI, predisposing factors, drug susceptibility, cost |
| Subjects: | Q Science > Q Science (General) R Medicine > RA Public aspects of medicine > RA0421 Public health. Hygiene. Preventive Medicine |
| Divisions: | Africana |
| Depositing User: | Vincent Mpoza |
| Date Deposited: | 01 Oct 2018 13:06 |
| Last Modified: | 01 Oct 2018 13:06 |
| URI: | http://thesisbank.jhia.ac.ke/id/eprint/5765 |
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