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dc.contributor.authorMurphy, RA*
dc.contributor.authorOkoli, O*
dc.contributor.authorEssien, I*
dc.contributor.authorTeicher, C*
dc.contributor.authorElder, G*
dc.contributor.authorPena, J*
dc.contributor.authorRonat, JB*
dc.contributor.authorBernabé, KJ*
dc.date.accessioned2017-02-22T17:47:09Z
dc.date.available2017-02-22T17:47:09Z
dc.date.issued2016-08-11
dc.identifier.citationMultidrug-resistant surgical site infections in a humanitarian surgery project. 2016:1-7 Epidemiol. Infect.en
dc.identifier.issn1469-4409
dc.identifier.pmid27509824
dc.identifier.doi10.1017/S0950268816001758
dc.identifier.urihttp://hdl.handle.net/10144/618803
dc.descriptionWe regret that this article is behind a paywall.en
dc.description.abstractThe 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.
dc.languageENG
dc.language.isoenen
dc.publisherCambridge University Pressen
dc.titleMultidrug-Resistant Surgical Site Infections in a Humanitarian Surgery Projecten
dc.identifier.journalEpidemiology and Infectionen
dc.internal.reviewer-noteEpidemiology and Infection - Cambridgeen
html.description.abstractThe 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.


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