Incidence Rate And Risk Factors Of Surgical Wound Infection In General Surgery Patients

Abstract

Background: Hospital-acquired infections (HAIs) are considered a major challenge in health care systems. One of the main HAIs, playing an important role in increased morbidity and mortality, is surgical wound infection (SWI). This study aimed: to determine the incidence rate and risk factors of SWI in general surgery patients. Methods: A cross-sectional study was performed on 506 patients undergoing general surgery at five hospitals in Jeddah from January to June 2023. Bacterial isolates, antibiotic susceptibility pattern, antibiotic administration, and its type, operation duration and shift, the urgency of surgery, people involved in changing dressings, length of hospitalization, and levels of hemoglobin, albumin, and white blood cells after surgery were assessed. The frequency of SWI and its association with patient characteristics and laboratory results were evaluated. The SPSS software package (version 28.0) was used to analyze the data. Quantitative and qualitative variables were presented using mean (standard deviation) and number (percentage). The Shapiro–Wilk test was used to evaluate the normality of the data in this study. The data did no[1]t have a normal distribution. Hence, χ² and Fisher's exact tests were used to evaluate the relationship between variables. Results: SWI occurred in 4.7% (24 cases) of patients with a mean age of 59.34 (SD = 14.61) years. Preoperative (>3 days) and postoperative (>7 days) hospitalization, history of immunodeficiency (P < 0.001), and interns responsible for changing dressings (P = 0.021) were associated with SWI incidence. About 9.5% and 4.4% of SWI cases were significantly associated with pre- and postoperative antibiotic use. Gram-positive cocci were the most prevalent strains isolated from 24 SWI cases (15/24, 62.5%). Conclusion: Among these, Staphylococcus aureus was the predominant species, followed by coagulase-negative staphylococci. In addition, the most common Gram- negative isolates identified were Escherichia coli   bacteria. Overall, administration of antibiotics, emergency surgery, surgery duration, and levels of white blood cells and creatinine were identified as SWI associated risk factors. Identifying important risk factors could help control or prevent SWIs.