SURGICAL SITES INFECTIONS: PREVALENCE, ASSOCIATED FACTORS, BACTERIAL ETIOLOGIES, AND ANTIMICROBIAL SUSCEPTIBILITY PATTERN AMONG POST OPERATED PATIENTS ADMITTING PUBLICHOSPITALSIN HARARI REGION, EASTERN ETHIOPIA

Abstract

Surgical site infections still the major global problem particularly, in developing countries leading to increased morbidity and mortality. Advances in instrument sterilization and infection prevention strategieshave notcountered the problem due to the development of drug resistance. Such condition is serious in situation where inadequate culture and sensitivity services are present and irrational prescribing of antimicrobial in Eastern Ethiopia. Objective: The aim of this study was to assess the prevalence of SSIs, bacterial etiologies, associated factors and antimicrobial susceptibility pattern of the bacterial isolates among post operated patients admitted to public hospitals in Harari Region from March 16 to April 25, 2020. Method: Institutional based cross-sectional study was conducted among 306 who were undergone surgery based on convenience incorporating consecutive patients. Pre-tested structured questionnaire were used for associated factors. Following standard microbiological techniques, wound swabs and pus specimens were collected and transported to Harar Health Research and Regional Laboratory for isolation, identification of bacteria and antibiotic susceptibility test.After checking the completeness, Epi Data version 3.5.1 was data entry software and Statistical Package for the Social Sciences version 20.0 was selected for analysis.P-value < 0.05 was declared statistical significance for the association between dependent and independent variables. Results: In this study the overallprevalence of SSI was 11.8% (95% CI: 8.3% - 15.4%). Staphylococcus aureus (30.3%) was the most frequent isolate. Both S. aureus and Coagulase negative Staphylo cocci were 100% resistant to Penicillin. Wound with drain (AOR = 24.538; 95% CI: 10.053 - 59.898), diabetic (AOR= 7.457, 95% CI 2.893 – 19.221), elder age >60 years(AOR= 4.139, 95% CI 1.278 – 13.40), >2 hours surgical procedure time (AOR= 0.159, 95% CI 0.040, 0.630), alcohol (AOR= 2.58, 95% CI 1.091-6.102) and dirty surgical wound (AOR = 9.026; 95% CI: 3.503 - 23.255) were factors significantly associated with surgical site infections. Conclusion: In this study the prevalence of SSI was moderate. Age >60 years, drinking alcohol, duration of surgery, dirty wound classification; wound drain and diabetics were factors associated with the occurrence of the infection. In this study single and multiple drug resistance to the commonly used antibioticswere high. Therefore, intensifying the implementation of infection prevention and patient safety measures and identifying etiological cause may minimize the burden