Incidence and spectrum of microbiological infection in surgical wounds of patients attending a South African quaternary hospital.

Background: Surgical site infections (SSIs) are a significant cause of morbidity and mortality worldwide, especially in resourcelimited settings. This study aimed to describe the incidence and spectrum of microbiological infection in patients attending a South African quaternary hospital. Patients and methods: This was a retrospective analysis of patients who had surgery between 2012 and 2016 at a quaternary hospital in KwaZulu-Natal Province, South Africa. High volume specialties including orthopaedic, gynaecologic, vascular, and general surgery were studied. Patients were identified from the hospital admissions database. Demographic characteristics and selected surgical variables were collected directly from the hospital admissions database. The study outcome was SSI up to 30 days postoperatively, established by reviewing microbiology test orders and laboratory reports. The laboratory reports were also used to establish the microbiology of SSIs. Data were descriptively analysed. Results: Of the 6620 patients included in this analysis, 609 developed SSI (Overall SSI incidence rate = 9.2 per 100 procedures). Overall, the most common micro-organisms were Staphylococcus species (28.6%) and culture negative SSI (18.1%). SSI incidence was highest in the vascular surgery specialty (Incidence rate: 36.4 per 100 procedures). For each speciality, important micro-organisms were as follows - Orthopaedic surgery: Culture-negative SSI, 45.2%; Gynaecologic surgery: Culture-negative, 29.4%; Vascular surgery: Staphylococcus species, 30.1%; General surgery: Staphylococcus, 36.2%. Conclusion: This study highlights the high incidence of SSIs, particularly culture-negative SSI, in resource-limited settings such as South Africa. Improved preventative and diagnostic strategies are needed to reduce the burden of SSIs in this setting. [ABSTRACT FROM AUTHOR]