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Multidrug-resistant surgical site infections in a humanitarian surgery project | Journal Article / Research | MSF Science Portal
Journal Article
|Research

Multidrug-resistant surgical site infections in a humanitarian surgery project

Murphy RA, Okoli O, Essien I, Teicher CL, Elder G, Pena J, Ronat JB, Bernabe KJ
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Abstract
The epidemiology of surgical site infections (SSIs) in surgical programmes in sub-Saharan Africa is inadequately described. We reviewed deep and organ-space SSIs occurring within a trauma project that had a high-quality microbiology partnership and active follow-up. Included patients underwent orthopaedic surgery in Teme Hospital (Port Harcourt, Nigeria) for trauma and subsequently developed a SSI requiring debridement and microbiological sampling. Data were collected from structured chart reviews and programmatic databases for 103 patients with suspected SSI [79% male, median age 30 years, interquartile range (IQR) 24-37]. SSIs were commonly detected post-discharge with 58% presenting >28 days after surgery. The most common pathogens were: Staphylococcus aureus (34%), Pseudomonas aeruginosa (16%) and Enterobacter cloacae (11%). Thirty-three (32%) of infections were caused by a multidrug-resistant (MDR) pathogen, including 15 patients with methicillin-resistant S. aureus. Antibiotics were initiated empirically for 43% of patients and after culture and sensitivity report in 32%. The median number of additional surgeries performed in patients with SSI was 5 (IQR 2-6), one patient died (1%), and amputation was performed or recommended in three patients. Our findings suggest the need for active long-term monitoring of SSIs, particularly those associated with MDR organisms, resulting in increased costs for readmission surgery and treatment with late-generation antibiotics.

Countries

Nigeria

Subject Area

antibiotic resistanceinfections, othersurgery & trauma careantimicrobial resistance

Languages

English
DOI
10.1017/S0950268816001758
Published Date
11 Aug 2016
PubMed ID
27509824
Journal
Epidemiology and Infection
Volume | Issue | Pages
Volume 144, Issue 16, Pages 3520-3526
Issue Date
2016-08-11
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