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Surgical site infections among patients underwent clen and clean-contaminated surgery in Hospital Universiti Sains Malaysia : risk factors, microbiological and staphylococcus aureus molecular profile

Surgical site infections (SSI) are among the most commonly encountered healthcare associated infection. The incidence were closely been monitored as it is associated with considerable morbidity and mortality. The common aetiological agents responsible for the infection include Staphylococcus aure...

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Main Author: Jun Leong, Wong
Format: Thesis
Language:English
Published: 2015
Subjects:
RD Surgery
Online Access:http://eprints.usm.my/41129/1/Dr._Wong_Jun_Leong-24_pages.pdf
http://eprints.usm.my/41129/
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spelling my.usm.eprints.41129 http://eprints.usm.my/41129/ Surgical site infections among patients underwent clen and clean-contaminated surgery in Hospital Universiti Sains Malaysia : risk factors, microbiological and staphylococcus aureus molecular profile Jun Leong, Wong RD Surgery Surgical site infections (SSI) are among the most commonly encountered healthcare associated infection. The incidence were closely been monitored as it is associated with considerable morbidity and mortality. The common aetiological agents responsible for the infection include Staphylococcus aureus, Streptococcus spp, Enterococcus spp, and Pseudomonas aeruginosa. The identification of the causative agents as well as their antimicrobial sensitivity pattern helps in the treatment plan. Therefore the aims of this study were to determine the incidence and risk factors of SSI as well as to identify the causative microorganisms and their sensitivity profile. This prospective cohort study was conducted from June 2013 until July 2014 at Hospital Universiti Sains Malaysia. Seventy-two patients underwent clean and clean-contaminated surgeries were consented preoperatively and strictly followed up for any signs of SSI for duration of 30 days post operation. Nasal screening for Staphylococcus aureus and Methicillin-resistance Staphylococcus aureus was carried out preoperatively. Tissue samples or wound swab from infected patients were taken for microbial identification and its sensitivity pattern. Staphylococcus aureus strain isolated were proceed to polymerase chain reaction analysis to detect the virulence genes (TSST, PVL, cna, hlg, icaA, and SdrE). The overall incidence rate of SSI was 18.1% specifically for clean and clean-contaminated surgeries are 20% and 11.8%, respectively. Significant risk associated with SSI by simple logistic regression analysis included patients admitted two days or more prior to surgery (OR 12.67; 95% CI, 2.02 to 79.53), underwent CABG surgery (OR 10.20; 95% CI, 2.66 to 39.08), underlying diseases (OR 9.46; 95% CI, 1.15 to 77.50), history of diabetes mellitus (DM) prior to the surgery (OR 9.40; 95% CI, 2.36 to 37.39), total hospitalization period more than seven days (OR 7.84; 95% CI, 2.12 to 29.0), duration of surgery more than four hours (OR 7.08; 95% CI, 1.84 to 27.27), and discharged home three days or longer after surgery (OR 5.13; 95% CI, 1.39 to 18.84). Multiple logistic regression method demonstrated that the patients who have history of DM (OR 6.97; 95% CI, 1.49 to 32.71) and underwent CABG surgery (OR 5.54; 95% CI, 1.22 to 25.03) had significant risks of SSI. Gram negative microorganism was the leading causative microorganism and in Staphylococcus aureus strains, icaA gene was the most common virulence gene detected. In conclusion, SSI among clean and clean-contaminated surgeries are high in our setting. DM and patients underwent CABG operation are at high risk to get SSI. Gram negative microorganisms are common as compare to Gram positive, however they are all sensitive strains. 2015-12 Thesis NonPeerReviewed application/pdf en http://eprints.usm.my/41129/1/Dr._Wong_Jun_Leong-24_pages.pdf Jun Leong, Wong (2015) Surgical site infections among patients underwent clen and clean-contaminated surgery in Hospital Universiti Sains Malaysia : risk factors, microbiological and staphylococcus aureus molecular profile. Masters thesis, Universiti Sains Malaysia.
institution Universiti Sains Malaysia
building Hamzah Sendut Library
collection Institutional Repository
continent Asia
country Malaysia
content_provider Universiti Sains Malaysia
content_source USM Institutional Repository
url_provider http://eprints.usm.my/
language English
topic RD Surgery
