Surgical site infections after neurosurgical procedures at Mulago National Referral hospital: prevalence and bacteriological patterns

Abstract

Introduction Surgical site infections (SSIs) remain a major cause of morbidity and mortality. They also cause high financial burden in healthcare systems worldwide. The development of postoperative surgical site infections after neurosurgical procedures represents a significant threat to life and often requires immediate medical/surgical intervention. Objective To determine the prevalence and bacteria involved in Surgical Site Infections (SSIs) after neurosurgical procedures at Mulago National Referral Hospital (MNRH) Methods This was a cross sectional study that was carried out in the Neurosurgical ward. We used a semi structured questionnaire to obtain participants’ socio demographic and clinical data. We collected pus swabs from the surgical site aseptically using a sterile cotton swab and processed as per standard operating procedures in appropriate culture media. We performed susceptibility testing on Mueller Hinton agar. Data were analyzed using STATA 13. Results A total of 80 patients were enrolled into the study with a mean age of 24.3 years and majority 58/80(72.5%) were males. A half had craniotomy as the primary operation and head injury was the main 49/80(61.2%) surgical pathology. The prevalence of surgical site infection was 11/80(13.7%) and high 7/22(31.8%) among patients aged 10 years and below. Higher 9/58(15.5%) in males than in females 2/22(9.1%). A total of 13 organisms were isolated and gram negatives constituted the highest number of isolates with 11/13(84.6%) organisms. Only 1/13(7.7%) enterococcus species and S. aureus gram positive bacteria were isolated. Among the gram negatives, Acinetobacter species 4/13(30.8%) and K. pneumoniae 3/13(23.1%) were the predominant isolates. All the gram positive isolates showed resistance to most of the anti-biotics including; Ampicillin, Linezolid, Tetracycline, Augmentin, cefotaxime, ciprofloxacin among others. All the gram negative isolates were multi-drug resistance. Conclusion The prevalence of SSI was relatively high; Gram negative bacteria were the most predominant contributing 84.6% of the Isolates. All of the isolates were multi-drug resistance. Therefore there is need for measures to reduce SSI and ensure appropriate use of anti-biotics.