Surveillance of surgical-site infections and antimicrobial resistance patterns in a tertiary hospital in Alexandria, Egypt

  • May Raouf Medical Microbiology and Immunology Department, Faculty of Medicine, Alexandria University, Alexandria, Egypt
  • Thoraya Ghazal Hospital Infection Prevention and Control specialist, Alexandria, Egypt
  • Mohamed Kassem GIT surgery and Endoscopy Department, Faculty of Medicine, Alexandria University, Alexandria, Egypt
  • Abdelfattah Agamya Obstetrics and Gynecology Department, Faculty of Medicine, Alexandria University, Alexandria, Egypt
  • Amira Amer Medical Microbiology and Immunology Department, Faculty of Medicine, Alexandria University
Keywords: surgical site infections, surveillance, epidemiology, MALDI-TOF, antimicrobial resistance patterns

Abstract

Introduction: Surveillance and antimicrobial resistance (AMR) monitoring are fundamental to Health care associated infections control. Limited data are available from developing countries for both. This study aimed to evaluate incidence and risk factors of surgical site infections (SSIs), etiological pathogens and AMR patterns identification.

Methodology: A prospective active surveillance study was implemented over a 24- month period at a 110-bed multispecialty non-teaching tertiary hospital. Follow up data were collected for 30-90 days. SSI was diagnosed according to Centers for Disease Control and Prevention and National Healthcare Safety Network (CDC/NHSN) criteria. The SSI isolates were identified by Matrix-assisted laser desorption ionization–time of flight mass spectrometry (MALDITOF/MS). Antibiotics susceptibility test was performed according to Clinical Laboratory Standards Institute (CLSI) and European Committee on Antimicrobial Susceptibility Testing (EUCAST).

Results: Out of a total of 3,642 patients, 70% had complete follow-up. SSI was detected in 57 cases (2.3%), 61.4% of which were detected post discharge. Factors significantly associated with increased SSI risk included smoking, diabetes, ASA score 5/E, ICU admission, previous admission and increased hospital stay. Sixty-five isolates were obtained; 70.8% were GNB while 24.6% were GPC and 4.6% were Candida albicans. Regarding AMR, 58.7% of isolates were extended spectrum β lactamase (ESBL) producers while 45.7% were Carbapenem resistant. Multi drug resistant (MDR) was detected in 13% of isolates, 54.3% were extended drug resistant (XDR) and 10.9% were pan drug resistant (PDR). Eighty-six percent of Staphylococci isolates were methicillin-resistant.

Conclusion: Despite low SSI rates detected, the high incidence of AMR identified is alarming.

Published
2020-03-31
How to Cite
1.
Raouf M, Ghazal T, Kassem M, Agamya A, Amer A (2020) Surveillance of surgical-site infections and antimicrobial resistance patterns in a tertiary hospital in Alexandria, Egypt. J Infect Dev Ctries 14:277-283. doi: 10.3855/jidc.12124
Section
Original Articles