A Retrospective Assessment of Surgical Site Infection Trends and Microbiological Profiles following Elective Cholecystectomy

International Journal of Medicine and Medical Sciences | Vol. 13, No. 9, September 2023 | pp. 65–72

DOI: 10.46882/2023/IJMMS/130065

Original Research Article

A Retrospective Assessment of Surgical Site Infection Trends and Microbiological Profiles following Elective Cholecystectomy

Blessing N. Chukwu¹, Patrick E. Lawson², Evelyn M. Kamau¹*

¹Department of Surgery, Faculty of Clinical Sciences, University of Port Harcourt, Port Harcourt, Nigeria.

²Department of Community Health, College of Health Sciences, Moi University, Eldoret, Kenya.

Abstract:

Surgical site infections (SSIs) complicate elective gastrointestinal surgeries, increasing healthcare costs and delaying recovery. This retrospective clinical study analyzed the five-year trend (2018–2022) and specific microbiological patterns of SSIs following elective open and laparoscopic cholecystectomy procedures at a regional referral hospital. We extracted data from 850 patient files meeting standard exclusion and inclusion criteria. Post-operative wound infections were identified and classified using the Centers for Disease Control and Prevention (CDC) definitions. Out of 850 cholecystectomies performed, 42 cases of SSIs were confirmed, representing an overall incidence rate of 4.94%. The incidence was significantly higher in open cholecystectomies (7.2%) compared to laparoscopic approaches (2.1%, p < 0.01). Microbiological characterization of wound swabs showed that Escherichia coli was the most common pathogen (38.1%), followed by Klebsiella pneumoniae (23.8%), Pseudomonas aeruginosa (16.7%), and Staphylococcus aureus (14.3%). Antibiogram mapping revealed high resistance rates among Gram-negative isolates to cefuroxime (72.4%) and amoxicillin-clavulanic acid (65.5%), while excellent susceptibility profiles were maintained for piperacillin-tazobactam (91.4%) and amikacin (94.8%). Logistic regression demonstrated that an operative duration > 120 minutes (OR = 2.9, 95% CI = 1.4–5.8, p < 0.01) and conversion from laparoscopic to open surgery (OR = 3.4, p < 0.01) were independent risk factors for SSI. Laparoscopic cholecystectomy significantly reduces the risk of post-operative wound infections. The high resistance to common cephalosporins highlights the need to update perioperative antibiotic prophylaxis guidelines based on local susceptibility patterns.

Keywords: Surgical Site Infection, Cholecystectomy, Laparoscopy, Escherichia coli, Antibiotic Resistance, Perioperative Prophylaxis

Manuscript Timeline: Received: June 11, 2023; Revised: July 20, 2023; Accepted: August 14, 2023; Published: September 15, 2023.

Citation: Chukwu BN, Lawson PE, Kamau EM. A Retrospective Assessment of Surgical Site Infection Trends and Microbiological Profiles following Elective Cholecystectomy. International Journal of Medicine and Medical Sciences, 2023, 13(9): 65–72. DOI: 10.46882/2023/IJMMS/130065

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