KUMJ | VOL. 14 | NO. 2 | ISSUE 54 | APR-JUN. 2016
Incidence and Risk Factors of Surgical Site Infections in Kathmandu University Hospital, Kavre, NepalAbstract:
Shrestha S, Wenju P, Shrestha R, Karmacharya RM
Surgical site infections (SSI) are the common nosocomial infection in surgical patients,
and are a significant source of postoperative morbidity resulting in increased hospital
stay, morbidity and cost.
The objective of this study was to obtain the incidence of SSI and determine various
risks factors influencing the SSI rate with special reference to the National Nosocomial
Infections Surveillance System risk index in Kathmandu University Hospital, Kavre,
Six hundred and thirty eight patients who underwent various surgeries in Dhulikhel
Hospital, Kathmandu University Hospital during a three-month period were included.
Using a pre designed questionnaire with follow up to 30 days and in orthopedic
cases, where metal implants were used as internal fixation devices, with follow up to
90 days data were collected. Infected cases were identified using Centre for Disease
Control and Prevention definition for surgical site infections. Swabs were obtained
from wounds and were processed without delay using standard microbiological
Overall SSI rate was 2.6%. The most common pathogen isolated was Escherichia coli
(5 isolates, 29.4 %). The SSI rate was 0.0% for clean wounds, 2.9%, 15.3% and 18.7%
for clean-contaminated, contaminated and dirty wounds respectively. Increased
incidence of surgical site infections were associated with higher grades of wound,
emergency surgeries, American Society of Anesthesiologists score >2 and increased
in National Nosocomial Infections Surveillance System risk index.
The incidence of SSI in this study meets the standard of center for disease prevention
and control. Increases in surgical wound class, National Nosocomial Infections
Surveillance System risk index, American Society of Anesthesiologist score >2 and
emergency surgeries were associated with increased SSI rates.Keyword :
National Nosocomial Infections Surveillance System (NNIS) risk index, Surgical site infection, wound class.