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

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), etiologic...

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Main Authors: May Raouf, Thoraya Ghazal, Mohamed Kassem, Abdelfattah Agamya, Amira Amer
Format: Article
Language:English
Published: The Journal of Infection in Developing Countries 2020-03-01
Series:Journal of Infection in Developing Countries
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Online Access:https://jidc.org/index.php/journal/article/view/12124
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author May Raouf
Thoraya Ghazal
Mohamed Kassem
Abdelfattah Agamya
Amira Amer
author_facet May Raouf
Thoraya Ghazal
Mohamed Kassem
Abdelfattah Agamya
Amira Amer
author_sort May Raouf
collection DOAJ
description 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.
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spelling doaj-art-e50f5ce795484468a6d08c7c6eecdde02025-08-20T02:16:14ZengThe Journal of Infection in Developing CountriesJournal of Infection in Developing Countries1972-26802020-03-01140310.3855/jidc.12124Surveillance of surgical-site infections and antimicrobial resistance patterns in a tertiary hospital in Alexandria, EgyptMay Raouf0Thoraya Ghazal1Mohamed Kassem2Abdelfattah Agamya3Amira Amer4Medical Microbiology and Immunology Department, Faculty of Medicine, Alexandria University, Alexandria, EgyptHospital Infection Prevention and Control specialist, Alexandria, EgyptGIT surgery and Endoscopy Department, Faculty of Medicine, Alexandria University, Alexandria, EgyptObstetrics and Gynecology Department, Faculty of Medicine, Alexandria University, Alexandria, EgyptMedical Microbiology and Immunology Department, Faculty of Medicine, Alexandria University 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. https://jidc.org/index.php/journal/article/view/12124surgical site infectionssurveillanceepidemiologyMALDI-TOFantimicrobial resistance patterns
spellingShingle May Raouf
Thoraya Ghazal
Mohamed Kassem
Abdelfattah Agamya
Amira Amer
Surveillance of surgical-site infections and antimicrobial resistance patterns in a tertiary hospital in Alexandria, Egypt
Journal of Infection in Developing Countries
surgical site infections
surveillance
epidemiology
MALDI-TOF
antimicrobial resistance patterns
title Surveillance of surgical-site infections and antimicrobial resistance patterns in a tertiary hospital in Alexandria, Egypt
title_full Surveillance of surgical-site infections and antimicrobial resistance patterns in a tertiary hospital in Alexandria, Egypt
title_fullStr Surveillance of surgical-site infections and antimicrobial resistance patterns in a tertiary hospital in Alexandria, Egypt
title_full_unstemmed Surveillance of surgical-site infections and antimicrobial resistance patterns in a tertiary hospital in Alexandria, Egypt
title_short Surveillance of surgical-site infections and antimicrobial resistance patterns in a tertiary hospital in Alexandria, Egypt
title_sort surveillance of surgical site infections and antimicrobial resistance patterns in a tertiary hospital in alexandria egypt
topic surgical site infections
surveillance
epidemiology
MALDI-TOF
antimicrobial resistance patterns
url https://jidc.org/index.php/journal/article/view/12124
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