spellingShingle RD Surgery
Jun Leong, Wong
Surgical site infections among patients underwent clen and clean-contaminated surgery in Hospital Universiti Sains Malaysia : risk factors, microbiological and staphylococcus aureus molecular profile
description Surgical site infections (SSI) are among the most commonly encountered healthcare associated infection. The incidence were closely been monitored as it is associated with considerable morbidity and mortality. The common aetiological agents responsible for the infection include Staphylococcus aureus, Streptococcus spp, Enterococcus spp, and Pseudomonas aeruginosa. The identification of the causative agents as well as their antimicrobial sensitivity pattern helps in the treatment plan. Therefore the aims of this study were to determine the incidence and risk factors of SSI as well as to identify the causative microorganisms and their sensitivity profile. This prospective cohort study was conducted from June 2013 until July 2014 at Hospital Universiti Sains Malaysia. Seventy-two patients underwent clean and clean-contaminated surgeries were consented preoperatively and strictly followed up for any signs of SSI for duration of 30 days post operation. Nasal screening for Staphylococcus aureus and Methicillin-resistance Staphylococcus aureus was carried out preoperatively. Tissue samples or wound swab from infected patients were taken for microbial identification and its sensitivity pattern. Staphylococcus aureus strain isolated were proceed to polymerase chain reaction analysis to detect the virulence genes (TSST, PVL, cna, hlg, icaA, and SdrE). The overall incidence rate of SSI was 18.1% specifically for clean and clean-contaminated surgeries are 20% and 11.8%, respectively. Significant risk associated with SSI by simple logistic regression analysis included patients admitted two days or more prior to surgery (OR 12.67; 95% CI, 2.02 to 79.53), underwent CABG surgery (OR 10.20; 95% CI, 2.66 to 39.08), underlying diseases (OR 9.46; 95% CI, 1.15 to 77.50), history of diabetes mellitus (DM) prior to the surgery (OR 9.40; 95% CI, 2.36 to 37.39), total hospitalization period more than seven days (OR 7.84; 95% CI, 2.12 to 29.0), duration of surgery more than four hours (OR 7.08; 95% CI, 1.84 to 27.27), and discharged home three days or longer after surgery (OR 5.13; 95% CI, 1.39 to 18.84). Multiple logistic regression method demonstrated that the patients who have history of DM (OR 6.97; 95% CI, 1.49 to 32.71) and underwent CABG surgery (OR 5.54; 95% CI, 1.22 to 25.03) had significant risks of SSI. Gram negative microorganism was the leading causative microorganism and in Staphylococcus aureus strains, icaA gene was the most common virulence gene detected. In conclusion, SSI among clean and clean-contaminated surgeries are high in our setting. DM and patients underwent CABG operation are at high risk to get SSI. Gram negative microorganisms are common as compare to Gram positive, however they are all sensitive strains.
format Thesis
author Jun Leong, Wong
author_facet Jun Leong, Wong
author_sort Jun Leong, Wong
title Surgical site infections among patients underwent clen and clean-contaminated surgery in Hospital Universiti Sains Malaysia : risk factors, microbiological and staphylococcus aureus molecular profile
title_short Surgical site infections among patients underwent clen and clean-contaminated surgery in Hospital Universiti Sains Malaysia : risk factors, microbiological and staphylococcus aureus molecular profile
title_full Surgical site infections among patients underwent clen and clean-contaminated surgery in Hospital Universiti Sains Malaysia : risk factors, microbiological and staphylococcus aureus molecular profile
title_fullStr Surgical site infections among patients underwent clen and clean-contaminated surgery in Hospital Universiti Sains Malaysia : risk factors, microbiological and staphylococcus aureus molecular profile
title_full_unstemmed Surgical site infections among patients underwent clen and clean-contaminated surgery in Hospital Universiti Sains Malaysia : risk factors, microbiological and staphylococcus aureus molecular profile
title_sort surgical site infections among patients underwent clen and clean-contaminated surgery in hospital universiti sains malaysia : risk factors, microbiological and staphylococcus aureus molecular profile
publishDate 2015
url http://eprints.usm.my/41129/1/Dr._Wong_Jun_Leong-24_pages.pdf
http://eprints.usm.my/41129/
_version_ 1643710136110284800
score 13.211869

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