TO STUDY THE PREVALENCE, RISK FACTORS OF SURGICAL SITE INFECTIONS AND THE MOLECULAR CHARACTERIZATION OF EXO T GENE IN DRUG RESISTANT PSEUDOMONAS AERUGINOSA PATIENTS ATTENDING A TERTIARY CARE CENTRE, INDIA.

Introduction: Surgical site infection (SSI) is still a common and widespread disease that leads to severe morbidity and death, longer hospital stays, and ultimately higher healthcare costs. P.aeruginosa clinical isolates have been shown to express the virulent gene Exo T, which is significant in the aetiology of infection. The current study aimed to identify the resistance gene Exo T gene in Pseudomonas aeruginosa and to ascertain the prevalence of SSI and associated risk factors among those who had undergone any type of surgical operation. Aim and Objective: To Study the Prevalence, Risk Factors of Surgical Site Infections and the Molecular Characterization of Exo T gene in Drug Resistant Pseudomonas aeruginosa patients at a Tertiary Care Centre, India. Material and Methods: This was a cross-sectional study conducted in a hospital setting over the period of 1 year i.e., August 2022 to August 2023 at a Tertiary Care Centre. All surgically treated adult patients of both sexes who were older than 16 years old were included. Patients who received a second surgery at the same location for any reason, patients receiving immunosuppressant medication, people with immunodeficiency diseases, people currently taking antibiotics, and people with infections elsewhere were all disqualified from participating. If there was signs of a wound infection 48 hours after surgery, the patient was diagnosed with SSI. The DNA was extracted using the Qiagen DNA Extraction kit and the resistant gene Exo T was detected using the conventional PCR. Results: In the present study a total of 170 patients underwent different types of surgeries. The prevalence of SSIs during the study period was 8.2%. SSIs were more common in abdominal surgeries with the Males (64.2%) have a higher risk of getting SSI than females (35.7%). Patients who underwent emergency surgery have a higher risk of getting SSI than those who underwent elective surgery. Those with diabetes had a higher risk of getting SSI than those who were nondiabetics. In the present study it was also observed that Klebsiella pneumoniae (28.5%) was the most common isolate followed by E.coli, Pseudomonas aeruginosa with 21.4%, S.aureus with 14.25% and least for Staphylococcus epidermitidis and Klebsiella oxytoca with 7.14%. It was observed that the site of the infection most common affected was the superficial site with 57.1%. The Molecular characterization confirms that out of 3 Pseudomonas 2 showed the presence of Exo T gene (66.6%). Conclusion: SSIs were more likely to follow abdominal operations. Patients who were male, in the 30-year-old age range, had emergency surgery, had diabetes, and/or had a protracted hospital stay prior to any kind of surgery were more likely to experience surgical site infections (SSIs). It was also found that the proven role of Exo T virulence genes in the pathogenicity of P. aeruginosa would help in treatment and prognosis of Pseudomonas infections. [ABSTRACT FROM AUTHOR]