A Retrospective Institutional Review of Surgical Site Infection Prevalence and Microbiological Proportions in Major Gynecological Surgeries

International Journal of Medicine and Medical Sciences | Vol. 14, No. 5, May 2024 | pp. 33–40

DOI: 10.46882/2024/IJMMS/140033

Original Research Article

A Retrospective Institutional Review of Surgical Site Infection Prevalence and Microbiological Proportions in Major Gynecological Surgeries

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

¹Department of Obstetrics and Gynaecology, 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) are common complications following major gynecological procedures, extending hospital stay and driving antimicrobial use. This retrospective clinical study evaluated the overall prevalence, specific risk factors, and microbiological susceptibility patterns of SSIs following elective and emergency gynecological laparotomies (hysterectomies and myomectomies) over a five-year period (2019–2023). Data from 750 patient files were extracted and analyzed using the Centers for Disease Control and Prevention (CDC) grading criteria for wounds. Out of the 750 procedures reviewed, 46 cases of confirmed SSIs were identified, resulting in an overall prevalence rate of 6.13%. The infection rate was significantly higher in emergency surgeries (11.4%) compared to elective interventions (3.4%, p < 0.01). Microbiological cultures from wound site swabs showed that Staphylococcus aureus was the most common pathogen (34.8%), followed by Escherichia coli (28.3%) and Klebsiella pneumoniae (19.6%). Antibiogram mapping revealed high resistance rates among Gram-negative isolates to amoxicillin-clavulanic acid (72.4%) and ceftriaxone (58.3%), while all isolates remained completely susceptible to imipenem and amikacin (100%). Methicillin resistance was confirmed in 31.3% of the S. aureus strains. Multivariate logistic regression analysis demonstrated that an operative duration > 120 minutes (OR = 2.9, 95% CI = 1.4–5.8, p < 0.01) and a high body mass index ≥ 30 kg/m² (OR = 2.4, p < 0.05) were independent predictors of infection. Post-gynecological SSIs represent a notable clinical challenge, highlighting the need to optimize perioperative glycemic control and strictly enforce antiseptic skin preparation protocols.

Keywords: Surgical Site Infection, Gynecological Surgery, Hysterectomy, Staphylococcus aureus, Antibiotic Resistance, Risk Factors

Manuscript Timeline: Received: February 14, 2024; Revised: March 22, 2024; Accepted: April 11, 2024; Published: May 15, 2024.

Citation: Chukwu BN, Lawson PE, Kamau EM. A Retrospective Institutional Review of Surgical Site Infection Prevalence and Microbiological Proportions in Major Gynecological Surgeries. International Journal of Medicine and Medical Sciences, 2024, 14(5): 33–40. DOI: 10.46882/2024/IJMMS/140033

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