The Epidemiology of Surgical Site Infections at a Tertiary Referral Hospital in a Low/Middle Income Country
BACKGROUND: Surgical site infections (SSIs), a common cause of healthcare-associated infections, significantly contribute to mortality and morbidity. Epidemiological data of SSIs in the Middle East and North Africa is scarce. AIM: We aimed to examine the epidemiology, clinical features, and mortalit...
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Elsevier
2024-12-01
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| Series: | Journal of Global Antimicrobial Resistance |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S2213716524002698 |
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| author | Caren Challita Nada Zahreddine Tamara Abdallah Nesrine Rizk Abdul Ghani Abou Koura Ali Slim Nisirine Haddad Souha Kanj Jamal Hoballah |
| author_facet | Caren Challita Nada Zahreddine Tamara Abdallah Nesrine Rizk Abdul Ghani Abou Koura Ali Slim Nisirine Haddad Souha Kanj Jamal Hoballah |
| author_sort | Caren Challita |
| collection | DOAJ |
| description | BACKGROUND: Surgical site infections (SSIs), a common cause of healthcare-associated infections, significantly contribute to mortality and morbidity. Epidemiological data of SSIs in the Middle East and North Africa is scarce. AIM: We aimed to examine the epidemiology, clinical features, and mortality of SSIs at a Lebanese tertiary referral hospital. METHODS: A retrospective analysis of patient charts from 2019 to 2022 was conducted, identifying SSI cases based on Centers for Disease Control and Prevention/National Healthcare Safety Network definitions. Data included patient demographics, comorbidities, previous hospitalizations, risk factors, types of infections, and causative microorganisms, including multi-drug resistant organisms (MDROs). In 2021, the hospital introduced an SSI prevention bundle, incorporating updated surgical prophylaxis tailored to local epidemiology. RESULTS: The study identified 360 SSI cases. Patients had a median age of 54 years, 58% being female. Common comorbidities included hypertension (36%) and diabetes mellitus (23%). 41% had a history of malignancy. 42% were hospitalized within the last 12 months. Most surgeries were elective (81%), with a median post-operative stay of 4 days and a total hospital stay of 5 days. SSIs were classified as superficial (39%), deep/tissue (42%), or organ space (19%). In-hospital mortality rates at 30, 60, and 90 days were 1%, 2%, and 3%, respectively. Staphylococcus spp. was mostly isolated (24%), followed by Enterococcus spp. and Escherichia coli (13% each). The proportion of SSIs caused by MDROs decreased from 18% in 2019 to 4% in 2022. CONCLUSION: These findings highlight the effectiveness of epidemiologically tailored prevention strategies in reducing MDRO-related SSIs. |
| format | Article |
| id | doaj-art-e1106d41359042219b85e76bc256fa8c |
| institution | DOAJ |
| issn | 2213-7165 |
| language | English |
| publishDate | 2024-12-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Journal of Global Antimicrobial Resistance |
| spelling | doaj-art-e1106d41359042219b85e76bc256fa8c2025-08-20T02:57:26ZengElsevierJournal of Global Antimicrobial Resistance2213-71652024-12-01393010.1016/j.jgar.2024.10.092The Epidemiology of Surgical Site Infections at a Tertiary Referral Hospital in a Low/Middle Income CountryCaren Challita0Nada Zahreddine1Tamara Abdallah2Nesrine Rizk3Abdul Ghani Abou Koura4Ali Slim5Nisirine Haddad6Souha Kanj7Jamal Hoballah8Division of Infectious Diseases, Department of Internal Medicine, American University of Beirut Medical Center, Beirut, LebanonInfection Prevention and Control Program, American University of Beirut Medical Center, Beirut, LebanonDivision of Infectious Diseases, Department of Internal Medicine, American University of Beirut Medical Center, Beirut, LebanonDivision of Infectious Diseases, Department of Internal Medicine, American University of Beirut Medical Center, Beirut, LebanonDivision of Plastic and Reconstructive Surgery, American University of Beirut Medical Center, Beirut, LebanonDivision of Plastic and Reconstructive Surgery, American University of Beirut Medical Center, Beirut, LebanonDepartment of Pharmacy, American University of Beirut Medical Center, Beirut, LebanonCenter for Infectious Diseases Research, American University of Beirut, Beirut, LebanonDivision of Vascular and Endovascular Surgery, Department of Surgery, American University of Beirut Medical Center, Beirut, LebanonBACKGROUND: Surgical site infections (SSIs), a common cause of healthcare-associated infections, significantly contribute to mortality and morbidity. Epidemiological data of SSIs in the Middle East and North Africa is scarce. AIM: We aimed to examine the epidemiology, clinical features, and mortality of SSIs at a Lebanese tertiary referral hospital. METHODS: A retrospective analysis of patient charts from 2019 to 2022 was conducted, identifying SSI cases based on Centers for Disease Control and Prevention/National Healthcare Safety Network definitions. Data included patient demographics, comorbidities, previous hospitalizations, risk factors, types of infections, and causative microorganisms, including multi-drug resistant organisms (MDROs). In 2021, the hospital introduced an SSI prevention bundle, incorporating updated surgical prophylaxis tailored to local epidemiology. RESULTS: The study identified 360 SSI cases. Patients had a median age of 54 years, 58% being female. Common comorbidities included hypertension (36%) and diabetes mellitus (23%). 41% had a history of malignancy. 42% were hospitalized within the last 12 months. Most surgeries were elective (81%), with a median post-operative stay of 4 days and a total hospital stay of 5 days. SSIs were classified as superficial (39%), deep/tissue (42%), or organ space (19%). In-hospital mortality rates at 30, 60, and 90 days were 1%, 2%, and 3%, respectively. Staphylococcus spp. was mostly isolated (24%), followed by Enterococcus spp. and Escherichia coli (13% each). The proportion of SSIs caused by MDROs decreased from 18% in 2019 to 4% in 2022. CONCLUSION: These findings highlight the effectiveness of epidemiologically tailored prevention strategies in reducing MDRO-related SSIs.http://www.sciencedirect.com/science/article/pii/S2213716524002698Surgical site infectionsEpidemiologyMulti-drug resistant organismsPrevention strategies |
| spellingShingle | Caren Challita Nada Zahreddine Tamara Abdallah Nesrine Rizk Abdul Ghani Abou Koura Ali Slim Nisirine Haddad Souha Kanj Jamal Hoballah The Epidemiology of Surgical Site Infections at a Tertiary Referral Hospital in a Low/Middle Income Country Journal of Global Antimicrobial Resistance Surgical site infections Epidemiology Multi-drug resistant organisms Prevention strategies |
| title | The Epidemiology of Surgical Site Infections at a Tertiary Referral Hospital in a Low/Middle Income Country |
| title_full | The Epidemiology of Surgical Site Infections at a Tertiary Referral Hospital in a Low/Middle Income Country |
| title_fullStr | The Epidemiology of Surgical Site Infections at a Tertiary Referral Hospital in a Low/Middle Income Country |
| title_full_unstemmed | The Epidemiology of Surgical Site Infections at a Tertiary Referral Hospital in a Low/Middle Income Country |
| title_short | The Epidemiology of Surgical Site Infections at a Tertiary Referral Hospital in a Low/Middle Income Country |
| title_sort | epidemiology of surgical site infections at a tertiary referral hospital in a low middle income country |
| topic | Surgical site infections Epidemiology Multi-drug resistant organisms Prevention strategies |
| url | http://www.sciencedirect.com/science/article/pii/S2213716524002698 |
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