TITLE:
Operating Site Infections at General Surgery Department of Gabriel Toure Training Hospital
AUTHORS:
Bakary Tientigui Dembélé, Alhassane Traoré, Adégné Togo, Lassana Kanté, Ibrahim Diakité, Bourama Diarra, Amadou Traoré, Madiassa Konaté, Boubacar Karembé, Yacaria Coulibaly, Mamby Keita, Souleymane Diallo, Souleymane Diallo, Gangaly Diallo
KEYWORDS:
Infections, Operating Sites, Bamako
JOURNAL NAME:
Surgical Science,
Vol.6 No.2,
February
11,
2015
ABSTRACT: The operating site infections constitute the
major postoperative issue in surgery. Our objectives were to determine the
hospital frequency, the risk factors, the involved germs as well as the cost
generated by the operating site infections. Method: Our three months
prospective survey run from September the 1st to November the 30th 2013 has included
all department patients being operated on and hospitalized. The criteria have
been set by CDC d’Atlanta. Results: 374 files were involved, among them 229
(61.2%) were emergencies and 145 (38.8%) were scheduled. The average age was 41
(extremes 7 and 95 standard deviation 17.46), the sex ratio 1.67. The infective
risk according to Altmeier has found 17.5% type 1, 25.1% type 2, 11.2% type 3
and 46.3% type 4; according to NNISS, 96 (25.7) were NNISS 0; 94 (51.9%) NNISS
1; 80 (21.4%) NNISS 2; and 4 (1.1%) NNISS. In the Altmeier class I have not got
antibiotic before infection signs appearances. Our overall rate of operating
site infections was 7.9% (29 cases), with 24 (82.8%) emergency cases. According
to Altmeier’s class of infective risk, the rate of operating site infections
was 1.54% making 1 out of 65 type I patients; 4.3% making 4 out of 93 type II
patients; 11.9% making 5 out of 42 type III patients; 10.9% making 19 out of
174 type IV patients. According to NNISS, the infective risk has been assessed
and was 2.08% for score 0, we have got 8.25% score 1, and 12.5% for score 2,
and 25% for score 3. The bacteriology has been dominated by Escherichia
colii(51.7), Proteus
mirabilisi(13.8), and Klebsiella
pneumoniaei(10.34). The germs have been resistant to the combination
Amoxicillin-clavulanic Acid between 50% and 87% of cases. The most active
antibiotics on the germs have been Cephalosporin, Polypeptides, and
aminoglycosides. The hospital stay has been delayed to 12 days on average by
operating site infections, making 2.5 times greater than those uninfected. The
infection has increased the cost of management around 600 Euro.