Publication:

Epidemiology, risk factors and microbiological profile of surgical site infections in emergency surgeries

Background Surgical site infections (SSIs) remain a major cause of postoperative morbidity, prolonged hospitalization, and increased healthcare expenditure. Identification of risk factors and local microbial patterns is essential for effective prevention and management. The objectives of this study are to evaluate the incidence of surgical site infections (SSI) in emergency surgical patients, identify associated risk factors, and analyze the bacteriological profile and antimicrobial susceptibility patterns of the isolated organisms.

Methods A prospective observational study was conducted in the Department of General Surgery, Postgraduate Institute of Medical Sciences (PGIMS), Rohtak, Haryana. A total of 150 adult patients who underwent emergency surgery and subsequently developed wound-related complications were included. Patients were followed for 30 days postoperatively. Clinical, demographic, and perioperative variables were recorded. Wound swabs were subjected to microbiological culture and antibiotic susceptibility testing. Statistical analysis was performed using SPSS version 21.0.

Results The mean age of patients was 41.46±17.93 years, with males constituting 72.7% of cases. Culture positivity was observed in 67 patients, of whom 76% yielded Gram-negative organisms and 24% Gram-positive organisms. Escherichia coli (14.7%) was the most common isolate, followed by Klebsiella spp. (12.7%). Gram-negative isolates demonstrated high resistance to fluoroquinolones and third-generation cephalosporins, while piperacillin-tazobactam and meropenem showed the best susceptibility profiles. Significant associations with SSI were observed for prolonged duration of surgery (p=0.003), blood transfusion requirement (p=0.024), and higher Southampton wound scores (p<0.001). Age, sex, comorbidities, body mass index, anemia, previous surgery, and type of surgery were not significantly associated with SSI.

Conclusions Prolonged operative duration, blood transfusion, and higher Southampton scores were significant predictors of SSI. The predominance of multidrug-resistant Gram-negative organisms highlights the importance of institution-specific antibiograms and antimicrobial stewardship programs to optimize patient outcomes.