Frequency of Causative Organisms in Surgical Site Infection in Clean Surgical Cases: A Cross-Sectional Study

Abstract

Background: Surgical site infection (SSI) remains a clinical problem even after clean surgery, and the causative pathogens vary between populations and geographical areas. This study determined the frequency of causative organisms in SSI after clean surgical procedures. Methods: A descriptive cross-sectional study was conducted at the Department of Surgery, Abbass Institute of Medical Sciences, Muzaffarabad, from 27 February to 26 August 2021. A total of 160 patients aged 20–60 years with SSI after appendectomy, herniorraphy or cholecystectomy were enrolled by non-probability consecutive sampling. Wound swabs or pus, and deep tissue where possible, were Gram-stained and cultured on blood agar and MacConkey agar, and isolates were identified by colony morphology and biochemical tests. Data wereanalysed in SPSS 25.0; the chi-square test was applied after stratification (p ≤ 0.05). Results: Mean age was 42.17 ± 9.45 years; 56.87% of patients were female and 61.25% lived in rural areas. Escherichia coli was the most frequent isolate (62; 38.75%), followed by Pseudomonas spp. (38; 23.75%), Staphylococcus aureus (29; 18.13%), coagulase-negative staphylococci (CoNS; 19; 11.87%) and Klebsiella spp. (12; 7.50%). CoNS differed significantly by age (p = 0.032) and type of procedure (p = 0.0007), S. aureus by gender (p = 0.007), Pseudomonas spp. by BMI (p = 0.012) and Klebsiella spp. by place of living (p = 0.007). Conclusion: E. coli was the most common pathogen causing SSI after clean surgery in this setting. Identifying the causative organism before starting antimicrobial therapy is recommended.